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用于修复1毫米和2毫米箍高度的上颌中切牙时,内冠与纤维桩核冠及铸造桩核冠的生物力学行为:三维静态线性有限元分析

Biomechanical behavior of endocrowns vs fiber post-core-crown vs cast post-core-crown for the restoration of maxillary central incisors with 1 mm and 2 mm ferrule height: A 3D static linear finite element analysis.

作者信息

Li Xixi, Kang Ting, Zhan Danting, Xie Jing, Guo Ling

机构信息

Department of prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, Luzhou.

Department of Stomatology, The First People's Hospital of Shuangliu District.

出版信息

Medicine (Baltimore). 2020 Oct 23;99(43):e22648. doi: 10.1097/MD.0000000000022648.

Abstract

To analyze the stress distribution of the maxillary central incisor with oblique fracture, repaired by different methods, using 3-dimensional finite element analysis. From the biomechanical point of view, it is expected to provide a reference for clinical selection of restoration method which is more conducive to stress distribution and preservation of dental tissue as much as possible.Use cone beam CT and finite element software to establish the finite element models of the maxillary central incisor with oblique fracture, and then create models according to 5 repairing methods(A. fiber post-core-crown group; B. cast post-core-crown group; C.3 mm deep endocrown; D.4 mm deep endocrown; E.5 mm deep endocrown)after root canal treatment, and analyze the Von Mises equivalent stress and maximum principal stress distribution and peak value of each model.When the height of dentin ferrule was fixed, the value of the Von Mises equivalent stress and the maximum principal stress in residual tooth tissue: group A was the highest, and there was no significant difference in group B, C, D and E. And the stress distribution area of 5 groups were the same. In prosthodontic layer: group B was the highest, while group A was the lowest, and the stress peak slightly increased with the increase of depth in group C, D and E. And the 5 groups were with the same stress distribution area as well. In adhesive layer: group A was the highest, while group B was the lowest, and there was little difference among group C, D and E. Group A was concentrated in 1/3 of the post tip, while group B,C,D and E were concentrated in 1/3 of the post and the post tips.Complete and high enough dentin ferrule is a requirement for repairing heavily defected maxillary central incisor with fiber post-core crown and cast post-core crown. When the dentin ferrule is incomplete, the stress distribution of the endocrown is more excellent than post-core-crown. And the endocrown with a depth of 3 mm retainer may be the best repair method. As for post-core crown restoration, the cast post-core crown is more favorable for the uniform distribution of residual tooth tissue than the fiber post-core crown.

摘要

采用三维有限元分析方法,分析不同修复方法修复上颌中切牙斜折后的应力分布情况。从生物力学角度出发,期望为临床选择更有利于应力分布及尽可能保留牙体组织的修复方法提供参考。利用锥形束CT和有限元软件建立上颌中切牙斜折的有限元模型,然后根据根管治疗后的5种修复方法(A.纤维桩核冠组;B.铸造桩核冠组;C.3mm深的嵌体冠;D.4mm深的嵌体冠;E.5mm深的嵌体冠)创建模型,并分析各模型的Von Mises等效应力、最大主应力分布及峰值。当牙本质肩领高度固定时,剩余牙体组织中的Von Mises等效应力和最大主应力值:A组最高,B、C、D、E组无显著差异。且5组的应力分布区域相同。在修复体层:B组最高,A组最低,C、D、E组应力峰值随深度增加略有升高。且5组的应力分布区域也相同。在粘结层:A组最高,B组最低,C、D、E组之间差异不大。A组集中在桩尖的1/3处,而B、C、D、E组集中在桩体及桩尖的1/3处。完整且足够高的牙本质肩领是用纤维桩核冠和铸造桩核冠修复严重缺损上颌中切牙的必要条件。当牙本质肩领不完整时,嵌体冠的应力分布比桩核冠更优。且3mm深固位体的嵌体冠可能是最佳修复方法。对于桩核冠修复,铸造桩核冠比纤维桩核冠更有利于剩余牙体组织的应力均匀分布。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6ed4/7581096/2e756935f85a/medi-99-e22648-g002.jpg

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