上海口腔医学 ›› 2025, Vol. 34 ›› Issue (3): 257-261.doi: 10.19439/j.sjos.2025.03.006

• 论著 • 上一篇    下一篇

大面积缺损的上颌第一前磨牙不同修复类型及修复材料的三维有限元分析

李小曼1,*, 田本鉴2,*, 米热阿力木·米阿迪力1, 高益鸣1   

  1. 1.上海交通大学医学院附属瑞金医院 口腔中心,上海 200025;
    2.上海航空材料结构检测股份有限公司,上海 201318
  • 收稿日期:2024-01-11 修回日期:2024-02-06 出版日期:2025-06-25 发布日期:2025-06-24
  • 通讯作者: 高益鸣,E-mail: drgaoym@163.com
  • 作者简介:李小曼(1988-),女,博士研究生,主治医师,E-mail: 171392723@qq.com;田本鉴(1988-),男,博士研究生,高级工程师,E-mail: rocky.droll@163.com。*并列第一作者

Three dimensional finite element analysis of different restoration types and materials for maxillary first premolar with large defect

Li Xiaoman1, Tian Benjian2, Mirealimu·Miadili1, Gao Yiming1   

  1. 1. Stomatology Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. Shanghai 200025;
    2. Shanghai Aeronautical Materials & Structures Testing Company. Shanghai 201318, China
  • Received:2024-01-11 Revised:2024-02-06 Online:2025-06-25 Published:2025-06-24

摘要: 目的: 为临床上大面积缺损第一前磨牙的修复类型和修复材料选择提供参考。方法: 建立上颌第一前磨牙大面积缺损模型,采用不同修复类型和修复材料进行修复,分为A组(嵌体组)、B组(髓腔固位冠组)、C组(纤维桩桩核冠组)和D组(纯钛桩桩核冠组);再根据不同冠部修复材料分为三个亚组,分别为1组(氧化锆)、2组(玻璃陶瓷)和3组(树脂基陶瓷),共12组。在三维有限元软件中进行载荷,比较不同修复类型和修复材料各部分受力大小及分布。结果: 嵌体组应力集中区范围较大且存在应力沿牙釉质传导至颈部的趋势,桩核冠组和髓腔固位冠组应力分布更均匀。髓腔固位冠使用树脂基陶瓷材料修复时应力最小,玻璃陶瓷材料次之,氧化锆材料修复时应力最大。结论: 第一前磨牙牙体大面积缺损可通过髓腔固位冠修复和桩核冠修复,髓腔固位冠具有较好的适用性和优势。当选择树脂基陶瓷修复材料时,剩余牙体组织所受应力最小。

关键词: 上颌第一前磨牙, 大面积缺损, 髓腔固位冠, 三维有限元, 应力分析

Abstract: PURPOSE: To provide references for the selection of restoration types and materials for the first premolar with large defect in clinical practice. METHODS: A large area defect model of the maxillary first premolar was established and repaired with different types and materials, including group A (inlay group), group B (endocrown group), group C (fiber post core crown group), and group D (pure titanium post core crown group). And then, according to different repair materials, it was divided into 3 subgroups, namely group 1 (zirconia), group 2 (glass ceramic), and group 3 (resin based ceramic), totaling 12 groups. The stress distribution and magnitude were investigated using finite element analysis software. RESULTS: In the inlay group, the stress concentration area was large and tended to spread along the neck of tooth; in the post core crown group and endocrown group, the stress distribution was more uniform. In terms of restorative materials for endocrown, resin based ceramic materials had the lowest stress, followed by glass ceramic materials, and zirconia materials had the highest stress. CONCLUSIONS: Large defects of the first premolar can be repaired with endocrowns and post core crowns, and endocrowns have good applicability and advantages. Resin based ceramic materials are recommended for the selection of the endocrown materials for the least stress of the remaining tooth.

Key words: Maxillary first premolar, Large defects, Endocrown, Three-dimensional finite element analysis, Stress analysis

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