Assif David, Nissan Joseph, Gafni Yaron, Gordon Moshe
Department of Oral Rehabilitation, The Maurice and Gabriela Goldshleger School of Dental Medicine, Tel Aviv University, Israel.
J Prosthet Dent. 2003 May;89(5):462-5. doi: 10.1016/s0022-3913(02)52748-7.
Controversy exists concerning the preferred type of final restoration of endodontically treated molars regarding their resistance to fracture under occlusal load.
The aim of this study was to assess the resistance to fracture of endodontically treated molars with various degrees of tooth structure loss restored with amalgam under simulated occlusal load.
. The study teeth consisted of 90 noncarious, nonrestored molars stored in physiological saline solution. The teeth were endodontically treated and randomly divided into 9 experimental groups of 10 specimens each with various degrees of tooth loss, ranging from a conservative endodontic access to removal of all cusps. All teeth were restored with a standardized technique to their original contour with amalgam. Each specimen was mounted onto a specialized jig for loading at the central fossa at a 30-degree angle to the long tooth axis. The resistance to fracture, under continuous compressive force at a cross-head speed of 2 mm/minute, was applied by a universal testing machine and was recorded. One-way analysis of variance with Scheffé contrast was used to statistically compare the differences between the groups at significance level P<.05.
One-way analysis of variance showed that the group with a conservative endodontic access (1137.6 +/- 311.6 N) and the group with removal of all cusps (1261.4 +/- 195.1 N) presented a significantly higher resistance to fracture when compared with the other groups (P<.05). There was no significant difference in resistance to fracture under the simulated load between the other 7 groups, which ranged from 655.8 +/- 229.4 to 906.3 +/- 168.1 N (P>.05).
Within the limitations of this study, the endodontically treated molars with a conservative endodontic access or after removal of all cusps that were restored to their original contour with amalgam presented the highest resistance to fracture under a simulated occlusal load.
关于牙髓治疗后磨牙最终修复的首选类型,在咬合负荷下其抗折性方面存在争议。
本研究的目的是评估在模拟咬合负荷下,用银汞合金修复的不同程度牙体结构丧失的牙髓治疗后磨牙的抗折性。
研究用牙包括90颗非龋、未修复的磨牙,保存在生理盐溶液中。对这些牙齿进行牙髓治疗,并随机分为9个实验组,每组10个样本,牙体丧失程度各不相同,从保守的牙髓开髓到所有牙尖的去除。所有牙齿均采用标准化技术用银汞合金恢复至原始外形。每个样本安装在专门的夹具上,在中央窝处以与牙长轴成30度角加载。通过万能试验机施加以2毫米/分钟的十字头速度连续施加的压缩力,记录抗折性。采用带有Scheffé对比的单因素方差分析,在显著性水平P<0.05下对各组之间的差异进行统计学比较。
单因素方差分析表明,与其他组相比,保守牙髓开髓组(1137.6±311.6 N)和所有牙尖去除组(1261.4±195.1 N)的抗折性显著更高(P<0.05)。其他7组在模拟负荷下的抗折性无显著差异,范围为655.8±229.4至906.3±168.1 N(P>0.05)。
在本研究的局限性内,采用保守牙髓开髓或所有牙尖去除后用银汞合金恢复至原始外形的牙髓治疗后磨牙在模拟咬合负荷下表现出最高的抗折性。