J Endod：加压牙胶充填的双根上颌前磨牙颊根垂直根裂的分析

2018-06-09 lishiting MedSci原创

上颌前磨牙是所有牙齿中侧方加压牙胶充填后最易发生垂直性根折(VRF)的牙齿。这些牙齿的显著区别在于颊根的复杂解剖，包括其面向分叉处牙本质壁内的大凹陷。研究推测：牙齿切片法加上2维折裂分析可作为了解此类牙齿VRF的手段。通过牙齿切片法以及断裂力学分析检测VRF可以预测此类牙根VRF的发生。

上颌前磨牙是所有牙齿中侧方加压牙胶充填后最易发生垂直性根折(VRF)的牙齿。这些牙齿的显著区别在于颊根的复杂解剖，包括其面向分叉处牙本质壁内的大凹陷。研究推测：牙齿切片法加上2维折裂分析可作为了解此类牙齿VRF的手段。通过牙齿切片法以及断裂力学分析检测VRF可以预测此类牙根VRF的发生。

研究收集患者因VRF而拔除的牙齿，通过一系列的水平横向切片观察分析断裂面形态。对结合处实施2维断裂力学分析并应用有限元技术评估因根管压力造成的VRF (q)。按照作者之前的单根牙齿模型，通过一个简单的公式测算根尖封闭强度(F)与q的相关性。

结果显示，折裂主要发生在颊根，它展现出某种竞争模式，包括：从凹陷底至牙根表面以及根管表面至根表面，它既可以沿着直线发生，也可以像凹陷外形一样沿着弯曲轨迹发生。该分析可以较好的预测临床折裂的发生，它能够得出临床医师在侧方加压牙胶充填过程中产生VRF力值的上限。

结论：发生VRF的主要原因为楔形根管凹陷以及连接根和骨的牙周韧带组织的弹性所联合导致的应力集中。这种缺陷可以通过最小化根管扩大和根管治疗过程中的根尖加压强度而得到缓和。

原始出处：

Chai H， Tamse A. Vertical Root Fracture in Buccal Roots of Bifurcated Maxillary Premolars from Condensation of Gutta-percha. J Endod. 2018 Jun 1. pii： S0099-2399(18)30238-3. doi： 10.1016/j.joen.2018.03.017.

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2018-06-11 shanyongle

#根裂#

32 0
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2018-06-11 12498474m35暂无昵称

#磨牙#

28 0
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2018-06-11 医生2400

#前磨牙#

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2018-06-11 hanhaisha2015

#上颌#

30 0
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2018-06-09 有备才能无患

上颌前磨牙是所有牙齿中侧方加压牙胶充填后最易发生垂直性根折(VRF)的牙齿.这些牙齿的显著区别在于颊根的复杂解剖.包括其面向分叉处牙本质壁内的大凹陷.研究推测:牙齿切片法加上2维折裂分析可作为了解此类牙齿VRF的手段.通过牙齿切片法以及断裂力学分析检测VRF可以预测此类牙根VRF的发生.

58 0
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2018-06-09 1e1b8538m79(暂无匿称)

不错的文章.值得拥有

78 0
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2018-06-09 天地飞扬

了解一下.谢谢分享!

60 0

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