髓腔固位冠修复髓腔壁缺损下颌第一前磨牙的有限元分析

发布时间：2018-01-22 18:10

本文关键词： 下颌第一前磨牙髓腔固位冠髓腔壁缺损有限元　出处：《太原理工大学》2017年硕士论文　论文类型：学位论文

【摘要】：口腔健康与生活质量息息相关,不但影响人的外在美观、咀嚼和消化功能,还会影响患者的心理健康。因此,口腔健康日益受到关注和重视。临床上常见因龋病、外伤、严重磨耗等造成的牙体缺损。缺损牙修复方式众多,如何根据病人的牙体缺损情况确定最佳修复方式,尽可能延长修复牙的使用寿命,显得尤为重要。对于下颌第一前磨牙不同髓腔壁缺损的情况,目前临床常采用三种修复方式:整体式髓腔固位冠修复(IER);流动树脂行龈壁提升+髓腔固位冠修复(FRER);超声波树脂行龈壁提升+髓腔固位冠修复(URER)。对于特定髓腔壁缺损形态,不同修复方式对修复牙的应力分布有何影响,以及采用何种修复方式可以达到最理想的应力分布状态,相关研究未见报道,临床上多基于医生经验。本文采用有限元法对此临床问题进行分析研究,期望可为临床优化设计、方案选择提供参考。基于CT断层图像,利用Mimics、Geomagic、UG、Hypermesh软件建立了下颌第一前磨牙五种不同髓腔壁缺损形态(A组:完整髓腔壁;B组:舌侧髓腔壁;C组:颊侧髓腔壁;D组:远中侧髓腔壁以及E组:颊舌侧髓腔壁)的基牙预备体有限元模型,且设计了对应的三组共13个修复体有限元模型。采用Abaqus软件计算分析三种修复方式分别修复不同髓腔壁缺损形态时,修复牙的应力分布情况。并对比分析了三种修复方式用于修复不同髓腔壁缺损形态时的优劣性。主要结果如下:(1)不论何种修复方式及髓腔壁缺损形态,咀嚼产生的侧向力是威胁修复牙修复效果和寿命的重要因素。提示临床应尽量减小牙尖倾斜度以减小侧向力对修复牙的不良影响;(2)颊侧髓腔壁的存在可改善IER的修复效果。远中侧髓腔壁的存在可改善FRER、URER的修复效果。颊侧髓腔壁的缺损会使得IER修复牙本质内应力水平显著提高,远中侧髓腔壁缺损会使得FRER、URER修复牙体组织中应力水平显著提高;(3)不论何种髓腔壁缺损形态,IER修复均可使修复牙获得最理想的应力分布状态,URER修复方式次之,FRER修复方式的修复效果最不理想。
[Abstract]:Oral health and life quality are closely related, not only affect the external appearance of masticatory and digestive function, will also affect the mental health of the patient. Therefore, oral health has been paid more and more attention. The common clinical due to caries, trauma, tooth defect caused by severe wear. Many teeth defect repair methods, how to determine the best way to repair according to the patient's tooth defect, as far as possible to extend the service life of the repaired teeth, is particularly important. The mandibular first premolar different medullary cavity wall defects, the current clinical often uses three kinds of repair type integral endocrowns repair (IER); resin flow for gingival wall lifting cord cavity crown (FRER); ultrasonic resin for gingival wall lifting and endocrowns repair (URER) for specific medullary cavity wall defect morphology, different restoration methods to repair teeth should be what is the effect of stress distribution, and the What kind of repair can reach the ideal state of stress distribution, which has not been reported, most of the clinical experience of doctors. Based on this analysis using the finite element method this clinical problem, is expected to be designed for clinical optimization, scheme selection reference. CT fault image, based on the use of Mimics, Geomagic, UG, Hypermesh software the establishment of the mandibular first premolar with five different medullary cavity wall defect morphology (group A: complete medullary cavity wall; group B: lingual medullary cavity wall; group C: buccal cavity wall; group D: distal lateral medullary cavity wall and E group: the buccal and lingual pulp cavity wall) of the abutment preparation of finite element model, and the design of the three groups corresponding to a total of 13 restorations. The finite element model using Abaqus software to analyze three kinds of different repair methods were used to repair the medullary cavity wall defect repair tooth form, the stress distribution. And comparative analysis of three kinds of different repair methods for repair of spinal cord The advantages and disadvantages of cavity wall defect form. The main results are as follows: (1) no matter how to repair and medullary cavity wall defect morphology, the lateral force generated by chewing is an important factor threatening repair dental restoration effect and life. Clinical should minimize the cusp inclination of the lateral force to reduce the adverse effects on the restoration of teeth; (2) the repairing effect of buccal medullary cavity wall can improve the IER. The distal medullary cavity wall can improve the FRER repair effect of URER. The defect of buccal pulp cavity wall will make the IER repair dentin stress level increased significantly, the distal medullary cavity wall defects will make the FRER. Stress significantly increased the level of URER in dental tissues; (3) regardless of medullary cavity wall defect morphology, IER repair repair can make the teeth get stress distribution condition in the most ideal way to repair, URER, repair repair FRER the effect is not ideal.

【学位授予单位】：太原理工大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R783.3

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