The use of different adhesive filling material and mass combinations to restore class II cavities under loading and shrinkage effects: a 3D-FEA

Effect of Polywave and Monowave Light Curing Units on the Microtensile Bond Strength and Failure Types of Different Bulk-Fill Resin Composites: An in vitro Study

Aim

This study aimed to evaluate the effects of polywave and monowave light-emitting diode curing units on the microtensile bond strength and failure types of three bulk-fill resin composites.

Materials and Methods

This in vitro experimental study was performed on 180 microbars obtained from human third molars and were distributed into 12 groups according to the type of bulk-fill resin composite and the light-curing unit. Third molars were restored using Filtek One Bulk Fill Restorative, Tetric® N-Ceram Bulk Fill, and Opus Bulk Fill resin composites was light-cured with Elipar Deep Cure L and Valo in three modes: standard, high power, and extra power. Subsequently, microtensile analysis was carried out with a universal testing machine and the type of failure with an optical stereomicroscope. For statistical analysis, the Kruskal-Wallis H-test was used, with the Bonferroni post hoc test and Fisher's exact test, considering a significance of p<0.05.

Results

There were significant differences in the microtensile bond strength between the Filtek One Bulk Fill restorative and Opus Bulk-Fill (p = 0.042) when light was cured with the polywave unit at standard power. On the other hand, the Filtek One Bulk Fill Restorative and Opus Bulk Fill resins showed significant differences in microtensile bond strength when light was cured with the monowave unit compared with the polywave unit (p<0.05).

Conclusion

The presence of alternative photoinitiator systems that are more reactive than camphorquinone produced higher microtensile bond strength in Tetric N-Ceram Bulk Fill and Opus Bulk Fill resins when light-cured with a high and standard polywave unit, respectively, compared to Filtek One Bulk Fill resins. Finally, Tetric N-Ceram Bulk Fill and Opus Bulk Fill resins had the highest percentage of mixed failures, while Filtek One Bulk Fill resin had adhesive failures, which was related to its lower microtensile bond strength.

Influence of internal angle and shape of the lining on residual stress of Class II molar restorations

Polymerization shrinkage is a major side effect of resin composite materials that affects the success and longevity of caries restorations. This study was to analyze the effect of the internal angle and shape of the lining on the shrinkage residual stress of dental restorations in Class II mesio-occlusal-distal (MOD) cavities through finite element analysis (FEA). A 3D reconstructed model of a human mandibular first molar was created from micro-CT images, and then the tooth was prepared as a Class II MOD cavity. 3D models of four regular internal corner shapes of Class II MOD cavities with different internal angles of lining and one 90° filleted corner model were created. The thermal expansion technique was applied to approximate the shrinkage impact of composite resin polymerization in the FE software ABAQUS. Von Mises stress was taken as a metric. The results showed that the level of residual stresses in the Class II MOD cavities was greatly dependent on the internal angle of the lining. The maximum von Mises stress in tooth tissue decreased as the internal angle of the lining increased. The internal shapes of the lining had no obvious effect on the stress, and the filleted corner model had less stress. This lining strategy is appropriate for Class II MOD cavities with serious loss of tooth tissue.

A 3D-FEA study on the impact of different preparation forms and materials on posterior occlusal veneers

OBJECTIVES

To study the stress distribution and bonding performance in posterior occlusal veneers and tooth bodies under different preparation forms and materials.

METHODS

An isolated lower right first molar was prepared with non-retention type (type A), cavity-retained type (type B), and encircling-retention type (type C) forms. MicroCT images of the tooth were obtained and digitally converted into three-dimensional solid models. Three-dimensional models of veneers for the three abutment teeth were designed, fabricated, and divided into nine models (AEM, ALU, AVE, BEM, BLU, BVE, CEM, CLU, and CVE) according to the material used (E.max CAD [EM], Lava Ultimate [LU] and Vita Enamic [VE]). Three-dimensional finite element stress analysis was performed by applying vertical and oblique forces (200 N) to simulate chewing loads using ABAQUS. Finally, an adhesive stiffness degradation diagram was obtained using the rotatory dislocation simulation method.

RESULTS

The BEM model had the largest equivalent stress extreme value (160.50 MP A) when a vertical load was applied to the veneers, while there was no significant difference when it was applied to dental tissues. The equivalent stress extreme values of each part under an oblique load were significantly greater than those under a vertical load. The AEM model had the largest values when the loads were applied to the veneers (350.60 MP A) and the dental tissues (40.13 MP A). The equivalent stress extreme values of the veneers were ranked as LU < VE < EM for different materials, and LU > VE > EM for dental tissues. Bonding performance results were C > B ≈ A and LU > VE > EM.

CONCLUSIONS

The cavity-retained type better protected the veneers and dental tissues than the non-retention and encircling-retention types under lateral forces. E.max CAD material, with a high elastic modulus, reduced the stress transmitted to the remaining dental tissues. Lava Ultimate exhibited the best bonding performance.

Low and high viscosity bulk-fill composite resins stress distribution in primary molar tooth inlay cavity

The aim of this study is to evaluate the stress distributions of low and high viscosity bulk-fill composite resins at class II MOD inlay cavity in primary molar tooth using Finite Element Analysis (FEA). Original DICOM data of a primary molar tooth from a research archive was used to create a 3D model. Two models were prepared as Model 1: the tooth model without restoration (control group) and Model 2: the tooth model with class II MOD inlay restoration. Two different bulk-fill composite resins were tested in study: Model 2 A (class II MOD inlay cavity model restored with low viscosity bulk-fill composite resin) and Model 2B (class II MOD inlay cavity model restored with high viscosity bulk-fill composite resin). Occlusal vertical loading of 232 N was applied to the teeth in occlusal contact areas. Maximum Von Mises stress values in the models for enamel, dentin, and restorative material were evaluated as MPa. More intense stress accumulation is observed in enamel than in dentin. In addition, more stress values were determined in Model 2B (206.15 MPa, 32.76 MPa, 128.95 MPa) than in Model 2 A (203.39 MPa, 29.77 MPa, 120.61 MPa) for enamel, dentin and restorative material, respectively.

The stress distribution of a primary molar tooth restored with stainless steel crown using different luting cements

BACKGROUND

The aim of this study is to evaluate the stress distributions of a primary molar tooth restored with a stainless steel crown (SSC) using resin and glass ionomer luting cements by Finite Element Analysis (FEA).

METHODS

Original DICOM data of a primary molar was used to create a 3D model. One model was prepared as a tooth model with SSC. A 30 μm cement layer was used in model. Two different luting cements were tested in the study: self-cure adhesive resin cement, and glass ionomer cement. Vertical and oblique loads of 330 N were applied to simulate maximum bite force and lateral forces in the occlusal contact areas of the models. Maximum von Mises stress values in the models were evaluated as MPa.

RESULTS

The maximum von Mises stress value was observed in the force application and general occlusal contact areas for all models. The maximum von Mises stress values were higher in the tooth model with SSC using self-cure adhesive resin cement (478.09 MPa and 214.62 MPa) than in the tooth model with SSC using glass ionomer cement (220.06 MPa and 198.72 MPa) in both vertical and oblique loading, respectively.

CONCLUSIONS

Depending on the magnitude of the bite force on the SSC, fracture of the luting cement materials could occur if the stress exceeds the endurance limit of the luting cement. Cementation with glass ionomer cement may help to reduce stress levels in SSC restorations of primary molars in children.

Fracture Resistance of Class II MOD Cavities Restored by Direct and Indirect Techniques and Different Materials Combination

This study aimed to evaluate the fracture resistance of class II MOD cavities restored using different techniques and materials. Sixty extracted maxillary molars were selected and standardized class II MOD cavities were prepared using a custom-made paralleling device. The specimens were divided into four groups based on the restoration technique used: Group 1 (direct resin composite), Group 2 (short-fiber-reinforced composite resin), Group 3 (composite polyethylene fiber reinforcement), and Group 4 (CAD/CAM resin inlays). Fracture resistance was assessed for each group after thermocycling aging for 10,000 cycles. The mode of fracture was assigned to five types using Burke's classification. To compare the fracture force among the tested materials, a paired sample t-test was performed. The significance level for each test was set at p < 0.05. Significant differences in fracture resistance were observed among the different restoration techniques. CAD/CAM inlays (2166 ± 615 N), short-fiber-reinforced composite resin (2471 ± 761 N), and composite polyethylene fiber reinforcement (1923 ± 492 N) showed superior fracture resistance compared to the group restored with direct resin composite (1242 ± 436 N). The conventional resin composite group exhibited the lowest mean fracture resistance. The choice of restoration material plays a critical role in the clinical survival of large MOD cavities. CAD/CAM inlays and fiber-reinforced composites offer improved fracture resistance, which is essential for long-term success in extensive restorations.

A Nonlinear Three-Dimensional Finite Element Analysis of Stress Distribution and Microstrain Evaluation in Short Dental Implants with Three Different Implant-Abutment Connections in Single and Splinted Conditions in the Posterior Mandible

Background

Stress distribution plays a vital role in the longevity and success of implant-supported prosthesis. This study evaluated the von Mises stress and microstrain in the peri-implant bone and the implant-abutment junction of short dental implants with three different implant-abutment connections in splinted and unsplinted conditions using finite element analysis (FEA).

Materials and Methods

In this experimental study, nine transversely isotropic finite element models were developed, and randomly divided into three equal groups (n = 3): control, (Group AC) single-standard 4.3 × 10 mm bone level implant-supported restorations with external hexagonal (EH) connection, internal conical (IC) and internal trichannel (ITC) connection, single short implant-supported restorations (Group AT), and splinted short implant-supported restorations (Group B) for each of the three implant-abutment connections, respectively. A 200 N load was applied along the long axis of the implants and a 100 N (45°) oblique load was applied and von Mises stress and microstrain values were evaluated.

Results

Single standard implants demonstrated the highest von Mises stress and microstrain values followed by single short implants and splinted short implants, respectively. Among the implant-abutment connections, the IC connection showed the highest values and the ITC connection showed the least values.

Conclusion

Within the limitations of this study, it was concluded that splinting of short dental implants demonstrated lesser and more homogeneous stress and microstrain, especially on oblique loading. The microstrain values for all connections evaluated were within the physiological loading limit (200-2,500 N) and were hence considered safe for clinical use.

Evaluation of Biomechanical Stability of Teeth Tissue According to Crown Materials: A Three-Dimensional Finite Element Analysis

The biomechanical effects of dental tissue according to various dental crown materials were investigated using finite element analysis. Bone, prepared tooth, root canal, and periodontal ligament were modeled based on computed tomography. Depending on the characteristics of the crown material, it was classified into zirconia, hybrid ceramic, gold alloy, and acrylic resin. A loading force of 200 N was applied in the vertical direction to the occlusal surface of the crown, and analysis was performed under the condition that all interfaces were tied. The results demonstrate that the highest von Mises stress was shown in the prepared tooth of the acrylic resin model, which is a temporary prosthesis, and the pulpal pressure was also the highest. Additionally, among the final prosthesis, the highest stress was shown in the hybrid ceramic model prepared teeth. The properties of restoration materials can be a factor influencing the tooth structure. Thus, in order to make a correct decision when selecting a material for restorative treatment, it is necessary to understand, analyze, and evaluate the properties of these restoration materials.

Influence of the cervical margin relocation on stress distribution -

Aim: Evaluate the influence of the cervical margin relocation (CMR) on stress distribution in the lower first molar restored with direct nano-ceramic composite (zenit). Methods: A 3D model of the lower first molar was modeled and used. Standardized mesio-occluso-distal (MOD) preparation consisted in two models used in this study with mesial subgingival margin in model II. (CMR) was applied in model II using flowable composite or resin glass ionomer (Riva). Both models were restored with nanoceramic composite and then subjected to six runs (2 for the model I and 4 for model II) with load (100N) as two load cases, one at (11º) and other at (45º) from the vertical axis. The stress distributions (FEA) in the final restoration and (CMR) material were analyzed using 3D models. Results: The two models recorded an equivalent Von Mises stress and Total deformation in the final restoration, regardless of the difference in the oblique angle incidence from (11º to 45º) or the type of the material used for (CMR) there was no significant difference in the (FEA) between the model with CMR (model II) and the model without CMR (model I). Conclusions: (CMR) technique seems to be biomechanically beneficial with high eccentric applied stress, (CMR) with resin glass ionomer or flowable composite resin in combination with nanoceramic composite improved the biomechanical behavior of (MOD) cavities extended below cement enamel junction (CMR) with high modulus elasticity material like (Riva) exhibits a more uniform stress distribution. 

Stress intensity factor of a cracked molar restored with different materials and designs: A 3D-FEA

OBJECTIVE

This work used 3D finite element analysis (FEA) to analyze and directly compare the stress intensity factor (SIF) and stress distribution at the crack tip of identical cracked tooth models restored with different materials and crown parameters.

METHODS

A 3D model of the cracked tooth was generated. Then, we applied 25 restorative models, including three parameters (shoulder height, width, and degree of polymerization), five restorative materials (GC, IPS, LU, ZC, VE), and two combinations of types of cement (RMGIC and GIC). An occlusal load of 800N was applied to the spherical part along the longitudinal axis. The stress distribution of the preparation and the SIF of the crack tip was analyzed.

RESULTS

The crack tip SIF was minimal for a shoulder height offset of 0.8 mm (P = 0.032), a shoulder width of 0.6 mm (P = 0.045), a crown material of ZC (P < 2e-16), and a cement material of RMGIC (P < 0.05), respectively. In contrast, the effect of different polymerization degrees on SIF was insignificant (P = 0.95).

CONCLUSION

Our results suggest that the selection of a larger modulus of elasticity (MOE) material for the crown, the preparation of a smaller shoulder width within a safe range, a reasonable increase in the crown length, and the selection of adhesive materials with high fracture toughness are favorable methods to prevent further crack extension.

Effect of the Combination of Restorative Material and the Etching Protocol in Enamel Microleakage in Class II Cavities after Thermocycling

This study is aimed at evaluating the marginal microleakage of bulk-fill class II restorations after thermocycling. Thirty-two human third molars received class II cavities prepared on mesial and distal faces. The cavities were bonded according to the adhesive protocol (total or self-etching). The cavities were then restored with composite and divided into 8 groups based on the composite combination: layering technique with Filtek Z350XT (G1 and G5), first layer with Filtek Z350 XT Flowable Restorative and then Filtek Z350XT (G2 and G6), bulk-fill technique with Filtek One Bulk Fill (G3 and G7), and first layer with Filtek One Bulk Fill Flow and Filtek Z350 XT (G4 and G8). The restorations were then subjected to thermocycling (2000 cycles, 5°C and 55°C, dwell time of 30 s). After aging, the restored teeth were immersed in methylene blue for 48 hours. The restorations (n = 32) were sectioned in the middle (two sections). The microleakage results were analyzed by two-way ANOVA followed by Tukey's post hoc test (α = 0.05). The groups did not differ statistically from each other in terms of marginal microleakage (p = 0.295). It can be concluded that there is no difference in the percentage of microleakage between conventional and bulk-fill resins on both consistencies, as well as there is also no statistically significant difference when the adhesive system is used in a conventional or self-etching mode.

Biomechanical Performance of Mandibular Molars with Deep Mesio-Occlusal-Distal Cavities Rehabilitated with Horizontal Posts: A 3D Finite Element Analysis

Aim

To compare and contrast by three-dimensional finite element analysis the biomechanical performance of deep mesio-occlusal-distal cavities of mandibular molars reinforced by different sizes of horizontal fiber posts.

Materials and Methods

The finite element (FE) stress analysis was performed with the ANSYS, a commercial finite element method package. Based on the evidence-based scientific data and on the mechanical properties of materials, i.e., Young's modulus and Poisson ratio, the model of a mandible and mandibular first molar was replicated. The mandibular molar models replicating the clinical scenarios were simulated, designed, and built, assuming all materials to be homogenous, isotropic, and linearly elastic as follows: Model 1 control: the model of an intact first mandibular molar. Model 2: the prepared cavity mesio-occlusal-distal is replicated by the subtraction Boolean method. The remaining thickness of dentin is 1 mm. Model 3: these were rehabilitated by three different diameters of two horizontal fiber posts. Model 3A: fiber post diameter 1 mm, Model 3B: 1.5 mm and Model 3C: 2 mm. The dimensions of the cavity, the intercuspal distance between buccal walls and lingual walls, and the distance of placement of the post from occlusal reference points were all kept constant for all three subgroups of Model 3. The cavities of Model 3 were restored with Filtek bulk-fill posterior composite. After meshing the models, loads were defined on the buccal and lingual distal cusps with a constant value of 600 N and at an angle of 45°.

Results

The results of finite element analysis are expressed as stresses, i.e., tensile compressive, shear, or a combination known as von Mises stresses. The overall von Mises stresses were as follows: Model 1:154.83 Mpa; Model 2: 376.877 Mpa; Model 3A: 160.221 Mpa; Model 3B: 159.488 Mpa; Model 3C: 147.231 Mpa. Statistical analysis of the compiled data was carried out. It was seen that there was a significant difference in stress values from the intact tooth Model 1 and cavity Model 2 (p < 0.05) with means values of 53.1 and 139.22, respectively. The means of all subgroups were comparable but there was a statistically significant difference between Model 3, i.e., 3A (67.74), Model 3B (60.47), Model 3C (53.70), and Model 2. Model 1 and Model 3C had comparable mean values.

Conclusion

Rehabilitation of deep mesio-occlusal-distal cavities of molars with intact buccal and lingual walls with the aid of a horizontal post of any diameter has a similar stress distribution to an intact tooth. However, the biomechanical performance of a 2 mm horizontal post was exacting of the natural tooth. Horizontal posts can be included in expanding our restorative option for rehabilitating grossly mutilated teeth.

Comparison of Two Types of Preparation for Laminate Veneer with Three Types of All-Ceramic Materials

OBJECTIVE

 The objective of this study was to compare types of veneer preparations and their combination with three materials.

MATERIALS AND METHODS

 Two finite element models were specially prepared used representing window and wrap around preparation for veneers. The "central incisor" tooth geometry was acquired using a laser scanner, and then its surface was adjusted to form a solid model prior to the removal of each preparation separately. Three materials (Lava Ultimate, IPS e-max, and Celtra) were tested in combination with the preparation type. Bone geometry was simplified as two coaxial cylinders in all models. Each model was subjected to two loading conditions of occlusion (edge-to-edge bite and normal bite).

STATISTICAL ANALYSIS AND RESULTS

 It was observed that cortical, cancellous bone, and periodontal ligament are insensitive to preparation or materials. Their stresses and deformation were within physiological limits. Significant changes appeared on the central incisor tooth structure, cement layer, and veneer layer stresses and deformations under loading cases.

CONCLUSIONS

 Edge-to-edge bite stresses are severe with window-type preparation, and normal bite did not show any critical values on tooth structure, cement layer, or veneer layer. Veneer layer finish line and its contact with the cement layer and tooth structure play a role in the loading transfer mechanism. Preparation type alters the values of stresses on tooth structure, cement, and veneer layers. With window preparation, extreme stresses appear at finish line, while stresses appear under the loading site with wrap around preparation. Veneer and cement layers withstand the load energy with wrap around preparation and reduce tooth structure stresses. Thus, the lifetime of veneer and cement layers might be longer with window preparation.

Mechanical Behavior of Alkasite Posterior Restorations in Comparison to Polymeric Materials: A 3D-FEA Study

The present investigation evaluated the effect of the combination of different dental filling materials in Class I cavities under occlusal loading using three-dimensional finite elements analysis (FEA). Six computer-generated and restored models of a lower molar were created in the CAD software and compared according to the biomechanical response during chewing load condition. Two adhesively bonded bulk restorative materials [bulk-fill resin composite (BF) or Alkasite (Alk)] were evaluated with or without the presence of a base material below (flowable resin composite or glass ionomer cement). A food bolus was placed on the occlusal surface mimicking the compressive occlusal load (600 N) during the static linear analysis. The maximum principal stress (tensile) was calculated as stress criteria in enamel, dentin and restoration. All models showed high stresses along the enamel/restoration margin with a similar stress trend for models restored with the same upper-layer material. Stress values up to 12.04 MPa (Alk) or up to 11.12 MPa (BF) were recorded at the enamel margins. The use of flexible polymeric or ionic base material in combination with bulk-fill resin composite or Alk did not reduce the stress magnitude in dentine and enamel. Class I cavities adhesively restored with bulk-fill resin composite showed lighter stress concentration as well as Alk. Therefore, adhesively bonded Alk restoration showed a promising mechanical behavior when used with different base materials or as a bulk restoration for posterior Class I cavity.

Effect of the bracketless orthodontics technique and resin composite material on the biomechanical response of the upper central incisor: 3D finite element analysis

Objectives:

The bracketless orthodontic treatment (BOT) is an alternative technique which indicates using an orthodontic appliance composed of wires and composite resin assisted by 3D technology. However, the biomechanical response of central incisor orthodontic movement has yet to be investigated. Thus, the aim of the present investigation was to calculate the stress magnitude in central incisor movement through 3D finite element analysis using different wire diameters (0.012”, 0.014”, and 0.016”) of nickel–titanium wire and two different resin composites (Opallis and Filtek).

Materials and Methods:

A 3D volume composed of enamel, dentin, cortical bone, cancellous bone, periodontal ligament, composite resin, and different orthodontic wire diameters was designed. After the modeling process, the models were exported to computer-aided engineering software divided into a finite number of elements, and a mechanical structural static analysis was conducted.

Results:

The stress results were plotted on colorimetric maps and in tables for comparison between the different models. The results showed that the central incisor orthodontic movement with BOT does not induce damage to the periodontal ligament, dental root, or bone tissue, regardless of the simulated orthodontic wire diameter and resin composite materials. The palatal composite resin and orthodontic wire also presented acceptable stress magnitude during orthodontic movement.

Conclusion:

Thus, the BOT technique promoted a suitable biomechanical response during central incisor movement regardless the resin composite.

The role of cortical zone level and prosthetic platform angle in dental implant mechanical response: A 3D finite element analysis

OBJECTIVE

The aim of this study was to evaluate the influence of three different dental implant neck geometries, under a combined compressive/shear load using finite element analysis (FEA). The implant neck was positioned in D2 quality bone at the crestal level or 2 mm below.

METHODS

One dental implant (4.2 × 9 mm) was digitized by reverse engineering techniques using micro CT and imported into Computer Aided Design (CAD) software. Non-uniform rational B-spline surfaces were reconstructed, generating a 3D volumetric model similar to the digitized implant. Three different models were generated with different implant neck configurations, namely 0°, 10° and 20°. D2 quality bone, composed of cortical and trabecular structure, was modeled using data from CT scans. The implants were included in the bone model using a Boolean operation. Two different fixture insertion depths were simulated for each implant: 2 mm below the crestal bone and exactly at the level of the crestal bone. The obtained models were imported to FEA software in STEP format. Von Mises equivalent strains were analyzed for the peri-implant D2 bone type, considering the magnitude and volume of the affected surrounding cortical and trabecular bone. The highest strain values in both cortical and trabecular tissue at the peri-implant bone interface were extracted and compared.

RESULTS

All implant models were able to distribute the load at the bone-implant contact (BIC) with a similar strain pattern between the models. At the cervical region, however, differences were observed: the models with 10° and 20° implant neck configurations (Model B and C), showed a lower strain magnitude when compared to the straight neck (Model A). These values were significantly lower when the implants were situated at crestal bone levels. In the apical area, no differences in strain values were observed.

SIGNIFICANCE

The implant neck configuration influenced the strain distribution and magnitude in the cortical bone and cancellous bone tissues. To reduce the strain values and improve the load dissipation in the bone tissue, implants with 10° and 20 neck configuration should be preferred instead of straight implant platforms.

Effect of Direct and Indirect Materials on Stress Distribution in Class II MOD Restorations: A 3D-Finite Element Analysis Study

The aim of this study is to investigate the stress distributions of different restoration options for class II mesio-occluso-distal (MOD) cavities. A class II MOD cavity with proximal box gingival floor 1 mm below cementoenamel junction was designed in a mandibular first molar tooth model. 3D finite-element analysis (FEA) and 3D-CAD modelling were used to examine the occlusal stresses distributed to the remaining buccal enamel (RBE), remaining lingual enamel (RLE), adhesive surfaces, and restorative materials by direct and indirect materials resulting from a 600 N of static occlusal load stimulating foodstuff. von Mises (VM) and maximum principal (Pmax) stresses were evaluated for two CAD/CAM materials and three direct materials. CAD/CAM materials exerted less stress than the direct restorative materials. Significant von Mises and Pmax stress value differences were seen among all restoration models on RBE. Reducing RLE and including it into the cavity would be a more effective option for this model in this scenario. As VM and Pmax stresses of PIHC CAD/CAM material for RBE and dentin were significantly lower than other tested materials, it may be the choice of material for indirect MOD restorations.

Computer Aided Design Modelling and Finite Element Analysis of Premolar Proximal Cavities Restored with Resin Composites

This study evaluated the stress distribution in five different class II cavities of premolar models restored with conventional or bulk-fill flowable composite by means of finite element analysis (FEA) under shrinkage and occlusal loading. An upper validated premolar model was imported in the software, and five class II cavities with different occlusal extensions and dimensions were prepared: horizontal cavity on the mesial surface (horizontal slot), mesio-occlusal cavity, mesial cavity (vertical slot), tunnel type cavity and direct access cavity. The models were restored with conventional or bulk-fill flowable resin composite. The tested materials were considered as homogeneous, linear, and isotropic. The Maximum Principal Stress criteria was chosen to evaluate the tensile stress results. The lowest shrinkage stress value was observed in the direct access cavity restored with bulk-fill flowable resin composite (36.12 MPa). The same cavity, restored with conventional composite showed a score of 36.14 MPa. The horizontal slot cavity with bulk-fill flowable showed a score of 46.71 MPa. The mesio-occlusal cavity with bulk-fill flowable had a score of 53.10 MPa, while with conventional composite this was 55.35 MPa. Higher shrinkage stress was found in the vertical slot cavity with conventional resin 56.14 MPa, followed by the same cavity with bulk-fill flowable 56.08 MPa. Results indicated that the use of bulk-fill flowable composite resin more significantly decreased the polymerization shrinkage stress magnitude. The larger the cavity and the volume of material necessary to restore the tooth, the greater the residual stress on enamel and dentin tissue.

Mechanical Behavior of Different Restorative Materials and Onlay Preparation Designs in Endodontically Treated Molars

This study evaluated the effect of the combination of three different onlay preparation designs and two restorative materials on the stress distribution, using 3D-finite element analysis. Six models of first lower molars were created according to three preparation designs: non-retentive (nRET), traditional with occlusal isthmus reduction (IST), and traditional without occlusal isthmus reduction (wIST); and according to two restorative materials: lithium-disilicate (LD) and nanoceramic resin (NR). A 600 N axial load was applied at the central fossa. All solids were considered isotropic, homogeneous, and linearly elastic. A static linear analysis was performed, and the Maximum Principal Stress (MPS) criteria were used to evaluate the results and compare the stress in MPa on the restoration, cement layer, and tooth structure (enamel and dentin). A novel statistical approach was used for quantitative analysis of the finite element analysis results. On restoration and cement layer, nRET showed a more homogeneous stress distribution, while the highest stress peaks were calculated for LD onlays (restoration: 69–110; cement layer: 10.2–13.3). On the tooth structure, the material had more influence, with better results for LD (27–38). It can be concluded that nRET design showed the best mechanical behavior compared to IST and wIST, with LD being more advantageous for tooth structure and NR for the restoration and cement layer.

Lithium Disilicate Ceramic Endocrown Biomechanical Response According to Different Pulp Chamber Extension Angles and Filling Materials

The purpose of this study is to evaluate the effect of pulp chamber extension angles and filling material mechanical properties on the biomechanical response of a ceramic endocrown. A 3D model of maxillary molar that underwent endodontically treatment was exported to computer aided design software to conduct finite element analysis (FEA). The endocrown model was modified considering different pulp chamber extension angles (right angle; 6°, 12° and 18° of axial divergence). The solids were imported into the computer aided engineering software in Standard for the Exchange of Product Data (STEP) format. Nine different filling materials were simulated to seal the orifice of the root canal system under each endocrown restoration (resin composite, bulk-fill resin composite, alkasite, flowable resin composite, glass ionomer cement, autocured resin-reinforced glass ionomer cement, resin cement, bulk-fill flowable resin composite, zinc oxide cement), totaling 36 models. An axial load (300 N) was applied at the occlusal surface. Results were determined by colorimetric graphs of von-Misses stress (VMS) and Maximum Principal Stress (MPS) on tooth, cement layer, and endocrown restorations. VMS distribution showed a similar pattern between the models, with more stress at the load region for the right-angled endocrowns. The MPS showed that the endocrown intaglio surface and cement layer showed different mechanical responses with different filing materials and pulp chamber angles. The stress peaks plotted in the dispersion plot showed that the filling material stiffness is proportional to the stress magnitude in the endocrown, cement layer and tooth adhesive surface. In addition, the higher the pulp chamber preparation angle, the higher the stress peak in the restoration and tooth, and the lower the stress in the cement layer. Therefore, 6° and 12° pulp chamber angles showed more promising balance between the stresses of the adhesive interface structures. Under the conditions of this study, rigid filling materials were avoided to seal the orifice of root canal system when an endocrown restoration was planned as rehabilitation. In addition, the pulp chamber axial walls were prepared between 6° and 12° of divergence to balance the stress magnitude in the adhesive interface for this treatment modality.

Effect of Shrinking and No Shrinking Dentine and Enamel Replacing Materials in Posterior Restoration: A 3D-FEA Study

The aim of the present study was to investigate the effect of shrinking and no shrinking dental filling materials combination in posterior restorations under the combined effects of polymerization shrinkage and occlusal load by means of 3D Finite Elements Analysis. Six computer-generated and restored class I or class II cavities models of a lower molar were designed in the CAD software and evaluated according to the cavity and restorative procedure. Different shrinking and no shrinking adhesive materials combination with diverse Young’s modulus were considered. A food bolus was modeled on the occlusal surface replicating the chewing load using static linear analyses Polymerization shrinkage was simulated for the shrinking different restorative materials. The maximum principal stress was selected as analysis criteria. All models exhibited higher stresses along the dentine restoration interfaces with different magnitude and a similar stress trend along enamel restoration interface. Stress values up to 22 MPa and 19 MPa were recorded in the enamel and restoration, respectively. The use of elastic not shrinking material layer in combination with bulk fill composite reduced the stress magnitude in dentine and enamel to replace dental tissues. Class I and class II posterior cavities adhesively restored with shrinking filling material’s combination showed the most unfavorable stress concentrations and the multilayer technique is a promising restorative alternative in posterior adhesive restorations when deep dentin and enamel volumes are missing.

Influence of Polymeric Restorative Materials on the Stress Distribution in Posterior Fixed Partial Dentures: 3D Finite Element Analysis

Background: This study evaluated the effect of interim restorative materials (acrylic resin (AR), resin composite (RC) or polyetheretherketone (PEEK) for dental computer-aided design/computer-aided manufacturing (CAD/CAM)) on the stress distribution of a posterior three-unit fixed partial denture. Methods: The abutment teeth (first molar and first premolar) were modeled using the BioCAD protocol containing 1.5 mm of axial reduction and converging axial walls. A static structural analysis was performed in the computer-aided engineering software, and the Maximum Principal Stress criterion was used to analyze the prosthesis and the cement layers of both abutment teeth. The materials were considered isotropic, linearly elastic, homogeneous and with bonded contacts. An axial load (600 N) was applied to the occlusal surface of the second premolar. Results: Regardless of the restorative material, the region of the prosthetic connectors showed the highest tensile stress magnitude. The highest stress peak was observed with the use of RC (129 MPa) compared to PEEK and AR. For the cement layers, RC showed the lowest values in the occlusal region (7 MPa) and the highest values for the cervical margin (14 MPa) compared to PEEK (21 and 12 MPa) and AR (21 and 13 MPa). Conclusions: Different interim restorative materials for posterior fixed partial dentures present different biomechanical behavior. The use of resin composite can attenuate the stress magnitude on the cement layer, and the use of acrylic resin can attenuate the stress magnitude on the connector region.

Effect of Restorative Material on Mechanical Response of Provisional Endocrowns: A 3D-FEA Study

The goal of this study was to evaluate the stress distribution in an endocrown restoration according to different provisional restorative materials. An endodontically treated maxillary molar model was selected for conducting the finite element analysis (FEA), with a determined amount of dental remnant of 1.5 mm. The model was imported to the analysis software (ANSYS 19.2, ANSYS Inc., Houston, TX, USA) in STEP format. All contacts were considered perfectly bonded. The mechanical properties of each structure were considered isotropic, linear, elastic, and homogeneous. Three different provisional restorative materials were simulated (acrylic resin, bis-acrylic resin, and resin composite). An axial load (300 N) was applied at the occlusal surface in the center of the restoration. Results were determined by colorimetric stress maps of maximum principal stress, maximum shear stress, and total deformation. The different materials influenced the stress distribution for all structures; the higher the material’s elastic modulus, the lower the stress magnitude on the cement layer. In the present study, all provisional restorative materials showed similar stress patterns in the endocrown and on the cement layer however, with different magnitude. Based on this study limitation, the use of resin composite to manufacture provisional endocrowns is suggested as a promising material to reduce the stresses in the cement layer and in the dental tissue surfaces.

Does overlay preparation design affect polymerization shrinkage stress distribution? A 3D FEA study

This study evaluated the polymerization shrinkage stress of three tooth preparation designs for indirect ceramic overlay by finite element analysis: isthmus preparation (IST); without isthmus preparation (wIST); and non-retentive preparation (nRET). The models were created based in prepared dental typodonts and were digitally impressed with an intraoral scanner. The interfaces in all models were considered perfectly bonded and all materials were considered homogeneous, linear, and isotropic. The polymerization shrinkage of the cement layer (100 µm) was simulated and evaluated by maximum principal stress criteria. The stress peaks followed this sequence: restoration = IST (13.4 MPa) > wIST (9.3 MPa) > nRET (9 MPa); cement layer = IST (16.9 MPa) > wIST (12.6 MPa) > nRET (10-7.5 MPa); and teeth = IST (10.7 MPa) > wIST (10.5 MPa) > (9 MPa). For the cement layer, the non-retentive preparation (nRET) had the lowest shrinkage stress from all the groups, obtaining a more homogeneous stress distribution on the cement surface. Regarding the abutment teeth, the IST generated a higher shrinkage stress area on the dental structure, concentrating higher stress magnitude at the axiopulpar and axiogingival angles. Non-retentive preparation seems to reduce polymerization shrinkage stress.