Document Type

Article

Publication Date

2023

Abstract

Introduction: This study investigated the effects from the carious cavity and access from it on the fracture resistance of endodontically treated maxillary premolars using finite element analysis (FEA). Methods: A maxillary premolar was used to compare three types of access cavity related to having a proximal carious defect: Caries-driven access (CDA), Conservative access that has a mesial component (MCA) as well as traditional access with the same mesial component (MTA). Cyclic loading was simulated on the occlusal surface and number of cycles till failure (NCF) was compared to the intact tooth model (IT). Mathematical analysis was done to evaluate the stress distribution patterns and calculated maximum von Mises (vM) and maximum principal stresses (MPS), with emphasis on pericervical region as a specific area of interest.

Results: Maximum vM registered on the IT was 6.14 MPa. The CDA provided the highest NCF with 92.28% of the IT, followed by MCA (84.90%) and MTA (83.79%). The vM and MPS analysis showed that the stress values and patterns are affected more by the proximity of the occlusal load to the tooth/restoration interface. Concerning the pericervical region, maximum vM was registered for IT (4.11 MPa), followed by the CDA (4.85 MPa), then MCA (8.13 MPa) and MTA (8.61 MPa). While the MPS analysis revealed that the CDA showed the highest magnitude of tensile stresses.

Conclusion: A proximal CDA benefits the mechanical properties of maxillary premolars, however its impact on the biological aspect should be assessed to provide a ruling for/against it.

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