Actual problems in dentistry Actual problems in dentistry Проблемы стоматологии 2077-7566 2412-9461 46789 10.18481/2077-7566-21-17-3-114-118 ОРТОПЕДИЧЕСКАЯ СТОМАТОЛОГИЯ ORTHOPEDIC DENTISTRY ОРТОПЕДИЧЕСКАЯ СТОМАТОЛОГИЯ THE LABORATORY STUDY OF RESIN-BONDED FIXED PARTIAL DENTURES IN THE POSTERIOR REGION (IN PREMOLAR-SIZED SPANS). PART 1 ЛАБОРАТОРНОЕ ИЗУЧЕНИЕ АДГЕЗИВНЫХ МОСТОВИДНЫХ ПРОТЕЗОВ, ЗАМЕЩАЮЩИХ ВКЛЮЧЕННЫЕ ДЕФЕКТЫ В БОКОВЫХ ОТДЕЛАХ ЗУБНЫХ РЯДОВ. ЧАСТЬ 1 Петрикас Олег Арнольдович Petrikas Oleg Arnoldovich opetrikas@mail.ru Цыганков Константин Викторович Tsigankov Kobstantin Viktorovich konstantin.tsigankov@yandex.ru Петрикас Инга Владимировна Petrikas Inga Vladimirovna petrikas@inbox.ru

кандидат медицинских наук;

candidate of medical sciences;

 Тверской государственный медицинский университет, г. Тверь Тверь Россия Tver State Medical University Tver Russian Federation Тверской государственный медицинский университет, г. Тверь Тверь Россия Tver State Medical University Tver Russian Federation Тверской государственный медицинский университет Тверь Россия Тверской государственный медицинский университет Тверь Russian Federation Тверской государственный медицинский университет Тверь Россия Tver State Medical University Tver Russian Federation 17 3 114 118 05 11 2021 https://dental-press.ru/en/nauka/article/46789/view

Предмет. Разработанные в конце ХХ века адгезивные мостовидные протезы представляют сейчас реальную альтернативу традиционным мостовидным протезам и внутрикостным имплантатам. Однако считается, что их выживаемость уступает традиционным мостовидным протезам на искусственных коронках. Нарушение фиксации адгезивных мостовидных протезов на зубах при жесткой двусторонней фиксации (fixed/fixed) связано с разницей естественной подвижности опорных зубов. Поэтому для адгезивных мостовидных протезов предпочтителен вариант двусторонней фиксации по типу жестко-подвижного соединения (fixed/movable). Цель — изучение напряженно-деформированного состояния АМП с двусторонней фиксацией по типу жестко-подвижного соединения (fixed/movable) на одной из сторон включенного дефекта в боковом отделе зубного ряда. Методология. Был использован метод конечных элементов с целью предварительной оценки картины распределения напряжений для фиксированного АМП (из металла либо стекловолокна) с жестко-подвижным соединением. Расчет проводился с использованием специальных программ (Ansys 12.2 Inc. Ansys — CША и АРМ 3 D Studio — Россия). Результаты. Медиальная область напряжений находится лишь в зоне контакта окклюзионной накладки-лапки и медиального опорного зуба в количественном диапазоне 32-60 н/мм2. Дистальная область напряжений соответствует дистальному коннектору, находясь примерно в том же диапазоне — 40-65 н/мм2. В случае с металлическим ретейнером напряжения распространяются и на него — 4-37 н/мм2. В случае с волоконно-композитным ретейнером напряжения на него практически не распространяются — 1-14 н/мм2. Выводы. Анализ картины распределения напряжений для адгезивных мостовидных протезов с жестко-подвижным соединением, полученной методом конечных элементов, подтвердил: 1) целесообразность укорочения медиальной адгезивной накладки (малый ретейнер) и 2) выбор жесткой металлической (возможно, керамической) дистальной адгезивной накладки вместо слабо-жесткой волоконно-композитной адгезивной накладки (большой ретейнер).

Background. Developed at the end of the 20th century, resin-bonded fixed partial dentures are now a real alternative to traditional bridges and intraosseous implants. The mean survival rate of conventional fixed partial dentures clearly exceeds the mean survival rate of adhesive fixed partial dentures. Debonding of fixed/fixed resin-bonded fixed partial dentures is associated with the difference in the natural mobility of the abutment teeth. Therefore, the fixed/movable resin-bonded fixed partial dentures are preferable. Objectives — to study the stress distribution in fixed/movable resin-bonded fixed partial dentures RBFPD using finite element analysis. Methods. The finite element method was used to preliminary estimate the stress distribution pattern in fixed/movable resin-bonded fixed partial dentures (metal or fiberglass-composite). The calculation was carried out using special programs (Ansys 12.2 Inc. Ansys — USA and AWP 3 D Studio — Russia). Results. The medial area of stresses is located only in the contact zone of the occlusal rest in the quantitative range of 32-60 N/mm2. The distal area of stresses corresponds to the distal connector, being approximately in the same range — 40-65 N/mm2. In the case of a metal retainer, the stresses also apply to it — 4-37 N/mm2. In the case of a fiber-composite retainer, stresses are practically not applied to it — 1-14 N/mm2. Conclusions. Analysis of the stress distribution pattern for the fixed/movable resin-bonded fixed partial dentures, obtained by the finite element method, confirmed: 1) the expediency of shortening the minor retainer 2) the choice of a rigid metal (possibly ceramic) major retainer instead of a weakly rigid fiber-composite major retainer.

 адгезивные мостовидные протезы с жестко-подвижным соединением метод конечных элементов картина распределения напряжений большой ретейнер окклюзионная накладка fixed/movable resin-bonded fixed partial denture finite element analysis stress distribution pattern major retainer occlusal rest

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