龈壁提升材料和高度对嵌体修复影响的有限元分析

doi:10.13701/j.cnki.kqyxyj.2024.10.013

口腔医学研究 ›› 2024, Vol. 40 ›› Issue (10): 914-919.DOI: 10.13701/j.cnki.kqyxyj.2024.10.013

龈壁提升材料和高度对嵌体修复影响的有限元分析

曹谅, 赵阿莉, 王利民, 王广慈, 张国庆, 王卫国^*

中国人民解放军联勤保障部队第九〇三医院口腔科浙江杭州 310013

收稿日期:2024-05-06 出版日期:2024-10-28 发布日期:2024-10-24
通讯作者: *王卫国,E-mail:wwgdk@126.com
作者简介:曹谅(1979~),女,安徽芜湖人,本科,主管护师,研究方向:牙齿的生物力学分析。
基金资助:
国家自然科学基金(编号:81600916);浙江省基础公益研究计划(编号:LTGY24H140001)

Three-dimensional Finite Element Analysis on Effect of Deep Margin Elevation Materials and Heights on First Mandibular Molar Inlay Restoration of Subgingival Defects

CAO Liang, ZHAO Ali, WANG Limin, WANG Guangci, ZHANG Guoqing, WANG Weiguo^*

Department of Stomatology, Joint Service Support Force 903 Hospital of the Chinese People's Liberation Army, Hangzhou 310013, China

Received:2024-05-06 Online:2024-10-28 Published:2024-10-24

摘要/Abstract

摘要： 目的: 评估不同龈壁提升(deep margin elevation,DME)的材料以及提升高度对下颌第一磨牙邻面龈下缺损嵌体修复生物力学行为特性的影响。方法: 基于Micro CT 的三维图像数据建立了下颌第一磨牙的三维有限元模型,在此基础上通过计算机辅助设计模拟DME层和嵌体修复建立了7组不同DME层高度的下颌第一磨牙嵌体修复的三维有限元模型。通过三维有限元仿真分析,对比分析流动树脂和膏状树脂两种不同的DME层材料以及7组不同的DME层高度对模型各部分及界面的应力分布及大小的影响。结果: 随着DME层高度上升,嵌体自身的最大主应力(MPS)峰值在不断上升,而DME层MPS峰值、DME层与嵌体间界面拉应力(ITS)峰值以及DME层与牙齿间ITS峰值在不断减小。同一DME层高度时,流动树脂组的DME层MPS应力峰值、DME层与嵌体间ITS峰值以及DME层与牙齿间ITS峰值均小于膏状树脂组。DME层材料以及高度的变化对其他观察指标无明显影响。结论: 低弹性模量的DME层材料以及增加DME层高度有利于降低模型及界面的应力,因此在临床操作中建议选择流动树脂作为DME材料,并适当提升DME层高度。

关键词: 龈壁提升, 嵌体, 龈下缺损, 有限元分析, 应力分布

Abstract: Objective: To evaluate the effects of different deep margin elevation (DME) materials and lifting heights on the biomechanical behavior characteristics of inlay in mandibular first molar with subgingival defects. Methods: Three-dimensional finite element models of mandibular first molars were established based on Micro CT three-dimensional image data. Seven groups of three-dimensional finite element models of mandibular first molar inlay restoration with different DME heights were established through computer-aided design simulation of DME and inlay restoration. The stress distribution and magnitude of each part and interface of the model under two different DME materials (flowable resin and packable resin) and seven different DME heights were studied and compared through three-dimensional finite element simulation analysis. Results: With the increase of DME height, the peak of maximum principal stress (MPS) of the inlay itself continued to rise, while the peak of MPS of the DME layer, the peak of interfacial tensile stress (ITS) between the DME layer and the inlay, and the peak of ITS between the DME layer and the tooth continued to decrease. At the same DME layer height, the peak of MPS of the DME layer, the peak of ITS between the DME layer and the inlay, and the peak of ITS between the DME layer and the tooth were all smaller than those of the packable resin group. The changes in DME layer material and height had no significant effect on other observation indicators. Conclusion: Low elastic modulus DME material and increased DME height are beneficial to reduce the stress of the model and interface. Therefore, it is recommended to choose flowable resin as DME material in clinical operation and appropriately lift the DME layer height.

Key words: deep margin elevation, inlay, subgingival defects, finite element analysis, stress distribution

曹谅, 赵阿莉, 王利民, 王广慈, 张国庆, 王卫国. 龈壁提升材料和高度对嵌体修复影响的有限元分析[J]. 口腔医学研究, 2024, 40(10): 914-919.

CAO Liang, ZHAO Ali, WANG Limin, WANG Guangci, ZHANG Guoqing, WANG Weiguo. Three-dimensional Finite Element Analysis on Effect of Deep Margin Elevation Materials and Heights on First Mandibular Molar Inlay Restoration of Subgingival Defects[J]. Journal of Oral Science Research, 2024, 40(10): 914-919.

参考文献

[1] 武忠圆,付静,刘杰.口腔液态污染物对复合树脂粘接性能的影响[J].口腔颌面修复学杂志,2019,20(3): 180-183.
[2] 王芳,庄润涛,冯广智,等.应用龈壁提升术修复下颌第二磨牙远中龈下缺损的临床效果[J].北京口腔医学,2023,31(2): 113-117.
[3] 柴梅. 龈壁提升结合铸瓷高嵌体修复后牙龈下缺损的疗效[J].锦州医科大学学报,2023,44(1): 59-62.
[4] 孟秀萍,侯建华,李怡然,等.龈壁提升术材料选择及边缘设计的研究进展[J].国际口腔医学杂志,2021,48(3): 280-286.
[5] 蔡长宇,冯娜,杨玉娥.垫底材料及厚度对下颌第二乳磨牙嵌体修复应力分布影响的三维有限元分析[J].口腔医学研究,2022,38(7): 654-658.
[6] Chen Y, Lin C, Hou C. Investigating inlay designs of class Ⅱ cavity with deep margin elevation using finite element method[J]. BMC Oral Health, 2021, 264(21): 1-13.
[7] 杨洋,谭建国.一步一步做好牙体缺损修复后食物嵌塞的预防和治疗[J].中华口腔医学杂志,2021,56(8): 821-824.
[8] 陈如婷,张红艳.不同修复方式对隐裂牙抗力影响的有限元分析[J].医学理论与实践,2023,36(13): 2186-2189.
[9] Alghulikah K, Alsulaiman N, Ibrahim H, et al. Deep margin elevation for indirect restorations: A systematic review[J]. J Pharm Res Int, 2021,33(37B):23-30.
[10] 蒋志勇,于琼琼.牙冠延长术后桩核修复在牙体缺损至龈下残根残冠患者中的应用观察[J].中国医疗美容,2021,11(3): 94-98.
[11] 王明辉.改良牙冠延长术和正畸牵引加牙冠延长术治疗上前龈下牙体缺损的效果观察[J].国际医药卫生导报,2018,24(9): 1388-1391.
[12] Bresser RA, Gerdolle D, van den Heijkant IA, et al. Up to 12 years clinical evaluation of 197 partial indirect restorations with deep margin elevation in the posterior region[J]. J Dent, 2019, 91: 103227.
[13] Bresser RA, van de Geer L, Gerdolle D, et al. Influence of deep margin elevation and preparation design on the fracture strength of indirectly restored molars[J]. J Mech Behav Biomed Mater, 2020, 110(1):103950.
[14] 马红.龈壁提升后高嵌体修复龈下缺损后牙的效果观察[J].口腔疾病防治,2019,27(9): 582-585.
[15] 廖莹,黄怡.微创修复用于短冠磨牙的三维有限元非线性应力分析[J].口腔医学研究,2023,39(11): 988-994.
[16] 颜旖萌,欧阳志强,江丽青,等.三维有限元分析在正畸生物力学中的应用及研究进展[J].医学研究与教育,2023,40(4): 25-30.
[17] Magne P. M-i-M for DME: matrix-in-a-matrix technique for deep margin elevation[J]. J Prosthet Dent, 2023, 130(4): 434-438.
[18] Xie H, Zhang F, Wu Y, et al. Dentine bond strength and microleakage of flowable composite, compomer and glass ionomer cement[J]. Aust Dent J, 2008, 53(4): 325-331.
[19] Rocca GT, Rizcalla N, Krejci I, et al. Evidence-based concepts and procedures for bonded inlays and onlays. Part Ⅱ. Guidelines for cavity preparation and restoration fabrication[J]. Int J Esthet Dent, 2015, 10(3):392-413.
[20] Kim SY, Kim BS, Kim H, et al. Occlusal stress distribution and remaining crack propagation of a cracked tooth treated with different materials and designs: 3D finite element analysis[J]. Dent Mater, 2021, 37(4): 731-740.

龈壁提升材料和高度对嵌体修复影响的有限元分析

Three-dimensional Finite Element Analysis on Effect of Deep Margin Elevation Materials and Heights on First Mandibular Molar Inlay Restoration of Subgingival Defects

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

编辑推荐

Metrics

[1]	陈精诚, 赵梦丽, 程志恒, 张吉利, 潘研, 刘昕. 隐形矫治器中尖牙移动设计的三维有限元分析[J]. 口腔医学研究, 2024, 40(4): 343-348.
[2]	康小翠, 周珊, 李晨, 燕高飞, 张荣, 王梅力, 张文卿, 郭阳. 洞壁倒凹的不同处理对下颌第一磨牙嵌体修复的三维有限元分析[J]. 口腔医学研究, 2023, 39(9): 827-831.
[3]	张萌, 马坚. 腭裂治疗中有限元方法的应用进展[J]. 口腔医学研究, 2023, 39(8): 679-683.
[4]	吴洁, 达云萌, 张钊, 袁硕, 马晓平. CAD/CAM高嵌体与全冠修复上颌前磨牙的抗折性能研究[J]. 口腔医学研究, 2023, 39(8): 727-731.
[5]	张婧秋, 何舒奇. 龈壁提升术对牙周组织影响的研究进展[J]. 口腔医学研究, 2023, 39(4): 295-299.
[6]	杜军, 邱延菊, 万哲. 植入位点及轴向对上颌中切牙即刻种植即刻负重后微动度影响的三维有限元分析[J]. 口腔医学研究, 2022, 38(9): 831-836.
[7]	胥鹏飞, 张闵, 范智博, 杨彬彬, 徐晓梅. 无托槽隐形矫治中牙周炎患者下切牙压低的三维有限元研究[J]. 口腔医学研究, 2022, 38(8): 757-761.
[8]	蔡长宇, 冯娜, 杨玉娥. 垫底材料及厚度对下颌第二乳磨牙嵌体修复应力分布影响的三维有限元分析[J]. 口腔医学研究, 2022, 38(7): 654-658.
[9]	周宏志, 张可, 王学玲, 王文洁, 王闻天. 不同形态种植体在两种骨质内以不同角度植入的应力分析[J]. 口腔医学研究, 2022, 38(2): 138-143.
[10]	向彪, 王星星, 杨颜菁, 徐逸晨, 王梦含, 吴刚. 无托槽隐形矫治器联合附件扭转下颌左侧第二前磨牙的三维有限元分析[J]. 口腔医学研究, 2022, 38(12): 1192-1198.
[11]	郭晓阳, 陈志宇, 付艺璇, 李绍萍, 高毛毛. 3种材质个性化一体化桩核改向修复上颌中切牙的三维有限元研究[J]. 口腔医学研究, 2022, 38(10): 954-958.
[12]	殷金萍, 王静, 孙亚丽, 林华洁. 动态载荷下不同材料修复非龋性颈部缺损有限元分析[J]. 口腔医学研究, 2021, 37(9): 820-824.
[13]	朱运握, 何万志. SonicFill声波树脂直接和间接法修复后牙Ⅱ类洞的微渗漏表现[J]. 口腔医学研究, 2021, 37(8): 732-736.
[14]	李洋, 王时越, 祁麟. 牙本质肩领位置对下颌切牙抗折强度影响的研究[J]. 口腔医学研究, 2021, 37(10): 945-950.
[15]	苏涛, 王星星, 向彪, 吴刚, 邹敏. 不同刚度的无托槽隐形矫治器扩大上颌牙弓的有限元分析[J]. 口腔医学研究, 2020, 36(5): 454-458.