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不同根管形态残根中应力分布的对比分析:评估 CAD/CAM 玻璃纤维和其他桩核材料。

Comparative analysis of stress distribution in residual roots with different canal morphologies: evaluating CAD/CAM glass fiber and other post-core materials.

机构信息

Department of Oral Implantology, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, No.117 North Street Nanjing Road, Shenyang, 110002, China.

The VIP Department, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, China.

出版信息

BMC Oral Health. 2024 Mar 15;24(1):337. doi: 10.1186/s12903-024-04109-9.

Abstract

BACKGROUND

The selection of post-core material holds significant importance in endodontically treated teeth, influencing stress distribution in the dental structure after restoration. The use of computer-aided design/computer-aided manufacturing (CAD/CAM) glass fiber post-core possesses a better adaptation for different root canal morphologies, but whether this results in a more favorable stress distribution has not been clearly established.

MATERIALS AND METHODS

This study employed finite element analysis to establish three models of post-core crown restoration with normal, oversized, and dumbbell-shaped root canals. The three models were restored using three different materials: CAD/CAM glass fiber post-core (CGF), prefabricated glass fiber post and resin core (PGF), and cobalt-chromium integrated metal post-core (Co-Cr), followed by zirconia crown restoration. A static load was applied and the maximum equivalent von Mises stress, maximum principal stress, stress distribution plots, and the peak of maximum displacement were calculated for dentin, post-core, crown, and the cement acting as the interface between the post-core and the dentin.

RESULTS

In dentin of three different root canal morphology, it was observed that PGF exhibited the lowest von Mises stresses, while Co-Cr exhibited the highest ones under a static load. CGF showed similar stress distribution to that of Co-Cr, but the stresses were more homogeneous and concentrated apically. In oversized and dumbbell-shaped root canal remnants, the equivalent von Mises stress in the cement layer using CGF was significantly lower than that of PGF.

CONCLUSIONS

In oversized root canals and dumbbell-shaped root canals, CGF has shown good performance for restoration of endodontically treated teeth.

CLINICAL RELEVANCE

This study provides a theoretical basis for clinicians to select post-core materials for residual roots with different root canal morphologies and should help to reduce the occurrence of complications such as root fracture and post-core debonding.

摘要

背景

在后牙牙本质内选择桩核材料对于修复后的牙体结构中的应力分布有重要影响。使用计算机辅助设计/计算机辅助制造(CAD/CAM)玻璃纤维桩核具有更好的适应不同根管形态的能力,但这是否会导致更有利的应力分布尚不清楚。

材料与方法

本研究采用有限元分析建立了三种具有正常、超大和哑铃形根管的桩核冠修复模型。三种模型使用三种不同的材料进行修复:CAD/CAM 玻璃纤维桩核(CGF)、预制玻璃纤维桩和树脂核(PGF)以及钴铬整体金属桩核(Co-Cr),然后进行氧化锆冠修复。施加静态负载,计算牙本质、桩核、牙冠和作为桩核与牙本质之间界面的粘结剂的最大等效 von Mises 应力、最大主应力、应力分布图和最大位移峰值。

结果

在三种不同根管形态的牙本质中,在静态负载下,PGF 表现出最低的 von Mises 应力,而 Co-Cr 则表现出最高的应力。CGF 表现出与 Co-Cr 相似的应力分布,但应力更均匀且集中在根尖。在超大和哑铃形根管残端中,使用 CGF 的粘结剂层中的等效 von Mises 应力明显低于 PGF。

结论

在超大根管和哑铃形根管中,CGF 对根管治疗后的牙齿修复表现出良好的性能。

临床意义

本研究为临床医生选择具有不同根管形态的残根的桩核材料提供了理论依据,有助于减少根折和桩核脱落等并发症的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1023/10943834/058e83b56000/12903_2024_4109_Fig1_HTML.jpg

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