桩和根管重塑材料对薄壁牙体抗折性能的影响

上海口腔医学 ›› 2014, Vol. 23 ›› Issue (3): 312-316.

桩和根管重塑材料对薄壁牙体抗折性能的影响

周文梅, 黄国伟

浙江省绍兴市上虞人民医院口腔科,浙江绍兴 312300

收稿日期:2013-12-10 出版日期:2014-06-20 发布日期:2014-09-09
通讯作者: 黄国伟,E-mail:2012103454@qq.com
作者简介:周文梅(1978-), 女, 学士, 主治医师, E-mail:wmeizhou@gmial.com

Fracture resistance of thin-walled teeth restored with different post and core materials

ZHOU Wen-mei, HUANG Guo-wei

Department of Stomatology, Shangyu People’s Hospital of Shaoxing. Shaoxing 312300, Zhejiang Province, China

Received:2013-12-10 Online:2014-06-20 Published:2014-09-09

摘要/Abstract

摘要： 目的:探讨如何选择合适直径的桩和根管重塑材料,使薄壁根管获得更好的抗折性能。方法:选择90颗完整的上颌中切牙,完成根管治疗后,截冠分为9组。其中,4组进行常规桩道预备后行1.3 mm、1.6 mm镍铬合金铸造桩(A1.3和A1.6)和玻璃纤维桩(B1.3和B1.6)黏结后全冠修复,其余5组桩道扩大至根管壁为1 mm后行铸造桩核(C)和玻璃纤维桩修复,其中1.3、1.6 mm纤维桩用Rely X Unicem(D1.3和D1.6)和ParaCore(E1.3和E1.6)进行根管重塑和黏结,再用复合树脂堆核型后全冠修复,比较各组的抗折力和折裂模式。采用SPSS16.0软件包对数据进行统计学分析。结果:常规根管中,A1.3组获得最大的抗折力(610.2±45.6)N,A1.3、A1.6和B1.3、B1.6之间无显著差异(P>0.05)。薄壁根管中,C组获得最大的抗折力(584.5±121.2)N,而纤维桩经ParaCore重塑根管后可以增加牙体的抗折力[E1.3为(420.6±95.7) N,E1.6为(517.9±67.2) N],分别较D1.3和D1.6有显著差异(P<0.05),而与B1.3、B1.6无显著差异(P>0.05)。纤维桩修复的折裂模式中大部分可以重新修复,而金属桩大部分为破坏性。结论:纤维桩修复后,折裂的牙体大部分可以再次修复,1.3 mm和1.6 mm直径的桩对于牙体的抗折性无显著影响,ParaCore重塑根管可有效增强牙体的抗折性能。

关键词: 薄壁根管, 抗折性能, 玻璃纤维桩, 折裂模式

Abstract: PURPOSE: To discuss the selection of appropriate post and core materials in order to obtain better fracture resistance for thin-walled teeth. METHODS: Ninety maxillary incisors were endodontically treated and the crowns were cut off. Then they were randomly divided into 9 groups. The teeth in the first 4 groups were restored with cast (A1.3 and A1.6) and fiber (B1.3 and B1.6) posts of 1.3 and 1.7mm diameters. The teeth in the other 5 groups were enlarged to simulate the 1 mm thin-walled teeth and restored with cast (C) and fiber posts. The fiber posts were reconstructed and cemented with Unicem (D1.3 and D1.6) and ParaCore (E1.3 and E1.6). All teeth were restored with full crown, and the fracture resistance and fracture mode were analysed. Statistical analysis was carried out using SPSS 16.0 software package. RESULTS: Largest fracture resistance values (610.2±45.6) N were found in Group A1.3 of ordinary root canals, and no significant difference (P>0.05) existed between Group A1.3, A1.6 and B1.3, B1.6. Group C received the largest fracture resistance value(584.5±121.2) N in thin-walled root canals, and fiber posts reconstructed with ParaCore cement could increase fracture resistance [E1.3,(420.6±95.7) N; E1.6,(517.9±67.2) N], which was significant different compared with D1.3 and D1.6 (P<0.05), but similar to B1.3 and B1.6 in ordinary root canals. CONCLUSIONS: The root can be better preserved by fiber post and the fracture resistance is not affected by the posts with diameters of 1.3 mm and 1.6 mm. The fracture resistance of teeth can be enhanced by reconstruction of root canals with Paracore.

Key words: Thin-walled root canal, Fracture resistance, Glass fiber post, Fracture mode

中图分类号:

R783.1

周文梅, 黄国伟. 桩和根管重塑材料对薄壁牙体抗折性能的影响[J]. 上海口腔医学, 2014, 23(3): 312-316.

ZHOU Wen-mei, HUANG Guo-wei. Fracture resistance of thin-walled teeth restored with different post and core materials[J]. Shanghai Journal of Stomatology, 2014, 23(3): 312-316.

参考文献

[1] Fernandes AS, Dessai GS. Factors affecting the fracture resistance of post-core reconstructed teeth: a review[J]. Int J Prosthodont, 2001, 14(4): 355-363.
[2] Mangold JT, Kern M. Influence of glass-fiber posts on the fracture resistance and failure pattern of endodontically treated premolars with varying substance loss: an in vitro study[J]. J Prosthet Dent, 2011, 105(6): 387-393.
[3] Dietschi D, Duc O, Krejci I, et al. Biomechanical considerations for the restoration of endodontically treated teeth: a systematic review of the literature--Part 1. Composition and micro- and macrostructure alterations [J]. Quintessence Int, 2007, 38(9): 733-743.
[4] Dejak B, Mlotkowski A. Finite element analysis of strength and adhesion of cast posts compared to glass fiber-reinforced composite resin posts in anterior teeth [J]. J Prosthet Dent, 2011, 105(2): 115-126.
[5] Leempoel PJ, van Rossum GM, de Haan AF, et al. Patients with crowns in general practice: a descriptive study of crown types in specific patients [J]. Ned Tijdschr Tandheelkd, 1987, 94(6): 241-244.
[6] Ma PS, Nicholls JI, Junge T, et al. Load fatigue of teeth with different ferrule lengths, restored with fiber posts, composite resin cores, and all-ceramic crowns [J]. J Prosthet Dent, 2009, 102(4): 229-234.
[7] Zhi-Yue L, Yu-Xing Z. Effects of post-core design and ferrule on fracture resistance of endodontically treated maxillary central incisors [J]. J Prosthet Dent, 2003, 89(4): 368-373.
[8] Akkayan B. An in vitro study evaluating the effect of ferrule length on fracture resistance of endodontically treated teeth restored with fiber-reinforced and zirconia dowel systems [J]. J Prosthet Dent, 2004, 92(2): 155-162.
[9] Chuang SF, Yaman P, Herrero A, et al. Influence of post material and length on endodontically treated incisors: an in vitro and finite element study [J]. J Prosthet Dent, 2010, 104(6): 379-388.
[10] Jindal S, Jindal R, Gupta K, et al. Comparative evaluation of the reinforcing effect of different post systems in the restoration of endodontically treated human anterior teeth at two different lengths of post space preparation- an in vitro study[J]. J Dent (Tehran), 2013, 10(2): 124-133.
[11] Borelli B, Sorrentino R, Zarone F, et al. Effect of the length of glass fiber posts on the fracture resistance of restored maxillary central incisors [J]. Am J Dent, 2012, 25(2): 79-83.
[12] Schiavetti R, Sannino G. In vitro evaluation of ferrule effect and depth of post insertion on fracture resistance of fiber posts [J]. Comput Math Methods Med, 2012, 2012: 816481.
[13] Jiangkongkho P, Kamonkhantikul K, Takahashi H, et al. Fracture resistance of endodontically treated teeth using fiber post with an elastic modulus similar to dentin[J]. Dent Mater J, 2013, 32(5): 781-786.
[14] Balkaya MC, Birdal IS. Effect of resin-based materials on fracture resistance of endodontically treated thin-walled teeth [J]. J Prosthet Dent, 2013, 109(5): 296-303.
[15] 屈波, 陈湘涛, 姜德志. 上颌中切牙常用桩核材料理想直径的三维有限元量化分析[J]. 中国组织工程研究与临床康复, 2010, 14(34): 6363-6366.
[16] Kivan? BH, Ala?am T, Ulusoy OI, et al. Fracture resistance of thin-walled roots restored with different post systems [J]. Int Endod J, 2009, 42(11): 997-1003.
[17] Ayad MF, Bahannan SA, Rosenstiel SF. Influence of irrigant, dowel type, and root-reinforcing material on fracture resistance of thin-walled endodontically treated teeth [J]. J Prosthodont, 2011, 20(3): 180-189.