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上颌前磨牙牙颈部牙本质粘结的生物力学效应。

Biomechanical Effects of Bonding Pericervical Dentin in Maxillary Premolars.

机构信息

University of Toronto, Toronto, Canada.

University of Toronto, Toronto, Canada.

出版信息

J Endod. 2018 Apr;44(4):659-664. doi: 10.1016/j.joen.2018.01.002. Epub 2018 Feb 16.

Abstract

INTRODUCTION

Pericervical dentin (PCD) loss may increase root fracture propensity in root-filled teeth. This study evaluated the impacts of bonding PCD with composite resin (CR) on radicular microstrain distribution and load at failure of root-filled maxillary premolars.

METHODS

Ten single-canal maxillary premolars decoronated 2 mm coronal to the cementoenamel junction (CEJ) had canals enlarged with ProTaper Universal instruments (Dentsply Tulsa Dental Specialties, Tulsa, OK) to F3. They were root filled with gutta-percha (GP) to the CEJ and restored with Cavit (3M Deutschland GmbH, Neuss, Germany) (GP group, n = 5) or 6 mm apical to the CEJ and restored with bonded CR to simulate bonding of PCD (bonded PCD group, n = 5). Digital moiré interferometry was used to evaluate pre- and postoperative whole-field microstrain distribution in the root dentin under physiologically relevant loads (10-50 N). Another 30 premolars, similarly treated as groups 1 and 2 or left untreated as controls (n = 10/group), were subjected to cyclic loads (1.2 million cycles, 45 N, 4 Hz) followed by uniaxial compressive load to failure. Mechanical data were analyzed with 1-way analysis of variance and the post hoc Tukey test at a 5% level of significance.

RESULTS

Microstrain distribution showed bending and compressive patterns at the coronal and apical root dentin, respectively. In the GP group, microstrain distribution was unaltered. In the bonded-PCD group, different microstrain distribution suggested stiffening at the PCD. The load at failure did not differ significantly for the GP, bonded PCD, and control groups (P > .05).

CONCLUSIONS

CR bonding of PCD might impact the biomechanical responses in maxillary premolar roots at low-level continuous loads. The effect of this impact on root fracture loads when subjected to cyclic load warrants further investigation.

摘要

简介

牙周牙本质丧失(PCD)可能会增加根管填充后牙齿的根折倾向。本研究评估了用复合树脂(CR)粘结 PCD 对根管填充上颌前磨牙根分叉微应变分布和破坏载荷的影响。

方法

10 个单根管上颌前磨牙,在牙颈下 2mm 处牙冠部分被截冠(CEJ),根管使用 ProTaper Universal 器械(Dentsply Tulsa Dental Specialties,Tulsa,OK)扩大到 F3。根管用牙胶(GP)填充到 CEJ 并使用 Cavit(3M Deutschland GmbH,Neuss,Germany)(GP 组,n=5)修复,或填充到 CEJ 下 6mm 并用粘结的 CR 模拟粘结 PCD(粘结 PCD 组,n=5)。数字云纹干涉法用于评估在生理相关载荷(10-50N)下,根管牙本质的术前和术后全场微应变分布。另外 30 个前磨牙,与第 1 组和第 2 组同样处理或未处理作为对照(n=10/组),在经受循环载荷(120 万次循环,45N,4Hz)后,进行单轴压缩破坏载荷试验。用单因素方差分析和事后 Tukey 检验对机械数据进行分析,显著性水平为 5%。

结果

微应变分布显示,在冠根和根尖根牙本质处分别呈弯曲和压缩模式。在 GP 组,微应变分布没有改变。在粘结 PCD 组,不同的微应变分布表明 PCD 处的刚度增加。GP、粘结 PCD 和对照组的破坏载荷差异无统计学意义(P>.05)。

结论

CR 粘结 PCD 可能会影响低水平连续载荷下上颌前磨牙根部的生物力学反应。当受到循环载荷时,这种影响对根折载荷的影响需要进一步研究。

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