目的:本研究旨在通过三维有限元分析(FEA)评估使用不同厚度的冠状动脉屏障材料进行再生牙髓治疗(RET)后由继发性创伤力引起的应力分布。
方法:使用计算机软件对未成熟的上颌中央牙齿的断层摄影图像创建了一个对照模型。使用RET中使用的材料的弹性模量和泊松比创建研究模型。搪瓷,牙本质,牙骨质,牙周膜,皮质,和松质骨被建模。冠状动脉屏障材料的应用厚度为3毫米和5毫米(模型1:对照模型,型号2:3毫米/富钙混合物(CEM),型号3:3毫米/矿物三氧化物骨料(MTA),型号4:3毫米/Biodentin,型号5:5mm/CEM,型号6:5mm/MTA,模型7:5毫米/Biodentin)。对于创伤力模拟,在第一方案中,在水平方向上向牙齿的颊表面施加300N的力。对于第二种情况,最大咬合力模拟,向牙齿的腭表面施加倾斜方向的240N的力。FEA用AlgorFempro进行。由此产生的应力被记录为冯·米塞斯,最大值,和最小主应力。
结果:与3mm模型相比,在5mm模型中获得了较低的应力值。然而,他们之间的差异是微不足道的。与对照模型相比,在所有RET模型中获得较低的应力值。在CEM模型中获得了牙齿组织和骨组织中的最低应力值。
结论:这是第一项研究,其中使用FEA评估了由不同厚度的CEM在牙齿组织上引起的应力。RET增强未成熟牙齿的生物力学。CEM和Biodentin在应力分布方面比MTA更成功。考虑到治疗费用,3mm材料厚度对于RET是理想的,因为使用5mm和3mm冠状动脉屏障材料产生的应力值之间没有显著差异。
This study aimed to evaluate the stress distribution caused by secondary trauma forces after regenerative endodontic treatment (RET) using different thicknesses of coronary barrier material with three-dimensional finite element analysis(FEA).
A control model was created using the tomography image of the immature maxillary central tooth with computer software.Study models were created with the modulus of elasticity and Poisson\'s ratio of the materials used in RET.Enamel, dentin, cementum, periodontal ligament, cortical, and cancellous bone were modeled. Coronary barrier materials were applied in 3 mm and 5 mm thicknesses (Model 1: control model, model 2:3 mm/Calcium Enriched Mixture(CEM), model 3:3 mm/Mineral Trioxide Aggregate(MTA), model 4:3 mm/Biodentin, model 5:5 mm/CEM, model 6:5 mm/MTA, model 7:5 mm/Biodentin). For the trauma force simulation, 300 N force in the horizontal direction was applied to the buccal surface of the tooth in the first scenario. For the second scenario, maximum bite force simulation, a force of 240 N in the oblique direction was applied to the palatal surface of the tooth. FEA was performed with Algor Fempro. The resulting stresses were recorded as Von Mises, maximum, and minimum principal stresses.
Lower stress values were obtained in 5 mm models compared to 3 mm models. However, the difference between them was insignificant. Lower stress values were obtained in all RET models compared to the control model. The lowest stress values in dental tissues and bone tissue were obtained in the CEM models.
This is the first study in which the stress caused by different thicknesses of CEM on dental tissues was evaluated with FEA. RET strengthens immature teeth biomechanically. CEM and Biodentin are more successful materials in stress distribution than MTA. Considering the cost of treatment, 3 mm material thickness is ideal for RET since there is no significant difference between the stress values resulting from the use of 5 mm and 3 mm coronary barrier material.