Coupling image processing and stress analysis for damage identification in a human premolar tooth

Non-carious cervical lesions are characterized by the loss of dental hard tissue at the cement-enamel junction (CEJ). Exceeding stresses are therefore generated in the cervical region of the tooth that cause disruption of the bonds between the hydroxyapatite crystals, leading to crack formation and eventual loss of enamel and the underlying dentine. Damage identification was performed by image analysis techniques and allowed to quantitatively assess changes in teeth. A computerized two-step procedure was generated and applied to the first left maxillary human premolar. In the first step, dental images were digitally processed by a segmentation method in order to identify the damage. The considered morphological properties were the enamel thickness and total area, the number of fragments in which the enamel is chipped. The information retrieved by the data processing of the section images allowed to orient the stress investigation toward selected portions of the tooth. In the second step, a three-dimensional finite element model based on CT images of both the tooth and the periodontal ligament was employed to compare the changes occurring in the stress distributions in normal occlusion and malocclusion. The stress states were analyzed exclusively in the critical zones designated in the first step. The risk of failure at the CEJ and of crack initiation at the dentin-enamel junction through the quantification of first and third principal stresses, von Mises stress, and normal and tangential stresses, were also estimated.