Pilo Raphael, Metzger Zvi, Brosh Tamar
Departments of Oral Rehabilitation, Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Departments of Endodontology, Goldschleger School of Dental Medicine, Tel-Aviv University, Tel-Aviv, Israel.
PLoS One. 2016 May 26;11(5):e0156461. doi: 10.1371/journal.pone.0156461. eCollection 2016.
To precisely quantify the circumferential strains created along the radicular dentin of maxillary incisors during a simulated clinical procedure of lateral compaction.
Six miniature strain gauges were bonded on the roots of fourteen recently extracted maxillary central incisors that were subjected to root canal instrumentation. The strain gauges were bonded at three levels (apical, middle, and coronal) and four aspects (buccal, lingual, mesial, and distal) of the roots. Each tooth was embedded in a PVC cylinder containing polyvinyl-siloxane impression material. Root filling was then performed by simulating the clinical procedure of lateral compaction using nickel-titanium finger spreaders. The force applied to the spreader and the strains developing in the surface root dentin were continuously recorded at a frequency of 10 Hz.
The highest strains that developed during lateral compaction were in the mesial and distal aspects at the apical level of the root. The magnitudes of the maximal mesial/distal strains at the apical as well as the mid-root levels were approximately 2.5-3 times higher than those at the buccal/lingual aspects (p = 0.041). The strains decreased significantly (p<0.04) from the apical through the mid-root levels to the coronal level, yielding gradients of 2.5- and 6-fold, respectively. The mesial and distal strains were consistently tensile and did not differ significantly; however, the buccal strains were generally 35-65% higher than the lingual strains (p = 0.078). Lateral compaction resulted in the gradual build-up of residual strains, resulting in generation of a 'stair-step' curve. These strains declined gradually and almost completely disappeared after 1000 sec.
With proper mounting of several miniature strain gauges at various levels and aspects of the root, significant circumferential strains can be monitored under clinically relevant compaction forces. The residual strains at the end of lateral compaction are not stored in the dentin but decrease gradually to negligible levels.
在模拟侧向加压的临床操作过程中,精确量化上颌切牙根管牙本质周围产生的周向应变。
将六个微型应变片粘贴在十四颗近期拔除的上颌中切牙的牙根上,这些牙齿已进行根管预备。应变片粘贴在牙根的三个水平(根尖、中部和冠部)和四个方位(颊侧、舌侧、近中侧和远中侧)。每颗牙齿嵌入含有聚乙烯基硅氧烷印模材料的聚氯乙烯圆柱体中。然后使用镍钛指状扩压器模拟侧向加压的临床操作进行根管充填。以10Hz的频率连续记录施加在扩压器上的力以及牙根表面牙本质中产生的应变。
侧向加压过程中产生的最高应变出现在牙根根尖水平的近中侧和远中侧。根尖以及牙根中部水平的最大近中/远中应变幅度比颊侧/舌侧大约高2.5 - 3倍(p = 0.041)。应变从根尖水平到牙根中部水平再到冠部水平显著降低(p<0.04),分别产生2.5倍和6倍的梯度。近中侧和远中侧应变始终为拉伸应变且无显著差异;然而,颊侧应变通常比舌侧应变高35 - 65%(p = 0.078)。侧向加压导致残余应变逐渐累积,形成“阶梯状”曲线。这些应变逐渐下降,在1000秒后几乎完全消失。
通过在牙根的不同水平和方位正确安装多个微型应变片,可以在临床相关的加压力下监测到显著的周向应变。侧向加压结束时的残余应变不会存储在牙本质中,而是逐渐降低到可忽略不计的水平。