牙周支持组织减少的牙齿的功能负荷能力:有限元分析
Functional Load Capacity of Teeth with Reduced Periodontal Support: A Finite Element Analysis.
作者信息
Dederichs Marco, Joedecke Paul, Weber Christian-Toralf, Guentsch Arndt
机构信息
Policlinic of Prosthetic Dentistry and Material Science, Centre for Dental Medicine, Jena University Hospital, D-07743 Jena, Germany.
Department of Engineering and Industrial Design, Magdeburg-Stendal University of Applied Sciences, D-39114 Magdeburg, Germany.
出版信息
Bioengineering (Basel). 2023 Nov 18;10(11):1330. doi: 10.3390/bioengineering10111330.
The purpose of this study was to investigate the functional load capacity of the periodontal ligament (PDL) in a full arch maxilla and mandible model using a numerical simulation. The goal was to determine the functional load pattern in multi- and single-rooted teeth with full and reduced periodontal support. CBCT data were used to create 3D models of a maxilla and mandible. The DICOM dataset was used to create a CAD model. For a precise description of the surfaces of each structure (enamel, dentin, cementum, pulp, PDL, gingiva, bone), each tooth was segmented separately, and the biomechanical characteristics were considered. Finite Element Analysis (FEA) software computed the biomechanical behavior of the stepwise increased force of 700 N in the cranial and 350 N in the ventral direction of the muscle approach of the masseter muscle. The periodontal attachment (cementum-PDL-bone contact) was subsequently reduced in 1 mm increments, and the simulation was repeated. Quantitative (pressure, tension, and deformation) and qualitative (color-coded images) data were recorded and descriptively analyzed. The teeth with the highest load capacities were the upper and lower molars (0.4-0.6 MPa), followed by the premolars (0.4-0.5 MPa) and canines (0.3-0.4 MPa) when vertically loaded. Qualitative data showed that the areas with the highest stress in the PDL were single-rooted teeth in the cervical and apical area and molars in the cervical and apical area in addition to the furcation roof. In both single- and multi-rooted teeth, the gradual reduction in bone levels caused an increase in the load on the remaining PDL. Cervical and apical areas, as well as the furcation roof, are the zones with the highest functional stress. The greater the bone loss, the higher the mechanical load on the residual periodontal supporting structures.
本研究的目的是使用数值模拟研究全牙弓上颌骨和下颌骨模型中牙周韧带(PDL)的功能负荷能力。目标是确定牙周支持完整和减少的多根牙和单根牙的功能负荷模式。使用CBCT数据创建上颌骨和下颌骨的3D模型。DICOM数据集用于创建CAD模型。为了精确描述每个结构(牙釉质、牙本质、牙骨质、牙髓、PDL、牙龈、骨)的表面,每个牙齿都单独进行分割,并考虑其生物力学特性。有限元分析(FEA)软件计算了咬肌肌肉入路方向上颅骨方向700 N和腹侧方向350 N逐步增加力的生物力学行为。随后,牙周附着(牙骨质-PDL-骨接触)以1 mm的增量减少,并重复模拟。记录定量(压力、张力和变形)和定性(彩色编码图像)数据并进行描述性分析。垂直加载时,负荷能力最高的牙齿是上颌和下颌磨牙(0.4-0.6 MPa),其次是前磨牙(0.4-0.5 MPa)和犬齿(0.3-0.4 MPa)。定性数据表明,PDL中应力最高的区域是颈部和根尖区域的单根牙以及颈部和根尖区域的磨牙以及分叉顶部。在单根牙和多根牙中,骨水平的逐渐降低都会导致剩余PDL上的负荷增加。颈部和根尖区域以及分叉顶部是功能应力最高的区域。骨丢失越多,残余牙周支持结构上的机械负荷就越高。