Failure analysis of a new post-and-core restoration system using the finite element method

Human teeth with substantial coronal defects are subject to reconstruction by means of post-and-core restorations. Typically, such a restoration comprises a slightly cylindrical post onto which an abutment of varying shape, depending on the designated restoration, is attached. As clinical results are not satisfactory to date, a new post-and-core design which makes use of positive locking (rather than relying on chemical bonding agents for retention in the residual root) was proposed. Using proprietary burs, an inversely conical hole is machined into the root, into which the prefabricated post-and-core restoration is inserted. This part can be spread at the bottom to match the cavity's undercut form, resulting in a positive lock which can only be separated by destruction of root, restoration or both. Another key feature of this system is a ring/groove geometry which is able to absorb the wedging forces created by said spreading and the stress of loading of the restoration which arises from mascatory forces. To assess the properties, especially in terms of the stress imposed on the remaining tooth at highest possible loading, both finite element simulations and in vitro failure tests were performed and the findings compared. The results suggest that the parameters of the finite element simulations are in good agreement with reality. As calculated and measured force levels immediately before failure of the restoration are high, the introduced new geometry has significant advantages over the classical restoration.     

Fracture resistance of endodontically treated teeth restored with intra-radicular post: The effects of post system and dentine thickness

To investigate the influence of post system and amount of remaining root tissue on the fracture resistance of endodontically treated teeth. Seventy upper canine teeth were divided into seven groups (n=10), one control (sound teeth) and six experimental groups resulting from the interaction between the two study factors: post system (FB, fiber post; FPC, fiber post relined with resin composite; CPC, cast Ni–Cr alloy post and core) and amount of remaining root tooth tissue (2 or 1 mm of thick root). All teeth were restored with metal crowns and exposed to 250,000 cycles in a controlled chewing simulator. The samples were submitted to the fracture resistance test in a universal testing machine, at an angle of 135° and speed of 0.5 mm/min, until fracture occurred. Failure modes were observed, and the data of fracture resistance, in Newtons, were submitted to the analysis of variance (ANOVA), followed by Tukey′s test (α=0.05). Roots restored with FPC had the highest fracture strength of the experimental groups, being statistically similar to the intact teeth group (P>0.05). FP and CPC did not differ statistically (P>0.05) and were statistically lower than those of FPC (P<0.05). No statistically significant difference was observed between amounts of remaining root tooth tissue to the same post systems (P>0.05). A prevalence of irreparable failures was observed in specimens restored with CPC, whereas FP and FPC posts showed more repairable failures. The post system had an influence significant on fracture resistance. However, the remaining dentine with 2- or 1-mm thickness was not an important factor for the fracture resistance.     

Optimal mechanical design of anatomical post-systems for endodontic restoration

This paper analyses the mechanical behaviour of a new reinforced anatomical post-systems (RAPS) for endodontic restoration. The composite restorative material (CRM) completely fills the root canal (as do the commonly used cast metal posts) and multiple prefabricated composite posts (PCPs) are employed as reinforcements. Numerical simulations based on 3D linearly elastic finite element models under parafunctional loads were performed in order to investigate the influence of the stiffness of the CRM and of the number of PCPs. Periodontal ligament effects were taken into account using a discretised anisotropic nonlinearly elastic spring system, and the full discrete model was validated by comparing the resulting stress fields with those obtained with conventional restorations (cast gold-alloy post, homogeneous anatomical post and cemented single PCP) and with the natural tooth. Analysis of the results shows that stresses at the cervical/middle region decrease as CRM stiffness increases and, for large and irregular root cavities that apical stress peaks disappear when multiple PCPs are used. Accordingly, from a mechanical point of view, an optimal RAPS will use multiple PCPs when CRM stiffness is equal to or at most twice that of the dentin. This restorative solution minimises stress differences with respect to the natural tooth, mechanical inhomogeneities, stress concentrations on healthy tissues, volumes subject to shrinkage phenomena, fatigue effects and risks of both root fracture and adhesive/cohesive interfacial failure.     

Mechanical behaviour of endodontic restorations with multiple prefabricated posts: a finite-element approach

This paper investigates some mechanical aspects of a new endodontic restoration technique, based on the idea that the root cavity can be more efficiently filled if multiple prefabricated composite posts (PCP) are employed. Multi-post technique increases bearing capacity and durability of endodontically treated teeth, as shown by numerical simulations performed through three-dimensional elastic finite-element static analyses of a lower premolar, constrained by a non-linearly elastic spring system representing the periodontal ligament, under several parafunctional loads. The influence of PCPs' number, material and dimensions is investigated by comparison of the resulting stress fields with those obtained in cases of traditional restorations (cast metal post and cemented single-PCP) and natural tooth, highlighting the advantages of the proposed technique when standard restorative materials are considered. A risk-analysis of root-fracture and interface-failure shows that cast gold-alloy post produces high stress concentrations at post-dentin interface, whereas multi-post solution leads to a behaviour closer to the natural tooth's, exhibiting some advantages with respect to single-PCP restorations. As a matter of fact, whenever PCPs' overall cross-section area increases, multi-post solution induces a significant reduction of stress levels into the residual dentin (and therefore the root-fracture-risk decreases) as well as of the expected polymerization shrinkage effects. Moreover, interfacial stress values in multi-post restorations can be higher than the single-PCP ones when carbon-fibre posts are considered. Nevertheless, the interfacial adhesive/cohesive failure-risk is certainly acceptable if glass-fibre posts are employed.     

Nano- and micromechanical properties of dentine: Investigation of differences with tooth side

The soft zone in dentine beneath the dentino-enamel junction is thought to play an important role in tooth function, strain distribution and fracture resistance during mastication. Recently reported asymmetry in mechanical properties with tooth side may point at a basic property of tooth function. The aim of our study was to test if this asymmetry was reflected in the nano- and micromechanical properties of dentine. We investigated the mechanical properties of dentine on the buccal and lingual side of nine extracted human teeth using nano- and microindentation. Properties were analysed on the natural log scale, using maximum likelihood to estimate the parameters. Two-sided 0.05-level likelihood ratio tests were used to assess the influences of surface (buccal versus lingual) and dentine depth, measured from the DEJ in crown dentine and from the CDJ in root dentine. Results showed the well known gradual increase in mechanical properties with increasing distance from the DEJ. Coronal dentine showed higher elastic modulus and hardness on the lingual side of teeth for all measurements, while root dentine was harder on the buccal side. Due to the subtlety of these effects and the small number of teeth studied, results failed to reach statistical significance. Results suggest that dentine nano- and micromechanical properties vary with tooth side in agreement with recent literature using macroscopic methods. They also reveal that buccal-lingual ratios of hardness are in opposite directions in crown and root dentine, suggesting compensatory functions.     

金属桩与玻璃纤维桩对老年上颌前牙残根残冠修复的临床疗效比较

目的:探讨金属桩与玻璃纤维桩对老年上颌前牙残根残冠修复的临床疗效。方法:收集我院口腔科收治的上颌前牙残根残冠修复患者40例,随机分为玻璃纤维桩组和金属桩组,每组各20例,玻璃纤维桩组患者给予玻璃纤维桩进行残根残冠修复,金属桩组给予金属桩进行残根残冠修复,治疗结束后1年随访,对所有患者的牙龈指数(GI)、修复齿出血指数(SBI)、不良反应发生率、患者修复效果以及患者疗效进行检测并比较。结果:与治疗前相比,两组患者的牙龈指数(GI)以及修复齿出血指数(SBI)均下降(P0.05);与金属桩组相比,玻璃纤维桩组患者的牙龈指数(GI)以及修复齿出血指数(SBI)较低(P0.05),不良反应发生率较低(P0.05),颜色匹配率以及边缘适合率较高(P0.05),两组患者修复体完整例数百分率比较无明显差异(P0.05),玻璃纤维桩组患者的治疗成功率较高(P0.05)。结论:玻璃纤维桩在老年上颌前牙残根残冠修复的应用与金属桩组相比临床效果较好。     

Finite element analysis of a new customized composite post system for endodontically treated teeth

This paper investigated the mechanical behavior of a new customized post system built up with a composite framework presently utilized for crowns, bridges, veneers and inlay/onlay dental restorations. The material has been shaped so to follow perfectly the profile of the root canal in order to take advantage of the better mechanical properties of composites with respect to metallic alloys commonly used for cast posts.

The analysis has been carried out with 3D finite element models previously validated on the basis of experimental work. The new post system has been compared to a variety of restorations using either prefabricated or cast posts. The structural efficiency of the new restoration has been evaluated for an upper incisor under different loading conditions (mastication, bruxism, impact).

Results prove that maximum stress values in restored teeth are rather insensitive to post types and materials. However, the new customized composite restoration allows to reduce significantly the stresses inside the dentinal regions where conservative clinical interventions are not possible.     

The influence of the root cross-section on the stress distribution in teeth restored with a positive-locking post and core design: a finite element study

Human teeth with substantial coronal defects are subject to reconstruction by means of post and core restorations. Typically, such a restoration comprises a slightly cylindrical post onto which an abutment of varying shape, depending on the designated restoration, is attached. As clinical results are not satisfactory to date, we proposed a new proprietary post and core design which makes use of positive locking. As this prefabricated system is not customised to an individual root's cross-sectional geometry (usually oval), a varying amount of radicular dentin is left in periphery of the core's outer edge. The aim of this study was to assess the implications of this fact, i.e., whether the root has to endure higher overall stress levels which ultimately may lead to failure of one of the components involved. A series of finite element simulations were performed to evaluate stress and strain on the system, in which the proposed post and core was embedded into a virtual dentin cylinder of different diameters, ranging from flush mounting of the restoration to a dentin excess of 4 mm, and subsequently loaded with forces with two angles of attack (90 degrees and 130 degrees ). The results show that flush mounting yields an agreeable stress and strain distribution within the radicular dentin, but overall stress levels drop significantly with an excess of 0.5 mm of surrounding dentin. More than 1 mm excess was not found to have profound positive effects.     

How the microstructure of dentine can contribute to reconstructing developing dentitions and the lives of hominoids and hominins

Accounts of dentine microstructure are less well established in the primate life history literature than those of enamel microstructure. The aim of this paper is to draw some basic comparisons between enamel and dentine, but at the same time to show how dentine microstructure can make a major but different contribution to reconstructing past lives than enamel can. Dentine has both an organic and an inorganic component. The organic component contains growth factors, stable isotopes and DNA that survive long after death. The mineral component contains trace elements and preserves an incremental record of tooth growth. These can be used to put a time scale to many past events when the chemistry or microstructure of dentine has become altered during tooth growth. Dentine microstructure allows us to reconstruct tooth root growth in the past and has contributed to a fuller understanding of the modular nature of developing dentitions among hominoids and hominins.     

Structure of comblike teeth of the ayu sweetfish,Plecoglossus altivelis (Teleostei: Isospondyli): I. Denticles and tooth attachment

The structure and tooth attachment of the comblike teeth and denticles of the ayu sweetfish, Plecoglossus altivelis, were examined by light and scanning electron microscopy. The denticle is composed of a spoonlike crown with a spine pointed anteriorly, a triangular plate in the cervical region, and a root that curves laterally and tapers off to a point. The root apex is fused with a long thin pedicle that turns abruptly anteriad toward the jaw bone. Planes of the spine, the spoonlike crown, the triangle plate and the root of the denticle are varied, and the denticle is twisted in the region of the triangle plane. The superficial layer of the dentine is homogeneously calcified and is considered to be enameloid, because some of the inner dentinal epithelial cells in the tooth germ are columnar and possess cellular processes at their apical ends. The dentine is fibrous and fine dentinal tubules are visible in dentine treated with sodium hydroxide and observed by scanning electron microscopy. The upper half of the root is surrounded by a dense layer of collagen fibers running parallel to the tooth axis, and the lower half is encompassed by interlaced collagen fibers. The lower part of the root is open on its lingual side. The pedicle is a long rod which is homogeneously calcified and enmeshed by interlaced collagen fibers, and it curves mediad as it nears the jaw bone. The pedicles are interposed between a layer of gelatinous connective tissue and the jaw bone and terminate on the periosteum. Comparative aspects of ayu tooth morphology are discussed. © 1993 Wiley-Liss, Inc.     

Effects of Pre-Planting Soaking on Growth and Survival of Black Willow Cuttings

Black willow (Salix nigra) uses periodic flood events for dispersal of vegetative propagules, subjecting them to periods of soaking before their deposition along the streambank. It was hypothesized that this life history trait results in optimal conditions for willow growth and survival. To test this hypothesis, a greenhouse experiment was conducted using 1.2‐m‐long black willow cuttings (posts) with a basal diameter of 5 cm. Cuttings were subjected to three soaking treatments (0, 3, and 10 days) and then grown under four soil moisture regimes (control, drought, permanently flooded, and intermittently flooded). Growth, biomass, and survival were recorded. Results showed that soaking posts for 10 days was most beneficial in the control soil moisture regime, enhancing root, shoot, leaf, and total biomass production. Shoot abundance and growth were also enhanced by 10 days of soaking in the control and permanently flooded moisture regimes. Finally, survival increased significantly in control and drought moisture regimes in response to the 10‐day soaking treatment. Results clearly demonstrated that soaking had significant effects on willow post success when evaluated across all soil moisture regimes. Posts subjected to the 10‐day soaking treatment consistently had greatest growth and biomass and displayed a doubling of the survival rate. Therefore, soaking willow cuttings before planting is a simple, inexpensive technique that may be used to bolster streambank restoration success.     

Structure and histogenesis of tooth plates in Sagenodus inaequalis Owen considered in relation to the phylogeny of post-Devonian dipnoans.

The histology of tooth plates of Sagenodus inaequalis has been investigated to obtain information on the histogenesis of the tissue. The histological mechanisms of growth and replacement of the tooth plate are described in terms of an increase in area of the tooth plate by addition of denticles to the lateral margins of the ridges, replacement of worn dentine at the tritoral surface by basal growth of dentine and invasive growth of dentine into the surrounding bone at the anterior and medial margins. The histogenesis of a specialized character for dipnoans is described, namely hypermineralized dentine, or petrodentine, within the tooth plates. This has placed an advanced character further back in the phylogenetic organization of dipnoans than was previously recognized. The implications of these observations are discussed in relation to proposed phylogenies and previous observations on tooth plates of other dipnoans. It is concluded that Sagenodus inaequalis shared a common ancestor with both the ceratondontids and the lepidosirenids. A sequence is proposed for the phyletic relationship of tooth plate-bearing dipnoans. From a consideration of the features of histogenesis of this specialized dentine, the alternative terminologies are reviewed and petrodentine (Lison 1941) chosen for the hypermineralized dentine and syndentine (Thomasset 1928) as the collective term for the entire mass of dentine in the tooth plate.     

Effects of Mechanical and Chemical Pretreatments of Zirconia or Fiber Posts on Resin Cement Bonding

The bonding strength between resin cement and posts is important for post and core restorations. An important method of improving the bonding strength is the use of various surface pretreatments of the post. In this study, the surfaces of zirconia (fiber) posts were treated by mechanical and/or chemical methods such as sandblasting and silanization. The bonding strength between the zirconia (fiber) post and the resin cement was measured by a push-out method after thermocycling based on the adhesion to Panavia F 2.0 resin cement. The zirconia and fiber posts exhibited different bonding strengths after sandblasting and/or silanization because of the different strengths and chemical structures. The zirconia post showed a high bonding strength of up to 17.1 MPa after a combined treatment of sandblasting and silanization because of the rough surface and covalent bonds at the interface. This effect was also enhanced by using 1,2-bis(trimethoxysilyl)ethane for the formation of a flexible layer at the interface. In contrast, a high bonding strength of 13.9 MPa was obtained for the fiber post treated by silane agents because the sandblasting treatment resulted in damage to the fiber post, as observed by scanning electron microscopy. The results indicated that the improvement in the bonding strength between the post and the resin cement could be controlled by different chemical and/or mechanical treatments. Enhanced bonding strength depended on covalent bonding and the surface roughness. A zirconia post with high bonding strength could potentially be used for the restoration of teeth in the future.     

Three-dimensional finite element analysis of the composite and compomer onlays in primary molars

Resin onlay restoration is an esthetic alternative technique used for restoring extensively damaged primary molars. Understanding the behavior of materials under repeated functional stress and how the stress is transmitted to the remaining tooth structure is important. The aim of this study was to compare stresses in primary molars restored with indirect composite and compomer onlay. 3D frame models of the right mandibular and maxillary primary molars and the alveolar bone were created using computerized tomography images of a six-year-old girl. The enamel and dentine layers above the cement layer were unified to generate onlay restoration, and composite and compomer were used as restorative materials. The vertical occlusal load (100?N) was applied to the teeth in the occlusal contact areas. The von Mises stress distributions and normal stress distributions of the y-axis (parallel to the long axis of tooth) were evaluated. The occlusal stress is transmitted to the cervical part of healthy teeth by spreading it through the enamel layer. The composite and compomer restorative materials exhibited similar stress distribution patterns. An indirect technique creates a structure similar to the original morphological form, and it allows restorations to distribute high occlusal stresses and to minimize possible breakages.     

Finite element analysis of anterior tooth root stresses developed during endodontic treatment

Vertical tooth root fractures are diagnostically challenging, frustrating, and an increasingly common cause of failure of tooth restoration. These vertical root fractures have been associated with many causes, including the endodontic process itself. To investigate these endodontic causes, various phases of crown replacement for an anterior tooth were modeled using nonlinear, plane strain finite element (FE) analysis. Stresses developed during obturation, post positioning, crown placement, and masticatory and occlusal loading of the restored tooth were estimated using this analysis method. The minimum (compressive) principal stress was greatest during obturation of cones 1 and 2, and during mastication of the restored tooth. Although these stresses were significant (-150 to -280 MPa), they did not exceed the compressive strength of dentin. The maximum (tensile) principal stresses, 160 to 300 MPa, were also observed during obturation of cones 1 and 2. These peak stresses exceed the dentin tensile strength.     

Morphology and growth of lepidosirenid lungfish tooth plates (Pisces: Dipnoi)

The structure of the tooth plates of Protopterus and Lepidosiren was investigated to determine the causes and consequences of postlarval shape change. During growth, the basal area of the tooth plates increases, some cusps become more prominent, and shearing surfaces are sharpened. The jaw articulation restricts the range of movements of the lower jaw, and causes the tooth plates to occlude precisely; the resulting wear patterns are regular. The tooth plates are composed of enamel, trabecular dentine, and petrodentine. A petrodentine column forms the core of a tooth plate; it is flanked by trabecular dentine. Microhardness measurements show that trabecular dentine is comparable in hardness to mammalian dentine, whereas the petrodentine is comparable to enamel. The location and differential wear of these tissues produce the prominent cusps and self-sharpened blades of the adult tooth plates.     

Sexual dimorphism in modern human permanent teeth

On average, males possess larger tooth crowns than females in contemporary human populations, although the degree of dimorphism varies within different populations. In previous studies, different amounts of either enamel or dentine were implicated as the cause of this dimorphism. In this study, we attempt to determine the nature of sexual dimorphism in the crowns of permanent modern human teeth and to determine if two contrasting tooth types (permanent third molars and canines) show identical patterns of dimorphism in enamel and dentine distribution. We estimated the relative contributions of both enamel and dentine to total crown size, from buccolingual sections of teeth. Our sample consisted of a total of 144 mandibular permanent third molars and 25 permanent mandibular canines of known sex. We show that sexual dimorphism is likely due, in part, to the presence of relatively more dentine in the crowns of male teeth. However, whatever the underlying cause, dimorphism in both tooth root and tooth crown size should produce measurable dimorphism in tooth weight, though this has not been previously explored. Therefore, we provide some preliminary data that indicate the usefulness of wet tooth weight as a measure of sexual dimorphism. Both male permanent third molars and canines are significantly heavier than those of females. The weight dimorphism reported here for both classes of teeth may prove a useful finding for future forensic studies. In particular, weights of canines may be more useful as a means of sexing modern human skeletal material than linear or area measurements of teeth.     

纤维桩树脂核用于老年残根残冠修复的效果及对生活质量的影响

目的:探讨老年残根残冠应用纤维桩树脂核修复的临床效果及对病人生活质量的影响。方法:抽选我院行纤维桩树脂核修复的79例(86颗)老年残根残冠患者,对其进行3年随访,观察总体及不同牙位修复成功率和修复前、后生活质量的变化。结果:修复后进行3年随访,86颗残根残冠修复总成功率为95.3%,不同牙位修复成功率无显著差异(P0.05),均在94%以上,86颗牙失败4颗(其中2颗并发牙周炎、2颗牙纤维桩脱落,均未出现牙桩折断);修复后患者生活质量总分及各维度评分均明显优于修复前(P0.05)。结论:纤维桩树脂核是一种极为理想的残冠残根修复材料,能显著提高老年患者术后的生活质量,值得临床推广。     

Tigaran (Point Hope,Alaska) tooth drilling

In a sample of 48 adult Tigarans (1300–1700 A.D.) from Point Hope, Alaska, 33 exhibited various degrees of periodontal disease, which, in 25, resulted in tooth loss (Schwartz, unpublished data). Although extreme examples of tooth wear were prevalent in the sample, carious infection was noted in only one individual, in whom the lower central incisors (I¹s) had been affected. In the left I¹ infection had spread through the root's apex into the alveolar bone, causing an abscess. The buccal (labial) side of the root of this tooth, just below the crown, bears a shallow, relatively flat-bottomed depression, with a small perforation into, as well as a second hole that fully penetrates, the root canal. Both of these features appear to have been produced by an implement, and, as they are associated with a diseased tooth, and ritualistic tooth shaping or drilling of any sort was, and is, not practiced among Arctic groups, their purpose was probably therapeutic. As such, this specimen appears to represent a case of precontact New World Arctic dentistry. © 1995 Wiley-Liss, Inc.     

Song post exposure, song features, and predation risk

Male birds use song to attract mates and deter other males,but in doing so, they also attract the attention of predatorsand parasites. Such viability costs are inherent in reliablesignals, potentially causing females to prefer mates that displayfrom the most exposed sites. However, viability costs of sexualsignals may be ameliorated by affecting the choice of microhabitat,which in turn may affect the design of song features that aremost efficiently transmitted in this microhabitat. We estimatedthe exposure of song posts (microsites used by males when singing)used by passerine birds in relation to prey selection by thesparrowhawk Accipiter nisus, by calculating the proportion ofmales that sang from song posts that were at the maximum levelof the vegetation, in an attempt to quantify the costs of sexualselection. We quantified prey susceptibility to predation asthe difference between the log-transformed observed number ofprey minus the log-transformed expected number of prey in theenvironment. This prey susceptibility index increased with increasingsong post exposure similarly in sexually dichromatic and monochromaticspecies, although the prey susceptibility index was relatedto sexual dichromatism. Song post exposure was dependent onhabitat, but comparative models controlling for the potentiallyconfounding effects of habitat, sexual dichromatism, hole nesting,coloniality, body mass, cognitive capacities, and flying abilitiesindicated that the relationship between the prey susceptibilityindex and song post exposure is strong. Path analyses of therelationship between song post exposure, sexual dichromatism,and prey susceptibility index revealed that selection actingon sexual dichromatism and song post exposure has secondaryimpact on prey susceptibility index. The opposite causal mechanismsby which predation affects sexual traits are less likely. Thesemodels suggest that female preference for high song posts ordichromatic plumage increases predation risk on an evolutionarytime scale.