Optimization of resilience and stress distribution in porcelain veneers for the treatment of crown-fractured incisors. 1999

P Magne, and W H Douglas
Department of Oral Science, School of Dentistry, University of Minnesota, Minneapolis, USA. Pascal.Magne@medecine.unige.ch

The present study was conducted to define, when restoring extensive loss of dentin, the configuration of the restoration that will best reproduce the biomechanical properties of the intact original tooth in terms of resilience and stress distribution. The treatment of 1/3-crown fractures and 2/3-crown fractures was investigated using different designs of facial porcelain veneers with and without underlying composite buildup. The stress distribution and tooth compliance were assessed in a numeric model reproducing a 2-dimensional buccolingual cross section of an incisor. A 50-N facial force was applied to simulate an incisal impact situation. The facial surface tangential stresses were calculated, and the maximum displacement (horizontal direction) at the most incisal node of the enamel surface was also recorded and used to calculate the tooth compliance (i.e., displacement/load or resilience) for each test condition. Tensile stresses were generated on the facial surface of the porcelain laminates with a similar pattern for all test conditions, the cervical part of the crown being the most quiescent area. Substantial differences appeared in the incisal half of the crown, the lowest stresses being observed for extensively fractured teeth restored without composite buildup (facial peaks at approximately 33 MPa). Fractured teeth restored with minimal veneers and a "dentin-like" composite buildup showed stress patterns similar to the intact tooth (facial peaks at approximately 50 MPa). The natural tooth gave the highest tooth compliance or flexibility. All restorative designs featured increased tooth stiffness. However, the original tooth compliance was almost restored when composite was used to replace the missing dentin, with the porcelain acting only as a facial and incisal enamel substitute. When restoring crown-fractured incisors, tooth compliance and stress distribution can be modulated by the combination of composite and ceramics. Optimized configurations can be reached to reproduce the original biomechanical behavior of the intact tooth. The use of ceramic alone generates low stress concentrations, but also less compliant restored teeth.

UI MeSH Term Description Entries
D007180 Incisor Any of the eight frontal teeth (four maxillary and four mandibular) having a sharp incisal edge for cutting food and a single root, which occurs in man both as a deciduous and a permanent tooth. (Jablonski, Dictionary of Dentistry, 1992, p820) Incisors
D003776 Dental Porcelain A type of porcelain used in dental restorations, either jacket crowns or inlays, artificial teeth, or metal-ceramic crowns. It is essentially a mixture of particles of feldspar and quartz, the feldspar melting first and providing a glass matrix for the quartz. Dental porcelain is produced by mixing ceramic powder (a mixture of quartz, kaolin, pigments, opacifiers, a suitable flux, and other substances) with distilled water. (From Jablonski's Dictionary of Dentistry, 1992) Porcelain,Porcelain, Dental,Dental Porcelains,Porcelains,Porcelains, Dental
D003799 Dental Stress Analysis The description and measurement of the various factors that produce physical stress upon dental restorations, prostheses, or appliances, materials associated with them, or the natural oral structures. Analyses, Dental Stress,Analysis, Dental Stress,Stress Analyses, Dental,Stress Analysis, Dental,Dental Stress Analyses
D003801 Dental Veneers The use of a layer of tooth-colored material, usually porcelain or acrylic resin, applied to the surface of natural teeth, crowns, or pontics by fusion, cementation, or mechanical retention. Dental Laminates,Dental Laminate,Dental Veneer,Laminate, Dental,Laminates, Dental,Veneer, Dental,Veneers, Dental
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001696 Biomechanical Phenomena The properties, processes, and behavior of biological systems under the action of mechanical forces. Biomechanics,Kinematics,Biomechanic Phenomena,Mechanobiological Phenomena,Biomechanic,Biomechanic Phenomenas,Phenomena, Biomechanic,Phenomena, Biomechanical,Phenomena, Mechanobiological,Phenomenas, Biomechanic
D014082 Tooth Fractures Break or rupture of a tooth or tooth root. Fracture, Tooth,Fractures, Tooth,Tooth Fracture
D017267 Dental Prosthesis Design The plan and delineation of dental prostheses in general or a specific dental prosthesis. It does not include DENTURE DESIGN. The framework usually consists of metal. Dental Prosthesis Designs,Design, Dental Prosthesis,Designs, Dental Prosthesis,Prosthesis Design, Dental,Prosthesis Designs, Dental
D019228 Tooth Crown The upper part of the tooth, which joins the lower part of the tooth (TOOTH ROOT) at the cervix (TOOTH CERVIX) at a line called the cementoenamel junction. The entire surface of the crown is covered with enamel which is thicker at the extremity and becomes progressively thinner toward the cervix. (From Jablonski, Dictionary of Dentistry, 1992, p216) Crown, Tooth,Crowns, Tooth,Tooth Crowns
D020342 Finite Element Analysis A computer based method of simulating or analyzing the behavior of structures or components. Analysis, Finite Element,Analyses, Finite Element,Element Analyses, Finite,Element Analysis, Finite,Finite Element Analyses

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