Effect of partial restorative treatment on stress distributions in non-carious cervical lesions: a three-dimensional finite element analysis

Abstract

Background Partial restoration combined with periodontal root coverage surgery can be applied to the treatment of non-carious cervical lesions (NCCLs) accompanied with gingival recessions in clinical practice. However, the feasibility of NCCL partial restorative treatment from a biomechanical perspective remains unclear. This study aimed to investigate the effect of partial restorations on stress distributions in the NCCLs of mandibular first premolars via three-dimensional finite element analysis. Methods Three-dimensional finite element models of buccal wedge-shaped NCCLs in various locations of a defected zenith (0 mm, 1 mm, and 2 mm) were constructed and divided into three groups (A, B, and C). Three partially restored NCCL models with different locations of the lower restoration border (1 mm, 1.5 mm, and 2 mm), and one completely restored NCCL model were further constructed for each group. The following restorative materials were used in all restoration models: composite resin (CR), glass-ionomer cement (GIC), and mineral trioxide aggregate (MTA). The first principal stress distributions under buccal oblique loads of 100 N were analyzed. Restoration bond failures were also evaluated based on stress distributions at dentin-restoration interfaces. Results When the partial restoration fully covered the defected zenith, the first principal stress around the zenith decreased and the maximum tensile stress was concentrated at the lower restoration border. When the partial restoration did not cover the defected zenith, the first principal stress distribution patterns were similar to those in unrestored models, with the maximum tensile stress remaining concentrated at the zenith. As the elastic modulus of the restorative material was altered, the stress distributions at the interface were not obviously changed. Restoration bond failures were not observed in CR, but occurred in GIC and MTA in most models. Conclusions Partial restorations that fully covered defected zeniths improved the stress distributions in NCCLs, while the stress distributions were unchanged or worsened under other circumstances. CR was the optimal material for partial restorations compared to GIC and MTA.

Morphological and Optical Coherence Tomography Aspects of Non-Carious Cervical Lesions

“…The majority of specialists have stated that the predominance of one of the three main etiological mechanisms (friction, biocorrosion and stress) conditions the shape of the lesion [ 1 , 34 ]. The wedge shape of some NCCLs was considered indicative that abfraction/stress is the main etiological agent [ 24 , 54 ]. The saucer shape of some NCCLs is generally shallower and is considered to be determined by erosion [ 34 ].…”

Stereomicroscopic Aspects of Non-Carious Cervical Lesions

“…The establishment of the shape of the lesions thus becomes an important step in therapeutic management [51,52]. The wedge-shape of NCCLs was considered an indicator of abfraction/occlusal stress is the main etiological agent [53,54]. The saucer-shape of NCCLs was considered to be determined by biocorrosion/erosion [52].…”

Lesão cervical não cariosa: etiologia e possíveis tratamentos

“…Corroborando com essa ideia, Goodacre et al, (2022), afirmaram que os dentes tendem a mostrar sinais de desgaste ao atingir a meia-idade. Lessa (2019), Almeida (2020), Gonçalves et al, (2021) e Luo et al, (2022), relatam que as lesões cervicais não cariosas (LCNC) possuem como característica a perda de tecido dentário na região cemento-esmalte. Em concordância, Teixeira et al, (2018) acrescentaram que essa perda não está associada a presença de processos cariosos.…”

“…Entretanto, necessita-se de mais estudos para avaliar diferentes procedimentos de enxerto. Luo, X. et al, (2022) Effect of partial restorative treatment on stress distributions in non-carious cervical lesions: a three-dimensional finite element analysis Dentes hígidos distribuem a tensão de tração foi no colo cervical e na dentina radicular.…”

“…Explicando mais afundo sobre os tipos de possibilidades de tratamento, é possível utilizar os procedimentos restauradores, que visam recuperar as estruturas perdidas e diminuir a concentração de forças da região dos defeitos(Luo, 2022) Goodacre et al, (2023). defenderam que a resina composta é um material de escolha, mesmo tendo o ionômero de vidro (CIV) ou CIV modificado por resina, que também podem ser usados.…”