Qualitative assessment of stress distribution during insertion of endodontic posts in photoelastic material

Investigation of stress distribution in roots restored with different crown materials and luting agents

The purpose of this study was to identify crown materials and luting agents that would decrease the stress concentrated at the roots of endodontically treated teeth. To this end, natural tooth model (NT), full cast crown model (gold-silver-palladium alloy; MC), polymer-based restorative material crown model (HCC), and all-ceramic crown model (ACC) were constructed. In each model, methyl methacrylate-based resin cement (MMA) and composite cement (CC) were used as luting agents. The magnitudes of von Mises stress of the roots during function were compared. When the luting agent was changed from MMA to CC, von Mises stress in the cervical area decreased by 37.8% for MC, 27.1% for HCC, and 37.0% for ACC. Within the limitations of this study, the combination of HCC and CC gave rise to the lowest stress concentration at the cervical area.

Stress distribution in a post-restored tooth using the three-dimensional finite element method

Clinicians are opting ever more frequently for restorative materials which have an elastic modulus similar to that of dentin when reconstructing endodontically treated teeth. Metallic posts, which are capable of causing dangerous and non-homogenous stresses in root dentin, are slowly being abandoned. Ideal posts may be those made of various types of fibre (carbon, mineral and glass) and which are adhesively luted into the canal. Among the different methods for evaluating the mechanical behaviour of posts in root canals (progressive loads and photo-elastic technique) the finite element method (FEM) presents many advantages. The aim of this paper is to evaluate, utilizing three-dimensional analysis of the finite elements, what the effect of material rigidity, depth of insertion and post diameter could be on the stress distribution in the different components of the single tooth-post-core reconstruction unit. The results of the FEM analyses, expressed as the distribution of Von Mises stress values, has allowed us to conclude that (i) fibreglass-reinforced composite distributes stress better than titanium alloy or stainless steel; (ii) fibreglass-reinforced composite posts should be inserted as deeply as possible (but maintaining 5-6 mm of gutta-percha apical seal); (iii) fibreglass-reinforced composite post diameter does not affect stress distribution, therefore, as much radicular dentin as possible should be preserved.

Post and core systems, refinements to tooth preparation and cementation

With a plethora of post systems available, it is often difficult to decide which one to use. This is made more difficult by the fact that new posts are introduced before existing ones are fully evaluated in laboratory and clinical studies. This paper therefore describes the different post types and the main advantages and disadvantages of each. In addition, the choice of post system will influence whether further tooth preparation is required and will dictate which luting cement and core material are most appropriate. Whilst the choice of post will, for many dentists, be driven by personal preference and a history of clinical success, there are certain pit falls to avoid and these are outlined.

Photomechanical investigations on post endodontically rehabilitated teeth

An investigation of the stress distribution patterns in post-core restored teeth and the behavior of dentin material to fracture propagation was conducted using experimental techniques such as digital photoelasticity (on photoelastic models), mechanical testing and scanning electron microscopy (SEM) (on extracted teeth). Digital photoelastic experiments showed that endodontic post-core restoration resulted in regions of high tensile stress and of stress concentrations in the remaining dentin structure. It was observed from mechanical testing that the fracture resistance in post-core restored teeth is significantly lower (p<0.0001) than that in intact tooth. There was a significant correspondence between the plane of stress concentrations identified in the photoelastic models and in those of the plane of fracture exhibited by the rehabilitated tooth specimens. While the fracture of post-core rehabilitated teeth was consistent, that of control teeth was not as distinct. The SEM highlighted varying dentin response to fracture propagation at the inner core and the outer regions. The fractographs showed brittle and ductile response to fracture propagation in the outer and inner core dentin, respectively. These photomechanical studies highlighted that the stress concentrations, high tensile stress and loss of inner ductile dentin associated with post endodontic rehabilitation diminished their resistance to fracture.

Measurement of strain on tooth roots during post removal with the Eggler post remover

AIM

The aim was to measure root surface strains in teeth when removing cast post/cores with the Eggler post remover.

METHODOLOGY

Two groups of 10 teeth each were tested: group 1 had 1 mm thickness of dentine coronally, and group 2 had 2 mm thickness of dentine. After root filling, 10 mm long cast post/cores were constructed and cemented with zinc phosphate cement, and strain gauges were applied to the roots. The post/cores were removed with the Eggler post remover whilst strain measurements were being recorded. Posts were removed twice: initially along the long axis of the tooth and then at a 10 degrees angle to the long axis. Comparisons between groups 1 and 2 were analysed statistically with the Mann-Whitney U-test whilst strains within each group were analysed with the Wilcoxon Signed Rank test at the 95% level of confidence.

RESULTS

There was no significant difference in the strains measured between groups 1 and 2, and no significant difference within each group when removing posts along the long axis of the tooth and at a 10 degrees angle. Three teeth in group 1 and one tooth in group 2 fractured when removing posts at the 10 degrees angle. Three fractures were small slivers of dentine at the point where the Eggler's repeller arms contacted the tooth mesially and distally, whilst one tooth (from group 1) fractured obliquely.

CONCLUSIONS

Post removal with the Eggler device is a relatively safe procedure but care must be taken when there is a possibility of pulling the post out in a nonaxial direction or when less than 1 mm of dentine surrounds the apical end of the post.

Stress analysis of human tooth root using various root canal instruments

This study compared external root stresses from instrumentation by several motor-driven nickel-titanium instruments to stresses developed by hand files. Twelve curved first molar mesial roots were invested in PLM-9 photoelastic material to disclose net stress transmitted from the canal through the dentin. Minimal fringe patterns were observed during instrumentation with all techniques. Light-speed yielded the least change. In no case was a complete 60 psi fringe change noted.