Tooth deformation patterns in molars after composite restoration.

OBJECTIVE: Residual stresses from polymerization shrinkage in composite restorations deform a tooth. This may cause debonding, enamel crack propagation, and post-operative sensitivity. Deformation due to shrinkage has been measured previously at a few discrete points. The purpose of this study was to analyze cuspal deformation pattern of the occlusal portion of molars for various cavity types and sizes after restoration with a light-initiated composite. METHODS: Five extracted human molars were successively prepared as Class I, Class II OM, large Class II OM, and large Class II MOD. The cavities were filled with a light-curing composite using a dentin adhesive system. The occlusal portion of the unrestored cavity and the restoration were digitized with a profilometer. The digitized data of the unrestored and restored tooth were used to calculate the cuspal contour change with Cumulus software. Deformation was visualized as a color contour map. RESULTS: Cuspal deformation showed up in the contour map as a reduction of buccal and lingual contour perpendicular to the surface. Large Class II MODs exhibited the highest cuspal deformation, followed by large OM restorations. Cuspal deformations in Class I and small Class II OM restorations were not significantly different. SIGNIFICANCE: When a composite restoration was cured, the surrounding tooth deformed due to polymerization shrinkage. Cavity type and size affected how much cusps moved inward as a result of polymerization shrinkage. This study quantified and visualized the pattern of cuspal deformation.     

Effect of adhesive layer properties on stress distribution in composite restorations--a 3D finite element analysis.

OBJECTIVES: Teeth, adhesively restored with resin-based materials, were modeled by 3D-finite elements analysis that showed a premature failure during polymerization shrinkage and occlusal loading. METHODS: Simulation of Class II MOD composite restorations with a resin bonding system revealed a complex biomechanical behavior arising from the simultaneous effects of polymerization shrinkage, composite stiffness and adhesive interface strain. Due to a polymerization contraction, shrinkage stress increases with the rigidity of the composites utilised in the restoration, while the cusp movements under occlusal loading are inversely proportional to the rigidity of the composites. The adhesive layer's strain also plays a relevant role in the attenuation of the polymerization and occlusal loading stresses. RESULTS: The choice of an appropriately compliant adhesive layer, able to partially absorb the composite deformation, limits the intensity of the stress transmitted to the remaining natural tooth tissues. For adhesives and composites of different rigidities, FEM analysis allows the determination of the optimal adhesive layer thickness leading to maximum stress release while preserving the interface integrity. Application of a thin layer of a more flexible adhesive (lower elastic modulus) leads to the same stress relief as thick layers of less flexible adhesive (higher elastic modulus).     

Filling cavities or restoring teeth?

Teeth seldom fracture under normal functional loading. This indicates that the natural tooth design is optimized for the distribution of regular masticatory forces by means of its properties and structure. When a tooth is restored with an intracoronal restoration, however, the incidence of tooth fracture increases. Since remaining tissues do not change, the restorative actions apparently alter the original stress distributions. In this study, the effect of different restoration types (unbonded amalgam and bonded composite restorations) were compared with the original stress conditions of the intact tooth, using finite element analysis. It was shown that an unbonded amalgam restoration did not restore the original stress conditions but led to much higher stresses in the buccal and lingual enamel and to higher tensile stresses in the cavity floor. The unbonded amalgam thus filled the cavity but did not restore the tooth. In contrast, a bonded composite restoration restored the original stress pattern in the tooth if there was no polymerization shrinkage. Polymerization shrinkage causes residual tensile stresses in the dentin around the cavity and in the buccal and lingual enamel. Residual tensile stresses in the buccal and lingual enamel are momentary compensated by compressive stress components during occlusal loading. It was concluded that bonding and elimination of residual stresses are prerequisites for restoring the original tooth integrity.     

Does layering minimize shrinkage stresses in composite restorations?

Polymerization shrinkage of resin composites may impair restoration longevity. It is hypothesized that layering, rather than bulk, techniques result in less stress in the tooth-restoration complex. The aim of this study was to compare shrinkage stresses for different restorative techniques used for cusp-replacing restorations with direct resin composite. In a 3-D FE model, the dynamic process of shrinkage during polymerization was simulated. Time-dependent parameters (shrinkage, apparent viscosity, Young's modulus, Poisson ratio, and resulting creep), which change during the polymerization process, were implemented. Six different restorative procedures were simulated: a chemically cured bulk technique, a light-cured bulk technique, and 4 light-cured layering techniques. When polymerization shrinkage is considered, a chemically cured composite shows the least resulting stress. The differences seen among various layering build-up techniques were smaller than expected. The results indicate that the stress-bearing locations are the interface and the cervical part of the remaining cusp.     

A mathematical analysis of shrinkage stress development in dental composite restorations during resin polymerization.

OBJECTIVE: To derive an analytical solution of shrinkage stresses in a simplified Class-I composite restoration using a visco-elastic material model. METHODS: Simplified, multi-layer, circular plane models were used to represent different sections of a tooth with a Class-I restoration: one section is close to the top occlusal surface and the other is at a deeper location of the restoration. The sections are therefore subjected to different stress states, i.e., plane-stress and plane-strain, respectively. The analytical solution obtained was compared with the numerical results from finite element analysis. A sensitivity study was then carried out to examine the relative influence of geometric and material parameters on the shrinkage stress development. RESULTS: The analytical solution for the shrinkage stress agrees reasonably well with the numerical results given by finite element analysis of more realistic geometries. The result shows that the residual stresses deep inside the restoration are much higher than those at the occlusal surface. This is because material at the former location is subjected to a stress state similar to that of equi-triaxial tension, which limits stress relaxation through viscous flow. However, a stress concentration exists at the restoration margin on the occlusal surface. Sensitivity analysis indicates that the most important factor in shrinkage stress development is material shrinkage, and the second most important factor is Young's modulus. Viscosity and polymerization rate only affect the residual stresses at the surface. The size of the restoration had relatively little influence on the residual stress development. On the other hand, increasing the enamel thickness increases the stresses inside the restoration but not those at the occlusal surface. SIGNIFICANCE: A visco-elastic solution for the shrinkage stresses developed in a simplified Class-I restoration during polymerization has been derived. The solution allows the influence of several geometric and material parameters on shrinkage stress development to be examined readily. It also provides a benchmark test for more elaborate numerical schemes before they are used to analyse more complicated cases.     

Influence of the shape of the layers in photo-cured dental restorations on the shrinkage stress peaks—FEM study

ObjectiveThe aim of the paper is to analyse an influence of the shape of the layers in photo-cured dental restorations of Class I on distribution of shrinkage stresses along the tooth-restoration interface. The study is a continuation of the previous considerations (Kowalczyk and Gambin (2008) [1]), where techniques, which reduce stress concentration at the top of the tooth-restoration interface, were considered. The analysis leads to proposition of new layer forming techniques, which diminish the stress peaks at the interface and prevent the crack propagation process.MethodsTo find the stress distributions in the dental restoration layers and the tooth tissues the finite element method implemented in the ABAQUS (Simulia, Providence, USA) software is used. For Class I restoration of the premolar tooth, the axisymmetrical model is assumed. The restoration is made of four layers of a photo-cured composite. Between the tooth tissues and the restoration, a layer of bonding agent 0.01 mm thick is placed and modeled by FEM with help of the cohesive elements. The assumed model takes into account an influence of changes of elastic properties and viscous effects. For each case of the restoration layers system, the Huber–Mises stresses are analysed.ResultsThe investigations show that the stresses near the restoration-tooth tissue interface are reduced due to viscous flow of the cured material and due to existence of a thin layer of the bonding agent. However, the stress distribution both, in the restoration and in the tooth tissues, is strongly dependent on a shape of the filling layers. Numerical simulations disclose that stress peaks are located at the top corners of each layer. The top corners of the last layer are the places where microleakage may occur. Stress concentrations at the corners of the preceding layers may lead to a growth of uprising crack. It will be shown that the flat layers in the restoration create relatively high values of the stress peaks. The rounded layers, with shapes close to those used in dental practice, reduce maximal stresses about 40%. According to a common opinion of dentists, the wedge-shaped layers give the best result. In the present paper, another way of the shrinkage stress reduction is proposed. Before the layering, one can cover the surface of the tooth cavity with a thin “pre-layer”. Next, the remainder cavity may be filled with flat, rounded or wedged layers. It will be shown, that in the fillings with the pre-layers, stress peaks are reduced up to 75%, with respect to the fillings composed of the rounded layers only. The proposed method considerably reduces the shrinkage stress, both in the tooth restoration, as well as, in the tooth tissues.SignificanceThe fillings with the pre-layer are easy in application and its analysis gives promising results. The pre-layer may be applied with other layers of different shapes, and its thickness may vary. The method is recommended for cavities with a great loss of the tooth tissue.     

Structural optimization of dental restorations using the principle of adaptive growth.

OBJECTIVES: In a restored tooth, the stresses that occur at the tooth-restoration interface during loading could become large enough to fracture the tooth and/or restoration and it has been estimated that 92% of fractured teeth have been previously restored. The tooth preparation process for a dental restoration is a classical optimization problem: tooth reduction must be minimized to preserve tooth tissue whilst stress levels must be kept low to avoid fracture of the restored unit. The objective of the present study was to derive alternative optimized designs for a second upper premolar cavity preparation by means of structural shape optimization based on the finite element method and biological adaptive growth. METHODS: Three models of cavity preparations were investigated: an inlay design for preparation of a premolar tooth, an undercut cavity design and an onlay preparation. Three restorative materials and several tooth/restoration contact conditions were utilized to replicate the in vitro situation as closely as possible. The optimization process was run for each cavity geometry. RESULTS: Mathematical shape optimization based on biological adaptive growth process was successfully applied to tooth preparations for dental restorations. Significant reduction in stress levels at the tooth-restoration interface where bonding is imperfect was achieved using optimized cavity or restoration shapes. In the best case, the maximum stress value was reduced by more than 50%. SIGNIFICANCE: Shape optimization techniques can provide an efficient and effective means of reducing the stresses in restored teeth and hence has the potential of prolonging their service lives. The technique can easily be adopted for optimizing other dental restorations.     

Substantial regional differences in the biomechanical behavior of molar treated with selective caries tissue removal technique: a finite element study

ObjectivesSelective caries removal (SCR) is recommended over non-selective removal for managing deep carious lesions to avoid pulp exposure and maintain pulp vitality. During SCR, residual carious dentin is left behind and sealed beneath the restoration. The biomechanical effects of such residual lesions on the restored tooth remain unclear and were assessed using finite element modeling (FEM).MethodsBased on μ-CT images of a healthy permanent human third molar, we developed five finite element models. Generic class I and II cavity restorations were modeled where residual lesions of variable sizes were either left or fully removed on occlusal and proximal surfaces. The cavities were restored with adhesive composite. All 3D-FE models were compared with a model of a healthy, non-treated molar. A vertical load of 100 N was applied onto the occlusal surface.ResultsRegardless of the lesion size, in molars with occlusal lesions higher mean stresses were predicted along the filling-lesion interface than in all other models. The smallest occlusal lesion (Ø₁ = 1 mm) resulted in the highest maximum stresses at the filling-lesion interface with large stress concentrations at the filling walls indicating failure risk. In conclusion, lesion site and extent are influencing parameters affecting the filling-lesion interactions and thus the biomechanical behavior of the tooth after SCR.SignificanceRetaining carious lesions around the pulpal floor affects the deformation and stress states in tooth-filling complexes. The higher stresses observed in molars with occlusal lesions may affect restoration stability and longevity. Suprisingly, more extended occlusal lesions may provide a more favorable tooth performance than less extended ones. In contrast, in molars with proximal lesions the residual lesion had only limited effect on the tooth’s biomechanical condition.     

A review of polymerization shrinkage stress: current techniques for posterior direct resin restorations

In general excellent results cannot be guaranteed when using resin-based composites for posterior restorations. This is due to polymerization shrinkage which can still be regarded as the primary negative characteristic of composite resins. A review of available literature regarding the polymerization process, its flaws, and suggested strategies to avoid shrinkage stress was conducted. Several factors responsible for the polymerization process may negatively affect the integrity of the tooth-restoration complex. There is no straightforward way of handling adhesive restorative materials that can guarantee the reliability of a restoration. At present, the practitioner has to coexist with the problem of polymerization shrinkage and destructive shrinkage stress. However, evolving improvements associated with resin-based composite materials, dental adhesives, filling, and light curing techniques have improved the predictability of such restorations. This critical review paper is meant to be a useful contribution to the recognition and understanding of problems related to polymerization shrinkage and to provide clinicians with the opportunity to improve the quality of composite resin restorations.     

Porcelain versus composite inlays/onlays: effects of mechanical loads on stress distribution, adhesion, and crown flexure

This study used 2-D finite element modeling to simulate cuspal flexure and stresses at the surface and tooth-restoration interface of a restored maxillary molar using three restorative materials; the influence of four inlay/onlay preparation configurations on stress distribution within the complex was also investigated. A buccolingual cross-section of an intact molar was digitized and used to create 2-D models restored with different restorative materials (feldspathic porcelain, high- and low-elastic modulus composites) and tooth preparations (small and large inlays, small and large onlays). Two simulated 25-N oblique loads were applied to the cusps. The tangential stress for each finite element node located at the tooth surface, interfacial stress, and relative cuspal flexure were analyzed. All materials and tooth preparations exhibited similar surface tangential stress patterns, with a definite compressive area at the external cusp ridges, a tensile zone at the occlusal surface, and compression stress peaks at the CEJ. The low-elastic modulus composite showed reduced tensile stresses at its surface but increased tension at the dentin-adhesive interface when compared to ceramics. All types of onlays demonstrated a majority of compressive interfacial stresses, while inlays showed a majority of tensile stresses. The interfacial tension at the dentin level increased with the flexibility of the restorative material. Only the large ceramic onlay displayed almost pure compression at the interface. Composite-restored teeth exhibited increased crown flexure, while porcelain-restored teeth showed increased crown stiffness. Porcelain inlays/onlays featured more detrimental stresses at the occlusal surface but better potential protection against debonding at the dentin-restoration interface compared to composite inlays/onlays. Ceramic onlays/overlays seem to represent an effective answer to restore severely damaged posterior teeth.     

Handling of mechanical stresses in composite restorations.

The origin of stress in adhesive resin composite restorations is attributed to restrained shrinkage during polymerization and is dependent on the configuration of the restoration. Moreover, non-homogeneous deformations during functional loading can damage the interface as well as the coherence of the material. Damage from these stresses can be reduced by application of an elastic lining at the adhesive interfaces and by slowing the initial conversion by two-step light initiation of the resin. The various factors that mediate flow and compliance are discussed.     

Visible light-curing: part II

Multiple studies on composite light-curing have focused on the effects of polymerization contraction stresses on restoration margins. Those stresses can potentially cause debonding of restorations and gap formation if they exceed resin bond strengths to enamel and dentin. Such gaps may permit microleakage, resulting in postoperative sensitivity or clinical failure of the restorative treatment. The effects of polymerization shrinkage are dependent on the configuration of the cavity, properties of the restorative material, and the kinetics of polymerization shrinkage. This review analyzes several studies that have been published on the subject     

Stress distribution of inlay-anchored adhesive fixed partial dentures: a finite element analysis of the influence of restorative materials and abutment preparation design

STATEMENT OF PROBLEM: Indirect composite or ceramic fixed partial dentures (FPDs) have become an alternative to conventional metal-ceramic adhesive fixed partial dentures (AFPDs). Little information about the adequate restorative material and tooth preparation design for inlay-anchored AFPDs is available to the clinician. PURPOSE: The purposes of this simulation study were: (1) to use 2-dimensional finite element modeling to simulate stresses at the surface and interface of 3-unit posterior AFPDs made with 6 different restorative materials, and (2) to investigate the influence of 3 different abutment preparation configurations on the stress distribution within the tooth/restoration complex. MATERIAL AND METHODS: A mesio-distal cross-section of a 3-unit AFPD was digitized and used to create 2-dimensional models of the periodontal membrane, supporting bone, different restorative materials (gold, alumina, zirconia, glass-ceramic, composite, and fiber-reinforced composite), and different abutment preparation configurations (interproximal slots vs. 2-surface [MO, DO] vs. 3-surface [MOD]). A simulated 50-N vertical occlusal load was applied to the standardized pontic element. The principal stress within the restorative materials, stresses at the tooth/restoration interface, and surface tangential stresses at the level of the pontic were calculated in MPa from the postprocessing files and compared to each other. RESULTS: All materials and tooth preparation design exhibited a similar stress pattern, with a definite compressive area at the occlusal side of the pontic, a tensile zone at the gingival portion of the pontic, and tensile stress peaks in the abutment/pontic connection areas. Among isotropic materials, standard non-reinforced composites exhibited better stress transfer and reduced tensile stresses at the adhesive interface than ceramics and gold. Optimized placement of the glass fibers within the composite resulted in similar stress distribution when tested in 2-surface abutment preparation configuration. There was no detectable influence of preparation design on the behavior of the pontic area. Among all 3 preparation designs, only the DO design exhibited almost pure compression at the interface. CONCLUSION: Within the limitations of this simulation experiment, the composite materials tested demonstrated a resilient component that favored stress transfer within the tooth/restoration complex. Their clinical use, however, may be contraindicated due to insufficient strength and fracture toughness. The addition of extremely tough fibers to composites represents the most promising combination. Clinical trials are required to ensure that veneering composite can survive under clinical conditions.     

Quality and durability of marginal adaptation in bonded composite restorations

Excellent marginal adaptation extends the longevity of restorations. Unfortunately, polymerization shrinkage of composite restorations adversely affects this quality requirement. The residual stress within the cured resin compromises the material's properties, causes marginal openings, and flexes cavity walls. In this study, the wall-to-wall contraction in MOD cavities was measured for different placement techniques. In addition, the restoration margins were quantitated before and after thermo-cycling and mechanical stressing. Factors which enhanced adaptation also optimized marginal quality and reduced the amount of residual stress. The latter was expressed by intercuspal narrowing after the restoration was completed. Both quality and stress resistance of the marginal adaptation were inversely correlated to the intercuspal narrowing caused by the polymerization contraction of bonded and excellently adapted resin restorations. The most effective factors which optimized marginal quality included: guidance of the shrinkage vectors; reducing the ratio of bonded to free, unbonded restoration surfaces; and minimizing the mass of in situ-cured composite. The latter principle was followed best in the adhesive inlay technique. In medium-sized adhesive MOD composite inlays, the volume loss induced by the polymerization contraction of the composite cement was non-destructively compensated for by an inward flexing of each cavity wall of approximately 10 microM.     

Evaluation of the biomechanical behavior of maxillary central incisors restored by means of endocrowns compared to a natural tooth: a 3D static linear finite elements analysis.

OBJECTIVE: The present study aimed at evaluating different restoring configurations of a crownless maxillary central incisor, in order to compare the biomechanical behavior of the restored tooth with that of a sound tooth. MATERIALS AND METHODS: A 3D FE model of a maxillary central incisor is presented. An arbitrary static force of 10 N was applied with an angulation of 125 degrees to the tooth longitudinal axis at level of the palatal surface of the crown. Different material configurations were tested: composite, syntered alumina, feldspathic ceramic endocrowns and glass post resorations with syntered alumina and feldspathic ceramic crown. RESULTS: High modulus materials used for the restoration strongly alter the natural biomechanical behavior of the tooth. Critical areas of high stress concentration are the restoration-cement-dentin interface both in the root canal and on the buccal and lingual aspects of the tooth-restoration interface. Materials with mechanical properties underposable to that of dentin or enamel improve the biomechanical behavior of the restored tooth reducing the areas of high stress concentration. SIGNIFICANCE: The use of endocrown restorations present the advantage of reducing the interfaces of the restorative system. The choice of the restorative materials should be carefully evaluated. Materials with mechanical properties similar to those of sound teeth improve the reliability of the restoartive system.     

纤维桩对复合树脂修复根管治疗后磨牙影响的有限元研究

目的 探讨上颌第一磨牙根管治疗后树脂充填修复和纤维桩结合树脂充填修复对其牙体及充填体的应力分布的影响。方法 采用计算机体层摄影术（CT）、有限元法建立根管治疗后树脂修复（A组）及纤维桩树脂修复（B组）的上颌第一磨牙模型,以600 N总载荷垂直加载模拟最大咬合力,以200 N总载荷45°斜向加载模拟咀嚼力,分析两组模型的牙体及充填体Von Mises应力特征。结果 A组、B组的牙体Von Mises应力分布模式相似,B组颊侧颈部形成应力集中,应力峰值位于釉牙骨质界;最大咬合力条件下,B组Von Mises应力峰值在牙本质外表面低于A组,内表面高于A组;咀嚼力条件下,B组Von Mises应力峰值在剩余牙体的各部位均较A组低。B组树脂充填体表面的Von Mises应力峰值及高应力区范围均明显小于A组。结论 纤维桩的存在可降低牙本质及树脂充填体的应力峰值,提高患牙抗折强度,而颈部应力集中可能导致牙折发生位置偏高。     

Polymerization contraction stress of resin composite restorations in a model Class I cavity configuration using photoelastic analysis

PURPOSE: An important factor that contributes to deterioration of resin composite restorations is contraction stress that occurs during polymerization. The purpose of this article is to familiarize the clinician with the characteristics of contraction stress by visualizing the stresses associated with this invisible and complex phenomenon. MATERIALS AND METHODS: Internal residual stresses generated during polymerization of resin composite restorations were determined using micro-photoelastic analysis. Butt-joint preparations simulating Class I restorations (2.0 mm x 5.0 mm, 2.0 mm in depth) were prepared in three types of substrates (bovine teeth, posterior composite resin, and transparent composite resin) and were used to examine contraction stress in and around the preparations. Three types of composite materials (a posterior composite, a self-cured transparent composite, and a light-cured transparent composite) were used as the restorative materials. The self-cured composite is an experimental material, and the others are commercial products. After treatment of the preparation walls with a bonding system, the preparations were bulk-filled with composite. Specimens for photoelastic analysis were prepared by cutting sections perpendicular to the long axis of the preparation. Fringe patterns for directions and magnitudes of stresses were obtained using transmitted and reflected polarized light with polarizing microscopes. Then, the photoelastic analysis was performed to examine stresses in and around the preparations. RESULTS: When cavity preparations in bovine teeth were filled with light-cured composite, a gap was formed between the dentinal wall and the composite restorative material, resulting in very low stress within the restoration. When cavity preparations in the posterior composite models were filled with either self-cured or light-cured composite, the stress distribution in the two composites was similar, but the magnitude of the stress was greater in the light-cured material. When preparations in the transparent composite models were filled with posterior composite and light-cured transparent composite material, significant stress was generated in the preparation models simulating tooth structure, owing to the contraction of both restorative materials. CLINICAL SIGNIFICANCE: Polymerization contraction stress is an undesirable and inevitable characteristic of adhesive restorations encountered in clinical dentistry that may compromise restoration success. Clinicians must understand the concept of polymerization contraction stress and realize that the quality of composite resin restorations depends on successful management of these stresses.     

Cuspal flexure of teeth with composite restorations subjected to occlusal loading

PURPOSE: To measure in vitro the cuspal deflection produced by polymerization shrinkage and occlusal loading in mesio-occlusal (MO) and mesio-occlusal-distal (MOD) bonded composite restorations. MATERIALS AND METHODS: Twenty first premolars were studied, attaching a small crystal ball to each cusp vertex as a reference point for intercuspal distance measurements. MO cavities were made in ten premolars and MOD cavities in the other ten. Cavities were then restored with Syntac Single adhesive and Tetric Ceram composite in two increments. A precision micrometer was used to measure intercuspal distances in unaltered teeth (baseline distance), unaltered teeth under 150 N load, restored teeth at 5 min after restoration completion, and restored teeth under 150 N load. RESULTS: In the two study groups, both polymerization shrinkage and application of 150 N load produced a statistically significant change in intercuspal distance compared with baseline measurement. The cuspal deflection produced by 150 N load was statistically similar between unaltered and restored teeth, although polymerization shrinkage acted as a preload in the latter case (starting point was not baseline condition). The cuspal deflection produced by polymerization shrinkage and occlusal load was significantly greater in MOD than in MO restorations. CONCLUSION: The cuspal deflection produced by composite polymerization shrinkage and occlusal loading is significantly greater in MOD vs MO composite restorations.     

A comparison of the mechanical behavior of posterior teeth with amalgam and composite MOD restorations

OBJECTIVE: To compare the mechanical behavior, and infer differences in fracture resistance, of mandibular molars with amalgam and composite MOD restorations to that of an unrestored molar. METHOD: Finite element models were developed for an unrestored molar and molars with MOD amalgam and composite restorations. The location and magnitude of maximum principal stress resulting from simultaneous mechanical and thermal loads were determined for each molar using a series of designed experiments. An analysis of variance was conducted with the components of stress to distinguish the relative influence of oral parameters and restoration on the stress distribution in each molar. RESULTS: The maximum principal stress in the unrestored molar was the largest of all three molars examined and occurred within the dentin along the pulpal wall. Maximum principal stresses in the molars with amalgam and composite restorations both occurred along the cavosurface margin. Maximum principal stresses in the molar with amalgam restoration occurred at the pulpal floor and lingual wall junction and resulted from large occlusal loads. Although occlusal loading had minimal effects on the stress distribution within the molar with composite restoration, low oral temperatures were responsible for the maximum principal stresses, which were found at the lingual margin and occlusal surface junction. CONCLUSION: There was no significant difference in the magnitude of maximum stress that occurred in the molars with amalgam and light curing composite restorations. However, the location and orientation of maximum stress in the restored molars were largely dependent on the restorative material. Although clinical studies report that tooth fracture occurs predominately to restored molars, the unrestored molar experienced the highest stress in this investigation. Therefore, the reduction in fracture resistance of restored posterior teeth appears to result from changes in the location of maximum stress resulting from mastication and temperature changes.     

Effects of polymerization shrinkage on the interfacial stress at resin-metal joint in denture-base: a non-linear FE stress analysis.

OBJECTIVES: The purpose of this study was to investigate the effects of polymerization shrinkage on stress at the interface between resin and metal in removable dentures. METHODS: Three-dimensional finite element models of a denture-base were studied, which consisted of acrylic occlusal rims with different heights and metal frameworks. A relaxation modulus of 1.5 GPa for the resin and a Young's modulus of 220 GPa for the metal were used as the material properties. Each model was constrained at the edge of the framework on the palatal vault. Surface-to-surface contact elements were used to calculate the interfacial stress in a direction perpendicular to the bond surface under a linear shrinkage ranging from 0.41 to 0.65%. The principal stress within the resin was also calculated. RESULTS: The maximum interfacial and principal stresses within the denture-base increased with resin shrinkage. Under the lowest linear shrinkage, the mean area percentages in the resin-metal joint that showed interfacial tensile stresses over 10 and 20 MPa were 63.4 and 0%, respectively. While under the highest linear shrinkage, these mean area percentages were 98.8 and 38.1%, respectively. Negligible differences in the stresses were shown by occlusal heights. SIGNIFICANCE: The polymerization shrinkage level has a significant influence on the residual stress at the resin-metal interface. Enhancement of the bond strength on the interface can reduce the failure probability at a resin-metal joint.