牙尖覆盖厚度对全瓷高嵌体修复前磨牙应力分布影响的三维有限元分析

doi:10.7518/hxkq.2019.06.012

华西口腔医学杂志 ›› 2019, Vol. 37 ›› Issue (6): 636-641.doi: 10.7518/hxkq.2019.06.012

牙尖覆盖厚度对全瓷高嵌体修复前磨牙应力分布影响的三维有限元分析

佘雅鹄,张一祎,刘雨萱,方厂云()

中南大学湘雅医院口腔医学中心,长沙 410008

收稿日期:2019-04-05 修回日期:2019-07-25 出版日期:2019-12-01 发布日期:2019-11-27
通讯作者: 方厂云 E-mail:fangcy@csu.edu.cn
作者简介:佘雅鹄,硕士,E-mail：981516522@qq.com
基金资助:
国家自然科学基金(81600915)

Three-dimensional finite element analysis of cuspal-coverage thickness influence on the stress distribution of all-ceramic onlay-restored premolars

She Yahu,Zhang Yiyi,Liu Yuxuan,Fang Changyun()

Center of Stomatology, Xiangya Hospital, Central South University, Changsha 410008, China

Received:2019-04-05 Revised:2019-07-25 Online:2019-12-01 Published:2019-11-27
Contact: Changyun Fang E-mail:fangcy@csu.edu.cn
Supported by:
The National Natural Science Foundation of China(81600915)

摘要/Abstract

摘要：

目的应用三维有限元法探讨牙尖覆盖厚度对全瓷高嵌体修复前磨牙应力分布的影响,以期为临床全瓷高嵌体的设计提供参考。方法采用显微CT扫描的数据建立全瓷高嵌体修复根管治疗后上颌第一前磨牙的三维模型,设计不同牙尖覆盖厚度为2、3、4 mm的3组模型,分别施加600 N垂直载荷和200 N侧向载荷,分析高嵌体、树脂粘接剂层及牙本质的应力分布。结果随着牙尖覆盖厚度的增大,全瓷高嵌体内部的最大主应力峰值减小,粘接剂层边缘的最大主应力峰值增大,侧向载荷下冠部腭侧剩余牙本质的应力集中面积增大。结论增大全瓷高嵌体的牙尖覆盖厚度可减小全瓷高嵌体破裂的风险,但可能会导致高嵌体脱落和腭侧牙本质折裂。

关键词: 有限元分析, 全瓷高嵌体, 牙尖覆盖, 根管治疗

Abstract:

Objective To investigate the influence of cuspal-coverage thickness on the stress distribution of all-ceramic onlay-restored premolars by using 3D finite element (FE) analysis and to provide references for the design of all-ceramic onlays for clinical application.Methods 3D FE models of all-ceramic onlays with three cuspal-coverage thicknesses (2, 3, and 4 mm) of endodontically treated maxillary premolar were constructed based on micro-CT images. Stress distributions in the onlay, adhesive resin cement layer, and dentin of models were analyzed under vertical load (600 N) and oblique load (200 N).Results When the cuspal-coverage thickness increased, the peak maximum principal stress value decreased inside the onlay but increased in the margin of the adhesive resin cement layer. In addition, stress concentration areas increased in the coronal residual dentin on the palatal side under oblique load.Conclusion An increase in the cuspal-coverage thickness of all-ceramic onlays may reduce the risk of rupture of the restoration but may deteriorate the restoration and cause palatal dentin fracture.

Key words: finite element analysis, all-ceramic onlay, cuspal-coverage, root canal therapy

中图分类号:

R783

佘雅鹄,张一祎,刘雨萱,方厂云. 牙尖覆盖厚度对全瓷高嵌体修复前磨牙应力分布影响的三维有限元分析[J]. 华西口腔医学杂志, 2019, 37(6): 636-641.

She Yahu,Zhang Yiyi,Liu Yuxuan,Fang Changyun. Three-dimensional finite element analysis of cuspal-coverage thickness influence on the stress distribution of all-ceramic onlay-restored premolars[J]. West China Journal of Stomatology, 2019, 37(6): 636-641.

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参考文献 19

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组织与材料	弹性模量/MPa	泊松比
釉质^[8]	84 100.0	0.30
牙本质^[9]	18 600.0	0.31
牙槽骨^[9]	13 700.0	0.30
牙髓^[10]	6.8	0.45
牙周膜^[9]	68.9	0.45
树脂粘接剂^[9]	2 800.0	0.33
玻璃离子^[9]	22 000.0	0.35
牙胶^[9]	140.0	0.45
瓷（Vita Mark Ⅱ）^[11]	69 000.0	0.25

组别	高嵌体	粘接剂	粘接剂	冠部牙	根部牙
组别	内部	轴壁	边缘	本质	本质
完整牙齿	-	-	-	11.06	20.12
2 mm模型	42.88	10.65	3.79	11.60	19.95
3 mm模型	22.92	10.14	4.86	10.55	19.82
4 mm模型	20.68	9.97	5.76	9.32	18.63

组别	高嵌体	粘接剂	粘接剂	冠部牙	根部牙
组别	内部	洞底	边缘	本质	本质
完整牙齿	-	-	-	11.19	65.79
2 mm模型	19.54	12.93	4.19	15.04	73.95
3 mm模型	18.16	11.86	7.48	13.11	73.39
4 mm模型	16.49	11.85	13.30	11.81	72.64

牙尖覆盖厚度对全瓷高嵌体修复前磨牙应力分布影响的三维有限元分析

Three-dimensional finite element analysis of cuspal-coverage thickness influence on the stress distribution of all-ceramic onlay-restored premolars

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