3种机用镍钛锉根管预备对上颌第一磨牙应力的影响  

Stress analysis of simulated maxillary first molar prepared with three rotary nickel-titanium instruments

作　　者：袁理 白雪岭[2] 李飒 金艳 游洪霞 黄盛兴 YUAN Li;BAI Xueling;LISa;JIN Yan;YOU Hongxia;HUANG Shengxing(Department of Stomatology,Shenzhen People＇s Hospital,Second Clinical Medical College of Jinan University,Shenzhen 518020,China;Shenzhen Institutes of Advanced Technology,Chinese Academy of Sciences,Shenzhen 518055,China)

机构地区：[1]深圳市人民医院口腔医学中心暨南大学第二临床医学院,广东深圳518020 [2]中国科学院深圳先进技术研究院,广东深圳518055

出　　处：《口腔疾病防治》2018年第7期445-450,共6页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：深圳市科技计划项目(JCYJ20140416122812030)

摘　　要：目的比较3种机用镍钛锉根管预备对上颌第一磨牙应力大小和分布影响的差异。方法采用上颌第一磨牙树脂模型,分别用Reciproc、Wave One和Protaper机用镍钛根管锉进行根管预备。使用Micro-CT分别扫描预备前后的树脂模型,将扫描结果导入Mimics 16.0软件建立相应的三维模型,通过Abaqus 6.14有限元分析软件在垂直和侧方加载条件下进行应力分析。结果 3种机用镍钛根管锉根管预备后,在垂直力加载下,Reciproc组、Wave One组、Protaper组牙釉质最大应力增幅分别为1.36%、21.48%、20.99%;牙骨质最大应力增幅分别为55.98%、41.18%、33.04%;牙槽骨最大应力增幅分别为45.55%、40.37%、24.09%;在斜向45°力加载下,Reciproc组、Wave One组、Protaper组牙釉质最大应力增幅分别为1.79%、-4.58%、3.82%;牙骨质最大应力增幅分别为16.33%、7.58%、4.32%;牙槽骨最大应力增幅分别为46.82%、36.40%、8.29%。3种机用镍钛根管锉根管预备后,在相同的加载条件下,牙骨质和牙槽骨的最大应力均较预备前增大,应力集中区均位于牙冠与牙根交界区。3组在侧方加载时的应力均明显大于垂直加载时的应力。两种加载条件下,Reciproc组牙骨质和牙槽骨应力增大幅度均大于其余两组。结论根管预备会造成上颌第一磨牙应力增大,Reciproc组牙骨质和牙槽骨应力增大更明显。Objective To compare the differences in the stress distribution in simulated first molars prepared with three rotary nickel-titanium instruments. Methods Four simulated first molars were prepared without instruments and with Reciproc, Wave One and Protaper. Before and after preparation, each simulated molar was scanned by Micro-CT.The data were imported to Mimics 16.0 software to establish three-dimensional models. Finite element analysis was processed with Abaqus 6.14 software under conditions of longitudinal and lateral load. Results Under vertical load conditions, the maximum von Mises stress of the enamel increased by 1.36%, 21.48% and 20.99% in the Reciproc, Wave One and Protaper groups, respectively, after preparation, while the maximum von Mises stress of the cementum increased by55.98%, 41.18% and 33.04%, respectively, and the maximum von Mises stress of the alveolar bone increased by45.55%, 40.37% and 24.09%, respectively. Under 45° lateral load conditions, the maximum von Mises stress of the enamel increased by 1.79%,-4.58% and 3.82% in the Reciproc, Wave One and Protaper groups, respectively, after preparation, while the maximum von Mises stress of cementum increased by 16.33%, 7.58% and 4.32%, respectively, and the maximum von Mises stress of the alveolar bone increased by 46.82%, 36.40% and 8.29%, respectively. Under the same conditions, the von Mises stresses of the cementum and alveolar bones of the simulated molars were higher after preparation than before preparation, especially under lateral load conditions. The stress was focused on the border between the crown and the root. The von Mises stress of the cementum and alveolar bones increased much more in the Reciproc group than in the other two groups under both conditions. Conclusion The von Mises stress of simulated molars was greater after preparation than before preparation. The von Mises stress of the cementum and alveolar bones increased much more in the Reciproc group than in the other two groups.

关 键 词：根管预备 镍钛根管锉 应力 单支锉 MICRO-CT 有限元分析 

分 类 号：R781.05[医药卫生—口腔医学]