Influence of occlusal reduction design on the fracture resistance and biomechanical behavior of endocrowns restoring maxillary premolars

Abstract

Purpose To investigate the effect of different occlusal reduction design on stress distribution and fracture resistance of different endocrown systems. Material and methods Sixty-four maxillary human premolars with endodontic treatment, prepared for endocrowns were divided into 2 groups (n = 32) according to the occlusal design: Butt joint preparation (B group) and Anatomical preparation (A group). Each group were subdivided into four groups according to ceramic systems: IPS E max CAD (EM group), monolithic zirconia (ZR group), Nacera Hyprid (NH group) and PEKKTON (PE group). After manufacturing of endocrowns and adhesive bonding the specimens were thermomechanically loaded and subsequently they were tested in a universal testing machine for evaluating the fracture resistance. The specimens failure mode was qualitatively assessed. The stress distribution in each group was assessed using three-dimensional finite element analysis (FEA). 1-way ANOVA and the Post Hoc Tukey HSD test were used to evaluate the data (a = .05). Results The fracture resistance values between the groups showed statistically significant variations. The B PE and A PE groups had a higher ratio of fracture resistance values. Regarding failure mode, ceramic endocrowns recorded mainly irreparable failures. FEA showed that anatomical occlusal preparation have reduced the stress concentration under all endocrown systems. Conclusion Endocrowns could be used to restore endodontically treated maxillary premolars. PEKKTON endocrowns with anatomical preparations revealed most appropriate restoration. The tested new endocrown systems enhanced the biomechanical performance of the tooth. Clinical significance The innovative endocrown systems (PEKK, Nacera Hyprid) can be seen as a promising choice for restoration of severely-destructed endodontic treated premolars, with less stress transmit to the residual tooth structure. Although the traditional endocrown technology might increase the longevity of tooth bonding, it shouldn’t be used for clenching cases since the risk of failure is too great overall.

Digital Protocol to Record Occlusal Analysis in Prosthodontics: A Pilot Study

“…Esposito et al [ 14 ] investigated the reliability of recording occlusal contacts using an intraoral scanner versus articulating paper, finding significant differences in contact numbers except for upper central incisors and first premolars, with low clinician agreement on occlusions, highlighting the need for a precise method for recording occlusal contacts. Abbas et al [ 15 ] studied the influence of occlusal reduction design on the biomechanics of endocrowns in maxillary premolars, revealing that PEKKTON endocrowns with anatomical preparations offer optimal restoration, suggesting these innovative systems could improve the longevity of tooth restorations. Pereira et al [ 16 ] assessed the accuracy and reproducibility of real versus virtual occlusal contact points in implant-supported dentures, finding that both methods provided clinically excellent contact points with no significant difference in reproducibility, indicating intraoral scanners as a viable tool for occlusion mapping.…”