Cleudmar Amaral de Araújo

Influence of restorative technique on the biomechanical behavior of endodontically treated maxillary premolars.: Part II: Strain measurement and stress distribution

STATEMENT OF PROBLEM Unresolved controversy exists concerning the preferred cavity design and restorative technique used to restore endodontically treated maxillary premolars to minimize strain and improve stress distribution under occlusal load. PURPOSE The purpose of this study was to analyze the influence of cavity design and restorative material on strain measurement and stress distribution in maxillary premolars under occlusal loading conditions, and correlate these influences with the failure modes analyzed in Part I. MATERIAL AND METHODS For the strain gauge test, 21 additional specimens were prepared as described in Part 1 of this study (n=3). Two strain gauges were fixed on the buccal (B) and palatal (P) cusps of each specimen with cyanoacrylate adhesive. The specimens were submitted to continuous axial compression loading at a speed of 0.5 mm/min, using a 6-mm sphere, to a maximum limit of 150 N in a universal testing machine. Total strain values were obtained by combining the B and P cusp strain values. These values were submitted to 2-way ANOVA and the Dunnet test (alpha=.05). For finite element analyses, 7 numerical 2-D models were generated: MODd, direct mesio-occlusal-distal preparation; MODi, indirect mesio-occlusal-distal preparation; AM, MODd restored with amalgam; CR, MODd restored with composite resin; LPR, MODi restored with laboratory-processed composite resin; and LGC, MODi restored with leucite-reinforced glass ceramic; each corresponding to 1 of the experimental groups tested in Part I of this study. The models were analyzed with finite element software, using the von Mises criteria for stress distribution analysis. RESULTS With the strain gauge test, MODd, MODi, and AM groups showed significantly higher strain values than the CR, LPR, and LGC. Finite element analyses revealed that tooth structure removal and the type of restorative material altered the stress distribution pattern. The MODd, MODi, AM, and LPR models showed higher stress concentration within the tooth structure. CONCLUSIONS The specimens with adhesive restorations were shown to behave in a manner similar to the biomechanical behavior of healthy teeth, while the behavior of those restored with amalgam restorations was more like that observed for teeth with nonrestored cavity preparations. These results directly correlate with the fracture mode results obtained in Part I of this study.

Fracture Resistance and Stress Distribution in Endodontically Treated Maxillary Premolars Restored with Composite Resin

PURPOSE The aim of this study was to evaluate the effect of endodontic and restorative treatment on the fracture resistance of posterior teeth. MATERIALS AND METHODS Fifty intact premolars were selected and randomly placed into five groups (n = 10): G1, intact teeth (control); G2, mesial-occlusal-distal (MOD) preparation; G3, MOD preparation restored with composite resin (Z-250, 3M ESPE); G4, MOD preparation and endodontic treatment; and G5, MOD preparation, endodontic treatment, and composite resin restoration. The specimens were submitted to an axial compression load in a mechanical test machine (EMIC), at a speed of 0.5 mm/min. Fracture patterns were analyzed at four levels. Five 2D numerical models were created by Ansys 10.0 for finite element analysis (FEA). RESULTS Mean values of compressive strength for all groups were (Kgf): G1 (83.6 +/- 25.4); G2 (52.7 +/- 20.2); G3 (82.1 +/- 24.9); G4 (40.2 +/- 14.2); G5 (64.5 +/- 18.1). Statistical analysis (ANOVA and Tukeys test) showed that fracture resistance of G1 was significantly higher than that of G5, G2, and G4. Resistance of G3 was also higher than that of G2 and G4. Results showed that the tooth resistance is completely maintained when MOD preparation is restored with composite resin and partially recovered when MOD preparation associated with an endodontic access is restored in the same way. The endodontic treatment and composite resin restoration influenced stress distribution in the dental structure. CONCLUSIONS Composite resin restoration plays an important role in recovering tooth strength. With regard to fracture mode, restoration and endodontic treatment increased the incidence of periodontal involvement, which was demonstrated by association with the finite element mechanical test method.

Effect of low-elastic modulus liner and base as stress-absorbing layer in composite resin restorations

OBJECTIVES The aim of this study was to evaluate the effectiveness of liner and base materials to reduce the stress resulting from polymerization shrinkage. The null hypothesis tested was that the presence of low-viscosity liner and base materials under the composite resin restoration reduces the polymerization shrinkage stress. METHODS A quasi-three-dimensional photoelastic model of a second premolar with a class I preparation was restored using four experimental groups (n=7): RC, resin composite (Filtek Z250); FLRC, flowable liner (Filtek Flow)+resin composite restoration; VLRC, resin-modified glass-ionomer liner+resin composite restoration; and VBRC, resin-modified glass-ionomer base+resin composite restoration. The maximum shear stresses (tau(max)) were calculated along the adhesive interface in 13 predefined and standardized point locations. Data were submitted to one-way ANOVA, followed by a Tukeys post hoc test (p<0.05). RESULTS A significant difference was found among the experimental groups (p=0.001); therefore, the null hypothesis was rejected. The mean maximum shear stress was: 38.0kPa for RC, 52.1kPa for FLRC, 72.8kPa for VLRC, and 90.2kPa for VBRC. The polymerization shrinkage stress level from least to greatest was: RC<FLRC<VLRC<VBRC. The overall stress distribution in class I restoration indicated that stresses were primarily accumulated at the cavosurface and internal line angles. SIGNIFICANCE Using a flowable composite or resin-modified glass-ionomer as liner or base material under composite resin restoration increases the polymerization shrinkage stresses at the adhesive interface leading to a possible adhesive failure.

In vitro integrity of implant external hexagon after application of surgical placement torque simulating implant locking

The aim of this study was to evaluate the integrity of the external hexagon of an implant system with internal and external hexagons but with prosthetic connection through the external hexagon (Internal Torque, IT) in comparison with that of an implant system with external hexagon with mount (External Hexagon, EH). A device was made to measure the rotational freedom angles between implant and abutment hexagons in 10 implants from each group after the application of surgical placement torques of 45, 60 and 80 Ncm simulating implant locking. The distances between the vertices of the external hexagon were also obtained. Rotational freedom data were subjected to ANOVA and Tukeys test (P < .05) showing no significant difference between the angles of the intact implants (EH - 3.31 +/- 0.41 degrees and IT - 3.30 +/- 0.17 degrees ) and after application of a 45 Ncm torque (EH - 3.27 +/- 0.38 degrees and IT - 3.31 +/- 0.22 degrees ). However, after application of a 60 Ncm torque there were significant differences (IT - 3.40 +/- 0.20 degrees and EH - 4.03 +/- 0.54 degrees ). After application of a 80 Ncm torque, the IT implant presented values of 3.39 +/- 0.21 degrees whereas the EH did not support the torque, suffering deformation of its external hexagon. Within the limits of this study, it can be concluded that the IT implant system may be preferable in clinical situations where implant placement within a certain bone density could generate torques higher than 60 Ncm.

Laser and plasma dental soldering techniques applied to Ti-6Al-4V alloy: ultimate tensile strength and finite element analysis.

STATEMENT OF PROBLEM The literature provides limited information regarding the performance of Ti-6Al-4V laser and plasma joints welded in prefabricated bars in dental applications. PURPOSE The purpose of this study was to evaluate the mechanical strength of different diameters of Ti-6Al-4V alloy welded with laser and plasma techniques. MATERIAL AND METHODS Forty-five dumbbell-shaped rods were created from Ti-6Al-4V and divided into 9 groups (n=5): a control group with 3-mm and intact bars; groups PL2.5, PL3, PL4, and PL5 (specimens with 2.5-, 3-, 4-, and 5-mm diameters welded with plasma); and groups L2.5, L3, L4, and L5 (specimens with 2.5-, 3-, 4-, and 5-mm diameters welded with laser). The specimens were tested for ultimate tensile strength (UTS), and elongation percentages (EP) were obtained. Fractured specimens were analyzed by stereomicroscopy, and welded area percentages (WAP) were calculated. Images were made with scanning electron microscopy. In the initial analysis, the data were analyzed with a 2-way ANOVA (2×4) and the Tukey Honestly Significant Difference (HSD) test. In the second analysis, the UTS and EP data were analyzed with 1-way ANOVA, and the Dunnett test was used to compare the 4 experimental groups with the control group (α=.05). The Pearson and Spearman correlation coefficient tests were applied to correlate the study factors. Finite element models were developed in a workbench environment with boundary conditions simulating those of a tensile test. RESULTS The 2-way ANOVA showed that the factors welding type and diameter were significant for the UTS and WAP values. However, the interaction between them was not significant. The 1-way ANOVA showed statistically significant differences among the groups for UTS, WAP, and EP values. The Dunnett test showed that all the tested groups had lower UTS and EP values than the control group. The 2.5- and 3-mm diameter groups showed higher values for UTS and WAP than the other test groups. A positive correlation was found between welded area percentage and UTS and a negative correlation between these parameters and the diameters of the specimens. No statistically significant difference was found between the weld techniques. CONCLUSIONS Under the experimental conditions described, diameters of 2.5 and 3 mm resulted in higher UTS and WAP for both laser and plasma welding and appear to be the best option for joining prefabricated rods in this kind of union.

Stress Distribution in Co-Cr Implant Frameworks after Laser or TIG Welding

Lack of passivity has been associated with biomechanical problems in implant-supported prosthesis. The aim of this study was to evaluate the passivity of three techniques to fabricate an implant framework from a Co-Cr alloy by photoelasticity. The model was obtained from a steel die simulating an edentulous mandible with 4 external hexagon analog implants with a standard platform. On this model, five frameworks were fabricated for each group: a monoblock framework (control), laser and TIG welding frameworks. The photoelastic model was made from a flexible epoxy resin. On the photoelastic analysis, the frameworks were bolted onto the model for the verification of maximum shear stress at 34 selected points around the implants and 5 points in the middle of the model. The stresses were compared all over the photoelastic model, between the right, left, and center regions and between the cervical and apical regions. The values were subjected to two-way ANOVA, and Tukeys test (α=0.05). There was no significant difference among the groups and studied areas (p>0.05). It was concluded that the stresses generated around the implants were similar for all techniques.

Analysis of stress induced by screws in the vertebral fixation system

Objective: To compare, using photoelasticity, internal stress produced by USS II type screw with 5.2 and 6.2 mm external diameters, when submitted to three different pullout strengths. Methods: Two photoelastic models were especially made. The simulation was performed using loads of 1.8, 2.4 e 3.3 kgf.The fringe orders were evaluated around the screws. In all the models analyzed the shear stress were calculated. Results: Independently of the applied load, the smaller screw showed higher values of shear stress. Conclusion: According to the analysis performed, we observed that the place of highest stress was in the first thread of the lead, close to the head of the screws. Experimental study.

The Influence of Interproximal Contact on Implant-Supported Fixed Partial Dentures in the Posterior Jaw: A Photoelastic Analysis

The aim of this study was to analyze the effect of the separation of prosthetic crowns from fixed partial dentures by means of stress gradient evaluation. Three photoelastic models were created to examine contiguous implants with varying contact between the crowns (contact point [CP], contact surface [CS], splinted [SP]). The SP group presented the best results, followed by the CS group, indicating that the use of splinted prosthetic crowns and crowns with broad surface contacts is viable when considering the stress values.

Photoelastic stress analysis of mandibular fixed prostheses supported by 3 dental implants.

Purpose:To observe the photoelastic stress patterns generated around implants in relation to variations in the diameter and total number of implants supporting fixed complete-arch mandibular frameworks. Materials and Methods:Three different implant configurations were analyzed (n = 3): 5 standard implants with diameters of 3.75 mm (C), 3 standard implants with diameters of 3.75 mm (3S), and 3 wide implants with diameters of 5.0 mm (3W). The samples were subjected to a vertical compressive load (1.33 kgf) applied at the end of the distal cantilever of the framework. The shear stresses were calculated around the implants, and the data were analyzed using one-way analysis of variance. Results:The implants nearest to the loading showed higher stress values regardless of the group. The C group showed lower shear stress when compared with the other groups (P = 0.001). No significant difference was observed between the 3W and 3S groups (P = 0.785). Conclusion:A reduction in the number of implants, regardless of the implant diameter, showed higher stress concentration around the implants. Five-implant configuration showed lower stress concentration and seems to be more biomechanically predictable.

Effect of plasma welding parameters on the flexural strength of ti-6al-4v alloy

The aim of this study was to assess the effect of different plasma arc welding parameters on the flexural strength of titanium alloy beams (Ti-6Al-4V). Forty Ti-6Al-4V and 10 NiCr alloy beam specimens (40 mm long and 3.18 mm diameter) were prepared and divided into 5 groups (n=10). The titanium alloy beams for the control group were not sectioned or subjected to welding. Groups PL10, PL12, and PL14 contained titanium beams sectioned and welded at current 3 A for 10, 12 or 14 ms, respectively. Group NCB consisted of NiCr alloy beams welded using conventional torch brazing. After, the beams were subjected to a three-point bending test and the values obtained were analyzed to assess the flexural strength (MPa). Statistical analysis was carried out by one-way ANOVA and Tukeys HSD test at 0.05 confidence level. Significant difference was verified among the evaluated groups (p<0.001), with higher flexural strength for the control group (p<0.05). No significant differences was observed among the plasma welded groups (p>0.05). The NCB group showed the lowest flexural strength, although it was statistically similar to the PL 14 group (p>0.05). The weld depth penetration was not significantly different among the plasma welded groups (p=0.05). Three representative specimens were randomly selected to be evaluated under scanning electron microcopy. The composition of the welded regions was analyzed by energy dispersive X-ray spectroscopy. This study provides an initial set of parameters supporting the use of plasma welding during fabrication of titanium alloy dental frameworks.