中国组织工程研究

中国组织工程研究 ›› 2018, Vol. 22 ›› Issue (18): 2877-2883.doi: 10.3969/j.issn.2095-4344.0876

• 组织工程口腔材料 tissue-engineered oral materials • 上一篇    下一篇

两种粘接剂的近中-合-远中洞型金合金嵌体三维有限元模型及应力分析

胡 杨1，冯 明2，祝 军3   

  1. 1新疆医科大学第一附属医院口腔修复科，新疆维吾尔自治区乌鲁木齐市 830054；2新疆维吾尔自治区乌鲁木齐市口腔医院牙体牙髓科，新疆维吾尔自治区乌鲁木齐市 830054；3上海市宝山区罗店医院口腔科，上海市 201908
  • 收稿日期:2018-05-10 出版日期:2018-06-28 发布日期:2018-06-28
  • 通讯作者: 祝军，主任医师，上海市宝山区罗店医院口腔科，上海市 201908
  • 作者简介:胡杨，男，1983年生，湖北省黄冈市人，汉族，2009年新疆医科大学毕业，硕士，主治医师，主要从事组织工程骨和牙支架材料研究。
  • 基金资助:

    新疆维吾尔自治区重点研发任务专项基金(2016B03049-2)

Stress analysis of two kinds of adhesives used in a three-dimensional finite element model of mesio-occluso-distal cavity gold alloy inlay

Hu Yang1, Feng Ming2, Zhu Jun3   

  1. 1Department of Prosthodontics, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China; 2Department of Endodontics, Stomatological Hospital of Urumqi, Urumqi 830054, Xinjiang Uygur Autonomous Region, China; 3Department of Stomatology, Luodian Hospital of Baoshan District in Shanghai, Shanghai 201908, China
  • Received:2018-05-10 Online:2018-06-28 Published:2018-06-28
  • Contact: Zhu Jun, Chief physician, Department of Stomatology, Luodian Hospital of Baoshan District in Shanghai, Shanghai 201908, China
  • About author:Hu Yang, Master, Attending physician, Department of Prosthodontics, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
  • Supported by:

    the Special Fund for Major Research and Development Tasks in Xinjiang Uygur Autonomous Region, No. 2016B03049-2

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摘要：

文章快速阅读：

 

文题释义：
金合金嵌体：因龋病、创伤、酸蚀症等病因导致的牙体缺损患者逐渐增多，随着患者日益增高的口腔修复需求，迎合全球牙体缺损修复精细化、固定化及微创修复等新兴修复理念，口腔临床医师和患者多倾向于选择嵌体修复。金合金嵌体修复在牙体缺损修复领域有着悠久的临床应用历史，是指黄金含量在70%及以上金合金粉制作的嵌体修复体，关于嵌体临床洞型设计和粘结剂选择，国内外学者尚未达到共识。
三维有限元模型：牙体缺损修复的难题在于口腔复杂咬合应力环境、微生物代谢及电化学腐蚀，唾液和潮湿的环境，多种因素易造成牙体缺损修复体和粘接界面破坏。其中口腔修复体与咬合应力、粘接界面应力集中和分布区域，剩余牙体组织抗力形及固位形预估和设计是研究热点。三维有限元模型是指利用计算机数学算法对口颌系统(几何和载荷工况)进行模拟。利用简单而又相互作用的元素(即单元)，用有限数量的未知量去推算无限未知量的真实系统。可模拟口颌系统咬合应力施加环境，便于分析咬合应力与修复体、粘接界面和剩余牙体组织的应力状况，优化金合金嵌体洞型设计和粘结剂选择。
 
 
背景：金合金嵌体在后牙牙体缺损的修复领域应用历史悠久，作为嵌体修复领域的金标准，其优异的机械性能和生物相容性得到长期认可。然而，国内外口腔界关于金合金嵌体的洞型设计、粘接剂选择、粘接界面应力分析、剩余牙体组织抗力形和固位形设计和预估，尚未达到一致共识，需进一步研究以期提高金合金嵌体远期成功率。

目的：建立右下颌第三磨牙近中-合-远中洞型金合金嵌体三维有限元模型，探究不同洞型深度下，3M RelyX Unicem和vario-link树脂粘接剂粘接金合金嵌体后，粘接界面和牙体组织应力分布规律及特点。

方法：采用Micro-CT扫描，Mimics、Goemagic Studio、NX 10.0等软件，建立不同深度和粘接剂的右下颌第三磨牙近中-合-远中洞型金合金嵌体三维有限元模型。其中模型A：合面洞型深度为1 mm，合面宽度为    3 mm，3M RelyX Unicem树脂粘结剂；模型B：合面洞型深度为2 mm，合面宽度为3 mm，3M RelyX Unicem树脂粘结剂；模型C：合面洞型深度为4 mm，合面宽度为3 mm，3M RelyX Unicem树脂粘结剂；模型D：合面洞型深度为1 mm，合面宽度为3 mm，vario-link树脂粘接剂；模型E：合面洞型深度为2 mm，合面宽度为3 mm，vario-link树脂粘接剂；模型F：合面洞型深度为4 mm，合面宽度为3 mm, vario-link树脂粘接剂。用ANSYS Workbench软件网格划分，并分析各模型在10 N•mm转矩、垂直载荷600 N和舌向45°加载175 N条件下应力分布情况。

结果与结论：不同洞深及粘接剂条件下，舌向45°加载175 N条件下各模型后，在洞深2 mm时，牙根等效应力最小，适宜金合金嵌体和vario-link粘接修复。垂直载荷600 N后，对于牙根等效应力，模型F高于模型C；对于牙根最大主应力，模型D高于模型A；对于粘接剂等效应力，vario-link树脂粘接剂模型较大。提示4 mm深度时，vario-link粘接界面产生的牙根部破坏性应力较大。各模型的应力集中区域为根分叉区、髓室顶、龈壁、近中或远中根颈1/3处。提示不同洞深、粘接剂和加载条件下，应力集中大小和区域有所不同，应避免过浅(< 1 mm)或过深近中-合-远中洞型(> 4 mm)洞型设计，3M RelyX Unicem 和vario-link均可作为金合金嵌体粘接剂，但需进一步临床实验验证三维有限元模型分析结果。

ORCID: 0000-0002-5014-6142(胡杨) 

关键词: 嵌体, 金合金, 近中-合-远中洞型, 三维有限元模型, 粘接剂, 粘接界面, 应力, 牙体缺损, 生物材料

Abstract:

BACKGROUND: Gold alloy inlays have a long history of application in the repair of posterior dental defects. As the gold standard for inlay repair, its excellent mechanical properties and biocompatibility have long been recognized. However, there is no consensus on the design of gold alloy inlays, selection of adhesives, stress analysis of the bonding interface, and design and assessment of resistance and retention forms of the remaining tooth tissues. Further investigation is beneficial to increase the long-term success in gold alloy inlays.

OBJECTIVE: To establish a three-dimensional finite element model of mesio-occluso-distal cavity (MOD) gold inlay of the third molar in the right mandible, and after the use of 3M RelyX Unicem and vario-link resin adhesive to bond the gold alloy inlay, to explore the stress distribution and characteristics of bonding interface and dental tissues with different cavity depth.
METHODS: Micro-CT scanning, Mimics, Goemagic Studio, NX 10.0 and other software were used to establish a three-dimensional finite element model of MOD gold inlay with different cavity depths and adhesives. Profiles for different models are as follows: Model A: cavity depth, 1 mm; cavity width, 3 mm; adhesive, 3M RelyX Unicem resin adhesive. Model B: cavity depth, 2 mm; cavity width, 3 mm; adhesive, 3M RecessX Unicem resin adhesive. Model C: cavity depth, 4 mm; cavity width, 3 mm; adhesive, 3M RelyX Unicem resin adhesive. Model D: cavity depth, 1 mm; cavity width, 3 mm; adhesive, vario-link resin adhesive. Model E: cavity depth, 2 mm; cavity width, 3 mm; adhesive, vario-link resin adhesive. Model F: cavity depth, 4 mm; cavity width, 3 mm; adhesive, vario-link resin adhesive. With the grid of ANSYS Workbench software, the stress distribution of models at 10 N•mm torque under lingual 45° 175 N and lingual 90° 600 N were analyzed.
RESULTS AND CONCLUSION: Minimal equivalent stress of the tooth root was found in the model with cavity depth of 2 mm under lingual 45° 175 N, which was suitable for gold alloy inlays and vario-link adhesive repair. Under lingual 90° 600 N, the equivalent stress of the tooth root was higher in model F than model C; the maximum root stress in model A was higher than that in model A; the equivalent stress of the tooth root was higher in vario-link models than 3M RelyX Unicem models. When the cavity depth was equal to 4 mm, a higher destructive stress of the tooth root produced on the vario-link bonding interface. In each model, the stress mainly concentrated on the root bifurcation zone, roof of the medullary cavity, gingival wall, and the 1/3 of the mesial or distal root. These findings suggest that the size and area of stress concentration are different under different cavity depth, adhesives and loading conditions. The shallow (< 1 mm) or deep (> 4mm) MOD cavity design should be avoided. Both 3M RelyX Unicem and vario-link are adhesives for gold alloy inlay. However, further clinical trials are needed to verify the results of three-dimensional finite element models. 

Key words: Inlays, Dental Cements, Tissue Engineering

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