华西口腔医学杂志 ›› 2023, Vol. 41 ›› Issue (5): 541-553.doi: 10.7518/hxkq.2023.2023123
收稿日期:
2023-04-19
修回日期:
2023-07-10
出版日期:
2023-10-01
发布日期:
2023-10-08
通讯作者:
钱捷
E-mail:3194272135@qq.com;Janeqian2009@hotmail.com
作者简介:
马典,医师,硕士,E-mail:Received:
2023-04-19
Revised:
2023-07-10
Online:
2023-10-01
Published:
2023-10-08
Contact:
Qian Jie.
E-mail:3194272135@qq.com;Janeqian2009@hotmail.com
摘要:
目的 探讨2种陶瓷材料贴面式嵌体及纤维桩修复上颌第一前磨牙穿髓型非龋性颈部缺损的应力分布规律,以期为临床选择微创、有效的修复方法提供思考。 方法 选择符合标准的右上第一前磨牙锥形束CT数据,建立健康对照(HC)组、缺损对照(DC)组,根据2种贴面式嵌体材料[IPS e.max CAD(LD)、Lava Ultimate(LU)]以及不同的纤维桩位置[无纤维桩(NP)、颊侧根管纤维桩(B)、腭侧根管纤维桩(P)、颊腭侧根管纤维桩(BP)],建立8个实验模型(LDNP、LDB、LDP、LDBP、LUNP、LUB、LUP、LUBP)组,模拟轴向和侧向载荷,采用有限元软件分析各结构最大主应力峰值,采用颊尖位移量分析颊尖顶位移变化量。在各实验组中:缺损尖端牙体应力峰值与DC组进行变化量分析;颊尖位移量、釉质应力峰值、牙本质应力峰值与HC组进行变化量分析,变化量百分数相差小于5%认为是无差异的。 结果 LD组与LU组均可有效减小缺损尖端牙体的应力峰值,且LD组降幅更为显著。关于贴面式嵌体及树脂粘接剂应力,LD组高于LU组,并且呈现同一材料不同实验组之间应力峰值相近。此外,双根管纤维桩组可显著减小颊尖位移量。 结论 贴面式瓷嵌体可在穿髓非龋性颈部缺损的修复中进行应用,且与Lava Ultimate相比,IPS e.max CAD可更好保护尖端牙体组织,此外推测联合颊腭双根管纤维桩修复时可减小整体变形量及修复体脱粘接事件的发生。
中图分类号:
马典, 钱捷. 贴面式瓷嵌体修复上颌第一前磨牙穿髓型非龋性颈部缺损的三维有限元应力分析[J]. 华西口腔医学杂志, 2023, 41(5): 541-553.
Ma Dian, Qian Jie.. Three-dimensional finite element stress analysis of surface-mounted inlays in repairing pulp-penetrating non-carious cervical lesion of maxillary first premolar[J]. West China Journal of Stomatology, 2023, 41(5): 541-553.
表 3
缺损尖端牙体最大主应力峰值和各实验组较DC组的变化量
组别 | F1载荷下的应力峰值/MPa | 较DC组的变化量 | F2载荷下的应力峰值/MPa | 较DC组的变化量 |
---|---|---|---|---|
DC | 9.248 | - | 156.690 | - |
LDNP | 4.665 | -49.56% | 19.198 | -87.75% |
LDB | 3.481 | -62.36% | 19.054 | -87.84% |
LDP | 4.617 | -50.07% | 19.095 | -87.81% |
LDBP | 4.757 | -48.55% | 18.703 | -88.06% |
LUNP | 4.019 | -56.54% | 36.446 | -76.74% |
LUB | 3.669 | -60.32% | 35.860 | -77.11% |
LUP | 3.959 | -57.19% | 36.491 | -76.71% |
LUBP | 4.023 | -56.49% | 35.992 | -77.03% |
表 4
不同载荷下颊尖位移量和各实验组较HC组的变化量
组别 | F1载荷下的颊尖位移量/μm | 较HC组变化量 | F2载荷下的颊尖位移量/μm | 较HC组变化量 |
---|---|---|---|---|
HC | 6.723 | - | 34.658 | - |
DC | 7.188 | - | 39.130 | - |
LDNP | 6.756 | 0.49% | 34.319 | -0.97% |
LDB | 6.750 | 0.40% | 34.284 | -1.07% |
LDP | 6.737 | 0.20% | 34.217 | -1.27% |
LDBP | 4.780 | -28.90% | 31.779 | -8.30% |
LUNP | 7.008 | 4.23% | 35.524 | 2.49% |
LUB | 6.982 | 3.85% | 34.945 | 0.82% |
LUP | 6.902 | 2.66% | 34.873 | 0.62% |
LUBP | 4.982 | -25.89% | 32.449 | -6.37% |
表 5
釉质最大主应力峰值和各实验组较HC组的变化量
组别 | F1载荷下的应力峰值/MPa | 较HC组的变化量 | F2载荷下的应力峰值/MPa | 较HC组的变化量 |
---|---|---|---|---|
HC | 43.854 | - | 52.713 | - |
DC | 44.685 | - | 156.690 | - |
LDNP | 43.701 | -0.34% | 55.759 | 5.77% |
LDB | 43.761 | -0.21% | 55.253 | 4.81% |
LDP | 41.768 | -4.75% | 50.327 | -4.52% |
LDBP | 41.820 | -4.63% | 50.292 | -4.59% |
LUNP | 43.660 | -0.44% | 55.570 | 5.41% |
LUB | 43.725 | -0.29% | 55.061 | 4.45% |
LUP | 41.728 | -4.84% | 50.136 | -4.88% |
LUBP | 41.796 | -4.69% | 50.092 | -4.97% |
表 6
牙本质最大主应力峰值和各实验组较HC组的变化量
组别 | F1载荷下的应力峰值/MPa | 较HC组的变化量 | F2载荷下的应力峰值/MPa | 较HC组的变化量 |
---|---|---|---|---|
HC | 2.116 | - | 15.285 | - |
DC | 1.906 | - | 53.199 | - |
LDNP | 1.594 | -24.66% | 14.946 | -2.21% |
LDB | 1.612 | -23.81% | 15.429 | -0.94% |
LDP | 1.509 | -28.68% | 15.166 | -0.77% |
LDBP | 1.655 | -21.78% | 13.950 | -8.73% |
LUNP | 1.648 | -22.11% | 13.960 | -8.66% |
LUB | 1.144 | -45.93% | 14.568 | -4.69% |
LUP | 1.540 | -27.22% | 14.252 | -6.75% |
LUBP | 1.164 | -44.99% | 12.930 | -15.40% |
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