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龈壁提升材料和高度对嵌体修复影响的有限元分析

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目的:评估不同龈壁提升(deep margin elevation,DME)的材料以及提升高度对下颌第一磨牙邻面龈下缺损嵌体修复生物力学行为特性的影响.方法:基于Micro CT的三维图像数据建立了下颌第一磨牙的三维有限元模型,在此基础上通过计算机辅助设计模拟DME层和嵌体修复建立了 7组不同DME层高度的下颌第一磨牙嵌体修复的三维有限元模型.通过三维有限元仿真分析,对比分析流动树脂和膏状树脂两种不同的DME层材料以及7组不同的DME层高度对模型各部分及界面的应力分布及大小的影响.结果:随着DME层高度上升,嵌体自身的最大主应力(MPS)峰值在不断上升,而DME层MPS峰值、DME层与嵌体间界面拉应力(ITS)峰值以及DME层与牙齿间ITS峰值在不断减小.同一 DME层高度时,流动树脂组的DME层MPS应力峰值、DME层与嵌体间ITS峰值以及DME层与牙齿间ITS峰值均小于膏状树脂组.DME层材料以及高度的变化对其他观察指标无明显影响.结论:低弹性模量的DME层材料以及增加DME层高度有利于降低模型及界面的应力,因此在临床操作中建议选择流动树脂作为DME材料,并适当提升DME层高度.
Three-dimensional Finite Element Analysis on Effect of Deep Margin Elevation Materials and Heights on First Mandib-ular Molar Inlay Restoration of Subgingival Defects
Objective:To evaluate the effects of different deep margin elevation(DME)materials and lifting heights on the biomechanical behavior characteristics of inlay in mandibular first molar with subgingival defects.Methods:Three-dimensional finite element models of mandibular first molars were established based on Micro CT three-dimensional image data.Seven groups of three-dimensional finite element models of mandibular first molar in-lay restoration with different DME heights were established through computer-aided design simulation of DME and inlay restoration.The stress distribution and magnitude of each part and interface of the model under two different DME materials(flowable resin and packable resin)and seven different DME heights were studied and compared through three-dimensional finite element simulation analysis.Results:With the increase of DME height,the peak of maximum principal stress(MPS)of the inlay itself continued to rise,while the peak of MPS of the DME layer,the peak of interfacial tensile stress(ITS)between the DME layer and the inlay,and the peak of ITS between the DME layer and the tooth continued to decrease.At the same DME layer height,the peak of MPS of the DME layer,the peak of ITS between the DME layer and the inlay,and the peak of ITS between the DME layer and the tooth were all smaller than those of the packable resin group.The changes in DME layer material and height had no significant effect on other observation indicators.Conclusion:Low elastic modulus DME material and increased DME height are beneficial to reduce the stress of the model and interface.Therefore,it is recommended to choose flowable resin as DME material in clinical operation and appropriately lift the DME layer height.

deep margin elevationinlaysubgingival defectsfinite element analysisstress distribution

曹谅、赵阿莉、王利民、王广慈、张国庆、王卫国

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中国人民解放军联勤保障部队第九○三医院口腔科 浙江 杭州 310013

龈壁提升 嵌体 龈下缺损 有限元分析 应力分布

国家自然科学基金浙江省基础公益研究计划

81600916LTGY24H140001

2024

口腔医学研究
武汉大学口腔医学院

口腔医学研究

CSTPCD北大核心
影响因子:0.48
ISSN:1671-7651
年,卷(期):2024.40(10)