Boțilă Mihaela-Roxana, Popa Dragos Laurențiu, Mercuț Răzvan, Iacov-Crăițoiu Monica Mihaela, Scrieciu Monica, Popescu Sanda Mihaela, Mercuț Veronica
Department of Prosthetic Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Department of Automotive, Transportation and Industrial Engineering, Faculty of Mechanics, University of Craiova, 200478 Craiova, Romania.
Bioengineering (Basel). 2024 Aug 29;11(9):878. doi: 10.3390/bioengineering11090878.
The design of the access cavity is an important factor in endodontic treatment for the further evolution of the tooth. The objective of this study was to highlight the most favorable access cavity design (TrussAC, UltraAC, TradAC, CariesAC, ConsAC, RestoAC) based on the stress distribution on virtual models of mandibular molars. To achieve the objectives of the study, four series of virtual models of six molars were made. The first two series of external virtual models were obtained based on the three-dimensional scanning of the molars before the access cavity preparation and after their restoration, to obtain the density of the restorative materials. Internal morphology was added to the next two series of virtual models and after that, materials were added, specific for root canal obturation and coronal restoration. The simulations were performed for two coronary restoration materials, bulk fill composite and amalgam. The results showed, based on the stress maps, that the highest values were recorded for CariesAC and the lowest values for UltraAC. Comparing the two restorative materials, the lowest level of stress, strains, and displacements was highlighted in the case of UltraAC, TradAC, and ConsAC cavities for amalgam. The results obtained in this study should guide doctors towards a conservative attitude with the preservation of as much hard tissue as possible and the differentiated use of restorative materials according to the amount of tissue lost when preparing the access cavity.
进入髓腔的设计是牙髓治疗中影响牙齿进一步发展的重要因素。本研究的目的是根据下颌磨牙虚拟模型上的应力分布，突出最有利的进入髓腔设计（桁架式髓腔、超常规髓腔、传统髓腔、龋坏性髓腔、保守性髓腔、修复性髓腔）。为实现本研究的目的，制作了四组共六个磨牙的虚拟模型。前两组外部虚拟模型是通过对磨牙在制备进入髓腔前和修复后的三维扫描获得的，以得到修复材料的密度。接下来的两组虚拟模型添加了内部形态，之后添加了用于根管充填和冠部修复的特定材料。针对两种冠部修复材料（大块充填复合树脂和汞合金）进行了模拟。基于应力图的结果显示，龋坏性髓腔记录到的应力值最高，而超常规髓腔的应力值最低。比较这两种修复材料，在使用汞合金时，超常规髓腔、传统髓腔和保守性髓腔的应力、应变和位移水平最低。本研究所得结果应引导医生采取保守态度，尽可能保留更多的硬组织，并根据制备进入髓腔时丢失的组织量区别使用修复材料。
