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单保持器与双保持器后 RBFDP 经咀嚼模拟后的保持力耐久性。

Retention durability of one-retainer versus two-retainer posterior RBFDPs after chewing simulation.

机构信息

Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel, Germany; Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel, Germany.

出版信息

J Mech Behav Biomed Mater. 2022 Sep;133:105353. doi: 10.1016/j.jmbbm.2022.105353. Epub 2022 Jul 8.

Abstract

The clinical use of one-retainer RBFDPs in the anterior region has shown higher survival rates compared to conventional two-retainer RBFDPs. The motivation for this study was to assess the validity of this observation when extended to the posterior region. The aim was thus to evaluate different preparation and framework designs for replacing premolars, particularly one-retainer versus two-retainer designs, on the retention of monolithic zirconia posterior RBFDPs. Extracted caries-free human premolars and third molars were embedded in auto-curing resin to create models with an edentulous space of premolar width. Abutment teeth were prepared according to these six designs (n = 8 each): one or two upper retainers with narrow rests, one or two upper retainers with wide rests, and one or two-retainers with wide rests. RBFDPs were milled from monolithic zirconia (KATANA Zirconia HT), and were adhesively bonded using Panavia V5 with corresponding primers. After thermodynamic loading, the quasi-static tensile force required for failure was determined. Failure modes were evaluated using a microscope. Survival rates after thermodynamic loading were 75% for one group (one upper-molar retainer with narrow rest), 100% for the other groups. The debonding forces ranged from 310 ± 224 N (group one upper-molar retainer with narrow rest) to 927 ± 292 N (group two upper retainers with narrow rests). Two-retainer designs failed at significantly higher tensile forces than designs with one retainer (p ≤ 0.05). There were no significant differences between upper and lower designs, or rest widths. Although RBFDPs with two retainers withstood higher debonding forces, RBFDPs with one retainer and wide rest still have a high potential for clinical treatment because of the high forces required for their debonding.

摘要

单保持架 RBFDP 在 前牙区的临床应用显示出比传统的双保持架 RBFDP 更高的存活率。本研究的动机是评估将这一观察结果扩展到后牙区的有效性。因此,目的是评估用于替代前磨牙的不同预备体和框架设计,特别是单保持架与双保持架设计,以评估单保持架与双保持架设计对整体氧化锆后牙 RBFDP 的保留力。从无龋的人上颌前磨牙和第三磨牙中提取出来,并嵌入自固化树脂中,以创建具有前磨牙宽度的无牙空间模型。根据这六种设计(每组 8 个)制备基牙:带有窄支托的一个或两个上保持架、带有宽支托的一个或两个上保持架以及带有宽支托的一个或两个保持架。RBFDP 由整体氧化锆(KATANA Zirconia HT)铣削而成,并使用 Panavia V5 及其相应的底漆进行胶接。在热力学加载后,确定失效所需的准静态拉伸力。使用显微镜评估失效模式。热力学加载后的存活率为 75%(一组为上颌单磨牙保留架,带有窄支托),100%(其他组)。离解力范围为 310±224 N(一组上颌单磨牙保留架,带有窄支托)至 927±292 N(两组上颌双保留架,带有窄支托)。双保持架设计的失效拉伸力明显高于单保持架设计(p≤0.05)。上、下设计或支托宽度之间没有显著差异。尽管带有两个保持架的 RBFDP 承受了更高的离解力,但由于其离解所需的高力,带有一个保持架和宽支托的 RBFDP 仍然具有很高的临床治疗潜力。

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