Inclusion of the periodontal ligament in studies on the biomechanical behavior of fiber post-retained restorations: An in vitro study and three-dimensional finite element analysis.

Endodontically treated teeth are known to have reduced structural strength. Periodontal ligament may influence fracture resistance. The purpose of this study was to assess the influence of including the periodontal ligament in biomechanical studies about endodontically treated and restored teeth. Forty human maxillary central incisors were treated endodontically and randomly divided into four groups: non-crowned (with and without an artificial ligament) and crowned (with and without an artificial ligament) with glass-ceramic crowns. All groups received prefabricated glass-fiber posts and a composite resin core. Specimens were tested, under a flexural-compressive load, until failure occurred. The failure mode was registered for all specimens. The failure loads were recorded and analyzed using an analysis of variance test (p < 0.05). These results were compared with those predicted by a finite element model. The analysis of variance did not show significant differences between the use of crown on the failure load (p = 0.331) and the use of periodontal ligament (p = 0.185). A cohesive mode in crown appeared in crowned teeth and in core in non-crowned groups. For non-crowned teeth, adhesive failure occurred along the cement-enamel junction with a slight tendency in specimens without periodontal ligament. Furthermore, an unfavorable failure mode affects partially the root with no differences regarding non-crown specimens. In crowned teeth, the tendency was an adhesive failure along the cement-enamel junction. The model predicted a distribution of the safety factor consistent with these results. This study showed that inclusion of periodontal ligament is not particularly important on biomechanical behavior of post-retained restorations. However, we recommend its inclusion in fatigue studies.

Analysis of the effect of design parameters and their interactions on the strength of dental restorations with endodontic posts, using finite element models and statistical analysis.

Many previous studies, both in vitro and with model simulations, have been conducted in an attempt to reach a full understanding of how the different design parameters of an endodontically restored tooth affect its mechanical strength. However, differences in the experimental set-up or modelling conditions and the limited number of parameters studied in each case prevent us from obtaining clear conclusions about the real significance of each parameter. In this work, a new approach is proposed for this purpose based on the combination of a validated three-dimensional parametric biomechanical model of the restored tooth and statistical analysis using full factorial analysis of variance. A two-step approach with two virtual tests (with, respectively, 128 and 81 finite element models) was used in the present work to study the effect of several design parameters on the strength of a restored incisor, using full factorial designs. Within the limitations of this study, and for cases where the parameters are within the ranges that were tested, the conclusions indicate that the material of the post is the most significant factor as far as its strength is concerned, the use of a low Young's modulus being preferable for this component. Once the post material has been chosen, the geometry of the post is of less importance than the Young's modulus selected for the core or, especially, for the crown.

Mechanical performance of endodontic restorations with prefabricated posts: sensitivity analysis of parameters with a 3D finite element model.

Many studies have investigated the effect of different parameters of the endodontically restored tooth on its final strength, using in vitro tests and model simulations. However, the differences in the experimental set-up or modelling conditions and the limited number of parameters studied in each case prevent us from obtaining clear conclusions about the relative importance of each parameter. In this study, a validated 3D biomechanical model of the restored tooth was used for an exhaustive sensitivity analysis. The individual influence of 20 different parameters on the mechanical performance of an endodontic restoration with prefabricated posts was studied. The results bring up the remarkable importance of the loading angle on the final restoration strength. Flexural loads are more critical than compressive or tensile loads. Young's modulus of the post and its length and diameter are the most influential parameters for strength, whereas other parameters such as ferrule geometry or core and crown characteristics are less significant.

Premolars restored with posts of different materials: fatigue analysis.

Previous works studied the effect of the material and the dimensions of the post on the biomechanical performance (fracture strength and stress distribution) of restored teeth, under static loads. The aim of this work was to study the effect of the post material (glass fibre and stainless steel) on restored teeth, which have the final crown, under dynamic conditions. The use of a biomechanical model, including a fatigue analysis from FEA, is presented as a powerful method to study the effect of the material of the intraradicular post. The inclusion of the fatigue analysis allows for a more realistic study that takes into account the dynamic nature of masticatory forces. At the same time, the results obtained are easier to interpret by both dentists and mechanical engineers. No differences were found, with the load and number of cycles considered, between glass fibre and stainless steel as material for the intraradicular post used in premolars restorations.

Interpreting finite element results for brittle materials in endodontic restorations.

BACKGROUND: Finite element simulation has been used in last years for analysing the biomechanical performance of post-core restorations in endodontics, but results of these simulations have been interpreted in most of the works using von Mises stress criterion. However, the validity of this failure criterion for brittle materials, which are present in these restorations, is questionable. The objective of the paper is to analyse how finite element results for brittle materials of endodontic restorations should be interpreted to obtain correct conclusions about the possible failure in the restoration. METHODS: Different failure criteria (Von Mises, Rankine, Coulomb-Mohr, Modified Mohr and Christensen) and material strength data (diametral tensile strength and flexural strength) were considered in the study. Three finite element models (FEM) were developed to simulate an endodontic restoration and two typical material tests: diametral tensile test and flexural test. RESULTS: Results showed that the Christensen criterion predicts similar results as the Von Mises criterion for ductile components, while it predicts similar results to all other criteria for brittle components. The different criteria predict different failure points for the diametral tensile test, all of them under multi-axial stress states. All criteria except Von Mises predict failure for flexural test at the same point of the specimen, with this point under uniaxial tensile stress. CONCLUSIONS: From the results it is concluded that the Christensen criterion is recommended for FEM result interpretation in endodontic restorations and that the flexural test is recommended to estimate tensile strength instead of the diametral tensile test.