Finite Element Evaluation of Stress Distribution in Mature and Immature Teeth
INTRODUCTION: Traumatic injuries may affect the vitality and development of tooth. So divergence or parallelism of canal walls induces an open apex which is very susceptible to fracture. The aim of this study was to determine the stress distribution pattern in immature teeth and compare it with mature teeth. MATERIALS AND METHODS: In order to analyze stress distribution using finite element method, models were first designed according to actual samples by "ANSYS" software. Two models of the maxillary central incisors were designed, one mature and one with open apex. Mature tooth was designed as having undergone root canal therapy with gutta-percha and the immature one with both MTA plug and gutta-percha. Samples were loaded in seven stages and then, the stress distribution in each model was measured, using the "ANSYS" software. RESULTS: During gutta-percha condensation, the immature tooth transfers the stress directly to the external root surface where force is directly applied, whereas during masticatory occlusal forces, the stress is transferred to middle third of buccal and lingual surfaces and to buccal cervix in lunar shape. During traumatic forces, stress concentration was on the cervical region of buccal surface and middle third of buccal and lingual surfaces. MTA plug prevents stress distribution toward apical region and forces concentrate in dentin at the point where stress terminates. CONCLUSION: Within the limitations of this simulated mechanical analysis, it was confirmed that the pattern of stress distribution in mature and immature teeth is different. Cervical area of the buccal surface in immature teeth is one of the stress concentration areas, which contribute to the high rate of fracture in this area.
Fracture Resistance of Immature Incisors Following Root Filling with Various Bioactive Endodontic Cements Using an Experimental Bovine Tooth Model
Objective The aim of this study was to compare the fracture resistance of immature bovine roots when using ProRoot MTA, CEM Cement, and Biodentine as root filling materials. Materials and Methods An immature bovine tooth model was developed by removing the coronal and apical portions of 70 bovine incisors 8 mm above and 12 mm below the cementoenamel junction (CEJ). The specimens were then divided into five groups: ProRoot MTA, CEM Cement, Biodentine, gutta-percha/AH26 sealer, and control. All groups received a 5-mm apical plug with a temporary restorative material. Then, the remaining root canal space was filled with one of the afore-mentioned materials. After setting, the specimens were mounted in acrylic resin. Then, 3 mm coronal to the CEJ from the buccal side of the teeth and at a 135°angle to the long axis, the specimens were loaded until fracture. Results The specimens in the Biodentine (2196 N) and ProRoot MTA (2103 N) groups had significantly greater fracture resistance in comparison to the control group ( p = 0.01). No significant difference was found between CEM Cement, gutta-percha and sealer AH26, and control groups. No significant differences occurred between the four experimental groups ( p = 0.45). Conclusion Filling the root canal space with ProRoot MTA and Biodentine contributed to higher fracture resistance values.
Failure of endodontically treated teeth: classification and evaluation.
All endodontically treated teeth that were extracted over a 1-yr period in a busy group practice were evaluated for cause of failure. The 116 teeth collected were classified into major failure categories of prosthetic, periodontic, and endodontic origin. Of the teeth, 59.4% were prosthetic failures which were due primarily to crown fracture. Teeth that had been crowned had greater longevity than uncrowned teeth. Periodontal failures constituted 32% of the study. Only 8.6% of the failures were due to endodontic causes, but these failures became evident more quickly than those in the other categories. A classification of failures is presented, and the results are analyzed.