Gümrükçü Zeynep, Kurt Sevda, Köse Sinan
Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Recep Tayyip Erdoğan University, Rize, Turkey.
Assistant Professor, Department of Periodontology, Faculty of Dentistry, Recep Tayyip Erdoğan University, Rize, Turkey.
J Oral Maxillofac Surg. 2019 Sep;77(9):1770.e1-1770.e8. doi: 10.1016/j.joms.2019.04.029. Epub 2019 May 8.
Apical resection is a surgical technique that involves removing a tooth's root tip and sealing the apical extent of the root canal system. However, evidence-based information on the biomechanical effects of apically resected tooth determinants is lacking. The aim of the present study was to examine the biomechanical effects of using different graft materials and the effect of different resection quantities on the tooth radix.
Thirty finite element models of mandibular central incisors with 1-cm defects in their apical regions were constructed using SolidWorks software (SolidWorks, Waltham, MA). Resections of 0, 1, 2, 3, 4, and 5 mm were created at the root tips, and tissue regeneration was simulated in the empty cavity models using the material properties of healed bone, an allograft, a xenograft, and hydroxyapatite to the grafts used to fill the apical sites. A 100-N force was applied to the various groups of teeth in the oblique (45°) direction, and the maximal von Mises stress and displacement values were determined using Ansys, version 16, software (ANSYS, Inc, Canonsburg, PA).
The highest of these values was observed in the 5-mm resected and empty model. Increasing the resection amount caused the stress and displacement to increase. The lowest stress and deformation values were seen in the hydroxyapatite group, followed by the xenograft group and the allograft group.
The results of the present study have shown that grafting into the apical defect provides biomechanical support for resection of the root structure.
根尖切除术是一种外科技术,包括切除牙齿的根尖并封闭根管系统的根尖部分。然而,关于根尖切除牙齿决定因素的生物力学效应,缺乏基于证据的信息。本研究的目的是研究使用不同移植材料的生物力学效应以及不同切除量对牙根的影响。
使用SolidWorks软件(SolidWorks,沃尔瑟姆,马萨诸塞州)构建30个下颌中切牙的有限元模型,其根尖区域有1厘米的缺损。在根尖处进行0、1、2、3、4和5毫米的切除,并使用愈合骨、同种异体移植物、异种移植物和羟基磷灰石的材料特性,在空穴模型中模拟用于填充根尖部位的移植物的组织再生。在倾斜(45°)方向上对各组牙齿施加100牛的力,并使用Ansys 16版软件(ANSYS公司,卡农斯堡,宾夕法尼亚州)确定最大冯·米塞斯应力和位移值。
在切除5毫米的模型和空模型中观察到这些值中的最高值。切除量的增加导致应力和位移增加。在羟基磷灰石组中观察到最低的应力和变形值,其次是异种移植物组和同种异体移植物组。
本研究结果表明,向根尖缺损处植入移植物可为牙根结构切除提供生物力学支持。