不同桩核金属烤瓷全冠修复后前牙抗剪切力的实验研究

目的 探讨不同桩核系统金属烤瓷全冠修复上颌前牙后修复体抗剪切力的差异.方法 对40颗大小相似的新鲜上颌中切牙行根管充填后截冠,随机分成4组,每组10颗.其中3组分别用纤维增强树脂桩和树脂核、预成钛合金桩和树脂核,铸造镍铬合金桩核修复,桩核与金属烤瓷全冠均用树脂粘接剂粘固;另1组用玻璃离子粘固剂粘固铸造镍铬合金桩核和金属烤瓷全冠作为对照组.经温度循环疲劳实验,用万能力学实验机测试样本牙的抗剪切力,并观测折裂型,进行统计学分析.结果 纤维增强树脂桩组、预成钛合金桩组、铸造桩核组及对照组的抗剪切力分别为(534.4±145.7)N、(499.8±168.9)N、(412.6±99.3)N、(337.4±121.2)N.纤维增强树脂桩组和预成钛合金桩组的抗剪切力大于对照组,差异有统计学意义(P＜0.05);纤维增强树脂桩组中可再修复折裂型样本牙数量多于其他组,差异有统计学意义(P＜0.05).结论 纤维增强树脂桩核金属烤瓷全冠修复有较好的抗剪切力,且折裂型多为可再修复型,修复后残根保存率高.

An experimental study on fracture resistance of metal-ceramic crowned incisors with different postcore systems

OBJECTIVE: To evaluate fracture resistance of metal-ceramic crown restored incisors with different post-and-core systems. METHODS: Selected 40 intact maxillary central incisors were endodontically treated and then randomly assigned to four groups of 10 teeth each. Teeth in Group A were prepared to root canal with 10 mm in length, 1.6 mm in diameter and restored with fiber-reinforced posts and composite cores. Same final preparation but root canal with 1.5 mm in diameter was achieved for teeth in the other three groups. Teeth in Group B were restored with prefabricated titanium alloy posts and composite cores and teeth in Group C were restored with cast nickel-chromium post-cores. The posts were luted with a composite resin luting system, and metal-ceramic crowns were restored and cemented with the same luting system for all of the teeth in Group A, B and C. The other 10 teeth were restored with cast nickel-chromium post-cores and metal-ceramic crowns as a control, which were cemented with glass-ionomer cement. All restored teeth were thermocycled for 5000 cycles (5 degrees C/55 degrees C) as a fatigue test. The tooth was loaded in a universal testing machine at an angle of 135 degrees to the long-axis at the incisal edge with a crosshead speed of 1.5 mm/min until fracture. Fracture loads (N) and modes (repairable or catastrophic) were recorded. One-way ANOVA and SNK test were used to determine the significance of the failure loads between groups. Chi-square test was conducted for evaluation of the fracture mode. RESULTS: The fracture loads from Group A, B, C and control group were (534.4 +/- 145.7) N, (499.8 +/- 168.9) N, (412.6 +/- 99.3) N, (337.4 +/- 121.2) N, respectively. A significant difference was existed among four groups (P < 0.05). The fracture loads of Group A and Group B were significantly higher than control group (P < 0.05). The repairable mode of fracture observed from Group A to control group was 80%, 40%, 20% and 30%, Group A had a significantly higher number of repairable fractures than those of the other groups (P < 0.05). CONCLUSIONS: Within the limitations of this study, fiber-reinforced post has an excellent fracture resistance, and can be recommended as an alternative to cast post-cores, especially for incisor esthetic restoration.