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Bepu DAN, Scatolin RS, Franco NSJ, Sanchez LP, Souza-Gabriel AE, Corona SAM. Alkasite restorative material for endodontically treated teeth: a randomized controlled pilot study. Restor Dent Endod 2024; 49:e24. [PMID: 39247650 PMCID: PMC11377874 DOI: 10.5395/rde.2024.49.e24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 04/13/2024] [Accepted: 05/26/2024] [Indexed: 09/10/2024] Open
Abstract
Objectives This study aimed to evaluate the clinical performance of an alkasite restorative material in molars that had undergone root canal treatment. Materials and Methods The research was registered in Brazilian Registry of Clinical Trials. The randomized clinical trial involved 33 patients, each with at least 1 mandibular molar requiring restoration after receiving endodontic treatment. Patients were randomly assigned to receive either bulk-fill resin composite (Tetric N Ceram Bulk Fill, Ivoclar Vivadent) or the alkasite restorative material (Cention N, Ivoclar Vivadent). Upon completion of the restorations, 3 calibrated professionals utilized the United States Public Health Service criteria to assess various factors, including retention, secondary caries, marginal adaptation, restoration color, marginal pigmentation, and anatomical form. Evaluations were conducted at intervals of 7 days, 6 months, and 17 months. Additionally, the assessment encompassed the presence of radiolucent lines adjacent to the restoration, material deficiencies or excess, contact points, and caries recurrence. The data underwent analysis using the Friedman and Mann-Whitney tests (α = 0.05). Results After 17 months, the results revealed that the alkasite restorative material exhibited greater wear of anatomical shape compared to the bulk-fill resin composite (p = 0.0189). Furthermore, the alkasite restorative material significantly differed from the natural tooth color in most cases (p = 0.0000). However, no other criteria displayed significant differences between the materials or over time (p > 0.05). Conclusions The alkasite restorative material (Cention N) emerges as a viable option for restoring endodontically treated teeth, displaying clinically acceptable alterations after a 17-month evaluation period. Trial Registration Brazilian Registry of Clinical Trials (ReBEC) Identifier: RBR-97kx5jv.
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Affiliation(s)
- Davi Ariel Nobuo Bepu
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Renata Siqueira Scatolin
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Natalia Saud Junqueira Franco
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Luiza Pejon Sanchez
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Aline Evangelista Souza-Gabriel
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Silmara Aparecida Milori Corona
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
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Özyürek T, Uslu G, Arıcan B, Gündoğar M, Nekoofar MH, Dummer PMH. Influence of endodontic access cavity design on mechanical properties of a first mandibular premolar tooth: a finite element analysis study. Clin Oral Investig 2024; 28:433. [PMID: 39026036 PMCID: PMC11258061 DOI: 10.1007/s00784-024-05808-x] [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: 03/12/2024] [Accepted: 06/27/2024] [Indexed: 07/20/2024]
Abstract
OBJECTIVES This study aimed to investigate the influence of access cavity designs on the mechanical properties of a single-rooted mandibular first premolar tooth under various static loads using a finite element analysis. MATERIALS AND METHODS 3-dimensional FEA designs were modeled according to the access cavity designs: an intact tooth (control), traditional access cavity (TEC-I), traditional access cavity with Class-II mesio-occlusal cavity design (TEC-II), conservative access cavity (CEC), ninja access cavity (NEC), caries-driven access cavity (Cd-EC), buccal access cavity (BEC) and bucco-occlusal access cavity (BOEC). After the simulated access cavity preparations, root canal treatment was simulated and three different static loads which mimicked oblique and vertical mastication forces were applied to the models. The stress distribution and maximum Von Misses stress values were recorded. The maximum stress values were obtained on both enamel and dentin under multi-point vertical loads. RESULTS The maximum stress values were obtained on both enamel and dentin under multi-point vertical loads. Under all load types, the minimum stress distribution was observed in the control group, followed by CEC, NEC and BEC designs. The highest stress concentration was detected in Cd-EC and TEC-II designs. Under single-point vertical loading, the stress was mostly concentrated in the lingual PCD area, while under multi-point vertical loading, the entire root surface was stress-loaded except for the lingual apical third of the root. CONCLUSION Preserving tooth tissue by simulating CEC, NEC and BEC access cavities increased the load capacity of a single-rooted mandibular first premolar following simulated endodontic treatment.
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Affiliation(s)
- Taha Özyürek
- Department of Endodontics, School of Dental Medicine, Bahçeşehir University, Istanbul, Turkey
| | - Gülşah Uslu
- Department of Endodontics, Faculty of Dentistry, Çanakkale Onsekiz Mart University, Istanbul, Turkey
| | - Burçin Arıcan
- Department of Endodontics, School of Dental Medicine, Bahçeşehir University, Istanbul, Turkey.
| | - Mustafa Gündoğar
- Department of Endodontics, Faculty of Dentistry, Medipol University, Istanbul, Turkey
| | - Mohammad Hossein Nekoofar
- Department of Endodontics, School of Dental Medicine, Bahçeşehir University, Istanbul, Turkey
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
- Department of Tissue Engineering, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Prado HS, Petean IBF, Franco NJS, Camargo RV, Carvalho KKTD, Mazzi-Chaves JF, Lopes-Olhê FC, Silva-Sousa YTC, Souza-Gabriel AE, Sousa-Neto MD. Impact of access cavities on root canal preparation, restorative protocol quality, and fracture resistance of teeth. Braz Oral Res 2023; 37:e096. [PMID: 38055514 DOI: 10.1590/1807-3107bor-2023.vol37.0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 06/15/2023] [Indexed: 12/08/2023] Open
Abstract
The survival of endodontically treated teeth depends on the remaining tooth structure. The aim of this study was to evaluate the impact of different access cavities on root canal preparation, restorative protocol, and fracture resistance of endodontically treated teeth. Fifty-six mandibular molars were divided into control (n=8) and experimental (n=16) groups according to access cavity: Traditional, Conservative, and Truss; and redistributed (n=8) according to instrumentation protocols: Reciproc Blue and R-motion. After, teeth were scanned in micro-CT and then filled and redistributed according to composite resin restoration (n=8): Filtek One BulkFill and Filtek Z350. A new micro-CT scan was performed to analyze the restorative material. Then, samples were submitted to fracture resistance testing and the failure pattern was determined. Data were analyzed using paired T-test, ANOVA, Tukey, and chi-square tests (α=0.05). In Truss, R-Motion promoted less transportation in different thirds of root canals. Higher percentages of voids (5.05%) and filling material (11.7%) were observed in Truss. Fracture resistance values were higher for the control group, followed by Truss, Conservative, and Traditional. The predominant failure pattern was type-II. In Truss, reciprocating instruments with smaller taper showed less canal transportation. Also, Truss provided higher values of fracture resistance, although it presented a higher percentage of voids and remaining filling material. Thus, in Truss, reciprocating files with smaller taper showed less canal transportation, and these cavities provided higher values of fracture resistance, although it presented a higher percentage of voids and remaining filling material.
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Affiliation(s)
- Heitor Silva Prado
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
| | - Igor Bassi Ferreira Petean
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
| | - Natália Junqueira Saud Franco
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
| | - Rafael Verardino Camargo
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
| | | | - Jardel Francisco Mazzi-Chaves
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
| | - Fabiane Carneiro Lopes-Olhê
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
| | | | - Aline Evangelista Souza-Gabriel
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
| | - Manoel Damião Sousa-Neto
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
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Luo X, Rong Q, Luan Q, Yu X. Effect of partial restorative treatment on stress distributions in non-carious cervical lesions: a three-dimensional finite element analysis. BMC Oral Health 2022; 22:607. [PMID: 36522633 PMCID: PMC9753429 DOI: 10.1186/s12903-022-02647-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Partial restoration combined with periodontal root coverage surgery can be applied to the treatment of non-carious cervical lesions (NCCLs) accompanied with gingival recessions in clinical practice. However, the feasibility of NCCL partial restorative treatment from a biomechanical perspective remains unclear. This study aimed to investigate the effect of partial restorations on stress distributions in the NCCLs of mandibular first premolars via three-dimensional finite element analysis. METHODS Three-dimensional finite element models of buccal wedge-shaped NCCLs in various locations of a defected zenith (0 mm, 1 mm, and 2 mm) were constructed and divided into three groups (A, B, and C). Three partially restored NCCL models with different locations of the lower restoration border (1 mm, 1.5 mm, and 2 mm), and one completely restored NCCL model were further constructed for each group. The following restorative materials were used in all restoration models: composite resin (CR), glass-ionomer cement (GIC), and mineral trioxide aggregate (MTA). The first principal stress distributions under buccal oblique loads of 100 N were analyzed. Restoration bond failures were also evaluated based on stress distributions at dentin-restoration interfaces. RESULTS When the partial restoration fully covered the defected zenith, the first principal stress around the zenith decreased and the maximum tensile stress was concentrated at the lower restoration border. When the partial restoration did not cover the defected zenith, the first principal stress distribution patterns were similar to those in unrestored models, with the maximum tensile stress remaining concentrated at the zenith. As the elastic modulus of the restorative material was altered, the stress distributions at the interface were not obviously changed. Restoration bond failures were not observed in CR, but occurred in GIC and MTA in most models. CONCLUSIONS Partial restorations that fully covered defected zeniths improved the stress distributions in NCCLs, while the stress distributions were unchanged or worsened under other circumstances. CR was the optimal material for partial restorations compared to GIC and MTA.
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Affiliation(s)
- Xin Luo
- grid.11135.370000 0001 2256 9319Department of Periodontology, Peking University School and Hospital of Stomatology, No. 22, Zhongguancun South Avenue, Haidian District, Beijing, 100081 China
| | - Qiguo Rong
- grid.11135.370000 0001 2256 9319Department of Mechanics and Engineering Science, College of Engineering, Peking University, Beijing, China
| | - Qingxian Luan
- grid.11135.370000 0001 2256 9319Department of Periodontology, Peking University School and Hospital of Stomatology, No. 22, Zhongguancun South Avenue, Haidian District, Beijing, 100081 China
| | - Xiaoqian Yu
- grid.11135.370000 0001 2256 9319Department of Periodontology, Peking University School and Hospital of Stomatology, No. 22, Zhongguancun South Avenue, Haidian District, Beijing, 100081 China
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Ausiello P, Dal Piva AMDO, di Lauro AE, Garcia-Godoy F, Testarelli L, Tribst JPM. Mechanical Behavior of Alkasite Posterior Restorations in Comparison to Polymeric Materials: A 3D-FEA Study. Polymers (Basel) 2022; 14:polym14081502. [PMID: 35458251 PMCID: PMC9024758 DOI: 10.3390/polym14081502] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 03/31/2022] [Accepted: 04/05/2022] [Indexed: 01/27/2023] Open
Abstract
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.
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Affiliation(s)
- Pietro Ausiello
- School of Dentistry, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy;
- Correspondence:
| | - Amanda Maria de Oliveira Dal Piva
- Academic Centre for Dentistry Amsterdam (ACTA), Department of Dental Materials, University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (A.M.d.O.D.P.); (J.P.M.T.)
| | | | - Franklin Garcia-Godoy
- Department of Bioscience Research, College of Dentistry—University of Tennessee Health Science Center, Memphis, TN 38163, USA;
| | - Luca Testarelli
- Department of Oral and Maxillofacial Sciences, La Sapienza University of Rome, 00161 Rome, Italy;
| | - João Paulo Mendes Tribst
- Academic Centre for Dentistry Amsterdam (ACTA), Department of Dental Materials, University of Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (A.M.d.O.D.P.); (J.P.M.T.)
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Lithium Disilicate Ceramic Endocrown Biomechanical Response According to Different Pulp Chamber Extension Angles and Filling Materials. MATERIALS 2021; 14:ma14051307. [PMID: 33803194 PMCID: PMC7963147 DOI: 10.3390/ma14051307] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 12/28/2022]
Abstract
The purpose of this study is to evaluate the effect of pulp chamber extension angles and filling material mechanical properties on the biomechanical response of a ceramic endocrown. A 3D model of maxillary molar that underwent endodontically treatment was exported to computer aided design software to conduct finite element analysis (FEA). The endocrown model was modified considering different pulp chamber extension angles (right angle; 6°, 12° and 18° of axial divergence). The solids were imported into the computer aided engineering software in Standard for the Exchange of Product Data (STEP) format. Nine different filling materials were simulated to seal the orifice of the root canal system under each endocrown restoration (resin composite, bulk-fill resin composite, alkasite, flowable resin composite, glass ionomer cement, autocured resin-reinforced glass ionomer cement, resin cement, bulk-fill flowable resin composite, zinc oxide cement), totaling 36 models. An axial load (300 N) was applied at the occlusal surface. Results were determined by colorimetric graphs of von-Misses stress (VMS) and Maximum Principal Stress (MPS) on tooth, cement layer, and endocrown restorations. VMS distribution showed a similar pattern between the models, with more stress at the load region for the right-angled endocrowns. The MPS showed that the endocrown intaglio surface and cement layer showed different mechanical responses with different filing materials and pulp chamber angles. The stress peaks plotted in the dispersion plot showed that the filling material stiffness is proportional to the stress magnitude in the endocrown, cement layer and tooth adhesive surface. In addition, the higher the pulp chamber preparation angle, the higher the stress peak in the restoration and tooth, and the lower the stress in the cement layer. Therefore, 6° and 12° pulp chamber angles showed more promising balance between the stresses of the adhesive interface structures. Under the conditions of this study, rigid filling materials were avoided to seal the orifice of root canal system when an endocrown restoration was planned as rehabilitation. In addition, the pulp chamber axial walls were prepared between 6° and 12° of divergence to balance the stress magnitude in the adhesive interface for this treatment modality.
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Pai S, Bhat V, Patil V, Naik N, Awasthi S, Nayak N. Numerical Three-dimensional Finite Element Modeling of Cavity Shape and Optimal Material Selection by Analysis of Stress Distribution on Class V Cavities of Mandibular Premolars. J Int Soc Prev Community Dent 2020; 10:279-285. [PMID: 32802773 PMCID: PMC7402252 DOI: 10.4103/jispcd.jispcd_75_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/12/2020] [Accepted: 04/02/2020] [Indexed: 11/13/2022] Open
Abstract
Aim: Adhesive restoration does not depend primarily on the configuration of the shape of the cavity. Under varying loading conditions, it is essential to know the stress concentration and load transfer mechanism for distinct cavity shapes. The aim of this study was to evaluate and compare the biomechanical characteristics of various cavity shapes, namely oval, elliptical, trapezoidal, and rectangular shapes of class V cavities on mandibular premolars restored with amalgam, glass ionomer cement, and Cention N using three-dimensional (3D) finite element analysis. Materials and Methods: A 3D prototype of a mandibular premolar was generated by Digital Imaging and Communications in Medicine (DICOM) images obtained from the cone beam computed tomography and imported to 3D modeling software tool, SpaceClaim. The four distinct load magnitudes of 100, 150, 200, and 250N were applied as a pressure load perpendicular to the lingual plane of the lingual cusp of the occlusal surface (normal load) and at 45° to same (oblique load). The stress distribution patterns and the maximum von Mises stresses were analyzed and compared. Results: The occlusal stresses were distributed from the force loading point in an approximate actinomorphic pattern, and when the force load was close to the margin, the stress was much greater. Conclusion: Ovoid cavity showed lesser stress concentration and deformation for each of the tested restorative material.
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Affiliation(s)
- Swathi Pai
- Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal, Manipal, Karnataka, India
| | - Vishal Bhat
- Department of Pharmacology, Melaka Manipal Medical College, Manipal, Karnataka, India
| | - Vathsala Patil
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal, Karnataka, India
| | - Nithesh Naik
- Department of Mechanical and Manufacturing Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Swetank Awasthi
- Department of Mechanical and Manufacturing Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Nithin Nayak
- Department of Mechanical and Manufacturing Engineering, Manipal Institute of Technology, Manipal Academy of Higher Education, Manipal, Karnataka, India
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