Guduk Omer Faruk, Sivrikaya Efe Can, Yilmaz Nagehan, Baygin Ozgul, Tuzuner Tamer
Trabzon Oral and Dental Health Hospital, Trabzon, Turkey.
Department of Oral Maxillofacial Surgery, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey.
Technol Health Care. 2022;30(5):1199-1207. doi: 10.3233/THC-213505.
Stainless steel crowns (SSCs), which have been used frequently in the treatment of first permanent molars in children until now, has become less applicable due to its poor aesthetic appearance. Zirconia crowns (ZCs) have become more popular due to their aesthetic advantage. However, stress transmission of ZCs to dental tissues under occlusal forces in endodontically treated teeth has not been described.
The aim of this study was to compare the stress distribution of different crown materials (ZCS, SSCs) and adhesive materials on dentin in endodontically treated permanent teeth and to specify the crown-adhesive model with lower stress.
Finite element analysis (FEA) was used to apply a force of 300 N from the inner part of the buccal tubercles (vertical loading) and a lingo-buccal at an angle of 30 degrees (oblique loading) of the first permanent molars (FPM) with different crown (ZCS, SSCs) and adhesive (Glass ionomer cement, Resin modified glass ionomer cement, Resin cement) materials in twelve separate models. The von Mises values obtained from the models were compared and the optimal stress values were determined by FEA.
The lowest stress values of dentin were found in zirconia crown model with glass ionomer cement (GIC) adhesive under vertical loading (26,793 Mpa). In the zircon crown and GIC adhesive model, less von Mises stress occurred on the dentin under all conditions.
ZCs and GIC adhesive may be recommended for teeth with a high probability of dentin fracture.
迄今为止，不锈钢冠（SSCs）常用于儿童第一恒磨牙的治疗，但因其美观性差，应用越来越少。氧化锆冠（ZCs）因其美观优势而更受欢迎。然而，尚未有关于根管治疗后牙齿在咬合力作用下氧化锆冠向牙体组织应力传递的描述。
本研究旨在比较不同冠材料（ZCS、SSCs）和粘结材料对根管治疗后恒牙牙本质应力分布的影响，并确定应力较低的冠 - 粘结模型。
采用有限元分析（FEA），在12个独立模型中，对第一恒磨牙（FPM）施加来自颊结节内部的300 N力（垂直加载）以及与舌 - 颊呈30度角的力（斜向加载），模型采用不同的冠（ZCS、SSCs）和粘结剂（玻璃离子水门汀、树脂改性玻璃离子水门汀、树脂水门汀）材料。比较模型得到的冯·米塞斯值，并通过有限元分析确定最佳应力值。
在垂直加载下，使用玻璃离子水门汀（GIC）粘结剂的氧化锆冠模型中牙本质的应力值最低（26,793 Mpa）。在氧化锆冠和GIC粘结剂模型中，在所有条件下牙本质上产生的冯·米塞斯应力较小。
对于牙本质骨折可能性高的牙齿，可推荐使用氧化锆冠和GIC粘结剂。
