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不同桩长度的不同陶瓷材料修复与全瓷冠修复的根管治疗前牙的应力分布对比——三维有限元分析

Stress Distribution on Endodontically Treated Anterior Teeth Restored via Different Ceramic Materials with Varying Post Lengths Versus Endocrown-A 3D Finite Element Analysis.

作者信息

Soliman Mai, Almutairi Nawaf, Alenezi Ali, Alenezi Raya, Abo-Elmagd Amal Abdallah A, Abdelhafeez Manal M

机构信息

Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia.

Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraydah 52571, Saudi Arabia.

出版信息

J Funct Biomater. 2025 Jun 12;16(6):221. doi: 10.3390/jfb16060221.

Abstract

OBJECTIVE

This study aims to evaluate the stress distribution on endodontically treated anterior teeth restored using different restorative materials and different post lengths versus endocrowns employing finite element analysis (FEA).

METHODS

An extracted human central incisor tooth with a fully formed apex was scanned using high-resolution cone beam computed tomography (CBCT) to generate 3D finite element models. Six models of restorations of badly destructed central incisor were grouped according to the type of ceramic material and post length versus endocrown restorations. Group V-L: Vita Enamic, long post (10 mm intra-radicular), Group C-L: Celtra Duo, long post (10 mm intra-radicular), Group V-Sh: Vita Enamic, short post (3 mm intra-radicular), Group C-Sh: Celtra Duo, short post (3 mm intra-radicular), Group V-E: Vita Enamic endocrown (3 mm intra-radicular), and Group C-E: Celtra Duo endocrown (3 mm intra-radicular). A static load of 200 N was applied to the palatal surface at a 45 degree angle to the tooth's long axis. The maximum equivalent von Mises stress and maximum principal stress were analyzed at four locations: the finish line, coronal third of the root (12 mm from the apex), middle third of the root (8 mm from the apex), and apical third of the root (4 mm from the apex).

RESULTS

Group C-L exhibited the highest maximum VM stress and PS at the finish line, in addition to the highest maximum VM stress and PS at the root apical third, while group C-Sh reported the least maximum VM stress at the root apical third among the groups. All Celtra Duo groups reported higher maximum VM stress than the corresponding groups of Vita Enamic at the finish line and root coronal thirds. However, at the root middle and apical thirds, both materials recorded similar stresses.

CONCLUSIONS

Short posts and Vita Enamic endocrowns showed minimal stress, especially at the finish line, while long posts increased stress and fracture risk. The findings support conservative restorations without posts, although clinical validation is needed to confirm their long-term effectiveness and safety.

摘要

目的

本研究旨在通过有限元分析(FEA)评估使用不同修复材料和不同桩长度修复的根管治疗前牙与全瓷冠相比的应力分布情况。

方法

使用高分辨率锥形束计算机断层扫描(CBCT)对一颗根尖完全形成的拔除人中央切牙进行扫描,以生成三维有限元模型。根据陶瓷材料类型和桩长度与全瓷冠修复情况,将严重破坏的中央切牙的六种修复模型分组。V-L组:维他灵瓷聚合体,长桩(根管内10毫米),C-L组:Celtra Duo,长桩(根管内10毫米),V-Sh组:维他灵瓷聚合体,短桩(根管内3毫米),C-Sh组:Celtra Duo,短桩(根管内3毫米),V-E组:维他灵瓷聚合体全瓷冠(根管内3毫米),C-E组:Celtra Duo全瓷冠(根管内3毫米)。在与牙长轴呈45度角的腭面施加200 N的静载荷。在四个位置分析最大等效应力和最大主应力:龈缘、根冠三分之一处(距根尖12毫米)、根中三分之一处(距根尖8毫米)和根尖三分之一处(距根尖4毫米)。

结果

C-L组在龈缘处表现出最高的最大VM应力和PS,此外在根尖三分之一处也具有最高的最大VM应力和PS,而C-Sh组在各小组中根尖三分之一处的最大VM应力最小。所有Celtra Duo组在龈缘和根冠三分之一处的最大VM应力均高于相应的维他灵瓷聚合体组。然而,在根中三分之一和根尖三分之一处,两种材料的应力相似。

结论

短桩和维他灵瓷聚合体全瓷冠的应力最小,尤其是在龈缘处,而长桩会增加应力和骨折风险。这些发现支持无桩的保守修复,尽管需要临床验证来确认其长期有效性和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/365a/12194378/48c916039473/jfb-16-00221-g001.jpg

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