Comparative 3D Finite Element Stress Analysis of Monolithic Lithium Disilicate and Dual-Layered Endocrown Restorations
DOI:
https://doi.org/10.32828/mdj.v21i2.1198Keywords:
Finite Element Analysis, Endocrown, Hybrid Ceramics, Lithium Disilicate, Dual Layered, Stress DistributionAbstract
Aim: To evaluate and compare the stress distribution of monolithic lithium disilicate (LDS) and dual-layered endocrown restorations for endodontically treated teeth (ETT) using finite element analysis (FEA).
Method: A mandibular first molar model was created using CBCT and CAD software with standardized cavity dimensions and material properties. Two models were designed: Model A (monolithic LDS endocrown) and Model B (dual-layered endocrown with a Lava Ultimate endocore veneered with LDS). FEA simulated stress distribution under a 600 N axial load. The von Mises stress values were analyzed to evaluate stress concentration and distribution.
Result: Model A exhibited higher stress concentration at the occlusal surface and cervical regions, with a maximum von Mises (VM) stress of 17.20 MPa in LDS. In contrast, Model B demonstrated a more uniform stress distribution, with the maximum VM stress reduced to 4.87 MPa in LDS and 4.24 MPa for endocore. Additionally, Model A showed high stress levels at the cervical rim (16.05 MPa), while Model B presented a lower VM stress of 9.88 MPa. Dentin stress was also higher in Model A (4.37 MPa) compared to Model B (3.49 MPa).
Conclusion: Dual-layered endocrowns demonstrated favorable stress distribution compared to monolithic designs, suggesting greater durability for restoring endodontically treated teeth. Experimental validation is recommended.
References
1. Schestatsky R, Dartora G, Felberg R, Spazzin AO, Sarkis-Onofre R, Bacchi A, et al. Do endodontic retreatment techniques influence the fracture strength of endodontically treated teeth? A systematic review and meta-analysis. J Mech Behav Biomed Mater. 2019; 90:306-12.
2. Phang ZY, Quek SHQ, Teoh KH, Tan KBC, Tan K. A retrospective study on the success, survival, and incidence of complications of post-retained restorations in premolars supporting fixed dental prostheses with a mean of 7 years in function. Int J Prosthodont. 2020; 33:176-83.
3. Govare N, Contrepois M. Endocrowns: A systematic review. J Prosthet Dent. 2020; 123:411-8. e9.
4. Sedrez-Porto JA, da Rosa WLdO, Da Silva AF, Münchow EA, Pereira-Cenci T. Endocrown restorations: A systematic review and meta-analysis. J Dent. 2016; 52:8-14.
5. Pissis P. Fabrication of a metal-free ceramic restoration utilizing the monobloc technique. Pract Periodontics Aesthet Dent: PPAD. 1995; 7:83-94.
6. Biacchi G, Basting R. Comparison of fracture strength of endocrowns and glass fiber post-retained conventional crowns. Oper Dent. 2012; 37:130-6.
7. El-Damanhoury HM, Haj-Ali RN, Platt JA. Fracture resistance and microleakage of endocrowns utilizing three CAD-CAM blocks. Oper Dent. 2015; 40:201-10.
8. Chen Y, Yeung AW, Pow EH, Tsoi JK. Current status and research trends of lithium disilicate in dentistry: A bibliometric analysis. J Prosthet Dent. 2021; 126:512-22.
9. El Ghoul W, Özcan M, Silwadi M, Salameh Z. Fracture resistance and failure modes of endocrowns manufactured with different CAD/CAM materials under axial and lateral loading. J Esthet Restor Dent. 2019; 31:378-87.
10. Sedrez-Porto JA, Münchow EA, Cenci MS, Pereira-Cenci T. Which materials would account for a better mechanical behavior for direct endocrown restorations? J Mech Behav Biomed Mater. 2020; 103:103592.
11. Tribst JPM, Dal Piva AMdO, Madruga CFL, Valera MC, Borges ALS, Bresciani E, et al. Endocrown restorations: Influence of dental remnant and restorative material on stress distribution. Dent Mater. 2018; 34:1466-73.
12. Huang M, Wang R, Thompson V, Rekow D, Soboyejo W. Bioinspired design of dental multilayers. J Mater Sci Mater Med. 2007; 18:57-64.
13. Jargalsaikhan U, Wan H, Leung N, Song X, Hu J, Su B, et al. Micromechanical modelling for bending behaviour of novel bioinspired alumina-based dental composites. Dent Mater. 2024; 40:1669-76.
14. Eskitaşçioğlu M, Küçük O, Eskitaşçioğlu G, Eraslan O, Belli S. The effect of different materials and techniques on stress distribution in CAD/CAM endocrowns. Strength Mater. 2020; 52:812-9.
15. Awada A, Nathanson D. Mechanical properties of resin-ceramic CAD/CAM restorative materials. J Prosthet Dent. 2015; 114:587-93.
16. Della Bona A, Corazza PH, Zhang Y. Characterization of a polymer-infiltrated ceramic-network material. Dent Mater. 2014; 30:564-9.
17. Fathy H, Hamama HH, El-Wassefy N, Mahmoud SH. Clinical performance of resin-matrix ceramic partial coverage restorations: a systematic review. Clin Oral Investig. 2022; 26:3807-22.
18. Goujat A, Abouelleil H, Colon P, Jeannin C, Pradelle N, Seux D, et al. Mechanical properties and internal fit of 4 CAD-CAM block materials. J Prosthet Dent. 2018; 119:384-9.
19. Ural Ç, Çağlayan E. A 3-dimensional finite element and in vitro analysis of endocrown restorations fabricated with different preparation designs and various restorative materials. J Prosthet Dent. 2021; 126:586. e1-. e9.
20. Albelasy EH, Hamama HH, Tsoi JK, Mahmoud SH. Fracture resistance of CAD/CAM occlusal veneers: a systematic review of laboratory studies. J Mech Behav Biomed Mater. 2020; 110:103948.
21. Shams A, Elsherbini M, Elsherbiny AA, Özcan M, Sakrana AA. Rehabilitation of severely-destructed endodontically treated premolar teeth with novel endocrown system: biomechanical behavior assessment through 3D finite element and in vitro analyses. J Mech Behav Biomed Mater. 2022; 126:105031.
22. Dartora G, Pereira GKR, de Carvalho RV, Zucuni CP, Valandro LF, Cesar PF, et al. Comparison of endocrowns made of lithium disilicate glass-ceramic or polymer-infiltrated ceramic networks and direct composite resin restorations: fatigue performance and stress distribution. J Mech Behav Biomed Mater. 2019; 100:103401.
23. Zhu J, Rong Q, Wang X, Gao X. Influence of remaining tooth structure and restorative material type on stress distribution in endodontically treated maxillary premolars: A finite element analysis. J Prosthet Dent. 2017; 117:646-55.
24. Zheng Z, He Y, Ruan W, Ling Z, Zheng C, Gai Y, et al. Biomechanical behavior of endocrown restorations with different CAD-CAM materials: A 3D finite element and in vitro analysis. J Prosthet Dent. 2021; 125:890-9.
25. Gresnigt MM, Özcan M, van den Houten ML, Schipper L, Cune MS. Fracture strength, failure type and Weibull characteristics of lithium disilicate and multiphase resin composite endocrowns under axial and lateral forces. Dent Mater. 2016; 32:607-14.
26. Bakke M, Michler L, Möller E. Occlusal control of mandibular elevator muscles. Eur J Oral Sci. 1992; 100:284-91.
27. Tortopidis D, Lyons M, Baxendale R, Gilmour W. The variability of bite force measurement between sessions, in different positions within the dental arch. J Oral Rehabil. 1998; 25:681-6.
28. [Dal Piva AMdO, Tribst JPM, Borges ALS, e Souza ROdA, Bottino MA. CAD-FEA modeling and analysis of different full crown monolithic restorations. Dent Mater. 2018; 34:1342-50.
29. Al-khafaji S, Jasim H. Fracture Resistance of Endodontically Treated Teeth Restored by Full Crown and Two Endocrowns Preparation Design Made from Lithium Disilicate Material (A Comparative in Vitro Study). Int Med J. 2020; 25:2531-42.
30. Al-Dabbagh RA. Survival and success of endocrowns: A systematic review and meta-analysis. J Prosthet Dent. 2021; 125:415. e1-. e9.
31. Kwon SJ, Lawson NC, McLaren EE, Nejat AH, Burgess JO. Comparison of the mechanical properties of translucent zirconia and lithium disilicate. J Prosthet Dent. 2018; 120:132-7.
32. Köseoğlu M, Furuncuoğlu F. Effect of polyetheretherketone and indirect composite resin thickness on stress distribution in maxillary premolar teeth restored with endocrown: a 3D finite element analysis. J Biotechnol Strateg Health Res. 2020; 4:298-305.
33. Attik N, Richert R, Garoushi S. Biomechanics, Bioactive and Biomimetic Philosophy in Restorative Dentistry ̶ Quo vadis? J Dent. 2024:105036.
34. Madeira L, Weber KR, Carpenedo N, Zhang Y, Porto TS, Meira JBC, et al. Effect of elastic gradients on the fracture resistance of tri-layer restorative systems. Dent Mater. 2024.
35. Habelitz S, Marshall S, Marshall Jr G, Balooch M. Mechanical properties of human dental enamel on the nanometre scale. Arch Oral Biol. 2001; 46:173-83.
36. Craig RG, Peyton FA. Elastic and mechanical properties of human dentin. J Dent Res. 1958; 37:710-8.
37. Reinhardt RA, Krejci R, Pao Y, Stannard J. Dentin stresses in post-reconstructed teeth with diminishing bone support. J Dent Res. 1983; 62:1002-8.
38. Rocca GT, Daher R, Saratti CM, Sedlacek R, Suchy T, Feilzer AJ, et al. Restoration of severely damaged endodontically treated premolars: The influence of the endo-core length on marginal integrity and fatigue resistance of lithium disilicate CAD-CAM ceramic endocrowns. J Dent. 2018; 68:41-50.
39. Kim SY, Kim BS, Kim H, Cho SY. Occlusal stress distribution and remaining crack propagation of a cracked tooth treated with different materials and designs: 3D finite element analysis. Dent Mater. 2021; 37:731-40.
40. Tribst JPM, Dal Piva AM, de Melo RM, Borges AL, Bottino MA, Özcan M. Influence of restorative material and cement on the stress distribution of posterior resin-bonded fixed dental prostheses: 3D finite element analysis. J Mech Behav Biomed Mater. 2019; 96, 279-284.
41. Soares CJ, Soares PV, Santos-Filho PCF, Castro CG, Magalhaes D, Versluis A. The influence of cavity design and glass fiber posts on biomechanical behavior of endodontically treated premolars. J Endod. 2008; 34:1015-9.
42. Aversa R, Apicella D, Perillo L, Sorrentino R, Zarone F, Ferrari M, et al. Non-linear elastic three-dimensional finite element analysis on the effect of endocrown material rigidity on alveolar bone remodeling process. Dent Mater. 2009; 25:678-90.
43. Yamaguchi S, Kani R, Kawakami K, Tsuji M, Inoue S, Lee C, et al. Fatigue behavior and crack initiation of CAD/CAM resin composite molar crowns. Dent Mater. 2018; 34:1578-84.
44. He J, Zheng Z, Wu M, Zheng C, Zeng Y, Yan W, et al. Influence of restorative material and cement on the stress distribution of endocrowns: 3D finite element analysis. BMC Oral Health. 2021; 21:1-9.
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