3-D stress analysis in first maxillary premolar

The aim of this study was to investigate the stress distribution in a 3-D model of two-rooted tooth (first maxillary premolar) under two different occlusal force vectors by using finite element analysis. In the first model overall force of 200 N was divided into three vectors (cusp to fossa occlusion), and in the second model overall force was divided into 4 vectors (cusp to fossa and cusp to marginal ridge occlusion). The greatest compressive stress was found at the dentino- enamel junction in the cervical area of the both models (about -200 MPa). The greatest tensile stress was found at the vestibular aspect of buccal cusp in second model (about +3 MPa) and in the central fossa of the both models (about +28 MPa). Results indicate that in the both types of occlusal loadings the stress distribution was mainly compression and compressive forces were predominant over tensile stresses. In the second model with 4 vectors, stresses generated in the tooth structure were higher compared to the stresses generated in the first model with 3 vectors.     

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.     

下颌起排法全口排牙临床效果研究

目的:研究通过比较不同的排牙方式制作的全口义齿对咀嚼次数、咀嚼效率以及患者的主观感受的影响。方法:78例无牙颌患者按照牙槽嵴高度分为正常组和低平组,正常组有患者32例,低平组有患者46例,每组分别戴用上颌起排法和下颌起排法制作的全口义齿,比较咀嚼次数、咀嚼效率和满意度的差别。结果:在戴用上颌起排法制作的全口义齿时,正常组的咀嚼次数高于低平组,差异具有统计学意义(t=3.60,P0.05);戴用下颌起排法制作的全口义齿后,低平组的咀嚼次数高于采用上颌起排法的全口义齿,差异具有统计学意义(t=4.41,P0.05);在戴用上颌起排法制作的全口义齿中,正常组的咀嚼效率高于低平组,差异具有统计学意义(t=5.72,P0.05);而在戴用下颌起排法制作的全口义齿后,低平组的咀嚼效率高于采用上颌起排法的全口义齿,差异具有统计学意义(t=7.16,P0.05)。正常组认为使用下颌起排法制作全口义齿咀嚼能力、稳固感好于上颌起排法,差异均具有统计学意义(P0.05);低平组认为使用下颌起排法制作全口义齿咀嚼能力、稳固感和舒适感好于上颌起排法,差异均具有统计学意义(P0.05)。结论:对于牙槽嵴低平无牙颌患者使用下颌起排法制作的全口义齿,能够有效地增强咀嚼效率,提高义齿的稳定性。     

Three-dimensional finite element analysis of glass-ceramic dental crowns

Because of the improved esthetic potential of glass-ceramic crowns as dental restorations, they are sometimes preferred over metal-ceramic crowns for restoration of anterior teeth. Because of their relatively high strength, these ceramic crowns are also frequently used for restoration of posterior teeth. However, due to the larger magnitude of biting forces on posterior teeth, intraoral fracture of all-ceramic crowns tends to occur more frequently in posterior crowns (Moffa, 1988). The objective of this study was to determine the relative influence of load orientation and the occlusal thickness of posterior ceramic crowns on the stress distribution which develops under these loading and design conditions. Three-dimensional finite element models for a molar crown were developed to determine the stress distribution under simulated applied loads. Glass-ceramic crowns with occlusal thicknesses of 0.5, 1.5, and 3.0 mm were considered. The largest principal tensile stresses induced in ceramic due to a distributed load of 600 N applied in a cuspal region were approximately 12 and 182 MPa for vertical and horizontal loading orientations, respectively. Stresses which developed in the facial and lingual marginal regions were primarily compressive under vertical loads. However, tensile stresses developed when the load was applied horizontally. Differences in stress distribution within crowns with the three occlusal thicknesses occurred only near the site of loading. Because of the relatively large failure rates of ceramic crowns in the posterior regions, these restorations should be strengthened by improvement in design, composition, and thermal processing conditions. Before any significant progress is made in these areas, these restorations should be used for the anterior teeth. The results of this study suggest that orientation of the applied load has a more important effect on development of large tensile stresses than the occlusal thickness of ceramic.     

The oral health‐related quality of life in edentulous patients treated with Conventional complete dentures

Objective: To compare the oral health‐related quality of life (OHRQoL) between patients with both maxillary and mandibular complete denture and those with either the maxillary or the mandibular complete denture. Background: Satisfaction of denture wearers can be estimated using the OHRQoL questionnaires like the OHIP‐EDENT and the Geriatric Oral Health Assessment Index (GOHAI). Methods: Two questionnaires were used to compare the OHRQoL between edentulous patients who had conventional removable complete denture on both jaws and those who had on either one of the jaws. Result: The age of the participants ranged from 42 to 75 years, with the mean age of 58 ± 8.12 years. The mean OHIP‐EDENT scores were significantly high among those who wore conventional dentures in both jaws (54.12 ± 5.21), compared with the participants who only had denture either on upper or lower jaw (46.52 ± 7.35). It was noticed that the mean GOHAI score was significantly lower (p < 0.05) among participants who had conventional denture on both upper and lower jaw (28.25 ± 3.67), as compared to those who had conventional denture only on one arch (35.12 ± 2.11). Conclusion: Patients with complete dentures in both jaw (Group I) were less satisfied than patients with single complete denture (Group II). The result obtained in this study shows dissatisfaction with conventional dentures among edentulous patients.     

Maxillary complete denture movement during chewing in mandibular removable partial denture wearers

Objectives: To evaluate the pattern of maxillary complete denture movement during chewing for free‐end removable partial dentures (RPD) wearers, compared to maxillary and mandibular complete denture wearers. Materials and methods: Eighteen edentulous participants (group I) and 10 volunteers with bilateral posterior edentulous mandibles (group II) comprised the sample. Measures of mean denture movement and its variability were obtained by a kinesiographic instrument K6‐I Diagnostic System, during the mastication of bread and a polysulphide block. Data were analysed using two‐way anova (α = 0.05). Results: Upper movement during chewing was significantly lower for group II, regardless of the test food. The test food did not influence the vertical or lateral position of the denture bases, but more anterior dislocation was found when polysulphide blocks were chewed. Group II presented lower intra‐individual variability for the vertical axis. Vertical displacement was also more precise with bread as a test food. Conclusion: It can be concluded that mandibular free‐end RPD wearers show smaller and more precise movements than mandibular complete denture wearers.     

Stress amplifications in dental non-carious cervical lesions

This study aims to investigate the influence of the presence, shape and depth of NCCLs on the mechanical response of a maxillary second premolar subjected to functional and non-functional occlusal loadings using 3-D finite element (FE) analysis. A three-dimensional model of a maxillary second premolar and its supporting bone was constructed based on the contours of their cross-sections. From the sound model, cervical defects having either V- or U-shapes, as found clinically, were subtracted in three different depths. The models were loaded with 105 N to simulate normal chewing forces according to a functional occlusal loading (F1) vertically applied and two non-functional loadings (F2 and F3) obliquely oriented. Two alveolar bone crest heights were tested. Ansys™ FE software was used to compute stress distributions and maximum principal stress for each of the models. The presence of a lesion had no effect on the overall stress distribution of the system, but affected local stress concentrations. Non-functional loadings exhibited tensile stresses concentrating at the cervical areas and root surfaces, while the functional loading resulted in homogeneous stress distributions within the tooth. V-shaped lesions showed higher stress levels concentrated at the zenith of the lesion, whereas in U-shaped defect stresses concentrated over a wider area. As the lesions advanced in depth, the stress was amplified at their deepest part. A trend of stress amplification was observed with decreasing bone height. These results suggest a non-linear lesion progression with time, with the progression rate increasing with patient's age (deeper lesions and lower bone support).     

Cephalometric evaluation of the changes in mandibular symphysis after 7 years of denture wearing

Objective: To evaluate changes in mandibular symphysis during 7 years of complete denture wearing following extraction of natural anterior teeth. Design: Comparison among measurements taken at four different occasions in a prospective cephalometric study. Setting: The study was conducted at the Dental School of Athens University. Subjects: 10 complete denture wearers (5 women, 5 men) with average age of 53.2 years, at the beginning of the study. Measures: Linear and area measurements of the mandibular symphysis. Results: The overall reduction in the anterior mandibular height was 7.87 mm and in the mandibular symphysis area 54.8 mm² (p<0.05). Females presented higher total average reduction in both variables tested, and more rapid bone loss during the first two years of denture wear, compared to men. Superimposition of the tracings revealed considerable individual variation in mandibular symphysis changes. Conclusion: Results are in line with the findings of other authors indicating continuous reduction and dramatic inter-subject variation in the mandibular alveolar bone, following extraction of natural teeth and wearing of complete dentures.     

Brief communication: comparing loading scenarios in lower first molar supporting bone structure using 3D finite element analysis

Finite element analysis (FEA) is a widespread technique to evaluate the stress/strain distributions in teeth or dental supporting tissues. However, in most studies occlusal forces are usually simplified using a single vector (i.e., point load) either parallel to the long tooth axis or oblique to this axis. In this pilot study we show how lower first molar occlusal information can be used to investigate the stress distribution with 3D FEA in the supporting bone structure. The LM₁ and the LP²‐LM¹ of a dried modern human skull were scanned by μCT in maximum intercuspation contact. A kinematic analysis of the surface contacts between LM₁ and LP²‐LM¹ during the power stroke was carried out in the occlusal fingerprint analyzer (OFA) software to visualize contact areas during maximum intercuspation contact. This information was used for setting the occlusal molar loading to evaluate the stress distribution in the supporting bone structure using FEA. The output was compared to that obtained when a point force parallel to the long axis of the tooth was loaded in the occlusal basin. For the point load case, our results indicate that the buccal and lingual cortical plates do not experience notable stresses. However, when the occlusal contact areas are considered, the disto‐lingual superior third of the mandible experiences high tensile stresses, while the medio‐lingual cortical bone is subjected to high compressive stresses. Developing a more realistic loading scenario leads to better models to understand the relationship between masticatory function and mandibular shape and structures. Am J Phys Anthropol, 2012. © 2011 Wiley Periodicals, Inc.     

Influence of different mucosal resiliency and denture reline on stress distribution in peri-implant bone tissue during osseointegration. A three-dimensional finite element analysis

doi: 10.1111/j.1741‐2358.2011.00569.x Influence of different mucosal resiliency and denture reline on stress distribution in peri‐implant bone tissue during osseointegration. A three‐dimensional finite element analysis Objective: The aim of this study was to evaluate the influence of mucosal properties and relining material on the stress distribution in peri‐implant bone tissue during masticatory function with a conventional complete denture during the healing period through finite element analysis. Materials and Methods: Three‐dimensional models of a severely resorbed mandible with two recently placed implants in the anterior region were created and divided into the following situations: (i) conventional complete denture and (ii) relined denture with soft lining material. The mucosal tissue properties were divided into soft, resilient and hard. The models were exported to mechanical simulation software; two simulations were carried out with a load at the lower right canine (35 N) and the lower right first molar (50 N). Data were qualitatively evaluated using Maximum Principal Stress, in MPa, given by the software. Results: All models showed stress concentrations in the cortical bone corresponding to the cervical part of the implant. The mucosal properties influenced the stress in peri‐implant bone tissue showing a different performance according to the denture base material. The simulations with relined dentures showed lower values of stress concentration than conventional ones. Conclusions: It seems that the mucosal properties and denture reline have a high influence on the stress distribution in the peri‐implant bone during the healing period.     

Eight-year mortality associated with dental occlusion and denture use in community-dwelling elderly persons

Objective: To evaluate the influence of dental occlusion, with or without the use of dentures, on mortality in community‐dwelling elderly persons. Subjects: A total of 1030 randomly selected healthy independent elderly aged 65 and over were surveyed in 1995. For the study reported here, subjects were classified into three groups according to the presence or absence of maxillo‐mandibular tooth contacts. Subjects with no maxillo‐mandibular tooth contacts were further subdivided into those with and without dentures. Methods: Data on mortality were obtained from Kure City Council in September 2003. Cox regression models were used in analysing the risk for death with gender and age as covariates. Results: Individuals whose teeth had contact in at least the bilateral premolar regions at baseline had 0.78 times (95% CI: 0.60–0.99) smaller risk for death during the succeeding 8 years than those who had no occlusion. Among those who had no occlusion with their own teeth, the risk for mortality among denture non‐users was 1.52 times (95% CI: 1.25–1.83) higher than the risk for denture users. Conclusion: These results may support the view that, in the elderly, poor dental occlusion is associated with an increased risk for mortality and that, in the edentulous, the use of dentures is associated with a decreased risk for mortality.     

Age-related variability in occlusal wear planes

Investigation of two populations of 136 individuals shows several patterns of occlusal wear plane change which are positively correlated with age. For individuals up to the age of 18, there is a characteristic pattern in which the occlusal wear planes of the mandibular teeth are lingually sloped and those of the maxillary dentition buccally sloped, with the exception of the maxillary premolars, which are also lingually sloped. The long axes of the mandibular teeth give them a lingual orientation relative to the maxillary teeth, and the long axes of the maxillary molars, by contrast, are buccally oriented. In the 18-30 age range for all sexes, the mandibular M1 becomes buccally sloped on its occlusal surface while the occlusal wear plane on the maxillary M1 becomes lingually sloped. Later age changes indicate a trend for the mandibular premolars to become buccally sloped, while the wear planes of the maxillary premolars remain lingually sloped. There is a corresponding tendency for the maxillary and mandibular second molars to undergo changes in the initial orientation of the occlusal wear planes.     

The effects of the periodontal ligament on mandibular stiffness: a study combining finite element analysis and geometric morphometrics

It is generally accepted that the periodontal ligament (PDL) plays a crucial role in transferring occlusal forces from the teeth to the alveolar bone. Studies using finite element analysis (FEA) have helped to better understand this role and show that the stresses and strains in the alveolar bone are influenced by whether and how PDL is included in FE models. However, when the overall distribution of stresses and strains in crania and mandibles are of interest, PDL is often not included in FE models, although little is known about how this affects the results. Here we study the effect of representing PDL as a layer of solid material with isotropic homogeneous properties in an FE model of a human mandible using a novel application of geometric morphometrics. The results show that the modelling of the PDL affects the deformation and thus strain magnitudes not only of the alveolar bone around the biting tooth, but that the whole mandible deforms differently under load. As a result, the strain in the mandibular corpus is significantly increased when PDL is included, while the strain in the bone beneath the biting tooth is reduced. These results indicate the importance of the PDL in FE studies. Thus we recommend that the PDL should be included in FE models of the masticatory apparatus, with tests to assess the sensitivity of the results to changes in the Young's modulus of the PDL material.     

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.     

In-vitro results of rapid maxillary expansion on adults compared with finite element simulations

This study was mainly performed to investigate the effects of high maxillary expansion forces on the skull with fresh and thiel-fixed human skulls. The maxillary suture was not weakened except in one experiment. This study compares the strain measured on the zygomatic process of the skull with the results of a finite element model generated for this purpose. An increasing transversal force was applied on the alveolar process (teeth) until rupture. Strain on the zygomatic process, maxilla displacement and the expanding forces were registered.The results of this study show linear material behaviour of the skull before rupture. The highest stress during the experiments and FE simulation was observed on the alveolar process.Conclusions of this study are the necessity of the existence of appropriate models and that female specimens seem to rupture at a lower force than male ones. Both male and female specimens show a similar linear behaviour in the force/strain curve within each gender group. The probability of maxillary suture opening in adults during ultra-rapid maxillary expansion with tooth anchorage is very low. Complications and unwanted rupture could occur.     

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.     

Compressive strains and displacement in a partially dentate lower jaw rehabilitated with two different treatment modalities

doi: 10.1111/j.1741‐2358.2011.00572.x Compressive strains and displacement in a partially dentate lower jaw rehabilitated with two different treatment modalities Background: Understanding of the biomechanical consequences of the stresses generated to the supporting bone during occlusal loading is significant for improving the design and clinical planning process in partial edentulism therapy. Objective: The aim of this study was to analyse the distribution of strain and displacement on the partially dentate lower jaw rehabilitated with an partial denture (RPD) and to compare it to the strain and displacement distribution on a partially dentate lower jaw rehabilitated with a cantilever fixed partial denture (FPD). Material and methods: The experimental models were a partially dentate mandible with full‐arch PFM crowns and RPD and a partially dentate mandible rehabilitated with a full‐arch cantilever FPD. Strains and displacement were measured using the Digital Image Correlation Method. Results: Displacement values of the first experimental model ranged from 0.31 to 0.54 mm with strains from 1.35 to 2.34%. Analysis of the second experimental model results showed displacement values from 0 to 0.34 mm, while strains were in the range of 0–1.40%. Conclusion: Higher displacements and strains of bone tissue were observed below the RPD, especially in the region of the distal abutment and distal portion of the free‐end saddle. Strains within bone and the bone‐denture contact area were mostly influenced by the teeth and denture vertical displacement.     

Brief communication: Identification reassessment of the isolated tooth Krapina D58 through occlusal fingerprint analysis

High variability in the dentition of Homo can create uncertainties in the correct identification of isolated teeth. For instance, standard tooth identification criteria cannot determine with absolute certainty if an isolated tooth is a second or third maxillary molar. In this contribution, using occlusal fingerprint analysis, we reassess the identification of Krapina D58 (Homo neanderthalensis), which is catalogued as a third maxillary molar. We have hypothesized that the presence/absence of the distal occlusal wear facets can be used to differentiate second from third maxillary molars. The results obtained confirm our hypothesis, showing a significant difference between second and third maxillary molars. In particular we note the complete absence of Facets 7 and 10 in all third molars included in this analysis. The presence of these facets in Krapina D58 eliminates the possibility that it is a third maxillary molar. Consequently it should be reclassified as a second molar. Although this method is limited by the degree of dental wear (i.e., unworn teeth cannot be analyzed) and to individual molars in full occlusion, it can be used for tooth identification when other common criteria are not sufficient to discriminate between second and third maxillary molars. Am J Phys Anthropol 143:306–312, 2010. © 2010 Wiley‐Liss, Inc.     

Malocclusion in the Kwaio, a Melanesian group on Malaita, Solomon Islands

In the present investigation, a number of occlusal variables which contribute to malocclusion were quantified among the Kwaio people of Malaita, Solomon Islands. Angle classification, overjet, overbite, openbite, crossbite, rotation, crowding, and spacing were assessed from dental casts of 180 persons (94 males, 86 females) who had complete permanent dentitions anterior to the first molar. Males had significantly more overjet and mandibular incisor crowding than females, and significantly less posterior openbite and mandibular canine-premolar spacing. The frequency of openbite, rotation of maxillary teeth, and crowding of anterior teeth increased with advancing age. The frequency of posterior crowding decreased after age 30. Spacing, in general, increased with advancing age. In the distribution of the Angle classes of occlusion, the Kwaio resembled Australian aborigines living in technologically primitive circumstances.     

Effect of double flasking and investing methods on artificial teeth movement in complete dentures processing

doi: 10.1111/j.1741‐2358.2011.00494.x
Effect of double flasking and investing methods on artificial teeth movement in complete dentures processing Purpose: The aim of this study was to evaluate linear dimensional alterations of artificial teeth for complete dentures when using different investment and flasking techniques. Background: Dimensional changes in the vertical dimension may occur owing to changes in artificial teeth positioning caused by different investing and flasking techniques. Materials and methods: Thirty pairs of the complete dentures were manufactured and randomly divided into three groups (n = 10): (1) invested with type III stone in monomaxillary PVC flask; (2) invested with type III stone in bimaxillary PVC flask; and (3) invested with laboratory silicone in bimaxillary PVC flask. Dentures were polymerised by microwave, and 12 linear distances were measured before and after denture processing. Data were analysed by one‐way anova , considering manufacturing technique as the study factor. Tukey’s HSD was used as post hocanova (p = 0.05). Results: Most of the linear distances were comparable for all groups. All transversal maxillary and mandibular distances were higher for group 1 compared with groups 2 and 3 (p < 0.05), except the distance 3–6 for mandibular arch, in which no difference was found between groups (p < 0.05). Both maxillary diagonal distances were higher in group 1 (p < 0.05), and no differences were found among all groups for mandibular measurements. Conclusions: Double flasking technique independent on the investment material is shown to be the most effective method to reduce changes in artificial teeth positioning.