Nawar Nawar Naguib, Elkholy Mostafa M A, Ha William Nguyen, Saber Shehabeldin Mohamed, Kim Hyeon-Cheol
Department of Endodontics, Faculty of Dentistry, The British University in Egypt, Cairo, Egypt.
Department of Endodontics, Faculty of Dentistry, The British University in Egypt, Cairo, Egypt; School of Dentistry, University of Western Australia, Perth, Western Australia, Australia.
J Endod. 2023 May;49(5):567-574. doi: 10.1016/j.joen.2023.03.007. Epub 2023 Mar 23.
This study investigated the effect of shaping parameters of 2 different configurations of middle mesial canals (MMCs) on the biomechanical behavior and life span of a mandibular first molar using finite element analysis (FEA).
A mandibular molar with an independent MMC and another with a confluent MMC were scanned via micro-computed tomography, and FEA models were produced. For each tooth, an intact model and 5 experimental models were produced that differed by parameters of how the MMC was shaped: unshaped MMC, 25/.04, 25/.06, 30/.04, and 30/.06. Cyclic loading of 50 N was applied on the occlusal surface in vertical and oblique scenarios, and the number of cycles until failure (NCF) was compared with the intact models. In addition, mathematical analyses evaluated the stress distribution patterns and calculated maximum von Mises and maximum principal stresses.
For both the independent and confluent MMC models, shaping the MMC reduced the NCF. The lifelog percentage of models was inversely proportional with radicular shaping parameters during the vertical and oblique loading scenarios. The shaping size of 30/.06 resulted in lower lifelog percentage than the cases with shaping size of 25/.04 in both of the independent and confluent MMC models. For all models, oblique loading reduced NCF more than vertical loading.
Shaping the MMC should be kept as conservative as 25/.04. Also, whether the MMC is independent or confluent is a deciding factor in whether to increase the apical diameter or the root canal taper when larger shaping parameters are needed.
本研究采用有限元分析(FEA),调查了下颌第一磨牙中近中根管(MMC)两种不同形态的成形参数对其生物力学行为和寿命的影响。
通过微计算机断层扫描对具有独立MMC的下颌磨牙和具有融合MMC的下颌磨牙进行扫描,并建立FEA模型。对于每颗牙齿,制作了一个完整模型和5个实验模型,这些模型因MMC的成形参数不同而有所差异:未成形的MMC、25/.04、25/.06、30/.04和30/.06。在垂直和倾斜情况下,在咬合面上施加50 N的循环载荷,并将直至失效的循环次数(NCF)与完整模型进行比较。此外,通过数学分析评估应力分布模式,并计算最大von Mises应力和最大主应力。
对于独立MMC模型和融合MMC模型,对MMC进行成形均降低了NCF。在垂直和倾斜加载情况下,模型的寿命百分比与根管成形参数成反比。在独立MMC模型和融合MMC模型中,30/.06的成形尺寸导致的寿命百分比均低于25/.04的成形尺寸情况。对于所有模型,倾斜加载比垂直加载更能降低NCF。
MMC的成形应保持在尽可能保守的25/.04。此外,当需要更大的成形参数时,MMC是独立还是融合是决定是否增加根尖直径或根管锥度的一个因素。