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如何在牙齿缺损治疗中自适应地平衡“经典”或“保守”方法:一项三维有限元分析研究

How to adaptively balance 'classic' or 'conservative' approaches in tooth defect management: a 3D-finite element analysis study.

作者信息

Xu Jiani, Liang Xu, Hu Lili, Sun Chen, Zhang Zhipeng, Yang Jiawei, Wang Jie

机构信息

Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

State Key Laboratory of Ocean Engineering, School of Naval Architecture, Ocean and Civil Engineering, Shanghai Jiao Tong University, Shanghai, China.

出版信息

BMC Oral Health. 2025 May 31;25(1):865. doi: 10.1186/s12903-025-06178-w.

Abstract

BACKGROUND

The widespread adoption of resin-based composites has increased interest in minimally invasive treatment strategies that prioritize the preservation of sound dentin. While classic cavity preparation techniques remain clinically relevant, the optimal cavity design for ensuring restoration longevity and residual tooth structure integrity remains uncertain. This study aims to investigate the influence of cavity dimensions on the mechanical performance of resin composites and natural tooth structures using finite element analysis (FEA). By evaluating stress distribution across different cavity configurations, this study seeks to determine the optimal cavity design for various tooth defects, ultimately offering insights into effectively balancing conventional and conservative cavity preparation principles.

METHODS

Twelve Class II cavity models with varying lengths (L), widths (W), and depths (D) were generated using a single extracted natural tooth. A vertical occlusal load of 500 N was applied, and interactions among the different model components were simulated using tie constraints. The distribution of maximum principal stress (MaxPS) was analyzed via static linear FEA.

RESULTS

Medium-sized cavities exhibited relatively lower stress concentrations. The depth, width, and length of the cavities significantly influenced the MaxPS values. Notably, cavities with a depth of 2/3 demonstrated lower MaxPS values compared to both shallower and deeper counterparts (Dentin: W-D-L: 61.499 MPa; W-D-L: 32.796 MPa; W-D-L: 38.724 MPa). Additionally, cavities with full-length configurations exhibited lower MaxPS values than those with 4/5-length designs (Dentin: W-D-L: 44.929 MPa; W-D-L: 73.362 MPa).

CONCLUSION

Cavity dimensions play a critical role in influencing stress distribution within both the restorative material and the tooth structure, underscoring the need to optimize cavity size. These findings support decision-making during cavity preparation, highlighting the trade-off between preserving tooth structure and ensuring mechanical stability. It is important to note that this approach should not be considered as a one-size-fit-all recommendation, but rather as a case-specific strategy tailored to the unique clinical conditions of each patient.

摘要

背景

树脂基复合材料的广泛应用使得人们对优先保留健康牙本质的微创治疗策略越来越感兴趣。虽然经典的窝洞预备技术在临床上仍然具有相关性,但确保修复体长期使用和剩余牙体结构完整性的最佳窝洞设计仍不明确。本研究旨在使用有限元分析(FEA)研究窝洞尺寸对树脂复合材料和天然牙体结构力学性能的影响。通过评估不同窝洞构型的应力分布,本研究旨在确定各种牙齿缺损的最佳窝洞设计,最终为有效平衡传统和保守窝洞预备原则提供见解。

方法

使用一颗拔除的天然牙生成12个具有不同长度(L)、宽度(W)和深度(D)的II类窝洞模型。施加500 N的垂直咬合载荷,并使用绑定约束模拟不同模型组件之间的相互作用。通过静态线性有限元分析来分析最大主应力(MaxPS)的分布。

结果

中等尺寸的窝洞表现出相对较低的应力集中。窝洞的深度、宽度和长度显著影响MaxPS值。值得注意的是,深度为2/3的窝洞与较浅和较深的窝洞相比,MaxPS值更低(牙本质:W-D-L:61.499兆帕;W-D-L:32.796兆帕;W-D-L:38.724兆帕)。此外,全长构型的窝洞比4/5长度设计的窝洞表现出更低的MaxPS值(牙本质:W-D-L:44.929兆帕;W-D-L:73.362兆帕)。

结论

窝洞尺寸在影响修复材料和牙体结构内的应力分布方面起着关键作用,强调了优化窝洞大小的必要性。这些发现为窝洞预备过程中的决策提供了支持,突出了保留牙体结构和确保机械稳定性之间的权衡。需要注意的是,这种方法不应被视为一刀切式的建议,而应作为根据每个患者独特临床情况量身定制的具体策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c466/12125724/969ee471ef2d/12903_2025_6178_Fig1_HTML.jpg

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