咬合接触对桩核冠修复后牙体及牙周组织应力分布的影响  

Effect of occlusal contacts on stress distribution in the dentin and peridentium after post-core crown restoration

作　　者：姚蔚[1,2] 陈维毅[1] 李冰[2] 赵彬[2] 王为 Yao Wei Chen Wei-yi Li Bing Zhao Bin Wang Wei(Institute of Applied Mechanics and Biomedica Engineering, Taiyuan University of Technology, Taiyuan 030024, Shanxi Province, China Stomatological Hospital, Shanxi Medical University, Taiyuan 030001, Shanxi Province, China Urumqi Dawei Innovation InfoTech Co., Ltd., Urumqi 830013, Xinjiang Uygur Autonomous Region, China)

机构地区：[1]太原理工大学应用力学与生物医学工程研究所,山西省太原市030024 [2]山西医科大学口腔医院,山西省太原市030001 [3]乌鲁木齐大为创新信息科技有限公司,新疆维吾尔自治区乌鲁木齐市830013

出　　处：《中国组织工程研究》2017年第4期615-620,共6页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金资助(31271005);山西省科技攻关项目资助(20150313010-1)~~

摘　　要：背景:桩核冠修复牙体缺损是恢复牙齿形态与功能的有效方法,但其修复效果受到多种因素影响,需进一步研究多重影响的效应以优化设计。目的:研究不同咬合接触状态下,不同程度牙体缺损采用不同桩核材料修复后的组织应力水平变化。方法:通过CT数据建立人下颌第一磨牙的三维实体模型,并通过软件生成完整天然牙、6种缺损形式(全颌面轻度缺损、全颌面重度缺损、近中颌面轻度缺损、近中颌面重度缺损、远中颌面轻度缺损、远中颌面重度缺损)及2种桩核(纤维桩、氧化锆桩)冠修复的模型,导入ANSYS三维有限元软件,分析在稳定咬合接触(ABC)和不稳定咬合接触(AC)状态下的牙体、牙周组织应力。结果与结论:相对于稳定咬合(ABC)接触,不稳定咬合(AC)接触提高了牙体和牙周组织应力水平,并且不稳定咬合对修复后牙影响更明显;采用高弹性模量的桩材料修复时,牙体组织应力更高且缺损越大应力越高;纤维桩修复后牙周组织应力略高于氧化锆桩,与缺损形式关系不明显;结果表明,临床修复体咬合调整需精确恢复,尤其是不能缺少B区接触。BACKGROUND： The post-core crown system is an effective method for dental defect repair, but its repair outcomes are influenced by various factors; thereby, a further study is needed to optimize this method.OBJECTIVE： To investigate the stress distribution in different degrees of dental defect after post-core crown restoration under different occlusal contacts. METHODS： Three-dimensional models of the mandibular first molar were established by CT images, and models of complete natural teeth, six different defected teeth（total maxillofacial slight and severe defects, distal middle maxillofacial slight and severe defects, proximal middle maxillofacial slight and severe defects） and two different post-core crowns（fiber post and zirconia post） were created by software. These models were imported into ANSYS software to analyze the stress distribution in dentin and periodontium under stable occlusal contact（ABC） and unstable occlusal contact（AC）, respectively. RESULTS AND CONCLUSION： The stress in dentin and the periodontium after post-core crown restoration under AC was obviously higher than that under ABC, and AC affected the restored teeth more markedly. The post-core crown material with higher elastic modulus could induce higher stresses, and severe defected teeth showed higher stress distribution. Different defected types made no overt effects on the stress distribution in the periodontium. These results suggest that the B area contact is critical in regulating occlusal contacts of restoration.

关 键 词：咬合力 桩核技术 有限元分析 牙应力分析 组织工程 组织构建 下颌第一磨牙 牙体缺损 纤维桩 树脂核 氧化锆桩 咬合 力 Von Mises应力 国家自然科学基金 

分 类 号：B318[哲学宗教—外国哲学]