The Stresses and Deformations in the Abfraction Lesions of the Lower Premolars Studied by the Finite Element Analyses: Case Report and Review of Literature

BACKGROUND

The purpose of the study was to investigate the behavior of hard dental structures of the teeth with abfraction lesions when experimental occlusal loads were applied.

METHODS

A 65-year-old patient came to the dentist because she had painful sensitivity in the temporomandibular joints and the lower right premolars. The patient was examined, and cone-beam computed tomography (CBCT) of the orofacial area was indicated. The data provided from the CBCT were processed with Mimics Innovation Suite 17 software to create the desired anatomical area in 3D format. Then, the structural calculation module was used in order to perform a finite element analysis of the lower right premolar teeth. A focused review of articles published between 2014 and 2023 from specialty literature regarding the FEA of premolars with abfraction lesions was also conducted.

RESULTS

The parcel area and the cervical third of the analyzed premolars proved to be the most vulnerable areas under the inclined direction of occlusal loads. The inclined application of experimental loads induced 3-4 times higher maximum shears, stresses, and deformations than the axial application of the same forces.

CONCLUSIONS

FEA can be used to identify structural deficiencies in teeth with abfractions, a fact that is particularly important during dental treatments to correct occlusal imbalances.

Noncarious cervical lesions in the aging population analyzed through digital scanning: occlusal risk factors, dimensions, and morphology

OBJECTIVES

To evaluate noncarious cervical lesions (NCCL) in older adults by analyzing each lesion's morphology, dimension, and occlusal risk factors using intraoral scanning and clinical evaluation.

MATERIALS AND METHODS

Individuals over 60 treated at the School of Dentistry in Minas Gerais, Brazil, were invited to participate in this cross-sectional study. We clinically evaluated 1245 teeth for the presence of NCCL and dentin hypersensitivity (DH) in 53 individuals. Three-dimensional models were obtained using Omnicam, and occlusal risk factors were evaluated through the presence of wear facets, intense occlusal contacts, and interferences. The 3Shape 3DViewer software was used to classify NCCL morphology and to measure their height. NCCL depth, width, and area measurements were determined using ImageJ. Descriptive analyses were performed. The Kolmogorov-Smirnov test showed that quantitative data exhibited non-normal distribution. For bivariate analyses of quantitative data, the Mann-Whitney test was employed. The results were reported with mean, standard deviation, median, minimum, and maximum. For bivariate analyses of categorical data, the Pearson chi-square test was used. The results were reported with frequencies (counts) and percentages. A regression model evaluating the association between occlusal risk factors and the absence/presence of NCCL was built.

RESULTS

Most participants were female (58.5%), with a mean age of 66. The frequency of NCCL was 28.27%, corresponding to 352 teeth. Of these, 68.18% exhibited saucer morphology and 31.82% wedge-shaped morphology. The frequency of DH was 13.92% in teeth with NCCL. Saucer NCCL exhibited significantly greater height (p = 0.02), while wedge-shaped lesions showed greater depth (p < 0.001). Also, teeth with NCCL had a higher proportion of wear facets (66.8%; p < 0.001), intense occlusal contacts (39.8%; p = 0.008), and occlusal interferences (21.9%; p = 0.05). The regression model showed that teeth with wear facets were 1.50 times more likely to exhibit NCCL than teeth without wear facets (p < 0.001). Teeth with intense occlusal contact were 1.22 times more likely to exhibit NCCL than teeth without intense occlusal contact (p = 0.031).

CONCLUSIONS

NCCL is a common dental condition in the older adults evaluated in this study. Wedge-shaped NCCL exhibited greater depth, while saucer NCCL had more expressive height. Occlusal risk factors may represent a crucial mechanism for the occurrence of NCCL in this population.

CLINICAL RELEVANCE

Understanding the mechanisms involved in developing NCCL is helpful in diagnostic and preventive practices. The study showed the importance of dental occlusion and characteristics of different NCCL morphologies that help the clinician in decision-making.

Influence of carbonated acid beverage on fracture resistance and marginal gap formation in different restorative approaches to non-carious cervical lesions

OBJECTIVE

This study is to evaluate fracture resistance, failure mode, and gap formation at the restorative interface of unrestored or restored non-carious cervical lesions (NCCLs) submitted to a short-term erosive environment.

MATERIALS AND METHODS

Artificial NCCLs were produced in vitro in bovine incisors, and were randomly divided into four restorative resins groups (n = 22): nanohybrid-NR; bulk-fill-BR; flow with a nanohybrid layer-FNR; bulk-fill with a nanohybrid layer-BNR; and a group unrestored-UR (n = 16). Half of the specimens were submitted to an erosive challenge (per 5 min, 3 × a day for 7 days, before and after restoration), and the other half, was immersed in artificial saliva. After, all teeth undergone thermal (5 ºC, 37 ºC, and 55 ºC, 3600 cycles) and mechanical (50 N, 2 Hz, 300,000 cycles) aging. Eighty teeth were subjected to compressive loading, and resistance and failures were analyzed, while 24 teeth were evaluated for gaps by microcomputed tomography. Statistical tests were performed (p < 0.05).

RESULTS

The restorative approaches affected fracture resistance (η2p = 0.14, p = 0.023), and gap formation (η2 = 0.18, p = 0.012) and so did the immersion medium (fracture η2p = 0.09, p = 0.008; gap η2 = 0.09, p = 0.017). BNR showed the highest resistance, while UR the lowest. FNR showed the highest gaps in both immersion media. Neither the resin groups nor the immersion media were associated with failure mode.

CONCLUSIONS

The erosive immersion medium based in acid beverages has been shown to affect NCCLs with or without restoration, but when Bulk-Fill resin is covered by nanohybrid resin, the performance is good.

CLINICAL RELEVANCE

Erosion negatively affects restorations, but unrestored NCCL shows worse biomechanical performance in stress-bearing situations.

Evaluation of a novel restorative protocol to treat non-carious cervical lesion associated with gingival recession: a 2-year follow-up randomized clinical trial

OBJECTIVE

To compare 2 different resin composites and 2 adhesive systems used in a new restorative protocol (partial restoration) to treat non-carious cervical lesions associated with gingival recession type 1 (RT1).

MATERIAL AND METHODS

Eighty combined defects (CDs) were treated with a partial restoration and periodontal plastic surgery for root coverage. The CDs were randomly assigned to one of the following groups: NP + TE (n = 20), nanofilled composite and 2-step total-etch adhesive system; NP + UA (n = 20), nanofilled composite and universal adhesive system; MH + TE (n = 20), microhybrid composite and 2-step total-etch adhesive; MH + UA (n = 20), microhybrid composite and universal adhesive. Restorations were assessed using the United States Public Health Service (USPHS) criteria at 1 week (baseline) and 6, 12, and 24 months. Survival rate, periodontal parameters, dentin hypersensitivity (DH), and aesthetics were also evaluated.

RESULTS

After 24 months, only the MH + TE group did not lose any restoration, with no significant differences between groups. For surface roughness parameter, MH presented 83.3% of the restorations scoring Bravo, whereas NP presented 48.5% of the restorations scoring Bravo. All groups presented restorations with marginal discoloration. All periodontal parameters behaved similarly, regardless of the restorative material. All groups presented significant reductions of dentin hypersensitivity and improved aesthetic perceptions (p < 0.05).

CONCLUSION

Both resin composites and adhesives tested can be combined for partial restorations to treat CDs.

CLINICAL RELEVANCE

This new restorative-surgical protocol to treat CDs presents satisfactory outcomes. The partial restorations can be successfully executed with both combinations of adhesives and resin composites evaluated in this investigation. TRN : ClinicalTrial.gov: NCT03215615; registration date July 12, 2017.

Effect of partial restorative treatment on stress distributions in non-carious cervical lesions: a three-dimensional finite element analysis

BACKGROUND

Partial restoration combined with periodontal root coverage surgery can be applied to the treatment of non-carious cervical lesions (NCCLs) accompanied with gingival recessions in clinical practice. However, the feasibility of NCCL partial restorative treatment from a biomechanical perspective remains unclear. This study aimed to investigate the effect of partial restorations on stress distributions in the NCCLs of mandibular first premolars via three-dimensional finite element analysis.

METHODS

Three-dimensional finite element models of buccal wedge-shaped NCCLs in various locations of a defected zenith (0 mm, 1 mm, and 2 mm) were constructed and divided into three groups (A, B, and C). Three partially restored NCCL models with different locations of the lower restoration border (1 mm, 1.5 mm, and 2 mm), and one completely restored NCCL model were further constructed for each group. The following restorative materials were used in all restoration models: composite resin (CR), glass-ionomer cement (GIC), and mineral trioxide aggregate (MTA). The first principal stress distributions under buccal oblique loads of 100 N were analyzed. Restoration bond failures were also evaluated based on stress distributions at dentin-restoration interfaces.

RESULTS

When the partial restoration fully covered the defected zenith, the first principal stress around the zenith decreased and the maximum tensile stress was concentrated at the lower restoration border. When the partial restoration did not cover the defected zenith, the first principal stress distribution patterns were similar to those in unrestored models, with the maximum tensile stress remaining concentrated at the zenith. As the elastic modulus of the restorative material was altered, the stress distributions at the interface were not obviously changed. Restoration bond failures were not observed in CR, but occurred in GIC and MTA in most models.

CONCLUSIONS

Partial restorations that fully covered defected zeniths improved the stress distributions in NCCLs, while the stress distributions were unchanged or worsened under other circumstances. CR was the optimal material for partial restorations compared to GIC and MTA.

Biomechanical Modelling for Tooth Survival Studies: Mechanical Properties, Loads and Boundary Conditions-A Narrative Review

Recent biomechanical studies have focused on studying the response of teeth before and after different treatments under functional and parafunctional loads. These studies often involve experimental and/or finite element analysis (FEA). Current loading and boundary conditions may not entirely represent the real condition of the tooth in clinical situations. The importance of homogenizing both sample characterization and boundary conditions definition for future dental biomechanical studies is highlighted. The mechanical properties of dental structural tissues are presented, along with the effect of functional and parafunctional loads and other environmental and biological parameters that may influence tooth survival. A range of values for Young's modulus, Poisson ratio, compressive strength, threshold stress intensity factor and fracture toughness are provided for enamel and dentin; as well as Young's modulus and Poisson ratio for the PDL, trabecular and cortical bone. Angles, loading magnitude and frequency are provided for functional and parafunctional loads. The environmental and physiological conditions (age, gender, tooth, humidity, etc.), that may influence tooth survival are also discussed. Oversimplifications of biomechanical models could end up in results that divert from the natural behavior of teeth. Experimental validation models with close-to-reality boundary conditions should be developed to compare the validity of simplified models.

Mechanical Properties and In Vitro Biocompatibility of Hybrid Polymer-HA/BAG Ceramic Dental Materials

The aim of this study is to prepare hybrid polymer-ceramic dental materials for chairside computer-aided design/computer-aided manufacturing (CAD/CAM) applications. The hybrid polymer-ceramic materials were fabricated via infiltrating polymerizable monomer mixtures into sintered hydroxyapatite/bioactive glass (HA/BAG) ceramic blocks and thermo-curing. The microstructure was observed by scanning electron microscopy and an energy-dispersive spectrometer. The phase structure was analyzed by X-ray diffraction. The composition ratio was analyzed by a thermogravimetric analyzer. The hardness was measured by a Vickers hardness tester. The flexural strength, flexural modulus, and compressive strength were measured and calculated by a universal testing machine. The growth of human gingival fibroblasts was evaluated by a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) colorimetric assay and immunofluorescence staining. The results showed that the sintering temperature and BAG content affected the mechanical properties of the hybrid polymer-ceramic materials. The X-ray diffraction analysis showed that high-temperature sintering promoted the partial conversion of HA to β-tricalcium phosphate. The values of the hardness, flexural strength, flexural modulus, and compressive strength of all the hybrid polymer-ceramic materials were 0.89-3.51 GPa, 57.61-118.05 MPa, 20.26-39.77 GPa, and 60.36-390.46 MPa, respectively. The mechanical properties of the hybrid polymer-ceramic materials were similar to natural teeth. As a trade-off between flexural strength and hardness, hybrid polymer-ceramic material with 20 wt.% BAG sintered at 1000 °C was the best material. In vitro experiments confirmed the biocompatibility of the hybrid polymer-ceramic material. Therefore, the hybrid polymer-ceramic material is expected to become a new type of dental restoration material.

The prevalence of non-carious cervical lesions (NCCLs) with or without erosive etiological factors among adults of different ages in Tokyo

OBJECTIVES

To evaluate the prevalence of non-carious cervical lesions (NCCLs) on teeth with or without erosive etiological factors across a broad range of ages of Japanese adults.

MATERIALS AND METHODS

The study sample consisted of a total of 1108 subjects aged 15 to 89 years in Tokyo, Japan. Two examiners evaluated NCCLs and dental erosion (DE) during a full-mouth examination. Subjects were asked to complete a self-administered daily diet, habits, and health condition questionnaire. Subjects who had frequent acid consumption or gastric reflux and at least one tooth with initial enamel wear were placed in the erosion present (EP) group, and the remainder of subjects were placed in the erosion not present (EN) group. Logistic regression analyses were carried out to identify etiological factors of NCCLs associated with DE.

RESULTS

Overall prevalence of NCCLs was 60.2%; the prevalence increased with age. There were no statistical differences in the prevalence of NCCLs between the EP and EN groups, except for the 60-69 years group. Multiple logistic regression analysis showed the frequency of consumption of carbonated soft drinks, citrus juice, and acidic fruits such as oranges; tooth brushing pressure; and bruxism were associated with the presence of NCCLs.

CONCLUSION

There were no statistical differences in the prevalence of NCCLs with or without erosive etiological factors except for the 60-69 years group.

CLINICAL RELEVANCE

NCCL distribution increased with age, and erosive risk factors caused by change in dietary habits might affect the incidence of NCCLs for elders.

TRIAL REGISTRATION

UMIN000041982.

Prevalence of non-carious cervical lesions and cervical dentinary hypersensitivity in undergraduate students

Abstract Introduction The non-carious cervical lesion (NCCL) is currently a common oral disease. Objective This observational and descriptive study aimed to assess risk factors associated with non-carious cervical lesions, cervical dentin hypersensitivity (CDH), gingival recession (GR) and the relationship between these conditions in students in the last years of undergraduate dentistry. Material and method One hundred eighty-five dentistry students from a private college in Ceará with an average of 22.7 ± 2.3 years participated by filling out a google docs form. Two calibrated examiners performed the exams to verify the presence of NCCL, CDH and RG. Result The presence of NCCL was 22.7%, GR was 48.1% and cervical dentin hypersensitivity 8.6%. The chi-square test with p < 0.05% verified a correlation between the presence of NCCL and the presence of GR and CDH. 25% of students had NCCL and 14% considered themselves stressed. There was no association between the variables bruxism and stress (p=0.529), bruxism and year of graduation course (p=0.716), as well as no association between stress and year of course (p = 0.397) was observed. There were no correlations between NCCL and bruxism, muscle symptoms, parafunctional habits and temporomandibular dysfunction. 10.8% of students who reported using legal and illegal drugs had NCCL. Conclusion The NCCL, GR and CDH were correlated in the group of students in the last two years of an undergraduate dentistry course in Ceará.

Enhancing Collagen Mineralization with Amelogenin Peptide: Towards the Restoration of Dentin

Mammalian teeth primarily consist of two distinct calcified tissues, enamel and dentin, that are intricately integrated by a complex and critical structure, the dentin-enamel junction (DEJ). Loss of enamel exposes the underlying dentin, increasing the risk of several irreversible dental diseases. This paper highlights the significance of utilizing the functional domains of a major enamel matrix protein, amelogenin, intrinsic to tooth enamel and the DEJ interface, to rationally design smaller bioinspired peptides for regeneration of tooth microstructures. Using this strategy, we designed a synthetic peptide, P26, that demonstrates a remarkable dual mineralization potential to restore incipient enamel decay and mineralization defects localized in peripheral dentin below the DEJ. As a proof of principle, we demonstrate that interaction between P26 and collagen prompts peptide self-assembly, followed by mineralization of collagen fibrils in vitro. P26-mediated nucleation of hydroxyapatite (HAP) crystals on demineralized dentin in situ significantly facilitates the recovery of mineral density and effectively restores the biomechanical properties of dentin to near-native levels, suggesting that P26-based therapy has promising applications for treating diverse mineralized tissue defects in the tooth.

Do Tooth- and Cavity-related Aspects of Noncarious Cervical Lesions Affect the Retention of Resin Composite Restorations in Adults? A Systematic Review and Meta-analysis

PURPOSE

The purpose was to perform a systematic review and meta-analysis based on the following research question: do tooth- and cavity-related aspects of noncarious cervical lesions (NCCLs) affect the retention of composite restorations?

METHODS

Randomized clinical trials (RCTs) that evaluated the retention rate of resin restorations in NCCLs were included for the identification and comparison of their characteristics. The search was conducted in PubMed and adapted for Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database (LILACS), Brazilian Library in Dentistry (BBO), Cochrane Library, and System for Information on Grey Literature in Europe (SIGLE) without restrictions until July 2018. Unpublished and ongoing trial registries were also searched. The Cochrane Collaboration tool was used for assessing risk of bias. The quality of the evidence was graded using the Grading of Recommendations: Assessment, Development and Evaluation. Using the random effects model, a meta-analysis was conducted for each aspect (arch distribution, tooth location, wear facets, dentin sclerosis, shape, size, depth, occluso-gingival distance, and margin location).

RESULTS

We retrieved 6738 articles. After removal of duplicates and nonrelevant articles, 24 RCTs remained. The anterior tooth location favored the retention rates of restoration of NCCLs (relative risk [RR], 1.08; 95% confidence interval [CI], 1.00-1.16). The presence of wear facets is a risk factor for the retention of restorations (RR, 0.91; 95% CI, 0.83-0.99). The evidence was moderate for arch distribution and low or very low for all other factors because of heterogeneity, imprecision, and inconsistency.

CONCLUSION

The tooth location and the presence of wear facets can affect the retention of composite resins in NCCLs.

Development of a fiber-reinforced material for fiber posts: Evaluation of stress distribution, fracture load, and failure mode of restored roots

STATEMENT OF PROBLEM

The biomechanical behavior of post-restored roots with an experimental fiber-reinforced composite resin is unknown.

PURPOSE

The purpose of this in vitro study was to investigate the biomechanical behavior of an experimental composite resin (3-mm short glass fiber incorporated in methacrylate matrix with filler particles) used to produce the custom post itself or to reline fiber posts.

MATERIAL AND METHODS

Four testing groups (n=10) were created according to the root restoration method: FG, commercially available fiber post; FG+RC, fiber post relined with conventional composite resin; FG+EXP, fiber post relined with the experimental composite resin; and EXP, a custom post made of experimental composite resin. A three-dimensional finite element linear elastic analysis was performed by using geometric representations of groups, and the results were analyzed by von Mises (σ_vM) and maximum principal stress criteria. In sequence, 40 bovine incisors were assigned to these groups and subjected to a fracture load test (Instron 5965; 0.5 mm/min), and the failure mode was determined.

RESULTS

The EXP group showed more homogeneous stress distribution for σ_vM. ANOVA and the Tukey honestly significant difference (HSD) tests showed significant differences (P<.001) in fracture load (mean ±standard deviation; different superscript letters indicate statistical difference): FG+EXP (669.5 ±107.7)^A; FG (620.7 ±59.2)^A; EXP (506.5 ±27.0)^B; FG+RC (452.7 ±81.6)^B. No differences were found for failure mode (P=.595).

CONCLUSIONS

The experimental composite resin significantly increases fracture load when used to reline commercially available fiber posts and, irrespective of its use, presented lower stress concentration.

Composite vs. ionomer vs. mixed restoration of wedge-shaped dental cervical lesions: Marginal quality relative to eccentric occlusal loading

Dental cervical restorations may be impacted by resultants of occlusal loads that may have already contributed to the development of the lesion and should rely on materials' favorable properties to bear the stresses. The marginal quality of cervical restorations made with materials of different moduli of elasticity in essence, isolated, or in combination, was evaluated relative to eccentric occlusal loading. Cervical wedge-shaped cavities, prepared in extracted premolars, were restored with a composite resin (CR), a restorative ionomer (GIC), or the composite in combination with a lining ionomer (Mixed restoration: M). Half of the teeth in each group were subjected to eccentric occlusal loading (eol; 150 N / 10⁶ cycles / 2.5 Hz; CReol / GICeol / Meol, n = 10), and the others were stored in 37 °C distilled water (Control: c; CRc / GICc / Mc, n = 10). A fluorescein-modified adhesive favored delimitation of formed gaps, which were evaluated by confocal laser scanning microscopy regarding their presence, location related to the cavity walls, and width and depth (µm), at a 5% significance level. From a comprehensive perspective, neither the loading nor the materials were significantly associated with the qualitative response variables or exerted any influence over the quantitative variables. More specifically, the use of the different materials was significantly associated with the frequency of gaps exclusively when loading was applied (Chi-square test, p = 0.029, CR > M > GIC). Though the marginal quality of cervical restorations may not be influenced by eccentric occlusal loading or the use of different materials, even in association in general, the unfavorable aspects of the use of the composite may be relevant, particularly in face of the existence of eccentric occlusal loads.

A REVIEW OF FINITE ELEMENT APPLICATIONS IN ORAL AND MAXILLOFACIAL BIOMECHANICS

Finite element method (FEM) is preferred to carry out mechanical analyses for many complex biomechanical structures. For most of the biomechanical models such as oral and maxillofacial structures or patient-specific dental instruments, including nonlinearities, complicated geometries, complex material properties, or loading/boundary conditions, it is not possible to accomplish an analytical solution. The FEM is the most widely used numerical approach for such cases and found a wide range of application fields for investigating the biomechanical characteristics of oral and maxillofacial structures that are exposed to external forces or torques. The numerical results such as stress or strain distributions obtained from finite element analysis (FEA) enable dental researchers to evaluate the bone tissues subjected to the implant or prosthesis fixation from the viewpoint of (i) mechanical strength, (ii) material properties, (iii) geometry and dimensions, (iv) structural properties, (v) loading or boundary conditions, and (vi) quantity of implants or prostheses. This review paper evaluates the process of the FEA of the oral and maxillofacial structures step by step as followings: (i) a general perspective on the techniques for creating oral and maxillofacial models, (ii) definitions of material properties assigned to oral and maxillofacial tissues and related dental materials, (iii) definitions of contact types between tissue and dental instruments, (iv) details on loading and boundary conditions, and (v) meshing process.

Effects of non-carious cervical lesion size, occlusal loading and restoration on biomechanical behaviour of premolar teeth

BACKGROUND

Information on fracture biomechanics has implications in materials research and clinical practice. The aim of this study was to analyse the influence of non-carious cervical lesion (NCCL) size, restorative status and direction of occlusal loading on the biomechanical behaviour of mandibular premolars, using finite element analysis (FEA), strain gauge tests and fracture resistance tests.

METHODS

Ten buccal cusps were loaded on the outer and inner slopes to calculate the strain generated cervically. Data were collected for healthy teeth at baseline and progressively at three lesion depths (0.5 mm, 1.0 mm and 1.5 mm), followed by restoration with resin composite. The magnitude and distribution of von Mises stress and maximum principal stress were simulated at all stages using FEA, and fracture strength was also determined (n = 7 per group).

RESULTS

There were significant effects of the lesion size and loading directions on stress, strain and fracture resistance (p < 0.05). Fracture resistance values decreased with increase in lesion size, but returned to baseline with restorations.

CONCLUSIONS

Combined assessment of computer-based and experimental techniques provide an holistic approach to characterize the biomechanical behaviour of teeth with both unrestored and restored NCCLs.

Occlusal loading during biting from an experimental and simulation point of view

OBJECTIVES

Occlusal loading during clenching and biting is achieved by the action of the masticatory system, and forms the basis for the evaluation of the functional performance of prosthodontic and maxillofacial components. This review provides an overview of (i) current bite force measurement techniques and their limitations and (ii) the use of computational modelling to predict bite force. A brief simulation study highlighting the challenges of current computational dental models is also presented.

METHODS

Appropriate studies were used to highlight the development and current bite force measurement methodologies and state-of-the-art simulation for computing bite forces using biomechanical models.

RESULTS

While a number of strategies have been developed to measure occlusal forces in three-dimensions, the use of strain-gauges, piezo-electric sensors and pressure sheets remain the most widespread. In addition to experimental-based measurement techniques, bite force may be also estimated using computational models of the masticatory system. Simulations of different bite force models clearly show that the use of three-dimensional force measurements enriches the evaluation of masticatory functional performance.

SIGNIFICANCE

Hence, combining computational modelling with three-dimensional force measurement techniques can significantly improve the evaluation of masticatory system and the functional performance of prosthodontic components.