Effects of Apical Barriers and Root Filling Materials on Stress Distribution in Immature Teeth: Finite Element Analysis Study |
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| Affiliation: | 1. School of Dentistry, Loma Linda University, Loma Linda, California;2. Endodontics Department, School of Dentistry, Loma Linda University, Loma Linda, California;3. Center for Dental Research, School of Dentistry, Loma Linda University, Loma Linda, California;1. Department of Endodontics, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas;2. Department of Restorative Dentistry and Prosthodontics, The University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas;1. Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada;2. Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran;3. School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran;4. Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, Ontario, Canada;6. Department of Oral and Maxillofacial Radiology, North Khorasan University of Medical Sciences, Bojnurd, Iran;5. Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada;1. Department of Endodontics, University of Iowa College of Dentistry, Iowa City, Iowa;2. Advanced Endodontics of Texas, Keller, Texas;1. Department of Periodontology, Medical University of Warsaw, Warsaw, Poland;2. Private Orthodontic Practice, Warsaw, Poland;3. Department of Orthodontics, Medical University of Warsaw, Warsaw, Poland;4. Department of Molecular Biology and Genetics, Medical University of Silesia, Katowice, Poland;6. Orthodontic and Dental Private Practice, Zabrze, Poland;5. Faculty of Humanities, University of Silesia, Katowice, Poland |
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| Abstract: | PurposeA finite element analysis (FEA) study was performed to determine whether the material of apical barrier used for root apexification and/or the use of canal reinforcement affect the stress distribution in an endodontically treated immature permanent tooth in order to infer in which clinical scenarios a fracture is more likely to occur based on the ultimate tensile strength threshold of dentin.Methods and MaterialsAn extracted human immature mandibular premolar was selected as the reference model and scanned by micro-computed tomography (micro-CT). The digital model was segmented and converted to STL (Standard Tessellation Language) using Simpleware Scan-IP and exported in IGES (Initial Graphics Exchange Specification) to Ansys 19. Six experimental models were designed with different combinations of composite, mineral trioxide aggregate (MTA), and Biodentine (BIO). Using FEA, a static 300 N load at a 135 angle with respect to the axis of the tooth was applied to each model and von Mises stress values (MPa) were measured at the sagittal, apical 8-mm, 5-mm, 2-mm, and 1-mm levels.ResultsIn all regions examined, the control (NT model) had lower stress in the root compared WITH experimental models. At the mid-root level, models with composite, MTA, and BIO reinforcement exhibited lower stresses in the root dentin than those with pulp or gutta-percha. BIO models had equal or greater average von Mises stress values than those of MTA models in all regions. Both, MTA and BIO, caused increases in stress of surrounding root dentin, with BIO causing a greater increase than MTA.ConclusionsStress distribution in immature permanent teeth treated by apexification is affected by the types of materials used. Root dentin's stress was lower when the mid-root canal was reinforced by composite, MTA, or BIO, which provided similar stress reduction to the root dentin. MTA is a more favorable apical barrier material from a mechanical standpoint because it induces less stress on apical root dentin than BIO. |
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| Keywords: | Apical barriers filling materials finite element analysis endodontic |
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