Mechanical behavior of post-restored upper canine teeth: A 3D FE analysis

Stress distribution on teeth restored with veneers using various incisal preparation designs: A 3D finite element analysis study

STATEMENT OF PROBLEM

The type of veneer preparation is often chosen according to the patient's tooth structure and occlusion. Taking biomechanics into account in this decision-making process provides the clinician with more technical information on how to improve the clinical longevity of restorations. However, biomechanical analyses of veneer preparation designs are sparse.

PURPOSE

The purpose of this 3-dimensional (3D) finite element analysis with microcomputed tomography (µCT) data obtained from realistic models was to assess the influence of different preparations for ceramic and composite resin veneers on restoration and resin layer stress distribution.

MATERIAL AND METHODS

Four replicas of a central incisor were printed and prepared for laminate veneers with 4 different incisal edge designs: shoulder (SH), palatal chamfer (PC), palatal chamfer and oblique fracture involving the distal angle (OF-PC), and palatal chamfer involving horizontal incisal fracture (IF-PC). After fabrication and cementation of the veneers, the restored replicas were assessed with µCT, and 3D finite element models were built. A 100-N load was applied on the palatal surface at 60 and 125 degrees relative to the longitudinal axis. Maximum principal stress and stress distribution on the veneers, cement layer, and tooth structure were calculated and analyzed.

RESULTS

The SH preparation exhibited better stress distribution than the PC preparation, and the cement layer and the veneer were subjected to lower stress. The IF-PC preparation had better stress distribution than the OF-PC. The shoulder and IF-PC showed higher stress on laminate veneers, but lower stress on the cement layer. Ceramic veneers exhibited lower stress than composite resin veneers.

CONCLUSIONS

The different incisal preparations for laminate veneers influenced stress distribution on restorations and on the resin cement layer. The shoulder type preparation showed better stress distribution and the composite resin veneers showed unfavorable results compared with the ceramic veneers.

Mechanical behavior of endodontically treated teeth: A three-dimensional finite element analysis using displacement vector

PURPOSE

This study aimed to analyze the effects of core materials, remaining tooth structures, and interfacial bonding on stress distribution in endodontically treated teeth using finite element analysis (FEA).

MATERIALS AND METHODS

Three-dimensional FEA was conducted using a reverse engineering technique based on maxillary premolars scanned by micro-computed tomography. Six models were generated with or without ferrules and with one of the following three abutment systems: metal core, resin core, or resin core with fiber posts. In each model, bonding and debonding were assumed in the dentin and surrounding structures: bonded and debonded models. The maximum principal stress values were recorded, and stress distribution of the entire restored teeth and dentin was generated. Furthermore, the distribution of the displacement vector of the debonded models was generated.

RESULTS

In comparing the bonded and debonded models, the debonded models showed larger values for tensile stresses than those in bonded models for all abutment models. The models without ferrules rotated around the center of the abutment, whereas those with ferrules did not show remarkable displacement in the analysis.

CONCLUSION

FEA assuming fracture of adhesive interface proved to be an effective method to clarify the significance of ferrules. It prevents stress concentration in dentin by reducing the rotation of the abutment, even when the adhesive fails.

Finite element analysis of maxillary first molar with mesial-occlusal-distal-palatal defect restored with different post-and-core strategies

Purpose

To explore which restoration strategy generates the most favorable stress distribution in an endodontically-treated maxillary first molar with mesial-occlusal-distal-palatal defect.

Methods

Models with one post in palatal canal (PP), each post in palatal and distobuccal canals (PDP), each post in palatal and mesiobuccal canals (PMP), and each post in all canals (PDMP) were established for an endodontically-treated maxillary first molar with mesial-occlusal-distal-palatal defect either with fiber-reinforced composite (FRC) post or gold alloy cast (GAC) post. A 400-N vertical force and a 225-N lateral force were respectively applied. The Mohr-Coulomb stress ratio (σ_{MC ratio}) in the residual tooth structure (RTS), the resin cement, and the crowns, the tensile stress (σ_t) and compressive stress (σ_c) in the FRC posts, the von-Mises stress ratio (σ_{vM ratio}) in the GAC post-and-cores, and the σ_t and shear stress (σ_s) at the adhesive interfaces were calculated using finite element analysis.

Results

FRC posts generated lower σ_{MC ratio} than GAC posts in the RTS (0.3274-0.3643 vs. 0.3399-0.4118). Among the FRC post groups, the PDMP group got the lowest σ_s at the dentin-post interface (14.92 MPa) and the abutment-crown interface (8.242 MPa) under vertical loading, as well as the lowest σ_{MC ratio} in the RTS (0.3381) and the lowest σ_s at the dentin-post interface (38.00 MPa) under lateral loading.

Conclusions

From the point of stress distribution, placing FRC posts in the palatal, distobuccal, and mesiobuccal canals is the optimal strategy in restoring a severely damaged maxillary first molar, provided that lateral occlusal force is reduced.

Dental Fiber-Post Systems: An In-Depth Review of Their Evolution, Current Practice and Future Directions

The field of dental medicine is constantly evolving and advancing toward minimally invasive techniques. Several studies have demonstrated that bonding to the tooth structure, particularly enamel, yields the most predictable results. In some instances, however, significant tooth loss, pulpal necrosis, or irreversible pulpitis may limit the options available to the restorative dentist. In these cases, placement of a post and core followed by a crown is the preferred treatment option, provided all requirements are met. This literature review provides an overview of the historical development of dental FRC post systems as well as a comprehensive examination of the currently available posts and their bonding requirements. In addition, it offers valuable insights for dental professionals seeking to understand the current state of the field and the prospects of dental FRC post systems.

Biomechanical Behavior Evaluation of Resin Cement with Different Elastic Modulus on Porcelain Laminate Veneer Restorations Using Micro-CT-Based Finite Element Analysis

The aim of this study is to evaluate the biomechanical behavior of the porcelain laminate veneer restorations (PLV) of the maxillary central incisor luted with two types of resin cements having different incisal preparations: butt joint and palatal chamfer. Biomechanical analyses were performed using the micro-CT-based finite element models, and von Mises stress and strain values of the PLV, resin cement, adhesive layer, and tooth structure were computed. The PLV with butt joint preparation showed larger stress values than those of restored with palatal chamfer preparation, regardless of the elasticity of the cement and loading conditions. An increase in the elasticity modulus of the resin cement induced slightly larger stresses on the adhesive layer, tooth tissues, and restorative materials. Overall, this study demonstrates the role of the preparation design and luting materials on the mechanical behavior of the PLV restorations and discusses the potential failure mechanisms of the PLV restorations under different loading mechanisms.

Influence of New Sleeve Composite on Fracture Behavior of Anterior Teeth with Flared Root Canals

We evaluated the fracture strength and failure mode of non-ferrule teeth with flared root canals that were restored using new experimental sleeve composites. Fifty endodontically treated anterior teeth with flared root canals were restored with direct restorations utilizing different techniques. Group A had teeth (non-ferrule) restored using commercialized MI glass fiber post + Gradia Core as core build-up. Group B had teeth (non-ferrule) restored with commercialized i-TFC glass fiber post + sleeve system. In Group C, the teeth (non-ferrule) were restored with an experimental sleeve composite with commercialized MI glass fiber post and Gradia Core. Group D, teeth (non-ferrule), were restored using custom-made tapered E-glass filling post and Gradia Core. Group E, teeth (with ferrule), were restored with commercialized MI glass fiber post + Gradia Core. After core construction, all specimens underwent direct composite crown restoration and were loaded until fracture using a universal testing machine. Average fracture loads were compared, and the failure modes were observed. Group C exhibited significantly greater fracture strength than other groups (p < 0.05). Favorable fracture teeth ratio of group C was more than that of the other groups. Thus, the new experimental sleeve composite could be clinically useful for core construction of non-ferrule teeth.

Influence of glass fiber posts on the fracture susceptibility of endodontically treated maxillary anterior teeth with direct veneers: Preliminary results of a randomized clinical trial

OBJECTIVE

The purpose of this randomized clinical trial was to evaluate the influence of glass fiber posts on fracture susceptibility of endodontically treated maxillary anterior teeth with direct veneers.

MATERIALS AND METHODS

Fifty participants had 1 maxillary anterior tooth restored with a direct veneer. They were divided into 2 groups (n = 25) according to the use of intraradicular glass fiber posts. Clinical evaluation was performed at baseline, 6 and 12 months. The treatment success was determined by the absence of tooth fracture. If there was fracture, it was classified according to its extent. Fischer exact test was performed to analyze the criteria among the groups at each evaluation time. Friedman repeated analysis of variance assessed the difference in the performance of each group at three recall times (α = 0.5).

RESULTS

For control group, at the 6-month follow-up, one tooth had suffered a catastrophic failure, which resulted in tooth extraction. Fisher statistical analysis showed no significant difference between the cumulative success rate of the groups for the 6 (P > .999) and the 12-month (P > .999) period. Friedman test showed no significant difference among the periods of evaluation (P > .999).

CONCLUSIONS

Both groups had a similar success rate for maxillary anterior endodontically treated teeth with direct veneers after 12 months.

CLINICAL IMPLICATIONS

Glass fiber post use does not influence the fracture susceptibility of maxillary anterior endodontically treated teeth with direct veneers in the short term.

Stress Distributions for Hybrid Composite Endodontic Post Designs with and without a Ferrule: FEA Study

The aim of the current work was to analyze the influence of the ferrule effect for hybrid composite endodontic post designs consisting of carbon (C) and glass (G) fiber-reinforced polyetherimide (PEI), in upper canine teeth. Starting from theoretical designs of C-G/PEI hybrid composite posts with different Young's moduli (Post A-57.7 GPa, Post B-31.6 GPa, Post C-graduated from 57.7 to 9.0 GPa in the coronal-apical direction) in endodontically treated anterior teeth, the influence of the ferrule effect was determined through finite element analysis (FEA). On the surface of the crown, a load of 50 N was applied at 45° to the longitudinal axis of the tooth. Maximum principal stresses were evaluated along the C-G/PEI post as well as at the interface between the surrounding tooth structure and the post. Maximum stress values were lower than those obtained for the corresponding models without a ferrule. The presence of a ferrule led to a marked decrease of stress and gradients especially for posts A and B. A less marked effect was globally found for Post C, except in a cervical margin section along a specific direction, where a significant decrease of the stress was probably due to local geometric features, compared to the model without a ferrule. The presence of a ferrule did not generally provide a marked benefit in the case of the graduated Post C, in comparison to other C-G/PEI posts. The outcomes suggest how such a hybrid composite post alone should be sufficient to optimize the stress distribution, dissipating stress from the coronal to the apical end.

Adaptable fiberglass post after 3D guided endodontic treatment: Novel approaches in restorative dentistry

OBJECTIVE

The rehabilitation of extensively damaged teeth with great structural loss and calcified root canals represents a challenge for dentistry. Classically, this restorative procedure of endodontically treated teeth involves intraradicular post placement. Retentive function post that can closely adapt to the root canal without the excessive wear of intraradicular dentin has a fundamental importance to ensure the longevity of the restoration.

CLINICAL CONSIDERATIONS

This report presents a clinical case of 3D guided access to a severely calcified pulp canal followed by the cementation of a fiberglass post that is adaptable to the root canal and prosthetic rehabilitation with full ceramic crown.

CONCLUSIONS

3D guided access allowed conservative and safe root canal treatment. The adaptable fiberglass post meets the specific needs of the described case and has a simple technique and low cost.

CLINICAL SIGNIFICANCE

Guided endodontics is a minimally invasive approach for teeth with calcified root canals. The post used in this study meets the demands of teeth endodontically treated with conservative techniques. The professional should not need to adapt the anatomy of the root canal to the anatomical reality of the post. This one adapts itself to the shape of the canal.

Biomechanical behavior of cavity design on teeth restored using ceramic inlays: An approach based on three-dimensional finite element analysis and ultrahigh-speed camera

Ceramic fracture and debonding are the primary failures that follow ceramic inlay and can lead to stress and tooth fracture. In this study, we examined two designs-concave and flat-of the gingival cavity bottom for tooth cavities restored using ceramic inlays. We investigated the biomechanical behavior of ceramic inlay-restored teeth (concave and flat) through three-dimensional finite element analysis (FEA) and experimentally validated the results using an ultrahigh-speed camera. We conducted in vitro real-time recording of the deformation of a restored tooth during loading using an ultrahigh-speed camera. This technique enables further image registration to observe deformation variation and vector fields. The deformation vector fields revealed that the concave design moved the deformation toward the buccal side of the cavity bottom, whereas the flat design moved it toward the palatal side. These findings correlated with the FEA results, which indicated that the concave design constrained stress in the dentin cavity and relieved palatal stress. Our results suggest that incorporating a concave design in cavity preparation can improve the fracture resistance of ceramic inlay-restored teeth, preventing unrestorable fractures. The current study is the first to utilize an ultrahigh-speed camera in dental biomechanics, and such cameras are useful for nondestructive and dynamic analysis. STATEMENT OF SIGNIFICANCE: First utilize ultrahigh-speed cameras in dental biomechanics analysis. Tooth fracture videos captured by ultrahigh-speed camera helps us learn fracture mechanics in between tooth cavity design and ceramic inlay. Concave design leads to stress in safer areas that causes a less damaging fracture. Minimal invasive preparation by concave design strengthens tooth fracture resistance. Non-destructive data from ultrahigh-speed cameras combined with FEA can get more insight into how the stress and strain derived in biomaterials.

Metal Posts and the Effect of Material–Shape Combination on the Mechanical Behavior of Endodontically Treated Anterior Teeth

The control of the process–structure–property relationship of a material plays an important role in the design of biomedical metal devices featuring desired properties. In the field of endodontics, several post-core systems have been considered, which include a wide range of industrially developed posts. Endodontists generally use posts characterized by different materials, sizes, and shapes. Computer-aided design (CAD) and finite element (FE) analysis were taken into account to provide further insight into the effect of the material–shape combination of metal posts on the mechanical behavior of endodontically treated anterior teeth. In particular, theoretical designs of metal posts with two different shapes (conical-tapered and conical-cylindrical) and consisting of materials with Young’s moduli of 110 GPa and 200 GPa were proposed. A load of 100 N was applied on the palatal surface of the crown at 45° to the longitudinal axis of the tooth. Linear static analyses were performed with a non-failure condition. The results suggested the possibility to tailor the stress distribution along the metal posts and at the interface between the post and the surrounding structures, benefiting from an appropriate combination of a CAD-based approach and material selection. The obtained results could help to design metal posts that minimize stress concentrations.

FE analysis of conceptual hybrid composite endodontic post designs in anterior teeth

OBJECTIVES

To assess conceptual designs of dental posts consisting of polyetherimide (PEI) reinforced with carbon (C) and glass (G) glass fibers in endodontically treated anterior teeth.

METHODS

3D tessellated CAD and geometric models of endodontically treated anterior teeth were generated from Micro-CT scan images. Model C-G/PEI composite posts with different Young's moduli were analyzed by Finite Element (FE) methods post A (57.7GPa), post B (31.6GPa), post C (from 57.7 to 9.0GPa in the coronal-apical direction). A load of 50N was applied at 45° to the longitudinal axis of the tooth, acting on the palatal surface of the crown. The maximum principal stress distribution was determined along the post and at the interface between the post and the surrounding structure.

RESULTS

Post C, with Young's modulus decreasing from 57.7 to 9.0GPa in the coronal-apical direction, reduced the maximum principal stress distribution in the restored tooth. Post C gave reduced stress and the most uniform stress distribution with no stress concentration, compared to the other C-G/PEI composite posts.

SIGNIFICANCE

The FE analysis confirmed the ability of the functionally graded post to dissipate stress from the coronal to the apical end. Hence actual (physical) C-G/PEI posts could permit optimization of stress distributions in endodontically treated anterior teeth.

Evaluation of Stress Distribution in Endodontically Weakened Teeth Restored with Different Crown Materials: 3D-FEA Analysis

This study evaluated the stress distribution in endodontically treated teeth, weakened (W) or not weakened (NW), restored with different materials of prosthetic crown using 3D-FEA. Models of a maxillary canine were constructed based on micro-CT images and divided into the groups: G1 (control) - sound tooth; G2 to G7 - endodontically treated teeth restored with glass fiber post (GFP); which G2 to G4 simulated NW root and G5 to G7 simulated W root. For crown material the teeth were restored with: G2 and G5: metallic coping and ceramic veneering, G3 and G6: zirconia coping and ceramic veneering, G4 and G7: alumina coping and ceramic veneering. Load of 180 N was applied at the incisal third of lingual surface at 45º. Models were supported by the periodontal ligament (x=y=z=0). The von Mises stress (VMS) values were calculated. The W teeth presented higher VMS at coping when compared to NW teeth and group G1 showed lower VMS value. For crown material, for both W or NW teeth, increasing VMS was found at metallic, zirconia and alumina coping, respectively. Metallic coping showed a better performance despite its unfavorable esthetics, suggesting as an appropriate material for prosthetic restoration of endodontically treated teeth.

Effects of post core materials on stress distribution in the restoration of mandibular second premolars: a finite element analysis

STATEMENT OF PROBLEM

Previous studies have not resolved the question as to which post and core combination optimizes the stress distribution within the post restoration and tooth.

PURPOSE

The purpose of this study was to determine which post and core combination provides the most favorable stress distribution upon loading.

MATERIAL AND METHODS

Three-dimensional models of teeth were created with the Ansys program to simulate different materials used for post and cores (Ti, NiCr, AuPd, zirconia, zirconia post/composite resin core, glass fiber post/composite resin core, and carbon fiber post/composite resin core) and metal ceramic crowns (nickel chromium alloy [Group NiCr] and gold palladium alloy [Group AuPd]). A force of 400 N was applied to the occlusal surface, and von Mises equivalent stress values were calculated.

RESULTS

Carbon fiber post/composite resin core/metal ceramic crowns with NiCr alloy core had the highest stress values in the weakened root, tooth/post interface, and post. NiCr post/NiCr core/metal ceramic crowns with NiCr alloy core had the lowest stress values in the weakened root and post. The zirconia post and core had the lowest stress value in the tooth/post interface.

CONCLUSIONS

A post material with a high elastic modulus led to lower stress in the weakened root (approximately 6%) and tooth/post interface (approximately 12%) and to higher stress in the post (approximately 5 times). A composite resin core led to higher stress in the weakened root (approximately 11% to 17%) and lower deformation in the tooth/post interface (approximately 17.5%) and post materials (approximately 24%). Group AuPd resulted in lower stress in the root and high stress in the post (approximately 4.5% to 7%) and affected the amount of deformation in posts with a composite resin core.

A new method to assess the accuracy of a Cone Beam Computed Tomography scanner by using a non-contact reverse engineering technique

AIM

Today Cone Beam Computed Tomography (CBCT) has become an important image technique for dento-maxilla facial applications. In the paper a new method to assess the geometric accuracy of these systems was proposed. It uses a free form benchmark model and a non-contact Reverse Engineering (RE) system.

METHOD

The test geometry chosen for this study was designed in such a way that it simulated human spongy bone, cortical bone, gingiva and teeth and it composed of removable free form parts. It was acquired with a high-resolution laser scanner (D700 Scanner - 3Shape, Denmark). The reference 3D surface models obtained with the laser scanner was compared with the 3D models that were created from a CBCT system (Scanora 3D - Soderex, Finland) and from a traditional Multi-Slice Computed Tomography (MSCT) scanner (LightSpeed VCT 64 Slice - General Electric, USA) at different reconstruction settings, using an iterative closest point algorithm (ICP) in Geomagic(®) software.

RESULTS

The comparison between the different pairs of CAD models clearly shows that there is a good overlap between the models.

CONCLUSIONS

Although the results obtained in this study could lead to increase the use of CBCT for an increasing number of dental procedures, the publication of the European Commission guidelines represents a baseline on which the clinicians should rely heavily when considering the use of CBCT in their practice.

CLINICAL SIGNIFICANCE

The results of this research show that the accuracy of CBCT 3D models is comparable to MSCT 3D models.

Effect of the crown design and interface lute parameters on the stress-state of a machined crown-tooth system: a finite element analysis

The effect of preparation design and the physical properties of the interface lute on the restored machined ceramic crown-tooth complex are poorly understood. The aim of this work was to determine, by means of three-dimensional finite element analysis (3D FEA) the effect of the tooth preparation design and the elastic modulus of the cement on the stress state of the cemented machined ceramic crown-tooth complex. The three-dimensional structure of human premolar teeth, restored with adhesively cemented machined ceramic crowns, was digitized with a micro-CT scanner. An accurate, high resolution, digital replica model of a restored tooth was created. Two preparation designs, with different occlusal morphologies, were modeled with cements of 3 different elastic moduli. Interactive medical image processing software (mimics and professional CAD modeling software) was used to create sophisticated digital models that included the supporting structures; periodontal ligament and alveolar bone. The generated models were imported into an FEA software program (hypermesh version 10.0, Altair Engineering Inc.) with all degrees of freedom constrained at the outer surface of the supporting cortical bone of the crown-tooth complex. Five different elastic moduli values were given to the adhesive cement interface 1.8GPa, 4GPa, 8GPa, 18.3GPa and 40GPa; the four lower values are representative of currently used cementing lutes and 40GPa is set as an extreme high value. The stress distribution under simulated applied loads was determined. The preparation design demonstrated an effect on the stress state of the restored tooth system. The cement elastic modulus affected the stress state in the cement and dentin structures but not in the crown, the pulp, the periodontal ligament or the cancellous and cortical bone. The results of this study suggest that both the choice of the preparation design and the cement elastic modulus can affect the stress state within the restored crown-tooth complex.