A Comparison of Volume of Tissue Removed and Biomechanical Analysis of Different Access Cavity Designs in 2-rooted Mandibular First Molars: A Multisample 3-dimensional Finite Element Analysis. 2022

Yujie Fu, and Lan Zhang, and Yuan Gao, and Dingming Huang
State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Department of Endodontics, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China.

BACKGROUND The aim of this study was to compare the biomechanical properties and the amount of coronal tissue removed among the different access cavities with a multisample 3-dimensional finite element analysis in the mandibular first molar. The correlation between the amount of tissue removed and the fracture resistance of the teeth was also analyzed. METHODS Micro-computed tomography data from 20 2-rooted mandibular first molars were included in this study as 3-dimensional modeling prototypes. Models of untreated molars and molars treated with the traditional access cavity (TradAC), the conservative access cavity (ConsAC), and the straight-line minimally invasive endodontic access cavities (SMIAC) were created. Each model was loaded in 3 ways to simulate the functional conditions of occlusion. The amount of tissue removed and the maximum stress in the cervical region were recorded and analyzed, and the correlation between them was also analyzed. RESULTS The amount of coronal tissue and pericervical dentin (PCD) removed in SMIAC and ConsAC was less than that of TradAC. The mean maximum stress in the cervical region was significantly smaller in SMIAC and ConsAC than in TradAC. The amount of hard tissue and PCD loss was positively correlated with the maximum stress in the cervical region of the tooth. CONCLUSIONS In mandibular first molars, it could be beneficial to improve the fracture resistance of the tooth after endodontic treatment by the minimally invasive access cavity to reduce the loss of coronal tooth tissue and PCD. The SMIAC may be an option balancing biomechanical properties and clinical convenience.

UI MeSH Term Description Entries
D008963 Molar The most posterior teeth on either side of the jaw, totaling eight in the deciduous dentition (2 on each side, upper and lower), and usually 12 in the permanent dentition (three on each side, upper and lower). They are grinding teeth, having large crowns and broad chewing surfaces. (Jablonski, Dictionary of Dentistry, 1992, p821) Molars
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014070 Tooth One of a set of bone-like structures in the mouth used for biting and chewing. Teeth
D055114 X-Ray Microtomography X-RAY COMPUTERIZED TOMOGRAPHY with resolution in the micrometer range. MicroCT,Microcomputed Tomography,X-Ray Micro-CAT Scans,X-Ray Micro-CT,X-Ray Micro-CT Scans,X-Ray Micro-Computed Tomography,X-Ray Microcomputed Tomography,X-ray MicroCT,Xray Micro-CT,Xray MicroCT,Micro-CAT Scan, X-Ray,Micro-CAT Scans, X-Ray,Micro-CT Scan, X-Ray,Micro-CT Scans, X-Ray,Micro-CT, X-Ray,Micro-CT, Xray,Micro-CTs, X-Ray,Micro-CTs, Xray,Micro-Computed Tomography, X-Ray,MicroCT, X-ray,MicroCT, Xray,MicroCTs,MicroCTs, X-ray,MicroCTs, Xray,Microcomputed Tomography, X-Ray,Microtomography, X-Ray,Scan, X-Ray Micro-CAT,Scan, X-Ray Micro-CT,Scans, X-Ray Micro-CAT,Scans, X-Ray Micro-CT,Tomography, Microcomputed,Tomography, X-Ray Micro-Computed,Tomography, X-Ray Microcomputed,X Ray Micro CAT Scans,X Ray Micro CT,X Ray Micro CT Scans,X Ray Micro Computed Tomography,X Ray Microcomputed Tomography,X Ray Microtomography,X ray MicroCT,X-Ray Micro-CAT Scan,X-Ray Micro-CT Scan,X-Ray Micro-CTs,X-ray MicroCTs,Xray Micro CT,Xray Micro-CTs,Xray MicroCTs
D019553 Tooth, Nonvital A tooth from which the dental pulp has been removed or is necrotic. (Boucher, Clinical Dental Terminology, 4th ed) Tooth, Devitalized,Tooth, Endodontically-Treated,Tooth, Pulpless,Teeth, Devitalized,Teeth, Endodontically-Treated,Teeth, Nonvital,Teeth, Pulpless,Devitalized Teeth,Devitalized Tooth,Endodontically-Treated Teeth,Endodontically-Treated Tooth,Nonvital Teeth,Nonvital Tooth,Pulpless Teeth,Pulpless Tooth,Teeth, Endodontically Treated,Tooth, Endodontically Treated
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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