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

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.

Numerical biomechanical finite element analysis of different trimming line designs of orthodontic aligners: An in silico study

BACKGROUND

A finite element model was used to investigate the effect of different designs and thicknesses of orthodontic aligner margins on their biomechanical behavior.

METHODS

A three-dimensional data set of an upper jaw was imported into the 3-matic software. The upper right central incisor tooth (Tooth 11) was separated from the remaining model, and its periodontal ligament and surrounding bone were designed. Aligners were designed with four different trimming lines (scalloped, straight, scalloped extended, straight extended), each with four different thicknesses (0.3, 0.4, 0.5, and 0.6 mm). The models were imported into a finite element package (Marc/Mentat). A linear elastic constitutive material model was applied. A facial 0.2 mm bodily malalignment of tooth 11 was simulated.

RESULTS

The maximum resultant force was in the range of 1.0 N to 2.2 N. The straight trimming designs deliver higher resultant forces compared with scalloped trimming designs. Increasing the aligner thickness and/or extending the aligner edge beyond the gingival line leads to an increase in the resultant force. All designs showed an uneven distribution of the normal contact forces over the tooth surface with a predominant concentration toward the cervical third and distal third, particularly with the extended trimming designs. All designs showed uncontrolled tipping of the tooth.

CONCLUSIONS

Based on the current model outcomes, the use of a straight extended trimming line design for aligners is favored because of its positive impact on force distribution and, consequently, the control of tooth movement.

CLINICAL RELEVANCE

These findings provide aligner companies and orthodontists a valuable biomechanical evidence and guidance to enhance control over tooth movement and therefore optimize treatment outcomes. This can be achieved by trimming the edges of aligners with a straight extended design and selecting the appropriate aligner thickness.

A comprehensive biomechanical evaluation of length and diameter of dental implants using finite element analyses: A systematic review

Background

With a wide range of dental implants currently used in clinical scenarios, evidence is limited on selecting the type of dental implant best suited to endure the biting force of missing teeth. Finite Element Analysis (FEA) is a reliable technology which has been applied in dental implantology to study the distribution of biomechanical stress within the bone and dental implants.

Purpose

This study aimed to perform a systematic review to evaluate the biomechanical properties of dental implants regarding their length and diameter using FEA.

Material and methods

A comprehensive search was performed in PubMed/MEDLINE, Scopus, Embase, and Web of Science for peer-reviewed studies published in English from October 2003 to October 2023. Data were organized based on the following topics: area, bone layers, type of bone, design of implant, implant material, diameter of implant, length of implant, stress units, type of loading, experimental validation, convergence analysis, boundary conditions, parts of Finite Element Model, stability factor, study variables, and main findings. The present study is registered in PROSPERO under number CRD42022382211.

Results

The query yielded 852 results, of which 40 studies met the inclusion criteria and were selected in this study. The diameter and length of the dental implants were found to significantly influence the stress distribution in cortical and cancellous bone, respectively. Implant diameter was identified as a key factor in minimizing peri-implant stress concentrations and avoiding crestal overloading. In terms of stress reduction, implant length becomes increasingly important as bone density decreases.

Conclusions

The diameter of dental implants is more important than implant length in reducing bone stress distribution and improving implant stability under both static and immediate loading conditions. Short implants with a larger diameter were found to generate lower stresses than longer implants with a smaller diameter. Other potential influential design factors including implant system, cantilever length, thread features, and abutment collar height should also be considered in future implant design as they may also have an impact on implant 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.

Substrate Rigidity Effect on CAD/CAM Restorations at Different Thicknesses

OBJECTIVES

 This article evaluated the effect of substrates rigidities on the post-fatigue fracture resistance of adhesively cemented simplified restorations in lithium disilicate glass ceramic.

METHODS

 Precrystalized computer-aided design/computer-aided manufacturing ceramic blocks were processed into disc-shaped specimens (n = 10, Ø = 10 mm), mimicking a simplified restoration at two thicknesses (0.5 and 1.0 mm). Thereafter, the discs were cemented onto different base substrates (dentin analogue [control], dentin analogue with a central core build-up of resin composite [RC], or glass ionomer cement [GIC]). The specimens were subjected to mechanical cycling in a chewing simulator (100 N, 1 × 106 cycles, 4 Hz) and then subjected to thermocycling aging (10,000 cycles, 5/37/55°C, 30 seconds). After the fatigue protocol, the specimens were loaded until failure (N) in a universal testing machine. Finite element analysis calculated the first principal stress at the center of the adhesive interface.

RESULTS

 The results showed that "restoration thickness," "type of substrate," and their interaction were statistically significant (one-way analysis of variance; p < 0.001). Regardless the restoration thickness a higher fracture load was observed for specimens cemented to dentin analogue. Among the base materials, RC build-up presented the highest fracture load and lower stress magnitude for both restoration thicknesses in comparison with GIC build-up. The 0.5-mm restoration showed higher stress peak and lower fracture load when submitted to the compressive test.

CONCLUSION

 More flexible base material reduces the fracture load and increases the stress magnitude of adhesively cemented lithium disilicate restorations regardless the ceramic thickness. Therefore, more rigid substrates are suggested to be used to prevent restoration mechanical failures.

Simulating the shrinkage-induced interfacial damage around Class I composite resin restorations with damage mechanics

OBJECTIVES

To investigate the shrinkage-induced damage at the composite-tooth interface by finite element analysis (FEA) using the cohesive zone model (CZM).

METHODS

Axisymmetric models of Class I restorations were created to illustrate the interfacial damage around composite resin restorations of different dimensions, with polymerization shrinkage modeled analogously to thermal shrinkage. The damage to the adhesive interface was determined using a CZM based on the fracture strength and fracture energy. To show the effects of damage, conventional models with perfectly bonded composite resin restorations were created as controls.

RESULTS

The results indicated interfacial damage at the butt-joint cavosurface margin, dentinoenamel junction, and internal line angle. The percentage of damaged interfacial area was found to increase with decreasing diameter for restorations of the same height. For a given diameter, the damage was more severe for restorations of greater depth. The effects of the damage were further illustrated in the model with a restoration of 2-mm diameter and height. The interfacial damage occurred primarily at the internal line angle (83.3 % of all the damaged interfacial area), leading to local stress relief (from 18.3 MPa to 12.8 MPa), but also higher stress at the damage fronts. Greater local shrinkage was found in composites adjacent to the damage.

SIGNIFICANCE

The damage mechanics-based CZM is an essential refinement of the FEA to predict interfacial damage and its implications. The extent of damage was found to be greater around restorations with smaller diameters and greater depths. The entire simulation is available via an open-source platform to facilitate further applications in adhesive dentistry.

Effect of trimming line design and edge extension of orthodontic aligners on force transmission: A 3D finite element study

OBJECTIVES

To investigate in a numerical study the effect of the geometry and the extension of orthodontic aligner edges and the aligner thickness on force transmission to upper right central incisor tooth (Tooth 11).

METHODS

A three-dimensional (3D) digital model, obtained from a 3D data set of a complete dentulous maxilla, was imported into 3-matic software. Aligners with four different trimming line designs (scalloped, straight, scalloped extended, straight extended) were designed, each with four different thicknesses (0.3, 0.4, 0.5, and 0.6 mm). The models were exported to a finite element (FE) software (Marc/Mentat). A facial 0.2 mm bodily malposition of tooth 11 was simulated.

RESULTS

The maximum resultant force was in the range of (7.5 - 55.2) N. The straight trimming designs had higher resultant force than the scalloped designs. The resultant force increases with increasing the edge extension of the aligner. The normal contact forces were unevenly distributed over the entire surface and were concentrated in six areas: Incisal, Mesio-Incisal, Disto-Incisal, Middle, Mesio-Cervical, and Disto-Cervical. The resultant force increases super linearly with increasing thickness.

CONCLUSIONS

The design of the trimming line, the edge extension, and the thickness of the aligner affect significantly the magnitude of the resultant force and the distribution of normal contact force. The straight extended trimming design exhibited better force distribution that may favor a bodily tooth movement.

CLINICAL RELEVANCE

A straight extended trimming design of an orthodontic aligner may improve the clinical outcomes. In addition, the manufacturing procedures of the straight design are much simpler compared to the scalloped design.

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.

Fluoride and Calcium Release from Alkasite and Glass Ionomer Restorative Dental Materials: In Vitro Study

This study evaluated the effect of pH and temperature on the ion (F^- and Ca²⁺) release of a resin-based material containing alkaline fillers and a self-setting high-viscous glass ionomer cement. Disks were prepared according to manufacturers' instructions for both materials: the EF group (Equia Forte HT filling, GC) and the CN group (Cention N, Ivoclar). Specimens were immersed in 50 mL buffer solution with three different pHs (4.8, 6.8, and 8.8), and stored at 0°, 18°, 37°, and 44 °C. After 24 h, 7 d, and 28 d, cumulative F^- and Ca²⁺ releases were analyzed by chromatography and mass spectrometry, and pH was measured. Both materials showed minimal changes in pH with final values after 28 d of 5.17 ± 0.56 for CN and 5.12 ± 0.24 for EF. In all experimental conditions, the percentages of ion release were higher for EF than for CF. In particular, both materials showed a significant difference in temperature in F^- release. Regardless of the pH values, the highest Ca²⁺ ion release was after 28 days, with a significant difference in temperature for CN and EF. Within the limit of this study, the temperature storage influenced ion release and the high-viscous glass ionomer showed the maximum values.

Computer-aided finite element model for biomechanical analysis of orthodontic aligners

OBJECTIVES

To design a finite element (FE) model that might facilitate understanding of the complex mechanical behavior of orthodontic aligners. The designed model was validated by comparing the generated forces - during 0.2-mm facio-lingual translation of upper left central incisor (Tooth 21) - with the values reported by experimental studies in literature.

MATERIALS AND METHODS

A 3D digital model, obtained from scanning of a typodont of upper jaw, was imported into 3-matic software for designing of aligners with different thicknesses: 0.4, 0.5, 0.6, 0.7 mm. The model was exported to Marc/Mentat FE software. Suitable parameters for FE simulation were selected after a series of sensitivity analyses. Different element classes of the model and different rigidity values of the aligner were also investigated.

RESULTS

The resultant maximum forces generated on facio-lingual translation of Tooth 21 were within the range of 1.3-18.3 N. The force was direction-dependent, where lingual translation transmitted higher forces than facial translation. The force increases with increasing the thickness of the aligner, but not linearly. We found that the generated forces were almost directly proportional to the rigidity of the aligner. The contact normal stress map showed an uneven but almost repeatable distribution of stresses all over the facial surface and concentration of stresses at specific points.

CONCLUSIONS

A validated FE model could reveal a lot about mechanical behavior of orthodontic aligners.

CLINICAL RELEVANCE

Understanding the force systems of clear aligner by means of FE will facilitate better treatment planning and getting optimal outcomes.

Effect of crown stiffness and prosthetic screw absence on the stress distribution in implant-supported restoration: A 3D finite element analysis

This in-silico investigation evaluated the mechanical impact of Morse tape implant-abutment interface and retention system (with and without screw) and restorative materials (composite block and monolithic zirconia) by means of a three-dimensional finite element analysis (3D-FEA). Four 3D models were designed for the lower first molar. A dental implant (4.5 × 10 mm B&B Dental Implant Company) was digitized (micro CT) and exported to computer-aided design (CAD) software. Non-uniform rational B-spline surfaces were reconstructed, generating a 3D volumetric model. Four different models were generated with the same Morse-type connection, but with a different locking system (with and without active screw) and a different crown material made of composite block and zirconia. The D2 bone type, which contains cortical and trabecular tissues, was designed using data from the database. The implants were juxtaposed inside the model after Boolean subtraction. Implant placement depth was simulated for the implant model precisely at crestal bone level. Each acquired model was then imported into the finite element analysis (FEA) software as STEP files. The Von Mises equivalent strains were calculated for the peri-implant bone and the Von Mises stress for the prosthetic structures. The highest strain values in bone tissue occurred in the peri-implant bone interface and were comparable in the four implant models (8.2918e-004-8.6622e-004 mm/mm). The stress peak in the zirconia crown (64.4 MPa) was higher than in the composite crown (52.2 MPa) regardless of the presence of the prosthetic screw. The abutment showed the lowest stress peaks (99.71-92.28 MPa) when the screw was present (126.63-114.25 MPa). Based on this linear analysis, it is suggested that the absence of prosthetic screw increases the stress inside the abutment and implant, without effect on the crown and around the bone tissue. Stiffer crowns concentrate more stress on its structure, reducing the amount of stress on the abutment.

In Vitro Evaluation of the Strength of Dentin Replacement in Complex Posterior Tooth Restoration

Due to the increasing interest in direct restoration, there is a need to address the shortcomings of these restorations, mainly by increasing the longevity of complex direct restorations. The present study aimed to evaluate the tensile strength differences in the complex restoration of posterior teeth with dentin replacement constructed by fiber and non-fiber materials. The samples were extracted from the mandibular permanent-molar and prepared using a complex cavity. The cavity was subsequently restored with the centripetal incremental technique using a nano-fill composite and different base materials, namely fiber dentin replacement, non-fiber dentin replacement, and flowable composite. The universal testing machine was used to consider the tensile strength and the fracture patterns were assessed using stereomicroscopy, followed by Scanning Electron Microscopy (SEM) examination. The data were statistically analyzed using the one-way ANOVA test. No significant differences were noted in the tensile strength of the three base materials. By using stereomicroscopy and SEM, the adhesive fracture patterns were observed more clearly in the cavities with fiber-based dentin replacement, whereas mixed fracture patterns were evident in cavities with non-fiber dentin replacement and flowable composite bases. The results indicated that the addition of fiber in dentin replacement did not affect the tensile strength in the complex restoration. Therefore, dentin replacement of both fiber and non-fiber materials is applicable as a base material for complex restoration of the posterior tooth.

Influence of Practitioner-Related Placement Variables on the Compressive Properties of Bulk-Fill Composite Resins-An In Vitro Clinical Simulation Study

Aims: To determine if restoration location and/or execution behavior force parameters have an influence on the mechanical properties of bulk-fill composite dental restorations. Methods: Pressure transducers were placed within each quadrant of dental mannequin jaws. Cylindrical molds were placed above the transducers and filled with two bulk-fill composite materials, Filtek and Tetric, by four experienced dentists. Each dentist prepared five specimens per quadrant and material. The total placement time, mean force, number of peak forces (above 25 N), and mean peak(s) force during placement were measured. Then, the stiffness and maximal compressive strength of the specimens were determined while loading the specimens up to failure using a universal loading machine. Results: Placement time was affected by jaw (p < 0.004) and side (p < 0.029), with the shortest time demonstrated for the left side of the mandible. Force exerted during restoration placement was not normally distributed without differences in location (jaw) or material. A higher application force was found on the right side (p < 0.01). The number of peak forces was affected by side (p < 0.03), with less peaks on the left side. No significant differences were found in compressive strength when correlated to restoration location, participant, or material (p = 0.431). The stiffness values of Filtek (3729 ± 228 N/mm) were found to be 15% higher than Tetric (3248 ± 227 N/mm) (p < 0.005). No correlations were found between the compressive strength or stiffness and the amount of force applied during placement. Conclusions: The individual restoration material placement parameters did influence practitioner performance; however, these differences did not affect the mechanical properties of the final restoration.

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.

Flowable fiber-reinforced versus flowable bulk-fill resin composites: Degree of conversion and microtensile bond strength to dentin in high C-factor cavities

OBJECTIVES

To compare flowable fiber-reinforced and flowable bulk-fill resin composites regarding their degree of conversion (DC) and microtensile bond strength (μTBS) to dentin in high C-factor class I cavities.

MATERIALS AND METHODS

One flowable fiber-reinforced (EverX Flow, GC) and two flowable bulk-fill composites (SDR, Dentsply, and Tetric N-flow Bulk fill, Ivoclar Vivadent) were tested. Regarding DC, 10 cylindrical-shaped specimens were prepared from each material (N = 30), measured using Fourier-Transform Infrared Spectroscopy (FTIR). Regarding µ TBS , class I cavities (4.5 × 4.5 × 3) were prepared on flat dentin surfaces of 30 molars, divided into three equal groups, restored with the three restorative materials, thermocycled, sectioned to create 1 mm × 1 mm cross-sectional beams, then tested using a universal testing machine. Failure mode was assessed using a stereomicroscope. Two-way ANOVA and Tukey's HSD post-hoc tests were used in DC, while One-way ANOVA was used for µ TBS .

RESULTS

The used materials showed statistically significant differences in DC with the fiber-reinforced composite having the highest value. No statistically significant differences were found between the materials regarding their µ TBS .

CONCLUSIONS

Flowable fiber-reinforced composite provided the most DC performance compared to the flowable bulk-fill composites. The three used restorative materials provided comparable bonding ability to dentin in high C-factor cavities.

CLINICAL SIGNIFICANCE

Flowable fiber-reinforced resin composite is preferred as a dentin-replacement material in high-stress bearing areas. However, both flowable fiber-reinforced and bulk-fill resin composites are equally effective in bonding to dentin in high C-factor cavities.

Pre-Heating Effect on Monomer Elution and Degree of Conversion of Contemporary and Thermoviscous Bulk-Fill Resin-Based Dental Composites

Detection of unreacted monomers from pre-heated resin-based dental composites (RBC) is not a well-investigated topic so far. The objectives were to determine the temperature changes during the application and polymerization, the degree of conversion (DC) and unreacted monomer elution of room temperature (RT), and pre-heated thermoviscous [VisCalor Bulk(VCB)] and high-viscosity full-body contemporary [Filtek One Bulk(FOB)] bulk-fill RBCs. The RBCs' temperatures during the sample preparation were recorded with a K-type thermocouple. The DC at the top and bottom was measured with micro-Raman spectroscopy and the amounts of eluted BisGMA, UDMA, DDMA, and TEGDMA were assessed with High-Performance Liquid Chromatography. The temperatures of the pre-heated RBCs decreased rapidly during the manipulation phase. The temperature rise during photopolymerization reflects the bottom DCs. The differences in DC% between the top and the bottom were significant. RT VCB had a lower DC% compared to FOB. Pre-heating did not influence the DC, except on the bottom surface of FOB where a significant decrease was measured. Pre-heating significantly decreased the elution of BisGMA, UDMA, DDMA in the case of FOB, meanwhile, it had no effect on monomer release from VCB, except TEGDMA, which elution was decreased. In comparison, RBC composition had a stronger influence on DC and monomer elution, than pre-cure temperature.

Effect of Biologically Oriented Preparation Technique on the Stress Concentration of Endodontically Treated Upper Central Incisor Restored with Zirconia Crown: 3D-FEA

The aim of this study was to evaluate the effect of biologically oriented preparation technique on the stress concentration of endodontically treated upper central incisors restored with zirconia crown (yttria-stabilized zirconia polycrystalline ceramic) through finite element analysis (FEA). Four models of maxillary central incisors containing enamel, dentin, periodontal ligament, cortical and medullary bone were created in CAD. Each model received a polymeric core-build up with nanofilled dental resin composite. The evaluated models were SM-preparation in shoulder 90°; CM-chamfer preparation; BOPT-biologically oriented preparation technique and BOPTB-BOPT preparation 1 mm below the cement-enamel junction. All models received zirconia crowns (5Y-TZP), fiberglass post and 1 mm ferrule. The models were imported into the analysis software with parameters for mechanical structural testing using the maximum principal stress and the tensile strength as the analysis criteria. Then, load of 150 N was applied at the cingulum with 45° slope to the long axis of the tooth, with the fixed base for each model. The type of marginal preparation affected the stresses concentration in endodontically treated teeth and in the zirconia crown margin. Considering the stress magnitude only, BOPT is a viable option for anterior monolithic zirconia crowns; however, with the highest stress magnitude at the restoration margin.

Polymerization Shrinkage of Short Fiber Reinforced Dental Composite Using a Confocal Laser Analysis

The purpose of this study was to investigate the polymerization shrinkage of short fiber reinforced composite (SFRC) using a multicolor confocal displacement laser that can measure the polymerization shrinkage with high accuracy. The three types of SFRCs used in this study were XD (Ever X Flow Dentin), XB (Ever X Flow Bulk), and XP (EverX Posterior). In addition, CF (Clearfil majesty ES Flow) with hybrid type filler was used as a control. The measured values of the final polymerization shrinkage rate and amount of polymerization shrinkage rate when the polymerization shrinkage rate became constant (less than 0.1 µm/s) were approximated for all SFRCs. XP had a large aspect ratio of glass fiber filler and showed a significant difference from XD with a small aspect ratio (p < 0.05). There was no significant difference in the measured value of time when the polymerization contraction reached a constant speed (0.1 µm/s or less) for all SFRCs (p > 0.05). There was no significant difference in the measured values of polymerization shrinkage rate after the polymerization shrinkage reached a constant rate for all SFRCs (p > 0.05). These results show that glass fiber with large aspect ratio can alleviate polymerization shrinkage stress. The polymerization behavior of SFRC was found to be dependent on the amount of glass fiber filler, aspect ratio, and orientation.

Effect of Cement Layer Thickness on the Immediate and Long-Term Bond Strength and Residual Stress between Lithium Disilicate Glass-Ceramic and Human Dentin

This study tested whether three different cement layer thicknesses (60, 120 and 180 μm) would provide the same bonding capacity between adhesively luted lithium disilicate and human dentin. Ceramic blocks were cut to 20 blocks with a low-speed diamond saw under cooling water and were then cemented to human flat dentin with an adhesive protocol. The assembly was sectioned into 1 mm² cross-section beams composed of ceramic/cement/dentin. Cement layer thickness was measured, and three groups were formed. Half of the samples were immediately tested to evaluate the short-term bond strength and the other half were submitted to an aging simulation. The microtensile test was performed in a universal testing machine, and the bond strength (MPa) was calculated. The fractured specimens were examined under stereomicroscopy. Applying the finite element method, the residual stress of polymerization shrinkage according to cement layer thickness was also calculated using first principal stress as analysis criteria. Kruskal–Wallis tests showed that the ‘‘cement layer thickness’’ factor significantly influenced the bond strength results for the aged samples (p = 0.028); however, no statistically significant difference was found between the immediately tested groups (p = 0.569). The higher the cement layer thickness, the higher the residual stress generated at the adhesive interface due to cement polymerization shrinkage. In conclusion, the cement layer thickness does not affect the immediate bond strength in lithium disilicate restorations; however, thinner cement layers are most stable in the short term, showing constant bond strength and lower residual stress.

Stress Concentration of Endodontically Treated Molars Restored with Transfixed Glass Fiber Post: 3D-Finite Element Analysis

The loss of dental structure caused by endodontic treatment is responsible for a decrease in tooth resistance, which increases susceptibility to fracture. Therefore, it is important that minimally invasive treatments be performed to preserve the dental structure and increase the resistance to fracture of endodontically treated posterior teeth. To evaluate under axial loads, using the finite element method, the stress distribution in endodontically treated molars restored with both transfixed or vertical glass fiber posts (GFP) and resin composite. An endodontically treated molar 3D-model was analyzed using finite element analyses under four different conditions, class II resin composite (G1, control model), vertical glass fiber post (G2), transfixed glass fiber posts (G3) and vertical and transfixed glass fiber posts (G4). Ideal contacts were considered between restoration/resin composite and resin composite/tooth. An axial load (300 N) was applied to the occlusal surface. The resulting tensile stresses were calculated for the enamel and dentin tissue from five different viewports (occlusal, buccal, palatal, mesial and distal views). According to the stress maps, similar stress trends were observed, regardless of the glass fiber post treatment. In addition, for the G1 model (without GFP), a high-stress magnitude can be noticed in the proximal faces of enamel (7.7 to 14 MPa) and dentin (2.1 to 3.3 MPa) tissue. The use of transfixed glass fiber post is not indicated to reduce the stresses, under axial loads, in both enamel and dentin tissue in endodontically treated molar with a class II cavity.

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.