不同嵌体材料修复右下颌第二前磨牙非龋性颈部缺损的生物力学性能比较  

Comparison of biomechanical properties of different inlay materials for repairing non-carious neck defects of right mandibular second premolars

作　　者：郭冬梅[1] 谢莉莉[1] 全涛 GUO Dong-mei;XIE Li-li;QUAN Tao(Hainan General Hospital,Haikou 510102,China)

机构地区：[1]海南省人民医院,海口510102

出　　处：《医疗卫生装备》2022年第3期14-18,共5页Chinese Medical Equipment Journal

基　　金：国家自然科学基金地区科学基金项目(81860195);海南省重点科技合作项目(ZDYF2019216)。

摘　　要：目的:比较采用不同嵌体材料修复右下颌第二前磨牙非龋性颈部缺损(non-carious cervical lesions,NCCLs)的生物力学性能。方法:选择因治疗需要拔除的右下颌第二前磨牙,首先采用锥形束CT(cone beam CT,CBCT)口腔扫描仪进行断层扫描,然后采用Mimics三维重建软件、Geomagic Studio 2020逆向处理软件对影像图像预处理后建立右下颌第二前磨牙三维模型,再使用Unigraphics NX三维重建软件对模型处理后获得NCCLs模型。将NCCLs模型导入有限元分析软件,分别选择复合树脂(Filtek^(TM) Z350纳米复合树脂)、玻璃离子(GC Fuji Ⅱ LC树脂改性光固化玻璃)、铸瓷(义获嘉IPS-E.Max铸瓷)、优韧瓷(Lava^(TM) Ultimate优韧瓷)4种嵌体材料进行缺损修复及建模,并分析不同材料修复后不同加载条件下的生物力学差异。结果:静态载荷状态下,不同嵌体材料修复后应力分布趋势基本相同,最大应力峰值由小到大依次为优韧瓷<复合树脂<玻璃离子<铸瓷;动态载荷模拟口腔咀嚼状态下,Von Mises应力峰值与主应力峰值由小到大依次为优韧瓷<复合树脂<玻璃离子<铸瓷。在垂直和侧向加载条件下均显示嵌体与牙体各交界点的应力值降低,其中铸瓷的顶端与底端的应力值较大,左、右两端的应力值较小,其他各嵌体材料顶端与底端应力值较小,而左、右两端应力值较大,各嵌体材料检测点应力值由小到大依次为优韧瓷<复合树脂<玻璃离子<铸瓷。加载后不同嵌体材料修复的各模型颊尖位移值均有所减小,并均以颊向舌侧斜向45°加载的位移减小幅度最大。结论:嵌体修复是治疗右下颌第二前磨牙NCCLs的有效方案,不同嵌体材料修复后所表现出的应力分布及应力峰值近似,但整体来看以Lava^(TM) Ultimate优韧瓷的修复效果更佳。Objective To compare the biomechanical properties of the non-carious cervical lesions(NCCLs)of the right mandibular second premolars repaired with different inlay materials.Methods The right mandibular second premolar,which needed to be extracted for treatment,was firstly scanned tomographically using a cone beam CT(CBCT)oral scanner,and then a 3D model of the right mandibular second premolar was established by pre-processing the images with Mimics 3D reconstruction software and Geomagic Studio 2020 reverse-engineering software,and then the model was processed with Unigraphics NX 3D reconstruction software to obtain a NCCLs model.The NCCLs model was imported into the finite element analysis software,and four inlay materials,namely composite resin(Filtek^(TM) Z350 XT Universal Restorative),glass ionomer(GC Fuji Ⅱ LC glass ionomer restorative),cast porcelain(IVOCLAR IPS-E.Max Ceram Dentin)and nano composite ceramic(Lava^(TM) Ultimate CAD/CAM Restorative),were selected for defect repair and modeling,and the biomechanical differences between the different materials were analyzed under various loading conditions.Results Under static loading,the stress distribution trends were basically the same for the different inlay materials,with the maximum stress peaks in the order of nano composite ceramic<composite resin<glass ionomer<cast porcelain;the Von Mises stress peaks and the main stress peaks were in descending order of nano composite ceramic<composite resin<glass ionomer<cast porcelain under the simulated oral mastication condition using dynamic loading.The stress values at the left and right ends of all the inlay-dental junction decreased under both vertical and lateral loading conditions.The cast porcelain had high stresses at the apical and bottom ends while low stresses at the left and right ends,and the other inlay materials had high stresses at the apical and bottom ends while low stresses at the left and right ends.All the inlay materials had the stresses at the detection points being in descending order of n

关 键 词：下颌第二前磨牙 非龋性颈部缺损 嵌体材料 三维建模 生物力学 

分 类 号：R318.08[医药卫生—生物医学工程]