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体外评估全冠修复和不同核材料修复的牙齿保留和抗力失败负荷。

In Vitro Assessment of Retention and Resistance Failure Loads of Teeth Restored with a Complete Coverage Restoration and Different Core Materials.

机构信息

Hellenic Air Force Dental Corp, 251 General Air Force Hospital, Athens, Greece.

Department of Prosthodontics, Aristotle University School of Dentistry, Thessaloniki, Greece.

出版信息

J Prosthodont. 2019 Jan;28(1):e229-e236. doi: 10.1111/jopr.12668. Epub 2017 Nov 16.

Abstract

PURPOSE

To investigate in vitro the retention and the resistance form, as well as the failure modes of maxillary premolars restored with cast metal crowns and different core materials.

MATERIALS AND METHODS

Sixty human extracted maxillary premolars were selected according to their size and were embedded in PMMA resin blocks. After removing a part of their clinical crowns, the teeth were randomly divided into 3 groups of 20 teeth and were either left unrestored, or they were restored with amalgam or composite resin. All teeth were prepared for a cast metal complete coverage restoration. The restorations were cemented on the prepared teeth with a resin-modified glass ionomer luting agent (GC Fuji Plus). All specimens were subjected to static loading at 1 mm/min by a universal testing machine, until failure. Half the specimens of each group were subjected to tensile loading along the long axis of the teeth. The other half were subjected to compressive loading at a 30° angle. Failure loads and failure modes for each tooth were recorded. The statistical analysis included descriptive statistics, one-way ANOVA, and Tukey's HSD test.

RESULTS

One-way ANOVA revealed statistically significant differences among the 3 tested groups (p < 0.05) for both tests. The group of teeth with no core material presented the highest failure loads for both the tensile and the compressive loading tests, with mean loads of 381.02 Ν and 741.21 Ν, respectively. Mean tensile and compressive failure loads for the amalgam group were 277.34 Ν and 584.75 Ν, while the composite resin group presented the lowest tensile and compressive failure values, which were 250.77 Ν and 465.78 Ν, respectively. The compression loading test resulted in the same failure mode for all specimens, which included unfavorable fracture of the teeth in combination with detachment of the cast metal complete coverage restorations. The tensile loading test resulted in different failure modes between the groups that used a core material and the group with no core material.

CONCLUSIONS

Teeth that lost more than half of their coronal structure presented better retention and resistance form if no core material was used, provided that a minimum of 2-mm axial wall height was present at the missing part. Teeth that have lost more than half of their coronal structure and were restored with amalgam core presented better retention and resistance form than those restored with composite resin. Catastrophic fractures, extending to the root, were associated with compression forces but not with tensile forces.

摘要

目的

研究上颌前磨牙用铸造金属冠和不同核材料修复后的保留和阻力形式以及失效模式。

材料和方法

根据大小选择 60 个人工上颌前磨牙,并将其嵌入 PMMA 树脂块中。去除部分临床冠后,将牙齿随机分为 3 组,每组 20 颗牙齿,分别为未修复组、银汞合金组或复合树脂组。所有牙齿均制备铸造金属全冠修复体。用树脂改性玻璃离子水门汀(GC Fuji Plus)将修复体粘接到预备好的牙齿上。所有标本均以 1mm/min 的速度通过万能试验机进行静态加载,直至失效。每组的一半标本沿牙齿的长轴进行拉伸加载,另一半标本以 30°角进行压缩加载。记录每颗牙齿的失效载荷和失效模式。统计分析包括描述性统计、单因素方差分析和 Tukey HSD 检验。

结果

单向方差分析显示,两种测试中,3 组测试之间存在统计学差异(p < 0.05)。无核材料组的牙齿在拉伸和压缩测试中均表现出最高的失效载荷,分别为 381.02N 和 741.21N。银汞合金组的平均拉伸和压缩失效载荷分别为 277.34N 和 584.75N,而复合树脂组的拉伸和压缩失效载荷最低,分别为 250.77N 和 465.78N。压缩加载试验导致所有标本均出现相同的失效模式,包括牙齿不利断裂并伴有铸造金属全冠修复体脱落。拉伸加载试验导致使用核材料的组与无核材料组之间出现不同的失效模式。

结论

如果不使用核材料,失去超过一半冠部结构的牙齿如果保留至少 2mm 的轴向壁高度,其保留和阻力形式更好。失去超过一半冠部结构并用银汞合金核修复的牙齿的保留和阻力形式优于用复合树脂修复的牙齿。灾难性骨折延伸至根部分叉与压缩力有关,与拉伸力无关。

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