Stress distribution of bulk-fill resin composite in class II restorations. 2017

Pietro Ausiello, and Stefano Ciaramella, and Franklin Garcia-Godoy, and Massimo Martorelli, and Roberto Sorrentino, and Antonio Gloria
School of Dentistry, University of Naples Federico II, Naples, Italy.

OBJECTIVE To study the influence of the resin bonding layer thickness and the bulk filling material stiffness in adhesive class II mesio-occlusal-distal (MOD) restorations using numerical finite element analysis (FEA). METHODS Four 3D-FE models of teeth restored with different filling material stiffness and resin bonding layer thickness were built-up and analyzed. The 3D model of a sound lower molar was also analyzed and compared with restored ones. The tooth tissues (enamel, dentin), dental restoration and bolus on the occlusal surface, was divided into 3D solid CTETRA elements with four grid points. The adhesive bonding around the dental restoration was modeled with shell elements. Polymerization shrinkage was simulated with a thermal expansion approach. Mechanical behavior of restored models in terms of stress and displacement distributions, under the combination effects of polymerization shrinkage and occlusal load (600 N), was analyzed. All the materials were assumed to behave as elastic materials throughout the entire deformation. RESULTS Numerical results show that the mechanical response of the restored models was very different compared to the sound tooth ones, where the stress was uniformly distributed from enamel to dentin with no critical stress concentration. In the restored models, the highest stress values were detected in the enamel, near the enamel-dentin interface and in the bulk restorative material. Tooth preparations A and B showed lower gradient stresses than corresponding C and D. The value of the vertical displacement components in models A and B were higher than corresponding C and D. The maximum displacement values were mainly located around the groove and were higher by an order of magnitude than the sound models. The results showed better mechanical response with models A and B compared to C and D. It is also evident that resin bonding thickness slightly affected the stress level of the restored teeth. CONCLUSIONS Class II MOD direct bulk resin composite restorations showed a high susceptibility to damage at the marginal and internal tissue interfaces depending on their own stiffness. The use of resin-based bulk filling materials is not recommended for large class II MOD adhesive restorations due to mechanical behavior failure risk.

UI MeSH Term Description Entries
D008422 Materials Testing The testing of materials and devices, especially those used for PROSTHESES AND IMPLANTS; SUTURES; TISSUE ADHESIVES; etc., for hardness, strength, durability, safety, efficacy, and biocompatibility. Biocompatibility Testing,Biocompatible Materials Testing,Hemocompatibility Testing,Testing, Biocompatible Materials,Testing, Hemocompatible Materials,Hemocompatibility Testings,Hemocompatible Materials Testing,Materials Testing, Biocompatible,Materials Testing, Hemocompatible,Testing, Biocompatibility,Testing, Hemocompatibility,Testing, Materials,Testings, Biocompatibility
D003188 Composite Resins Synthetic resins, containing an inert filler, that are widely used in dentistry. Composite Resin,Resin, Composite,Resins, Composite
D003737 Dental Cavity Preparation An operation in which carious material is removed from teeth and biomechanically correct forms are established in the teeth to receive and retain restorations. A constant requirement is provision for prevention of failure of the restoration through recurrence of decay or inadequate resistance to applied stresses. (Boucher's Clinical Dental Terminology, 4th ed, p239-40) Cavity Preparation, Dental,Cavity Preparations, Dental,Dental Cavity Preparations,Preparation, Dental Cavity,Preparations, Dental Cavity
D003764 Dental Materials Materials used in the production of dental bases, restorations, impressions, prostheses, etc. Dental Material,Material, Dental,Materials, Dental
D003793 Dental Restoration, Permanent A restoration designed to remain in service for not less than 20 to 30 years, usually made of gold casting, cohesive gold, or amalgam. (Jablonski, Dictionary of Dentistry, 1992) Dental Fillings, Permanent,Dental Filling, Permanent,Dental Permanent Filling,Dental Permanent Fillings,Dental Restorations, Permanent,Filling, Dental Permanent,Filling, Permanent Dental,Fillings, Dental Permanent,Fillings, Permanent Dental,Permanent Dental Filling,Permanent Dental Fillings,Permanent Dental Restoration,Permanent Dental Restorations,Permanent Filling, Dental,Permanent Fillings, Dental,Restoration, Permanent Dental,Restorations, Permanent 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
D013314 Stress, Mechanical A purely physical condition which exists within any material because of strain or deformation by external forces or by non-uniform thermal expansion; expressed quantitatively in units of force per unit area. Mechanical Stress,Mechanical Stresses,Stresses, Mechanical
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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