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北京大学学报（医学版） ›› 2021, Vol. 53 ›› Issue (4): 764-769. doi: 10.19723/j.issn.1671-167X.2021.04.024

• 论著 • 上一篇    下一篇

垫底材料弹性模量对髓腔固位冠修复后上颌前磨牙应力分布的影响

姜又升,冯琳(),高学军   

  1. 北京大学口腔医学院·口腔医院,牙体牙髓科 国家口腔医学中心 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室,北京 100081
  • 收稿日期:2021-06-15 出版日期:2021-08-18 发布日期:2021-08-25
  • 通讯作者: 冯琳 E-mail:1165155446@qq.com
  • 基金资助:
    北京市自然科学基金(7113176)

Influence of base materials on stress distribution in endodontically treated maxillary premolars restored with endocrowns

JIANG You-sheng,FENG Lin(),GAO Xue-jun   

  1. Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology,Beijing 100081, China
  • Received:2021-06-15 Online:2021-08-18 Published:2021-08-25
  • Contact: Lin FENG E-mail:1165155446@qq.com
  • Supported by:
    Beijing Natural Science Foundation(7113176)

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摘要：

目的: 构建根管治疗后上颌前磨牙经髓腔固位冠修复后的三维有限元模型,分析髓室底垫底材料弹性模量对应力分布的影响。方法: 利用显微CT扫描逆向建立上颌第二前磨牙缺损的三维有限元模型,模拟髓腔固位冠进行修复。实验组采用4 种不同弹性模量的材料:光固化玻璃离子(3M Vitrebond)、流动树脂(3M Filtek Z350XT Flowable Restorative)、高强度玻璃离子(GC Fuji Ⅸ)和后牙复合树脂(3M Filtek P60)进行垫底,4 种不同类型材料的弹性模量依次是3 657、7 300、13 130、19 700 MPa。垫底厚度选择为1 mm,设无垫底材料修复为对照。采用轴向和侧向载荷(30°)分别加载200 N的力,观察应力分布情况,比较应力集中部位及应力峰值的差异。结果: 各模型牙本质和粘接层上的von Mises应力峰值(轴向/侧向加载时)如下:(1)无垫底材料时牙本质19.39/70.49 MPa,粘接层6.97/17.97 MPa;(2)光固化玻璃离子垫底时牙本质19.00/69.75 MPa,粘接层6.87/16.30 MPa;(3)流动树脂垫底时牙本质18.78/69.33 MPa,粘接层6.79/16.17 MPa;(4)高强度玻璃离子垫底时牙本质18.71/69.20 MPa,粘接层6.74/16.07 MPa;(5)后牙复合树脂垫底时牙本质18.61/69.03 MPa,粘接层6.70/16.01 MPa。具有不同弹性模量的垫底材料在相同加载条件下,在牙体组织上应力集中的部位相似,主要集中于牙颈部。侧向力加载时,应力集中的位置与轴向力时相比无明显变化,但应力值增加。有垫底层存在时,牙颈部的应力集中与无垫底层时相比缓解。随着垫底材料的弹性模量不断增加,逐渐接近牙本质的弹性模量,测得的剩余牙体组织及粘接层上的von Mises应力峰值下降。结论: 使用与牙本质弹性模量相近的后牙复合树脂类材料进行适宜厚度的粘接垫底,有利于缓解髓腔固位冠修复后上颌前磨牙牙颈部和粘接层的应力集中。

关键词: 有限元分析, 髓腔固位冠, 垫底材料, 上颌前磨牙

Abstract:

Objective: To evaluate the influence of base materials on stress distribution in endodontically treated maxillary premolars restored with endocrowns using three-dimensional finite element analysis. Methods: A maxillary second premolar was scanned by Micro-CT and a three-dimensional finite element model of ceramic endocrown with 1 mm thickness of base was established. A model without base was also established as a negative control. Four kinds of conventional base materials with different elastic modulus were adopted: light cure glass ionomer(3M Vitrebond, 3 657 MPa), flowable composite resin(3M Filtek Z350XT Flowable Restorative, 7 300 MPa), high strength glass ionomer(GC Fuji Ⅸ, 13 130 MPa), and posterior composite resin(3M Filtek P60, 19 700 MPa). With a 200 N force loaded vertically and obliquely, the distribution and magnitude of stress in the tooth tissue and adhesive layer were investigated by three-dimensional finite element analysis. Results: The maximum von Mises stress values(vertical/oblique) in dentin and adhesive layer were measured as follows: (1) no base material: 19.39/70.49 MPa in dentin and 6.97/17.97 MPa in adhesive layer; (2) light cure glass ionomer: 19.00/69.75 MPa in dentin and 6.87/16.30 MPa in adhesive layer; (3) flowable composite resin: 18.78/69.33 MPa in dentin and 6.79/16.17 MPa in adhesive layer; (4) high strength glass ionomer: 18.71/69.20 MPa in dentin and 6.74/16.07 MPa in adhesive layer; (5) posterior composite resin: 18.61/69.03 MPa in dentin and 6.70/16.01 MPa in adhesive layer. Under the same loading condition, models with different elastic moduli of base materials had similar stress distribution patterns. The von Mises stress of tooth tissue was mainly concentrated in the tooth cervix. Under oblique load, the regions where von Mises stress concentrated in were similar to those under a vertical load, but the values increased. The stress concentration in the tooth cervix was alleviated in models with base materials compared with the model without base material. The maximum von Mises stress in the tooth tissue and adhesive layer decreased when the elastic modulus of base materials increased and got close to that of dentin. Conclusion: The posterior composite resin of which the elastic moduli is high and close to that of dentin is recommended as base material for premolar endocrowns to alleviate the concentration of stress in tooth cervix and adhesive layer.

Key words: Finite element analysis, Endocrown, Base materials, Maxillary premolar

中图分类号: 

  • R782.1

图1

实体模型剖面图"

图2

上颌前磨牙髓腔固位冠模型"

图3

网格划分后的三维有限元模型"

表1

三维有限元模型材料力学参数"

Materials Elastic modulus/MPa Poisson ratio
Enamel 84 100 0.33
Dentin 18 600 0.31
Periodontal ligament 70 0.45
Cortical bone 13 700 0.30
Cancellous bone 1 370 0.30
Endocrown 10 000 0.20
Adhesive layer 5 000 0.29
Light cure glass ionomer 3 657 0.36
Flowable composite resin 7 300 0.39
High strength glass ionomer 13 130 0.30
Posterior composite resin 19 700 0.32

表2

不同垫底材料时各部分von Mises应力峰值的比较"

Items Enamel Dentin Adhesive layer Base material Restoration
Vertical Oblique Vertical Oblique Vertical Oblique Vertical Oblique Vertical Oblique
No base material 51.20 152.00 19.39 70.49 6.97 17.97 409.90 447.50
Light cure glass ionomer 50.45 151.20 19.00 69.75 6.87 16.30 4.89 14.09 448.80 429.20
Flowable composite resin 49.61 149.80 18.78 69.33 6.79 16.17 5.81 14.44 448.90 429.20
High strength glass ionomer 48.96 148.60 18.71 69.20 6.74 16.07 7.46 17.14 449.00 429.30
Posterior composite resin 48.55 147.80 18.61 69.03 6.70 16.01 8.56 20.73 449.10 429.30

图4

不同垫底材料上颌前磨牙髓腔固位冠修复后侧向力加载下的应力分布云图"

图5

不同垫底材料上颌前磨牙髓腔固位冠修复后轴向力加载下的应力分布云图"

图6

不同垫底材料侧向力加载下牙本质髓腔内侧壁的应力分布云图"

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ISSN 1671-167X
CN 11-4691/R
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