Journal of Prevention and Treatment for Stomatological Diseases ›› 2019, Vol. 27 ›› Issue (8): 515-521.doi: 10.12016/j.issn.2096-1456.2019.08.008

• Cinical Study • Previous Articles     Next Articles

Influence of the shape, materials and occlusal mode of the maxillary first premolars on stress in noncarious cervical lesions

CAO Tingting1,GE Chunhui2,ZHANG Hongyan2()   

  1. 1. Heifei Stomatological Hospital, Hefei Dental Clinical College, Anhui Medical University, Heifei 230001, China
    2. Department of Endodontics, Stomatologic Hospital & College, Anhui Medical University, Hefei 230032, China;
  • Received:2018-12-11 Revised:2019-01-27 Online:2019-08-20 Published:2019-08-16
  • Contact: Hongyan ZHANG E-mail:toothyan@126.com

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Abstract:

Objective To study the stress distribution in noncarious cervical lesions (NCCLs) of maxillary first premolars under the conditions of different defect shapes, restorative materials and loading directions and to analyze the effect of different conditions on the treatment of NCCLs.Methods Three-dimensional finite element models of cervical defects of the maxillary first premolar were established by oral CBCT in a healthy adult. According to the shape of the cavity bottom, the cavity was divided into two groups: acute angle and obtuse angle. In addition to healthy dental controls, defects in each group were simulated and virtually treated with three kinds of restorative materials (glass ionomer cement, Z350 resin and bulk resin) as research objects. Four kinds of loads (normal occlusal vertical load, normal occlusal lateral load, traumatic occlusal vertical and lateral load) were applied. The lateral load of occlusion was 100 N, and the stress distribution in the prosthesis was analyzed.Results Under the condition with different cavity types that the NCCL near the pulp line was sharp, the stress in the wedge-shaped defect repair material was concentrated and significantly higher than that in the other obtuse groups. Under the condition with different repair materials, in the bottom of the acute cavity, the glass ionomer cement showed less stress than the two kinds of resin. The maximum stress in the prosthetic material in the traumatic occlusion state was significantly higher than that in the normal occlusion state, and the lateral load was more concentrated than the vertical load on the neck defect.Conclusion The stress in maxillary first premolar NCCLs is affected by the shape of the cavity and the loading direction. A simulated acute cavity morphology and traumatic force mode produced concentrated stress in the material used to repair the NCCL. Before restoration, the bottom of an acute cavity should be adjusted to an obtuse angle. After treatment, the bite of the affected tooth adjusts over time to reduce traumatic occlusion, which is beneficial for improving the service life of the filling material.

Key words: non-carious cervical lesions, three-dimensional finite element, stress analysis, resin repairing, occlusal, traumatic occlusal

CLC Number: 

  • R781.2

Figure 1

Simulated NCCLs defect size corresponding to the repair material"

Figure 2

Model nodes and limits"

Table 1

Mechanics parameters of materials"

弹性模量/GPa 泊松比
牙体组织 釉质[13] 84.1 0.33
牙本质[14] 18.6 0.31
牙周膜[14] 6.89 × 10-2 0.45
牙髓[15] 2.07 × 10-3 0.45
皮质骨[16] 13.7 0.30
松质骨[16] 1.37 0.30
修复材料 玻璃离子[17] 10.8 0.3
Z350[18] 13.45 0.17
Bulk树脂[18] 13.46 0.18

Figure 3

Simulation of different stresses"

Figure 4

Simulation of two NCCL cavity types and different applied loads"

Figure 5

von Mises stress distribution at the bottom of an acute cavity"

Figure 6

von Mises stress distribution at the bottom of an obtuse cavity"

Table 2

Maximum stress of repair materials in an acute cavity under four different stress conditions Mpa"

正常??
垂直		 正常??
侧向		 创伤??
垂直		 创伤??
侧向
正常牙体 14.470 22.317 23.249 35.368
玻璃离子 12.214 16.936 19.229 31.546
Z350 14.306 19.492 22.372 36.471
Bulk树脂 14.229 19.458 22.248 36.257

Table 3

Maximum stress of repair materials in an obtuse cavity under four different stress conditions Mpa"

正常??
垂直		 正常??
侧向		 创伤??
垂直		 创伤??
侧向
正常牙体 10.682 19.737 16.036 30.471
玻璃离子 10.738 14.366 16.360 28.383
Z350 9.708 14.815 17.805 27.655
Bulk树脂 9.669 14.751 17.734 27.566

Figure 7

NCCLs with different hole bottom patterns and simulated maximum stress values for different repair aterials under different loading forces"

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