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目的:应用三维有限元法比较颈部穿髓型缺损的切牙,在唇侧和舌侧不同开髓入路下的牙体受力情况,探讨唇侧入路在抗折力方面是否具有优势。方法:进行锥形束CT(cone-beam CT,CBCT)扫描,采用Mimics、Catia、Ansys软件建立上切牙模型,分别用唇、舌侧2种入路及直接树脂充填、纤维桩树脂修复、纤维桩全瓷冠修复3种不同修复方式,对其施加载荷,比较缺损部位及髓腔根管表面应力分布和最大von Mises值,采用Ansys10.0有限元分析软件对数据进行统计学分析。结果:在实验条件下,直接树脂修复时,唇、舌侧入路无明显区别;纤维桩复合树脂修复时,唇侧入路可以转移牙体应力集中部位,降低缺损处牙体折断几率而增加根折几率;桩冠修复可有效分散缺损处的应力集中,从而降低牙体从缺损处折断的几率。结论:对于颈部穿髓型缺损的切牙,直接树脂充填时,唇、舌侧入路均可采用;纤维桩树脂修复和桩冠修复时,分散了牙体应力的集中,而唇侧入路较舌侧入路更为明显。
OBJECTIVE: To compare the stress of the tooth under different open pulp approach on the labial and lingual sides using three-dimensional finite element method to compare the incisors of the cervical pulp-type defects and to explore whether the labial approach has an advantage in the resistance to fracture . Methods: Cone-beam CT (CBCT) scanning was performed. The upper incisor model was established by using Mimics, Catia and Ansys software. The lip and lingual approach and direct resin filling, Three different repair methods were applied to the fiber post crown. The stress distribution and the maximum von Mises value of the defect site and canal surface were compared. The data were analyzed by Ansys10.0 finite element software. Results: Under the experimental conditions, there was no significant difference between the lip and lingual approach when the direct resin was repaired. When the fiber post composite resin was repaired, the labial approach could transfer the tooth stress concentration site and decrease the probability of tooth fracture in the defect Root fracture rate; post crown repair can effectively disperse the stress concentration at the defect, thereby reducing the probability of tooth damage from the defect. CONCLUSIONS: For the incisors with cervical medullary defect, the lip and lingual approach can be used for the direct resin filling. When the fiber post resin restoration and post crown restoration, the dental stress is concentrated, and the lip side The road is more obvious than the lingual approach.