Suppr超能文献

正畸力过大对牙周组织减少时牙髓及神经血管束产生的缺血性风险

Ischemic Risks Induced by Larger Orthodontic Forces on Dental Pulp and Neuro-Vascular Bundle in Reduced Periodontium.

作者信息

Moga Radu-Andrei, Olteanu Cristian Doru, Delean Ada Gabriela

机构信息

Department of Cariology, Endodontics and Oral Pathology, School of Dental Medicine, University of Medicine and Pharmacy Iuliu Hatieganu, Str. Motilor 33, 400001 Cluj-Napoca, Romania.

Department of Orthodontics, School of Dental Medicine, University of Medicine and Pharmacy Iuliu Hatieganu, Str. Avram Iancu 31, 400083 Cluj-Napoca, Romania.

出版信息

J Clin Med. 2024 Nov 7;13(22):6698. doi: 10.3390/jcm13226698.

Abstract

There are few data about the ischemic risks induced by the large orthodontic forces during periodontal breakdown in dental pulp and neuro-vascular bundle (NVB) and none on the individual tissular stress distribution, despite their great importance for orthodontic treatment planning. Our aim was to assess, by a numerical analysis, the biomechanical behavior of dental pulp and the NVB during a simulated horizontal periodontal breakdown (1-8 mm), under 2-4 N of applied orthodontic forces and five movements (rotation, translation, tipping, intrusion, and extrusion). Additionally, the ischemic and degenerative-resorptive risks were assessed. The analysis involved 72 3D models of nine patients, totaling 720 simulations. The models were CBCT-based, having the second lower premolar and surrounding periodontium, and they suffered 1 mm of gradual horizontal periodontal breakdown (up to 8 mm loss). Both forces displayed a similar qualitative stress distribution in all five movements, but with a quantitative increase (doubling of stress amounts for 4 N when compared with 2 N). The highest amounts of stress were displayed at 8 mm of periodontal loss, which is lower than the 16 KPa of the maximum hydrostatic pressure. The NVB stress was higher than the pulpal stress. Rotation was the most stressful, closely followed by tipping, intrusion, and extrusion. A total of 4 N of applied force seems to not induce any ischemic or degenerative-resorptive risks for healthy intact teeth, in up to 8 mm of periodontal breakdown. Intrusion and extrusion determined the highest visible tissular deformation in the NVB, with potential ischemic and resorptive-generative risks for previously traumatized/injured teeth (i.e., occlusal trauma). Rotation and translation (in particular) showed the highest coronal and radicular pulpal stress with potential ischemic and resorptive-generative risks for previously injured/traumatized dental pulp (i.e., direct-indirect pulp capping). It seems that 4 mm of periodontal breakdown could signal a clinical stress increase with potential ischemic and degenerative-resorptive risks for the previously traumatized/injured tissues.

摘要

关于在牙髓和神经血管束(NVB)发生牙周破坏期间,较大正畸力所引发的缺血风险的数据很少,而且对于个体组织应力分布的数据则完全没有,尽管这些数据对于正畸治疗计划非常重要。我们的目的是通过数值分析,评估在模拟水平牙周破坏(1 - 8毫米)过程中,在2 - 4牛顿的正畸力以及五种移动方式(旋转、平移、倾斜、压入和伸出)作用下,牙髓和NVB的生物力学行为。此外,还评估了缺血和退行性吸收风险。该分析涉及9名患者的72个三维模型,总共进行了720次模拟。这些模型基于锥形束计算机断层扫描(CBCT),包含下颌第二前磨牙及其周围的牙周组织,并且经历了1毫米的逐渐水平牙周破坏(牙周丧失达8毫米)。在所有五种移动方式中,两种力均呈现出相似的定性应力分布,但应力在数量上有所增加(与2牛顿相比,4牛顿时应力量翻倍)。牙周丧失8毫米时显示出最高应力量,该应力量低于最大静水压力的16千帕。NVB的应力高于牙髓的应力。旋转是压力最大的移动方式,紧随其后的是倾斜、压入和伸出。在牙周破坏达8毫米的情况下,施加4牛顿的力似乎不会对健康完好的牙齿引发任何缺血或退行性吸收风险。压入和伸出在NVB中导致了最高可见的组织变形,对于先前受过创伤/损伤的牙齿(即咬合创伤)存在潜在的缺血和吸收 - 再生风险。旋转和平移(特别是旋转)显示出最高的冠部和根部牙髓应力,对于先前受伤/受创伤的牙髓(即直接 - 间接牙髓盖髓术)存在潜在的缺血和吸收 - 再生风险。似乎牙周破坏4毫米可能预示着临床应力增加,对于先前受过创伤/损伤的组织存在潜在的缺血和退行性吸收风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8963/11594315/6ad91f991227/jcm-13-06698-g001.jpg

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验