3D-Finite Element Analysis of Molars Restored with Endocrowns and Posts During Masticatory Simulation

Objective: The objective was to compare equivalent stresses in molars restored with endocrowns as well as posts and cores during masticatory simulation using finite element analysis.

Methods: Four three-dimensional models of first mandibular molars were created: A - intact tooth; B - tooth restored by ceramic endocrown; C - tooth with FRC posts, composite core and ceramic crown; D - tooth with cast post and ceramic crown. The study was performed using finite element analysis, with contact elements. The computer simulations of mastication were conducted. The equivalent stresses of modified von Mises failure criterion (mvM) in models were calculated, Tsai-Wu index for FRC post was determinate. Maximal values of the stresses in the ceramic, cement and dentin were compared between models and to strength of the materials. Contact stresses in the cement-tissue adhesive interface around restorations were considered as well.

Results: During masticatory simulation, the lowest mvM stresses in dentin arisen in molar restored with endocrown (Model B). Maximal mvM stress values in structures of restored molar were 23% lower than in the intact tooth. The mvM stresses in the endocrown did not exceed the tensile strength of ceramic. In the molar with an FRC posts (Model C), equivalent stress values in dentin increased by 42% versus Model B. In ceramic crown of Model C the stresses were 31% higher and in the resin luting cement were 61% higher than in the tooth with endocrown. Tensile contact stresses in the adhesive cement-dentin interface around FRC posts achieved 4 times higher values than under endocrown and shear stresses increased twice. The contact stress values around the appliances were several time smaller than cement-dentin bond strength.

Significance: Teeth restored by endocrowns are potentially more resistant to failure than those with FRC posts. Under physiological loads, ceramic endocrowns ideally cemented in molars should not be demaged or debonded.