Yoon Hong Gi, Oh Hyun Keun, Lee Dong-Yul, Shin Joo-Hee
Department of Conservative Dentistry, Seoul National University Dental Hospital, Seoul, South Korea.
Department of Orthodontics, Graduate School of Clinical Dentistry, Korea University, Seoul, South Korea.
J Appl Oral Sci. 2018;26:e20160406. doi: 10.1590/1678-7757-2016-0406. Epub 2018 Feb 8.
Objective The purpose of this study was to evaluate, by using finite element analysis, the influence of post location and occlusal loading location on the stress distribution pattern inside the root canals of the mandibular 1st molar. Material and Methods Three different 3-D models of the mandibular 1st molar were established: no post (NP) - a model of endodontic and prosthodontic treatments; mesiobuccal post (MP) - a model of endodontic and prosthodontic treatments with a post in the mesiobuccal canal; and distal post (DP) - a model of endodontic and prosthodontic treatments with a post in the distal canal. A vertical force of 300 N, perpendicular to the occlusal plane, was applied to one of five 1 mm2 areas on the occlusal surface; mesial marginal ridge, distal marginal ridge, mesiobuccal cusp, distobuccal cusp, and central fossa. Finite element analysis was used to calculate the equivalent von Mises stresses on each root canal. Results The DP model showed similar maximum stress values to the NP model, while the MP model showed markedly greater maximum stress values. The post procedure increased stress concentration inside the canals, although this was significantly affected by the site of the force. Conclusions In the mandibular 1st molar, the distal canal is the better place to insert the post than the mesiobuccal canal. However, if insertion into the mesiobuccal canal is unavoidable, there should be consideration on the occlusal contact, making central fossa and distal marginal ridge the main functioning areas.
目的 本研究旨在通过有限元分析评估桩的位置和咬合加载位置对下颌第一磨牙根管内应力分布模式的影响。
材料与方法 建立了三种不同的下颌第一磨牙三维模型:无桩(NP)——根管治疗和修复治疗模型;近中颊侧桩(MP)——近中颊根管有桩的根管治疗和修复治疗模型;远中桩(DP)——远中根管有桩的根管治疗和修复治疗模型。在咬合面上五个1平方毫米区域之一(近中边缘嵴、远中边缘嵴、近中颊尖、远中颊尖和中央窝)施加一个垂直于咬合面的300 N垂直力。采用有限元分析计算每个根管上的等效冯·米塞斯应力。
结果 DP模型显示的最大应力值与NP模型相似,而MP模型显示的最大应力值明显更大。桩操作增加了根管内的应力集中,尽管这受到力作用部位的显著影响。
结论 在下颌第一磨牙中,远中根管比近中颊根管更适合插入桩。然而,如果不可避免要插入近中颊根管,则应考虑咬合接触,使中央窝和远中边缘嵴成为主要功能区域。