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Zeng B, Luo B, Hu J, Meng D, Zhang J, Cao X, Jiang Q. Effect of margin designs and loading conditions on the stress distribution of endocrowns: a finite element analysis. BMC Oral Health 2024; 24:657. [PMID: 38840138 PMCID: PMC11151608 DOI: 10.1186/s12903-024-04422-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 05/30/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Margin designs and loading conditions can impact the mechanical characteristics and survival of endocrowns. Analyzing the stress distribution of endocrowns with various margin designs and loading conditions can provide evidence for their clinical application. METHODS Three finite element analysis models were established based on the margin designs: endocrown with a butt-joint type margin (E0), endocrown with a 90° shoulder (E90), and endocrown with a 135° shoulder (E135). The E0 group involved lowering the occlusal surface and preparing the pulp chamber. The E90 group created a 90° shoulder on the margin of model E0, measuring 1.5 mm high and 1 mm wide. The E135 group featured a 135° shoulder. The solids of the models were in fixed contact with each other, and the materials of tooth tissue and restoration were uniform, continuous, isotropic linear elasticity. Nine static loads were applied, with a total load of 225 N, and the maximum von Mises stresses and stress distribution were calculated for teeth and endocrowns with different margin designs. RESULTS Compared the stresses of different models under the same loading condition. In endocrowns, when the loading points were concentrated on the buccal side, the maximum von Mises stresses were E0 = E90 = E135, and when there was a lingual loading, they were E0 < E90 = E135. In enamel, the maximum von Mises stresses under all loading conditions were E0 > E90 > E135. In dentin, the maximum von Mises stresses of the three models were basically similar except for load2, load5 and load9. Compare the stresses of the same model under different loading conditions. In endocrowns, stresses were higher when lingual loading was present. In enamel and dentin, stresses were higher when loaded obliquely or unevenly. The stresses in the endocrowns were concentrated in the loading area. In enamel, stress concentration occurred at the cementoenamel junction. In particular, E90 and E135 also experienced stress concentration at the shoulder. In dentin, the stresses were mainly concentrated in the upper section of the tooth root. CONCLUSION Stress distribution is similar among the three margin designs of endocrowns, but the shoulder-type designs, especially the 135° shoulder, exhibit reduced stress concentration.
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Affiliation(s)
- Baijin Zeng
- Department of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, No. 4 Tiantanxili, Dongcheng District, Beijing, 100050, China
| | - Bin Luo
- Department of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, No. 4 Tiantanxili, Dongcheng District, Beijing, 100050, China
| | - Jiangqi Hu
- Department of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, No. 4 Tiantanxili, Dongcheng District, Beijing, 100050, China
| | - Dan Meng
- Department of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, No. 4 Tiantanxili, Dongcheng District, Beijing, 100050, China
| | - Jiebing Zhang
- Department of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, No. 4 Tiantanxili, Dongcheng District, Beijing, 100050, China
| | - Xu Cao
- Department of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, No. 4 Tiantanxili, Dongcheng District, Beijing, 100050, China.
| | - Qingsong Jiang
- Department of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, No. 4 Tiantanxili, Dongcheng District, Beijing, 100050, China.
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Al Ahmari NM, Alshehri AH, Gadah TS, Alqahtani JA, Almushafi MA, Al Moaleem MM, Al Hatlan EN, Alqhatani AS, Alabydi SM. Comparison of color changes, fracture strengths, and failure modes of conventional endocrowns and endocrowns with different design modifications. Technol Health Care 2024; 32:2395-2408. [PMID: 38427513 DOI: 10.3233/thc-231175] [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] [Indexed: 03/03/2024]
Abstract
BACKGROUND Endocrowns (ECs) are alternatives for rebuilding severely damaged teeth and show superior efficacy in molars over premolars. OBJECTIVE The objective of this in vitro study is to evaluate the effects of different preparation designs with short pulp chambers on the mean color change (ΔE), fracture resistance, and failure types of mandibular molar ECs. METHOD A total of 40 extracted mandibular molars were treated endodontically and divided into four groups. Samples in groups 1, 2, 3, and 4 had occlusal preparation depths of 5 mm, 3 mm, 3 mm with ferrule, and 3 mm with boxes, respectively. The samples were immersed in coffee and their ΔE values were measured by using the Commission Internationale de l'Eclairage color system. They were also subjected to a fracture test. Next, all specimens were examined visually under a stereomicroscope to evaluate their failure modes and identify their fracture origins. Data were entered and analyzed by using Statistical Package for Social Sciences. RESULTS Among all groups, group 4 (3 mm + boxes) presented the highest ΔE (4.15) after immersion in coffee. Moreover, ANOVA revealed that the ΔE of group 4 (occlusal preparation depth of 3 mm with boxes) was significantly different (p< 0.05) from that of group 2 (3 mm + ferrule, 3.07). The EC with a 3 mm chamfer and ferrule showed the highest maximum load of 2847.68 ± 693.27 N, whereas that with a 5 mm chamfer finish line had a marginally reduced load at fracture of 2831.52 ± 881.83 N. The EC with a 3 mm chamber and boxes had a slightly increased maximum load of 2700.75 ± 436.40 N, whereas that with the 3 mm chamber had the lowest maximum load at fracture of 2385.97 ± 465.61 N. One-way ANOVA showed that different EC preparation designs had no effect on maximum fracture load (F [3,16] = 0.550, p= 0.6). CONCLUSION The recorded ΔE values of ECs in all groups were equal or marginally higher than the acceptable values. The EC with a 3 mm chamfer and ferrule displayed the highest mean maximum load. The EC with a 5 mm chamfer finish line had a marginally lower maximum load at fracture than other ECs. Failures, such as ceramic fracture, split fracture, and ceramic and tooth splitting above the cemento-enamel junction (CEJ) or vertically were predominant in samples with occlusal preparation depths of 3 mm with ferrule and 5 mm.
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Affiliation(s)
| | - Abdulkarim H Alshehri
- Department of Prosthetic Dental Science, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Thrya S Gadah
- College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Jaber A Alqahtani
- Aseer Specialized Dental Center, Ministry of Health, Abha, Saudi Arabia
| | | | - Mohammed M Al Moaleem
- Department of Prosthetic Dental Science, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Alwadai GS, Al Moaleem MM, Daghrery AA, Albar NH, Daghriri AA, AlGhamdi MM, Ageel SE, Daghreeri FA, Al-Amri TM, Aridhi WH, Almnea RA, Alhendi KD. A Comparative Analysis of Marginal Adaptation Values between Lithium Disilicate Glass Ceramics and Zirconia-Reinforced Lithium Silicate Endocrowns: A Systematic Review of In Vitro Studies. Med Sci Monit 2023; 29:e942649. [PMID: 38148601 PMCID: PMC10758219 DOI: 10.12659/msm.942649] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 10/16/2023] [Indexed: 12/28/2023] Open
Abstract
This systematic review aimed to identify and analyze in vitro studies on the marginal adaptation values of computer-aided-design/computer-aided-manufacturing (CAD/CAM) and heat-pressed lithium disilicate glass ceramics and zirconia-reinforced lithium silicates and endocrown restorations. A full literature search was conducted in Web of Science, PubMed/Medline, EMBASE, Scopus, Cochrane Library, Google Scholar, and ProQuest electronic databases. The following keywords: endocrown [(marginal adaption) or (marginal fit) or internal fitting)], endocrown [(molar(s)) or (premolar(s) or (posterior teeth) or (maxillary arch) or (mandibular arch)] and ceramic materials as [(lithium disilicate glass ceramic CAD/CAM) or (zirconia) or (heat-press)] were used. Articles were manually searched utilizing their reference lists. Study selection was restricted or limited to the time of publication but not to the type of tested teeth or ceramic material, endocrown design, system of endocrown construction, abutment scanning, and system of the marginal adaption measurement. A total of 17 in vitro studies published between 2016 and 2023 were included in this systemic review. Less than half of the studies were published during 2023. Most studies used lithium disilicate glass ceramic and zirconia-reinforced lithium silicate all-ceramic materials by CAD/CAM or heat-press systems. Marginal adaptation, or marginal gap, was almost equal in the 2 materials, while it was slightly or marginally higher in the heat-press than in the CAD/CAM system. All-ceramic lithium disilicate glass ceramic and/or zirconia endocrowns fabricated for posterior teeth in both arches using CAD/CAM or heat-press had recorded marginal adaptation values within an acceptable range.
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Affiliation(s)
- Ghadeer S. Alwadai
- Department of Restorative Dental Science, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Mohammed M. Al Moaleem
- Department of Prosthetic Dental Science, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Arwa A. Daghrery
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Nassreen H. Albar
- Department of Restorative Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | | | | | - Sana E. Ageel
- College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | | | | | - Waseem H. Aridhi
- Dental Department, Abo Aresh North Primary Health Care Center, Ministry of Health, Jazan, Saudi Arabia
| | - Raid A. Almnea
- Division of Endodontics, Department of Restorative Dentistry, College of Dentistry, Najran Uiversity, Najran, Saudi Arabia
| | - Khalid D. Alhendi
- Department of Prosthodontics, College of Dentistry, Najran University, Najran, Saudi Arabia
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