中国组织工程研究

中国组织工程研究 ›› 2019, Vol. 23 ›› Issue (14): 2183-2189.doi: 10.3969/j.issn.2095-4344.1650

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

近中-牙合-远中洞型嵌体三维有限元模型及粘接界面的应力分析

冯 明1，张国梅2，胡 杨3，祝 军2   

  1. 1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 830002；2上海市宝山区罗店医院口腔科，上海市 201908；3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
  • 收稿日期:2018-12-12
  • 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:冯明，男，1981年生，河南省平舆县人，汉族，主治医师，主要从事牙体牙髓病学和牙体缺损修复研究。
  • 基金资助:

    上海市宝山区科学技术委员会科技创新专项资金项目(16-E-24)，三维有限元法分析CAD/CAM制备瓷嵌体的应力分布及修复机制，项目责任人：祝军

A three-dimensional finite element model of mesio-occluso-distal cavity zirconium dioxide inlay and its bonding interface: a stress analysis

Feng Ming1, Zhang Guomei2, Hu Yang3, Zhu Jun2   

  1. 1Department of Dental Endodontics, Urumqi Stomatological Hospital, Urumqi 830002, Xinjiang Uygur Autonomous Region, China; 2Department of Stomatology, Shanghai Baoshan Luo Dian Hospital, Shanghai 201908, China; 3Department of Prosthodontics, the First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China
  • Received:2018-12-12
  • Contact: Zhu Jun, Chief physician, Department of Stomatology, Shanghai Baoshan Luo Dian Hospital, Shanghai 201908, China
  • About author:Feng Ming, Attending physician, Department of Dental Endodontics, Urumqi Stomatological Hospital, Urumqi 830002, Xinjiang Uygur Autonomous Region, China
  • Supported by:

    the Scientific Innovation Special Fund Project of Shanghai Baoshan District Science and Technology Commission, No. 16-E-24 (to ZJ)

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摘要：

文章快速阅读：

 

文题释义：
二氧化锆嵌体：嵌体是一种临床应用悠久的口腔修复技术，是嵌入牙体内部，用以恢复牙体缺损形态和功能的修复体。嵌体属于口腔固定修复体类，具有咀嚼效率高、磨牙量少、异物感较小等特点，金属类嵌体的机械强度高，全瓷类嵌体(包括铸瓷和二氧化锆嵌体等)的美学性能和生物相容性较好。
树脂粘接剂：能够将一种或数种固体物质粘接起来的材料，称为粘接剂。粘接口腔修复体至牙齿表面的树脂粘接剂，多由酸蚀剂、底涂剂和粘接树脂等构成。
 
 
背景：在口腔修复领域，二氧化锆嵌体具有良好的机械、生物相容性和美学性能，但有关其临床洞型设计、牙体预备、粘接材料选择等尚无统一的标准。
目的：探究3M RelyX Unicem或vario-link树脂粘接剂粘接后，二氧化锆嵌体模型粘接界面、牙体和牙周组织的应力分布规律及特点。
方法：采用Micro-CT扫描人右下颌第三磨牙，通过Mimics、Goemagic Studio、NX 10.0等软件构建不同粘接剂(3M RelyX Unicem树脂黏结剂、vario-link树脂粘接剂)和洞型(牙合面洞深分别为2，3，4 mm)的近中-      牙合-远中二氧化锆嵌体三维有限元模型。利用ANSYS Workbench网格划分，分析各模型在10 N•mm转矩、45°加载175 N、90°加载600 N后的应力分布情况。

结果与结论：①加载10 N•mm转矩后，洞深为3 mm模型的粘接剂等效应力、牙根面等效应力等最大，故在粘接界面、牙冠和牙根所受的应力最大；②舌向45°加载175 N后，洞深4 mm模型的粘接界面受力较大；在相同牙合面洞深下，3M RelyX Unicem树脂黏结剂模型的牙根和牙周组织应力值较大；③90°加载600 N后，洞深3 mm模型的牙根受力最大；在相同洞深下，3M RelyX Unicem树脂黏结剂模型的牙冠、牙根和牙周组织受力较大；vario-link树脂粘接剂模型的粘接界面受力较大；④各模型应力集中区域为牙根分叉区、嵌体边缘线、髓室顶、龈壁、近中根颊面近颈1/3处和远中根舌面近颈1/3等处；⑤结果说明，vario-link树脂粘接剂和3M RelyX Unicem树脂黏结剂均适宜做作为二氧化锆嵌体的粘接剂，但vario-link粘接强度较大且粘接界面应力较大，需综合考虑洞型设计、剩余牙体组织抗力形、固位形、牙周支持力等因素，采用优化洞型设计、牙体预备、垫底、高嵌体等设计方案，以期提高二氧化锆嵌体远期修复效果，但需进一步临床试验验证三维有限元模型实验结果。

ORCID: 0000-0001-6391-7834(冯明)

 

关键词: 嵌体, 二氧化锆, 粘接剂, 二氧化锆嵌体, 嵌体, 粘接界面, 应力, 牙体缺损

Abstract:

BACKGROUND: Zirconia inlays have good mechanical, biocompatible and aesthetic properties in the field of dental prosthodontics, but there is no consensus on the standards of zirconia inlays for clinical cavity design, dental preparation and selection of bonding materials.

OBJECTIVE: To investigate the stress distribution and characteristics of the bonding interface, tooth and periodontal tissues of the zirconia inlay model after 3M RelyX Unicem or vario-link resin adhesive bonding.
METHODS: Micro-CT was used to scan the right mandibular third molars. A three-dimensional finite element model of MOD zirconia inlay with different adhesives (3M RelyX Unicem resin binder, vario-link resin binder) and cavity types (2, 3, 4 mm in the depth of the joint cavity) was constructed by software Mimics, Goemagic Studio and NX 10.0. Using ANSYS Workbench mesh generation, the stress distribution of each model was analyzed after loading 10 N•mm torque, 45° 175 N, 90° 600 N.
RESULTS AND CONCLUSION: (1) After loading 10 N•mm torque, the bonding agent equivalent stress and root surface equivalent stress of the model with 3 mm cavity depth were largest, so the stress on the bonding interface, crown and root was largest. (2) After loading 175 N at 45° lingual direction, the bonding interface of the model with 4 mm cavity depth undertook a higher stress. The stress values of the root and periodontal tissue of 3M RelyX Unicem resin bonding agent model with the same cavity depth were higher. (3) After loading 600 N at 90°, the root force of the model with 3 mm cavity depth was largest. The crown, root and periodontal tissue of the 3M RelyX Unicem resin bonding agent model with the same cavity depth undertook a higher stress. The bonding interface of the vario-link resin bonding agent model was under greater stress. (4) The regions of stress concentration areas included the bifurcation zone of the root, the inlay edge line, the roof of pulp chamber, the gingival wall, 1/3 mesial part of the buccal surface near the neck, and 1/3 mesial part of the lingual surface near the neck. (5) All these findings indicate that vario-link resin adhesive and 3M RelyX Unicem resin adhesive are suitable for the bonding of zirconia inlay, but the vario-link adhesive strength is larger and the bonding interface stress is larger. The factors such as cavity design, residual tooth tissue resistance, retention shape, and periodontal support should be considered comprehensively. The optimization of cavity design, tooth preparation, cushion bottom and high inlay should be adopted, in order to improve the long-term repair effect of zirconia inlay. However, further clinical trials are needed to verify the results of three-dimensional finite element model.

Key words: Inlays, Finite Element Analysis, Dental Cements, Tissue Engineering

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