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Comparison of stress distribution between zirconia/alloy endocrown and CAD/CAM multi-piece zirconia post-crown: three-dimensional finite element analysis

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Abstract

Objectives

This study aimed to evaluate a digital multi-piece zirconia post-crown to restore a mandibular second molar with extensive coronal loss and limited restoration space, and to compare the stress distribution between endocrowns made of zirconia or alloy and CAD/CAM multi-piece zirconia post-crowns.

Material and methods

Four three-dimensional finite element analysis models of a mandibular second molar with extensive coronal loss and limited restoration space were created as follows: (A) intact molar; (B) zirconia endocrown restored molar; (C) multi-piece post-crown restored-molar with tapered nail; (D) multi-piece post-crown restored molar with T-shaped nail. Models C and D were divided into two subgroups according to the material type: C1/D1, zirconia; C2/D2, NiCr alloy. The maximum modified von Mises failure criterion (mvM) stresses were calculated, and the stress distribution was recorded to analyze the effects of the restoration and material types on the biomechanical properties of dentin and prosthesis.

Results

The maximum mvM stress of dentin in model B (33.80 MPa) was lower compared with models C (C1, 37.81 MPa; C2, 36.36 MPa) and D (D1, 36.34 MPa; D2, 34.97 MPa) under vertical load, but the opposite was observed under oblique load. The highest mvM stress was concentrated in the nail region located in the root canal, and the T-shaped nail values were greater than the tapered nail, whereas model D with T-shaped nail showed a lower mvM stress level in dentin compared with Model C with tapered nail.

Conclusions

The digital multi-piece zirconia post-crown is a potential approach to restore mandibular second molars with extensive coronal loss and limited restoration space.

Clinical relevance

The digital multi-piece zirconia post-crown has potential to restore mandibular second molars with extensive coronal loss and limited restoration space using an innovative approach.

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Funding

This study was funded by the National Natural Science Foundation of China (grant number 81970927); the Medical Research Projects of the Health Department of Jiangsu Province (grant number M2020066); the Priority Academic Program Development of Jiangsu Higher Education Institutions (grant number 2018–87).

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Authors and Affiliations

  1. Department of Prosthodontics, Jiangsu Province Key Laboratory of Oral Diseases, Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, China

    Jiaxue Yang, Fei Han & Haifeng Xie

  2. Department of Endodontics, Jiangsu Province Key Laboratory of Oral Diseases, Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, The Affiliated Stomatological Hospital of Nanjing Medical University, Han-Zhong Road 136, Nanjing, 210029, China

    Chen Chen

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  1. Jiaxue Yang
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Correspondence to Chen Chen.

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Jiaxue Yang and Fei Han contributed equally to this work.

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Yang, J., Han, F., Chen, C. et al. Comparison of stress distribution between zirconia/alloy endocrown and CAD/CAM multi-piece zirconia post-crown: three-dimensional finite element analysis. Clin Oral Invest 26, 5007–5017 (2022). https://doi.org/10.1007/s00784-022-04470-5

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