下颌第一磨牙残冠高嵌体与桩核冠修复的三维有限元分析  

Three-dimensional finite element analysis of fiber post-and-core crown and onlay restorations for mandibular first molars

作　　者：樊旭东 曹天翼 于东民 陆雨蒙 孙汉堂 FAN Xu-dong;CAO Tian-yi;YU Dong-ming;LU Yu-meng;SUN Han-tang(Nantong Stomatology Hospital affiliated to Nantong University,Nantong 226000,China;不详)

机构地区：[1]南通大学,江苏南通226000 [2]南通大学附属南通口腔医院,江苏南通226000

出　　处：《牙体牙髓牙周病学杂志》2025年第3期155-161,共7页Chinese Journal of Conservative Dentistry

基　　金：南通市卫生健康委员会科研课题项目(MS2022092)。

摘　　要：目的:评估不同牙体缺损修复策略对修复体和剩余牙体组织应力的影响,以期为临床修复方案的选择和设计提供科学依据。方法:选取1个因牙周病拔除的成人下颌第一磨牙。使用Micro CT进行高精度扫描,通过Mimics 21.0软件重建获得牙体的三维模型,并利用3ds Max 2024软件进行优化和模拟。最后将模型导入ANSYS Workbench 2020 R2软件进行应力分析。根据牙体缺损程度模拟二壁、三壁和四壁3组缺损,每组分别进行高嵌体修复和桩核冠修复的三维有限元分析。结果:在垂直和舌向加载条件下,三维模型显示出两种不同修复方法对应的等效应力和最大主应力分布相似,应力主要集中在中央窝、边缘嵴及颊尖等区域。三壁缺损模型中,高嵌体修复在垂直加载时等效应力和最大主应力峰值最高;而在舌向加载时,等效应力的最大峰值出现于桩核冠组,主应力的最大峰值则出现于高嵌体组。结论:(1)在面对大面积牙体缺损时,修复方法的选择对牙体剩余结构应力分布有重要影响。(2)从应力方面考虑,在下颌第一磨牙三壁或四壁缺损时优先考虑桩核冠修复。二壁缺损时,桩核冠修复和高嵌体修复无明显差异。AIM:To evaluate the effects of post-and-core crown and onlay restorations on the stress distribution of restorations and residual dental tissues,thus providing a scientific basis for the selection and design of clinical restoration options.METHODS:An adult mandibular first molar extracted due to periodontal disease was analyzed.High-resolution scanning was conducted using a Micro CT,followed by the reconstruction of a three-dimensional model using Mimics 21.0 software.The model was then optimized and simulated using 3ds Max 2024 software.Finally,the model was imported into ANSYS Workbench 2020 R2 software for stress analysis.Based on the extent of dental defects,three defect scenarios were simulated:two-wall defects,three-wall defects,and four-wall defects,with each scenario receiving either an onlay restoration or a post-and-core crown restoration.RESULTS:Under vertical and lingual loading conditions,the three-dimensional models demonstrated similar distributions of equivalent stress and maximum principal stress between different restoration methods.Stress was primarily concentrated in areas such as the central fossa,marginal ridges,and cusps.In the three-wall defect models,the onlay restoration group exhibited the highest values of equivalent stress and maximum principal stress under vertical loading;while under lingual loading,the post-and-core crown group showed the highest peak in equivalent stress,with the onlay group showing the highest peak in maximum principal stress.CONCLUSION:①When dealing with large-scale tooth defects,the choice of restoration method significantly affects the stress distribution of the remaining tooth structure.②From the perspective of stress,for three-wall or four-wall defect in the mandibular first molar,priority should be given to post-and-core crown restoration.For two-wall defects,there is no significant difference between post-and-core crown restoration and onlay restoration.

关 键 词：核桩冠 高嵌体 下颌第一磨牙 三维有限元分析 

分 类 号：R783.3[医药卫生—口腔医学]