Evaluation of stress distribution in restorations of maxillary central incisor with post-traumatic enamel-dentin fracture using two different techniques: A micro-computed tomography study

Abstract

Aim: The aim of this study is to investigate the stress distribution created by two restorative techniques, adhesive reattachment of the fractured fragment and direct composite restoration, used in the treatment of a maxillary central incisor with enamel-dentin fracture. The analysis is conducted using the finite element stress analysis method on a three-dimensional (3D) model prepared based on micro-computed tomography data, following the application of different adhesive procedures on fractured teeth.

Methodology: The avulsed left maxillary central incisor was scanned using a micro-computed tomography device. The obtained data was transferred to a computer and used for 3D modeling. In the models, a fracture line was created obliquely at a 45° angle, 3 mm away from the mesial surface towards the distoincisal corner of the tooth. Six restorations were planned on this model: three direct composite restorations and three adhesives, reattachments followed by composite application. The models for the adhesive reattachment method included: (1) internal dentin groove, (2) palatal composite laminate veneer, and (3) double palatal retentive groove. The models for the composite restoration technique included: (1) composite laminate veneer, (2) direct composite restoration following enamel beveling, and (3) composite application after double palatal groove preparation. Upon completion of the restorations, a 100-N force was applied from the palatal direction using the finite element stress analysis method. The results were analyzed to examine the amount and distribution of stress on the restorations and the tooth.

Results: In all models, the highest stress values within tooth structures were observed in the enamel. The lowest stress value in the enamel layer was seen in model R-1, whereas the highest stress value was observed in model K-2. For direct composite restorations, the stresses on enamel, dentin, and restoration were relatively similar in each model, with no significant differences noted among these values. Among all applied composite restorations, the lowest stress value was observed in model R-3. When analyzing the stresses generated at the tooth-restoration and tooth-fractured fragment interface of the six models, the lowest stress in the enamel was observed in models R-1 and K-3, while the highest stress was seen in model R-3.

Conclusion: According to the data obtained from the models, the shape of the restoration applied on the tooth, the technique used, and the location of the restoration affect the amount and distribution of stress accumulated in the tooth and restoration. However, the stress analysis results are not sufficient to evaluate the clinical success of restorations. There is a need for further studies utilizing different techniques to support the models used.

How to cite this article:

Olgaç Akgönül Ş, Çelenk S, Adıgüzel Ö. Evaluation of stress distribution in restorations of maxillary central incisor with post-traumatic enamel-dentin fracture using two different techniques: A finite element analysis based on micro-computed tomography data. Int Dent Res 2024;14(2):76-83. https://doi.org/10.5577/intdentres.535