The Effect of Different Materials and Techniques on Stress Distribution in CAD/CAM Endocrowns

Eskitaşçıoğlu, Murat; Küçük, Ö.; Eskitaşçıoğlu, Gürcan; Eraslan, Oğuz; Bellí, Sema

doi:10.1007/s11223-020-00235-1

Cited by 5 publications

(8 citation statements)

References 37 publications

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“…Another aspect of the endocrown design to think about is the walls of the central retainer in the endocrown’s pulp-chamber extension promoting an adequate load dissipation [ 32 ]. Therefore, the smoothening of the sharp edge at the base of the pulp chamber in the preparation for endocrowns is suggested to reduce the stress concentration in the cervical dentin beneath the endocrown, as well as on the cement layer [ 33 ]. This study followed this approach in the endocrown modelling and showed that the magnitude of shear stress concentration can be proportional to the restorative material elastic modulus.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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The goal of this study was to evaluate the stress distribution in an endocrown restoration according to different provisional restorative materials. An endodontically treated maxillary molar model was selected for conducting the finite element analysis (FEA), with a determined amount of dental remnant of 1.5 mm. The model was imported to the analysis software (ANSYS 19.2, ANSYS Inc., Houston, TX, USA) in STEP format. All contacts were considered perfectly bonded. The mechanical properties of each structure were considered isotropic, linear, elastic, and homogeneous. Three different provisional restorative materials were simulated (acrylic resin, bis-acrylic resin, and resin composite). An axial load (300 N) was applied at the occlusal surface in the center of the restoration. Results were determined by colorimetric stress maps of maximum principal stress, maximum shear stress, and total deformation. The different materials influenced the stress distribution for all structures; the higher the material’s elastic modulus, the lower the stress magnitude on the cement layer. In the present study, all provisional restorative materials showed similar stress patterns in the endocrown and on the cement layer however, with different magnitude. Based on this study limitation, the use of resin composite to manufacture provisional endocrowns is suggested as a promising material to reduce the stresses in the cement layer and in the dental tissue surfaces.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2021

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“…The stress distribution pattern of a tooth that is repaired with an endocrown is vital for damage and fracture analysis [ 10 ]. Several parameters can modify the endocrown’s mechanical behavior—e.g., the ferrule presence, pulp chamber extension height and different restorative materials [ 11 , 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Lithium Disilicate Ceramic Endocrown Biomechanical Response According to Different Pulp Chamber Extension Angles and Filling Materials

et al. 2021

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The purpose of this study is to evaluate the effect of pulp chamber extension angles and filling material mechanical properties on the biomechanical response of a ceramic endocrown. A 3D model of maxillary molar that underwent endodontically treatment was exported to computer aided design software to conduct finite element analysis (FEA). The endocrown model was modified considering different pulp chamber extension angles (right angle; 6°, 12° and 18° of axial divergence). The solids were imported into the computer aided engineering software in Standard for the Exchange of Product Data (STEP) format. Nine different filling materials were simulated to seal the orifice of the root canal system under each endocrown restoration (resin composite, bulk-fill resin composite, alkasite, flowable resin composite, glass ionomer cement, autocured resin-reinforced glass ionomer cement, resin cement, bulk-fill flowable resin composite, zinc oxide cement), totaling 36 models. An axial load (300 N) was applied at the occlusal surface. Results were determined by colorimetric graphs of von-Misses stress (VMS) and Maximum Principal Stress (MPS) on tooth, cement layer, and endocrown restorations. VMS distribution showed a similar pattern between the models, with more stress at the load region for the right-angled endocrowns. The MPS showed that the endocrown intaglio surface and cement layer showed different mechanical responses with different filing materials and pulp chamber angles. The stress peaks plotted in the dispersion plot showed that the filling material stiffness is proportional to the stress magnitude in the endocrown, cement layer and tooth adhesive surface. In addition, the higher the pulp chamber preparation angle, the higher the stress peak in the restoration and tooth, and the lower the stress in the cement layer. Therefore, 6° and 12° pulp chamber angles showed more promising balance between the stresses of the adhesive interface structures. Under the conditions of this study, rigid filling materials were avoided to seal the orifice of root canal system when an endocrown restoration was planned as rehabilitation. In addition, the pulp chamber axial walls were prepared between 6° and 12° of divergence to balance the stress magnitude in the adhesive interface for this treatment modality.

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“…The majority of studies with anterior teeth has the post‐core‐crown as the comparison group, and it might be assumed that the application of oblique loads associated to intracanal posts were responsible to provide deeper fractures into the root canal 3,4,9,10 . For posterior teeth, as vertical loads predominate during fatigue tests and load to failure analyses, the maximum stresses were located at cervical third of the remaining coronal structure, as shown by FEA, 14,16,19,21,26–29,32,34–36 contributing for more similar failure patterns among restorative configurations tested. Two studies have shown that using zirconia endocrowns in premolars would provide a significant higher number of non‐reparable failures comparing with lithium disilicate and resin composite endocrowns 11,12 .…”

Section: Discussionmentioning

confidence: 99%

“…11,12 This might be attributed to the greater discrepancy of elastic modulus between restorative material and tooth structure, in which the higher stiffness of zirconia results in amplified stress concentration in the supporting tooth. 19 In addition, an analysis showed that the ferule contributed for more favorable failure patterns in anterior teeth. 2 Clinical follow ups of endocrowns in molar and premolars reported biomechanical failures such as fracture of the restoration, [41][42][43][44] adhesive failure/debond, 41,42,44,45 and the facture of the supporting tooth structure; 45,46 these data corroborate with failure patterns reported by the in vitro studies (Tables 3 and 4).…”

Section: Discussionmentioning

confidence: 99%

“…For stresses at remaining tooth structure, ED led to lower values than PCC in two analyses, 26,32 and higher stresses in other 2 studies. 19,28 Two analyses assessed the stresses at restorative materials, with lower values for ED. 26,32 Stresses at luting agent were higher for ED in one analysis 26 and higher for PCC in another evaluation.…”

Section: Data Extracted For Molarsmentioning

confidence: 99%

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Biomechanical performance of endocrown and core‐crown restorations: A systematic review

Lenz

Bacchi²,

Bona

2023

J Esthet Restor Dent

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ObjectiveTo assess and compare, through a systematic review of the literature, the biomechanical performance of endocrowns and traditional core‐crowns (with and without intracanal post) for the rehabilitation of endodontically treated teeth with severe coronal structure damage.Materials and MethodsA systematic search was performed in MEDLINE/PubMed, Scopus, and Web of Science databases. In‐vitro studies comparing endocrowns with (post‐)core‐crown restorations were selected and screened by two independent reviewers. The included studies were submitted to the risk of bias analysis using the RoBDEMAT tool and the biomechanical outcomes were collected for qualitative analysis. The extracted data were presented based on comparative analyses among the included studies.ResultsThirty‐one studies were included: 9 studies evaluated restorations of molars, 14 for premolars, and 8 studies evaluated anterior restorations. For the majority of the studies, endocrowns showed either similar or greater survival rates under fatigue and monotonic load than (post‐)core‐crown restorations, irrespectively of the tooth. The endocrowns showed more favorable failure patterns than (post‐)core‐crowns, irrespectively of the tooth. Endocrowns produced lower stresses in the restorative material for molars and premolars and in the luting material for premolars than (post‐)core‐crown restorations. The included studies presented adequate information for most items of the RoBDEMAT risk of bias tool.ConclusionEndocrowns showed similar or greater biomechanical performance than the traditional (post‐)core‐crown restorations in most of the evaluated studies.Clinical SignificanceThis systematic review showed that endocrowns present either similar or greater biomechanical performance than core‐crown restorations for anterior and posterior endodontically treated teeth with severe structural damage.

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The Effect of Different Materials and Techniques on Stress Distribution in CAD/CAM Endocrowns

Cited by 5 publications

References 37 publications

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

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

Lithium Disilicate Ceramic Endocrown Biomechanical Response According to Different Pulp Chamber Extension Angles and Filling Materials

Biomechanical performance of endocrown and core‐crown restorations: A systematic review

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