보철물 변연의 위치가 abfraction된 치아의 응력 분포에 미치는 영향에 대한 유한요소법적 분석
Effect of the marginal position of prosthesis on stress distribution of teeth with abfraction lesion using finite element analysis
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이 연구의 목적은 abfraction병소가 있는 금속도재관수복 치아를 수복하거나 하지 않을 때 나타나는 응력집중과 분포를 유한요소분석으로 평가하는 것이다. 재료 및 방법: 상악 제1 소구치를 선정하여 총 10개의 유한요소모델을 만들었다. 모델 1은 자연치; 모델 2는 협측과구개측 백악법랑경계 상방 2 mm에 변연이 위치한 금속도재관; 모델 3은 협측과구개측 백악법랑경계에 변연이 위치한 금속도재관; 모델 4는 abfraction병소를 가진 자연치; 모델 5와 6은 다른 조건은 각각 모델 2와 3과 동일하면서 abfraction병소를 가진 치아; 모델 7은 abfraction병소를 가지고 composite resin으로 수복된 자연치;모델 8과 9는 각각 모델 5와 6과 동일한 모델에 abfraction병소를 composite resin으로 수복한 후 금속도재관 장착한 치아; 모델 10은 composite resin으로 abfraction lesion을 수복하고 금속도재관의변연을 abfraction병소보다 하방에 위치시킨 치아였다. 위치를 서로 달리한 하중 load A와 load B를 가하여, 각 기준점에서의 von Mises stress값들을 측정하여 비교하였다. 결과: Abfraction병소가 있는 치아에 load A 또는 load B를 주었을 때, 응력은 lesion의 apex에 집중되었다. 반면, abfraction병소를 composite resin으로 충전한 치아에 load A 또는 load B를 주었을 때 응력값은 apex에서 감소하였다. 결론: Abfraction이 있는 치아는 복합 레진으로 수복해주는 것이 응력의 집중을 줄여서 병소의 예후에 유리한 것으로 나타났으며, Abfraction이 발생된 치아를 금속 도재관으로 수복할 경우 협측변연을 법랑질 상에 위치시키는 것이 유리하였다.
Abstract
The aim of this study was to evaluate the stress concentration and distribution whether restoring the cavity or not while restoring with metal ceramic crown on tooth with abfraction lesion using finite element analysis. Materials and methods: Maxillary first premolar was selected and made a total of 10 finite element model. Model 1 wasnatural tooth; Model 2 was tooth with metal ceramic crown restoration which margin was positioned above 2 mm from CEJ; Model 3 was tooth with metal ceramic crown restoration which margin was positioned on CEJ; Model 4 was natural tooth which has abfraction lesion; Model 5 and 6 had abfraction lesion and the other condition was same as model 2 and 3, respectively; Model 7 was natural tooth which had abfraction lesion restored with composite resin; Model 8 and 9 was tooth with metal ceramic crown after restoring on abfraction lesion with composite resin; Model 10 was restored tooth on abfraction lesion with composite resin and metal ceramic crown restoration which margin is positioned on lower border of abfraction lesion. Load A and Load B was also designed. Von Mises value was evaluated on each point. Results: Under load A or load B, on tooth with abfraction lesion, stress was concentrated on the apex of lesion. Under load A or load B, on tooth that abfraction lesion was restored with composite resin, the stress value was reduced on the apex. Conclusion: In case of abfraction lesion was restored with composite resin, the stress was concentrated on the apical border of restored cavity regardless of marginal position. It was favorable to place crown margin on the enamel for restoring with metal ceramic crown.
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