颊舌侧牙体厚度对根管治疗后磨牙修复治疗的影响  

Effect of buccal and lingual tooth thickness on the restoration of molars after root canal therapy

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(Department of Stomatology,the No.903 Hospital of PLA Joint Logistic Support Force,Hangzhou 310000,Zhejiang,China;Department of Stomatology,the Affiliated Xihu Hospital Hangzhou Medical College,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口腔科,浙江杭州310000 [2]杭州医学院附属西湖医院口腔科,浙江杭州310000

出　　处：《中国现代医生》2025年第2期12-15,共4页China Modern Doctor

基　　金：浙江省基础公益研究计划项目(LTGY24H140001)。

摘　　要：目的比较不同颊舌侧剩余牙体组织厚度的下颌第一磨牙根管治疗后,两种不同修复方式受力后的修复体、剩余牙体组织与黏接界面的应力大小及分布。方法根据颊舌侧牙体组织剩余量设计三组不同的下颌第一磨牙根管治疗后模型,在此基础上模拟FO和EC的牙体预备及修复体的制备,生成6组不同的下颌第一磨牙根管治疗后FO和EC模型:A1组采用FO修复,颊舌侧剩余牙体组织厚度为2mm;A2组采用FO修复,颊舌侧剩余牙体组织厚度为3mm;A3组采用FO修复,颊舌侧剩余牙体组织厚度为4mm;B1组采用EC修复,颊舌侧剩余牙体组织厚度为2mm;B2组采用EC修复,颊舌侧剩余牙体组织厚度为3mm;B3组采用EC修复,颊舌侧剩余牙体组织厚度为4mm。施加垂直向及斜向载荷,记录两种加载模式下不同修复形式的修复体、剩余牙体组织与黏接界面的应力大小及分布。结果两种加载模式下,修复体等效应力分布均集中在加载点周围,牙本质等效应力均集中在牙齿颈部,全覆盖式高嵌体组修复体-牙体树脂界面最大主应力(maximum principal stress,MPS)集中在洞型底壁和轴壁线角处,髓腔固位冠组修复体-牙体树脂界面MPS集中在髓腔固位洞型的底壁线角处。同一颊舌侧牙体组织厚度的模型,除斜向加载时髓腔固位冠的修复体等效应力峰值大于全覆盖式高嵌体组的修复体等效应力峰值,其余条件下全覆盖式高嵌体的各项观察指标峰值均大于髓腔固位冠。结论髓腔固位冠更能保护根管治疗后牙体组织,建议在根管治疗后选择髓腔固位冠修复。Objective To compare the stress magnitude and distribution of the restorations,remaining tooth tissues,and bonding interfaces of endodontically mandibular first molar with different buccolingual residual tooth tissue thicknesses in two different restorations.Methods The finite element method was used to model the restorations of mandibular first molars with different buccolingual residual tissue thicknesses after root canal treatment.The vertical and oblique loads were applied to record the stress magnitude and distribution of restorations,residual tissues,and bonding interfaces of the different restorations.Results Three different models of mandibular first molar were designed based on the amount of buccal and glossal side dental tissue.Based on this simulation of the dental preparation of FO and EC and the preparation of the prosthesis,generating 6 different groups:FO repair in A1group,thickness of the buccal tooth tissue is 2mm;A2 group was repaired by FO,thickness of the buccal tooth tissue is 3mm;A3 Group was performed with FO repair,thickness of the buccal and lingual remaining tooth tissue is 4mm;In B1 group,with EC repair,thickness of buccal tooth tissue is 2mm;In B2 group with EC repair,thickness of buccal tooth tissue is 3mm;In B3 group,using EC repair,thickness of remaining dental tissue on buccal and lingual side was 4mm.Results Two loading modes,the restoration such as effect force distribution are concentrated around the loading point,dentin effect force are concentrated in the tooth neck,the full coverage of high embedded group restoration-dental resin interface maximum main stress(MPS)is concentrated in the hole wall and shaft wall Angle,the pulp cavity setting crown group restoration-dental resin interface MPS focus in the bottom wall angle of the pulp cavity setting hole type.In the model of tooth tissue thickness in the same buccal-lingual side,except that the peak effect force of the restoration was greater than the peak of the full coverage crown,the peak of the observed index of the full cov

关 键 词：三维有限元分析 等效应力 髓腔固位冠 高嵌体 根管治疗 

分 类 号：R783.3[医药卫生—口腔医学]