中国组织工程研究

中国组织工程研究 ›› 2019, Vol. 23 ›› Issue (6): 870-876.doi: 10.3969/j.issn.2095-4344.1557

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

三维有限元分析不同材料不同方法修复离体牙缺损模型的应力分布

冯广智1，付宏宇2，马鹏华3   

  1. 1北京市海淀医院口腔科，北京市 100080；2北京大学第一医院口腔科，北京市 100034；3北京中日友好医院口腔医学中心，北京市 100029
  • 收稿日期:2018-10-24 出版日期:2019-02-28 发布日期:2019-02-28
  • 通讯作者: 马鹏华，主治医师，北京中日友好医院口腔医学中心，北京市 100029
  • 作者简介:冯广智，男，1979年生，河北省抚宁市人，汉族，2016年首都医科大学毕业，硕士，主治医师，主要从事生物力学与三维有限元分析研究。
  • 基金资助:

    北京市海淀医院院级青年科研项目(KYQ2015008)，项目负责人：冯广智

Different materials and different methods for repairing an isolated tooth defect model: a three-dimensional finite element analysis of stress distribution

Feng Guangzhi1, Fu Hongyu2, Ma Penghua3   

  1. 1Department of Stomatology, Beijing Haidian Hospital, Beijing 100080, China; 2Department of Stomatology, Peking University First Hospital, Beijing 100034, China; 3Dental Medical Center, China-Japan Friendship Hospital, Beijing 100029, China
  • Received:2018-10-24 Online:2019-02-28 Published:2019-02-28
  • Contact: Ma Penghua, Attending physician, Dental Medical Center, China-Japan Friendship Hospital, Beijing 100029, China
  • About author:Feng Guangzhi, Master, Attending physician, Department of Stomatology, Beijing Haidian Hospital, Beijing 100080, China
  • Supported by:

    the Youth Research Project of Beijing Haidian Hospital, No. KYQ2015008 (to FGZ)

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摘要：

文章快速阅读：

 

文题释义：
观察应力分布的意义：从材料力学理论可知，在材料受到外力作用时，其各部分均承受大小不同的应力，并产生相应的形变，如果形变超过材料极限，就发生材料屈服，针对材料而言，意味着应力越集中的部位，出现折裂的可能性越大，因此观察各部位应力值的大小，是用来判断材料部位出现破坏或磨损的可能性的有效方法。
高嵌体：是一种由嵌体发展而来的修复方式，与嵌体的主要区别在于高嵌体覆盖了所有的牙尖，相比起嵌体减少了由于嵌体和残余牙体组织之间受力不均容易劈裂的可能性，而且相比起桩冠修复的牙体预备量来说显著减少，尽可能保留了牙体组织，符合当前微创修复的理念，近些年新修复材料的出现，特别是全瓷材料和高强度粘接剂的应用更加促进了高嵌体修复的发展。
 
 
背景：如何最大限度地保留根管治疗后的牙体组织，并能够保证修复后的强度是目前的研究热点。
目的：使用有限元法分析不同方式修复离体牙缺损模型的应力分布情况。
方法：收集北京市海淀医院口腔科因慢性牙周炎无法保留而拔除的上颌第一磨牙12颗，根管治疗后制备离体牙缺损模型，以钴铬合金、纯钛金属、二氧化锆、E.max全瓷为修复材料，每种材料分别进行嵌体、高嵌体、桩核冠3种修复方式。通过Micro CT扫描上颌第一磨牙修复模型，使用图像处理软件Mimics 17.0及Geomegic Studio 2013重建牙体及修复体三维数字模型，采用有限元分析软件进行力学模拟，力加载方式设为：8点90°加载、3点90°加载、3点90°加载、3点0°加载。

结果与结论：在各载荷条件下，桩冠组修复体边缘、预备体肩台、剩余牙本质颈部及桩核中部出现应力集中区；在各载荷条件下，嵌体组釉质的加载点出现应力集中区，并有将应力沿牙釉质传到至颈部的趋势，嵌体和预备体相对的龈壁和底面及二者移行处也出现应力集中区；在各载荷条件下，高嵌体组高嵌体与牙釉质接触处出现应力集中，预备体龈壁和底面及二者移行处，以及相对应的高嵌体髓腔内部分也出现应力集中的情况，但应力分布更为均匀；结果表明在上颌磨牙大面积缺损的修复方式中，高嵌体具有适用性和优势性。

ORCID: 0000-0001-5125-2169(冯广智)

关键词: 口腔材料, 高嵌体, 上颌磨牙, 三维有限元, 离体牙缺损模型, 慢性牙周炎, 上颌磨牙大面积缺损

Abstract:

BACKGROUND: Current concerns are on how to maximize the reservation of tooth tissues after root canal treatment and to ensure the strength of the tooth after repair.

OBJECTIVE: To analyze the stress distribution of an isolated tooth defect model after repair with different methods
METHODS: We collected 12 maxillary first molars which had been extracted for chronic periodontitis at the Department of Stomatology, Beijing Haidian Hospital in China. After root canal treatment, the isolated tooth defect model was prepared and repaired with different materials (cobalt-chromium alloy, pure titanium metal, zirconium dioxide, E.max all-ceramic) and using different repair methods (inlay, onlay, post-core crown). First, the model repaired by the corresponding materials and repair methods was scanned by Micro CT. The image processing software Mimics 17.0 and Geomegic Studio 2013 were then used to reconstruct the three-dimensional digital models of the tooth and restoration, and a simplified three-dimensional model of the alveolar bone was created. Finally, the above model data was imported into the finite element analysis software for mechanical simulation (the force was loaded at an angle of 90o at 8, 3, 3 points and at an angle of 0o at 0 point, respectively).

RESULTS AND CONCLUSION: Under different loading conditions, in the post-core crown group, the stress was concentrated in the edge of restoration, the shoulder of the preparation, the neck of the residual dentin, and the middle part of post-core crown in the post-core crown group. In the inlay group, the stress was concentrated in the load point of the enamel, and was transferred along the tooth enamel to the tooth neck; the stress concentration area also included the gingival wall and undersurface and transition site corresponding to the inlays and preparations. In the onlay group, the stress concentration occurred at the contact between the onlay and the enamel, at the gingival wall and undersurface of the preparation, and at the transition site. The stress was also concentrated and distributed evenly in the corresponding pulp cavity of the onlay. To conclude, the onlays have applicability and superiority in the repair of large-area defects of the maxillary molars.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

Key words: Inlays, Molar, Finite Element Analysis, Dental Stress Analysis, Tissue Engineering

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