3D-finite element analyses of cusp movements in a human upper premolar, restored with adhesive resin-based composites

The combination of diverse materials and complex geometry makes stress distribution analysis in teeth very complicated. Simulation in a computerized model might enable a study of the simultaneous interaction of the many variables. A 3D solid model of a human maxillary premolar was prepared and exported into a 3D-finite element model (FEM). Additionally, a generic class II MOD cavity preparation and restoration was simulated in the FEM model by a proper choice of the mesh volumes. A validation procedure of the FEM model was executed based on a comparison of theoretical calculations and experimental data. Different rigidities were assigned to the adhesive system and restorative materials. Two different stress conditions were simulated: (a) stresses arising from the polymerization shrinkage and (b) stresses resulting from shrinkage stress in combination with vertical occlusal loading. Three different cases were analyzed: a sound tooth, a tooth with a class II MOD cavity, adhesively restored with a high (25 GPa) and one with a low (12.5GPa) elastic modulus composite. The cusp movements induced by polymerization stress and (over)-functional occlusal loading were evaluated. While cusp displacement was higher for the more rigid composites due to the pre-stressing from polymerization shrinkage, cusp movements turned out to be lower for the more flexible composites in case the restored tooth which was stressed by the occlusal loading.This preliminary study by 3D FEA on adhesively restored teeth with a class II MOD cavity indicated that Young's modulus values of the restorative materials play an essential role in the success of the restoration. Premature failure due to stresses arising from polymerization shrinkage and occlusal loading can be prevented by proper selection and combination of materials.     

Asymptotic analysis of the stress field in adhering dental restorations

Polymer-based composites are widely used in restorative dentistry as alternatives to metals and ceramics to fill cavities in teeth. They adhere to the walls of the cavity in the tooth, thus forming a composite body consisting of dentine, enamel, and composite resin. Geometric discontinuities along the interfaces between these materials can induce singularities in the stress field, which in turn lead to premature failure of the restoration. In the present investigation, a complex stress function technique is employed to derive the order of the stress singularity. It is shown that the order of the singularity depends on both the material properties of the restorative material and the local geometry of the cavity. It is also shown that the singularity in the stress field can be avoided through careful design of the cavity shape. The results presented correlate well with experimental results reported in the literature.     

The effect of unerupted permanent tooth crowns on the distribution of masticatory stress in children

Human mothers wean their children from breast milk at an earlier developmental stage than do ape mothers, resulting in human children chewing solid and semi-solid foods using the deciduous dentition. Mechanical forces generated by chewing solid foods during the post-weaning period travel through not only the deciduous teeth, but also the enamel caps of the developing permanent teeth within the maxilla and mandible, which are not present in the adult face. The effects of mechanical stress propagating through these very stiff structures have yet to be examined. Based on a heuristic model, we predicted that the enamel of the embedded developing teeth would act to reduce stresses in the surrounding bony elements of the juvenile face. We tested this hypothesis by simulating occlusal loading in a finite element (FE) model of a child's cranium with a complete set of deciduous teeth and the first permanent molars embedded in the bony crypt in the maxilla. We modeled bone and enamel with appropriate material properties and assessed the effect of embedding high-stiffness enamel structures on stress distribution in the juvenile face. Against expectation, the presence of unerupted enamel caps does not affect the magnitude or location of stresses in the juvenile face. Our results do not support the hypothesis that the unerupted secondary teeth act to moderate stresses in the juvenile face.     

Postcanine microstructure in Cricodon metabolus,a Middle Triassic gomphodont cynodont from south‐eastern Africa

Cricodon metabolus is a trirachodontid cynodont from the Anisian (Middle Triassic) of eastern and southern Africa. It has labiolingually expanded (gomphodont) postcanines but also a sectorial tooth in the last postcanine locus. In this paper, we examine the crown microstructure of isolated sectorial and gomphodont postcanines belonging to the holotype specimen of this taxon using scanning electron microscopy. The enamel of both teeth is prismless and composed of discontinuous columnar divergence units, supporting the consistent presence of synapsid columnar enamel in cynognathians. Abundant tubules and numerous irregularly spaced incremental lines are also visible in the enamel and dentine layers in each tooth. This study reveals that the enamel thickness varies along the tooth row in Cricodon as the enamel layer of the gomphodont postcanines is 11.5 times thicker than that of the sectorial crown. It is likely that this difference reflects occlusal stresses and fewer replacements in gomphodont postcanines relative to sectorial teeth. Approximately 100 incremental growth lines of von Ebner are present in the dentine layer, indicating that the deposition of the dentine by odontoblasts occurred for three months before the animal's death.     

Enlarged occlusal surfaces on first molars due to severe attrition and hypercementosis: examples from prehistoric coastal populations of Texas

During an examination of prehistoric samples from the Texas coast, individuals consistently exhibited a suite of traits on the first molars that included severe wear, hypercementosis, and resorption of the buccal margin of the alveolus. The occlusal surface of the tooth was worn below the cervical margin, with the subsequent incorporation of the buccal surface of the buccal roots into the occlusal plane. This expanded occlusal surface, which extends the buccal surface beyond the normal edge of the tooth, is composed of a combination of original enamel, secondary dentin, and cementum. There is a marked rounding of the buccal aspect of the occlusal surface. These conditions were noted in both maxillary and mandibular first molars. The resorption of alveolar bone surrounding the buccal roots resembles resorption associated with periodontal infection and is thought to be the result of severe levels of stress being applied to this portion of the dentition.     

Biomechanical behaviour of modern human molars: Implications for interpreting the fossil record

Finite-element models of 29 intact molars were created and subjected to cleavage-type loads in order to assess differences in the biomechanical behaviour of molars. A simulated food particle, which was one-third the size of the intercuspal distance and had the properties of a Mezzettia seed, was pushed onto the occlusal basin of these models at various angles, resulting in either both or one particular cusp being preferentially loaded. In all cases, the maximum tensile stresses occurred in enamel at the intercuspal fissure. With regard to first maxillary molars, supporting (functional) and guiding (nonfunctional) cusps apparently dissipate loads equally well, whereas, in second and third maxillary molars, the guiding cusps are better designed to resist loads. Overall, lingual cusps of maxillary posterior molars dissipate loads poorly. Conversely, loads exerted toward supporting cusps of mandibular molars are consistently well dissipated, regardless of position along the tooth row. Because the directions of loads to which these teeth are best adapted change along the tooth row, it seems reasonable to suggest that these may correlate with the well-documented structural and functional orofacial complex. This study indicates that the biomechanical behaviour of molars and the orofacial skeleton are likely to have undergone complementary directional changes during evolution. Consequently, caution must be exercised in making inferences about dietary adaptations of extinct species on the basis of isolated teeth or fragmentary gnathic remains without proper regard of the orofacial skeleton as a whole. Am J Phys Anthropol 106:467–482, 1998. © 1998 Wiley-Liss, Inc.     

Hunter-Schreger band orientation in interproximal enamel of modern human molars with complex morphological traits

A recent paper concerning characteristic groove-shaped wear in interproximal attritional facets of Neandertal posterior teeth correlated groove formation with deep enamel structural traits (Villa & Giacobini, 1995). Further studies were carried out on modern human teeth in order to evaluate a possible correlation between deep enamel structure and some crown complex morphological features. Seventy-five isolated molars from medieval and recent ossuaries as well as five molars recently extracted for therapeutic purpose were examined using scanning electron and optic microscope ground sections of interproximal enamel. The results showed possible correlations between deep enamel structural characteristics (i.e., Hunter-Schreger band verticalization) and some crown complex traits (i.e., occlusal groove pattern, mesial and distalfovea, mesial and distal accessory tubercules, interproximal marginal ridges). Observations reported in this study showed a significantly higher frequency of Hunter-Schreger band verticalization in lower molars with an occlusal complex pattern (i.e. primitive fissure pattern “Y” or “+”). This observation suggests a positive correlation among crown complex traits (which occur frequently in Neandertal teeth) with deep enamel structural characteristics. In addition, analysis of teeth grouped according to individual showed crown morphological traits and deep enamel structural characteristics corresponding to the same individual. This observation supports a genetic basis in occlusal shape and microstructural dental traits.     

牙体预备对高嵌体修复下颌第一磨牙力学影响的初步研究

目的：通过有限元法,探讨高嵌体修复根管治疗后的下颌第一磨牙后,牙体预备形式对牙体组织受力的影响,为临床提供力学理论依据。方法：模拟右侧下颌第一磨牙的三维有限元模型,磨牙存在合面I类洞缺损,根管治疗后采用高嵌体修复,分别设计三种牙体预备形式,即覆盖全部牙尖、覆盖全部功能尖和覆盖部分功能尖的高嵌体修复,对模型进行加载,观察牙体组织的应力大小及分布。结果：覆盖全部牙尖高嵌体修复时牙釉质出现一个应力集中区,其他两种设计出现两个应力集中区。垂直载荷下,釉质的最大主应力在全部牙尖组分别低于其他两组92．29％和89．76％;舌颊向载荷下比其他两组分别降低80．91％和76．53％。三组牙本质的应力集中区趋于一致。垂直载荷下,牙本质的最大主应力在全部牙尖组分别高出其他两组12．92％和14．73％;舌颊向载荷下较其他两组高1．26％和5．08％。结论：从生物力学角度,覆盖全部牙尖的高嵌体更有利于牙体硬组织的受力,可以更好的对牙釉质起到保护作用。     

Finite element analysis of stress distribution in intact and porcelain veneer restored teeth

The aim of this study was to investigate the stress distribution generated in a veneer restoration of an upper central incisor compared to intact teeth using the finite element analysis after applying a lingual buccal loading at the incisal edge. Methods: Two models were developed: one model contained enamel, dentine, cementum, periodontal ligament, cortical and trabecullar bones, and the other model was a veneer restoration; both models were developed using MSC/Nastran software (MacNeal-Schwendler Corporation, Los Angeles, CA, USA) as the pre- and post-processor. A 10-N load was applied at the incisal edge from the lingual to the buccal side to simulate oral conditions in this area (protrusion). Results: Von Mises stresses were then analysed for three different regions: A-B (enamel elements under the veneer or second enamel layer), A'-B' (buccal enamel and/or veneer element layer) and C-D (lingual enamel elements layer). A higher stress mode was observed for both models at the lingual cervical region. Conclusions: The presence of a veneer restoration on the incisors is a good alternative to mimic the behaviour of enamel under protrusion loading conditions. The use of veneers to replace enamel during rehabilitations is recommended.     

Enamel thickness and the helicoidal occlusal plane

In the present study 38 unworn maxillary molars (M¹ = 16, M²= 12, M³ = 10) of modern humans from a Slavic necropolis were sectioned through the mesial cusps in a plane perpendicular to the cervical margin of the crown. Five slightly worn M¹s and one slightly worn M³ were also used thus increasing the total sample to 44, but measurements made on the worn areas were coded as missing values. Seven measurements of enamel thickness as well as the heights of the protocone and the paracone dentine horns were recorded in order to analyze whether changes in these dimensions in anteroposterior direction can be related to the helicoidal occlusal plane. Uni- and multivariate analyses revealed that the distribution of enamel thickness within and between maxillary molars corresponds to a helicoidal occlusal wear pattern. Enamel thickness along the occlusal basin increases from anterior to posterior, which may lead to rapid development of a reverse curve of Monson in first molars when compared to posterior teeth. However, although these overall differences together with the serial, especially delayed eruption pattern of human molars, contribute to the marked expression of the helicoidal occlusal plane in Homo, differences in enamel patterning between molars indicate that a helicoidal plane is a structural feature of the orofacial skeleton. In contrast to first upper molars, second and third molars show absolutely and relatively thicker enamel under the Phase I wear facet of the paracone, i. e., the lingual slope of the paracone, than under the Phase II facet of the protocone, i. e., the buccal slope of that cusp. These proportional differences are most pronounced in M³, as evidenced by uni- and multivariate statistics. It thus appears that the pattern of enamel thickness distribution from M¹ to M³ follows a trend towards providing additional tooth material in areas that are under greater functional demands, that is, corresponding to a lingual slope of wear anteriorly and to a flat or even buccal one posteriorly. In addition, the heights of the dentine horns in anteroposterior direction change in a way that lends support to the hypothesis that the axial inclination of teeth could be one of the most important factors for the development of the helicoidal occlusal plane. Finally, the changes in morphology and enamel thickness distribution from first to third upper molars found in this study suggest that molars could be “specialized” in their function, i. e., from performing proportionally more shearing anteriorly to increased crushing and grinding activities posteriorly. © 1994 Wiley-Liss, Inc.     

Stress analysis of irradiated human tooth enamel using finite element methods

The objectives of this project were to use finite element methods to determine how changes in the elastic modulus due to oral cancer therapeutic radiation alter the distribution of mechanical stresses in teeth and to determine if observed failures in irradiated teeth correlate with changes in mechanical stresses. A thin slice section finite element (FE) model was constructed from micro CT sections of a molar tooth using MIMICS and 3-Matic software. This model divides the tooth into three enamel regions, the dentin-enamel junction (DEJ) and dentin. The enamel elastic modulus was determined in each region using nano indentation for three experimental groups namely – control (non-radiated), in vitro irradiated (simulated radiotherapy following tooth extraction) and in vivo irradiated (extracted subsequent to oral cancer patient radiotherapy) teeth. Physiological loads were applied to the tooth models at the buccal and lingual cusp regions for all three groups (control, in vitro and in vivo). The principal tensile stress and the maximum shear stress were used to compare the results from different groups since it has been observed in previous studies that delamination of enamel from the underlying dentin was one of the major reasons for the failure of teeth following therapeutic radiation. From the FE data, we observed an increase in the principal tensile stress within the inner enamel region of in vivo irradiated teeth (9.97 ± 1.32 MPa) as compared to control/non-irradiated teeth (8.44 ± 1.57 MPa). Our model predicts that failure occurs at the inner enamel/DEJ interface due to extremely high tensile and maximum shear stresses in in vivo irradiated teeth which could be a cause of enamel delamination due to radiotherapy.     

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.     

Variation in enamel development of South African fossil hominids

Dental tissues provide important insights into aspects of hominid palaeobiology that are otherwise difficult to obtain from studies of the bony skeleton. Tooth enamel is formed by ameloblasts, which demonstrate daily secretory rhythms developing tissue-specific structures known as cross striations, and longer period markings called striae of Retzius. These enamel features were studied in the molars of two well known South African hominid species, Australopithecus africanus and Paranthropus robustus. Using newly developed portable confocal microscopy, we have obtained cross striation periodicities (number of cross striations between adjacent striae) for the largest sample of hominid teeth reported to date. These data indicate a mean periodicity of seven days in these small-bodied hominids. Important differences were observed in the inferred mechanisms of enamel development between these taxa. Ameloblasts maintain high rates of differentiation throughout cervical enamel development in P. robustus but not in A. africanus. In our sample, there were fewer lateral striae of Retzius in P. robustus than in A. africanus. In a molar of P. robustus, lateral enamel formed in a much shorter time than cuspal enamel, and the opposite was observed in two molars of A. africanus. In spite of the greater occlusal area and enamel thickness of the molars of both fossil species compared with modern humans, the total crown formation time of these three fossil molars was shorter than the corresponding tooth type in modern humans. Our results provide support for previous conclusions that molar crown formation time was short in Plio-Pleistocene hominids, and strongly suggest the presence of different mechanisms of amelogenesis, and thus tooth development, in these taxa.     

Measurements of tooth wear among Australian Aborigines: I. Serial loss of the enamel crown

The dental casts made from Aboriginal children during the course of a longitudinal growth study in Central Australia provided material for analyzing tooth wear under known environmental conditions. The wear facets produced on the occlusal surfaces were clearly preserved on the dental stone casts and recorded the progress of enamel attrition from ages 6 to 18. These casts were photographed and traced by electronic planimetric methods that automatically recorded the location and size of wear facets on the first and second permanent molars. These areas of worn tooth surface were compared to the total tooth surface. The worn surface was regressed on age to calculate wear rates of each tooth. Discriminant analyses were also performed to determine the significance of dental attrition differences between the sexes at each age group. The total wear on each tooth was highly correlated with age as expected but females wore their teeth at a significantly higher rate than males. The mandibular molars wore more rapidly than maxillary teeth in both sexes. The discriminant analysis successfully grouped 91% of the cases according to age and sex. Pattern of wear, the location, and size of wear facets also differed between age groups and sex. The questions of why there is a difference between male and female wear or why there is greater wear on one arch or arch region have no ready answers. The differing rates and pattern of dental wear do suggest that arch shape and growth rates may be the answer though it has yet to be tested. However, the occlusal surface wear is useful for age estimation in a population and provides a record of shifting masticatory forces during growth.     

Finite element analysis of stress distribution in intact and porcelain veneer restored teeth

The aim of this study was to investigate the stress distribution generated in a veneer restoration of an upper central incisor compared to intact teeth using the finite element analysis after applying a lingual buccal loading at the incisal edge. Methods: Two models were developed: one model contained enamel, dentine, cementum, periodontal ligament, cortical and trabecullar bones, and the other model was a veneer restoration; both models were developed using MSC/Nastran software (MacNeal-Schwendler Corporation, Los Angeles, CA, USA) as the pre- and post-processor. A 10-N load was applied at the incisal edge from the lingual to the buccal side to simulate oral conditions in this area (protrusion). Results: Von Mises stresses were then analysed for three different regions: A-B (enamel elements under the veneer or second enamel layer), A′-B′ (buccal enamel and/or veneer element layer) and C-D (lingual enamel elements layer). A higher stress mode was observed for both models at the lingual cervical region. Conclusions: The presence of a veneer restoration on the incisors is a good alternative to mimic the behaviour of enamel under protrusion loading conditions. The use of veneers to replace enamel during rehabilitations is recommended.     

Mastication and enamel microstructure in <Emphasis Type="Italic">Cambaytherium</Emphasis>, a perissodactyl-like ungulate from the early Eocene of India

The dentition of Cambaytherium was investigated in terms of dental wear, tooth replacement and enamel microstructure. The postcanine tooth row shows a significant wear gradient, with flattened premolars and anterior molars at a time when the last molars are only little worn. This wear gradient, which is more intensive in Cambaytherium thewissi than in Cambaytherium gracilis, and the resulting flattened occlusal surfaces, may indicate a preference for a durophagous diet. The tooth replacement (known only in C. thewissi) shows an early eruption of the permanent premolars. They are in function before the third molars are fully erupted. During the dominant phase I of the chewing cycle the jaw movement is very steep, almost orthal, with a slight mesiolingual direction and changes into a horizontal movement during phase II. The enamel microstructure shows Hunter-Schreger-bands (HSB) in the inner zone of the enamel. In some teeth the transverse orientation of the HSB is modified into a zig-zag pattern, possibly an additional indicator of a durophagous diet.     

Insights from stable light isotopes on enamel defects and weaning in Pliocene herbivores

A high prevalence of enamel hypoplasia in several herbivores from the early Pliocene Langebaanweg locality, South Africa, indicates general systemic stress during the growing years of life. The presence of several linear enamel hypoplasias per tooth crown in many teeth further suggest that these stress events may be episodic. The δ¹⁸O values along tooth crowns of mandibular second molars ofSivatherium hendeyi (Artiodactyla, Giraffidae) were used to investigate the cause of the stress events in this tooth type. Results show that weaning in this fossil giraffid occurred at a similar ontogenetic age to that in extant giraffes, and that the observed enamel hypoplasia towards the base of this tooth type manifested post-weaning. Further, high-resolution oxygen isotope analyses acrossS. hendeyi third molars suggest that the entire development of defective tooth crowns occurred under conditions of increased aridity in which the cool, rainy part of the seasonal cycle was missing. The high prevalence of this defect in many herbivores suggests that climatic conditions were not favourable. This study reiterates the value of stable isotope analyses in determining both the behaviour of fossil animals and the environmental conditions that prevailed during tooth development.     

To What Extent is Primate Second Molar Enamel Occlusal Morphology Shaped by the Enamel-Dentine Junction?

The form of two hard tissues of the mammalian tooth, dentine and enamel, is the result of a combination of the phylogenetic inheritance of dental traits and the adaptive selection of these traits during evolution. Recent decades have been significant in unveiling developmental processes controlling tooth morphogenesis, dental variation and the origination of dental novelties. The enamel-dentine junction constitutes a precursor for the morphology of the outer enamel surface through growth of the enamel cap which may go along with the addition of original features. The relative contribution of these two tooth components to morphological variation and their respective response to natural selection is a major issue in paleoanthropology. This study will determine how much enamel morphology relies on the form of the enamel-dentine junction. The outer occlusal enamel surface and the enamel-dentine junction surface of 76 primate second upper molars are represented by polygonal meshes and investigated using tridimensional topometrical analysis. Quantitative criteria (elevation, inclination, orientation, curvature and occlusal patch count) are introduced to show that the enamel-dentine junction significantly constrains the topographical properties of the outer enamel surface. Our results show a significant correlation for elevation, orientation, inclination, curvature and occlusal complexity between the outer enamel surface and the enamel dentine junction for all studied primate taxa with the exception of four modern humans for curvature (p<0.05). Moreover, we show that, for all selected topometrical parameters apart from occlusal patch count, the recorded correlations significantly decrease along with enamel thickening in our sample. While preserving tooth integrity by providing resistance to wear and fractures, the variation of enamel thickness may modify the curvature present at the occlusal enamel surface in relation to enamel-dentine junction, potentially modifying dental functionalities such as blunt versus sharp dental tools. In terms of natural selection, there is a balance between increasing tooth resistance and maintaining efficient dental tools. In this sense the enamel cap acts as a functional buffer for the molar occlusal pattern. In primates, results suggest a primary emergence of dental novelties on the enamel-dentine junction and a secondary transposition of these novelties with no or minor modifications of dental functionalities by the enamel cap. Whereas enamel crenations have been reported by previous studies, our analysis do not support the presence of enamel tubercles without dentine relief nuclei. As is, the enamel cap is, at most, a secondary source of morphological novelty.