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Vertical root fracture in upper premolars with endodontic posts: finite element analysis.

Andrea F V Santos¹, Carina B Tanaka, Raul G Lima

¹Department of Dental Materials, School of Dentistry, University of São Paulo, São Paulo, Brazil.

Journal of Endodontics

|December 17, 2008

Summary

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Endodontic posts in upper premolars can lead to root fractures. Effective bonding between the post and root significantly reduces stress, lowering the risk of vertical root fracture (VRF).

Area of Science:

Dental Materials Science
Biomechanical Engineering
Endodontics

Background:

Upper premolars restored with endodontic posts exhibit a high rate of vertical root fracture (VRF).
Understanding the biomechanical factors contributing to VRF is crucial for improving post-restoration longevity.

Purpose of the Study:

To investigate the influence of post characteristics and bonding on stress distribution in upper premolars.
To test the hypotheses that smaller root diameters concentrate stress and that poor bonding increases VRF risk.

Main Methods:

Finite element analysis (FEA) was employed on 3D models of intact upper second premolars.
Models were modified to include endodontic posts with varying elastic modulus and cross-sections (circular/oval).
Simulations assessed stress concentrations under bonded and nonbonded conditions.

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Main Results:

The hypothesis regarding smaller mesiodistal diameter was partially supported; nonbonded, low-modulus posts showed lower tensile stress in oval canals.
Nonbonded models exhibited tensile stress peaks approximately three times higher than bonded or intact models.
Effective bonding between the root and post was identified as a critical factor in mitigating stress.

Conclusions:

The lack of effective bonding between the endodontic post and the root canal significantly increases the risk of vertical root fracture.
While root canal shape plays a role, the bonding interface is a primary determinant of stress concentration and fracture risk.