Evaluation of Stress Distribution in Root Canal Treated Maxillary Incisors Treated with Different Fiber-Reinforced Composite Resins by Finite Element Analysis

Year 2023, Volume: 3 Issue: 2, 91 - 98, 25.08.2023

Özge Sönmez Uzel , Buket Ayna

https://doi.org/10.61139/ijdor.1310349

Abstract

Objective: The aim of this study is to evaluate the stress caused by different fiber reinforced composite resin (FRCR) restorations under functional forces in tooth models with two different types of horizontal and oblique fractures in the maxillary incisor using finite element analysis (FEA) method.
Materials and Methods: A maxillary incisor with complete root development was scanned in a microcomputed tomography device. With the information obtained, two different groups with horizontal and oblique fractures were formed by creating a maxillary incisor model with three-dimensional root development. Based on the sample model, root canal treatment was performed, horizontal and oblique fracture lines were created, maxillary incisor models were restored with different FRCR and simulated in three dimensions. Then, the stresses occurring in the teeth under functional force were evaluated with the FEA method.
Results: In models using FRCR, the stresses on the cervical region of root dentin and restorative material were reduced. When all models were examined, the highest stress values in both the cervical region of root dentin and the restorative material were observed in models using only composite resin. The lowest stress values were observed in the models using prefabricated long glass fiber post. It was observed that the stresses occurring in the models with the horizontal fracture line were higher than the models with the oblique fracture line.
Conclusion: The use of FGKR in teeth with crown fractures will help reduce both the stresses in the cervical region of root dentin and the stresses on the restorative material. Models restored with FGKR created less stress and strengthened the tooth structure more.

Keywords

FRCR, FEM, nanofil composite, post, complicated crown fracture

Project Number

DİŞ.22.013

Farklı Fiberle Güçlendirilmiş Kompozit Rezinler ile Tedavi Edilen Kök Kanal Tedavili Maksiller Kesici Dişlerde Oluşan Stres Dağılımının Sonlu Elemanlar Analizi ile Değerlendirilmesi

Abstract

Amaç: Bu çalışmanın amacı, maksiller kesici dişte horizontal ve oblik iki farklı kırık tipine sahip diş modellerinde farklı fiberle güçlendirilmiş kompozit rezin (FGKR) restorasyonlarının fonksiyonel kuvvetler altında oluşturduğu stresin sonlu elemanlar analizi (SEA) yöntemiyle değerlendirilmesidir.
Materyal ve Metod: Kök gelişimi tamamlanmış bir maksiller kesici diş mikrobilgisayarlı tomografi cihazında taranmıştır. Elde edilen bilgilerle üç boyutlu kök gelişimi tamamlanmış maksiller kesici diş modeli oluşturularak, horizontal ve oblik kırığa sahip iki farklı grup oluşturulmuştur. Örnek model esas alınarak, kök kanal tedavisi yapılmış horizontal ve oblik kırık hattı oluşturulmuş, maksiller kesici diş modelleri farklı FGKR ile restore edilerek üç boyutlu olarak simüle edilmiştir. Ardından dişlerde fonksiyonel kuvvet altında oluşan stresler SEA yöntemiyle değerlendirilmiştir.
Bulgular: FGKR kullanılan modellerde kök dentininin servikal bölgesi ve restoratif materyalde oluşan stresler azalmıştır. Tüm modeller incelendiğinde hem kök dentininin servikal bölgesinde hem de restoratif materyalde en yüksek stres değerleri yalnızca kompozit rezin kullanılan modellerde görülmüştür. En düşük stres değerleri ise prefabrik uzun cam fiber post kullanılan modellerde görülmüştür. Horizontal kırık hattına sahip olan modellerde oblik kırık hattına sahip modellere göre oluşan streslerin daha fazla olduğu görülmüştür.
Sonuç: Kron fraktürüne sahip dişlerde FGKR kullanımı hem kök dentininin servikal bölgesinde oluşan stresleri hem de restoratif materyaldeki stresleri azaltmaya yardımcı olacaktır.

Keywords

FGKR, SEA, nanofil kompozit, post, komplike kron kırığı

Supporting Institution

Dicle Üniversitesi Bilimsel Araştırmalar Projeleri Komisyonu Başkanlığı

Project Number

DİŞ.22.013

Thanks

Bu tez çalışması Dicle Üniversitesi Bilimsel Araştırmalar Projeleri Komisyonu Başkanlığı tarafından DİŞ.22.013 numaralı proje ile desteklenmiştir.

References

• 1.Gökcek M. Zonguldakta Travmatik Dental Yaralanmaların Retrospektif Analizi. Diş Hekimliğinde Uzmanlık Tezi, Zonguldak: Bülent Ecevit Üniversitesi Diş Hekimliği Fakültesi, 2017.
• 2.Andersson L. Epidemiology of traumatic dental injuries. Journal of endodontics. 2013;39(3):S2-S5.
• 3.Trope M. Avulsion of permanent teeth: theory to practice. Dental Traumatology. 2011;27(4):281-94.
• 4.Barnett F. The role of endodontics in the treatment of luxated permanent teeth. Dental Traumatology. 2002;18(2):47-56.
• 5.Bergman B, Lundquist P, Sjo U. Restorative and endodontic results after treatment with cast posts and cores. The Journal of prosthetic dentistry. 1989;61(1):10-5.
• 6.Scotti N, Eruli C, Comba A, Paolino D, Alovisi M, Pasqualini D, et al. Longevity of class 2 direct restorations in root-filled teeth: A retrospective clinical study. Journal of Dentistry. 2015;43(5):499-505.
• 7.Smith CT, Schuman N. Restoration of endodontically treated teeth: a guide for the restorative dentist. Quintessence international. 1997;28(7).
• 8.Aydemir M, Bağlar S. Post-kor sistemlerinin güncel siniflandirilması. Turkiye Klinikleri J Dental Sci. 2019;25(3):319-33.
• 9.Monticelli F, Grandini S, Goracci C, Ferrari M. Clinical behavior of translucent-fiber posts: a 2-year prospective study. Int J Prosthodont. 2003;16(6):593-6.
• 10.Kimmel S. Restoration and reinforcement of endodontically treated teeth with a polyethylene ribbon and prefabricated fiberglass post. General dentistry. 2000;48(6):700-6.
• 11.Keulemans F, Garoushi S, Lassila L. Fillings and core build-ups. In: Ozcan M, Vallittu P, eds. A Clinical Guide to Principles of Fiber-Reinforced Composites in Dentistry. UK: Elsevier; 2017, p:131-63.
• 12.Magne P. Efficient 3D finite element analysis of dental restorative procedures using micro-CT data. Dental materials. 2007;23(5):539-48.
• 13.Ko C-C, Chu C-S, Chung K-H, Lee M-C. Effects of posts on dentin stress distribution in pulpless teeth. The Journal of prosthetic dentistry. 1992;68(3):421-7.
• 14.Eraslan Ö, Eraslan O, Eskitaşcıoğlu G, Belli S. Conservative restoration of severely damaged endodontically treated premolar teeth: a FEM study. Clinical Oral Investigations. 2011;15(3):403-8.
• 15.Kydd WL, Mandley J. The stiffness of palatal mucoperiosteum. The Journal of Prosthetic Dentistry. 1967;18(2):116-21.
• 16.Belli S, Eraslan O, Eskitaşcıoğlu G. Effect of different treatment options on biomechanics of immature teeth: a finite element stress analysis study. Journal of endodontics. 2018;44(3):475-9.
• 17.Moszner N, Salz U. New developments of polymeric dental composites. Progress in polymer science. 2001;26(4):535-76.
• 18.MK Ş. Dört Farklı Cam Fiber Postun in vitro Bükülme Dirençlerinin ve Sonlu Eleman Metodu ile Stres Dağılımlarının Analizi. Doktora Tezi, Ankara: Gazi Üniversitesi Sağlık Bilimleri Enstitüsü, 2008.
• 19.Kaleli N, Ural Ç. Hibrid Abutment Kron Restorasyonlarda İmplant-Abutment Bağlantısının İmplant, Abutment ve Bazal Vidadaki Stres Dağılımı Üzerindeki Etkisinin İncelenmesi. Turkiye Klinikleri Dishekimligi Bilimleri Dergisi. 2020;26(1):43-50.
• 20.Barreto BCF, Van Ende A, Lise DP, Noritomi PY, Jaecques S, Sloten JV, et al. Short fibre-reinforced composite for extensive direct restorations: a laboratory and computational assessment. Clinical oral investigations. 2016;20(5):959-66.
• 21.Belli S, Eraslan O, Eraslan O, Eskitascioglu M, Eskitascioglu G. Effects of Na OC l, EDTA and MTAD when applied to dentine on stress distribution in post‐restored roots with flared canals. International Endodontic Journal. 2014;47(12):1123-32.
• 22.Pornamazeh T, Geramy A, Heidari S, Rajabizadeh M, Kamali E, Ghadirian H. Comparison of the debonding force of metal, glass and polyethylene Fiber reinforced composite retainers: Mechanical and finite element analyses. International Orthodontics. 2022;20(4):100685.
• 23.Türkün LS. Conservative restoration with resin composites of a case of amelogenesis imperfecta. International dental journal. 2005;55(1):38-41.
• 24.Roeters JJ. Extended indications for directly bonded composite restorations: a clinician's view. J Adhes Dent. 2001;3(1):81-7.
• 25.Grandini S, Goracci C, Tay FR, Grandini R, Ferrari M. Clinical evaluation of the use of fiber posts and direct resin restorations for endodontically treated teeth. International Journal of Prosthodontics. 2005;18(5).
• 26.Candan Ü, Eronat N, Türkün M. Fiberle güçlendirmenin nanofil kompozitin eğme direncine etkisinin incelenmesi. Curr Res Dent Sci. 2015;25(1):13-20.
• 27.Pierrisnard L, Bohin F, Renault P, Barquins M. Corono-radicular reconstruction of pulpless teeth: a mechanical study using finite element analysis. The Journal of prosthetic dentistry. 2002;88(4):442-8.
• 28.Eapen AM, Amirtharaj LV, Sanjeev K, Mahalaxmi S. Fracture resistance of endodontically treated teeth restored with 2 different fiber-reinforced composite and 2 conventional composite resin core buildup materials: an in vitro study. Journal of endodontics. 2017;43(9):1499-504.
• 29.Halaçoğlu DM, Yamanel K. The effects of different base materials on the stress distribution of the endodontically treated teeth: 3D FEA. Cumhuriyet Dent J. 2019;22(1):56-65.
• 30.Garoushi S, Vallittu PK, Lassila LV. Direct restoration of severely damaged incisors using short fiber-reinforced composite resin. Journal of dentistry. 2007;35(9):731-6.
• 31.Junior AdAG, Lopes MWF, da Silveira Gaspar G, Braz R. Comparative study of flexural strength and elasticity modulus in two types of direct fiber-reinforced systems. Brazilian oral research. 2009;23(3):236-40.
• 32.Ramesh P, Mathew S, Murthy SB, George JV, Hegde S, Premkumar R. Efficacy of Ribbond and a fibre post on the fracture resistance of reattached maxillary central incisors with two fracture patterns: a comparative in vitro study. Dental Traumatology. 2016;32(2):110-5.
• 33.Çetintaş Ş. İmplant Destekli Mandibular Overdenturelarda Fiberle Üretilmiş Altyapıların Stres Analizi. Doktora Tezi, Ankara: Gazi Üniversitesi Sağlık Bilimleri Enstitüsü, 2019.
• 34.Hunter A, Feiglin B, Williams J. Effects of post placement on endodontically treated teeth. The Journal of prosthetic dentistry. 1989;62(2):166-72.
• 35.Adanır N, Belli S, Eraslan O, Eskitaşçıoğlu G. Bir Cam Fiber Post Sistemiyle Restore Edilmiş Üst Birinci Kesici Diş Modelinde Post Uzunluğunun Fpnksiyonel Kuvvetler Altında Oluşan Stres Dağılımına Etkisi. Türk Dişhekimliği Dergisi. 2005;59:8-13.
• 36.Di Fiore PM, Reyes A, Dorn SO, Cron SG, Ontiveros JC. Evaluation of a calcium silicate-based cement as a root reinforcement material for endodontically treated maxillary anterior teeth. The Journal of Prosthetic Dentistry. 2016;115(1):35-41.
• 37.Bilgin S, Kahvecioğlu F. Kök ucu açik dişlerde sonlu elemanlar analizi kullanilarak farkli yönlerden gelen travmalarin oluşturduğu streslerin değerlendirilmesi. Selcuk Dent J. 202;7(2):318-25.
• 38.Scotti N, Scansetti M, Rota R, Pera F, Pasqualini D, Berutti E. The effect of the post length and cusp coverage on the cycling and static load of endodontically treated maxillary premolars. Clinical Oral Investigations. 2011;15(6):923-9.
• 39.Sorrentino R, Salameh Z, Zarone F, Tay FR, Ferrari M. Effect of post-retained composite restoration of MOD preparations on the fracture resistance of endodontically treated teeth. Journal of Adhesive Dentistry. 2007;9(1).
• 40.Akbaş M, Akbulut MB, Belli S. Sonlu Elemanlar Stres Analizi ve Endodontide Kullanımı. European Journal of Research in Dentistry. 2021;5(2):99-108.