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Dioguardi M, Polverari D, Spirito F, Iacovelli G, Sovereto D, Laneve E, Caloro GA, Ballini A, Lo Muzio L. Introspection of the Etiopathological Mechanisms Underlying Noncarious Cervical Lesions: Analysis of the Different Theories and Their Impact on the Mineralized Structures of the Tooth. Int J Dent 2023; 2023:8838314. [PMID: 37965274 PMCID: PMC10643036 DOI: 10.1155/2023/8838314] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 09/19/2023] [Accepted: 10/18/2023] [Indexed: 11/16/2023] Open
Abstract
The noncarious cervical lesions (NCCLs) recognize an etiological framework of onset very different from the carious processes with etiology whose bacteria aggregated in a biofilm play a predominant role, leading in this way to the loss of the mineralized structure of the tooth. The pathological picture of the NCCLs, which manifests itself with a clinical picture of dental wear, differs from caries because it mainly recognizes a series of pathological processes, such as erosion, through the action of generally acidic chemical agents and abrasion, which is basically expressed through repeated mechanical trauma characteristic of tooth brushing. However, in the literature, there is no unanimous agreement in identifying only these two mechanisms, but there are some who propose a more marked role of anomalous occlusal loads, which would be unloaded on some teeth which, in addition to both erosive and abrasive mechanisms, would give rise to abfraction. Therefore, the aim of this review was to collect literature etio-pathological information and discuss the mechanisms underlying NCCLs.
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Affiliation(s)
- Mario Dioguardi
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy
| | - Davide Polverari
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy
| | - Francesca Spirito
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy
| | - Giovanna Iacovelli
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy
| | - Diego Sovereto
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy
| | - Enrica Laneve
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy
| | - Giorgia Apollonia Caloro
- Unità Operativa Nefrologia e Dialisi, Presidio Ospedaliero Scorrano, ASL (Azienda Sanitaria Locale) Lecce, Via Giuseppina Delli Ponti, 73020, Scorrano, Italy
| | - Andrea Ballini
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy
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Maayan E, Ariel P, Waseem H, Andrey G, Daniel R, Rachel S. Investigating the etiology of non-carious cervical lesions: Novel µCT analysis. J Dent 2023; 136:104615. [PMID: 37454790 DOI: 10.1016/j.jdent.2023.104615] [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: 05/04/2023] [Revised: 06/06/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023] Open
Abstract
OBJECTIVES The etiology of non-carious cervical lesions (NCCLs) is not fully understood, limiting treatment and prevention. Our aim was to evaluate the effect of mechanical loading and acid exposure on the cervical tooth region using a random spectrum loading model that simulates the nature of oral mastication. METHODS Thirty extracted human premolars were divided into three experimental groups: 1) unloaded teeth immersed in acid (erosion group: Er), 2) loaded teeth immersed in acid (erosion with spectrum loading group: Er-SL), and 3) loaded teeth immersed in distilled water (spectrum loading group: SL). Random spectrum loading with loads ranging from 100 to 500 N was performed. All teeth were scanned using micro-CT. A novel 3D analysis was developed to evaluate the circumferential cervical tissue loss and regions under tension and compression. For parametric and non-parametric comparisons, one-way ANOVA with Tukey post-hoc tests and Kruskal-Wallis with Bonferroni post-hoc tests were used. RESULTS A significant difference was observed in the circumferential volumetric loss, with the Er-SL exhibiting the greatest volume loss (p < 0.001). Moreover, in the loaded groups (Er-SL and SL), regions subjected to tension showed significantly greater loss (p < 0.001, p = 0.007) compared with regions subjected to compression. CONCLUSIONS The novel high-resolution micro-CT analysis provided new insights into the etiology of NCCLs. The results suggested that the cumulative effect of mechanical loading and acid exposure may play a major role in NCCL formation. CLINICAL SIGNIFICANCE This study investigates the etiology of NCCLs by examining the combined effects of occlusal loads and acid exposure on cervical tissue loss. Understanding the pathogenesis of NCCLs paves the way for the development of improved preventative measures and treatment strategies to prevent tooth structure degradation.
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Affiliation(s)
- Elnatan Maayan
- Department of Oral Biology, Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, POB 39040, Tel Aviv 6997801, Israel.
| | - Pokhojaev Ariel
- Department of Oral Biology, Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, POB 39040, Tel Aviv 6997801, Israel.
| | - Habashi Waseem
- Department of Oral Biology, Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, POB 39040, Tel Aviv 6997801, Israel.
| | - Garkun Andrey
- Faculty of Mechanical Engineering, Technion, 32000 Haifa, Israel.
| | - Rittel Daniel
- Faculty of Mechanical Engineering, Technion, 32000 Haifa, Israel.
| | - Sarig Rachel
- Department of Oral Biology, Goldschleger School of Dental Medicine, Sackler Faculty of Medicine, Tel Aviv University, POB 39040, Tel Aviv 6997801, Israel; Shmunis Family Anthropology Institute, Dan David Center for Human Evolution and Biohistory Research, Sackler Faculty of Medicine, Tel Aviv University, POB 39040, Tel Aviv 6997801, Israel.
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Kamenskikh AA, Sakhabutdinova L, Astashina N, Petrachev A, Nosov Y. Numerical Modeling of a New Type of Prosthetic Restoration for Non-Carious Cervical Lesions. MATERIALS 2022; 15:ma15155102. [PMID: 35897535 PMCID: PMC9330095 DOI: 10.3390/ma15155102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/14/2022] [Accepted: 07/19/2022] [Indexed: 11/29/2022]
Abstract
The paper considers a new technology for the treatment of non-carious cervical lesions (NCCLs). The three parameterized numerical models of teeth are constructed: without defect, with a V-shaped defect, and after treatment. A new treatment for NCCL has been proposed. Tooth tissues near the NCCLs are subject to degradation. The main idea of the technology is to increase the cavity for the restoration of NCCLs with removal of the affected tissues. The new treatment method also allows the creation of a playground for attaching the gingival margin. The impact of three biomaterials as restorations is studied: CEREC Blocs; Herculite XRV; and Charisma. The models are deformed by a vertical load from the antagonist tooth from 100 to 1000 N. The tooth-inlay system is considered, taking into account the contact interaction. Qualitative patterns of tooth deformation before and after restoration were established for three variants of the inlay material.
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Affiliation(s)
- Anna A. Kamenskikh
- Department of Computational Mathematics, Mechanics and Biomechanics, Perm National Research Polytechnic University, 614990 Perm, Russia; (L.S.); (Y.N.)
- Correspondence: ; Tel.: +7-(342)-239-15-64
| | - Lyaysan Sakhabutdinova
- Department of Computational Mathematics, Mechanics and Biomechanics, Perm National Research Polytechnic University, 614990 Perm, Russia; (L.S.); (Y.N.)
| | - Nataliya Astashina
- Department of Orthopedic Dentistry, Perm State Medical University Named after Academician E.A. Wagner, 26 Petropavlovskaya St., 614990 Perm, Russia; (N.A.); (A.P.)
| | - Artem Petrachev
- Department of Orthopedic Dentistry, Perm State Medical University Named after Academician E.A. Wagner, 26 Petropavlovskaya St., 614990 Perm, Russia; (N.A.); (A.P.)
| | - Yuriy Nosov
- Department of Computational Mathematics, Mechanics and Biomechanics, Perm National Research Polytechnic University, 614990 Perm, Russia; (L.S.); (Y.N.)
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Secondary Dentin Formation Mechanism: The Effect of Attrition. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18199961. [PMID: 34639261 PMCID: PMC8507651 DOI: 10.3390/ijerph18199961] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 09/14/2021] [Accepted: 09/18/2021] [Indexed: 12/27/2022]
Abstract
Human dentin consists of a primary layer produced during tooth formation in early childhood and a second layer which first forms upon tooth eruption and continues throughout life, termed secondary dentin (SD). The effect of attrition on SD formation was considered to be confined to the area subjacent to attrition facets. However, due to a lack of three-dimensional methodologies to demonstrate the structure of the SD, this association could not be determined. Therefore, in the current study, we aimed to explore the thickening pattern of the SD in relation to the amount of occlusal and interproximal attrition. A total of 30 premolars (50-60 years of age) with varying attrition rates were evaluated using micro-computerized tomography. The results revealed thickening of the SD below the cementoenamel junction (CEJ), mostly in the mesial and distal aspects of the root (p < 0.05). The pattern of thickening under the tooth cervix, rather than in proximity to attrition facets, was consistent regardless of the attrition level. The amount of SD thickening mildly correlated with occlusal attrition (r = 0.577, p < 0.05) and not with interproximal attrition. The thickening of the SD below the CEJ coincided with previous finite element models, suggesting that this area is mostly subjected to stress due to occlusal loadings. Therefore, we suggest that the SD formation might serve as a compensatory mechanism aimed to strengthen tooth structure against deflection caused by mechanical loading. Our study suggests that occlusal forces may play a significant role in SD formation.
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Caviedes-Bucheli J, Rios-Osorio N, Usme D, Jimenez C, Pinzon A, Rincón J, Azuero-Holguin MM, Zubizarreta-Macho A, Gomez-Sosa JF, Munoz HR. Three-dimensional analysis of the root canal preparation with Reciproc Blue®, WaveOne Gold® and XP EndoShaper®: a new method in vivo. BMC Oral Health 2021; 21:88. [PMID: 33632187 PMCID: PMC7908651 DOI: 10.1186/s12903-021-01450-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 02/18/2021] [Indexed: 01/08/2023] Open
Abstract
Background The purpose of this study was to evaluate the changes in canal volume after root canal preparation in vivo with 3 different single-file techniques (Reciproc-Blue®, WaveOne-Gold® and XP-EndoShaper®), with a new method using CBCT and 3D reconstruction. Methods In this prospective study, thirty human lower premolars from healthy patients were used, in which extraction was indicated for orthodontic reasons. All the teeth used were caries- and restoration-free with complete root development, without signs of periodontal disease or traumatic occlusion, and with only one straight canal (up to 25º curvature). Teeth were randomly divided into three different groups: Reciproc-Blue, WaveOne-Gold and XP-EndoShaper. CBCT scans before root canal preparation were used to create a 3D reconstruction with RHINOCEROS 5.0 software to assess the initial canal volume, and then compared with 3D reconstructions after canal preparation to measure the increase in canal volume. Student’s t test for paired data were used to determine statistically significant differences between the before and after canal volumes. Anova test was used to determine statistically significant differences in the percentage of canal volume increase between the groups and Tukey's post-hoc test were used to paired comparison. Results Reciproc-Blue showed the higher increase in canal volume, followed by WaveOne-Gold and XP-EndoShaper (p = 0.003). XP-EndoShaper did not show a statistically significant increase in canal volume after root canal preparation (p = 0.06). Conclusion With this model, Reciproc-Blue showed higher increase in root canal volume, followed by WaveOne-Gold, while XP-EndoShaper did not significantly increase root canal volume during preparation.
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Affiliation(s)
- Javier Caviedes-Bucheli
- Centro de Investigaciones Odontologicas, Pontificia Universidad Javeriana, Bogota, Colombia.
| | - Nestor Rios-Osorio
- Postgraduate Endodontics Department, Institucion Universitaria Colegios de Colombia, Bogota, Colombia
| | - Diana Usme
- Postgraduate Endodontics Department, Institucion Universitaria Colegios de Colombia, Bogota, Colombia
| | - Cristian Jimenez
- Postgraduate Endodontics Department, Institucion Universitaria Colegios de Colombia, Bogota, Colombia
| | - Adriana Pinzon
- Postgraduate Endodontics Department, Institucion Universitaria Colegios de Colombia, Bogota, Colombia
| | | | - María M Azuero-Holguin
- Centro de Investigaciones Odontologicas, Pontificia Universidad Javeriana, Bogota, Colombia.,Postgraduate Endodontics Department, Institucion Universitaria Colegios de Colombia, Bogota, Colombia
| | - Alvaro Zubizarreta-Macho
- Department of Endodontics, Faculty of Health Sciences, Alfonso X El Sabio University, Madrid, Spain
| | - Jose F Gomez-Sosa
- Postgraduate Endodontics Department, Universidad Central de Venezuela, Caracas, Venezuela
| | - Hugo R Munoz
- Endodontics Department, Universidad de San Carlos, Guatemala, Guatemala
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Adou-Assoumou MN, Djolé SX, Krah-Sinan AA, Adou JA, Siendou D, Mansilla EC. Direct technique premolar coronal restorations: From metallic material to "complete adhesive restoration". J Conserv Dent 2020; 22:568-572. [PMID: 33088067 PMCID: PMC7542080 DOI: 10.4103/jcd.jcd_330_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 03/14/2020] [Accepted: 07/03/2020] [Indexed: 12/03/2022] Open
Abstract
Introduction: The choice of restorative materials has for a long time been determined by the tooth position. Thus, premolar restoration depended on the practitioner's clinical assessment and practical experience in regard to the material to be handled. Aim: The objective of this study was to assess, in the students' practice, the change in the choice of materials used for premolars restoration. Materials and Methods: This was a retrospective study based on the available care records in the department of conservative dentistry and endodontics of a dental school. Variables analyzed included the year of restoration, the type of material, the premolar position in the arch, and the coronal restoration site (occlusal, proximal, and cervical). Data collected were processed with the SPSS software version 22 (SPSS Inc., Chicago, IL, USA; 2013). The statistical significance threshold was set at 5% for Pearson's Chi-square test. Results: Between 1994 and 2017, 1738 restored premolars were identified. Over the years, amalgam restorations declined from 99.2% in 1994 to 1.3% in 2017, contrary to composite whose frequency increased from 0.6% to 88.6%. Maxillary premolars were exclusively restored with composite in 2017 when amalgam was still, somewhat, used for mandibular premolars. Conclusion: The reversal in the choice of materials in favor of composites reflects the global trend. This seems to be related to the current awareness of the prohibition, among others, of medical devices containing mercury.
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Affiliation(s)
- Marie Nwon Adou-Assoumou
- Conservative Dentistry and Endodontics Department, Faculty of Odonto-Stomatology, Félix Houphouët Boigny University, Abidjan, Côte d'Ivoire
| | - Stéphane X Djolé
- Conservative Dentistry and Endodontics Department, Faculty of Odonto-Stomatology, Félix Houphouët Boigny University, Abidjan, Côte d'Ivoire
| | - Aline A Krah-Sinan
- Conservative Dentistry and Endodontics Department, Faculty of Odonto-Stomatology, Félix Houphouët Boigny University, Abidjan, Côte d'Ivoire
| | - Jonas A Adou
- Conservative Dentistry and Endodontics Department, Faculty of Odonto-Stomatology, Félix Houphouët Boigny University, Abidjan, Côte d'Ivoire
| | - Dao Siendou
- Conservative Dentistry and Endodontics Department, Faculty of Odonto-Stomatology, Félix Houphouët Boigny University, Abidjan, Côte d'Ivoire
| | - Edmée C Mansilla
- Conservative Dentistry and Endodontics Department, Faculty of Odonto-Stomatology, Félix Houphouët Boigny University, Abidjan, Côte d'Ivoire
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7
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Prevalence and risk indicators of non-carious cervical lesions in male footballers. BMC Oral Health 2020; 20:215. [PMID: 32727438 PMCID: PMC7392645 DOI: 10.1186/s12903-020-01200-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 07/20/2020] [Indexed: 12/02/2022] Open
Abstract
Background Non-carious cervical lesions (NCCLs) have shown a significant incidence and prevalence and have been increasingly associated with people’s lifestyles and youths. This cross-sectional study aimed to determine the prevalence of NCCLs in footballers and to address potential risk indicators. Methods Fourty-three male semi-professional footballers with an average of 27 years old completed a questionnaire and were subjected to intraoral examination in terms of cervical tooth wear, morphological characteristics of NCCLs, tooth sensitivity, occlusal/incisal wear, and malocclusion classification. Also, laboratory assays were performed to determine salivary parameters: flow rate, pH, buffer capacity, level of Ca (calcium), Na (sodium), and K (potassium) ions, and level of cortisol. The data obtained from the questionnaire and intraoral examinations were subjected to Chi-square and Poisson regression models while the data obtained from the laboratory assays were analyzed by using analysis of variance (p < 0.05). Results The prevalence of NCCLs was 39.5%. The participants presented predominantly initial lesions with signs of mechanical stress. The daily training time was found as a significant risk indicator (p = 0.028). The multivariate analysis showed a significant difference in the variables daily training time (p = 0.023), lemon water intake while fasting (p = 0.002), toothpaste type (p = 0.004), tooth sensitivity (p = 0.006); previous orthodontic treatment (p = 0.003), and occlusion type (p = 0.008). All participants presented normal salivary parameters and levels of cortisol. Conclusion The prevalence of NCCLs among footballers was remarkable. The premolars were the most affected teeth and presented symptoms/signs of initial lesions. The daily training time was a dominant risk indicator of NCCLs development. Footballers presented adequate salivary parameters and cortisol levels.
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Lee Y, Chun Y. An investigation into structural behaviors of skulls chewing food in different occlusal relationships using FEM. Clin Exp Dent Res 2020; 6:277-285. [PMID: 32558315 PMCID: PMC7301394 DOI: 10.1002/cre2.273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 11/29/2019] [Accepted: 11/29/2019] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES This study aims to investigate the effect of different occlusal relationships on skull structural and mechanical behaviors through simulation of chewing food. METHODS Finite element (FE) skull models of occlusion for Class I, end-on Class II, and full-cusp Class II were generated. End-on Class II and full-cusp Class II were chosen as mild and severe Class II occlusions, respectively. A simplified food bolus was introduced between the upper and lower dentition of the right molars. Chewing food was simulated in the skulls by moving the mandible. An experiment was conducted to measure strains at selective locations and compared them to the analytical results for validation. RESULTS In the early stages of mandibular movement, masticatory forces predicted from the skull models without food were lower than the skull models with food but increased drastically after occluding teeth full enough. As a result, the relationship between masticatory force and mandible movement shows that there is no significant difference between the skull models with food and without food in the range of human masticatory force, approximately 250 N. In all the cases of skulls including a food bolus, stress was similarly propagated from the mandible to the maxilla and concentrated in the same regions, including the mandibular notch and alveolar bone around the lower molars. CONCLUSION It is predicted that there is no significant difference of bite force-mandible movement relationships and stress distributions of skull and teeth, between end-on Class II and full-cusp Class II models. When simulating chewing activities on candy and carrot, it is also found that there is no difference of masticatory performance between Class II occlusions, from structural as well as mechanical perspectives.
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Affiliation(s)
- Yeo‐Kyeong Lee
- Architectural and Urban System Engineering, Division of Sustainable Systems Engineering, ELTEC College of EngineeringEwha Womans UniversitySeoulSouth Korea
| | - Youn‐Sic Chun
- Orthodontics & dentofacial orthopedics, School of MedicineEwha Womans UniversitySeoulSouth Korea
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Du JK, Wu JH, Chen PH, Ho PS, Chen KK. Influence of cavity depth and restoration of non-carious cervical root lesions on strain distribution from various loading sites. BMC Oral Health 2020; 20:98. [PMID: 32264864 PMCID: PMC7140390 DOI: 10.1186/s12903-020-01083-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 03/24/2020] [Indexed: 02/07/2023] Open
Abstract
Background We aimed to investigate the load-induced strain variation in teeth with unrestored and resin-based composite restored non-carious cervical lesions (NCCLs). Methods Twelve extracted premolars were provided for measuring buccal-side root NCCLs. Strain gauges were fixed at four measuring sites of each tooth, two at the buccal surface and two at the lingual surface. NCCLs were prepared with occlusal margins at the cemento-enamel junction. A static 9-kg load was applied at seven occlusal loading points: buccal cusp tip (BC), inner inclination of the BC, lingual cusp tip (LC), inner inclination of the LC, center of the mesial marginal ridge or distal marginal ridge, and center of the central groove. The strain was detected at each site in teeth with NCCL depths of 0 (control), 0.5, 1.0, and 1.5 mm. Each NCCL was restored using an adhesive composite resin, and the strains were re-measured. Results The strains at the NCCL occlusal and gingival margins decreased with increasing defect depths, and the effect was significant when the depth of the defect was 1.5 mm. Loading on the buccal and lingual cusps induced prominent strain variation. The strains at all depth distribution recovered to nearly intact conditions when the NCCLs were restored. Conclusions NCCLs at 1.5 mm depth are detrimental, but they can be restored using resin composites. Clinical significance The existence of NCCLs should not be ignored. The depth of the NCCL may affect the progression of the lesion. Resin composite restoration is an appropriate method for preventing persistent NCCL deterioration.
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Affiliation(s)
- Je-Kang Du
- School of Dentistry, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, San-Ming, District, Kaohsiung, 807, Taiwan.,Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, 807, Taiwan
| | - Ju-Hui Wu
- Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, 807, Taiwan.,Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
| | - Ping-Ho Chen
- School of Dentistry, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, San-Ming, District, Kaohsiung, 807, Taiwan
| | - Pei-Shan Ho
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan.,Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, 807, Taiwan
| | - Ker-Kong Chen
- School of Dentistry, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, San-Ming, District, Kaohsiung, 807, Taiwan. .,Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, 807, Taiwan.
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Limjeerajarus N, Dhammayannarangsi P, Phanijjiva A, Tangsripongkul P, Jearanaiphaisarn T, Pittayapat P, Limjeerajarus CN. Comparison of ultimate force revealed by compression tests on extracted first premolars and FEA with a true scale 3D multi-component tooth model based on a CBCT dataset. Clin Oral Investig 2019; 24:211-220. [PMID: 31079245 DOI: 10.1007/s00784-019-02919-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 04/29/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The aim of this study was to develop a new method for creating a multi-component and true scale 3-dimensional (3D) model of a human tooth based on cone-beam computed tomography (CBCT) images. MATERIALS AND METHODS First maxillary premolar tooth model was reconstructed from a patient's CBCT images. The 2D serial sections were used to create the 3D model. This model was used for finite element analysis (FEA). Model validation was performed by comparing the ultimate compressive force (UF) obtained experimentally using a universal testing machine and from simulation. The simulations of three component-omitting models (silicone, cementum, and omitting both) were performed to analyze the maximum (max.) principal stress and stress distribution. RESULTS The simulation-based UF indicating tooth fracture was 637 N, while the average UF in the in vitro loading was 651 N. The discrepancy between the simulation-based UF and the experimental UF was 2.2%. From the simulation, the silicone-omitting models showed a significant change in max. principal stress, resulting in a UF error of 26%, whereas there was no notable change in the cementum-omitting model. CONCLUSION This study, for the first time, developed a true scale multi-component 3D model from CBCT for predicting stress distribution in a human tooth. CLINICAL RELEVANCE This study proposed a method to create 3D modeling from CBCT in a true scale and multi-component manner. The PDL-like component-omitting simulation led to a higher error value of UF, indicating the importance of multi-component tooth modeling in FEA. Tooth 3D modeling could help determine mechanical failure in dental treatments in a more precise manner.
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Affiliation(s)
- Nuttapol Limjeerajarus
- Research Center for Advanced Energy Technology, Faculty of Engineering, Thai-Nichi Institute of Technology, Bangkok, 10250, Thailand
| | - Phetcharat Dhammayannarangsi
- Research Center for Advanced Energy Technology, Faculty of Engineering, Thai-Nichi Institute of Technology, Bangkok, 10250, Thailand
| | - Anon Phanijjiva
- Research Center for Advanced Energy Technology, Faculty of Engineering, Thai-Nichi Institute of Technology, Bangkok, 10250, Thailand
| | - Pavita Tangsripongkul
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Thanomsuk Jearanaiphaisarn
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Pisha Pittayapat
- Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Chalida Nakalekha Limjeerajarus
- Department of Physiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand. .,Center of Excellence for Regenerative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand.
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11
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Haralur SB, Alqahtani AS, AlMazni MS, Alqahtani MK. Association of Non-Carious Cervical Lesions with Oral Hygiene Habits and Dynamic Occlusal Parameters. Diagnostics (Basel) 2019; 9:diagnostics9020043. [PMID: 31013807 PMCID: PMC6627150 DOI: 10.3390/diagnostics9020043] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 04/09/2019] [Accepted: 04/10/2019] [Indexed: 11/16/2022] Open
Abstract
Dentists routinely encounter non-carious cervical lesions (NCCLs) in daily clinical practices. The dental literature is contradictory regarding the occlusal etiology of NCCLs. NCCL is defined as the loss of dental structure at the cemento-enamel junction, with no association of bacteria. The aim of this study was to evaluate the association of dynamic occlusal factors and dental hygiene practices with NCCLs. In total, 100 participants were selected by the random stratified sampling method, 50 each for control and NCCL groups. Information regarding oral hygiene practices, including frequency, duration, force, and technique of brushing, was recorded. Dynamic occlusal parameters like initial contact, occlusion time (OT), disocclusion time (DT), and center of force were recorded with T-scan analysis. The obtained data were analyzed with Pearson's correlation and binary logistic regression. We found that 68% of participants in the NCCL group and 31% in the control group utilized the horizontal brushing technique; 46% of NCCL group participants used hard brush against 7% of participants in the control group. The mean OT was 0.727 and 0.516 s for NCCL and control groups, respectively. The OT and left and right lateral DT were strongly related to NCCL, with r-values of 0.661, 0.642, and 0.534, respectively, with p ≤ 0.001. Using a hard toothbrush was found to be associated with NCCL. The NCCL group had extended mean occlusion time and disocclusion time in all eccentric mandibular movements.
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Affiliation(s)
- Satheesh B Haralur
- Department of Prosthodontics, College of Dentistry, King Khalid University, 62529 Abha, Saudi Arabia.
| | | | - Mohammed Shaya AlMazni
- Department of Prosthodontics, College of Dentistry, King Khalid University, 62529 Abha, Saudi Arabia.
| | - Mohammad Khalid Alqahtani
- Department of Prosthodontics, College of Dentistry, King Khalid University, 62529 Abha, Saudi Arabia.
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Zeola LF, Pereira FA, Machado AC, Reis BR, Kaidonis J, Xie Z, Townsend GC, Ranjitkar S, Soares PV. Effects of non-carious cervical lesion size, occlusal loading and restoration on biomechanical behaviour of premolar teeth. Aust Dent J 2017; 61:408-417. [PMID: 26671647 DOI: 10.1111/adj.12391] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2015] [Indexed: 11/28/2022]
Abstract
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.
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Affiliation(s)
- L F Zeola
- Operative Dentistry and Dental Materials Department, School of Dentistry, Federal University of Uberlandia, Brazil
| | - F A Pereira
- Operative Dentistry and Dental Materials Department, School of Dentistry, Federal University of Uberlandia, Brazil
| | - A C Machado
- Operative Dentistry and Dental Materials Department, School of Dentistry, Federal University of Uberlandia, Brazil
| | - B R Reis
- Federal University of Uberlandia, Brazil
| | - J Kaidonis
- School of Mechanical Engineering, The University of Adelaide, South Australia, Australia
| | - Z Xie
- School of Dentistry, The University of Adelaide, South Australia, Australia
| | - G C Townsend
- School of Mechanical Engineering, The University of Adelaide, South Australia, Australia
| | - S Ranjitkar
- School of Mechanical Engineering, The University of Adelaide, South Australia, Australia
| | - P V Soares
- Operative Dentistry and Dental Materials Department, School of Dentistry, Federal University of Uberlandia, Brazil
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Askerbeyli Örs S, Serper A. Influence of nickel-titanium rotary systems with varying tapers on the biomechanical behaviour of maxillary first premolars under occlusal forces: a finite element analysis study. Int Endod J 2017; 51:529-540. [PMID: 28333370 DOI: 10.1111/iej.12770] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 03/18/2017] [Indexed: 11/30/2022]
Abstract
AIM To evaluate the effect of three nickel-titanium (Ni-Ti) rotary systems with varying tapers on stress distribution and to analyse potential fracture patterns as well as the volume of fracture-susceptible regions in two-rooted maxillary premolars. METHODOLOGY The root canals of three single-rooted premolars were prepared with either HeroShaper (Micro-Mega, Besançon, France) to (size 30, .04 taper), Revo-S (Micro-Mega) to AS30 (size 30, .06 taper) or ProTaper Universal (Dentsply Maillefer, Ballaigues, Switzerland) to F3 (size 30, .09 taper) Ni-Ti files. The three root canals were scanned using micro-computed tomography (μCT) (Skyscan 1174, Skyscan, Kontich, Belgium) and modelled according to the μCT data. An intact tooth model with a root length of 16 mm was also constructed based on μCT images of an extracted maxillary premolar with two roots. New models were constructed by replacing both of the original canals of the intact two-rooted premolar model with the modelled canals prepared with the HeroShaper, Revo-S or ProTaper Universal system. Occlusal forces of 200 N were applied in oblique and vertical directions. Finite element analysis was performed using Abaqus FEA software (Abaqus 6.14, ABAQUS Inc., Providence, RI, USA). RESULTS Upon the application of oblique occlusal forces, the palatal external cervical root surface and the bifurcation (palatal side of the buccal root) in tooth models experienced the highest maximum principal (Pmax) stresses. The application of vertical forces resulted in minor Pmax stress values. Models prepared using the ProTaper system exhibited the highest Pmax stress values. The intact models exhibited the lowest Pmax stress values followed by the models prepared with the HeroShaper system. CONCLUSION The differences in Pmax stress values amongst the different groups of models were mathematically minimal under normal occlusal forces. Rotary systems with varying tapers might predispose the root fracture on the palatal side of the buccal root and cervical palatal root surface in two-rooted premolars.
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Affiliation(s)
- S Askerbeyli Örs
- Department of Endodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - A Serper
- Department of Endodontology, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
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Machado AC, Soares CJ, Reis BR, Bicalho AA, Raposo L, Soares PV. Stress-strain Analysis of Premolars With Non-carious Cervical Lesions: Influence of Restorative Material, Loading Direction and Mechanical Fatigue. Oper Dent 2017; 42:253-265. [PMID: 28467256 DOI: 10.2341/14-195-l] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Noncarious cervical lesions (NCCLs) are characterized by a loss of dental structure at the cementoenamel junction (CEJ) caused by stress, biocorrosion, and attrition. Variations in occlusal loading can promote different stress and strain patterns on the CEJ. Restoration of NCCLs is part of lesion management; however, there is still no conclusive restorative protocol for NCCLs. This study aimed to evaluate the stress and strain distribution of maxillary premolars with NCCLs according to three factors: 1) restorative technique; 2) direction of occlusal loading; and 3) mechanical fatigue. Three-dimensional (3D) finite element analysis (FEA) and strain gauge testing were used to assess stress and strain, respectively. 3D-FEA orthotropic, linear, and elastic models were generated: sound tooth (SO); unrestored NCCL; or NCCL restored with glass ionomer; flowable composite resin; nanofilled composite resin (CR); lithium disilicate ceramic; and nanofilled composite resin core associated with a lithium disilicate laminate (CL). A 150-N compressive static load was applied in two conditions: axially in both cusps (Al); and at a 45° angle to the long axis of the tooth applied to the palatine cusp (Ol). For the experimental tests, specimens were treated as described previously, and one strain gauge was attached to the buccal surface of each tooth to record tooth strains before and after cyclic loading (200,000 cycles, 50 N). FEA showed that the association of NCCL and Ol resulted in higher stress values. CR and CL restorations showed the closest biomechanical behavior to SO for both loading types. Loaded Al or Ol specimens showed higher strain values after mechanical fatigue. Lower stress and strain were observed with Al when compared with Ol. The restoration of NCCLs with composite resin only or associated with ceramic laminates seems to be the best approach because the results for those groups were similar in biomechanical behaviors to sound teeth.
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Kuroshima S, Nakano T, Ishimoto T, Sasaki M, Inoue M, Yasutake M, Sawase T. Optimally oriented grooves on dental implants improve bone quality around implants under repetitive mechanical loading. Acta Biomater 2017; 48:433-444. [PMID: 27838462 DOI: 10.1016/j.actbio.2016.11.021] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 10/12/2016] [Accepted: 11/08/2016] [Indexed: 10/20/2022]
Abstract
The aim was to investigate the effect of groove designs on bone quality under controlled-repetitive load conditions for optimizing dental implant design. Anodized Ti-6Al-4V alloy implants with -60° and +60° grooves around the neck were placed in the proximal tibial metaphysis of rabbits. The application of a repetitive mechanical load was initiated via the implants (50N, 3Hz, 1800 cycles, 2days/week) at 12weeks after surgery for 8weeks. Bone quality, defined as osteocyte density and degree of biological apatite (BAp) c-axis/collagen fibers, was then evaluated. Groove designs did not affect bone quality without mechanical loading; however, repetitive mechanical loading significantly increased bone-to-implant contact, bone mass, and bone mineral density (BMD). In +60° grooves, the BAp c-axis/collagen fibers preferentially aligned along the groove direction with mechanical loading. Moreover, osteocyte density was significantly higher both inside and in the adjacent region of the +60° grooves, but not -60° grooves. These results suggest that the +60° grooves successfully transmitted the load to the bone tissues surrounding implants through the grooves. An optimally oriented groove structure on the implant surface was shown to be a promising way for achieving bone tissue with appropriate bone quality. This is the first report to propose the optimal design of grooves on the necks of dental implants for improving bone quality parameters as well as BMD. The findings suggest that not only BMD, but also bone quality, could be a useful clinical parameter in implant dentistry. STATEMENT OF SIGNIFICANCE Although the paradigm of bone quality has shifted from density-based assessments to structural evaluations of bone, clarifying bone quality based on structural bone evaluations remains challenging in implant dentistry. In this study, we firstly demonstrated that the optimal design of dental implant necks improved bone quality defined as osteocytes and the preferential alignment degree of biological apatite c-axis/collagen fibers using light microscopy, polarized light microscopy, and a microbeam X-ray diffractometer system, after application of controlled mechanical load. Our new findings suggest that bone quality around dental implants could become a new clinical parameter as well as bone mineral density in order to completely account for bone strength in implant dentistry.
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Evaluation of the Effect of Rotary Systems on Stresses in a New Testing Model Using a 3-Dimensional Printed Simulated Resin Root with an Oval-shaped Canal: A Finite Element Analysis Study. J Endod 2016; 42:1273-8. [DOI: 10.1016/j.joen.2016.05.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 05/07/2016] [Accepted: 05/14/2016] [Indexed: 11/20/2022]
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Naves LZ, Silva GRD, Correr-Sobrinho L, Costa AR, Valdivia ADCM, Soares CJ. Influence of crosshead speed on failure load and failure mode of restored maxillary premolars. Braz Oral Res 2015; 30:S1806-83242016000100206. [PMID: 26676190 DOI: 10.1590/1807-3107bor-2016.vol30.0003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Accepted: 06/19/2015] [Indexed: 11/21/2022] Open
Abstract
We analyzed the effect of the crosshead speed of an applied load on failure load and failure mode of restored human premolars. Fifty intact, noncarious human premolars were selected. Class II mesio-occlusodistal preparations were made with a water-cooled high-speed preparation machine, and the teeth were restored with composite resin. The specimens were divided into five groups (n = 10 each) and tested individually in a mechanical testing machine, in which a 6.0-mm-diameter steel cylinder was mounted to vary the crosshead speed: v0.5: 0.5 mm/min; v1: 1.0 mm/min; v2.5: 2.5 mm/min; v5: 5.0 mm/min; and v10: 10.0 mm/min. The cylinder contacted the facial and lingual ridges beyond the margins of the restorations. Peak load to fracture was measured for each specimen (N). The means were calculated and analyzed with one-way analysis of variance followed by Tukey's test (a = 0.05). The mean load at failure values were (N) as follows: v0.5, 769.4 ± 174.8; v1, 645.2 ± 115.7; v5, 614.3 ± 126.0; v2.5, 609.2 ± 208.1; and v10, 432.5 ± 136.9. The fracture modes were recorded on the basis of the degree of the tooth structural and restorative damage: (I) fracture of the restoration involving a small portion of the tooth; (II) fractures involving the coronal portion of the tooth with cohesive failure of the composite resin; (III) oblique tooth and restoration fracture with periodontal involvement; and (IV) vertical root and coronal fracture. Varying crosshead speeds of 0.5-5.0 mm/min did not influence the failure load of restored maxillary premolars; however, increasing the crosshead speed to 10 mm/min decreased the failure load values and the degree of tooth structural damage.
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Affiliation(s)
- Lucas Zago Naves
- Dental Materials Department, Piracicaba School of Dentistry, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Gisele Rodrigues da Silva
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Lourenço Correr-Sobrinho
- Dental Materials Department, Piracicaba School of Dentistry, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Ana Rosa Costa
- Dental Materials Department, Piracicaba School of Dentistry, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | | | - Carlos José Soares
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
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Pereira FA, Zeola LF, de Almeida Milito G, Reis BR, Pereira RD, Soares PV. Restorative material and loading type influence on the biomechanical behavior of wedge shaped cervical lesions. Clin Oral Investig 2015; 20:433-41. [PMID: 26159778 DOI: 10.1007/s00784-015-1523-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 06/30/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate the influence of restorative materials used on the rehabilitation of MOD cavities and loading type, on biomechanical behavior of wedge-shaped (WS) lesions in endodontically treated maxillary premolars. The investigation was conducted by 3D finite element analysis (FEA) and strain gauge test. MATERIALS AND METHODS Six models were generated, with MOD cavities and endodontic treatment: A (MOD amalgam restoration), R (MOD composite restoration), AL (A + cervical lesion (L)), RL, ALR (A + cervical lesion restored with composite (LR)), and RLR. Each model underwent two compressive loading (100N): axial and oblique-45° angle to the long axis on the buccal cusp. The models were analyzed by von Mises criteria. For strain gauge test, 14 standardized maxillary premolars were treated according to the groups described for FEA. Two strain gauges were bonded on each sample submitted to compressive loading in a mechanical testing machine. RESULTS A presented higher stress concentration and strain values than R. Oblique loading promoted highest stress concentration and strain rates for all groups. ALR and RLR presented similar stress-strain distribution pattern when compared to A and R. CONCLUSION The interaction between MOD cavity restored with amalgam and oblique loading propitiated the highest stress concentration and strain values on cervical region and WS lesion. CLINICAL RELEVANCE The MOD cavity restored with composite resin is a better option than amalgam to improve the biomechanical behavior of wedge-shaped lesion, avoiding dental failure. In addition, the occlusal interferences must be removed, allowing homogeneous contact distribution and preventing WS lesion progression.
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Affiliation(s)
- Fabrícia Araújo Pereira
- Operative Dentistry and Dental Materials Department, Federal University of Uberlandia, Rua Republica do Piratini S/N Bloco 4LA Sala 37 Campus Umuarama, Uberlândia, Minas Gerais, 38405-325, Brazil
| | - Livia Fávaro Zeola
- Operative Dentistry and Dental Materials Department, Federal University of Uberlandia, Rua Republica do Piratini S/N Bloco 4LA Sala 37 Campus Umuarama, Uberlândia, Minas Gerais, 38405-325, Brazil
| | - Giovana de Almeida Milito
- Operative Dentistry and Dental Materials Department, Federal University of Uberlandia, Rua Republica do Piratini S/N Bloco 4LA Sala 37 Campus Umuarama, Uberlândia, Minas Gerais, 38405-325, Brazil
| | - Bruno Rodrigues Reis
- Operative Dentistry and Dental Materials Department, Federal University of Uberlandia, Rua Republica do Piratini S/N Bloco 4LA Sala 37 Campus Umuarama, Uberlândia, Minas Gerais, 38405-325, Brazil
| | - Rodrigo Dantas Pereira
- Department of Dentistry, United Universities of the North of Minas, Avenida Osmane Barbosa, 11111, Montes Claros, Minas Gerais, 39404-549, Brazil
| | - Paulo Vinícius Soares
- Operative Dentistry and Dental Materials Department, School of Dentistry, Federal University of Uberlandia, Rua Republica do Piratini S/N Bloco 4LA Sala 37 Campus Umuarama, Uberlândia, Minas Gerais, 38405-325, Brazil.
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