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Stress Distribution After Different Apical Resection Techniques Under Different Vertical Facial Pattern-Related
Gülgün Atay Yılmaz1, Ahmet Keleş1
1Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Türkiye.
Journal of Endodontics
|August 12, 2026
Summary
Different apical surgery techniques affect stress on mandibular molars, especially with higher forces in short-face patterns. Bone window techniques showed higher stress than trephine burs.
Area of Science:
- Biomaterials and Biomechanics
- Endodontics and Dental Surgery
Background:
- Apical periodontitis often requires endodontic retreatment or apical surgery.
- Understanding stress distribution after apical surgery is crucial for long-term tooth survival.
Purpose of the Study:
- To evaluate stress distributions in mandibular molars after different apical resection techniques.
- To analyze the influence of occlusal forces related to facial patterns on stress.
Main Methods:
- Finite element analysis using Visible Human Project data.
- Simulated apical lesions and four surgical techniques: targeted endodontic microsurgery (TEMS) with two bur sizes, endodontic microsurgery (EMS), and bone window (BW).
- Applied vertical and oblique occlusal forces simulating short, average, and long facial patterns.
Main Results:
- Biomechanical stress was highest in short-face patterns under oblique loading.
- The bone window technique generally exhibited the highest stress values.
- Trephine techniques showed loading direction-dependent stress patterns, with concentrations at the cervical bone and graft-bone interface.
Conclusions:
- Apical surgical technique, loading direction, and occlusal force magnitude significantly influence stress distribution post-apical surgery.
- Findings provide insights into the biomechanical outcomes of different surgical approaches.
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