Huang Yuting, Fokkinga Wietske A, Zhang Qian, Creugers Nico H J, Jiang Qianzhou
Department of Endodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou, 510182, Guangdong, China.
Department of Oral Function and Prosthetic Dentistry, College of Dental Science, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.
J Mech Behav Biomed Mater. 2023 Apr;140:105691. doi: 10.1016/j.jmbbm.2023.105691. Epub 2023 Jan 24.
To compare the biomechanical properties of different endocrown designs on endodontically treated teeth with an extensive defect in the mesial wall using a three-dimensional finite element method (3D FEM).
Four finite element analysis models were designed and built up based on different endocrown configurations in a mandibular molar. One model was designed as a butt joint preparation with 2 mm occlusal thickness(control), the other three models were butt joint designs with different distances between the bottom of the mesial wall preparation and the cemento-enamel junction (CEJ): 2 mm, 1 mm and 0 mm respectively. A vertical load parallel with the longitudinal axis of the tooth and an oblique load with a 45°angle to the longitudinal axis were applied to the occlusal surfaces. The maximum Von Misses (VM) stresses and stress distribution patterns were calculated and compared. Weibull risk-of-rupture analysis was used to analyze the survival probability of the restorations and tooth in the different models.
For the restoration, the model with a mesial wall destruction at the level of CEJ showed much higher risk of failure than other models. Overall, none of the four models showed failure. Under oblique loading, VM stress in the cement layer of the models with a mesial wall defect was higher than in the control model. In the dentin, the highest VM stresses were found in the peri-cervical dentin. Under the oblique loading, the model with the mesial wall destruction at the level of CEJ restored by endocrown showed the highest risk of failure.
Under the oblique loading, with the increase of the simulated defect in the mesial wall, the peak VM stress values in the cement layer increased accordingly. In the model with a mesial wall defect up to the level of CEJ risk of failure was highest in the cervical dentin.
采用三维有限元方法(3D FEM)比较不同内冠设计对近中壁存在大面积缺损的根管治疗后牙齿生物力学性能的影响。
基于下颌磨牙不同的内冠结构设计并建立四个有限元分析模型。一个模型设计为咬合面厚度2mm的对接预备(对照),另外三个模型为近中壁预备底部与牙骨质-釉质界(CEJ)距离不同的对接设计:分别为2mm、1mm和0mm。在咬合面上施加与牙齿纵轴平行的垂直载荷和与纵轴成45°角的斜向载荷。计算并比较最大冯·米塞斯(VM)应力和应力分布模式。采用威布尔断裂风险分析来分析不同模型中修复体和牙齿的存活概率。
对于修复体,近中壁破坏至CEJ水平的模型比其他模型显示出更高的失败风险。总体而言,四个模型均未显示失败。在斜向载荷下,近中壁有缺损的模型中粘固层的VM应力高于对照模型。在牙本质中,最高的VM应力出现在颈周牙本质。在斜向载荷下,采用内冠修复的近中壁破坏至CEJ水平的模型显示出最高的失败风险。
在斜向载荷下,随着模拟近中壁缺损的增加,粘固层中的VM应力峰值相应增加。在近中壁缺损至CEJ水平的模型中,颈周牙本质的失败风险最高。