上颌第一前磨牙舌尖斜形折裂不同修复设计的有限元分析  

Finite Element Analysis of Different Designs for Maxillary First Premolars with Lingual Cusp Oblique Defect

作　　者：康婷 石思琼 赵威 郑睿 李茜茜 解静 郭玲 KANG Ting;SHI Siqiong;ZHAO Wei;ZHENG Rui;LI Xixi;XIE Jing;GUO Ling(Department of Prosthodontics,Affiliated Stomatological Hospital of Southwest Medical University,Luzhou 646000,China;Department of Stomatology,The First People's Hospital of Yibin,Yibin 644000,China;Department of Maxillofacial Surgery,Affiliated Stomatological Hospital of Southwest Medical University,Luzhou 646000,China;Department of Stomatology,Dazu People's Hospital of Chongqing,Dazu 402360,China.)

机构地区：[1]西南医科大学附属口腔医院修复科,四川泸州646000 [2]宜宾市第一人民医院口腔科,四川宜宾644000 [3]西南医科大学附属口腔医院颌面外科,四川泸州646000 [4]重庆市大足区人民医院口腔科,重庆402360

出　　处：《口腔医学研究》2019年第10期953-956,共4页Journal of Oral Science Research

基　　金：四川医事卫生法治研究中心课题(编号:YF17-Y27)

摘　　要：目的:通过三维有限元分析法研究上颌第一前磨牙舌尖斜形折裂后进行不同修复方式后的应力分布。方法:利用锥形束CT及有限元相关软件,建立舌尖斜形折裂的上颌第一前磨牙有限元模型,以完整牙作为对照组,同时对缺损牙按照根管治疗后修复方法的不同建立实验组模型,分析比较各组模型中剩余牙体组织Von Mises应力和最大主应力峰值。结果:(1)在一定范围内,当髓腔固位冠深度减小,材料弹性模量增大时,剩余牙体组织应力值增大。(2)选择纤维桩冠修复时颊根管(C1)组应力值大于舌根管(C2)组(P<0.05);金属桩冠修复时舌根管组(D2)应力值大于颊根管(D1)组(P<0.05)。(3)4 mm深度的优韧瓷髓腔固位冠组剩余牙体组织应力值低于舌根管纤维桩冠修复组(P<0.05)。结论:上颌第一前磨牙舌尖斜形折裂时,4 mm深度优韧瓷髓腔固位冠可能是最佳修复方式;纤维桩冠修复时应选择舌根管打桩;金属桩冠修复时应选择颊根管打桩。Objective: To analyze the stress distribution of the maxillary first premolar oblique defect with different methods by three-dimensional finite element analysis. Methods: Three dimensional finite element models of maxillary first premolar oblique defect were created by cone beam CT. The intact maxillary first premolar was served as the control group. Experimental groups were established according to different design. The stresses were investigated using finite element analysis software. Results: (1) The stresses of the residual dentine were increased by reduced depth of endocrowns restoration and increased elastic modulus of the material in certain range. (2) The stresses of the residual dentine in the fiber post and crown restoration of lingual canal group (C2) were smaller than that of the buccal canal group (C1) ( P <0.05). The stresses of the residual dentine in the metal post and crown restoration of buccal canal group (D1) were smaller than that of the lingual canal group (D2) ( P <0.05). (3) The stresses of the residual dentine of Lava Ultimate Endocrown restoration with the 4mm depth was lower than that of the lingual canal with the fiber post and crown restoration ( P <0.05). Conclusion: When the maxillary first premolar is obliquely fractured, Lava Ultimate endocrown restoration with the 4mm depth may be the best restoration. If fiber post and crown restoration is choosed, lingual canal should be selected. When metal post and crown restoration is choosed, buccal canal should be selected.

关 键 词：上颌第一前磨牙 斜形折裂 髓腔固位冠 桩 三维有限元 

分 类 号：R78[医药卫生—口腔医学]