Three-dimensional finite element stress analysis of surface-mounted inlays in repairing pulp-penetrating non-carious cervical lesion of maxillary first premolar

doi:10.7518/hxkq.2023.2023123

Abstract

Abstract:

Objective This study aimed to explore the stress distribution of surface-mounted inlays with two ceramic materials and different strategies for fiber post-restoration on pulp-penetrating non-carious cervical lesion in a maxillary first premolar to provide minimally invasive and reasonable restorative methods. Methods The cone beam computed tomography data of the standard right upper first premolar were selected. Healthy control (HC) and defective control (DC) finite element models were established. Then, eight experimental models were established according to two different ceramic materials (IPS e.max CAD [LD] and Lava Ultimate [LU]) and different locations of fiber post (without fiber post [NP], fiber post in buccal root canal [B], fiber post in palatal root canal [P], fiber post in both root canals [BP]), namely, LD_NP, LD_B, LD_P, LD_BP, LU_NP, LU_B, LU_P, and LU_BP. Axial load F1 and lateral load F2 were applied. Maximum principal stress and displacement of the buccal tip were investigated using finite element analysis software. Then, the percentage change of the following indicators in each experimental group was analyzed: stress of defective tip with group DC, stress of enamel and dentine, and displacement of buccal tips with group HC. It was considered similar when the percentage change was less than 5%. Results LD and LU groups could effectively reduce the stress of the defective tip, but the decreasing amplitude in the former was greater than that of the latter. For the stress of surface-mounted inlays and resin adhesive layer, LD groups were higher than LU groups, and no significant difference in stress peak was found among different experimental groups in the same material. In addition, fiber posts in double root canals could significantly reduce buccal tip displacement. Conclusion For pulp-penetrating non-carious cervical lesions, the restorative strategy of surface-mounted inlays could be applied. Compared with Lava Ultimate, IPS e.max CAD could better protect the defective tip tooth. Furthermore, fiber posts in double root canals could decrease overall deformation and increase the retention of surface-mounted inlays.

Key words: surface-mounted inlay, fiber post, stress analysis, displacement of buccal tip

CLC Number:

R 783.3

Ma Dian, Qian Jie.. Three-dimensional finite element stress analysis of surface-mounted inlays in repairing pulp-penetrating non-carious cervical lesion of maxillary first premolar[J]. West China Journal of Stomatology, 2023, 41(5): 541-553.

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组别	修复方式
HC	健康对照组
DC	缺损对照组
LD_NP	根管治疗+无纤维桩+LD贴面式嵌体
LU_NP	根管治疗+无纤维桩+LU贴面式嵌体
LD_B	根管治疗+颊侧根管纤维桩+LD贴面式嵌体
LU_B	根管治疗+颊侧根管纤维桩+LU贴面式嵌体
LD_P	根管治疗+腭侧根管纤维桩+LD贴面式嵌体
LU_P	根管治疗+腭侧根管纤维桩+LU贴面式嵌体
LD_BP	根管治疗+颊腭侧根管纤维桩+LD贴面式嵌体
LU_BP	根管治疗+颊腭侧根管纤维桩+LU贴面式嵌体

材料	弹性模量/MPa	泊松比
釉质	84 100	0.31
牙本质	18 600	0.31
牙髓	2	0.45
牙周膜	68.9	0.45
皮质骨	13 700	0.30
松质骨	1 370	0.30
树脂	10 000	0.24
纤维桩	18 000	0.30
树脂粘接剂	8 300	0.35
Lava Ultimate	12 700	0.45
IPS e.max CAD	102 700	0.215

组别	F1载荷下的应力峰值/MPa	较DC组的变化量	F2载荷下的应力峰值/MPa	较DC组的变化量
DC	9.248	-	156.690	-
LD_NP	4.665	-49.56%	19.198	-87.75%
LD_B	3.481	-62.36%	19.054	-87.84%
LD_P	4.617	-50.07%	19.095	-87.81%
LD_BP	4.757	-48.55%	18.703	-88.06%
LU_NP	4.019	-56.54%	36.446	-76.74%
LU_B	3.669	-60.32%	35.860	-77.11%
LU_P	3.959	-57.19%	36.491	-76.71%
LU_BP	4.023	-56.49%	35.992	-77.03%

组别	F1载荷下的颊尖位移量/μm	较HC组变化量	F2载荷下的颊尖位移量/μm	较HC组变化量
HC	6.723	-	34.658	-
DC	7.188	-	39.130	-
LD_NP	6.756	0.49%	34.319	-0.97%
LD_B	6.750	0.40%	34.284	-1.07%
LD_P	6.737	0.20%	34.217	-1.27%
LD_BP	4.780	-28.90%	31.779	-8.30%
LU_NP	7.008	4.23%	35.524	2.49%
LU_B	6.982	3.85%	34.945	0.82%
LU_P	6.902	2.66%	34.873	0.62%
LU_BP	4.982	-25.89%	32.449	-6.37%

组别	F1载荷下的应力峰值/MPa	较HC组的变化量	F2载荷下的应力峰值/MPa	较HC组的变化量
HC	43.854	-	52.713	-
DC	44.685	-	156.690	-
LD_NP	43.701	-0.34%	55.759	5.77%
LD_B	43.761	-0.21%	55.253	4.81%
LD_P	41.768	-4.75%	50.327	-4.52%
LD_BP	41.820	-4.63%	50.292	-4.59%
LU_NP	43.660	-0.44%	55.570	5.41%
LU_B	43.725	-0.29%	55.061	4.45%
LU_P	41.728	-4.84%	50.136	-4.88%
LU_BP	41.796	-4.69%	50.092	-4.97%