Biomechanical behavior of endocrowns vs fiber post-core-crown vs cast post-core-crown for the restoration of maxillary central incisors with 1 mm and 2 mm ferrule height

Abstract

To analyze the stress distribution of the maxillary central incisor with oblique fracture, repaired by different methods, using 3-dimensional finite element analysis. From the biomechanical point of view, it is expected to provide a reference for clinical selection of restoration method which is more conducive to stress distribution and preservation of dental tissue as much as possible. Use cone beam CT and finite element software to establish the finite element models of the maxillary central incisor with oblique fracture, and then create models according to 5 repairing methods(A. fiber post-core-crown group; B. cast post-core-crown group; C.3 mm deep endocrown; D.4 mm deep endocrown; E.5 mm deep endocrown)after root canal treatment, and analyze the Von Mises equivalent stress and maximum principal stress distribution and peak value of each model. When the height of dentin ferrule was fixed, the value of the Von Mises equivalent stress and the maximum principal stress in residual tooth tissue: group A was the highest, and there was no significant difference in group B, C, D and E. And the stress distribution area of 5 groups were the same. In prosthodontic layer: group B was the highest, while group A was the lowest, and the stress peak slightly increased with the increase of depth in group C, D and E. And the 5 groups were with the same stress distribution area as well. In adhesive layer: group A was the highest, while group B was the lowest, and there was little difference among group C, D and E. Group A was concentrated in 1/3 of the post tip, while group B,C,D and E were concentrated in 1/3 of the post and the post tips. Complete and high enough dentin ferrule is a requirement for repairing heavily defected maxillary central incisor with fiber post-core crown and cast post-core crown. When the dentin ferrule is incomplete, the stress distribution of the endocrown is more excellent than post-core-crown. And the endocrown with a depth of 3 mm retainer may be the best repair method. As for post-core crown restoration, the cast post-core crown is more favorable for the uniform distribution of residual tooth tissue than the fiber post-core crown.

Comparison of Short-Term Restorative Effects and Periodontal Health Status of Restorations Made of Different Materials in Full-Crown Restoration of Mandibular Premolar Tooth Defects

“…After the procedure, the pulp loses its vitality and the tooth tissue becomes brittle gradually, so crown restoration is needed to prevent tooth fracture [4]. Full-crown restoration is a common crown restoration method that can cover the entire crown surface and restore the shape, function, and aesthetics of the defective teeth, which is highly accepted by patients [5]. As dental restoration technology constantly advances, various dental prosthetic materials have been applied in dental restoration [6].…”

Effect of Restorative Material on Mechanical Response of Provisional Endocrowns: A 3D—FEA Study

“…This method has been extensively reported in literature, with previous studies that have evaluated this treatment modality [ 5 , 7 , 8 , 9 , 10 , 14 , 18 , 19 ]. As advantages, the FEM is able to identify problems by assessing the state of stress and deformation of materials and adhesive interfaces, evaluating the stress distribution generated by masticatory loads with model standardization, and offering an acceptable approximate solution [ 20 , 21 , 22 ]. Usually, failure origin consists of regions of high stress concentration, previously evidenced by the finite element analysis results [ 7 ].…”

"Minimally Invasive Rehabilitation Techniques for the Endodontically Treated Tooth – A Case Report"

“…Fiber posts are preferred over cast posts owing to their lower risk of catastrophic type fractures [3].Multiple studies reach consensus that the ferrule effect is one of the most important factors in determining the rehabilitative success of endodontically treated teeth, and that the posts material choice does not show statistically significant differences when a ferrule effect exists [4][5][6][7].…”