髓腔固位冠及桩核冠修复下颌第一磨牙大面积缺损的生物力学分析

doi:10.13701/j.cnki.kqyxyj.2018.05.013

口腔医学研究 ›› 2018, Vol. 34 ›› Issue (5): 513-517.DOI: 10.13701/j.cnki.kqyxyj.2018.05.013

髓腔固位冠及桩核冠修复下颌第一磨牙大面积缺损的生物力学分析

赵楚翘¹, 徐一驰¹, 刘定坤², 杨军星¹, 魏子清², 唐林俊², 沈杰², 刘宇昆², 刘志辉^1*

1. 吉林大学口腔医院吉林长春 130021;
2. 吉林大学口腔医学系吉林长春 130021

收稿日期:2017-11-10 出版日期:2018-05-28 发布日期:2018-05-29
通讯作者: 刘志辉,E-mail:liuzhihui1975@sina.com
作者简介:赵楚翘(1992~ ),女,1992年3月,吉林公主岭人,硕士在读,主要从事口腔生物力学研究。
基金资助:
吉林省重点科技攻关项目(编号:20150204004YY)
吉林省医药健康产业发展引导资金项目(编号:201603028YY)
长春市“双十工程”项目(编号:16ss12)
吉林省医药产业发展引导资金项目(编号:20150311070YY)
吉林大学研究生创新基金资助项目(编号:2017065)

Biomechanical Analysis of Repairing Large Area Defects of Mandibular First Molar with Endocrown and Post-core Crown.

ZHAO Chu-qiao¹, XU Yi-chi¹, LIU Ding-kun², YANG Jun-xing¹, WEI Zi-qing², TANG Lin-jun², SHEN Jie², LIU Yu-kun², LIU Zhi-hui^1*

1. Stomatology Hospital of Jilin University, Changchun 130021, China;
2. School of Stomatology, Jilin University, Changchun 130021, China

Received:2017-11-10 Online:2018-05-28 Published:2018-05-29

摘要/Abstract

摘要： 目的:利用有限元法对比分析髓腔固位冠及桩核冠对大面积缺损的下颌第一磨牙剩余牙体组织的应力大小及分布的影响。方法:应用CT扫描下颌第一磨牙后建立三维有限元模型并以完整牙齿作为对照组,模拟根管治疗过程后建立3种缺损的模型作为实验组:近远中壁缺损(A)组、颊壁近中壁缺损(B)组、颊壁及近远中壁缺损(C)组,分别采用髓腔固位冠及桩核冠修复。载荷1以200N的总载荷垂直向加载模拟正中咬合;载荷2以200 N的总载荷与牙长轴成45°斜向加载模拟侧方咬合,应用Abaqus软件分析剩余牙体组织的von Mises应力和最大主应力的大小及分布情况。结果:髓腔固位冠修复后牙体组织所受应力高于桩核冠,甚至可高出1倍;髓腔固位冠修复后应力集中于髓室底,桩核冠修复后应力集中于远中根尖1/3。结论:髓腔固位冠和桩核冠均是下颌第一磨牙大面积缺损可选择的修复方案,桩核冠对牙体组织具有更好的保护作用。

关键词: 桩核冠, 髓腔固位冠, 抗折性能, 有限元研究, 生物力学分

Abstract: Objective: To compare the stress magnitude and distribution of residual dentin in mandibular first molar restored with endocrown or post-core crown using three-dimension finite element methods. Methods: The three-dimensional finite element models of mandibular first molar were established after scanning by CT. A complete tooth was set as the control group. After simulating root canal therapy, three experimental group models with three kinds of defects were set as the experimental group: defect of mesial and distal proximal surface (group A); defect of buccal and mesial proximal surface (group B); defect of buccal, mesial, and distal proximal surface (group C). Then, endocrowns and post-core crowns were used to restore the defects. A load of 200N, simulating intercuspal occlusion, was applied vertically to the occlusal surface, and a load of 200 N simulating lateral occlusion was applied to the occlusal surface with a 45°angle to the long axis of the tooth. Von Mises stresses and max principal stresses were calculated by Abaqus software. Results: The stress of tooth tissue restored by endocrown was higher than that of post-core crown even more than 1 times. The stress of endocrown was concentrated in the pulp floor, and that of the post-core crown was concentrated in the distal apical 1/3. Conclusion: Endocrown and post-core crown are both applicable for mandibular first molar with large area defect, however, the post-core crown has better protective effect for the tooth tissue.

Key words: Post-core crown, Endocrown, Fracture resistance, Finite element analysis, Biomechanical analysis

赵楚翘, 徐一驰, 刘定坤, 杨军星, 魏子清, 唐林俊, 沈杰, 刘宇昆, 刘志辉. 髓腔固位冠及桩核冠修复下颌第一磨牙大面积缺损的生物力学分析[J]. 口腔医学研究, 2018, 34(5): 513-517.

ZHAO Chu-qiao, XU Yi-chi, LIU Ding-kun, YANG Jun-xing, WEI Zi-qing, TANG Lin-jun, SHEN Jie, LIU Yu-kun, LIU Zhi-hui. Biomechanical Analysis of Repairing Large Area Defects of Mandibular First Molar with Endocrown and Post-core Crown.[J]. Journal of Oral Science Research, 2018, 34(5): 513-517.

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髓腔固位冠及桩核冠修复下颌第一磨牙大面积缺损的生物力学分析

Biomechanical Analysis of Repairing Large Area Defects of Mandibular First Molar with Endocrown and Post-core Crown.

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