Biomechanical reinforcement by CAD-CAM materials affects stress distributions of posterior composite bridges: 3D finite element analysis.

Alaaeldin Elraggal, Islam m. Abdelraheem, David c. Watts, Sandipan Roy, Vamsi krishna Dommeti, Abdulrahman Alshabib, Khaled abid Althaqafi, Rania r. Afifi

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Abstract

Objectives
This 3D finite element analysis study aimed to investigate the effect of reinforcing CAD-CAM bars on stress distribution in various components of a posterior composite bridge.

Methods
A virtual model mimicking the absence of an upper second premolar was created, featuring class II cavity preparations on the proximal surfaces of the adjacent abutment teeth surrounding the edentulous space. Five distinct finite element analysis (FEA) models were generated, each representing a CAD-CAM reinforcing bar material: 3-YTZP (IPS. emax ZirCAD MO; Zr), lithium disilicate (IPS e.max CAD; EX), nano-hybrid resin composite (Grandio Blocs; GB), Fibre-reinforced composite (Trilor; Tri), and polyetheretherketone (PEEK). A veneering resin composite was employed to simulate the replacement of the missing premolar (pontic). In the FEA, an axial force of 600 N and a transverse load of 20 N were applied at the center of the pontic. Subsequently, maximum von Mises (mvM) and maximum principal stresses (σmax) were computed across various components of the generated models. Additionally, shear stresses at the interface between the CAD-CAM bars and the veneering resin composite were determined.

Results
CAD-CAM materials with high modulus of elasticity, such as Zr and EX, exhibited the highest mvM stresses and shear stresses while transferring the lowest stress to the veneering resin composite in comparison to other materials. Conversely, PEEK demonstrated the lowest mvM stresses but produced the highest stresses within the veneering resin composite. There was a uniform distribution of mvM stresses in the remaining tooth structure among all groups, except for a noticeable elevation in the molar region of Zr and EX groups.

Significance
Reinforcing CAD-CAM bar materials with a high modulus of elasticity, such as Zr and EX, may result in debonding failures at the connector sites of posterior composite bridges. Conversely, GB, PEEK, and Tri have the potential to cause fracture failures at the connectors rather than debonding.
Original languageEnglish
Pages (from-to)869-877
Number of pages9
JournalDental Materials
Volume40
Issue number5
Early online date11 Apr 2024
DOIs
Publication statusPublished - 1 May 2024

Keywords

  • Finite element analysis
  • Immediate composite bridges
  • Zirconia
  • Lithium disilicate
  • Trilor
  • PEEK

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