桩核粘固材料对牙本质应力的影响
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摘要
随着牙体治疗的广泛开展,桩核技术已成为残根残冠保存修复的重要技术方法,己为临床大量应用。为了有效地恢复缺损牙体的形态和功能,桩核必须粘固在根管内才能保证修复体在行使功能时不松动、不脱落;同时应能有效的保护牙根不折裂,因此,常用水门汀将根管桩核粘固在根管内。常用的水门汀有:磷酸锌水门汀(ZOP)、玻璃离子水门汀(GIC)、树脂水门汀(RC)和树脂加强型玻璃离子水门汀(RMGIC),它们不仅能为根管桩核提供固位、把整个桩核冠系统有机地结合在一起,而且能把修复体所受的应力通过其本身传递到根管牙本质,再传递到牙齿支持组织上,因此,使用不同弹性模量的水门汀粘固根管桩可能会引起牙本质的应力改变。本实验将采用三维有限元法(3D-FEM)来分析根管桩粘固后,不同的粘固水门汀对牙本质应力的影响,为临床应用提供理论力学的实验依据。
目的 本实验用3D-FEM分析常用水门汀粘固根管桩后牙本质应力峰值及应力分布的变化,来探讨水门汀对牙本质应力的影响以及在防止牙根折裂方面的作用。
材料和方法 选择标准离体无龋右上颌中切牙,经树脂包埋、多层螺旋CT断层扫描、扫描图形数字化输入AutoCAD建立三维模型,同时在三维模型上模拟出与实际相似的根管桩核、水门汀层、牙槽骨、牙周膜、牙本质、金属烤
The usage of post-core cemented in root canal is a conventional method to restore the decayed teeth. In order to have effective retention, we must use cements which can lute the post and form post-core system between root canal and post. We have four kinds of different cements, which are zinc phosphate cement(ZOP), glass ionomer cement(GIC), resin cement(RC), resin-modified glass ionomer cement(RMGIC) and have different elastic modulus .Objective: This study aimed at analyzing the effects of the different luting cements on the peak of the dentinal stress and dentinal stress distribution in order to evaluate their roles in fracture resistance of endodontically treated teeth.Materials and methods: In order to know how post luting cements influenced dentinal stress distribution and the peak of the dentinal stress, a standard human maxillary central incisor was chosen. The standard three-dimension finite
element models of maxillary central incisor restored with porcelain fused to metal crown and pure SDA-Ⅱpost which cemented by 4 different luting cements were constructed by AutoCAD. Then the finite element method(3-D FEM) was used to analyze the effects of four different luting cements which have different modulus of elasticity on the stress distribution of the dentin and the peak of dentinal stress. Two forces were used.Results: All these cements could lower the the peak of the dentinal stress, the first one was zinc phosphate cement(ZOP).The descendent rate of it was 46.3%.A11 the cements have not evident effects on the dentinal stress distribution.Conclusion: Within the limitations of this study, the zinc phosophate cements showed better condition than the other cements in the dentinal stress distribution.
目的 本实验用3D-FEM分析常用水门汀粘固根管桩后牙本质应力峰值及应力分布的变化,来探讨水门汀对牙本质应力的影响以及在防止牙根折裂方面的作用。
材料和方法 选择标准离体无龋右上颌中切牙,经树脂包埋、多层螺旋CT断层扫描、扫描图形数字化输入AutoCAD建立三维模型,同时在三维模型上模拟出与实际相似的根管桩核、水门汀层、牙槽骨、牙周膜、牙本质、金属烤
The usage of post-core cemented in root canal is a conventional method to restore the decayed teeth. In order to have effective retention, we must use cements which can lute the post and form post-core system between root canal and post. We have four kinds of different cements, which are zinc phosphate cement(ZOP), glass ionomer cement(GIC), resin cement(RC), resin-modified glass ionomer cement(RMGIC) and have different elastic modulus .Objective: This study aimed at analyzing the effects of the different luting cements on the peak of the dentinal stress and dentinal stress distribution in order to evaluate their roles in fracture resistance of endodontically treated teeth.Materials and methods: In order to know how post luting cements influenced dentinal stress distribution and the peak of the dentinal stress, a standard human maxillary central incisor was chosen. The standard three-dimension finite
element models of maxillary central incisor restored with porcelain fused to metal crown and pure SDA-Ⅱpost which cemented by 4 different luting cements were constructed by AutoCAD. Then the finite element method(3-D FEM) was used to analyze the effects of four different luting cements which have different modulus of elasticity on the stress distribution of the dentin and the peak of dentinal stress. Two forces were used.Results: All these cements could lower the the peak of the dentinal stress, the first one was zinc phosphate cement(ZOP).The descendent rate of it was 46.3%.A11 the cements have not evident effects on the dentinal stress distribution.Conclusion: Within the limitations of this study, the zinc phosophate cements showed better condition than the other cements in the dentinal stress distribution.
引文
[1] Libman WJ, Nicholls JI. Load fatigue of teeth restored with cast posts and cores and complete crowns [J]. ht J Prosthodont, 1995, 8(2): 155-161.
[2] Leary JM, Jensen ME, Sheth JJ. Load transfer of posts and cores to roots through cements [J]. J Prosthet dent, 1989, 62(3): 298-302.
[3] 陈治清主编.口腔材料学[M].北京:人民卫生出版社,2003:15.
[4] Mendoza DB, Eakle WS. Retention of posts cemented with various dentinal bonding cements[J]. J Prosthet dent, 1994, 72(6): 591-594.
[5] 王惠芸.我国人牙的测量与统计[J].中华口腔科杂志,1959,7 (3):149.
[6] 李美华,王伟,董丽华等.用三维有限元方法对单端固定桥进行应力分析[J].口腔医学纵横杂志,2000,16(3):197-199.
[7] HoMH, Lee SY, Chen HH, et al. Three-dimensional finite analysis of the effects of posts on stress distribution in dentin[J]. .Prosthet Dent, 1994, 72(5):367.
[8] 陈治清主编.口腔材料学[M]..北京:人民卫生出版社,2003:167.
[9] 巢永烈,杨永丰,赵云凤.天然牙-末端种植牙固定桥的受载分析[J].华西口腔医学杂志,1995,13(1):6.
[10] 杨立伟,张影,陈清军等.无髓牙修复应力分析初探[J].口腔材料器械杂志,1998,7(3):125.
[11] Chen ChunLi, Shane N, White B. Mechanical propertics of dental luting cements [J]. J Prosthet Dent, 1999, 81(5): 597-609.
[12] Stephen F, Martin F, Junhei Fujimoto. Contemporary Fixed Prosthodontics [M]. St. louis: Mosby Int, 2001:770.
[13] Protein kamposite. Finite element analysis estimates of cements microfracture under complete veneer crowns [J]. J Prothset Dent, 1994, 72(5): 435.
[14] 唐高妍,文志红,巢永烈等.桩影响前牙烤瓷冠修复后牙本质应力分布的三维有限元分析[J].华西口腔医学杂志,1998,16(3):256-258.
[15] 徐正红,张富强,杨宠莹.前牙桩核及根管壁应力的三维有限元分析[J].医用生物力学,1996,11(1):30-33.
[16] 夏荣.有限元法及其进展(一)[J].中国口腔种植学杂志,1997,2(2):96-100.
[17] Turner MS, Clough RW, Martin HC, et al. Stiffness and deflection analysis complex structure[J]. J Aero Sci, 1956, 23(8):805.
[18] Liu YK, Ray G, Hirsch C. The resistence of the lumber spine to direct shear [J]. Orthop Clin northAm, 1975, 6(1): 33-49.
[19] 马轩祥,应隆安.无限单元应力分析方法在口腔医学生物力学研究中的应用前景[J].中华口腔医学杂志,2002,37(3):235-236.
[20] Huiskes R, Chao EY. A survey of finite element analysis: northopedic biomechenics, the first decade [J]. J Biomech, 1988, 16(6): 385.
[21] 张少锋.有限元法及其在口腔医学研究中的应用[J].国外医学口腔医学分册,1990,17(2):92-94.
[22] 高勃,王忠义,施长溪等.牙冠表面形状测量造型方法[J].实用口腔医学杂志,1999,15(4):303.
[23] 魏洪涛,张天夫,曾晨光等.牙颌三维有限元模型生成方法的探讨[J].白求恩医科大学学报,2000,26(2):51-52.
[24] 罗立民,谢华.三维医学图象数据的分析与显示[J].中国生物医学工程学报,1995,14(2):113-115.
[25] 徐正红张富强,杨宠莹.铸造桩不同直径对根管壁应力影响[J]。中华口腔医学杂志,1995,30(6):364.
[26] David J, Sokel. Effective use of current core post concepts[J]. J Prosthet Dent, 1984; 5(2): 231-234.
[27] Hague MS, Wong RD, Lindemuth JS. Effect of dowel space preparation and composite cement thickness on retention of a prefabricated dowel[J]. J Prosthodont, 2002, 11 (1): 19-24.
[28] McLean JW. Glass-ionomer cements[J]. Br Dent J, 1988, 164(9): 293-300.
[29] Morando G, Leupold AM, Leafy JM. Measurement of hydrostatic pressures during simulated post cementation[J]. J Prosthet Dent, 1995, 74(6): 586-590.
[2] Leary JM, Jensen ME, Sheth JJ. Load transfer of posts and cores to roots through cements [J]. J Prosthet dent, 1989, 62(3): 298-302.
[3] 陈治清主编.口腔材料学[M].北京:人民卫生出版社,2003:15.
[4] Mendoza DB, Eakle WS. Retention of posts cemented with various dentinal bonding cements[J]. J Prosthet dent, 1994, 72(6): 591-594.
[5] 王惠芸.我国人牙的测量与统计[J].中华口腔科杂志,1959,7 (3):149.
[6] 李美华,王伟,董丽华等.用三维有限元方法对单端固定桥进行应力分析[J].口腔医学纵横杂志,2000,16(3):197-199.
[7] HoMH, Lee SY, Chen HH, et al. Three-dimensional finite analysis of the effects of posts on stress distribution in dentin[J]. .Prosthet Dent, 1994, 72(5):367.
[8] 陈治清主编.口腔材料学[M]..北京:人民卫生出版社,2003:167.
[9] 巢永烈,杨永丰,赵云凤.天然牙-末端种植牙固定桥的受载分析[J].华西口腔医学杂志,1995,13(1):6.
[10] 杨立伟,张影,陈清军等.无髓牙修复应力分析初探[J].口腔材料器械杂志,1998,7(3):125.
[11] Chen ChunLi, Shane N, White B. Mechanical propertics of dental luting cements [J]. J Prosthet Dent, 1999, 81(5): 597-609.
[12] Stephen F, Martin F, Junhei Fujimoto. Contemporary Fixed Prosthodontics [M]. St. louis: Mosby Int, 2001:770.
[13] Protein kamposite. Finite element analysis estimates of cements microfracture under complete veneer crowns [J]. J Prothset Dent, 1994, 72(5): 435.
[14] 唐高妍,文志红,巢永烈等.桩影响前牙烤瓷冠修复后牙本质应力分布的三维有限元分析[J].华西口腔医学杂志,1998,16(3):256-258.
[15] 徐正红,张富强,杨宠莹.前牙桩核及根管壁应力的三维有限元分析[J].医用生物力学,1996,11(1):30-33.
[16] 夏荣.有限元法及其进展(一)[J].中国口腔种植学杂志,1997,2(2):96-100.
[17] Turner MS, Clough RW, Martin HC, et al. Stiffness and deflection analysis complex structure[J]. J Aero Sci, 1956, 23(8):805.
[18] Liu YK, Ray G, Hirsch C. The resistence of the lumber spine to direct shear [J]. Orthop Clin northAm, 1975, 6(1): 33-49.
[19] 马轩祥,应隆安.无限单元应力分析方法在口腔医学生物力学研究中的应用前景[J].中华口腔医学杂志,2002,37(3):235-236.
[20] Huiskes R, Chao EY. A survey of finite element analysis: northopedic biomechenics, the first decade [J]. J Biomech, 1988, 16(6): 385.
[21] 张少锋.有限元法及其在口腔医学研究中的应用[J].国外医学口腔医学分册,1990,17(2):92-94.
[22] 高勃,王忠义,施长溪等.牙冠表面形状测量造型方法[J].实用口腔医学杂志,1999,15(4):303.
[23] 魏洪涛,张天夫,曾晨光等.牙颌三维有限元模型生成方法的探讨[J].白求恩医科大学学报,2000,26(2):51-52.
[24] 罗立民,谢华.三维医学图象数据的分析与显示[J].中国生物医学工程学报,1995,14(2):113-115.
[25] 徐正红张富强,杨宠莹.铸造桩不同直径对根管壁应力影响[J]。中华口腔医学杂志,1995,30(6):364.
[26] David J, Sokel. Effective use of current core post concepts[J]. J Prosthet Dent, 1984; 5(2): 231-234.
[27] Hague MS, Wong RD, Lindemuth JS. Effect of dowel space preparation and composite cement thickness on retention of a prefabricated dowel[J]. J Prosthodont, 2002, 11 (1): 19-24.
[28] McLean JW. Glass-ionomer cements[J]. Br Dent J, 1988, 164(9): 293-300.
[29] Morando G, Leupold AM, Leafy JM. Measurement of hydrostatic pressures during simulated post cementation[J]. J Prosthet Dent, 1995, 74(6): 586-590.