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Eskibağlar M, Erdem S, Karaağaç Eskibağlar B, Kaman MO. Evaluation of the forces applied by rubber dam clamps on mandibular first molar teeth with different endodontic access cavities: a 3D FEA study. PeerJ 2024; 12:e17921. [PMID: 39210915 PMCID: PMC11361261 DOI: 10.7717/peerj.17921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 07/23/2024] [Indexed: 09/04/2024] Open
Abstract
Background This study aimed to examine the effect of the force applied by rubber dam clamps made from different materials on mandibular first molar teeth with various designs of endodontic access cavities using finite element analysis. Methods A intact tooth (IT) and seven different endodontic access cavities namely, a traditional endodontic cavity (TRADAC), a guided endodontic cavity (GEC), a conservative endodontic cavity (CAC), an ultra-conservative access cavity (UAC), a truss access endodontic cavity (TRSAC), a mesial caries access cavity (MCAC), and a distal caries access cavity (DCAC), along with two different clamp finite element models, were created. The clamp models were made of polyether ether ketone (PEEK) and stainless steel (SS). The forces applied by the clamps were calculated based on the axial section distance of the tooth, and these forces were applied to the contact areas on the tooth. Stress distribution models were calculated using maximum von Mises (vM) stress. Results The lowest vM stress under the forces applied by the SS and PEEK clamps was found in the IT model (80.914 MPa) with the PEEK clamp. The highest vM stress was found in the DCAC model (759.49 MPa) applied with the SS clamp. The forces applied by SS clamps resulted in higher vM stress values in every cavity design than those applied by PEEK clamps. Conclusion PEEK clamps generated less force than SS clamps. However, clinicians should follow various isolation strategies (clamp made of different materials, split dam, etc.) according to different cavity types of the tooth.
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Affiliation(s)
- Mehmet Eskibağlar
- Department of Endodontics, Faculty of Dentistry, Firat (Euphrates) University, Elazığ, Turkey
| | - Serkan Erdem
- Department of Mechanical Engineering, Engineering Faculty, Firat (Euphrates) University, Elazığ, Turkey
| | - Büşra Karaağaç Eskibağlar
- Department of Pediatric Dentistry, Faculty of Dentistry, Firat (Euphrates) University, Elazığ, Turkey
| | - Mete Onur Kaman
- Department of Mechanical Engineering, Engineering Faculty, Firat (Euphrates) University, Elazığ, Turkey
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Rauber BF, De Carli JP, Dallepiane FG, Dogenski LC, Goedel F, Cecchin D, Palhano HS, Corazza PH, Collares KF, Souza MA, Farina AP. Aspects of glass and hybridization protocols for bonding of fiber posts to root dentine. Eur J Oral Sci 2024; 132:e13002. [PMID: 38938069 DOI: 10.1111/eos.13002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 06/03/2024] [Accepted: 06/06/2024] [Indexed: 06/29/2024]
Abstract
This study evaluated bond strength of glass fiber posts to root dentin using push-out (PO) and diametral compression (DC), testing glycolic acid as a conditioner and varying dentin moisture. An additional aim was to test whether DC can be an alternative test to PO for bond strength assessment. Eighty bovine teeth were divided into eight groups (n = 10) defined by the use of either 37% glycolic acid or 37% phosphoric acid (PA) on moist or wet dentin before bonding with either Adapter SingleBond/RelyX ARC or One Step Plus/Duo-Link Bisco. Each tooth provided discs with an internal diameter of 2 mm, external diameter of 5 mm, and height of 2 mm, which underwent PO and DC. Finite element analysis (FEA) was carried out on 3D models. When analyzing PO results through linear regression, the highest values of bond strength were observed using glycolic acid on wet dentin in the cervical and middle thirds of the teeth. Analyzing DC results, the only statistical influence on values was the dental thirds. The scatterplot of the DC results and the PO bond strength values indicated no relationship between the results of the two tests (r = 0.03; p = 0.64). PO test detected more sensitive changes in bond strength values than DC.
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Affiliation(s)
| | | | | | | | - Fábio Goedel
- School of Engineering, University of Passo Fundo, Passo Fundo, RS, Brazil
| | - Doglas Cecchin
- School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
| | | | | | | | | | - Ana Paula Farina
- School of Dentistry, University of Passo Fundo, Passo Fundo, RS, Brazil
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Dong S, Peng M, Wu G, Yao C, Huang C, Liang S. Does an incomplete ferrule affect the fracture of endodontically treated teeth? A systematic review of in vitro studies. J Dent 2024; 146:105068. [PMID: 38740250 DOI: 10.1016/j.jdent.2024.105068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 05/08/2024] [Accepted: 05/10/2024] [Indexed: 05/16/2024] Open
Abstract
OBJECTIVE The purpose of this systematic review was to assess the impact of the incomplete ferrule on the fracture of endodontically treated teeth (ETT). DATA The keywords such as "incomplete ferrule," "ferrule," "ferrule effect," "residual dentin," "remaining dentin," or "remaining coronal dentin" were used for searching, and only in vitro studies investigating the incomplete ferrule effect on natural teeth were included. SOURCES PubMed, Medline, Embase, Cochrane Library, and Science Direct databases, and manual-searching. STUDY SELECTION The search strategy yielded 1633 hits, and a total of 19 in vitro studies closely related to the effect of incomplete ferrule on ETT were included. CONCLUSION The presence of an incomplete ferrule may significantly increase the fracture resistance of restored ETT, compared with restored ETT without ferrule. The number of residual axial walls of the incomplete ferrule may have an impact on the fracture resistance and fracture mode. The location of residual axial walls of the incomplete ferrule may affect the fracture resistance but not the fracture mode. CLINICAL IMPLICATIONS Limited data suggest that the presence of incomplete ferrule has a positive effect on the fracture resistance of restored ETT. An incomplete ferrule can be an alternative for restoring ETT when a complete ferrule is not present. Nevertheless, further high-quality studies are still needed to offer more robust evidence and to take potential confounding factors into account.
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Affiliation(s)
- Shiying Dong
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 237# Luoyu Road, Hongshan District, Wuhan 430079, PR China; Clinical Research Center of Shaanxi Province for Dental and Maxillofacial Diseases, College of Stomatology, Xi'an Jiaotong University, Xi'an 710004, PR China
| | - Mengdong Peng
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 237# Luoyu Road, Hongshan District, Wuhan 430079, PR China
| | - Guomin Wu
- College & Hospital of Stomatology, Anhui Medical University, Key Lab of Oral Diseases Research of Anhui Province, Hefei 230032, PR China
| | - Chenmin Yao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 237# Luoyu Road, Hongshan District, Wuhan 430079, PR China
| | - Cui Huang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 237# Luoyu Road, Hongshan District, Wuhan 430079, PR China
| | - Shanshan Liang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, 237# Luoyu Road, Hongshan District, Wuhan 430079, PR China.
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Liang M, Zeyong L, Li Y, Chen Q, Meng X. Biomechanical impact of labiolingual diameter on endodontically treated anterior teeth with crown restoration under occlusal loading. J Appl Oral Sci 2024; 32:e20230439. [PMID: 38896638 PMCID: PMC11182641 DOI: 10.1590/1678-7757-2023-0439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/27/2024] [Accepted: 04/22/2024] [Indexed: 06/21/2024] Open
Abstract
OBJECTIVE To evaluate the effect of the labiolingual diameter and construction of an endodontically treated (ET) anterior tooth with crown restoration on stress distribution and biomechanical safety under occlusal loading. METHODOLOGY Three-dimensional finite element models were generated for maxillary central incisors with all-ceramic crown restorations. The labiolingual diameters of the tooth, defined as the horizontal distance between the protrusion of the labial and lingual surfaces, were changed as follows: (D1) 6.85 mm, (D2) 6.35 mm, and (D3) 5.85 mm. The model was constructed as follows: (S0) vital pulp tooth; (S1) ET tooth; (S2) ET tooth with a 2 mm ferrule, restored with a fiber post and composite resin core; (S3) ET tooth without a ferrule, restored with a fiber post and composite resin core. A total of 12 models were developed. In total, two force loads (100 N) were applied to the crown's incisal edge and palatal surface at a 45° oblique angle to the longitudinal axis of the teeth. The Von Mises stress distribution and maximum stress of the models were analyzed. RESULTS Regardless of the loading location, stress concentration and maximum stress (34.07~66.78MPa) in all models occurred in the labial cervical 1/3 of each root. Both labiolingual diameter and construction influenced the maximum stress of the residual tooth tissue, with the impact of the labiolingual diameter being greater. A reduction in labiolingual diameter led to increased maximum stress throughout the tooth. The ferrule reduced the maximum stress of the core of S2 models (7.15~10.69 MPa), which is lower compared with that of S3 models (19.45~43.67 MPa). CONCLUSION The labiolingual diameter exerts a greater impact on the biomechanical characteristics of ET anterior teeth with crown restoration, surpassing the influence of the construction. The ferrule can reduce the maximum stress of the core and maintain the uniformity of stress distribution.
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Affiliation(s)
- Miao Liang
- Nanjing University, Affiliated Hospital of Medical School, Nanjing Stomatological Hospital, Department of General Dentistry, Nanjing, 210008, China
| | - Lamu Zeyong
- Nanjing University, Affiliated Hospital of Medical School, Nanjing Stomatological Hospital, Department of Prosthodontics, Nanjing, 210008, China
| | - Yongheng Li
- Southeast University, School of Biological Science & Medical Engineering, Biomechanics Laboratory, Nanjing, 210008, China
| | - Qiang Chen
- Southeast University, School of Biological Science & Medical Engineering, Biomechanics Laboratory, Nanjing, 210008, China
| | - Xiangfeng Meng
- Nanjing University, Affiliated Hospital of Medical School, Nanjing Stomatological Hospital, Department of Prosthodontic Technology, Nanjing, 210008, China
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Ribeiro MTH, Oliveira GD, Oliveira HLQD, Mendoza LCL, Melo CD, Silva Peres T, Soares CJ. Survival of severely compromised endodontically treated teeth restored with or without a fiber glass post. J Appl Oral Sci 2023; 31:e20230241. [PMID: 37909530 PMCID: PMC10609643 DOI: 10.1590/1678-7757-2023-0241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 09/06/2023] [Indexed: 11/03/2023] Open
Abstract
OBJECTIVE The use of a fiber glass post (FGP) type and choice of FGP diameter to restore endodontically treated incisors without ferrule is controversial. This study evaluated survival rate and failure mode of severely compromised central incisors without ferrule rehabilitated using resin-based composite (RBC) with or without FGP with different diameters. METHODOLOGY A total of 60 decoronated bovine incisors without a ferrule were endodontically treated and prepared for 1.4, 1.6, and 1.8 mm diameter FGPs (Whitepost System DC 0.5, Fit 0.4, and DCE 0.5; FGM). Half of the teeth received FGPs cemented using dual-cure resin cement (Allcem Core; FGM), the other half were filled using only bulk-fill RBC (OPUS Bulk Fill; FGM). The crowns were directly restored with RBC. The roots were embedded in polystyrene resin and the periodontal ligament was simulated with polyether impression material. Fatigue testing was conducted under 5 Hz cyclic loading at 30 degrees to the incisal edge, beginning at 50 N (5,000 cycles) as a warmup. After, the load was increased 100 N every 15,000 cycles until fracture occurred. All specimens were subjected to transillumination, micro-CT analysis, and digital radiography before and after fatigue testing. Fracture mode was classified according to severity and repair potential. Data were analyzed with Kaplan-Meier survival test and post hoc log-rank test (α=0.05) for pairwise comparisons. RESULTS Using FGP significantly increased the number of cycles to failure, irrespective of FGP diameters (p=0.001). The FGP diameters had no statistically significant effect on cycles to failure or failure mode. CONCLUSION Using FGP without ferrule improved survival rate of structurally severely compromised central incisors compared with rehabilitation without FGP. The diameter of the FGPs had no effect on the survival rate and failure mode.
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Affiliation(s)
- Maria Tereza Hordones Ribeiro
- Universidade Federal de Uberlândia, Faculdade de Odontologia, Departamento de Dentística e Materiais Odontológicos, Uberlândia, Minas Gerais, Brasil
| | - Gabriella de Oliveira
- Universidade Federal de Uberlândia, Faculdade de Odontologia, Departamento de Dentística e Materiais Odontológicos, Uberlândia, Minas Gerais, Brasil
| | - Helena Letícia Quirino de Oliveira
- Universidade Federal de Uberlândia, Faculdade de Odontologia, Departamento de Dentística e Materiais Odontológicos, Uberlândia, Minas Gerais, Brasil
| | - Lilibeth Carola Leyton Mendoza
- Universidade Federal de Uberlândia, Faculdade de Odontologia, Departamento de Dentística e Materiais Odontológicos, Uberlândia, Minas Gerais, Brasil
| | - Calebe de Melo
- Universidade Federal de Uberlândia, Faculdade de Odontologia, Departamento de Dentística e Materiais Odontológicos, Uberlândia, Minas Gerais, Brasil
| | - Thiago Silva Peres
- Universidade Federal de Uberlândia, Faculdade de Odontologia, Departamento de Dentística e Materiais Odontológicos, Uberlândia, Minas Gerais, Brasil
| | - Carlos José Soares
- Universidade Federal de Uberlândia, Faculdade de Odontologia, Departamento de Dentística e Materiais Odontológicos, Uberlândia, Minas Gerais, Brasil
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Veselinova M, Diamantopoulou S, Paximada C, Papazoglou E. In-Vitro Comparison of Fracture Strength of Endocrowns and Overlays in Endodontically Treated Teeth Manufactured with Monolithic Lithium Disilicate and Zirconia. J Funct Biomater 2023; 14:422. [PMID: 37623666 PMCID: PMC10455451 DOI: 10.3390/jfb14080422] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/25/2023] [Accepted: 08/08/2023] [Indexed: 08/26/2023] Open
Abstract
To evaluate the fracture strength and the failure mode of endodontically treated molars restored with monolithic lithium disilicate and zirconia endocrowns and overlays. A total of 48 extracted mandibular molars were endodontically treated, decoronated 2 mm above the cementoenamel junction and divided into four 12-specimen groups. Group ELD: lithium disilicate endocrowns. Group EZ: monolithic zirconia endocrowns. Group OLD: lithium disilicate overlays. Group OZ: monolithic zirconia overlays. Overlays did not extend in the pulp chamber and endocrowns extended in the pulp chamber 2 mm. After adhesive bonding of the restorations, the specimens were subjected to thermocycling (×5000 cycles) and then to fracture resistance testing at lateral static loading (1 mm/min) at a universal testing machine. The failure mode of the specimens was qualitatively evaluated. Differences in means were compared using with t-tests for independent samples or Mann-Whitney test (p < 0.05). Weibull distribution analysis was also performed. Group ELD showed significantly higher fracture strength than all other groups (p = 0.001), and the highest Weibull modulus. Conclusions: Lithium disilicate endocrowns exhibit higher fracture strength and are more reliable compared to the other types of restorations examined. Endocrowns had more catastrophic failures compared to overlays.
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Affiliation(s)
| | | | | | - Efstratios Papazoglou
- Department of Operative Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.V.); (S.D.); (C.P.)
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Vilela ABF, Soares PBF, Versluis A, Soares CJ. Dental trauma splints for the mixed dentition - A finite element analysis of splint material, splint extension, missing teeth, and PDL representation. Dent Traumatol 2022; 38:495-504. [PMID: 35908269 DOI: 10.1111/edt.12777] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/05/2022] [Accepted: 07/12/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND/AIMS Dental traumatic injuries are common in children during the mixed dentition stage. These injuries usually require splinting for stabilization, which is complicated by the various stages of the permanent tooth development and primary tooth exfoliation. The aim of this study was to evaluate the effect on mobility of splint materials and extensions for an avulsed central incisor, stabilized with and without the adjacent incisor under intrusive and extrusive loading with different periodontal ligament (PDL) conditions. MATERIALS AND METHODS Seventeen 3D model variations were created from a CBCT scan of a 7-year-old patient without erupted permanent upper lateral incisors. A 1000 N palatal load on the right central incisor simulated the avulsion injury and created an increased alveolus and bone deformation, resulting in an increased PDL thickness of 0.45 mm. Wire-resin composite splints with 0.9 mm cross-section (WCS) or 1.0 mm diameter nylon-resin composite splints (NCS) were created. The models simulated conditions with and without the adjacent upper central incisor. Two PDL conditions were investigated, simulating detached PDL or PDL with polyether impression material-like properties. Mobility was calculated under simulated biting loads in horizontal and vertical (intrusive and extrusive) directions. RESULTS The NCS allowed greater tooth mobility of the avulsed incisor than the WCS, irrespective of splint extension, PDL condition, or load application. During horizontal loading, polyether-like properties for the PDL allowed around 0.2 mm mobility of the avulsed tooth with the WCS, similar to the intact tooth, whereas a simulated detached PDL allowed 25% more mobility with a WCS than with a NCS. CONCLUSIONS Based on the FEA analysis, a 1.0 mm NCS may be suitable for splinting avulsion injuries during the mixed dentition stage compared to the considerably more rigid WCS. The NCS models provided flexibility for PDL healing while maintaining stability, even when missing adjacent teeth increased span widths. Extensions beyond directly adjacent teeth did not alter the mobility with the NCS but should still be considered an extra protection in case of bond failure or exfoliation.
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Affiliation(s)
- Andomar Bruno Fernandes Vilela
- Department of Operative Dentistry and Dental Materials, Dental School, Federal University of Uberlândia, Uberlândia, Brazil
| | | | - Antheunis Versluis
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Carlos José Soares
- Department of Operative Dentistry and Dental Materials, Dental School, Federal University of Uberlândia, Uberlândia, Brazil
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Lahoud P, Jacobs R, Boisse P, EzEldeen M, Ducret M, Richert R. Precision medicine using patient-specific modelling: state of the art and perspectives in dental practice. Clin Oral Investig 2022; 26:5117-5128. [PMID: 35687196 DOI: 10.1007/s00784-022-04572-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 05/30/2022] [Indexed: 12/25/2022]
Abstract
The dental practice has largely evolved in the last 50 years following a better understanding of the biomechanical behaviour of teeth and its supporting structures, as well as developments in the fields of imaging and biomaterials. However, many patients still encounter treatment failures; this is related to the complex nature of evaluating the biomechanical aspects of each clinical situation due to the numerous patient-specific parameters, such as occlusion and root anatomy. In parallel, the advent of cone beam computed tomography enabled researchers in the field of odontology as well as clinicians to gather and model patient data with sufficient accuracy using image processing and finite element technologies. These developments gave rise to a new precision medicine concept that proposes to individually assess anatomical and biomechanical characteristics and adapt treatment options accordingly. While this approach is already applied in maxillofacial surgery, its implementation in dentistry is still restricted. However, recent advancements in artificial intelligence make it possible to automate several parts of the laborious modelling task, bringing such user-assisted decision-support tools closer to both clinicians and researchers. Therefore, the present narrative review aimed to present and discuss the current literature investigating patient-specific modelling in dentistry, its state-of-the-art applications, and research perspectives.
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Affiliation(s)
- Pierre Lahoud
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Periodontology and Oral Microbiology, Department of Oral Health Sciences, KU Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Philippe Boisse
- Laboratoire de Mécanique Des Contacts Et Structures, UMR 5259, CNRS/INSA, Villeurbanne, France
| | - Mostafa EzEldeen
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Oral Health Sciences, KU Leuven and Paediatric Dentistry and Special Dental Care, University Hospitals Leuven, Leuven, Belgium
| | - Maxime Ducret
- Hospices Civils de Lyon, PAM d'Odontologie, Lyon, France.,Faculty of Odontology, Lyon 1 University, Lyon, France.,Laboratoire de Biologie Tissulaire Et Ingénierie Thérapeutique, UMR5305 CNRS/UCBL, Lyon, France
| | - Raphael Richert
- Laboratoire de Mécanique Des Contacts Et Structures, UMR 5259, CNRS/INSA, Villeurbanne, France. .,Hospices Civils de Lyon, PAM d'Odontologie, Lyon, France. .,Faculty of Odontology, Lyon 1 University, Lyon, France.
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Aldesoki M, Bourauel C, Morsi T, El-Anwar MI, Aboelfadl AK, Elshazly TM. Biomechanical behavior of endodontically treated premolars restored with different endocrown designs: Finite element study. J Mech Behav Biomed Mater 2022; 133:105309. [DOI: 10.1016/j.jmbbm.2022.105309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/31/2022] [Accepted: 06/02/2022] [Indexed: 10/18/2022]
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10
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Santos Pantaleón D, Valenzuela FM, Morrow BR, Pameijer CH, García-Godoy F. Effect of Cervical Lesions on Fracture Resistance and Failure Mode of Maxillary Central Incisors Restored with Fiber Posts and Complete Crowns. Oper Dent 2021; 46:669-679. [PMID: 35507904 DOI: 10.2341/20-164-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2021] [Indexed: 11/23/2022]
Abstract
PURPOSE To investigate the effect of a cervical cavity extending 1 mm apical to the cemento-enamel junction (CEJ) on fracture resistance and failure mode of maxillary central incisors that have been treated endodontically, present with complete and incomplete ferrules, and are restored with and without a fiber post. METHODS AND MATERIALS 50 intact human maxillary central incisors were divided into five groups (n=10): CG (control group) 6-mm fer-rule height, no cervical cavity, and without post; (CO) 6-mm ferrule height without post, with a cervical cavity (access to root canal and cervical cavity restored with composite resin), cervical cavity; and post with ferrule heights of 1 mm (CP1), 2 mm (CP2), and 6 mm (CP6) restored with fiberglass post and composite resin core. After complete metal crowns were cemented on all specimens, they were subjected to thermal cycling (6000 cycles, 5°C/55°C), followed by immediate testing of fracture resistance. After failure, the specimens were sectioned buccolingually to evaluate and identify the mode of failure. The data were analyzed with an analysis of variance (ANOVA) and the Student-Newman-Keuls multiple comparison tests (α =0.05). RESULTS A 1-mm ferrule height (CP1) fracture resistance was significantly lower (531±125 N) compared to the 6-mm ferrule height (CP6) (769±175 N) (p<0.05). With respect to the groups with similar residual dentin, with and without a cervical cavity, CG (667±119 N) and CO (668±119 N), the presence of a post (CP6) increased the resistance to fracture, although no statistically significant difference was demonstrated. Partial decementation was observed in all specimens of CG and CP6, in nine of CP1 and CP2, and in three in CO. Root fractures occurred in 23 specimens. The root surface was exposed 2 mm below the CEJ to simulate bone level. Propagation of subosseous cracks occurred in four specimens in CG and CP2, in seven specimens in CP6, in two specimens in CP1, and in six specimens in CO. All were considered catastrophic failures. CONCLUSIONS Within the limitations of this study it is suggested that, when restoring an endodontically treated maxillary central incisor that has a cervical lesion and needs to be restored with a complete crown, a fiber post is cemented to improve fracture resistance.
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Affiliation(s)
- D Santos Pantaleón
- *Domingo Santos Pantaleón, DDS, MSD, PhD, professor (retired) of prosthodontics, School of Dentistry, Autonomous University of Santo Domingo, Santo Domingo, Dominican Republic
| | - F M Valenzuela
- Fabio M. Valenzuela, DDS, associate professor of prosthodontics, School of Dentistry, Autonomous University of Santo Domingo, Santo Domingo, Dominican Republic
| | - B R Morrow
- Brian R. Morrow, MS, research associate, Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - C H Pameijer
- Cornelis H. Pameijer, DMD, MScD, DSc, PhD, professor emeritus, Department of Reconstructive Sciences, University of Connecticut, Farmington, CT, USA
| | - F García-Godoy
- Franklin García-Godoy, DDS, MS, PhD, PhD, professor and director, Bioscience Research Center, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA, and Honorary Professor, School of Dentistry, Autonomous University of Santo Domingo, Santo Domingo, Dominican Republic
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11
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Li X, Kang T, Zhan D, Xie J, Guo L. Biomechanical behavior of endocrowns vs fiber post-core-crown vs cast post-core-crown for the restoration of maxillary central incisors with 1 mm and 2 mm ferrule height: A 3D static linear finite element analysis. Medicine (Baltimore) 2020; 99:e22648. [PMID: 33120754 PMCID: PMC7581096 DOI: 10.1097/md.0000000000022648] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
To analyze the stress distribution of the maxillary central incisor with oblique fracture, repaired by different methods, using 3-dimensional finite element analysis. From the biomechanical point of view, it is expected to provide a reference for clinical selection of restoration method which is more conducive to stress distribution and preservation of dental tissue as much as possible.Use cone beam CT and finite element software to establish the finite element models of the maxillary central incisor with oblique fracture, and then create models according to 5 repairing methods(A. fiber post-core-crown group; B. cast post-core-crown group; C.3 mm deep endocrown; D.4 mm deep endocrown; E.5 mm deep endocrown)after root canal treatment, and analyze the Von Mises equivalent stress and maximum principal stress distribution and peak value of each model.When the height of dentin ferrule was fixed, the value of the Von Mises equivalent stress and the maximum principal stress in residual tooth tissue: group A was the highest, and there was no significant difference in group B, C, D and E. And the stress distribution area of 5 groups were the same. In prosthodontic layer: group B was the highest, while group A was the lowest, and the stress peak slightly increased with the increase of depth in group C, D and E. And the 5 groups were with the same stress distribution area as well. In adhesive layer: group A was the highest, while group B was the lowest, and there was little difference among group C, D and E. Group A was concentrated in 1/3 of the post tip, while group B,C,D and E were concentrated in 1/3 of the post and the post tips.Complete and high enough dentin ferrule is a requirement for repairing heavily defected maxillary central incisor with fiber post-core crown and cast post-core crown. When the dentin ferrule is incomplete, the stress distribution of the endocrown is more excellent than post-core-crown. And the endocrown with a depth of 3 mm retainer may be the best repair method. As for post-core crown restoration, the cast post-core crown is more favorable for the uniform distribution of residual tooth tissue than the fiber post-core crown.
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Affiliation(s)
- Xixi Li
- Department of prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, Luzhou
- Department of Stomatology, The First People's Hospital of Shuangliu District
| | - Ting Kang
- Chengdu Second People's Hospital, Chengdu
| | - Danting Zhan
- Department of prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, Luzhou, China
| | - Jing Xie
- Department of prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, Luzhou, China
| | - Ling Guo
- Department of prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, Luzhou, China
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Ozkurt-Kayahan Z, Turgut B, Akin H, Kayahan MB, Kazazoglu E. A 3D finite element analysis of stress distribution on different thicknesses of mineral trioxide aggregate applied on various sizes of pulp perforation. Clin Oral Investig 2020; 24:3477-3483. [PMID: 32333173 DOI: 10.1007/s00784-020-03218-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 01/20/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the stress distribution on different thicknesses of mineral trioxide aggregate (MTA) placed on various widths of pulp perforations during the condensation of the composite resin material. MATERIALS AND METHODS The mandibular molar tooth was modeled by COSMOSWorks program (SolidWorks, Waltham, MA). Three finite elemental analysis models representing 3 different dimensions of pulp perforations, 1, 2, and 3 mm in diameter, were created. The perforation area was assumed as filled with MTA with different thicknesses, 1, 2, and 3 mm for each pulp perforation width, creating a total of 9 different models. Then, a composite resin material was layered on MTA for each model. A 66.7 N load was applied and an engineering simulation program (ANSYS, Canonsburg, US) was used for the analysis. Results were presented considering von Mises stress criteria. RESULTS As MTA thickness increased, the stress values recorded within the area between pulp and MTA decreased. Strain was decreased when the thickness of MTA increased. CONCLUSIONS Stresses at MTA-pulp interface and strain on MTA decreased with the increase in MTA thickness. CLINICAL RELEVANCE In clinical practice, when MTA is required for pulp capping, using a thick layer of the material seems to be a better option in order to reduce the stress under forces of hand condensation of overlying restorative materials.
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Affiliation(s)
- Zeynep Ozkurt-Kayahan
- Department of Prosthodontics, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey.
| | - B Turgut
- Department of Mechanical Engineering, Faculty of Natural Sciences and Engineering, Gaziosmanpasa University, Tokat, Turkey
| | - H Akin
- Department of Prosthodontics, Faculty of Dentistry, Sakarya University, Sakarya, Turkey
| | - M B Kayahan
- Department of Endodontics, Faculty of Dentistry, Okan University, Istanbul, Turkey
| | - E Kazazoglu
- Department of Prosthodontics, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
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Ibrahim RO, Al-Zahawi AR, Sabri LA. Mechanical and thermal stress evaluation of PEEK prefabricated post with different head design in endodontically treated tooth: 3D-finite element analysis. Dent Mater J 2020; 40:508-518. [PMID: 32999141 DOI: 10.4012/dmj.2020-053] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
An endodontic post is required to retain and support the core restoration in case of insufficient remaining coronal dentin after root canal therapy. This study analyzed the biomechanical and thermal behavior of PEEK prefabricated post after choosing the head design that produces the least amount of stress on the core and remaining tooth structure. These results were compared with the most common commercially available prefabricated post, which is titanium and glass fiber post. Thus a CBCT scanning of a maxillary central incisor with its supporting structure was used to construct a 3D solid model of an endodontically treated teeth for finite element analysis (FEA). The restored tooth with the spherical head design of PEEK prefabricated post yielded a more benign stress distribution and repairable failure mode on the crown, luting cement, core, and dentin under both mechanical and thermal loads, followed by glass fiber post and titanium post respectively.
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Affiliation(s)
- Rawa Omar Ibrahim
- Conservative Department, College of Dentistry, University of Sulaimani
| | | | - Laith Abed Sabri
- Department of Mechatronics, Al-Khwarizmi College of Engineering, University of Baghdad
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Camargos GDV, Lazari-Carvalho PC, Carvalho MAD, Castro MB, Neris NW, Del Bel Cury AA. 3D finite element model based on CT images of tooth. BRAZILIAN JOURNAL OF ORAL SCIENCES 2020. [DOI: 10.20396/bjos.v19i0.8658910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Aim: This study aimed the description of a protocol to acquire a 3D finite element (FE) model of a human maxillary central incisor tooth restored with ceramic crowns with enhanced geometric detail through an easy-to-use and low-cost concept and validate it through finite element analysis (FEA). Methods: A human maxillary central incisor was digitalized using a Cone Beam Computer Tomography (CBCT) scanner. The resulted tooth CBCT DICOM files were imported into a free medical imaging software (Invesalius) for 3D surface/geometric reconstruction in stereolithographic file format (STL). The STL file was exported to a computer-aided-design (CAD) software (SolidWorks), converted into a 3D solid model and edited to simulate different materials for full crown restorations. The obtained model was exported into a FEA software to evaluate the influence of different core materials (zirconia - Zr, lithium disilicate - Ds or palladium/silver - Ps) on the mechanical behavior of the restorations under a 100 N applied to the palatal surface at 135 degrees to the long axis of the tooth, followed by a load of 25.5 N perpendicular to the incisal edge of the crown. The quantitative and qualitative analysis of maximum principal stress (ceramic veneer) and maximum principal strain (core) were obtained. Results: The Zr model presented lower stress and strain concentration in the ceramic veneer and core than Ds and Ps models. For all models, the stresses were concentrated in the external surface of the veneering ceramic and strains in the internal surface of core, both near to the loading area. Conclusion: The described procedure is a quick, inexpensive and feasible protocol to obtain a highly detailed 3D FE model, and thus could be considered for future 3D FE analysis. The results of numerical simulation confirm that stiffer core materials result in a reduced stress concentration in ceramic veneer.
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Rodrigues MDP, Soares PBF, Gomes MAB, Pereira RA, Tantbirojn D, Versluis A, Soares CJ. Direct resin composite restoration of endodontically-treated permanent molars in adolescents: bite force and patient-specific finite element analysis. J Appl Oral Sci 2020; 28:e20190544. [PMID: 32348440 PMCID: PMC7185981 DOI: 10.1590/1678-7757-2019-0544] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 02/20/2020] [Indexed: 12/14/2022] Open
Abstract
Objective To evaluate the influence of three levels of dental structure loss on stress distribution and bite load in root canal-treated young molar teeth that were filled with bulk-fill resin composite, using finite element analysis (FEA) to predict clinical failure. Methodology Three first mandibular molars with extensive caries lesions were selected in teenager patients. The habitual occlusion bite force was measured using gnathodynamometer before and after endodontic/restoration procedures. The recorded bite forces were used as input for patient-specific FEA models, generated from cone-beam computed tomographic (CT) scans of the teeth before and after treatment. Loads were simulated using the contact loading of the antagonist molars selected based on the CT scans and clinical evaluation. Pre and post treatment bite forces (N) in the 3 patients were 30.1/136.6, 34.3/133.4, and 47.9/124.1. Results Bite force increased 260% (from 36.7±11.6 to 131.9±17.8 N) after endodontic and direct restoration. Before endodontic intervention, the stress concentration was located in coronal tooth structure; after rehabilitation, the stresses were located in root dentin, regardless of the level of tooth structure loss. The bite force used on molar teeth after pulp removal during endodontic treatment resulted in high stress concentrations in weakened tooth areas and at the furcation. Conclusion Extensive caries negatively affected the bite force. After pulp removal and endodontic treatment, stress and strain concentrations were higher in the weakened dental structure. Root canal treatment associated with direct resin composite restorative procedure could restore the stress-strain conditions in permanent young molar teeth.
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Affiliation(s)
- Monise de Paula Rodrigues
- Departamento de Dentística e Materiais Odontológicos, Faculdade de Odontologia, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brasil
| | - Priscilla Barbosa Ferreira Soares
- Departamento de Periodontia e Implantologia, Faculdade de Odontologia, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brasil
| | - Márcio Alex Barros Gomes
- Departamento de Dentística e Materiais Odontológicos, Faculdade de Odontologia, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brasil
| | - Renata Afonso Pereira
- Departamento de Dentística e Materiais Odontológicos, Faculdade de Odontologia, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brasil
| | - Daranee Tantbirojn
- Department of Restorative Dentistry, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Antheunis Versluis
- Department of Memphis, College of Dentistry, University of Tennessee Health Science Center, Tennessee, USA
| | - Carlos Jose Soares
- Departamento de Dentística e Materiais Odontológicos, Faculdade de Odontologia, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brasil
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Figueiredo FE, Santos RC, Silva AS, Valdívia AD, Oliveira-Neto LA, Griza S, Soares CJ, Faria-e-Silva AL. Ferrule Design Does Not Affect the Biomechanical Behavior of Anterior Teeth Under Mechanical Fatigue: An In Vitro Evaluation. Oper Dent 2019; 44:273-280. [DOI: 10.2341/17-296-l] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objectives:
To investigate the survival and failure mode of fiber-post resin restorations over preparations with different ferrule designs when submitted to a fatigue load test.
Methods and Materials:
Fifty bovine incisors were selected and divided into five groups (n=10) according to ferrule design: a no-ferrule group, a 2-mm circumferential ferrule group, a 2-mm buccal ferrule group, a 2-mm lingual ferrule group, and a 2-mm buccal and lingual ferrule group. The fiberglass post was cemented and the composite core was built up and prepared, followed by cementation of a full composite crown. The samples were subjected to a cyclic fatigue test with loading applicator at 135°; a staircase approach was used until fracture. Survival (cycles to fracture) and failure modes were recorded. Survival data were analyzed with the log-rank test, while Kruskal-Wallis and Fisher exact tests were used to analyze failure mode data (α=0.05).
Results:
The median number of cycles to fracture ranged from 215,000 to 236,153. The log-rank test showed no statistically significant difference in survival rates among the groups (p=0.82). Regarding failure mode, three types were observed: I, post and/or core fracture; II, root fracture in the cervical third; and III, root fracture in the middle third. No statistical difference was observed among the groups (Kruskal-Wallis test, p=0.147).
Conclusion:
The ferrule design had no effect on fatigue resistance or failure mode of endodontically treated incisor teeth restored with a fiber post, composite core buildup, and composite crown.
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Affiliation(s)
| | - RC Santos
- Renan C Santos, BS student, Department of Materials Science and Engineering, Federal University of Sergipe, São Cristóvão, Brazil
| | - AS Silva
- Abraão S Silva, PhD student, Program in Materials Science and Engineering, Federal University of Sergipe, São Cristóvão, Brazil
| | - AD Valdívia
- Andrea D Valdívia, DDS, MS, PhD student, School of Dentistry, Operative Dentistry and Dental Materials, Federal University of Uberlândia, Minas Gerais, Brazil
| | - LA Oliveira-Neto
- Luiz A Oliveira-Neto, PhD, Department of Dentistry, Federal University of Sergipe, Lagarto, Brazil
| | - S Griza
- Sandro Griza, PhD, Department of Materials Science and Engineering, Federal University of Sergipe, São Cristóivão, Brazil
| | - CJ Soares
- Carlos J Soares, DDS, MS, PhD, School of Dentistry, Federal University of Uberlândia, Operative Dentistry and Dental Materials, Minas Gerais, Brazil
| | - AL Faria-e-Silva
- Andre L Faria-e-Silva, DDS, MD, PhD, Federal University of Sergipe, Department of Dentistry, Aracaju, Brazil
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Vilela ABF, Soares PBF, Almeida GA, Veríssimo C, Rodrigues MP, Versluis A, Soares CJ. Three‐dimensional finite element stress analysis of teeth adjacent to a traumatized incisor. Dent Traumatol 2018; 35:128-134. [DOI: 10.1111/edt.12453] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 11/16/2018] [Accepted: 11/17/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Andomar B. F. Vilela
- Department of Operative Dentistry and Dental MaterialsSchool of DentistryFederal University of Uberlândia Uberlândia Minas Gerais Brazil
| | - Priscilla B. F. Soares
- Department of Periodontology and ImplantologySchool of DentistryFederal University of Uberlândia Minas Gerais Brazil
| | - Guilherme A. Almeida
- Department of OrthodonitcsSchool of DentistryFederal University of Uberlândia Minas Gerais Brazil
| | - Crisnicaw Veríssimo
- Department of Operative Dentistry and Dental MaterialsSchool of DentistryFederal University of Goiás Goiás Brazil
| | - Monise P. Rodrigues
- Department of Operative Dentistry and Dental MaterialsSchool of DentistryFederal University of Uberlândia Uberlândia Minas Gerais Brazil
| | - Antheunis Versluis
- Department of Bioscience ResearchUniversity of Tennessee Health Science CenterCollege of Dentistry Memphis Tennessee
| | - Carlos J. Soares
- Department of Operative Dentistry and Dental MaterialsSchool of DentistryFederal University of Uberlândia Uberlândia Minas Gerais Brazil
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Soares CJ, Rodrigues MDP, Faria-e-Silva AL, Santos-Filho PCF, Veríssimo C, Kim HC, Versluis A. How biomechanics can affect the endodontic treated teeth and their restorative procedures? Braz Oral Res 2018; 32:e76. [DOI: 10.1590/1807-3107bor-2018.vol32.0076] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Accepted: 06/13/2018] [Indexed: 11/22/2022] Open
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Allen C, Meyer CA, Yoo E, Vargas JA, Liu Y, Jalali P. Stress distribution in a tooth treated through minimally invasive access compared to one treated through traditional access: A finite element analysis study. J Conserv Dent 2018; 21:505-509. [PMID: 30294111 PMCID: PMC6161525 DOI: 10.4103/jcd.jcd_260_18] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction The purpose of this study was to compare the stress distributions in the teeth treated through minimally invasive access (MIA) designs to those of the teeth treated through traditional straight-line access and their relationship to the final restoration using three-dimensional finite element analysis (FEA). Materials and Methods Four FEA models of an extracted mandibular first molar were constructed. An intact model served as the control, whereas the other three were prepared with either an MIA or traditional straight-line access. Simulated composite access fillings with or without a simulated gold crown were applied to the models, followed by application of an occlusal load of 100 N. Von Mises stresses in the teeth were then calculated and analyzed. Results Stress values within the dentin for baseline, MIA with composite filling, MIA with composite filling and crown, and traditional access with composite filling and crown were 10.14 MPa, 6.98 MPa, 11.79 MPa, and 16.81 MPa, respectively. Higher stress values indicate that the tooth is more prone to fracture. Conclusions A traditional endodontic access cavity may render a tooth more susceptible to fracture compared with an MIA design.
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Affiliation(s)
- Chad Allen
- Department of Endodontics, Texas A and M University College of Dentistry, Richardson, Texas, USA
| | - Clark A Meyer
- Department of Bioengineering, University of Texas at Dallas, Richardson, Texas, USA
| | - Eunguk Yoo
- Department of Bioengineering, University of Texas at Dallas, Richardson, Texas, USA
| | - Jose Aldair Vargas
- Department of Bioengineering, University of Texas at Dallas, Richardson, Texas, USA
| | - Ying Liu
- Department of Biomedical Sciences, Texas A and M University College of Dentistry, Richardson, Texas, USA
| | - Poorya Jalali
- Department of Endodontics, Texas A and M University College of Dentistry, Richardson, Texas, USA
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