不同近远中向牙体缺损对根管治疗后下颌第一磨牙修复治疗影响的有限元分析  

Finite element analysis of the influence of different proximal and distal dental defects on the restoration of mandibular first molar after root canal treatment

作　　者：张国庆 王利民 赵阿莉 曹谅 王卫国 ZHANG Guoqing;WANG Limin;ZHAO Ali;CAO Liang;WANG Weiguo(The 903th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army,Hangzhou 310000,Zhejiang,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇三医院,杭州310000

出　　处：《现代实用医学》2024年第12期1553-1557,共5页Modern Practical Medicine

基　　金：浙江省基础公益研究计划项目(LTGY24H140001)。

摘　　要：目的比较不同近远中向牙体缺损的下颌第一磨牙根管治疗后,两种修复方式受力后的剩余牙体组织及修复体应力大小、分布。方法建立不同近远中向牙体缺损的下颌第一磨牙修复方案模型,分为近远中牙体组织较少的全覆盖式高嵌体组(A1组)、近远中牙体组织较多的全覆盖式高嵌体组(A2组)、近远中牙体组织较少的髓腔固位冠组(B1组)及近远中牙体组织较多的髓腔固位冠组(B2组)。4组模型均施加垂直向、斜向载荷,记录两种载荷下不同修复形式的修复体、冠部牙体组织及修复体-牙体组织界面的应力大小和分布情况。结果垂直加载模式下,修复体等效应力(EQV)集中在加载点周围,4组模型差异较小;冠部牙体组织EQV应力分布相似,峰值差异较小;修复体-牙体组织界面EQV应力分布产生差异,A1、A2组集中在底壁和轴壁线角处,B1、B2组集中在加载点附近,A1、A2组峰值>B1、B2组。斜向加载模式下,修复体EQV应力集中在加载点周围,A1、A2组峰值>B1、B2组;冠部牙体组织EQV应力分布产生差异,A1组峰值>A2组>B1组>B2组;修复体-牙体组织界面EQV应力分布产生差异,A1组峰值>A2组>B1组>B2组。结论髓腔固位冠相较于全覆盖式高嵌体可有效降低剩余牙体组织应力和冠折的可能性。Objective To compare the residual dental tissue and stress distribution of the mandibular first molar with different proximal and distal tooth defects after root canal treatment.Methods The finite element method was used to model the restorations of mandibular first molars with different mesiodistal tooth defects,and divided into the fully covered high embedding with less proximal and distal dental tissue group(Group A1),the fully covered high embedding with more proximal and distal dental tissue group(Group A2),the medullary cavity fixed crown with less proximal and distal dental tissue group(Group B1),and the medullary cavity fixed crown with more proximal and distal dental tissue group(Group B2).The vertical and oblique loads were applied to record the stress magnitude and distribution of the restorations,the crown tissues,the interfaces between the restorations and the tooth tissues in different restorative forms under the two loading modes.Results Under the vertical loading mode,the equivalent stress(EQV)of restorations were concentrated around the loading point,there were no differences between the four groups.The EQV of crown tissues were similarly distributed,with small differences in the peaks.The EQV stress distribution of the restoration-tooth structure interface was different,A1,A2 groups concentrated at the line angle of the bottom wall and the axial wall,while B1,B2 groups concentrated near the loading point,and the peak value of A1,A2 groups was higher than those of B1,B2 groups.Under the oblique loading mode,the EQV of restoration were concentrated around the loading point,the peaks of A1,A2 Group were higher than those of B1,B2 Group.The EQV distribution of crown tissue varied,the peaks of Group A1>A2>B1>B2,the EQVdistribution of the restorative-tissue interface varied,the peaks of Group A1>A2>B1>B2.Conclusions Compared with full overlays,pulp cavity retaining crowns can effectively reduce the residual tissue stress and the possibility of crown fracture.

关 键 词：三维有限元分析 等效应力 修复体 下颌第一磨牙 根管治疗 

分 类 号：R781.33[医药卫生—口腔医学]