CAD/CAM一体成型纤维桩核对修复下颌前磨牙漏斗状根管的桩核适合性及抗折性能的影响
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摘要
目的:对比计算机辅助设计与制作一体成型纤维桩核和预成纤维桩联合树脂间接法制备桩核,对修复下颌前磨牙漏斗状根管的桩核适合性及抗折能力的影响.方法:将22颗大小相近的单根下颌前磨牙统一制备为漏斗状根管,用随机数表法随机平均分成两组:A组用计算机辅助设计与制作一体成型纤维桩核;B组用预成纤维桩联合树脂间接法制备桩核,两组统一铸造金属全冠修复.每组中随机抽取1颗以垂直样本牙长轴方向制成牙切片于扫描电镜下观察两组样本牙不同部位横断界面的桩核适合性;其余样本牙包埋后通过万能试验机,以速度1.00mm/min对30°倾斜牙体功能尖进行加载并记录试件断裂时的最大载荷与折裂方式.结果:A组桩核根颈部、根中部、根尖部3个部位的根管适合性均显著优于B组;两组最大抗折载荷相比,A组(530.50±43.59)N>B组(351.10±38.88)N,有显著差异(F=94.34,P<0.001).结论:计算机辅助设计与制作一体成型纤维桩核修复下颌前磨牙漏斗状根管具有较好的根管适合性和较高的抗载荷性能.
Objective: To compare the fitness and fracture resistance of one-piece fiber post-core fabricated using computer-aided design and post-core fabricated using prefabricated fiber post combined with resin indirect method in restoring funnel-shaped root canal of mandibular premolar. Methods:Twenty-two single-root mandibular premolars of similar size were prepared into funnel-shaped root canals,and randomly divided into two groups by a random number table method. Computer-aided design and fabrication of one-piece fiber post and core was used in group A,and prefabricated fiber post combined with resin indirect method was used to fabricate post-core in group B. The two groups were uniformly restored using casted metal full crowns. One tooth in each group was randomly selected to prepare tooth sections in the direction vertical to the long axis of sample teeth. The transection interface of different part of the sample teeth was observed under scanning electron microscope to assess post-core fitness. Therest samples were embedded and tested using a universal testing machine. The force was loaded on the30-degree tilted dental tip by a speed of 1. 00 mm/min. The maximum load and fracture mode of the specimen was recorded. Results: The post-core fitness at the neck,middle and tip of root in group A was significantly better than that in group B. The maximum fracture load of group A( 530. 50 ± 43. 59 N) was distinctly higher than that of group B( 351. 10 ± 38. 88 N),which had significant difference( F= 94. 34,P < 0. 001). Conclusion: One-piece fiber post and core fabricated using computer-aided design showed good root canal fitness and high fracture load resistance in restoring funnel-shaped root canal of mandibular premolar.
Objective: To compare the fitness and fracture resistance of one-piece fiber post-core fabricated using computer-aided design and post-core fabricated using prefabricated fiber post combined with resin indirect method in restoring funnel-shaped root canal of mandibular premolar. Methods:Twenty-two single-root mandibular premolars of similar size were prepared into funnel-shaped root canals,and randomly divided into two groups by a random number table method. Computer-aided design and fabrication of one-piece fiber post and core was used in group A,and prefabricated fiber post combined with resin indirect method was used to fabricate post-core in group B. The two groups were uniformly restored using casted metal full crowns. One tooth in each group was randomly selected to prepare tooth sections in the direction vertical to the long axis of sample teeth. The transection interface of different part of the sample teeth was observed under scanning electron microscope to assess post-core fitness. Therest samples were embedded and tested using a universal testing machine. The force was loaded on the30-degree tilted dental tip by a speed of 1. 00 mm/min. The maximum load and fracture mode of the specimen was recorded. Results: The post-core fitness at the neck,middle and tip of root in group A was significantly better than that in group B. The maximum fracture load of group A( 530. 50 ± 43. 59 N) was distinctly higher than that of group B( 351. 10 ± 38. 88 N),which had significant difference( F= 94. 34,P < 0. 001). Conclusion: One-piece fiber post and core fabricated using computer-aided design showed good root canal fitness and high fracture load resistance in restoring funnel-shaped root canal of mandibular premolar.
引文
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[12]王家安,张新春.Tenax Fiber White玻璃纤维桩修复前牙残根残冠[J].中华口腔医学研究杂志(电子版),2012,6(1):57-64.WANG J A,ZHANG X C.Application and analysis of esthetic restoration of anterior residual roots and crowns by tenax fiber white glass fiber posts and all ceramic crowns[J].Chinese Journal of Stomatological Research(Electronic Edition),2012,6(1):57-64.
[13]谭建国,冯敏.两种桩系统修复对根管治疗牙强度的影响[J].现代口腔医学杂志,2005,19(1):10-12.TAN J G,FENG M.Fracture resistance of endodontically treated restored with two different post systems[J].Journal of Modern Stomatology,2005,19(1):10-12.
[14]王新知,杨茜.不同类型桩核修复牙体重度缺损的回顾与进展[J].北京大学学报:医学版,2011,43(1):6-12.WANG X Z,YANG Q.The review and progress of different types of post core restorations[J].Journal of Peking University(Health Sciences),2011,43(1):6-12.
[15]黄靖,汪俊.桩-桩道间隙的匹配对纤维桩修复牙根发育不完全牙的抗折性能的影响[J].上海口腔医学,2011,20(5):490-493.HUANG J,WANG J.Effect of post-post space adaption on the fracture resistance of immature permanent teeth[J].Shanghai Journal of Stomatology,2011,20(5):490-493.
[16]王瑞霞,李建,邵勇,等.上中切牙桩核冠修复黏接剂厚度与应力的研究[J].口腔医学,2005,25(2):88-89.WANG R X,LI J,SHAO Y,et al.Three dimensional finite element stress analyses of post and core restored maxillary central incisor with different thickness of bonding layer[J].Stomatology,2005,25(2):88-89.
[17]TURNER C H.Post retained crown failure:a survey[J].Dent Update,1982,9(4):193-202.
[18]JULOSKI J,BELOICA M,GORACCI C,et al.Shear Bond Strength to Enamel and Flexural Strength of Different Fiber-reinforced Composites[J].J Adhes Dent,2013,15(2):123-130.
[2]FEDERICK D R.An application of the dowel and compositeresin core technique[J].J Prosthet Dent,1974,32(1):420-420.
[3]刘翠玲,高旭,蓝菁,等.不同桩核系统及根管重塑对漏斗形根管下颌前磨牙抗折特性的研究[J].华西口腔医学杂志,2010,28(3):286-289.LIU C L,GAO X,LAN J,et al.Fracture behavior of mandibular premolars with flared root canals restored with different post-and-core systems and root rehabilitation[J].West China Journal of Stomatology,2010,28(3):286-289.
[4]于秀彬,邢鹏.桩核蜡型制作方法介绍[J].口腔颌面修复学杂志,2005,6(2):112-112.YU X B,XING P.Post core wax production method introduction[J].Chinese Journal of Prosthodoutics,2005,6(2):112-112.
[5]SHRESTHA D,WU W C,HE Q Y,et al.Effect of sodium Real Seal SE to sodium hypochlorite treated root dentin[J].Dental Materials Journal,2013,32(1):96-100.
[6]KATEBZADEH N,DALTON B C,TROPE M.Strengthening immature teeth during and after apexification J Endod,1998,24:256-259.
[7]LASSILA L P,TANNER J,LE BELL A M,et al.Flexural properties of fiber reinforced root canal posts[J].Dent Mater,2004.20:29-36.
[8]DIETSCHI D,DUC O,KREJCI I.Biomechanical considerations for the restoration of endodontically treated teeth:a systematic review of the literature,PartⅡ(Evaluation of fatigue behavior,interfaces,and in vivo studies)[J].Quintessence Int,2008,39(2):117-129.
[9]FELIX C A,PRICE R B.The effect of distance from light source on light intensity from curing lights[J].J Adhes Dent,2003,5(4):283-291.
[10]ROBERTS H W,LEONARD D L,VANDEWALLE K S,et al.The effect of a translucent post on resin composite depth of cure[J].Dent Mater,2004,20(7):617-622.
[11]WALISZEWSKI K J,SABALA C L.Combined endodontic and restorative treatment considerations[J].J Prosthet Dent,1978,40(2):152-156.
[12]王家安,张新春.Tenax Fiber White玻璃纤维桩修复前牙残根残冠[J].中华口腔医学研究杂志(电子版),2012,6(1):57-64.WANG J A,ZHANG X C.Application and analysis of esthetic restoration of anterior residual roots and crowns by tenax fiber white glass fiber posts and all ceramic crowns[J].Chinese Journal of Stomatological Research(Electronic Edition),2012,6(1):57-64.
[13]谭建国,冯敏.两种桩系统修复对根管治疗牙强度的影响[J].现代口腔医学杂志,2005,19(1):10-12.TAN J G,FENG M.Fracture resistance of endodontically treated restored with two different post systems[J].Journal of Modern Stomatology,2005,19(1):10-12.
[14]王新知,杨茜.不同类型桩核修复牙体重度缺损的回顾与进展[J].北京大学学报:医学版,2011,43(1):6-12.WANG X Z,YANG Q.The review and progress of different types of post core restorations[J].Journal of Peking University(Health Sciences),2011,43(1):6-12.
[15]黄靖,汪俊.桩-桩道间隙的匹配对纤维桩修复牙根发育不完全牙的抗折性能的影响[J].上海口腔医学,2011,20(5):490-493.HUANG J,WANG J.Effect of post-post space adaption on the fracture resistance of immature permanent teeth[J].Shanghai Journal of Stomatology,2011,20(5):490-493.
[16]王瑞霞,李建,邵勇,等.上中切牙桩核冠修复黏接剂厚度与应力的研究[J].口腔医学,2005,25(2):88-89.WANG R X,LI J,SHAO Y,et al.Three dimensional finite element stress analyses of post and core restored maxillary central incisor with different thickness of bonding layer[J].Stomatology,2005,25(2):88-89.
[17]TURNER C H.Post retained crown failure:a survey[J].Dent Update,1982,9(4):193-202.
[18]JULOSKI J,BELOICA M,GORACCI C,et al.Shear Bond Strength to Enamel and Flexural Strength of Different Fiber-reinforced Composites[J].J Adhes Dent,2013,15(2):123-130.