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.     

Probabilistic fatigue analysis of all-ceramic crowns based on the finite element method

The reliability evaluation and lifetime prediction of oral restorations for dentists have always been the major concern in the field of prosthodontics. This study introduced a new methodology for dealing with stress–strength interference and an analysis to quantify the reliability of all-ceramic crowns. The response stress was based on finite element models of all-ceramic crowns, which were constructed by reverse techniques. The method utilized in this study was a probabilistic analysis that considered the all-ceramic crown as a structural component associated with multiple factors involved in the all-ceramic system including occlusal loads and mechanical properties of porcelain. The results suggested the survival probability of all-ceramic crowns after 1, 5, 10, 15, and 20 years could be computed to be 98.89%, 98.03%, 97.50%, 97.13%, and 96.93%, respectively. Probabilistic analysis methods offer a systematic technique to incorporate and account for the nature of uncertainty in ceramic restorations and allow prediction of the reliability of all-ceramic crowns under cyclic occlusal loads with accuracy.     

Contact fracture of full-ceramic crowns subjected to occlusal loads

The mechanisms contributing to failure of full dental ceramic crowns under occlusal loads were studied using a unique optical approach. Model specimens comprising triple-layered crowns (veneer, core and substrate) were developed with both flat and curved occlusal surfaces and then subjected to simulated quasi-static occlusal loading using a spherical indenter. Deformation within the specimens during loading was analyzed by means of digital image correlation (DIC). Finite element models were also developed and used to examine the mechanics of contact. Results of the experiments with flat dental crowns indicated three typical modes of failure, i.e. cone cracks, plastic yielding and radial cracks. Fracture of the specimens with curved dental crowns was complicated by contributions from competing and multiple modes of failure. Both experimental and numerical results conclude that the dominant fracture mode in the full-ceramic crowns was radial cracking in the core beneath the contact area. However, displacement fields obtained using DIC showed that debonding developed near the shoulder of the crown, particularly during off-axis loading, and initiated under substantially lower occlusal loads than those required for crack initiation.     

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.     

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.     

Direct restorative treatment of anterior weared teeth after re‐establishment of occlusal vertical dimension: a case report

doi: 10.1111/j.1741‐2358.2012.00630.x Direct restorative treatment of anterior weared teeth after re‐establishment of occlusal vertical dimension: a case report Objective: The loss of posterior teeth resulting in a lack of stability may lead to excessive mandibular load on some points of occlusion of the remaining teeth, causing wear. The rehabilitation of these cases must be carefully planned and the treatment requires a period of adaptation with a new vertical dimension. Background: This case report describes the treatment of a patient with a loss of almost all posterior inferior teeth and a consequential loss of occlusal vertical dimension and accentuated wear of anterior elements. Materials and methods: Provisional removable partial dentures were manufactured and the patient used them for a period of adaptation prior to restoration of the anterior teeth. After the patient’s adaptation with the new occlusal dimension, anterior restorations were made using a mycrohibrid resin composite with different color aspects for an optimal stratification. Results: The restorations achieved an aesthetic configuration with ideal function as the final result and the occlusion showed a satisfactory stability for a provisional removable partial dentures. Conclusion: This article presents an anterior direct rehabilitation approach not only as an alternative option, but also as viable and less expensive treatment option with an optimally aesthetic and functional result.     

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.     

Viscoelastic finite element analysis of an all-ceramic fixed partial denture

In recent years metal-free ceramic systems have become increasingly popular in dental practice because of their superior aesthetics, chemical durability and biocompatibility. Recently, manufacturers have proposed new dental ceramic systems that are advertised as being suitable for posterior fixed partial dentures (FPDs). Reports indicate that some of these systems have exhibited poor clinical performance. The objective of this study was to use the viscoelastic option of the ANSYS finite element program to calculate residual stresses in an all-ceramic FPD for four ceramic-ceramic combinations. A three-dimensional finite element model of the FPD was constructed from digitized scanning data and calculations were performed for four systems: (1) IPS Empress 2, a glass-veneering material, and Empress 2 core ceramic; (2) IPS Eris a low fusing fluorapatite-containing glass-veneering ceramic, and Empress 2 core ceramic; (3) IPS Empress 2 veneer and an experimental lithium-disilicate-based core ceramic; and (4) IPS Eris and an experimental lithium-disilicate-based core ceramic. The maximum residual tensile stresses in the veneer layer for these combinations are as follows: (1) 77 MPa, (2) 108 MPa, (3) 79 MPa, and (4) 100 MPa. These stresses are relatively high compared to the flexural strengths of these materials. In all cases, the maximum residual tensile stresses in the core frameworks were well below the flexural strengths of these materials. We conclude that the high residual tensile stresses in all-ceramic FPDs with a layering ceramic may place these systems in jeopardy of failure under occlusal loading in the oral cavity.     

The use of functionally graded dental crowns to improve biocompatibility: a finite element analysis

In post-core crown restorations, the significant mismatch between stiffness of artificial crowns and dental tissues leads to stress concentration at the interfaces. The aim of the present study was to reduce the destructive stresses by using a class of inhomogeneous materials called functionally graded materials (FGMs). For the purpose of the study, a 3-dimentional computer model of a premolar tooth and its surrounding tissues were generated. A post-core crown restoration with various crown materials, homogenous and FGM materials, were simulated and analyzed by finite element method. Finite element and statistical analysis showed that, in case of oblique loading, a significant difference (p < 0.05) was found at the maximum von Mises stresses of the crown margin between FGM and homogeneous crowns. The maximum von Mises stresses of the crown margin generated by FGM crowns were lower than those generated by homogenous crowns (70.8 vs. 46.3 MPa) and alumina crown resulted in the highest von Mises stress at the crown margin (77.7 MPa). Crown materials of high modulus of elasticity produced high stresses at the cervical region. FGM crowns may reduce the stress concentration at the cervical margins and consequently reduce the possibility of fracture.     

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.     

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.     

Two-dimensional finite element analysis of stresses developed in the supporting tissues under complete dentures using teeth with different cusp angulations

Statement of problem: The selection of appropriate teeth for complete denture occlusion is very important for long‐term success, and adequate maintenance of the residual alveolar ridge. Purpose: The purpose of this study was to determine the stress generated underneath the complete denture by altering the cuspal angulations of the denture teeth. Material and methods: A two‐dimensional finite element model of a coronal section of maxillary and mandibular complete dentures, mucosa and alveolar bone in the first molar region was designed. The occlusal aspect of the denture teeth was altered to make 33°, 20°, 0° cuspal angulation. All the nodes at the bases of maxillary and mandibular alveolar bone of finite element analysis models were restrained in all directions. A functional occlusal load of 50 N was applied through the mandibular model base. To design these models and to analyse them, EMRC’s NISA II finite element analysis computer software was used. In these models, the elements were selected (a, b, c, d, e, f) in the region where it was necessary to determine the stresses generated in both the maxillary and mandibular portions. Results: The results were interpreted as Von Mises stresses and were observed in pre‐defined areas. The stress patterns observed within model with each type of posterior occlusion, showed unique variations as well as some similarities. Conclusion: Stresses of greater magnitude were observed in cuspal teeth, 33° and 20° respectively, where as 0° teeth showed a slightly less magnitude of stress generated.     

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.     

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.     

Finite element and experimental analyses of polymer-based dental bridges reinforced by ceramic bars

Dental bridges made of polymer materials reveal only low loading capacity. This paper analyzes possible improvements of the loading capacity of polymer-based dental bridges reinforced by incorporated ceramic bars. Finite element (FE) analyses were performed to study the stress distribution caused by the mastication process in the bridge material. In the experimental part of the study, the fracture load of dental bridges with and without ceramic bar reinforcement was evaluated. Critical stresses occur in the connector area between abutment and pontic of bridges without bar reinforcement. A suitably shaped ceramic bar incorporated into the polymer-based bridge can significantly reduce these critical stresses. The fracture load of the bridge was increased from 515 to 1603N by the bar reinforcement. We conclude from our study that a ceramic bar can significantly improve the loading capacity of a polymer-based dental bridge. The FE and the experimental analyses revealed that the detailed design of the ceramic bar is of decisive importance for the effectiveness of the suggested ceramic reinforcement.     

Movement behavior of teeth and dental implants in periotest measurement in occlusion--an in vitro study]

Early diagnosis of periodontal disease is essential for the planning of restorative, prosthetic and surgical treatment. The usual clinical methods are mostly subjective. Although the Periotest device has been specially developed for the diagnosis of periodontal disease, it can also be used to aid occlusal adjustment after insertion of inlays or artificial crowns. To investigate this application of the Periotest, a jaw model with idealized dental crowns incorporating motion and force sensors has been constructed. Motion and force are recorded during measurements with the Periotest. The maximum amplitudes in the apical (vertical) direction obtained with unpolished occlusal points increased with increasing occlusal load. With polished contact points, the maximum values in the apical direction revealed no dependence on occlusal load. The maximum amplitudes of movement and force in the oral (horizontal) direction decrease with increasing occlusal load both with polished and unpolished contact points. With the first, the teeth appear to slide one upon the other such that the overall distance between them remains unchanged, and no additional apical forces develop. In the case of rough contact points, additional forces develop, and falsify Periotest measurements.     

Preliminary studies on the optimum shape of dental bridges

Several pre-existing anterior and posterior dental bridge models using Finite elements and the new ceramic material In-Ceram have been developed. The mechanical behaviour of these models has been compared with optimised profiles obtained from a newly developed evolutionary algorithm known as Evolutionary Structural Optimisation (ESO). The results show that the mechanical behaviour of the bridges was mainly restricted by the properties of the porcelain veneer and the design of the bridges themselves. For the case of the anterior bridge, it was found that there existed a specific thickness of veneer that minimised the maximum principal stress. This was related to peak stresses that occurred at the bridge surface. Peak stresses also occurred in the material interface between the In-Ceram and the veneer. These extreme stresses were attributed to the notch size and shape. For the case of the posterior bridge, it was concluded that the shape of the bottom of the Pontic tooth is crucial in reducing the magnitude of the maximum principal tensile stress. The ESO process produced bridge designs which have uniformly stressed bridge surfaces, and which also have significantly lower maximum principal tensile stresses compared to the pre-existing designs (up to 44%).     

A novel computational method to determine subject-specific bite force and occlusal loading during mastication

The evaluation of three-dimensional occlusal loading during biting and chewing may assist in development of new dental materials, in designing effective and long-lasting restorations such as crowns and bridges, and for evaluating functional performance of prosthodontic components such as dental and/or maxillofacial implants. At present, little is known about the dynamic force and pressure distributions at the occlusal surface during mastication, as these quantities cannot be measured directly. The aim of this study was to evaluate subject-specific occlusal loading forces during mastication using accurate jaw motion measurements. Motion data was obtained from experiments in which an individual performed maximal effort dynamic chewing cycles on a rubber sample with known mechanical properties. A finite element model simulation of one recorded chewing cycle was then performed to evaluate the deformation of the rubber. This was achieved by imposing the measured jaw motions on a three-dimensional geometric surface model of the subject’s dental impressions. Based on the rubber’s deformation and its material behaviour, the simulation was used to compute the resulting stresses within the rubber as well as the contact pressures and forces on the occlusal surfaces. An advantage of this novel modelling approach is that dynamic occlusal pressure maps and biting forces may be predicted with high accuracy and resolution at each time step throughout the chewing cycle. Depending on the motion capture technique and the speed of simulation, the methodology may be automated in such a way that it can be performed chair-side. The present study demonstrates a novel modelling methodology for evaluating dynamic occlusal loading during biting or chewing.     

Preliminary Studies on the Optimum Shape of Dental Bridges

Several pre-existing anterior and posterior dental bridge models using Finite elements and the new ceramic material In-Ceram have been developed. The mechanical behaviour of these models has been compared with optimised profiles obtained from a newly developed evolutionary algorithm known as Evolutionary Structural Optimisation (ESO).

The results show that the mechanical behaviour of the bridges was mainly restricted by the properties of the porcelain veneer and the design of the bridges themselves. For the case of the anterior bridge, it was found that there existed a specific thickness of veneer that minimised the maximum principal stress. This was related to peak stresses that occurred at the bridge surface. Peak stresses also occurred in the material interface between the In-Ceram and the veneer. These extreme stresses were attributed to the notch size and shape. For the case of the posterior bridge, it was concluded that the shape of the bottom of the Pontic tooth is crucial in reducing the magnitude of the maximum principal tensile stress. The ESO process produced bridge designs which have uniformly stressed bridge surfaces, and which also have significantly lower maximum principal tensile stresses compared to the pre-existing designs (up to 44%).     

Mechanical vulnerability of lower second premolar utilising visco-elastic dynamic stress analysis

Stress analysis determines vulnerability of dental tissues to external loads. Stress values depend on loading conditions, mechanical properties and constrains of structural components. The critical stress levels lead to tissue damage. The aim of this study is to analyse dynamic stress distribution of lower second premolar due to physiological cyclic loading, and dependency of pulsatile stress characteristics to visco-elastic property of dental components by finite element modelling. Results show that visco-elastic property markedly influences stress determinants in major anatomical sites including dentin, cementum–enamel and dentin–enamel junctions. Reduction of visco-elastic parameter leads to mechanical vulnerability through elevation of stress pulse amplitude, maximum stress value; and reduction of stress phase shift as a determinant of stress wave propagation. The results may be applied in situations in which visco-elasticity is reduced such as root canal therapy and post and core restoration in which teeth are more vulnerable to fracture.