目的 探索单翼马里兰桥修复在不适合常规种植修复的上颌中切牙缺失修复中的应用。方法 选择单侧上颌中切牙缺失、骨条件不适合常规种植修复、要求微创修复患者1例,利用单翼马里兰桥完成固定修复缺失牙的临床目的及美学效果。建立三维有限元模型,对桥体分别进行100、150、200 N载荷模拟加载,进行力学分析。结果 上颌中切牙单翼马里兰桥载荷100、150、150 N时,桥体最大应力分别为67.68、101.53、135.37 MPa,不同载荷下的应力分布趋势相似,应力集中于桥体与天然牙切端交界处及加载点。随着载荷增加,各部位的等效应力相应增加,加载点及切端交界处尤为明显。结论 单翼马里兰桥应在天然牙黏结面近切端处增加桥体强度、黏结强度,适当减少桥体咬合接触。
Abstract
Objective To explore the use of cantilevered Maryland Bridge to repair the loss of maxillary anterior teeth that were not suitable for conventional implantation. Methods One case of maxillary central incisor missing, bone condition not suitable for conventional implantation and pursuing minimally invasive restoration was selected. The clinical purpose and aesthetic effect of repairing missing teeth were completed by using cantilevered Maryland Bridge. Through the three-dimensional finite element model of the cantilevered Maryland Bridge of maxillary central incisor, the bridge was loaded with 100, 150 and 200 N loads respectively, and the mechanical analysis was carried out. Results When the cantilevered Maryland Bridge loaded with 100, 150 and 150 N, the maximum stress of the bridge body were 67.68, 101.53 and 135.37 MPa respectively. The stress distribution trend of maxillary central incisor cantilevered Maryland Bridge under different loads was similar, and the stress was concentrated at the junction and loading point between the bridge and the natural incisor. With the increase of load, the equivalent stress of each part increased accordingly, especially at the junction of loading point and cutting end. Conclusions The bonding strength of cantilevered Maryland Bridge should be increased at the proximal end of the natural tooth bonding surface and the occlusal contact of the bridge should be appropriately reduced.
关键词
马里兰桥 /
三维有限元模型 /
应力分布 /
上颌中切牙
Key words
Maryland bridge /
three dimensional finite element model /
stress distribution /
maxillary central incisor
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参考文献
[1] Kern M, Knode H, Strubb J R. The all porcelain, resin-bonded bridge[J]. Quintessence Int, 1991, 22(4): 257-262.
[2] Weng D, Ries S, Richter E J. Treatment of a juvenile patient with a maxillary all-ceramic resin-bonded fixed partial denture: a case report[J]. Quintessence Int, 2002, 33(8): 584-588.
[3] 宁江海, 高 飞, 章捍东, 等. 改良式固定型马里兰桥修复老年前牙缺失的临床效果观察[J]. 解放军医学杂志, 2007, 32(4): 3.
[4] 胡 建, 章非敏, 戴 宁, 等. 不同厚度上颌中切牙全瓷冠应力分布的有限元研究[J]. 华西口腔医学杂志, 2012, 30(4): 356-359.
[5] Wei Y R, Wang X D, Zhang Q, et al. Clinical performance of anterior resin-bonded fixed dental prostheses with different framework designs: a systematic review and meta-analysis[J]. J Dent, 2016, 47:1-7.
[6] Pjetursson B E, Tan W C, Tan K, et al. A systematic review of the survival and complication rates of resin-bonded bridges after an observation period of at least 5 years[J]. Clin Oral Implants Res, 2008, 19(2): 131-141.
[7] Gratton D R, Jordan R E, Teteruck W R. Resin-bonded bridges: the state of the art[J]. Ont Dent, 1983, 60(5): 9-11, 13-16, 18-19.
[8] Kern M, Glaser R. Cantilevered all ceramic, resin-bonded fixed partial dentures: a new treatment modality[J]. J Esthet Dent, 1997, 9(5): 255-264.
[9] Sasse M, Eschbach S, Kern M. Randomized clinical trial on single retainer all-ceramic resin-bonded fixed partial dentures: influence of the bonding system after up to 55 months[J]. J Dent, 2012, 40(9): 783-786.
[10] Dundar M, Ozcan M, Comlekoglu M E, et al. A preliminary report on short-term clinical outcomes of three-unit resin-bonded fixed prostheses using two adhesive cements and surface conditioning combinations[J]. Int J Prosthodont, 2010, 23(4): 353-360.
[11] Dalen A, Feilzer A J, Kleverlaan C J. A literature review of two-unit cantilevered FPDs[J]. Int J Prosthodont, 2004, 17(3): 281-284.
[12] Rosentritt M, Ries S, Kolbeck C,et al. Fracture characteristics of anterior resin-bonded zirconia-fixed partial dentures[J]. Clin Oral Investig, 2009, 13(4): 453-457.
[13] Johnston C, Hussey D L. The immediate replacement of incisor teeth by cantilevered adhesive bridgework[J]. Dent Update, 1993, 20(8): 333-334.
[14] Saker S, Fallal A, Madina M, et al. Clinical survival of anterior metal-ceramic and all-ceramic cantilever resin-bonded fixed dental prostheses over a period of 60 months[J]. Int J Prosthodont, 2014, 27(5): 422-424.
[15] Sailer I, Bonani T, Brodbeck U, et al. Retrospective clinical study of single-retainer cantilever anterior and posterior glass-ceramic resin-bonded fixed dental prostheses at a mean follow-up of 6 years[J]. Int J Prosthodont, 2013, 26(5): 443-450.
[16] Sasse M, Kern M. CAD/CAM single retainer zirconia-ceramic resin-bonded fixed dental prostheses: clinical outcome after 5 years[J]. Int J Comput Dent, 2013, 16(2): 109-118.
[17] Gutmann J L. The origin of the Maryland bridge[J]. J Hist Dent, 2019, 67(2): 110.
[18] Moon S Y, Lim Y J, Kim M J, et al. Three-dimensional finite element analysis of platform switched implant[J]. J Adv Prosthodont, 2017, 9(1): 31-37.
[19] 刘佳怡, 何雨桐, 汪振华. 有限元分析法在口腔修复学中的应用进展[J]. 医学综述, 2019, 25(16): 5.
[20] Eraslan O, Eraslan O, Eskitascioglu G, et al. Conservative restoration of severely damaged endodontically treated premolar teeth: a FEM study[J]. Clin Oral Investig, 2011, 15(3): 403-408.
[21] Barink M, Mark P C, Fennis W M, et al. A three-dimensional finite element model of the polymerization process in dental restorations[J]. Biomaterials, 2003, 24(8): 1427-1435.
[22] Jiang W, Bo H, Yongchun G,et al. Stress distribution in molars restored with inlays or onlays with or without endodontic treatment: a three-dimensional finite element analysis[J]. J Prosthet Dent, 2010, 103(1): 6-12.
[23] Yokoyama D, Shinya A, Gomi H, et al. Effects of mechanical properties of adhesive resin cements on stress distribution in fiber-reinforced composite adhesive fixed partial dentures[J]. Dent Mater J, 2012, 31(2): 189-196.
[24] Toman M, Toksavul S, Sabanci S,et al. Three-dimensional finite element analysis of stress distribution of two-retainer and single-retainer all-ceramic resin-bonded fixed partial dentures[J]. Quintessence Int, 2015, 46(8): 691-696.
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