Influence of Apical Root Resection on the Biomechanical Response of a Single-rooted Tooth: A 3-dimensional Finite Element Analysis
Influence of Apical Root Resection on the Biomechanical Response of a Single-rooted Tooth: A 3-dimensional Finite Element Analysis
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DOI：
10.1016/j.joen.2014.03.006
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发表时间：
2014-09-01
影响因子：
4.2
通讯作者：
Chun, Heoung-Jae
中科院分区：
文献类型：
--
作者：
Jang, Youngjune;Hong, Hyoung-Taek;Chun, Heoung-Jae
前言：根尖切除术是根管显微外科的一个重要组成部分。然而，由于它减少了总的牙根长度和支持的牙根表面，它改变了牙齿的生物力学反应。本研究的目的是从生物力学的角度分析根尖切除术的生物力学效应，并比较根尖切除术与牙周骨缺损的差异。方法：建立上颌中切牙的有限元模型。首先，术前和手术治疗的模型，以评估改变牙齿的生物力学反应的因素。然后，建立不同切除量（3，4，5，6，7和8 mm）的根尖切除模型，以估计根尖切除的临床适用范围。牙周破坏的模型，不同程度的骨质流失（0.5，1，1.5，2，和3毫米），还建立了比较根尖根切除牙周骨流失的影响。分析了每种情况下的应力分布、牙齿位移和有效冠根比（α）。结果如下：根尖根切除术并没有显着改变最大冯米塞斯应力或牙齿位移，直到它达到6毫米（α = 0.67）时，牙齿是由正常的牙周组织支持。与根尖切除相比，牙周骨缺损对生物力学的影响更大。结论：对于正常牙周组织支持的牙齿，根尖切除3 mm（α = 1.07）似乎是机械上可接受的。与牙周骨缺损相比，根尖切除对牙周组织的生物力学影响较小。
Introduction: Apical root resection is a biologically essential component in endodontic microsurgery. However, because it reduces the total root length and supported root surface, it changes the biomechanical response of the tooth. The purpose of this study was to analyze the biomechanical effect of apical root resection and to compare apical root resection with periodontal bone loss from a biomechanical standpoint. Methods: Finite element models of the maxillary central incisor were reconstructed. First, preoperative and surgically treated models were generated to assess the factors altering the biomechanical response of the tooth. Then, apically resected models with different amounts of resection (3, 4, 5, 6, 7, and 8 mm) were created to estimate the clinically applicable limit of apical root resection. Periodontally destructed models with varying degrees of bone loss (0.5, 1, 1.5, 2, and 3 mm) were also created to compare the effect of apical root resection with periodontal bone loss. Stress distribution, tooth displacement, and effective crown-to-root ratio (alpha) were analyzed for each condition. Results: Apical root resection did not significantly alter the maximum von Mises stress or tooth displacement until it reached 6 mm (alpha = 0.67) when the tooth was supported by normal periodontium. In contrast, periodontal bone loss had a greater impact on biomechanical response change compared with apical root resection. Conclusions: For a tooth supported by normal periodontium, 3 mm of apical root resection (alpha = 1.07) appeared to be mechanically acceptable. The biomechanical influence of apical root resection was weak compared with that of periodontal bone loss.