有限元应力分析不同垫底材料在邻牙(牙合)面缺损磨牙的髓腔固位冠修复效果  

Finite element stress analysis of endocrown restoration effects of different bottom materials in molars with proximal-occlusal defects

作　　者：汤英娜 张修银[2] 王忠华[1] TANG Yingna;ZHANG Xiuyin;WANG Zhonghua(Department of Stomatology,the First People’s Hospital of Huzhou,Huzhou 313000,China;Department of Prosthodontics,the Ninth People's Hospital of Shanghai,Shanghai 200011,China)

机构地区：[1]湖州市第一人民医院口腔科,浙江湖州313000 [2]上海第九人民医院口腔修复科,上海200011

出　　处：《健康研究》2021年第4期462-465,共4页Health Research

基　　金：湖州市科学技术局项目(2019GYB01)。

摘　　要：目的采用有限元应力分析方法,探讨不同垫底材料对邻牙(牙合)面缺损磨牙的髓腔固位冠修复后的生物力学影响。方法 102例邻牙(牙合)面缺损磨牙患者(102颗磨牙),在髓腔固位冠修复中使用不同垫底材料,其中光固化玻璃离子41例,流动树脂33例,化学固化玻璃离子28例。有限元应力分析试验选择1名患者的下颌第一磨牙,制备光固化玻璃离子、流动树脂、化学固化玻璃离子3种垫底材料的髓腔固位冠修复体各10颗,比较3种垫底材料在填充体、牙釉质、牙本质、垫底层的最大主应力。评价不同垫底材料的临床效果,并于修复后6个月、12个月进行随访。结果有限元应力分析试验显示,3种垫底材料在填充体的最大主应力差异无统计学意义(P>0.05);在牙釉质、牙本质的最大主应力:光固化玻璃离子>流动树脂>化学固化玻璃离子,在垫底层的最大主应力:光固化玻璃离子<流动树脂<化学固化玻璃离子,差异均有统计学意义(P<0.05)。3种垫底材料的髓腔固位冠修复的合格率及修复6、12个月后的边缘密合度差异均无统计学意义(P>0.05)。结论从生物力学上分析,邻牙(牙合)面缺损磨牙的髓腔固位冠修复应考虑垫底材料的弹性模量,弹性模量高的化学固化玻璃离子对牙体组织的应力作用小,更能保护牙体组织,修复效果更好。Objective To investigate the biomechanical effects of different bottom materials after endocrown restoration for molars with proximal-occlusal defects by finite element stress analysis.Methods 102 patients(102 molars)with proximal-occlusal defects were enrolled in this study.Different bottom materials were used in endocrown restoration,including light-cured glass ionomer(41 cases),flowable resin(33 cases)and chemical-cured glass ionomer(28 cases).In the finite element stress analysis experiment,the mandibular first molar of one patient was selected to prepare endocrown restoration with three kinds of base materials,namely,light-cured glass ionomer,flowable resin and chemical-cured glass ionomer,respectively.The maximum principal stress of three kinds of base materials in the filling,enamel,dentin and bottom layer was compared.The clinical effects of different bottom materials were evaluated and followed up at 6 and 12 months after repair.Results Finite element stress analysis showed that there was no significant difference in the maximum principal stress of three kinds of bottom materials(P>0.05).The order of maximum principal stresses in enamel and dentin was as follows:light-cured glass ionomer>flowable resin>chemical-cured glass ionomer(P<0.05).The order of maximum principal stresses in bottom layer was as follows:light-cured glass ionomer<flowable resin<chemical-cured glass ionomer(P<0.05).There was no significant difference in the qualified rate and marginal fit of the three kinds of materials after 6 and 12 months(P>0.05).Conclusions According to biomechanical analysis,elasticity modulus of the bottom material should be considered in restoration with endocrown for molars with proximal-occlusal defects.The stress effect of chemical-cured glass ionomer with high elasticity modulus on dental tissues is less and it can protect tooth tissues,with better restoration effect.

关 键 词：磨牙 邻牙(牙合)面缺损 髓腔固位冠 垫底材料 有限元应力分析 

分 类 号：R783.3[医药卫生—口腔医学]