Abstract
Statement of problem
The performance of endocrowns fabricated with different types of computer-aided design
and computer-aided manufacturing (CAD-CAM) materials is unclear.
Purpose
The purpose of this finite element analysis (FEA) and in vitro study was to compare
and evaluate the stress distribution, failure probability, and fracture resistance
of endodontically treated teeth restored with endocrowns from CAD-CAM milling blocks
including ceramic, polymer-infiltrated ceramic (PICN), and composite resin.
Material and methods
An endodontically treated first mandibular molar restored with an endocrown was modeled
by using a CAD software program and imported into an FEA software program. The model
was duplicated and received restorations made from CAD-CAM blocks: Vita Suprinity
(VS), IPS e.max CAD (EMX), Vita Enamic (VE), Lava Ultimate (LU), and Grandio blocs
(GR). Stress distributions under axial and oblique loading were analyzed. The Weibull
function was combined with the FEA results to predict long-term failure probability.
The mechanical failure behavior of endocrowns manufactured with these materials was
tested by using a universal testing machine. Load-to-failure was recorded, and fractured
specimens were subjected to fractography. The data were analyzed by 1-way ANOVA and
the post hoc Tukey test (α=.05).
Results
The models of GR and LU exhibited a more even stress distribution. The Weibull analysis
revealed that 5 models performed in a similar manner under normal occlusal forces,
while LU and VE models achieved the highest probabilities during clenching. The fracture
loads of GR (3808 ±607 N) were significantly higher than those of other materials
(P<.05). More favorable failure modes were observed in the GR and VE groups. Fractography
showed a greater probability of compression curls and arrest lines in the endocrowns
of VE, LU, and GR groups.
Conclusions
When restoring endodontically treated teeth, endocrown fabricated with composite resin
exhibited a more uniform stress distribution and higher fracture resistance. More
evidence from long-term clinical studies is needed to verify this effect.
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Article info
Publication history
Published online: May 26, 2020
Footnotes
Supported by Natural Science Foundation of Guangdong Province of China (2018A0303130213) and Clinical Research Startup Program of Southern Medical University by High-level University Construction Funding of Guangdong Provincial Department of Education (LC2016PY023), as well as Clinical Research Program of Nanfang Hospital Southern Medical University (2018CR018).
Identification
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© 2020 by the Editorial Council for The Journal of Prosthetic Dentistry.
