计算机辅助设计与制作一体化玻璃纤维桩核修复漏斗状根管的抗疲劳和抗折性能  

Fatigue and fracture resistance of the flared roots restored with computer aided design and computer aided manufacturing glass fiber posts

作　　者：李智[1,2] 王新知[1] 高承志[2] IVO Krejci 

机构地区：[1]北京大学口腔医学院.口腔医院修复科,北京100081 [2]北京大学人民医院口腔科,北京100044 [3]Division of Cariology and Endodontics,School of Dentistry,University of Geneva

出　　处：《北京大学学报（医学版）》2013年第1期59-63,共5页Journal of Peking University:Health Sciences

基　　金：高等学校博士学科点专项科研基金(20090001110099)资助~~

摘　　要：目的:评价计算机辅助设计与制作(computer aided design and computer aided manufacturing,CAD/CAM)一体化玻璃纤维桩核修复漏斗状根管的抗疲劳性能和抗折强度。方法:收集32颗离体上颌中切牙,制作漏斗状根管模型后,利用随机数字表分为4组,每组8颗牙齿,分别用4种桩核修复,第1组:CAD/CAM一体化玻璃纤维桩核;第2组:预成石英纤维桩与树脂核;第3组:铸造金合金桩核;第4组:CAD/CAM一体化氧化锆桩核。使用化学固化的树脂粘接剂Superbond C&B将制作完成的桩核粘入到预备后的根管中,为每个牙齿制作氧化锆全冠并使用Superbond C&B粘接。使用加成型硅橡胶模拟牙周膜后把制作完成的试件固定到专用的咀嚼模拟器上,以1.67 Hz的频率在5℃和50℃每2 min交替一次的水浴中沿牙体长轴45°角,用49 N的力在牙冠舌侧加载1.2×106次,再将试件用力学测试机沿牙体长轴45°角加力将桩核折断,记录抗折强度,观察折断模式。结果:咀嚼模拟结束时,预成石英纤维桩组有4个样本的牙冠脱落,剩余样本中未观察到破坏;在抗力测试中,CAD/CAM一体化玻璃纤维桩核组和铸造金合金桩核组的抗折强度分别为(441.5±103.2)N和(462.9±170.0)N,差异无统计学意义(P>0.05),但是都高于CAD/CAM一体化氧化锆桩核组[(284.1±99.0)N]和预成石英纤维桩组[(315.4±112.3)N],其差异有统计学意义(F=4.613,P<0.05)。结论:漏斗状根管使用CAD/CAM一体化玻璃纤维桩核或铸造金合金桩核修复可能能取得更好的临床效果。Objective： To evaluate the fatigue and fracture resistance of the flared roots restored with computer aided design （CAD） and computer aided manufacturing （CAM） glass fiber posts. Methods. In the study, 32 maxillary central incisors with roots longer than 13 mm were selected and their canals were flared, and the roots were allocated into 4 groups （ n = 8 ） by a random number chart ： CAD/CAM glass fiber posts, prefabricated quartz fiber posts, cast gold alloy posts, and CAD/CAM zirconia posts. The posts were luted to the roots by resin cement and fabricate zirconia crown for every specimen. An ad- dition-type silicone impression material was used to simulate the periodontal ligament. All the specimens were submitted to 1.2 x 106 cycles loaded with a 49 N force, at 45 degree to the long axis of the teeth simultaneously with 3 000 thermal cycles （5℃ -50℃ -5℃ ）. After that, the specimens were subjec- ted to a load at a crosshead speed of 1 mm/min in a servo-hydraulic testing machine applied at 45 degree to the long axis of the tooth until fracture. The data were subjected to ANOVA test and the patterns of the failure were examined. Results： After the cycling loading, 4 crowns from prefabricated quartz fiber posts groups were deboned, and no other failure was found after the cycling loading; the fracture strengths of CAD/CAM glass fiber posts group [ （441.5±103.2） N] and cast gold alloy posts group [ （462.9 ± 170.0） N] were higher （F =4.613, P 〈0.05） than those of CAD/CAM zirconia posts group [ （284.1±99.0） N] and prefabricated quartz fiber posts group [ （315.4± 112.3） N l; the entire specimens

关 键 词：计算机辅助设计 根管制备 桩核技术 生物力学 锆 

分 类 号：R781.3[医药卫生—口腔医学]