使用不同桩核冠材料修复的根管治疗上颌中切牙的三维有限元研究
Three-Dimensional Finite Element Study of Endodontically Treated Maxillary Central Incisors Restored Using Different Post and Crown Materials.
作者信息
Kharboutly Nour Al-Deen, Allaf Mirza, Kanout Shaza
机构信息
Department of Fixed Prosthodontics, Faculty of Dental Medicine, Damascus University, Damascus, SYR.
出版信息
Cureus. 2023 Jan 14;15(1):e33778. doi: 10.7759/cureus.33778. eCollection 2023 Jan.
BACKGROUND/PURPOSE: Restoring endodontically treated teeth is a common problem in dental practice. Post and core restorations are one of the major options in the rehabilitation of these teeth. However, there is no final decision regarding the best material or technique to be used with these restorations. So, this study aimed to evaluate the effect of different post and crown materials on the biomechanical behavior of restored maxillary central incisor using the finite element method.
MATERIALS AND METHODS
A total of 10 3D models of endodontically treated maxillary central incisors restored with two prefabricated posts and three custom-made posts were modeled and grouped according to post material (gold, nickel-chrome, zirconia, and glass fiber) and crown material (lithium disilicate, and zirconia). Finite element analysis was conducted, and stress distribution was evaluated using von Mises criteria.
RESULTS
Both crown materials showed stress concentration at the force application site mainly on the intaglio palatal surface of the crown. However, more stress values were observed within zirconia crowns. All posts showed stress concentration at their buccal sides. However, more stress values were observed in zirconia and metal cast posts compared to glass fiber posts that transfer more stress to root dentin.
CONCLUSIONS
Post and crown materials affect the stress distribution in the tooth-restoration complex. Using high elastic modulus posts slightly decreased stress in root dentin despite concentrating more stress within their structure. However, glass fiber posts resulted in more homogenous stress distribution in the tooth-restoration complex. Crown material did not influence the stress distribution in root dentin. Custom-made posts decreased stress within crowns, regardless of the crown material. However, more stress values were observed within zirconia crowns. Custom-made zirconia posts and cores showed a similar stress distribution as non-precious metal cast posts, so they may be used as a suitable option where esthetic is desirable.
背景/目的：修复经过根管治疗的牙齿是牙科临床中常见的问题。桩核修复是这些牙齿修复的主要选择之一。然而，对于这些修复体使用的最佳材料或技术尚无最终定论。因此，本研究旨在使用有限元方法评估不同桩核材料对修复后的上颌中切牙生物力学行为的影响。
材料与方法
共建立10个经过根管治疗的上颌中切牙的三维模型，这些模型分别用两种预成桩和三种定制桩进行修复，并根据桩材料（金、镍铬、氧化锆和玻璃纤维）和冠材料（二硅酸锂和氧化锆）进行分组。进行有限元分析，并使用冯·米塞斯准则评估应力分布。
结果
两种冠材料在力的作用部位均显示应力集中，主要位于冠的腭侧内表面。然而，氧化锆冠内观察到更多的应力值。所有桩在其颊侧均显示应力集中。然而，与将更多应力传递至牙根牙本质的玻璃纤维桩相比，氧化锆桩和金属铸造桩中观察到更多的应力值。
结论
桩核材料会影响牙齿修复复合体中的应力分布。使用高弹性模量的桩尽管会在其结构内集中更多应力，但会略微降低牙根牙本质中的应力。然而玻璃纤维桩在牙齿修复复合体中产生更均匀的应力分布。冠材料不影响牙根牙本质中的应力分布。定制桩可降低冠内的应力，无论冠材料如何。然而，氧化锆冠内观察到更多的应力值。定制氧化锆桩核显示出与非贵金属铸造桩相似的应力分布，因此在需要美观的情况下它们可作为合适的选择。
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