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doi:10.1111/j.1365-2591.2011.01955.

Influence of customized composite resin fibreglass


posts on the mechanics of restored treated teeth

R. B. Anchieta1, E. P. Rocha1, E. O. Almeida1, A. C. Freitas Junior1, M. Martin Junior2,


A. P. Martini1, C. M. Archangelo2 & C.-C. Ko3
1
Department of Dental Materials and Prosthodontics, Faculty of Dentistry of Aracatuba UNESP, Sao Paulo State University, Sao
Paulo; 2Federal Institute of Parana IFPR, Parana, Brazil; and 3The University of North Carolina, Chapel Hill, NC, USA

Abstract polymerization shrinkage of 1% was simulated for the


resin cement. The surface of the periodontal ligament
Anchieta RB, Rocha EP, Almeida EO, Freitas Junior AC,
was fixed in the three axes (X =Y = Z = 0). The
Martin Junior M, Martini AP, Archangelo CM, Ko C-C.
maximum principal stress (rmax), minimum principal
Influence of customized composite resin fibreglass posts on the
stress (rmin), equivalent von Mises stress (rvM) and
mechanics of restored treated teeth. International Endodontic
shear stress (rshear) were calculated for the dentine/
Journal, 45, 146155, 2012.
cement/post interface using finite element software.
Aim To evaluate the mechanical behaviour of the Results The peak of rmax for the cement layer occurred
dentine/cement/post interface of a maxillary central first in CFGP1 (1.77 MPa), followed by CFGP2 (0.99),
incisor using the finite element method and to compare FGP2 (0.44) and FGP1 (0.2). The shrinkage stress (rvM)
the stresses exerted using conventional or customized of the cement layer occurred as follows: FGP1 (35 MPa),
post cementation techniques. FGP2 (34), CFGP1 (30.7) and CFGP2 (30.1).
Methodology Four models of a maxillary central Conclusions Under incisal loading, the cement
incisor were created using fibreglass posts cemented layer of customized posts had higher stress concentra-
with several techniques: FGP1, a 1-mm-diameter tions. The conventional posts showed higher stress
conventionally cemented post; CFGP1, a 1-mm-diam- because of polymerization shrinkage.
eter customized composite resin post; FGP2, a 2-mm-
Keywords: fibreglass post, finite element analysis,
diameter conventionally cemented post; CFGP2, a
mechanics, resindentine interface, root canal.
2-mm-diameter customized composite resin post. A
distributed load of 1N was applied to the lingual aspect Received 21 March 2011; accepted 15 August 2011
of the tooth at 45 to its long axis. Additionally,

the use of FGP have reported encouraging results


Introduction
during short- to medium-term clinical use (Fredriksson
Fibreglass-reinforced composite posts (FGP) have been et al. 1998, Ferrari et al. 2000a,b, Grande et al. 2009).
used as an option to restore root-filled teeth by Success rates of 9599% for FGP-restored teeth, with
replacing the dentineroot complex using materials no root fracture, have been achieved (Ferrari et al.
with matching mechanical properties (Mannocci et al. 2000a,b, Monticelli et al. 2003, Soares et al. 2008).
2001). Prospective and retrospective clinical studies on Debonding is the most common failure in FGP and is
influenced by cement layer thickness (Grandini et al.
2005, Tait et al. 2005). For example, debonding can
Correspondence: Eduardo Passos Rocha and Rodolfo Bruniera occur if a post, especially in the coronal region, does
Anchieta, Departamento de Materiais Odontologicos e Protese, not fit well, or if the resultant cement layer is too thick
Faculdade de Odontologia de Aracatuba, UNESP, Rua Jose
Bonifacio, 1193, Vila Mendonca, CEP 16015-000, Aracatuba-
and bubbles or voids are incorporate into the cement
SP, Brasil (e-mails: eduardo_rocha@foa.unesp.br and rodol (Grandini et al. 2005). The formation of bubbles or
foanchieta@hotmail.com). voids, representing areas of weakness within the

146 International Endodontic Journal, 45, 146155, 2012 2011 International Endodontic Journal
Anchieta et al. Mechanics of customized composite resin fibreglass post

material, is less likely to occur in a thin and uniform from the human tooth bank at the Department of
layer of cement (Grandini et al. 2005, DArcangelo Dental Materials and Prosthodontics was used to
et al. 2007, Martini et al. 2009). Furthermore, a thick develop the experimental models.
cement layer may jeopardize the longevity of the Based on a microcomputed tomography image
restorations because adhesive failures are more com- (lCT), a total of 720 slices were obtained after scanning
mon in a thick cement layer, because of the low the tooth (CT40; Scanco Medical, Bassersdorf, Switzer-
mechanical properties of this layer (Tait et al. 2005). land). For the solid model design, 82 slices were serially
Additionally, there is greater stress polymerization selected for 3-dimensional reconstruction using soft-
contraction in a thick cement layer within the root ware (SolidWorks 2009; Inovart, Sao Paulo, Brazil). All
canal (Ferracane 2005). tooth structures (enamel, crown and root dentine,
One of the disadvantages associated with the use of dental pulp and periodontal ligament) were represented
prefabricated posts is the need to adapt the root canal to in the solid model.
the shape and size of the post to be used. Prefabricated From this initial model, four solid models were
root canal posts often have cylindrical or progressively created. In all models, the root canal was considered
tapered shapes, yet are placed in canals that are oval or as being root filled, and canal preparations were
ribbon shaped (Bellucci & Perrini 2002, Sathorn et al. included to produce a metal-free full crown of feld-
2005, Grande et al. 2008, 2009). Furthermore, ana- spathic ceramic. All models exhibited a homogeneous
tomical variability of the tooth is often a complicating crown reduction of 1.0 mm on the buccal and lingual
factor in root canal treatment and restorative proce- surfaces and 2.0 mm on the incisal surface. The
dures, because cone-shaped anatomy with a circular ceramic crown thickness reflected the reductions men-
base is not the most common shape in root canals, tioned above. The models had a periodontal ligament
especially in the coronal and middle thirds (Bellucci & thickness of 0.25 mm.
Perrini 2002, Grande et al. 2008, 2009). The root canal was widened for 5 mm. The diver-
In an attempt to improve the mechanical behaviour gence of walls from the coronal to middle third was 13
of fibreglass post restorations and reduce the cement in a cone shape format. This provided a large space
thickness, several customization techniques have been between the post and canal walls in the coronal region
developed (Faria-e-Silva et al. 2009, Grande et al. (Fig. 1a). From the middle third to the beginning of the
2009, Macedo et al. 2010). This way, the post becomes apical third, the root canal diameter followed the post
more anatomically correct, and its adaptation to canal dimensions. The diameter of the post varied from 1 to
walls is enhanced with a reduction in the cement layer 2 mm in the middle third. The gap between the post
thickness (Macedo et al. 2010). and the dentine surface was 0.05 mm from middle to
The aim of this study was to evaluate the mechanical apical thirds in all models (Fig. 1a).
behaviour of the dentine/cement/post interface of a The differences between models were the diameter of
maxillary central incisor restored with a fibreglass post, the post (1 and 2 mm), the cementation technique
using either a conventional system or one customized (conventional or customized) and the resin cement
with composite resin. The hypotheses tested were the layer thickness in the coronal and middle thirds (0.05,
following: (i) the mechanical behaviour of teeth is 1.5 and 2 mm) (Table 1).
influenced by post cementation technique (customized A conventional cemented post was used in two
or conventional) under lingual loading, (ii) polymeri- models (FGP1 and FGP2), whereas a customized
zation stress is higher in models with no post custom- fibreglass post with composite resin was used in the
ization. remaining two models, producing a thin layer between
the post and canal walls (CFGP1 and CFGP2) (Fig. 1b,
Table 1).
Materials and methods
Following the geometric models, the .iges files were
The study was approved by the local Human Research imported to the finite element (FE) software (ANSYS
Ethics Committee at the School of Dentistry of Araca- Workbench 10.0; Swanson Analysis Inc., Houston, PA,
tuba, Sao Paulo State University UNESP (process # USA) for numerical analysis.
2008/01845). All procedures were conducted and The mechanical properties of all materials (elastic
used in accordance with and guided by the ethical modulus [E] and Poissons ratio [v]) were obtained from
statements of the Declaration of Helsinki, according the the literature. All materials were considered isotropic,
World Medical Association. A maxillary central incisor homogeneous and linearly elastic (Table 2) (Friedman

2011 International Endodontic Journal International Endodontic Journal, 45, 146155, 2012 147
Mechanics of customized composite resin fibreglass post Anchieta et al.

Figure 1 Characteristics of root canal


considered in this study. Visualization
of post considered in conventional tech-
nique (a) and customized post with
composite resin (b). Arrow indicates the
thickness of cement layer (red) in coro-
nal region. Materials and elastic modu-
lus (GPa): composite resin (CR: 16.6);
cement layer (CL: 9.5); dentine (D: 18.6);
gutta-percha (GP: 1.4 10)1).

Table 1 General characteristics of study models, such as root Table 3 Orthotropic properties of the fibreglass post (Garbin
canal (coronal from apical) and post diameters, cement layer et al. 2010)
thickness (mm) for coronal third and technique
Youngs Poissons Shear
Canal root Cement modulus (GPa) ratio moduli (G)
diameter Post layer
X = 37 Xy = 0.27 Gxy = 3.1
Models (mm) diameter thickness Technique
Y = 9.5 Xz = 0.34 Gxz = 3.5
FGP1 52.05 1 2 Conventional Z = 9.5 Yz = 0.27 Gyz = 3.1
FGP2 52.05 2 1.5 Conventional
CFGP1 52.05 1 0.05 Customized
CFGP2 52.05 2 0.05 Customized
incisal third of the lingual surface, 45 to the long axis
of the tooth for all models (Fig. 2) (Rocha et al. 2011).
et al. 1975, Yettram et al. 1977, Okamoto et al. 2008, Additionally, polymerization shrinkage was simu-
Liu et al. 2009), except the fibreglass post, which was lated by thermal analogy (Laughlin et al. 2002, Meira
considered orthotropic, homogeneous and linearly et al. 2007). An elastic modulus of 9.5 GPa and
elastic, according to Garbin et al. (2010) (Table 3). Poissons ratio of 0.33 were assumed for the resin
For boundary conditions, the external surface of the cement. An arbitrary thermal expansion coefficient of
periodontal ligament was fixed on x, y and z coordinates 3.33 10)3C)1 associated with a 1 C temperature
for all models (X = Y = Z = 0) (Fig. 2). A distributed decrease produced a volumetric shrinkage of 1%
load (approximately 10 mm2) of 1 N was applied to the (Laughlin et al. 2002, Meira et al. 2007).

Table 2 Elastic properties of isotropic


Materials E (GPa) v References
materials
Enamel 84.1 0.33 Liu et al. (2009)
Dentine 18.6 0.32 Liu et al. (2009)
Periodontal ligament 6.89 10)5 0.45 Yettram et al. (1977),
Okamoto et al. (2008)
Gutta-percha 1.4 10)1 0.45 Friedman et al. (1975)
Resin cement 9.5 0.30 Okamoto et al. (2008)
Ceramic 69 0.28 Okamoto et al. (2008)
Composite resin 16.6 0.24 Okamoto et al. (2008)

E, elastic modulus; v, Poissons ratio.

148 International Endodontic Journal, 45, 146155, 2012 2011 International Endodontic Journal
Anchieta et al. Mechanics of customized composite resin fibreglass post

Figure 3 Convergence of analysis (6%). Elements with


0.2 mm were selected for analysis. However, considering the
convergence of analysis to composed structures of interface
dentin/cement/post, the sizes of elements were reduced to
0.05 mm in cementation interfaces.

predicting failures in non-ductile materials, such as


dentine, as well as failures that could originate from
small flaws (Anchieta et al. 2007, Martini et al. 2009).
For the shrinkage stress, the von Mises stress (rvM) was
obtained (Ausiello et al. 2002).
A semi-quantitative analysis was performed to eval-
uate the modelling results.

Figure 2 Boundary (external surface of the periodontal liga-


ment) and loading conditions of models (lingual surface on
Results
incisal third).
Stress analysis after the lingual loading condition
The accuracy of the models was checked by conver- The stress distribution (rmax, rmin, rvM and rshear) for
gence tests (6%) to avoid stress estimation based on dentine, cement layer, post, post abutment and com-
under/over-refined meshing. The mesh was composed posite resin of customized post for all models is shown in
of parabolic tetrahedral elements with four nodes Table 4. When the rmax results were analysed compar-
(ANSYS Workbench 10.0; Swanson Analysis System) ing both post cementation techniques, the stress values
(Fig. 3) (Huang et al. 2008). The models were meshed were similar in most structures (Table 4). The largest
with an adaptive mapping mesh strategy with high difference occurred at the post cementation interface,
element density on the cement layers (element size of where the stress in CFGP1 was ninefold higher when
0.05 mm) and a gradual decrease in element density compared to FGP1, whereas in CFGP2, the cement
according to the distance from the dentine/cement/post stress was 2.25-fold higher than in FGP2. In these
interface (elements size up to 0.2 mm) (Liu et al. 2009) models, the maximum principal stress in the cementa-
(Fig. 4). The models predicted 268,152 (FGP1), tion interface occurred in the cervical region in contact
264,438 (FGP2), 272,480 (CFGP1) and 269,838 with the dentine (Table 4), except for CFGP2, in which
(CFGP2) elements. The number of nodes was the maximal stress occurred in the root middle third.
425,747 (FGP1), 424,014 (FGP2), 436,092 (CFGP1) In the dentine, the peak rmax occurred in CFGP1, a
and 436,246 (CFGP2). There was no stress shocking value threefold higher than in FGP1, followed by FGP2
and stress breaking in the smallest elements. (Table 4). The cervical region in contact with the
The maximum principal stress (rmax), minimum cement was the area where maximum principal stress
principal stress (rmin), von Mises stress (rvM) and shear occurred for the dentine. In the post, the maximum
stress (rshear) were obtained for dentine, cement layer, principal stresses occurred in FGP1 and FGP2 (Fig. 5).
post and composite resin of the customized post. The With respect to the other analysis criteria (rmin, rvM
maximum principal stress (rmax) is appropriate for and rshear), similar behaviour to those observed for

2011 International Endodontic Journal International Endodontic Journal, 45, 146155, 2012 149
Mechanics of customized composite resin fibreglass post Anchieta et al.

Figure 4 Finite element mesh elaborated


from adaptive mapping mesh with high
concentrate elements in cement layer
(0.05 mm) and reduction far from den-
tine/cement/post interface (0.2 mm). In
sequence (left to right), mesh in dentine,
customized post and cement layer.

rmax was also noted. Within all interface structures, and CFGP2 was 28-fold greater than FGP2 (Table 4).
the post cementation interface was the site where The peak of principal stress occurred in the coronal and
highest stress differences were found amongst the middle third in contact with the dentine.
models.
The cementation surface in contact with the dentine
Stress analysis after the polymerization shrinkage
in the cervical region showed rmin differences, as
CFGP1 was eightfold higher than FGP1 and CFGP2 was When polymerization shrinkage was simulated, the
1.12-fold higher than FGP2 (Table 4). Similarly, for the greatest von Mises stress in the dentine/cement
rvM, the difference in CFGP1 was 13.5-fold higher than interface occurred in models FGP1 and FGP2. Stress
FGP1, and CFGP2 was threefold higher than FGP2 in the dentine surface in contact with the cement was
(Table 4). For the rshear, although the absolute stress 2.5-fold higher in FGP1 than in CFGP1 and 1.5-fold
values were lower, the stress concentration difference higher in FGP2 than in CFGP2 (Fig. 6). In addition,
in the cement layer between models was higher, as the stress in the cement layer was higher for FGP1 and
CFGP1 was approximately 150-fold greater than FGP1, FGP2 than for CFGP1 and CFGP2 (Fig. 6) in all

Table 4 Maximum principal stress (rmax), minimum principal stress (rmin), von Mises stress (rvM) and shear stress (rshear) for
dentin (D), cement layer (CL), and post (P) and post composite resin (PCR)
rmax (MPa) rmin (MPa) rvM (MPa) rshear (MPa)

Models D CL P PCR D CL P PCR D CL P PCR D CL P PCR

FGP1 0.68 0.2 2.2 0.76 0.21 1.2 0.76 0.2 0.96 0.2 0.002 0.04
CFGP1 2 1.77 2.1 3.8 1 1.85 1 3.5 2.46 2.56 0.75 5 0.9 0.3 0.04 1.2
FGP2 1.0 0.44 0.9 2.15 0.77 0.5 2.49 0.38 0.96 0.8 0.007 0.05
CFGP2 0.8 1 0.8 3.7 1 0.87 0.35 3.5 1.51 1.1 0.9 5.4 0.6 0.2 0.04 1.25

D, dentin; CL, cement layer; P, post; PCR, post composite resin.

150 International Endodontic Journal, 45, 146155, 2012 2011 International Endodontic Journal
Anchieta et al. Mechanics of customized composite resin fibreglass post

Figure 5 Location of maximum princi-


pal stress in cementation interface for
models FGP1 (top left), FGP2 (top right),
CFGP1 (bottom left) and CFGP2 (bottom
right). Note stress concentrated in root
coronal region in contact with root canal
walls for all models, except for CFGP2.

models, and maximum stress occurred in the interface


between the cement and the dentine coronal region
(Figs 7 and 8).

Discussion
The findings of this study revealed different mechanical
behaviour of teeth when using two different techniques
for post cementation under lingual loading. The sim-
ulations using customized fibreglass posts revealed
higher stress concentration in the post resin cement
layer than that of the conventional fibreglass post
cementation technique.
Figure 6 Polymerization stress (rvM) in cement layer and Higher stress concentration (rmax, rmin, rshear and
dentine for all models (FGP1, CFGP1, FGP2 and CFGP2). rvM) was observed in the fibreglass post (FGP1) and in

2011 International Endodontic Journal International Endodontic Journal, 45, 146155, 2012 151
Mechanics of customized composite resin fibreglass post Anchieta et al.

Figure 7 Location of maximum von


Mises stress for models FGP1 (top left),
FGP2 (top right), CFGP1 (bottom left)
and CFGP2 (bottom right). Note that in
FGP1 and FGP2, there is great stress
concentration in coronal region of canal
walls in contact with cement. In models
CFGP1 and CFGP2, stress in dentine was
lower compared with conventional
technique.

the resin cement layer (CFGP1) (Table 4). These results a thick resin cement layer, the layer exhibits higher
support the first hypothesis that mechanical behaviour deformation capacity because of its lower elastic
of teeth is influenced by post cementation technique. modulus and lower stress (Faria-e-Silva et al. 2009).
However, the stress difference found in the resin Another important factor to be considered is the
cement layer across models does not necessarily shrinkage of the resin cement. In the present study, the
indicate that a thinner resin cement layer is more maximum stresses in the dentine/cement/post interface
susceptible to failure than a thicker one (Liu et al. occurred in models FGP1 and FGP2. In models CFGP1
2009). In a thin resin cement layer, the friction and CFGP2, lower stresses were observed, especially in
between the composite resin and dentine prevents post the dentine (canal walls) and post (external surface).
displacement under loading, generating higher stress The stress concentration in dentine for FGP1 was
concentration (Faria-e-Silva et al. 2009). In contrast, in 55.5% higher than CFGP1. Similarly, for FGP2, the

152 International Endodontic Journal, 45, 146155, 2012 2011 International Endodontic Journal
Anchieta et al. Mechanics of customized composite resin fibreglass post

Figure 8 A top view of location of maximum stress (rvM) under polymerization shrinkage for models FGP1 (top left), FGP2 (top
right), CFGP1 (bottom left) and CFGP2 (bottom right). Note on dentine in coronal region the higher stress concentration in FGP1
and FGP2 than in CFGP1 and CFGP2.

stress in dentine was 48% higher than that for CFGP2. factor that can increase the occurrence of failures in
Thus, the second hypothesis of this study proposing restorations with post debonding (Tay et al. 2005). In
that the polymerization stress is higher in conventional the root canal, the C-factor may exceed 200 (Bouillag-
models is supported, because the polymerization stress uet et al. 2007). The stresses are exacerbated inside the
was higher in models FGP1 and FGP2. root canal because the canal walls cannot compensate
The stress generated by resin cement shrinkage for shrinkage stresses by elastic deformation or com-
within the root canal during polymerization is a critical pliance (Tay et al. 2005). However, the differences in

2011 International Endodontic Journal International Endodontic Journal, 45, 146155, 2012 153
Mechanics of customized composite resin fibreglass post Anchieta et al.

stress polymerization found in the present study cannot interface was more stressed in CFGP1 and CFGP2. In
be justified by the C-factor, because the cement volume addition, considering the polymerization shrinkage, it
between models was different (Braga et al. 2005). Thus, could be concluded that the most affected interface
the volume of resin cement may have caused the stress occurred in models FGP1 and FGP2, especially in the
differences. coronal region of the root canal in the dentine and
Consequently, because the bond strength of resin cement layers.
materials is reduced in root canals when compared to
smooth dentinal surfaces, and this strength decreases
Acknowledgements
as the resin gets deeper in the root canal, the
customization of the fibreglass post can be a viable This study was supported by the Sao Paulo Research
clinical alternative to enhance the frictional retention Foundation (FAPESP, Brazil, grant no. 2008/00209-9
of the post (Rodig et al. 2010). and grant no. 2010/12926-7) and by the Foundation
Despite showing promising mechanical properties for for the Coordination of Higher Education and Graduate
the fibreglass post customization with composite resin Training (CAPES, Brazil, grant no. BEX 2325-05-5).
technique, especially in relation to the contraction The authors do not declare any conflicts of interest
generated during polymerization, this study presented related to this study.
some limitations. The loading incidence was projected
only to one interface of the tooth, reproducing no References
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