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Optimizing restorative procedure and material selection for pulpotomized primary molars: Mechanical characterization
Jiahui He1,2, Jin Sun1, Yun Liu3
1Department of Endodontics, Shenzhen Stomatology Hospital, Shenzhen, PR China.
Heliyon
|August 22, 2024
Summary
Endocrowns and other restorations reduce stress on pulpotomized primary teeth. This study used 3D-finite element analysis (FEA) to compare restorative materials, finding endocrowns best protect dental tissue and reduce pulpotomy failure risk.
Area of Science:
- Pediatric Dentistry
- Dental Materials Science
- Biomaterials Engineering
- Finite Element Analysis in Dentistry
Background:
- Pulpotomy is a common procedure for primary molars, but restoration selection impacts success.
- Understanding stress distribution in restored pulpotomized teeth is crucial for long-term outcomes.
- Previous studies have not fully elucidated the comparative stress behavior of various restorative materials in primary molars post-pulpotomy.
Purpose of the Study:
- To evaluate and compare stress distribution in pulpotomized primary molars restored with different materials using 3D-finite element analysis (FEA).
- To provide data-driven insights for selecting optimal restorative materials to minimize pulpotomy failure.
- To enhance the protection of residual dental tissue in primary molars after pulpotomy.
Main Methods:
- Developed four 3D FEA models of pulpotomized primary molars with distinct restorative materials: resin composite, stainless steel crowns (SSCs), prefabricated zirconia crowns, and endocrowns.
- Simulated physiological masticatory conditions by applying vertical and bucco-lingual forces to models with a food layer.
- Analyzed von Mises stresses (VMS) and recorded maximum shear stress at bonding interfaces and pressure stress at Mineral Trioxide Aggregate (MTA)-pulp interfaces.
Main Results:
- All tested restorative materials induced stress in the tooth structure post-pulpotomy.
- Resin composite restorations showed the highest stress peaks at the marginal enamel and higher pressure stress at the MTA-pulp interface.
- Endocrowns exhibited lower shear stress at bonding interfaces and reduced stress concentration near the restoration margin compared to SSCs and zirconia crowns.
Conclusions:
- Occlusal restorations, particularly endocrowns, effectively reduce stress on pulp capping materials under occlusal loads, potentially lowering pulpotomy failure rates.
- Endocrowns demonstrate superior performance in minimizing stress at bonding interfaces and stress concentration zones, offering better protection for residual dental tissue.
- The findings support endocrowns as a favorable restorative option for pulpotomized primary molars, enhancing treatment longevity and tissue preservation.
