Fracture simulation of restored teeth using a continuum damage mechanics failure model

Modeling fracture in multilayered teeth using the finite volume-based phase field method

The present work, utilizing the finite volume-based phase field method (FV-based PFM), aims to investigate the initiation and propagation of cracks in the second molar of the left mandible under occlusal loading. By reconstructing cone beam computed tomography scans of the patient, the true morphology and internal mesostructure of the entire tooth are implemented into numerical simulations, including both 2D slice models and a realistic 3D model. Weibull functions are introduced to represent the tooth's heterogeneity, enabling the stochastic distribution characteristics of mechanical parameters. The results indicate that stronger heterogeneity leads to greater crack tortuosity, uneven damage distribution, and lower fracture stress. Additionally, different cusp angles (50° and 70°) and pre-existing fissure morphologies (i.e., U-shape, V-shape, IK-shape, I-shape, and IY-shape) also significantly affect the mechanical performance of the tooth. The study reveals that different cusp angles affect the location of crack initiation. Overall, this work demonstrates the utility of the FV-based PFM framework in capturing the complex fracture behavior of teeth, which can contribute to improved clinical treatment and prevention of tooth fractures. The insights gained from this study can inform the design of dental crown restorations and the optimization of cusp inclination and contact during clinical occlusal adjustments.

Marginal integrity in minimally invasive molar resin composite restorations: Impact of polymerization shrinkage

OBJECTIVES

This study utilized non-linear finite element (FE) models to explore polymerization shrinkage and its impact on marginal integrity in molars following both selective caries removal (SCR) and conventional treatment. Specifically, we performed 2D in silico simulations to study residual stresses post-resin polymerization shrinkage and their influence on the marginal integrity of various restoration types.

METHODS

Initially, FE models were developed based on a cohesive zone framework to simulate crack propagation along the bonded interfaces between restoration and tooth structure in SCR-treated molars with class I and class II restorations. The modeled resin composite restorations first underwent polymerization shrinkage and were then subjected to various occlusal loading conditions. Stress magnitudes and distributions were identified to evaluate the margin integrity and predict the mechanism and location of interfacial failure.

RESULTS AND DISCUSSION

The FE models computed polymerization shrinkage stresses of less than 1 MPa, exerting a minor influence on the composite/tooth interface. Occlusal loading, however, significantly impacted the load-bearing capacity of the composite/tooth (c/t) interface, potentially jeopardizing the restoration integrity. Especially under bi-axial occlusal loading, interfacial debonding occurred in the vertical cavity walls of the class I restorations, increasing the risk of failure. Notably, SCR-treated teeth exhibited better margin integrity than restored teeth after complete caries removal (NCR). These findings provide valuable insights into the mechanical behavior of SCR-treated teeth under different loading conditions and highlight the importance of considering the load scenarios that may lead to failure at the c/t interface. By investigating the factors influencing crack initiation and delamination, this novel research contributes to the optimization of restorative treatments and aids in the design of more resilient dental restorations.

Simulating the shrinkage-induced interfacial damage around Class I composite resin restorations with damage mechanics

OBJECTIVES

To investigate the shrinkage-induced damage at the composite-tooth interface by finite element analysis (FEA) using the cohesive zone model (CZM).

METHODS

Axisymmetric models of Class I restorations were created to illustrate the interfacial damage around composite resin restorations of different dimensions, with polymerization shrinkage modeled analogously to thermal shrinkage. The damage to the adhesive interface was determined using a CZM based on the fracture strength and fracture energy. To show the effects of damage, conventional models with perfectly bonded composite resin restorations were created as controls.

RESULTS

The results indicated interfacial damage at the butt-joint cavosurface margin, dentinoenamel junction, and internal line angle. The percentage of damaged interfacial area was found to increase with decreasing diameter for restorations of the same height. For a given diameter, the damage was more severe for restorations of greater depth. The effects of the damage were further illustrated in the model with a restoration of 2-mm diameter and height. The interfacial damage occurred primarily at the internal line angle (83.3 % of all the damaged interfacial area), leading to local stress relief (from 18.3 MPa to 12.8 MPa), but also higher stress at the damage fronts. Greater local shrinkage was found in composites adjacent to the damage.

SIGNIFICANCE

The damage mechanics-based CZM is an essential refinement of the FEA to predict interfacial damage and its implications. The extent of damage was found to be greater around restorations with smaller diameters and greater depths. The entire simulation is available via an open-source platform to facilitate further applications in adhesive dentistry.

Fracture behavior of restored teeth and cavity shape optimization: Numerical and experimental investigation

OBJECTIVES

Since restored teeth are subject to more damages than intact teeth, investigating their fracture behavior is important. However, so far, improvement of the debonding behavior of the restoration and fracture of restored teeth considering the geometry of the restoration and different restorative materials has remained understudied. The aim of this paper is to numerically and experimentally investigate the debonding behavior of the restoration in premolar teeth in order to reduce the stress of restoration thereby reducing the mechanical failure.

METHODS

the fracture test for intact and Standard Class-II Mesial-Occlusal-Distal (MOD) restoration premolar teeth restored with several types of composite and conventional adhesive was performed in order to investigate their fracture behavior. The mechanical properties and fracture of composites as well as the adhesives used in experimental tests were obtained through separate standard mechanical tests. In addition, a number of composites and other adhesives were also chosen from other references, and by numerically simulating the fracture process of intact teeth and those restored with the materials of interest, the fracture behavior and yield load limit were investigated and predicted for them. Next, in order to reduce the stresses of bonding region and improve the damage behavior, using the stress-induced material transformation (SMT) optimization algorithm applied as code in finite element (FE) software, the shape of the restoration has been optimized based on different restorative materials. In order to confirm the numerical results, the fracture tests of teeth samples were performed with conventional and optimized restoration forms. Furthermore, using scanning electron microscopy (SEM) method, the fracture surface of the tested samples was examined.

RESULTS

since the fracture behavior of teeth restored with different materials is different, the optimized MOD restoration would be also different for each of these restorative materials. By selecting TU-shape for the restoration in each of the samples, the debonding resistance and final fracture of teeth compared to the MOD restoration increased 51% in P_d and 11% in P_f for numerical results and 40% in P_d and 4% in P_f for experimental results. The obtained results suggest that choosing a proper shape for the restoration based on the properties of restorative materials leads to diminished normal and shear stresses and enhanced debonding resistance. Also, the yield load limit of the defective teeth would also improve considerably.

SIGNIFICANCE

The clinical importance of this study is to predict strength of restored teeth and cavity shape optimization under variable conditions. Also, this paper introduces effective parameters on strength reduction/enhancement to dentists.

OpenMandible: An open-source framework for highly realistic numerical modelling of lower mandible physiology

OBJECTIVE

Computer modeling of lower mandible physiology remains challenging because prescribing realistic material characteristics and boundary conditions from medical scans requires advanced equipment and skill sets. The objective of this study is to provide a framework that could reduce simplifications made and inconsistency (in terms of geometry, materials, and boundary conditions) among further studies on the topic.

METHODS

The OpenMandible framework offers: 1) the first publicly available multiscale model of the mandible developed by combining cone beam computerized tomography (CBCT) and μCT imaging modalities, and 2) a C++ software tool for the generation of simulation-ready models (tet4 and hex8 elements). In addition to the application of conventional (Neumann and Dirichlet) boundary conditions, OpenMandible introduces a novel geodesic wave propagation - based approach for incorporating orthotropic micromechanical characteristics of cortical bone, and a unique algorithm for modeling muscles as uniformly directed vectors. The base intact model includes the mandible (spongy and compact bone), 14 teeth (comprising dentin, enamel, periodontal ligament, and pulp), simplified temporomandibular joints, and masticatory muscles (masseter, temporalis, medial, and lateral pterygoid).

RESULTS

The complete source code, executables, showcases, and sample data are freely available on the public repository: https://github.com/ArsoVukicevic/OpenMandible. It has been demonstrated that by slightly editing the baseline model, one can study different "virtual" treatments or diseases, including tooth restoration, placement of implants, mandible bone degradation, and others.

SIGNIFICANCE

OpenMandible eases the community to undertake a broad range of studies on the topic, while increasing their consistency and reproducibility. At the same time, the needs for dedicated equipment and skills for developing realistic simulation models are significantly reduced.

Risk factors and the natural history of accelerated knee osteoarthritis: a narrative review

BACKGROUND

Osteoarthritis is generally a slowly progressive disorder. However, at least 1 in 7 people with incident knee osteoarthritis develop an abrupt progression to advanced-stage radiographic disease, many within 12 months. We summarize what is known - primarily based on findings from the Osteoarthritis Initiative - about the risk factors and natural history of accelerated knee osteoarthritis (AKOA) - defined as a transition from no radiographic knee osteoarthritis to advanced-stage disease < 4 years - and put these findings in context with typical osteoarthritis (slowly progressing disease), aging, prior case reports/series, and relevant animal models. Risk factors in the 2 to 4 years before radiographic manifestation of AKOA (onset) include older age, higher body mass index, altered joint alignment, contralateral osteoarthritis, greater pre-radiographic disease burden (structural, symptoms, and function), or low fasting glucose. One to 2 years before AKOA onset people often exhibit rapid articular cartilage loss, larger bone marrow lesions and effusion-synovitis, more meniscal pathology, slower chair-stand or walking pace, and increased global impact of arthritis than adults with typical knee osteoarthritis. Increased joint symptoms predispose a person to new joint trauma, which for someone who develops AKOA is often characterized by a destabilizing meniscal tear (e.g., radial or root tear). One in 7 people with AKOA onset subsequently receive a knee replacement during a 9-year period. The median time from any increase in radiographic severity to knee replacement is only 2.3 years. Despite some similarities, AKOA is different than other rapidly progressive arthropathies and collapsing these phenomena together or extracting results from one type of osteoarthritis to another should be avoided until further research comparing these types of osteoarthritis is conducted. Animal models that induce meniscal damage in the presence of other risk factors or create an incongruent distribution of loading on joints create an accelerated form of osteoarthritis compared to other models and may offer insights into AKOA.

CONCLUSION

Accelerated knee osteoarthritis is unique from typical knee osteoarthritis. The incidence of AKOA in the Osteoarthritis Initiative and Chingford Study is substantial. AKOA needs to be taken into account and studied in epidemiologic studies and clinical trials.

Occupational Activities: Factors That Tip the Balance From Bone Accrual to Bone Loss

Bone adaptation to persistent overloading can be counteracted by superimposed inflammatory and loading-induced damage that can tip the balance from bone accrual to loss.

Supplemental digital content is available in the text.

It is commonly assumed that beneficial adaptations in bone occur with vigorous exercise, yet any adaptive re/modeling in bone undergoing persistent overloading can be counteracted by superimposed inflammatory, compressive, and tensile loading–induced damage responses above thresholds of tissue fatigue failure and repair. This leads to a tenuous balance between achieving bone accrual and loss.

Fatigue Life of the Human Teeth: A Continuum Damage Approach

Normal oral food ingestion processes such as mastication would not have been possible without the teeth. The human teeth are subjected to many cyclic loadings per day. This, in turn, exerts forces on the teeth just like an engineering material undergoing the same cyclic loading. Over a period, there will be the creation of microcracks on the teeth that might not be visible ab initio. The constant formation of these microcracks weakens the teeth structure and foundation that result in its fracture. Therefore, the need to predict the fatigue life for human teeth is essential. In this paper, a continuum damage mechanics (CDM) based model is employed to evaluate the fatigue life of the human teeth. The material characteristic of the teeth is captured within the framework of the elastoplastic model. By applying the damage evolution equivalence, a mathematical formula is developed that describes the fatigue life in terms of the stress amplitude. Existing experimental data served as a guide as to the completeness of the proposed model. Results as a function of age and tubule orientation are presented. The outcomes produced by the current study have substantial agreement with the experimental results when plotted on the same axes. There is a notable difference in the number of cycles to failure as the tubule orientation increases. It is also revealed that the developed model could forecast for any tubule orientation and be adopted for both young and old teeth.

Prolonged high force high repetition pulling induces osteocyte apoptosis and trabecular bone loss in distal radius, while low force high repetition pulling induces bone anabolism

We have an operant rat model of upper extremity reaching and grasping in which we examined the impact of performing a high force high repetition (High-ForceHR) versus a low force low repetition (Low-ForceHR) task for 18weeks on the radius and ulna, compared to age-matched controls. High-ForceHR rats performed at 4 reaches/min and 50% of their maximum voluntary pulling force for 2h/day, 3days/week. Low-ForceHR rats performed at 6% maximum voluntary pulling force. High-ForceHR rats showed decreased trabecular bone volume in the distal metaphyseal radius, decreased anabolic indices in this same bone region (e.g., decreased osteoblasts and bone formation rate), and increased catabolic indices (e.g., microcracks, increased osteocyte apoptosis, secreted sclerostin, RANKL, and osteoclast numbers), compared to controls. Distal metaphyseal trabeculae in the ulna of High-ForceHR rats showed a non-significant decrease in bone volume, some catabolic indices (e.g., decreased trabecular numbers) yet also some anabolic indices (e.g., increased osteoblasts and trabecular thickness). In contrast, the mid-diaphyseal region of High-ForceHR rats' radial and ulnar bones showed few to no microarchitecture differences and no changes in apoptosis, sclerostin or RANKL levels, compared to controls. In further contrast, Low-ForceHR rats showed increased trabecular bone volume in the radius in the distal metaphysis and increased cortical bone area its mid-diaphysis. These changes were accompanied by increased anabolic indices, no microcracks or osteocyte apoptosis, and decreased RANKL in each region, compared to controls. Ulnar bones of Low-ForceHR rats also showed increased anabolic indices, although fewer than in the adjacent radius. Thus, prolonged performance of an upper extremity reaching and grasping task is loading-, region-, and bone-dependent, with high force loads at high repetition rates inducing region-specific increases in bone degradative changes that were most prominent in distal radial trabeculae, while low force task loads at high repetition rates induced adaptive bone responses.

Numerical fatigue analysis of premolars restored by CAD/CAM ceramic crowns

OBJECTIVES

The purpose of this study was to estimate the fatigue life of premolars restored with two dental ceramics, lithium disilicate (LD) and polymer infiltrated ceramic (PIC) using the numerical method and compare it with the published in vitro data.

METHODS

A premolar restored with full-coverage crown was digitized. The volumetric shape of tooth tissues and crowns were created in Mimics^®. They were transferred to IA-FEMesh for mesh generation and the model was analyzed with Abaqus. By combining the stress distribution results with fatigue stress-life (S-N) approach, the lifetime of restored premolars was predicted.

RESULTS

The predicted lifetime was 1,231,318 cycles for LD with fatigue load of 1400N, while the one for PIC was 475,063 cycles with the load of 870N. The peak value of maximum principal stress occurred at the contact area (LD: 172MPa and PIC: 96MPa) and central fossa (LD: 100MPa and PIC: 64MPa) for both ceramics which were the most seen failure areas in the experiment. In the adhesive layer, the maximum shear stress was observed at the shoulder area (LD: 53.6MPa and PIC: 29MPa).

SIGNIFICANCE

The fatigue life and failure modes of all-ceramic crown determined by the numerical method seem to correlate well with the previous experimental study.

Stress Analysis of a Class II MO-Restored Tooth Using a 3D CT-Based Finite Element Model

A computational method has been developed for stress analysis of a restored tooth so that experimental effort can be minimized. The objectives of this study include (i) developing a method to create a 3D FE assembly model for a restored tooth based on CT images and (ii) conducting stress analysis of the restored tooth using the 3D FE model established. To build up a solid computational model of a tooth, a method has been proposed to construct a 3D model from 2D CT-scanned images. Facilitated with CAD tools, the 3D tooth model has been virtually incorporated with a Class II MO restoration. The tooth model is triphasic, including the enamel, dentin, and pulp phases. To mimic the natural constraint on the movement of the tooth model, its corresponding mandible model has also been generated. The relative high maximum principal stress values were computed at the surface under loading and in the marginal region of the interface between the restoration and the tooth phases.

A comparison of bond strengths measured using cantilever bending and micro-tensile methods

OBJECTIVES

The purpose of this study was to evaluate the cantilever-bending test as a bond-strength measurement method for enamel/composite adhesion.

MATERIALS AND METHODS

The buccal surface of bovine incisors were flattened and subsequently placed with composite Z250 (3M ESPE) incrementally after either self-etching adhesive (SE) or etch-and-rinse adhesive (SB) was applied. Then, they were cut with a low-speed cutter to obtain stick-shape samples. The samples were divided into four groups (n=30 each) according to the adhesive and test method: SET, SE-B, SB-T and SB-B, where T denotes the microtensile test and B denotes the cantilever-bending test. The failure mode of each sample was examined under the microscope. Those samples with the fracture surface lying entirely or partially in the adhesive layer were considered to have provided successful measurements. The results from the two test methods were compared.

RESULTS AND DISCUSSION

The cantilever-bending method produced a comparable success rate of bond strength measurement to that of the microtensile method. The bond strengths of SE and SB from the cantilever-bending test were 58% and 40% higher, respectively, than those measured with the microtensile method. The adhesive SE exhibited almost the same bond strength as SB, irrespective of the test method.

CONCLUSIONS

Cantilever bending can be used as an alternative method for bond strength measurement. The ratio of bending to tensile strength is around 1.5.