Modified Technique of Porcelain Laminate Veneer in Premolars with Abfraction Lesions: Three-Dimensional Finite Element Analysis (FEA)
DOI:
https://doi.org/10.17921/2447-8938.2020v22n2p120-126Resumo
The incidence of non-carious cervical lesions (NCCLs) has increased as populations are aging, and teeth are increasingly retained for life. Several materials are available to treat these lesions. This study aimed to evaluate the stress distribution of maxillary premolars with NCCLs using three-dimensional (3D) finite element analysis (FEA) according to different restorative techniques. A 3D FEA mathematical model simulating a sound premolar was initially modeled and replicated in 6 more models simulating a tooth with abfraction: G.1 tooth with abfraction; G.2 tooth with abfraction + composite resin restoration; G.3 tooth with abfraction + glass-ionomer cement restoration; G.4 tooth with abfraction + resin composite restoration + porcelain laminate veneers; G.5 tooth with abfraction + glass-ionomer cement + porcelain laminate veneers; and G.6 modified porcelain laminate veneers filling the lesion. All materials and structures were considered linear, elastic, homogeneous and isotropic and the results were expressed as maximum principal stress. Lower stress concentration in dentin was calculated when the tooth was restored with composite resin and glass-ionomer cement. Regarding the veneer techniques, no difference was found to dentin stress among the groups, but the modified veneer concentrated less stress in the restoration than other the techniques. The control group had the highest concentration of stress in the lesion. All techniques decreased the stress concentration inside the NCCLs and the indirect veneer filling the lesion presented better biomechanical behavior than the veneer cemented above direct restorations.
Keywords: Finite Element Analysis. Dental Veneers. Ceramics. Bicuspid.
Resumo
A incidência de lesões cervicais não-cariosas (LCNC) tem aumentado, uma vez que a população tem envelhecido com uma menor perda de elementos dentários. Diferentes materiais estão disponíveis para tratar dessas lesões. Este estudo objetivou avaliar a distribuição de tensão de pré-molares superiores com LCNC por meio da análise tridimensional (3D) de elementos finitos (FEA) de acordo com diferentes técnicas restauradoras. Um modelo matemático 3D FEA simulando um pré-molar íntegro foi modelado e replicado em mais 6 modelos simulando um dente com abfração: G.1 dente com abfração; G.2 dente com abfração + resina composta; G.3 dente com abfração + cimento de ionômero de vidro; G.4 dente com abfração + resina composta + faceta; G.5 dente com abfração + cimento de ionômero de vidro + faceta cerâmica e G.6 com faceta cerâmica modificada, preenchendo a lesão. Todos os materiais e estruturas foram considerados lineares, elásticos, homogêneos e isotrópicos e os resultados foram expressos como máxima tensão principal. Menor concentração de tensão na dentina foi calculada quando o dente foi restaurado com resina composta ou cimento de ionômero de vidro. Dentre os grupos com laminados, não houve diferença para a dentina, entretanto a faceta modificada apresentou menor concentração de tensão na restauração. O grupo controle apresentou a maior concentração de tensão na lesão. Todas as técnicas restauradoras diminuíram a concentração de tensão no interior das LCNCs e dentre as técnicas com laminados a faceta modificada apresentou o melhor comportamento biomecânico.
Palavras-chave: Análise de Elementos Finitos. Facetas Dentárias. Cerâmica. Dente Pré-Molar.
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