發(fā)布時(shí)間：2018-01-22 18:10

  本文關(guān)鍵詞： 下頜第一前磨牙 髓腔固位冠 髓腔壁缺損 有限元　出處：《太原理工大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：口腔健康與生活質(zhì)量息息相關(guān),不但影響人的外在美觀、咀嚼和消化功能,還會(huì)影響患者的心理健康。因此,口腔健康日益受到關(guān)注和重視。臨床上常見因齲病、外傷、嚴(yán)重磨耗等造成的牙體缺損。缺損牙修復(fù)方式眾多,如何根據(jù)病人的牙體缺損情況確定最佳修復(fù)方式,盡可能延長(zhǎng)修復(fù)牙的使用壽命,顯得尤為重要。對(duì)于下頜第一前磨牙不同髓腔壁缺損的情況,目前臨床常采用三種修復(fù)方式:整體式髓腔固位冠修復(fù)(IER);流動(dòng)樹脂行齦壁提升+髓腔固位冠修復(fù)(FRER);超聲波樹脂行齦壁提升+髓腔固位冠修復(fù)(URER)。對(duì)于特定髓腔壁缺損形態(tài),不同修復(fù)方式對(duì)修復(fù)牙的應(yīng)力分布有何影響,以及采用何種修復(fù)方式可以達(dá)到最理想的應(yīng)力分布狀態(tài),相關(guān)研究未見報(bào)道,臨床上多基于醫(yī)生經(jīng)驗(yàn)。本文采用有限元法對(duì)此臨床問題進(jìn)行分析研究,期望可為臨床優(yōu)化設(shè)計(jì)、方案選擇提供參考�；贑T斷層圖像,利用Mimics、Geomagic、UG、Hypermesh軟件建立了下頜第一前磨牙五種不同髓腔壁缺損形態(tài)(A組:完整髓腔壁;B組:舌側(cè)髓腔壁;C組:頰側(cè)髓腔壁;D組:遠(yuǎn)中側(cè)髓腔壁以及E組:頰舌側(cè)髓腔壁)的基牙預(yù)備體有限元模型,且設(shè)計(jì)了對(duì)應(yīng)的三組共13個(gè)修復(fù)體有限元模型。采用Abaqus軟件計(jì)算分析三種修復(fù)方式分別修復(fù)不同髓腔壁缺損形態(tài)時(shí),修復(fù)牙的應(yīng)力分布情況。并對(duì)比分析了三種修復(fù)方式用于修復(fù)不同髓腔壁缺損形態(tài)時(shí)的優(yōu)劣性。主要結(jié)果如下:(1)不論何種修復(fù)方式及髓腔壁缺損形態(tài),咀嚼產(chǎn)生的側(cè)向力是威脅修復(fù)牙修復(fù)效果和壽命的重要因素。提示臨床應(yīng)盡量減小牙尖傾斜度以減小側(cè)向力對(duì)修復(fù)牙的不良影響;(2)頰側(cè)髓腔壁的存在可改善IER的修復(fù)效果。遠(yuǎn)中側(cè)髓腔壁的存在可改善FRER、URER的修復(fù)效果。頰側(cè)髓腔壁的缺損會(huì)使得IER修復(fù)牙本質(zhì)內(nèi)應(yīng)力水平顯著提高,遠(yuǎn)中側(cè)髓腔壁缺損會(huì)使得FRER、URER修復(fù)牙體組織中應(yīng)力水平顯著提高;(3)不論何種髓腔壁缺損形態(tài),IER修復(fù)均可使修復(fù)牙獲得最理想的應(yīng)力分布狀態(tài),URER修復(fù)方式次之,FRER修復(fù)方式的修復(fù)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.

【學(xué)位授予單位】：太原理工大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R783.3

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