Department of Endodontics, Dental School, Shahed University, Tehran, Iran.
Endodontic Division, Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, Maryland.
J Endod. 2023 Dec;49(12):1690-1697. doi: 10.1016/j.joen.2023.09.014. Epub 2023 Oct 5.
This study aimed to assess the fracture resistance of mandibular first molars after preparation with 3 different access cavity designs and 2 rotary systems using finite element analysis.
Six 3-dimensionally printed mandibular first molars simulating natural teeth received traditional, conservative, and ultraconservative (truss) access cavity preparations. The root canals in each group were instrumented with either XP-Endo Shaper (FKG Dentaire, La Chaux-de-Fonds, Switzerland) or TruNatomy (Dentsply Sirona, Ballaigues, Switzerland) rotary files. The models were individually digitized, and micro-computed tomographic scans were transferred to Mimics software (Materialise NV, Leuven, Belgium) to create a geometric model of the tooth. The designed model was exported to 3-matic software (Materialise NV), and STL files were transferred to Geomagic Design X (3D Systems, Rock Hill, SC). Point cloud data were used for surfacing and transferred to ANSYS software (Ansys, Canonsburg, PA). A 200-N superficial force was applied vertically to the buccal cusps and central fossa, and the maximum and minimum equivalent von Mises stress values were calculated and reported.
The traditional and ultraconservative access cavity designs yielded the highest and the lowest von Mises stress values, respectively. In the ultraconservative cavity design, the stress values in pericervical dentin were lower in canal preparation with TruNatomy compared with XP-Endo Shaper. In the traditional and conservative cavity designs, stress was lower in the first 2 mm from the cementoenamel junction in the XP-Endo Shaper group and in the next 3 mm in the TruNatomy group.
Stress was lower in the ultraconservative and conservative cavity designs compared with the traditional design. Also, root canal preparation with TruNatomy yielded lower stress values in general compared with XP-Endo Shaper.
本研究旨在通过有限元分析评估 3 种不同的窝洞预备设计和 2 种旋转系统对下颌第一磨牙抗折能力的影响。
6 颗 3D 打印的下颌第一磨牙模拟天然牙,分别接受传统、保守和超保守(桁架)窝洞预备。每组的根管均用 XP-Endo Shaper(FKG Dentaire,La Chaux-de-Fonds,瑞士)或 TruNatomy(Dentsply Sirona,Ballaigues,瑞士)旋转锉进行器械预备。将模型单独数字化,并将微计算机断层扫描转移到 Mimics 软件(Materialise NV,Leuven,比利时)中创建牙齿的几何模型。设计模型被导出到 3-matic 软件(Materialise NV)中,STL 文件被转移到 Geomagic Design X(3D Systems,Rock Hill,SC)中。点云数据用于曲面建模,并被转移到 ANSYS 软件(Ansys,Canonsburg,PA)中。在颊尖和中央窝施加 200-N 的表面力,并计算和报告最大和最小等效 von Mises 应力值。
传统和超保守窝洞设计分别产生了最高和最低的 von Mises 应力值。在超保守窝洞设计中,与 XP-Endo Shaper 相比,TruNatomy 根管预备时牙颈部周围牙本质的应力值较低。在传统和保守窝洞设计中,XP-Endo Shaper 组在牙合方 2mm 范围内和 TruNatomy 组在牙合方 3mm 范围内的牙本质内的应力较低。
与传统设计相比,超保守和保守窝洞设计的应力较低。此外,与 XP-Endo Shaper 相比,TruNatomy 根管预备通常产生较低的应力值。