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研究生： 林揚民
Lin, Yang-Ming
論文名稱： 用於All-on-4®全口重建之生物力學分析計算模型之可信度評估
Credibility Assessment of a Computational Model for Biomechanical Evaluation of All-on-4® Treatment Concept
指導教授： 林啟倫
Lin, Chi-Lun
學位類別： 碩士
Master
系所名稱： 工學院 - 機械工程學系
Department of Mechanical Engineering
論文出版年： 2022
畢業學年度： 111
語文別： 中文
論文頁數： 91
中文關鍵詞： All-on-4® 、有限元素分析 、生物力學 、ASME V&V 40 、模型可信度
外文關鍵詞： All-on-4®, Finite Element Analysis, Biomechanical Analysis, Verification & Validation 40, Model Credibility
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    • 臨床上All-on-4®全口重建療程已相當盛行，但仍會於術後發生嚴重程度不一的併發症，需要醫師為患者擬定合適的治療規劃來降低併發症的發生機率。有限元素模型透過完整的力學分析並提供適合的植體參數配置，為了能進一步將模型反映臨床之可適用性，必須透過嚴謹的體外測試證據來證明植體設計流程之安全性與可行性，本研究透過兩種現實模型 (R-COU與R-VAL)及兩種模擬模型(M-COU與M-VAL)進行差異分析、驗證與不確定性的討論與評估。
    考慮M-COU與M-VAL的差異，在有無肌肉施力下，兩模型的植體周圍骨應力與應變無顯著不同，說明M-VAL模型以單點施力方式來模擬人類咬合形式為合理之簡化；邊界條件並不會影響植體周圍骨應力與應變的分佈，反而對支架的位移有明顯影響。在R-VAL中，本研究提出兩個主要驗證證據，其中應變規實驗結果與模擬有高度相關，而DIC量測數據也呈現與模擬結果有相同之趨勢，兩者都證明有限元素模型具實際可信度。
    在M-COU中探討四種顎骨模型於四種不同咬合形式下的力學分析，對於植牙風險的評估，即使是在施以最大咬合力的情況下，高應變體積的結果對植體周圍骨的影響不大，且植體所受的最大應力也遠低於鈦金屬降伏強度，藉此以力學角度可以確定患者在正常咬合時不會造成骨流失等損傷。
    本研究以ASME V&V 40標準針對All-on-4®全口重建之生物力學模型提出可信度評估，從臨床情況的模擬分析到體外實驗的驗證，以證明有限元素模型於臨床使用情境的使用上是具有可信度。
    關鍵字： All-on-4®、有限元素分析、生物力學、ASME V&V 40、模型可信度

    Clinically, All-on-4® reconstruction has been quite popular; however, after surgery complications of varying severity still occur. It is necessary for doctors that formulating appropriate treatment plans for patients to reduce the incidence in complications. As a result, the finite element model provides suitable implant parameter configuration through complete mechanical analysis. To reflect the clinical applicability of the model further, it is necessary to prove that the safety and feasibility of the implant design process by rigorous evidence in vitro test.
    In this study, two realistic models (R-COU and R-VAL) and two simulation models (M-COU and M-VAL) were used for different analysis, validation, and uncertainty assessment. In the study of R-VAL, strains measured by strain gauges at several locations were highly correlated to the M-VAL, while the displacement measurements via DIC also showed the same trend as the simulation results, confirming that the finite element model is credible for realistic use. In the M-COU study, the risk assessment of the jawbone model under different occlusal forms was discussed, and found that even under the maximum occlusal force, the high strain volume of the peri-implant bone was not significant. The maximum stress on the implant is also far lower than the yield strength of titanium. In terms of biomechanical, it can be determined that the patient will not suffer bone loss and other damage during normal occlusion.
    This study used ASME V&V 40 standard to evaluate the reliability of the biomechanical model of All-on-4® reconstruction. Through clinical simulation and in vitro experimental verification, it proves that the finite element model is credible in clinical use.
    Keywords：All-on-4®, Finite Element Analysis, Biomechanical Analysis, Verification & Validation 40, Model Credibility

    摘要 I Extended Abstract II 致謝 XV 表目錄 XIX 圖目錄 XXI 第一章 緒論 1 1.1研究背景與動機 1 1.2文獻回顧 2 1.2.1 All-on-4®研究現況 2 1.2.2 有限元素參數設計於All-on-4®的應用 3 1.2.3 文獻搜尋策略 5 1.2.4 Validation & Verification 40 概述與應用 8 1.2.5 實驗驗證對有限元素分析之重要性 10 1.3 研究目的與貢獻 11 第二章 材料與方法 12 2.1 概述 12 2.2 V&V 40 目的與流程 12 2.2.1 描述建模目標 13 2.3 描述COU的現實(R-COU)與模型(M-COU) 14 2.3.1 R-COU 14 2.3.2 M-COU 15 2.3.2.1 下顎骨幾何 15 2.3.2.2 材料性質 17 2.3.3.3 邊界條件、負載與接觸 17 2.3.3.4 贋復物支架設定 20 2.3.3.5 植體參數設定 21 2.3.3.6 網格設定 23 2.3.3.7 力學分析 23 2.4 描述VAL的現實(R-VAL)與模型(M-VAL) 24 2.4.1 R-VAL驗證來源 24 2.4.1.1 實體模型製作 25 2.4.1.2 材料拉伸試驗 27 2.4.1.3 力學驗證實驗 29 2.4.2 M-VAL 33 2.4.2.1 實驗模型確認 33 2.4.2.2 材料性質 34 2.4.2.3 邊界條件、負載與接觸 35 2.4.2.4 網格設定 36 第三章 結果 37 3.1 M-COU結果 37 3.1.1 網格收斂性分析 37 3.1.2 有限元素模擬結果 39 3.2 主要驗證證據R-VAL與M-VAL結果 45 3.2.1列印材料試驗結果 45 3.2.2 DIC位移驗證 46 3.2.3 驗證比較器一-應變規實驗結果 47 3.2.4應變規與模擬結果比較 57 3.2.5 驗證比較器二-DIC實驗結果 61 第四章 討論 67 4.1 R-COU與R-VAL (∆R)之間的差異處 67 4.2 M-COU與M-VAL (∆M)之間的相似與差異處 68 4.2.1 M-COU與M-VAL相似處 68 4.2.2 M-COU與M-VAL差異處 68 4.3 考慮∆R的差異，使用M-VAL與M-COU來預測現實模型是否適當 69 4.4 植牙風險評估 71 4.4.1 植體周圍骨應變討論 71 4.4.2 植體應力討論 74 4.5 R-VAL與M-VAL之間的差異 75 4.6 驗證實驗討論 78 4.6.1 應變規實驗 78 4.6.2 DIC實驗 78 4.7 M-COU於R-COU中的適用性 82 第五章 結論與未來方向 83 5.1 結論 83 5.2 未來方向 83 參考文獻 85

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