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Dong X, Ban J, Guo H, Zeng Z, Ren N, Bai S, Wang Z. Optimization of endocrown design parameters for mandibular second molars: A 3D finite element analysis. J Mech Behav Biomed Mater 2025; 168:107038. [PMID: 40318472 DOI: 10.1016/j.jmbbm.2025.107038] [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: 02/19/2025] [Revised: 04/25/2025] [Accepted: 04/29/2025] [Indexed: 05/07/2025]
Abstract
This study aimed to investigate the optimal parameters for endocrown design in mandibular second molars using three-dimensional finite element analysis. Eighteen finite element models(n = 3)were created with varying ferrule heights (0, 1, 2 mm), post space depths (2, 3, 4 mm), and diameters (2, 3 mm). The models simulated zirconia endocrowns on root canal treated teeth. Von Mises stress distribution was analyzed under 200 N oblique loading. Results showed that in butt-joint designs, increasing post space depth and diameter led to higher stress concentration at the post apex and lower stress at the mesial-buccal bonding interface. For ferrule designs, increasing ferrule height reduced stress at both the post apex and bonding interface. Stress in dentin increased with post space depth and diameter in butt-joint designs but decreased with increased ferrule height in ferrule designs. The study concluded that smaller post space dimensions (diameter and depth) reduce dentin stress in both butt-joint and ferrule endocrown designs, thereby indicating better protection of the remaining tooth structure. Ferrule designs exhibited a more uniform stress distribution compared to butt-joint designs. These findings suggest that endocrown design can be optimized to enhance stress distribution and potentially improve clinical outcomes, though further long-term clinical studies are needed to validate these results.
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Affiliation(s)
- Xuechun Dong
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China
| | - Jinghao Ban
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Preventive Dentistry, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China
| | - Huihui Guo
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi International Joint Research Center for Oral Diseases, Department of General Dentistry and Emergency, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China
| | - Ziyu Zeng
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China
| | - Nan Ren
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Digital Dentistry Center, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China.
| | - Shizhu Bai
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Digital Dentistry Center, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China.
| | - Zhongshan Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Department of Prosthodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China.
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Jia X, Guo J, Wu M, Wang X, Fan L, Yao Y, Deng X, Yang L. Study on the effect of simulation-based case teaching method on the preclinical teaching of tooth defects restoration. BMC MEDICAL EDUCATION 2025; 25:487. [PMID: 40188128 PMCID: PMC11972495 DOI: 10.1186/s12909-025-07010-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 03/12/2025] [Indexed: 04/07/2025]
Abstract
BACKGROUND Clinical decision plays an important role in the prognosis of dental defect restoration. However, the current theoretical teaching and experimental teaching lack the training of clinical decision based on evidence-based medicine. Students have mastered theoretical knowledge and basic operating skills, they are extremely lacking in the ability to handle clinical cases before clinical practice. In order to improve students' clinical decision ability in dental defect restoration and enhance the connection of clinical practice and theory teaching, we applied the simulation-based case teaching (SCT) method in practice teaching courses. METHODS The study was carried out with 96 undergraduate dental students at Guanghua School of Stomatology, Sun Yat-sen University, including 51 females and 45 males, aged 17 ~ 20 years, with an average of (18.23 ± 1.02) years. The SCT course included case-based group discussion, teeth preparation, group report, question defense and teacher comments. We obtained effective and comprehensive classroom feedback through teaching effect evaluation by comparing the case analysis results before and after the SCT course, and questionnaire survey from students after class. All statistical analyses were performed using SPSS 25.0. The comparison between the two groups of percentages was made using a Chi-square test. Statistical significance was set at p < 0.05. RESULTS The results of objective evaluation of teaching effect showed a statistically significant difference (p < 0.01) between the results before and after SCT in the diagnosis, treatment plans, restoration materials and complications. The results of the questionnaire survey showed that students agreed their improvement in the treatment decision making, aesthetic restoration and dentists-patients communication and recognized their shortcomings in clinical critical thinking and knowledge development. CONCLUSIONS The study suggested that SCT is an excellent teaching method to cultivate students' clinical thinking, and we should integrate more imparting of experience related to clinical decision-making and medical humanities in the future preclinical teaching work.
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Affiliation(s)
- Xiaoshi Jia
- Prosthodontic Department, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 56 Lingyuan Road West, Guangzhou, Guangdong, 510055, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, China
| | - Jiawen Guo
- Prosthodontic Department, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 56 Lingyuan Road West, Guangzhou, Guangdong, 510055, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, China
| | - Maodan Wu
- Prosthodontic Department, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 56 Lingyuan Road West, Guangzhou, Guangdong, 510055, China
| | - Xiaodong Wang
- Prosthodontic Department, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 56 Lingyuan Road West, Guangzhou, Guangdong, 510055, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, China
| | - Le Fan
- Prosthodontic Department, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 56 Lingyuan Road West, Guangzhou, Guangdong, 510055, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, China
| | - Yichen Yao
- Prosthodontic Department, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 56 Lingyuan Road West, Guangzhou, Guangdong, 510055, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, China
| | - Xiaoyi Deng
- Prosthodontic Department, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 56 Lingyuan Road West, Guangzhou, Guangdong, 510055, China
| | - Ling Yang
- Prosthodontic Department, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, 56 Lingyuan Road West, Guangzhou, Guangdong, 510055, China.
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, Guangdong, 510055, China.
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Pereira GKR, Pilecco RO, da Rosa LS, Machry RV, Baldi A, Scotti N, Valandro LF, Tribst JPM, Kleverlaan CJ. Does the Restoration Design and Material Affect Indirect Restorations' Marginal and Internal Gap, Interfacial Volume, and Fatigue Behavior? Eur J Dent 2025. [PMID: 40073992 DOI: 10.1055/s-0045-1802569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2025] Open
Abstract
OBJECTIVES This article evaluates the marginal and internal gap, interfacial volume, and fatigue behavior in computer-aided design-computer-aided manufacturing (CAD-CAM) restorations with different designs (crowns or endocrowns) made from lithium disilicate-based ceramic (LD, IPS e.max CAD, Ivoclar AG) or resin composite (RC, Tetric CAD, Ivoclar AG). MATERIALS AND METHODS Simplified LD and RC crowns (-C) and endocrowns (-E) were produced (n = 10) using CAD-CAM technology, through scanning (CEREC Primescan, Dentsply Sirona) and milling (CEREC MC XL, Dentsply Sirona), and then adhesively bonded to fiberglass-reinforced epoxy resin. Computed microtomography was used to assess the marginal and internal gap and interfacial volume. A cyclic fatigue test (20 Hz, initial load = 100 N/5,000 cycles; step-size = 50 N/10,000 cycles until 1,500 N, if specimens survived, the step-size = 100 N/10,000 cycles until failure) was performed. Topography, finite element analysis (FEA), and fractography were also executed. STATISTICAL ANALYSIS Two-way analysis of variance and Tukey's post hoc tests were employed (α = 0.05) for marginal and internal gap and interfacial volume. Survival analysis based on Kaplan-Meier and Mantel-Cox tests (α = 0.05) was used for fatigue data. RESULTS RC crowns demonstrated the smallest marginal gap, LD crowns the largest. Endocrowns presented intermediary marginal gap values. Internal gaps were all above the planned 120 µm space. The lowest gap was seen at the cervical-axial angle at crowns, regardless of material. At the axio-occlusal angle, LD crowns presented a lower gap than RC; meanwhile, there was no difference among endocrowns. When comparing occlusal/pulpal space, LD crowns showed the lowest values, and RC-C, LD-E, and RC-E were statistically similar. Fatigue testing revealed superior behavior for RC restorations, withstanding higher loads and more cycles before failure compared to LD. FEA indicated that the crowns required higher stress concentration to unleash their failure than endocrowns. Fractographic features confirm failure origin at surface defects located at the restoration/cement intaglio surface, where it concentrated the highest maximum principal stress. CONCLUSION RC crowns and endocrowns presented lower marginal gaps than LD ones. Differences in other internal gap outcomes exist but within a nonclinically relevant threshold. The restoration fatigue behavior was influenced by the CAD-CAM material, but not by its design.
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Affiliation(s)
- Gabriel Kalil Rocha Pereira
- Department of Restorative Dentistry, Faculty of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil
| | - Rafaela Oliveira Pilecco
- Department of Conservative Dentistry, Faculty of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul State, Brazil
| | - Lucas Saldanha da Rosa
- Department of Restorative Dentistry, Faculty of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil
| | - Renan Vaz Machry
- Department of Restorative Dentistry, Faculty of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais State, Brazil
| | - Andrea Baldi
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy
| | - Nicola Scotti
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy
| | - Luiz Felipe Valandro
- Department of Restorative Dentistry, Faculty of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil
| | - João Paulo Mendes Tribst
- Department of Reconstructive Oral Care, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, The Netherlands
| | - Cornelis Johannes Kleverlaan
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, the Netherlands
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Falahchai M, Ardekani FR, Musapoor N, Hemmati YB, Asli HN. Effects of the Presence of Adjacent Tooth and Material Type on the Marginal and Internal Adaptation of Endocrowns Fabricated by the Digital Impression Technique. Clin Exp Dent Res 2025; 11:e70077. [PMID: 39903787 PMCID: PMC11793159 DOI: 10.1002/cre2.70077] [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: 07/10/2024] [Revised: 01/05/2025] [Accepted: 01/07/2025] [Indexed: 02/06/2025] Open
Abstract
PURPOSE To assess the effects of the presence of adjacent tooth and material type on the marginal and internal adaptation of endocrowns fabricated by the digital impression technique. MATERIAL AND METHODS An endodontically treated molar tooth was used for the fabrication of endocrowns in this in vitro study. Five groups of specimens (n = 17) were evaluated based on the material type and presence of adjacent tooth: three groups of monolithic zirconia (Zir), lithium disilicate (LDS), and zirconia-reinforced lithium silicate (ZLS) in the presence of adjacent teeth, and two groups of zirconia endocrowns, one in the absence of an adjacent anterior tooth (second premolar; Zir-no ant.) and one in the absence of a posterior adjacent tooth (second molar; Zir-no post.). Marginal and internal adaptation of endocrowns was evaluated by the silicone replica technique. Data were analyzed by ANOVA with Tukey test for pairwise comparisons and generalized estimating equation with Bonferroni correction for pairwise comparisons (α = 0.05). RESULTS The largest marginal gap was found in the ZLS, followed by the LDS and Zir groups (p < 0.05). The Zir group showed significantly higher internal adaptation than the ZLS group (p < 0.05); LDS had no significant difference with the ZLS and Zir groups (p > 0.05). The Zir group showed larger marginal and internal gaps than the Zir-no ant. and Zir-no post. groups (p < 0.05); the latter two groups had no significant difference (p > 0.05). All groups showed the largest gap at the pulpal and the smallest gap at the marginal and cervical areas (p < 0.05). CONCLUSION Zirconia endocrowns showed the highest marginal and internal adaptation. Digital impression technique in absence of anterior or posterior adjacent tooth would result in higher marginal and internal adaptation of endocrowns.
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Affiliation(s)
- Mehran Falahchai
- Dental Sciences Research Center, Department of Prosthodontics, School of DentistryGuilan University of Medical SciencesRashtIran
| | - Fatemeh Razavi Ardekani
- Department of Prosthodontics, School of DentistryYasuj University of Medical SciencesYasujIran
| | - Naghme Musapoor
- Dental Sciences Research Center, Department of Prosthodontics, School of DentistryQazvin University of Medical SciencesQazvinIran
| | - Yasamin Babaee Hemmati
- Dental Sciences Research Center, Department of Orthodontics, School of DentistryGuilan University of Medical SciencesRashtIran
| | - Hamid Neshandar Asli
- Dental Sciences Research Center, Department of Prosthodontics, School of DentistryGuilan University of Medical SciencesRashtIran
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Fehrenbach J, de Soares JLS, do Nascimento Foly JCS, Miotti LL, Münchow EA. Mechanical performance of endocrown restorations in anterior teeth: A systematic review and network meta-analysis. Dent Mater 2025; 41:28-41. [PMID: 39489638 DOI: 10.1016/j.dental.2024.10.012] [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: 06/27/2024] [Revised: 10/18/2024] [Accepted: 10/22/2024] [Indexed: 11/05/2024]
Abstract
OBJECTIVES To conduct a systematic review and network meta-analysis (NMA) to answer whether endocrown restorations have similar mechanical behavior than other traditional core-crown systems with or without intracanal posts for the rehabilitation of anterior endodontically treated teeth. METHODS The review followed the PRISMA Extension Statement for NMA. Studies were identified by a systematic search to select reports on endocrown restorations in anterior teeth. A search was performed in PubMed (MEDLINE), Scopus, Web of Science, Embase, SciELO, and LILACS databases. Articles evaluating mechanical performance through in vitro and finite element analysis (FEA) studies were selected and the risk of bias was assessed using the RoBDEMAT and ROBFEAD tools, respectively. The data were analyzed qualitatively and quantitatively through NMA using the MetaInsight tool. RESULTS Eleven articles were included (eight in vitro and three with FEA design). Six in vitro studies were evaluated using NMA. Composite resin endocrowns showed greater load-to-fracture and lower occurrence of catastrophic failures than traditional restorations. Combining glass fiber post with composite restoration also showed good strength behavior. Regarding FEA studies, two out of three studies showed a more homogeneous distribution of stress for the endocrown group. SIGNIFICANCE Endocrowns performed similarly to or better than conventional restorative strategies, with composite resin being the most recommended material of choice. The rehabilitation of endodontically treated anterior teeth with extensive coronal destruction is typically challenging for the dentist, and there is still no consensus in the literature that provides conclusive answers for choosing the appropriate material and restorative strategy. Exploring new techniques and materials that make this procedure easier for the dentist and guarantee good results is paramount.
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Affiliation(s)
- Julia Fehrenbach
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul, Porto Alegre, RS, Brazil
| | | | | | - Leonardo Lamberti Miotti
- Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul, Porto Alegre, RS, Brazil
| | - Eliseu Aldrighi Münchow
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul, Porto Alegre, RS, Brazil; Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul, Porto Alegre, RS, Brazil.
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Ardekani FR, Neshandar Asli H, Musapoor N, Falahchai M. Comparison of Internal and Marginal Adaptation of Endocrowns at Different Depths Fabricated by the Digital and Conventional Impression Techniques: Internal and Marginal Fit of Endocrowns. Int J Dent 2024; 2024:5526272. [PMID: 39545176 PMCID: PMC11563701 DOI: 10.1155/2024/5526272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 10/03/2024] [Accepted: 10/08/2024] [Indexed: 11/17/2024] Open
Abstract
Introduction: Sufficient information is not available regarding the comparative accuracy of digital and conventional impression techniques at different depths for the fabrication of endocrown restorations. Thus, this study aimed to compare the marginal (M) and internal (I) adaptation of endocrowns at different depths fabricated by the digital and conventional impression techniques. Materials and Methods: In this in vitro study, two endodontically treated molar teeth with 2- and 4-mm cavity depths were used for the fabrication of endocrowns. Conventional and digital impressions were made from each tooth 17 times. A total of 68 zirconia endocrowns were fabricated and seated, and their I and M adaptation was assessed by the silicone replica technique. Data were statistically analyzed. Results: The M and I gaps at 2- and 4-mm cavity depths were significantly smaller in the digital, than the conventional, impression technique (p < 0.05). Increasing the cavity depth significantly increased the M and I gaps only in the digital technique (p < 0.05). The largest gap in all groups was noted in the pulpal (P) region (p < 0.05). The smallest gap was found in the M and cervical (C) regions in the conventional groups with 2- and 4-mm cavity depths, and the digital group with 4 mm cavity depth, and in the M region in the digital group with 2 mm cavity depth (p < 0.05). Conclusion: Unlike the conventional impression technique, the M and I adaptation decreased by an increase in cavity depth in the digital technique; nonetheless, the digital impression technique still showed higher M and I adaptation than the conventional technique.
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Affiliation(s)
- Fatemeh Razavi Ardekani
- Department of Prosthodontics, School of Dentistry, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Hamid Neshandar Asli
- Department of Prosthodontics, Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Naghme Musapoor
- Department of Prosthodontics, Dental Sciences Research Center, School of Dentistry, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mehran Falahchai
- Department of Prosthodontics, Dental Sciences Research Center, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
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Bardales-Espinoza KA, Mora-Ipince AR, Chávez-Méndez MA, Peña-Soto C, Flores-Fraile J, De la Garza-Ramos MA, Cano-Verdugo G. Compressive Stress in Teeth Restored with Endocrown and Build-up: A Finite Element Analysis. J Contemp Dent Pract 2024; 25:1027-1033. [PMID: 39905608 DOI: 10.5005/jp-journals-10024-3777] [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: 02/06/2025]
Abstract
AIM This study evaluates compressive stress in teeth restored with endocrown (ECW) and build-up (BUP) using finite element analysis (FEA). Understanding stress distribution in dental restorations is crucial for improving treatment outcomes and longevity. MATERIALS AND METHODS A second lower molar was modeled using Solidworks® (Version 2017). The ECW was simulated with nanoceramic resin, while the BUP included a core and nanoceramic crown. Mechanical properties, including modulus of elasticity, Poisson's ratio, and tensile strength were assigned to materials. Axial and oblique loads of 900N were applied, and stress was analyzed using Solidworks®. RESULTS Results indicated that under axial loading, ECW experienced a maximum stress of 91.9 MPa, significantly higher than BUP's 49 MPa. Under oblique loading, ECW exhibited 132 MPa compared with 116 MPa in BUP. The highest stress concentration was in the cervical area, where ECW showed greater stresses in both the substrate and restored area. Build-up demonstrated better stress distribution and lower fracture risk. CONCLUSION Endocrown restoration results in higher compressive stresses, especially in the cervical region, which may increase the risk of fracture. Conversely, the BUP technique, which preserves cervical dentin, offers improved stress distribution and reduced fracture risk, making it a more robust solution for endodontic rehabilitation. CLINICAL SIGNIFICANCE This study underscores the importance of selecting appropriate restoration methods to minimize stress and enhance the longevity of dental treatments, ultimately leading to better patient outcomes. How to cite this article: Bardales-Espinoza KA, Mora-Ipince AR, Chávez-Méndez MA, et al. Compressive Stress in Teeth Restored with Endocrown and Build-up: A Finite Element Analysis. J Contemp Dent Pract 2024;25(11):1027-1033.
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Affiliation(s)
| | - Anderson R Mora-Ipince
- Department of Stomatology, Faculty of Sciences of Life and Health, Universidad Científica del Sur, Lima, Peru
| | - Martín A Chávez-Méndez
- Department of Stomatology, Faculty of Sciences of Life and Health, Universidad Científica del Sur, Lima, Peru; Department of Surgery and Odontostomatology, University of Salamanca, Salamanca, Spain, Phone: +51 997002094, e-mail:
| | - Claudio Peña-Soto
- Department of Stomatology, Faculty of Sciences of Life and Health, Universidad Científica del Sur, Lima, Peru
| | - Javier Flores-Fraile
- Department of Surgery, Faculty of Medicine, University of Salamanca, Salamanca, Spain
| | - Myriam A De la Garza-Ramos
- Department of Stomatology, Faculty of Sciences of Life and Health, Universidad Científica del Sur, Lima, Peru; Department of Oral Microbiology, School of Dentistry, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
| | - Guillermo Cano-Verdugo
- Department of Stomatology, Faculty of Sciences of Life and Health, Universidad Científica del Sur, Lima, Peru; Department of Social and Preventive Dentistry, School of Dentistry, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México
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Yang Y, Zhou SC, Ma YH, Wang X, Dong QS. Clinical efficacy, bone density, and follow-up in implant and orthodontic treatment for inclined adjacent teeth. World J Clin Cases 2024; 12:5542-5548. [PMID: 39188610 PMCID: PMC11269983 DOI: 10.12998/wjcc.v12.i24.5542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/07/2024] [Accepted: 06/20/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND Tooth defects can cause elongation of occlusal teeth, leading to insufficient repair space. The combination of dental implant restoration and orthodontic treatment of oblique adjacent teeth has a significant therapeutic effect. AIM To explore clinical efficacy, bone density, and follow-up of implant and orthodontic treatment for patients with inclined adjacent teeth. METHODS In total, 98 patients with oblique adjacent teeth were randomly assigned to implant restoration combined with orthodontic treatment (group A, n = 49) or to receive implant restoration alone (group B, n = 49). Changes in alveolar ridge bone density and apical bone density were observed before and after treatment in the two groups. Changes in chewing function and language function were compared between the two groups of patients. Follow-up lasted for 12 mo after repair to observe any adverse reactions in the oral cavity. RESULTS The clinical effective rates of group A and group B were 97.96% and 85.71%, respectively, with group A having a higher clinical effective rate than group B. After treatment, the bone density of the alveolar ridge and apical bone in both groups decreased compared to before treatment, while the chewing and language functions improved. The changes in various indicators in group A were more significant. After treatment, the satisfaction rate of group A (97.96%) was higher than that of group B (79.59%). The incidence of adverse reactions in group A (2.04%) was lower than that in group B (24.49%). CONCLUSION The amalgamation of implant restoration and orthodontic treatment for adjacent tilted teeth demonstrates notable clinical efficacy, diminishes alveolar bone resorption, and fosters patient functional rehabilitation while exhibiting negligible adverse reactions.
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Affiliation(s)
- Yi Yang
- Department of Stomatology, General Hospital of Central Theater Command, Wuhan 430012, Hubei Province, China
| | - Shun-Cheng Zhou
- Department of Stomatology, General Hospital of Central Theater Command, Wuhan 430012, Hubei Province, China
| | - Yi-Hui Ma
- Department of Stomatology, General Hospital of Central Theater Command, Wuhan 430012, Hubei Province, China
| | - Xiang Wang
- Department of Stomatology, General Hospital of Central Theater Command, Wuhan 430012, Hubei Province, China
| | - Qing-Shan Dong
- Department of Stomatology, General Hospital of Central Theater Command, Wuhan 430012, Hubei Province, China
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Pilecco RO, da Rosa LS, Baldi A, Machry RV, Tribst JPM, Valandro LF, Kleverlaan CJ, Scotti N, Pereira GKR. How do different intraoral scanners and milling machines affect the fit and fatigue behavior of lithium disilicate and resin composite endocrowns? J Mech Behav Biomed Mater 2024; 155:106557. [PMID: 38657286 DOI: 10.1016/j.jmbbm.2024.106557] [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: 02/27/2024] [Revised: 04/03/2024] [Accepted: 04/17/2024] [Indexed: 04/26/2024]
Abstract
The aim of this in vitro study was to evaluate the effect of the combinations of two different intraoral scanners (IOS), two milling machines, and two restorative materials on the marginal/internal fit and fatigue behavior of endocrowns produced by CAD-CAM. Eight groups (n= 10) were considered through the combination of TRIOS 3 (TR) or Primescan (PS) IOS; 4-axes (CR; CEREC MC XL) or 5-axes (PM; PrograMill PM7) milling machines; and lithium disilicate (LD; IPS e.max CAD) or resin composite (RC; Tetric CAD) restorative materials. Specific surface treatments were applied to each material, and the bonding to its corresponding Endocrown-shaped fiberglass-reinforced epoxy resin preparations was performed (Variolink Esthetic DC). Computed microtomography (μCT) was performed to assess the marginal/internal fit, as well as a mechanical fatigue test (20 Hz, initial load = 100 N/5000 cycles; step-size = 50 N/10,000 cycles until a threshold of 1500 N, then, the step-size was increased if needed to 100 N/10,000 cycles until failure or a threshold of 2800 N) to evaluate the restorations long-term behavior. Complementary analysis of the fracture features and surface topography in scanning electron microscopy was performed. Three-way ANOVA and Kaplan-Meier test (α = 0.05) were performed for marginal/internal fit, and fatigue behavior data, respectively. PS scanner, CR milling machine, and RC endocrowns resulted in a better marginal fit compared to their counterparts. Still, the PM machine resulted in a better pulpal space fit compared to the CR milling machine. Regardless of the scanner and milling machine, RC endocrowns exhibited superior fatigue behavior than LD ones. LD endocrowns presented margin chipping regardless of the milling machine used. Despite minor differences in terms of fit, the 'IOS' and 'milling machine' factors did not impair the fatigue behavior of endocrowns. Resin-composite restorations resulted in a higher survival rate compared to glass-ceramic ones, independently of the digital devices used in the workflow.
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Affiliation(s)
- Rafaela Oliveira Pilecco
- Post-Graduate Program in Oral Sciences (Prosthodontics Units), Faculty of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - Lucas Saldanha da Rosa
- Post-Graduate Program in Oral Sciences (Prosthodontics Units), Faculty of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - Andrea Baldi
- Department of Surgical Sciences, Dental School, University of Turin (UNITO), Turin, Piedmont, Italy.
| | - Renan Vaz Machry
- Post-Graduate Program in Oral Sciences (Prosthodontics Units), Faculty of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - João Paulo Mendes Tribst
- Department of Reconstructive Oral Care, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, the Netherlands.
| | - Luiz Felipe Valandro
- Post-Graduate Program in Oral Sciences (Prosthodontics Units), Faculty of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - Cornelis Johannes Kleverlaan
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, the Netherlands.
| | - Nicola Scotti
- Department of Surgical Sciences, Dental School, University of Turin (UNITO), Turin, Piedmont, Italy.
| | - Gabriel Kalil Rocha Pereira
- Post-Graduate Program in Oral Sciences (Prosthodontics Units), Faculty of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
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10
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Tribst JPM, Dal Piva AMDO, Muris J, Kleverlaan CJ, Feilzer AJ. One-piece endodontic crown fixed partial denture: Is it possible? J Prosthet Dent 2024; 131:1118-1125. [PMID: 36801103 DOI: 10.1016/j.prosdent.2023.01.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/18/2023] [Accepted: 01/18/2023] [Indexed: 02/18/2023]
Abstract
STATEMENT OF PROBLEM Whether the replacement of a missing tooth with a fixed partial denture supported by an endodontically treated abutment could be improved with 1-piece endodontic crowns is unclear. PURPOSE The purpose of the study was to evaluate the mechanical behavior of a fixed partial denture (FPD) according to the preparation of the abutment teeth (1-piece endodontic crown or complete crown) in terms of stress magnitude in the prosthesis, cement layer, and tooth. MATERIAL AND METHODS A posterior model with 2 abutment teeth (first molar and first premolar) was modeled with a computer-aided design (CAD) software program for conducting a 3-dimensional finite element analysis (FEA). To replace the missing second premolar, the model was replicated in different possible FPDs according to the abutment preparation design (complete crown [Conventional], 2 1-piece endodontic crowns [EC]) or a 1-piece endodontic crown on one of the abutment teeth (first molar [ECM] and first premolar [ECP]) for a total of 4 designs. All FPDs were in lithium disilicate. The solids were imported to an analysis software program (ANSYS 19.2) in the standard for the exchange of product data (STEP) format. The mechanical properties were considered isotropic and the materials to show linear elastic and homogeneous behavior. An axial load (300 N) was applied at the occlusal surface of the pontic. The results were evaluated by colorimetric stress maps of von Mises and maximum principal stress in the prosthesis, maximum principal stress and shear stresses on the cement layer, and maximum principal stress in the abutment teeth. RESULTS The von Mises stresses revealed that all FPD designs behaved similarly and that, considering the maximum principal stress criteria, the pontic was the most stressed region. For the cement layer, the combined designs presented an intermediate behavior, with the ECM more suitable to reducing the stress peak. The conventional preparation allowed less stress concentration in both teeth, and higher stress concentration in the premolar was observed with a 1-piece endodontic crown. The 1-piece endodontic crown decreased the risk of fracture failure. Considering the risk of debonding failure for the prosthesis, the 1-piece endodontic crown preparation was only able to decrease the failure risk when the EC design was used and when only the shear stress was considered. CONCLUSIONS Performing 1-piece endodontic crown preparations to retain a 3-unit lithium disilicate FPD is an alternative to conventional complete crown preparations.
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Affiliation(s)
- João Paulo M Tribst
- Assistant Professor, Department of Oral Regenerative Medicine, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands
| | - Amanda Maria de O Dal Piva
- Assistant Professor, Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands.
| | - Joris Muris
- Assistant Professor, Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands
| | - Cornelis J Kleverlaan
- Professor, Department of Dental Materials Science, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam & Vrije Universiteit, Amsterdam, the Netherlands
| | - Albert J Feilzer
- Professor, Department of Oral Regenerative Medicine, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam & Vrije Universiteit, Amsterdam, the Netherlands
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11
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Santos Pantaleón D, Tribst JPM, García-Godoy F. Influence of size-anatomy of the maxillary central incisor on the biomechanical performance of post-and-core restoration with different ferrule heights. J Adv Prosthodont 2024; 16:77-90. [PMID: 38694191 PMCID: PMC11058349 DOI: 10.4047/jap.2024.16.2.77] [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: 10/19/2023] [Revised: 03/08/2024] [Accepted: 04/09/2024] [Indexed: 05/04/2024] Open
Abstract
PURPOSE The study aims to investigate the influence of the ferrule effect and types of posts on the stress distribution in three morphological types of the maxillary central incisor. MATERIALS AND METHODS Nine models were created for 3 maxillary central incisor morphology types: "Fat" type - crown 12.5 mm, root 13 mm, and buccolingual cervical diameter 7.5 mm, "Medium" type - crown 11 mm, root 14 mm, and buccolingual cervical diameter 6.5 mm, and "Slim" type - crown 9.5 mm, root 15 mm, and buccolingual cervical diameter 5.5 mm. Each model received an anatomical castable post-and-core or glass-fiber post with resin composite core and three ferrule heights (nonexistent, 1 mm, and 2 mm). Then, a load of 14 N was applied at the cingulum with a 45° slope to the long axis of the tooth. The Maximum Principal Stress and the Minimum Principal Stress were calculated in the root dentin, crown, and core. RESULTS Higher tensile and compression stress values were observed in root dentin using the metallic post compared to the fiber post, being higher in the slim type maxillary central incisor than in the medium and fat types. Concerning the three anatomical types of maxillary central incisors, the slim type without ferrule height in mm presented the highest tensile stress in the dentin, for both types of metal and fiber posts. CONCLUSION Post system and tooth morphology were able to modify the biomechanical response of restored endodontically-treated incisors, showing the importance of personalized dental treatment for each case.
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Affiliation(s)
- Domingo Santos Pantaleón
- Health Research Institute, Faculty Health Sciences, Autonomous University of Santo Domingo, and Institute for Dental Education and Research, San Francisco de Macorís, Dominican Republic
| | - João Paulo Mendes Tribst
- Department of Reconstructive Oral Care, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Free University Amsterdam, The Netherlands
| | - Franklin García-Godoy
- Bioscience Research Center, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
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12
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da Rosa LS, Pilecco RO, Soares PM, Rippe MP, Pereira GKR, Valandro LF, Kleverlaan CJ, Feilzer AJ, Tribst JPM. Repair protocols for indirect monolithic restorations: a literature review. PeerJ 2024; 12:e16942. [PMID: 38406292 PMCID: PMC10893862 DOI: 10.7717/peerj.16942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/23/2024] [Indexed: 02/27/2024] Open
Abstract
Despite the advancements in indirect monolithic restorations, technical complications may occur during function. To overcome this issues, intraoral repair using resin composite is a practical and low-cost procedure, being able to increase the restoration's longevity. This review aimed to evaluate the need for repair and suggest a standardized repair protocol to the main indirect restorative materials. For this, studies were surveyed from PubMed with no language or date restriction, to investigate the scientific evidence of indirect monolithic restoration repair with direct resin composite. A classification to guide clinical decisions was made based on the FDI World Dental Federation criteria about defective indirect restorations considering esthetic and functional standards, along with the patient's view, to decide when polishing, repairing or replacing a defective restoration. Based on 38 surveyed studies, different resin composite intraoral repair protocols, that included mechanical and chemical aspects, were defined depending on the substrate considering resin-based, glass-ceramic or zirconia restorations. The presented criteria and protocols were developed to guide the clinician's decision-making process regarding defective indirect monolithic restorations, prolonging longevity and increasing clinical success.
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Affiliation(s)
| | | | | | | | | | | | - Cornelis Johannes Kleverlaan
- Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam en Vrije Universiteit, Amsterdam, the Netherlands
| | - Albert J. Feilzer
- Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam en Vrije Universiteit, Amsterdam, the Netherlands
| | - João Paulo Mendes Tribst
- Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam en Vrije Universiteit, Amsterdam, the Netherlands
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Lai H, Lin X, Zhang Y, Gong Q, Tong Z. Effect of different endodontic access preparations on the biomechanical behavior of lithium disilicate and resin nanoceramic onlay restorations: An in vitro and 3D finite element analysis study. J Prosthet Dent 2024; 131:64-74. [PMID: 35216818 DOI: 10.1016/j.prosdent.2021.12.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 12/21/2021] [Accepted: 12/21/2021] [Indexed: 02/06/2023]
Abstract
STATEMENT OF PROBLEM The effect of different sizes of endodontic access preparations on the performance of lithium disilicate glass-ceramic and resin nanoceramic onlay restorations is unclear. PURPOSE The purpose of this in vitro and 3D finite element analysis study was to assess the effect of a conservative endodontic access cavity and a traditional endodontic access cavity on the fracture resistance and stress distribution of lithium disilicate glass-ceramic and resin nanoceramic onlays. MATERIAL AND METHODS Sixty caries-free human mandibular molars were anatomically prepared for onlays and divided into 6 groups. After restoration with a lithium disilicate glass-ceramic (N=30) or resin nanoceramic (N=30), each material was further divided into traditional or conservative endodontic access cavity or intact tooth groups. After endodontic therapy and thermocycling, all specimens were submitted to a cycle fatigue test and then loaded until fracture. Failure type and location after debonding or fracture were classified and recorded. Furthermore, stress distribution in the 6 models was analyzed by using a finite element analysis software program. The data were compared by using a 2-way ANOVA test and the Tukey post hoc test (α=.05). The Weibull modulus and Weibull failure probabilities were also estimated for each group. RESULTS The lithium disilicate glass-ceramic onlays had lower fracture resistance values than the resin nanoceramic onlays in both the traditional and conservative endodontic access cavity groups (P<.05). The fracture resistance of the 2 materials for onlays with endodontic access was significantly lower than that for the intact restorations (P<.05). No significant difference was found between the fracture resistance of Lava Ultimate restorations with traditional endodontic access and conservative endodontic access, while the fracture resistance of EMAX restorations with traditional endodontic access was significantly lower than that of restorations with conservative endodontic access (P<.05). A higher percentage of irreparable fractures was found in the 3 resin nanoceramic restoration groups. The von Mises stresses were higher in the lithium disilicate glass-ceramic restorations than in the resin nanoceramic restorations with the same access cavities. The von Mises stresses in the tooth structure were higher with the resin nanoceramic restorations than with the lithium disilicate glass-ceramic restorations with the same access cavities. CONCLUSIONS An endodontic access cavity had more influence on the lithium disilicate glass-ceramic onlays than on the resin nanoceramic onlays, and a traditional endodontic access cavity significantly decreased the fracture resistance of lithium disilicate glass-ceramic onlays.
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Affiliation(s)
- Hongbin Lai
- Graduate student, Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, PR China; Graduate student, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Xinwei Lin
- Graduate student, Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, PR China; Graduate student, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Yuejiao Zhang
- Lecturer, Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, PR China; Lecturer, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Qimei Gong
- Professor, Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, PR China; Professor, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Zhongchun Tong
- Professor, Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, PR China; Professor, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, PR China.
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14
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Soares PM, da Rosa LS, Pereira GKR, Valandro LF, Rippe MP, Dal Piva AMDO, Feilzer AJ, Kleverlaan CJ, Tribst JPM. Mechanical Behavior of Repaired Monolithic Crowns: A 3D Finite Element Analysis. Dent J (Basel) 2023; 11:254. [PMID: 37999018 PMCID: PMC10670502 DOI: 10.3390/dj11110254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/20/2023] [Accepted: 10/26/2023] [Indexed: 11/25/2023] Open
Abstract
This study evaluated the mechanical behavior and risk of failure of three CAD-CAM crowns repaired with different resin composites through a three-dimensional (3D) finite element analysis. Three-dimensional models of different cusp-repaired (conventional nanohybrid, bulk-fill, and flowable resin composites) crowns made of zirconia, lithium disilicate, and CAD-CAM resin composite were designed, fixed at the cervical level, and loaded in 100 N at the working cusps, including the repaired one. The models were analyzed to determine the Maximum Principal and Maximum Shear stresses (MPa). Complementary, an in vitro shear bond strength test (n = 10) was performed to calculate the risk of failure for each experimental group. The stress distribution among the models was similar when considering the same restorative material. The crown material affected the stress concentration, which was higher for the ceramic models (±9 MPa for shear stress; ±3 MPa for tensile stress) than for the CAD-CAM composite (±7 MPa for shear stress; ±2 MPa for tensile stress). The shear bond strength was higher for the repaired CAD-CAM resin composite (±17 MPa) when compared to the ceramics (below 12 MPa for all groups), while the repair materials showed similar behavior for each substrate. The stress distribution is more homogenous for repaired resin composite crowns, and a flowable direct resin composite seems suitable to repair ceramic crowns with less risk of failure.
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Affiliation(s)
- Pablo Machado Soares
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria 97105-900, Brazil (L.S.d.R.); (G.K.R.P.)
| | - Lucas Saldanha da Rosa
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria 97105-900, Brazil (L.S.d.R.); (G.K.R.P.)
| | - Gabriel Kalil Rocha Pereira
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria 97105-900, Brazil (L.S.d.R.); (G.K.R.P.)
| | - Luiz Felipe Valandro
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria 97105-900, Brazil (L.S.d.R.); (G.K.R.P.)
| | - Marilia Pivetta Rippe
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria (UFSM), Santa Maria 97105-900, Brazil (L.S.d.R.); (G.K.R.P.)
| | - Amanda Maria de Oliveira Dal Piva
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (A.M.d.O.D.P.)
| | - Albert J. Feilzer
- Department of Reconstructive Oral Care, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands;
| | - Cornelis J. Kleverlaan
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands; (A.M.d.O.D.P.)
| | - João Paulo Mendes Tribst
- Department of Reconstructive Oral Care, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit Amsterdam, 1081 LA Amsterdam, The Netherlands;
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15
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Zhu J, Li S, Wang D, Li D, Wang X, Rong Q. Effect of remaining pericervical dentin on biomechanical behavior of endocrown-restored molars with different materials: Three-dimensional finite element and Weibull analyses. Dent Mater J 2023; 42:683-691. [PMID: 37612061 DOI: 10.4012/dmj.2023-015] [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: 08/25/2023]
Abstract
To evaluate the effect of remaining pericervical dentin (PCD) on the biomechanical behavior of endocrown-restored molars with different materials, six three-dimensional finite element (FE) models were reconstructed with different thicknesses and heights of pulp-chamber lateral dentinal wall (PCLDW). IPS Empress 2, In-Ceram Zirconia, and Lava Ultimate were selected as the materials. Compared with the Lava Ultimate FE models, the maximum tensile stress in the FE models using ceramics was higher in the endocrown and lower in the PCD surrounding it, and the overall failure probabilities with different PCLDW thicknesses and heights were similar, ranging from 9.8% to 12.9% under the normal lateral masticatory force, which were lower than the FE models using Lava Ultimate (ranging from 13.4% to 15.1%). Considering the bonding properties of ceramics, endocrown-restored molars using etchable lithium disilicate-reinforced glass ceramic exhibit superior longevity due to the stress shielding effect, regardless of the thickness and height of PCLDW.
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Affiliation(s)
- Junxin Zhu
- Second Dental Center, Peking University School and Hospital of Stomatology
| | - Shiying Li
- Second Dental Center, Peking University School and Hospital of Stomatology
| | - Dongmei Wang
- Second Dental Center, Peking University School and Hospital of Stomatology
| | - Deli Li
- Second Dental Center, Peking University School and Hospital of Stomatology
| | - Xiaoyan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology
| | - Qiguo Rong
- Department of Mechanics and Engineering Science, College of Engineering, Peking University
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16
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Munoz-Sanchez ML, Gravier A, Francois O, Nicolas E, Hennequin M, Decerle N. In Vitro Resistance of Natural Molars vs. Additive-Manufactured Simulators Treated with Pulpotomy and Endocrown. J Funct Biomater 2023; 14:444. [PMID: 37754858 PMCID: PMC10531589 DOI: 10.3390/jfb14090444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/23/2023] [Accepted: 08/27/2023] [Indexed: 09/28/2023] Open
Abstract
Endocrowns are designed to restore endodontically treated teeth with root canal treatment (Rct). Recently, endocrowns were proposed for teeth treated with full pulpotomy (FP). No data exist on in vitro evaluations for this combination. This study aimed to evaluate the mechanical behavior of pulpotomy-treated teeth with endocrowns according to different protocols for preparation design and materials and to assess whether 3D-printed resin simulators could be a reliable alternative for human teeth during in vitro strength tests. One hundred and ten extracted natural molars were randomized into 11 groups according to the type of endodontic treatment, the material used, and the design of peripheric preparation. One hundred and ten resin simulators were separated similarly. The samples were embedded in epoxy resin blocks before being subjected to oblique compressive load until failure. For natural teeth, the variance analysis separated two homogeneous groups, one regrouping the endodontically treated or pulpotomy-treated teeth without coronal restoration and the other one regrouping all the other samples, i.e., the untreated teeth (positive controls) and the treated and restored teeth. The strength resistance was lower for the resin simulators than for natural teeth in all groups. Within the limit of this study, strength resistance is not the most important criterion for choosing the type of material, preparation, or endodontic treatment for endocrowns. Resin simulators are not efficient for in vitro strength studies.
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Affiliation(s)
- Marie-Laure Munoz-Sanchez
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (M.-L.M.-S.); (O.F.); (M.H.); (N.D.)
- CHU Clermont-Ferrand, Service d’Odontologie, F-63003 Clermont-Ferrand, France
| | - Alexis Gravier
- Institut Pascal UMR CNRS 6602, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France;
| | - Olivier Francois
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (M.-L.M.-S.); (O.F.); (M.H.); (N.D.)
| | - Emmanuel Nicolas
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (M.-L.M.-S.); (O.F.); (M.H.); (N.D.)
- CHU Clermont-Ferrand, Service d’Odontologie, F-63003 Clermont-Ferrand, France
| | - Martine Hennequin
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (M.-L.M.-S.); (O.F.); (M.H.); (N.D.)
- CHU Clermont-Ferrand, Service d’Odontologie, F-63003 Clermont-Ferrand, France
| | - Nicolas Decerle
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (M.-L.M.-S.); (O.F.); (M.H.); (N.D.)
- CHU Clermont-Ferrand, Service d’Odontologie, F-63003 Clermont-Ferrand, France
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17
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Lu Y, Wang L, Dal Piva AMO, Tribst JPM, Nedeljkovic I, Kleverlaan CJ, Feilzer AJ. Influence of surface finishing and printing layer orientation on surface roughness and flexural strength of stereolithography-manufactured dental zirconia. J Mech Behav Biomed Mater 2023; 143:105944. [PMID: 37269603 DOI: 10.1016/j.jmbbm.2023.105944] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/27/2023] [Accepted: 05/28/2023] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To evaluate the effect of surface finishing and printing layer orientation on the surface roughness and flexural strength of three-dimensionally (3D) printed 3 mol% yttria-stabilized zirconia manufactured by stereolithography (SLA). METHODS Ninety bar-shaped zirconia specimens (1 mm x 1 mm x 12 mm) were 3D-printed via SLA. After debinding and sintering, they were randomly divided according to the printing layer orientation: parallel (PR) or perpendicular (PD) to the tensile surface for bending test. Each group was submitted to a surface finishing protocol (n=15/group): unpolished (subgroup 0), with polished tensile surface (subgroup 1), and with polished lateral and tensile surfaces (subgroup 3). Roughness of tensile surface was determined using a contact sensor and surface morphology was analyzed under Scanning Electron Microscopy (SEM). Flexural strength, apparent elastic modulus, and Weibull parameters were assessed using a 3-point bending test. Fractured specimens were examined to identify failure origins. Finite element analysis was used to evaluate tensile stress peaks and failure risk. RESULTS PR orientation exhibited higher strength, higher apparent elastic modulus, higher maximum principal stress peaks, and lower failure risk. For both layer orientations, groups with polished lateral and tensile sides (PR3 and PD3) were the strongest. SEM revealed that polishing led to changes in defect type, location, and size. SIGNIFICANCE SLA zirconia shows different mechanical properties according to surface roughness and defects. Orienting the printed layers parallel to the tensile side improves its mechanical performance. Polishing can significantly improve its flexural strength. It is necessary to reduce the final product's surface roughness and large pores for its best performance.
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Affiliation(s)
- Y Lu
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, the Netherlands
| | - L Wang
- Jiangsu Key Laboratory of Advanced Food Manufacturing Equipment and Technology, School of Mechanical Engineering, Jiangnan University, Wuxi, 214122, Jiangsu, China; Institute of Advanced Technology, Jiangnan University, Wuxi, 214122, Jiangsu, China
| | - A M O Dal Piva
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, the Netherlands.
| | - J P M Tribst
- Department of Reconstructive Oral Care, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands
| | - I Nedeljkovic
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, the Netherlands
| | - C J Kleverlaan
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, the Netherlands
| | - A J Feilzer
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, the Netherlands; Department of Reconstructive Oral Care, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands
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18
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Mertsöz B, Ongun S, Ulusoy M. In-Vitro Investigation of Marginal Adaptation and Fracture Resistance of Resin Matrix Ceramic Endo-Crown Restorations. MATERIALS (BASEL, SWITZERLAND) 2023; 16:2059. [PMID: 36903174 PMCID: PMC10004208 DOI: 10.3390/ma16052059] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
The aim of this study was to evaluate the fracture resistance and marginal adaptation of endo-crown restorations produced from different resin-matrix ceramics (RMS) and the effects of these materials on marginal adaptation and fracture resistance. Three frasaco models were used by preparing (first) premolar teeth in three different margin preparations: butt-joint, heavy chamfer and shoulder. Each group was further divided into four subgroups according to the type of restorative material used: Ambarino High Class (AHC), Voco Grandio (VG), Brilliant Crios (BC) and Shofu (S) (n = 30). Master models were obtained using an extraoral scanner and fabricated with a milling machine. Marginal gap evaluation was performed with a silicon replica technique using a stereomicroscope. Replicas of the models (n = 120) were produced with epoxy resin. The fracture resistance of the restorations was recorded using a universal testing machine. The data were statistically analyzed using two-way ANOVA, and a t-test was applied for each group. Tukey's post-hoc test was performed to compare significant differences (p ≤ 0.05). The highest marginal gap was observed in VG, and the best marginal adaptation and the highest fracture resistance were found in BC. The lowest fracture resistance in Butt-joint preparation design was found in S. In addition, the lowest fracture resistance value in the heavy chamfer preparation design was found in AHC. The heavy shoulder preparation design displayed the highest fracture resistance values for all materials.
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Affiliation(s)
- Burak Mertsöz
- Department of Prosthodontics, Faculty of Dentistry, Near East University, Mersin 10, Lefkosa 99040, Turkey
| | - Salim Ongun
- Department of Prosthodontics, Faculty of Dentistry, Final International University, Nicosia 99010, Turkey
| | - Mutahhar Ulusoy
- Department of Prosthodontics, Faculty of Dentistry, Near East University, Mersin 10, Lefkosa 99040, Turkey
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19
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Machry RV, Bergoli CD, Schwantz JK, Brondani LP, Pereira-Cenci T, Pereira GKR, Valandro LF. Longevity of metal-ceramic single crowns cemented onto resin composite prosthetic cores with self-adhesive resin cement: an update of a prospective analysis with up to 106 months of follow-up. Clin Oral Investig 2023; 27:1071-1078. [PMID: 36030454 DOI: 10.1007/s00784-022-04693-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/18/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To evaluate the longevity of metal-ceramic single crowns cemented onto resin composite prosthetic cores using a self-adhesive resin cement in a prospective clinical descriptive study. METHODS A total of 152 teeth were endodontically treated and received resin composite prosthetic cores and metal-ceramic crowns cemented with a self-adhesive resin cement. The patients included in the sample were recalled for clinical and radiography evaluation in an up-to-106-month period after the final cementation procedures, with an average of 62 months of follow-up. 91.5% of the sample (142 teeth) were evaluated regarding the treatment survival rate, analyzed considering the loss of crown retention (crown debonding) and tooth loss as the primary outcome. In addition, post debonding, and root fracture occurrences were also recorded as secondary outcomes to evaluate the success rate of the prosthetic treatment. The aesthetic parameters were also evaluated according to the FDI criteria. The Kaplan-Meier method and Cox regression with 95% confidence interval were applied for the statistical analysis. RESULTS Regarding the primary outcome, the metal-ceramic crowns cemented with self-adhesive resin cement presented a high survival rate (91.5%), with 8 crown debondings and 3 tooth losses (1 due to caries and 2 due to periodontal disease) occurring after the evaluation period. For secondary outcomes, 9 root fractures and 4 post debondings occurred, generating a success rate of 72%. All crowns had a score 1 on the FDI criteria, indicating that they were clinically excellent or very good regarding the aesthetic parameters. CONCLUSION The metal-ceramic crowns luted with a self-adhesive resin cement presented a survival rate of 91.5% after an average of 62 months of follow-up. Furthermore, the restorations remained aesthetically satisfactory over time, without changes that would indicate prosthetic retreatment. A success rate of 72% was obtained considering the secondary outcome, mainly related to intraradicular retainer failures (root fractures or post debonding). CLINICAL SIGNIFICANCE The self-adhesive resin cement is clinically indicated for cementation of metal-ceramic crowns onto resin composite prosthetic cores.
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Affiliation(s)
- Renan Vaz Machry
- Post-Graduate Program in Oral Science, School of Dentistry, Federal University of Santa Maria, UFSM Campus, 1000 Roraima Av., T Street, Building 26F, Room 2386, Santa Maria, Rio Grande Do Sul State, 97105-900, Brazil
| | - César Dalmolin Bergoli
- Post-Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Gonçalves Chaves Street 457, Pelotas, Rio Grande Do Sul State, 96015-560, Brazil
| | - Julia Kaster Schwantz
- Post-Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Gonçalves Chaves Street 457, Pelotas, Rio Grande Do Sul State, 96015-560, Brazil
| | - Lucas Pradebon Brondani
- Post-Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Gonçalves Chaves Street 457, Pelotas, Rio Grande Do Sul State, 96015-560, Brazil
| | - Tatiana Pereira-Cenci
- Post-Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Gonçalves Chaves Street 457, Pelotas, Rio Grande Do Sul State, 96015-560, Brazil
| | - Gabriel Kalil Rocha Pereira
- Post-Graduate Program in Oral Science, School of Dentistry, Federal University of Santa Maria, UFSM Campus, 1000 Roraima Av., T Street, Building 26F, Room 2386, Santa Maria, Rio Grande Do Sul State, 97105-900, Brazil
| | - Luiz Felipe Valandro
- Post-Graduate Program in Oral Science, School of Dentistry, Federal University of Santa Maria, UFSM Campus, 1000 Roraima Av., T Street, Building 26F, Room 2386, Santa Maria, Rio Grande Do Sul State, 97105-900, Brazil.
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20
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Darwich MA, Aljareh A, Alhouri N, Szávai S, Nazha HM, Duvigneau F, Juhre D. Biomechanical Assessment of Endodontically Treated Molars Restored by Endocrowns Made from Different CAD/CAM Materials. MATERIALS (BASEL, SWITZERLAND) 2023; 16:764. [PMID: 36676500 PMCID: PMC9864025 DOI: 10.3390/ma16020764] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/03/2023] [Accepted: 01/11/2023] [Indexed: 06/17/2023]
Abstract
The aim of this study was to evaluate the deflection and stress distribution in endodontically treated molars restored by endocrowns from different materials available for the computer-aided design/computer-aided manufacturing (CAD/CAM) technique using three-dimensional finite element analysis. The models represented extensively damaged molars restored by endocrowns from the following materials: translucent zirconia; zirconia-reinforced glass ceramic; lithium disilicate glass ceramic; polymer-infiltrated ceramic network (PICN) and resin nanoceramic. Axial and oblique loadings were applied and the resulting stress distribution and deflection were analyzed. The Mohr-Coulomb (MC) ratio was also calculated in all models. The translucent zirconia endocrown showed the highest stress concentration within it and the least stress in dental structures. The resin nanoceramic model was associated with the greatest stress concentration in dental tissues, followed by the PICN model. Stress was also concentrated in the distal region of the cement layer. The MC ratio in the cement was higher than 1 in the resin nanoceramic model. Oblique loading caused higher stresses in all components and greater displacement than axial loading, whatever the material of the endocrown was. The translucent zirconia model recorded deflections of enamel and dentin (38.4 µm and 35.7 µm, respectively), while resin nanoceramic showed the highest stress concentration and displacement in the tooth-endocrown complex.
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Affiliation(s)
- Mhd Ayham Darwich
- Faculty of Biomedical Engineering, Al-Andalus University for Medical Sciences, Tartous, Syria
- Faculty of Technical Engineering, University of Tartous, Tartous, Syria
| | - Abeer Aljareh
- Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Nabil Alhouri
- Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Szabolcs Szávai
- Faculty of Mechanical Engineering and Informatics, University of Miskolc, 3515 Miskolc, Hungary
| | - Hasan Mhd Nazha
- Faculty of Mechanical Engineering, Institute of Mechanics, Otto Von Guericke University Magdeburg, Universitätsplatz 2, 39106 Magdeburg, Germany
| | - Fabian Duvigneau
- Faculty of Mechanical Engineering, Institute of Mechanics, Otto Von Guericke University Magdeburg, Universitätsplatz 2, 39106 Magdeburg, Germany
| | - Daniel Juhre
- Faculty of Mechanical Engineering, Institute of Mechanics, Otto Von Guericke University Magdeburg, Universitätsplatz 2, 39106 Magdeburg, Germany
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21
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Stress distribution in resin-based CAD-CAM implant-supported crowns. Dent Mater 2023; 39:114-122. [PMID: 36566152 DOI: 10.1016/j.dental.2022.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE This study aimed to evaluate the influence of new resin-based CAD-CAM implant-supported materials on posterior crown restoration stress and strain concentrations. METHODS A previous 3D implant model was edited to receive a cement-retained posterior crown manufactured with different CAD/CAM materials (Estelite P Block, Estelite Block II or Estelite Layered Block). Each solid model was exported to the computer-aided engineering software and submitted to the finite element analysis of stress and strain. Material properties were assigned to each solid with isotropic and homogeneous behavior according to the manufacturer information. A vertical load of 600 N was applied in the occlusal region of the crown, via a simulated food bolus, and stress was calculated in Von Misses (σVM) for the implant, abutment and screw, Maximum (σMAX) Principal Stresses for the crown and microstrain for the bone. RESULTS All simulated materials showed acceptable stresses levels with a similar stress pattern among the models. At the crown intaglio region and cement layer, however, differences were observed: Estelite P Block showed a lower tensile and shear stresses magnitude when compared to other resin-based materials with lower elastic modulus. SIGNIFICANCE The stress effect of different resin-based CAD-CAM implant-supported crowns is predominant in the crown and cement layer, with Estelite P Block showing 7.4 % versus 9.3 % and 9.2 % for Estelite Block II and Estelite Layered Block of crown failure risk.
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22
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Dal Piva AMO, Tribst JPM, Borges ALS, Kleverlaan CJ, Feilzer AJ. The ability of mouthguards to protect veneered teeth: A
3D
finite element analysis. Dent Traumatol 2022; 39:191-199. [PMID: 36573913 DOI: 10.1111/edt.12812] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/17/2022] [Accepted: 11/22/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND/AIMS Professional and amateur athletes might have veneer restorations. The aim of this study was to investigate the protective effect of mouthguards on veneered anterior restorations. METHODS A nonlinear dynamic analysis was performed to simulate conditions during an impact with or without a custom-made mouthguard. Using a computer-aided design (CAD) software, a slice of a human maxilla was designed containing an upper right central incisor. The model was composed of mucosa, cortical bone, trabecular bone, periodontal ligament, dentin, enamel, and pulp tissue. The enamel was prepared (feather design), restored with an indirect veneer (1.0 mm thickness), and duplicated to simulate both conditions with or without a mouthguard (4 mm thickness). Both models were subdivided into finite elements using the computer-aided engineering (CAE) software. Frictionless contacts were used, and an impact was simulated in which a rigid sphere hit the model at 1 m s-1 . Fixation was defined at the base of the bone. The elastic modulus of the veneer was assessed by using five different restorative materials (resin composite, hybrid ceramic, zirconia-reinforced lithium silicate, lithium disilicate, and zirconia). Von Mises stress, minimal principal stress, and maximum principal stress (in MPa) were obtained and plotted for visual comparison. RESULTS Von-Mises results showed higher stress concentrations in the veneer's cervical labial region for models without a mouthguard. Observing the quantitative results for each model, the highest compressive (709 MPa) and tensile (58 MPa) stresses occurred in the situation without a mouthguard with a zirconia veneer, while the lowest occurred in resin composite veneer with a mouthguard (8 and 5 MPa). The mouthguard was able to reduce the stresses in the tooth structure and it also reduced the risk of fracture in all conditions. CONCLUSIONS Mouthguards were beneficial in reducing the effects of dental trauma regardless of the restorative material used to manufacture the indirect veneer, since they act by dampening the generated stresses during the trauma event. Equal impact stresses on a mouthguard will lead to higher stresses in veneered teeth with more rigid restorative materials leading to a less protective effect.
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Affiliation(s)
- Amanda Maria O. Dal Piva
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA) Universiteit van Amsterdam and Vrije Universiteit Amsterdam the Netherlands
| | - João Paulo Mendes Tribst
- Department of Oral Regenerative Medicine, Academic Centre for Dentistry Amsterdam (ACTA) Universiteit van Amsterdam and Vrije Universiteit Amsterdam the Netherlands
| | - Alexandre Luiz S. Borges
- Applied Sciences to Oral Health (Restorative Dentistry) São Paulo State University (Unesp), Institute of Science and Technology São José dos Campos Brazil
| | - Cornelis J. Kleverlaan
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA) Universiteit van Amsterdam and Vrije Universiteit Amsterdam the Netherlands
| | - Albert J. Feilzer
- Department of Oral Regenerative Medicine, Academic Centre for Dentistry Amsterdam (ACTA) Universiteit van Amsterdam and Vrije Universiteit Amsterdam the Netherlands
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23
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Luo B, Sun X, He L, Zhao L, Liu X, Jiang Q. Impact of different axial wall designs on the fracture strength and stress distribution of ceramic restorations in mandibular first molar. BMC Oral Health 2022; 22:549. [PMID: 36456942 PMCID: PMC9714140 DOI: 10.1186/s12903-022-02577-5] [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: 10/11/2022] [Accepted: 11/08/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The purpose of this study was to investigate the fracture strength and stress distribution of four ceramic restorations. METHODS Forty human mandibular first molars were collected and randomized into four groups after establishing the distal defect: full crown group with 4 mm axial wall height (AWH) (FC4); short AWH crown group with 2 mm AWH (SC2); occlusal veneer group with 0 mm AWH (OV0); occlusal distal veneer group with only the distal surface prepared, and 4 mm AWH (OD4). The teeth were prepared according to the groups and the ceramic restorations were completed using celtra duo ceramic blocks. The ceramic thickness of the occlusal surface is about 1.5 mm and the edge is about 1 mm. The failure load values and fracture modes of each group were detected by mechanical test in vitro. According to the groups to establish three-dimensional finite element analysis (FEA) models, a 600 N loading force was applied vertically using a hemispherical indenter with a diameter of 6 mm. and compare the stress distribution under the condition of different restorations. RESULTS In vitro mechanical tests showed that the failure load values were SC2 (3232.80 ± 708.12 N) > OD4 (2886.90 ± 338.72 N) > VO0 (2133.20 ± 376.15 N) > FC4(1635.40 ± 413.05 N). The failure load values of the short AWH crown and occlusal distal veneer were significantly higher than that of occlusal veneer and full crown (P<0.05). The fracture modes of the full crown and occlusal veneer groups were mainly ceramic fractures and some were restorable tooth fractures. The short AWH crown and occlusal distal veneer groups presented with three fracture modes, the proportion of non-restorable tooth fracture was higher. The results of FEA show that under the spherical loading condition, the stress of ceramic was concentrated in the contact area of the loading head, the maximum von Mises stress values were FC4 (356.2 MPa) > VO0 (214.3 MPa) > OD4 (197.9 MPa) > SC2 (163.1 MPa). The stress of enamel was concentrated in the area where the remaining enamel was thinner, the maximum von Mises stress values was OD4 (246.2 MPa) ≈ FC4 (212.4 MPa) > VO0 (61.8 MPa) ≈ SC2 (45.81 MPa). The stress of dentin is concentrated in the root furcation and the upper third region of the root. However, stress concentration was observed at the tooth cervix in the full crown. CONCLUSION Under certain conditions, the occlusal distal veneer shows better performance than the full crown.
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Affiliation(s)
- Bin Luo
- grid.24696.3f0000 0004 0369 153XDepartment of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 100050 Beijing, China
| | - Xiaolu Sun
- grid.479671.a0000 0004 9154 7430Shunyi Hospital, Beijing Traditional Chinese Medicine Hospital, 100010 Beijing, China
| | - Lin He
- grid.24696.3f0000 0004 0369 153XDepartment of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 100050 Beijing, China
| | - Lidan Zhao
- grid.410737.60000 0000 8653 1072Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, 510013 Guangzhou, China
| | - Xinggang Liu
- grid.24696.3f0000 0004 0369 153XDepartment of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 100050 Beijing, China
| | - Qingsong Jiang
- grid.24696.3f0000 0004 0369 153XDepartment of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 100050 Beijing, China
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Boonrawd N, Rungsiyakull P, Rungsiyakull C, Louwakul P. Effects of composite resin core level and periodontal pocket depth on crack propagation in endodontically treated teeth: An extended finite element method study. J Prosthet Dent 2022; 128:195.e1-195.e7. [PMID: 35779973 DOI: 10.1016/j.prosdent.2022.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 04/30/2022] [Accepted: 05/03/2022] [Indexed: 10/17/2022]
Abstract
STATEMENT OF PROBLEM Preserving teeth with radicular cracks with or without a periodontal pocket is an alternative to extraction. However, an effective protocol for the restoration of radicular cracks is lacking. PURPOSE The purpose of this study was to examine the composite resin core level and periodontal pocket depth effects on stress distribution, maximum von Mises stress, and crack propagation in endodontically treated teeth by using the extended finite element (FE) method. MATERIAL AND METHODS Four 3-dimensional models of a cracked endodontically treated mandibular first molar were constructed: PP2C2 (periodontal pocket depth, 2 mm; composite resin core level, 2 mm below the canal orifice level); PP2C4 (periodontal pocket depth, 2 mm; composite resin core level, 2 mm below the crack level); PP4C2 (periodontal pocket depth, 4 mm; composite resin core level, 2 mm below the canal orifice level); and PP4C4 (periodontal pocket depth, 4 mm; composite resin core level, 2 mm below the crack level). The crack initiation was at the same level in all models. A static 700-N load was applied to the models in a vertical direction. RESULTS The highest stress in dentin was observed in PP2C2, whereas PP2C4 exhibited the lowest stress and least crack propagation. Stress was high in the dentin and supporting bone. No reduction in crack propagation was observed in the PP4 models, regardless of the composite resin core level. CONCLUSIONS The periodontal pocket depth (2 mm and 4 mm) and composite resin core level (2 mm below the crack level and 2 mm below the canal orifice level) affected stress concentration in dentin, resulting in different patterns of crack propagation in the FE models.
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Affiliation(s)
- Narissara Boonrawd
- Graduate student, Department of Restorative Dentistry and Periodontology, Endodontic Division, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Pimduen Rungsiyakull
- Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Chaiy Rungsiyakull
- Assistant Professor, Department of Mechanical Engineering, Faculty of Engineering, Chiang Mai University, Chiang Mai, Thailand
| | - Phumisak Louwakul
- Assistant Professor, Department of Restorative Dentistry and Periodontology, Endodontic Division, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand.
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Li N, Li Y, Gao Y, Jiang L. Biomechanical Assessment of Tilted Mandibular Second Molars with Full-Crown Adjacent to Implant-Supported Restoration: 3D Finite Element Analysis. Int J Gen Med 2022; 15:3459-3470. [PMID: 35378916 PMCID: PMC8976503 DOI: 10.2147/ijgm.s353134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/23/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Materials and Methods Results Conclusion
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Affiliation(s)
- Ning Li
- Department of Stomatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200025, People’s Republic of China
| | - Yusi Li
- Department of Stomatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200025, People’s Republic of China
| | - Yiming Gao
- Department of Stomatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200025, People’s Republic of China
| | - Liting Jiang
- Department of Stomatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University, Shanghai, 200025, People’s Republic of China
- Correspondence: Liting Jiang; Yiming Gao, Department of Stomatology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University, No. 197, The Second Ruijin Road, Huangpu District, Shanghai, 200025, People’s Republic of China, Tel +86 21 64370045, Email ;
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Zheng Z, Sun J, Jiang L, Wu Y, He J, Ruan W, Yan W. Influence of margin design and restorative material on the stress distribution of endocrowns: a 3D finite element analysis. BMC Oral Health 2022; 22:30. [PMID: 35120525 PMCID: PMC8817586 DOI: 10.1186/s12903-022-02063-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background This study aimed to evaluate the stress distributions in endocrown restorations as applied to endodontically treated teeth (ETT), according to the factors of “margin design” (four levels) and “restorative material” (six levels). Methods Four 3D-finite elements models were constructed for endocrown restored molars considering different margin designs. Model A was prepared with a flat butt joint margin and received an endocrown with a 2.0-mm occlusal thickness. Model B was prepared with a 20° bevel margin and received an endocrown with a 2.0-mm occlusal thickness. Model C was prepared with an axial reduction and 1-mm shoulder margin and received an endocrown with a 2.0-mm occlusal thickness. Model D was prepared with an anatomic margin and received an endocrown with a 2.0-mm occlusal thickness. The following endocrown materials were used: In-Ceram Zirconia (Zr), Vita Suprinity (VS), IPS Empress (IE), Grandio blocs (GR), VisCalor bulk (VS), and CopraPeek Light (CP). The Load application (600 N) was performed at the food bolus and tooth surface during the closing phase of the chewing cycle. The results for the endocrown and tooth remnants were determined according to the von Mises stress. The failure risk of the cement layer was also calculated based on the normal stress criterion. Results Model D (with an anatomic margin) showed the greatest stress concentrations, especially in the irregular and sharp angles of the restoration and tooth remnants. The stress concentrated on the dentin was significantly lower in Model B with a 20° bevel margin (20.86 MPa), i.e., 1.3 times lower than the other three margin designs (27.80 MPa). Restorative materials with higher elastic moduli present higher stress concentrations inside the endocrown and transmit less stress to the cement layer, resulting in lower bonding failure risks. In contrast, materials with an elastic modulus similar to that of dentin presented with a more homogeneous stress distribution on the whole structure. Conclusions An endocrown with a 20° bevel margin design could be a favorable preparation option for ETT. Composite resins (GR and VC) exhibit a more even stress distribution, and seem to be more promising materials for endocrown molars.
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Affiliation(s)
- Ziting Zheng
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jieli Sun
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Department of Stomatology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Lifang Jiang
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yuan Wu
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jiahui He
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Wenhao Ruan
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Wenjuan Yan
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
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Yildirim G, Demir C, Güven MÇ, Koç O, Dalkiliç EE. Influence of fiber insertion and different material type on stress distribution in endocrown restorations: a 3D-FEA study. Comput Methods Biomech Biomed Engin 2021; 25:1509-1519. [PMID: 34964689 DOI: 10.1080/10255842.2021.2019228] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The study aimed to evaluate the effects of fibers insertion and restorative material type on the stress distribution in endocrowns with finite element analysis. Five 3D models of first mandibular molars were created and restored as follows: (1) IN: intact tooth, (2) IPS-E: tooth restored with lithium disilicat ceramic endocrowns, (3) C-E: tooth restored with composite endocrowns, (4) IPS-E + F: lithium disilicate ceramic endocrowns + fiber, (5) C-E + F: composite endocrowns + fiber. Vertical masticatory load was imitated with finite element analysis. The equivalent stress of von Mises failure criterion (mvM) was calculated. The maximum mvM stress, enamel/crown, dentin and cement were compared among models and strength of the materials. Endocrowns presented a lower mvM stress level than intact tooth. In IPS-E, the mvM stress values in the crown and dentin were higher than C-E, while the mvM stress values in cement were higher in C-E group. Fibers insertion did not affect the stress level of IPS-E and C-E groups. In IPS model, fiber showed more stress absorption than C-E. The restorative material type changed the stress distribution of endocrown restorations. The fiber application did not affect the stress distribution in either endocrown group. But, more stress absorption was observed in fiber under IPS-E than C-E.
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Affiliation(s)
- Gulhan Yildirim
- Department of Prosthodontics, Beykent University, Istanbul, Turkey
| | - Cihan Demir
- Faculty of Mechanical Engineering, Yildiz Technical University, Istanbul, Turkey
| | | | - Osman Koç
- Faculty of Mechanical Engineering, Yildiz Technical University, Istanbul, Turkey
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Sichi LGB, Pierre FZ, Arcila LVC, de Andrade GS, Tribst JPM, Ausiello P, di Lauro AE, Borges ALS. Effect of Biologically Oriented Preparation Technique on the Stress Concentration of Endodontically Treated Upper Central Incisor Restored with Zirconia Crown: 3D-FEA. Molecules 2021; 26:6113. [PMID: 34684695 PMCID: PMC8538003 DOI: 10.3390/molecules26206113] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/03/2021] [Accepted: 10/04/2021] [Indexed: 01/19/2023] Open
Abstract
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.
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Affiliation(s)
- Luigi Giovanni Bernardo Sichi
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil
| | - Fernanda Zapater Pierre
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil
| | - Laura Viviana Calvache Arcila
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil
| | | | | | - Pietro Ausiello
- School of Dentistry, University of Naples Federico II, via S. Pansini 5, 80131 Naples, Italy
| | | | - Alexandre Luiz Souto Borges
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil
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He J, Zheng Z, Wu M, Zheng C, Zeng Y, Yan W. Influence of restorative material and cement on the stress distribution of endocrowns: 3D finite element analysis. BMC Oral Health 2021; 21:495. [PMID: 34610825 PMCID: PMC8491409 DOI: 10.1186/s12903-021-01865-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 09/28/2021] [Indexed: 02/07/2023] Open
Abstract
Purpose This study aimed to evaluate the influence of different types of restorative materials and resin cements on the stress distribution in the regions of the restoration, cement layer and dental remnant in endodontically treated posterior endocrowns. Methods A 3D finite element analysis (FEA) model of the first mandibular molar that was restored with an endocrown designed by computer-aided design (CAD) software was generated. Three kinds of restorative materials (Vita Enamic (VE), IPS e.max CAD (EMX) and Grandio blocs (GR)) and two types of cementing materials (NX3 and Maxcem Elite Chroma (MX)) were analysed with such a model. The food layer was also designed before vertical (600 N) forces were applied to simulate physiological masticatory conditions. Thermal expansion was used to simulate the polymerization shrinkage effects of cement layers. The results were obtained by colorimetric graphs of the maximum principal stress in the restoration and tooth remnant. The failure risk of the cement layer was also calculated based on the normal stress. Results The elastic modulus was positively correlated with the tensile stress peak values in the restoration, mainly at the intaglio surface. However, in the cervical enamel and cement layer, restorative material with a higher elastic modulus generated lower peak stress values. The cement with a higher elastic modulus resulted in higher stress peak values inside the cement layer. The combination of EMX (restorative material) and NX3 (cement material) in the cement layer resulted in the lowest failure risk. Significance The ceramic material EMX with a higher elastic modulus appeared to be more effective at protecting the cement layer and residual enamel tissue. Based on the analysis of the failure risk of the cement layer, the combination of EMX and NX3 was recommended as an optional material for endocrowns for endodontically treated posterior teeth.
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Affiliation(s)
- Jiahui He
- Stomatology Health Care Center, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, China.,Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Ziting Zheng
- Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Min Wu
- Stomatology Health Care Center, Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Chunqing Zheng
- Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yuting Zeng
- Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Wenjuan Yan
- Nanfang Hospital, Southern Medical University, Guangzhou, China.
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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: 18] [Impact Index Per Article: 4.5] [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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Tribst JPM, Borges ALS, Silva-Concílio LR, Bottino MA, Özcan M. Effect of Restorative Material on Mechanical Response of Provisional Endocrowns: A 3D-FEA Study. MATERIALS 2021; 14:ma14030649. [PMID: 33572533 PMCID: PMC7866804 DOI: 10.3390/ma14030649] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/22/2021] [Accepted: 01/26/2021] [Indexed: 12/14/2022]
Abstract
The goal of this study was to evaluate the stress distribution in an endocrown restoration according to different provisional restorative materials. An endodontically treated maxillary molar model was selected for conducting the finite element analysis (FEA), with a determined amount of dental remnant of 1.5 mm. The model was imported to the analysis software (ANSYS 19.2, ANSYS Inc., Houston, TX, USA) in STEP format. All contacts were considered perfectly bonded. The mechanical properties of each structure were considered isotropic, linear, elastic, and homogeneous. Three different provisional restorative materials were simulated (acrylic resin, bis-acrylic resin, and resin composite). An axial load (300 N) was applied at the occlusal surface in the center of the restoration. Results were determined by colorimetric stress maps of maximum principal stress, maximum shear stress, and total deformation. The different materials influenced the stress distribution for all structures; the higher the material’s elastic modulus, the lower the stress magnitude on the cement layer. In the present study, all provisional restorative materials showed similar stress patterns in the endocrown and on the cement layer however, with different magnitude. Based on this study limitation, the use of resin composite to manufacture provisional endocrowns is suggested as a promising material to reduce the stresses in the cement layer and in the dental tissue surfaces.
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Affiliation(s)
- João Paulo Mendes Tribst
- School of Dentistry, University of Taubaté, Taubaté, São Paulo 12020-340, Brazil; (J.P.M.T.); (L.R.S.-C.)
| | - Alexandre Luiz Souto Borges
- Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo 12220-690, Brazil; (A.L.S.B.); (M.A.B.)
| | | | - Marco Antonio Bottino
- Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo 12220-690, Brazil; (A.L.S.B.); (M.A.B.)
| | - Mutlu Özcan
- Division of Dental Biomaterials, Center for Dental and Oral Medicine, Clinic for Reconstructive Dentistry, University of Zurich, 8032 Zurich, Switzerland
- Correspondence:
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