Stress analysis of maxillary central incisors endodontically -treated with varying ferrule heights and three different post dowel materials - A finite element analysis.
AbstractStatement of problem : fracture of endodontically treated teeth is reduced by the use of a post with ferrule, but the effect of different ferrule configurations and dowel materials is not clear. Purpose: to evaluate the effect of ferrules with different configurations and heights on the stress of endodontically treated teeth restored with three different post and dowel materials. Materials and Methods: fifteen models of maxillary central incisors restored with porcelain fused to metal crowns were obtained using pro engineer software. the models were divided into three groups, each consisting of five models with ferrule heights of 0mm, 2mm, 4mm, 2mm with oblique fracture, 4mm with oblique fracture, the models under group GFR were restored with fiberglass reinforced post (GFR) and composite core build-up, group NiCr with a custom cast post metal alloy (NiCr), and group Zr with zirconia post (Zr) and composite core build-up. an oblique load of 100N and 150N at an angle of 135 degrees was applied to the palatal surface of the tooth, a vertical load of 100N and 150N at an angle of 90 degrees was applied to the incisal tip of the tooth. The maximum principal stress and the von mises stress was calculated for the remaining tooth structure and post apex using the finite element analysis (FEA) software. Results: the maximum von misses stress was observed in the apex of the post (p<0.05). Group Zr showed the highest mean stress (6.39Mpa) followed by group NiCr (5.65Mpa). There was a significant difference between post and between NiCr and Zr post for 2mm and 4mm ferrule height, while for 0mm ferrule there was a significant difference between the GFR and NiCr groups (p<0.05). Under oblique load, the maximum mean stress was observed in remaining tooth structures while for vertical load, it was observed at the apex of the post. Regarding ferrule heights, there were significant differences between 0mm-2mm, and 0mm-4mm uniform ferrule in post apex in the case of NiCr posts (p<0.05). Absence of ferrule resulted in higher stress for the NiCr group. Conclusion: higher loads that led to fracture were observed only at the apex of the post. Zirconia posts (group Zr) had higher fracture loads, whereas absence of ferrule resulted in higher fracture load with custom cast posts (group NiCr). Fracture thresholds were high on the remaining tooth structure for all the dowel systems especially for composite core build up irrespective of ferrule height and configuration. Clinical implications: appropriate selection of post and dowel materials in different configurations of ferrule heights ensures clinical success.
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