Eur J Oral Sci 2012; 120: 161–167 !

2012 Eur J Oral Sci

DOI: 10.1111/j.1600-0722.2012.00943.x European Journal of
Printed in Singapore. All rights reserved
Oral Sciences

Haiping Xu1,2, Zhe Jiang1,2, Ximei

Influence of cavity design on the Xiao1,2, Jing Fu1, Qin Su2

biomechanics of direct composite resin

1
State Key Laboratory of Oral Diseases,
Sichuan University; 2Department of
Endodontics, West China College of

restorations in Class IV preparations Stomatology, Sichuan University, Chengdu,

Sichuan, China

Xu H, Jiang Z, Xiao X, Fu J, Su Q. Influence of cavity design on the biomechanics of

direct composite resin restorations in Class IV preparations.
Eur J Oral Sci 2012; 120: 161–167. ! 2012 Eur J Oral Sci

This study evaluated the effect of cavity design on stress distribution and fracture
resistance of direct composite resin restorations in Class IV preparations. A finite
element analysis (FEA) model of the maxillary central incisor with a Class IV
cavity was established. Five model variations were studied: (i) a 1-mm bevel (ii) a
2-mm bevel, (iii) a plain chamfer, (iv) a stair-step chamfer, and (v) butt joints
(a control configuration). All FEA variations modeled a tooth restored with
composite resin loaded under 100 N at an angle of 45" to the longitudinal axis. The
interfacial von Mises stress was evaluated. The FEA was complemented with an in
vitro assessment. Fracture resistance of direct composite resin restorations was
Qin Su, 14#, 3rd section, Ren Min Nan Lu,
tested with a universal testing machine and fracture patterns were observed. Finite West China School of Stomatology, Sichuan
element analysis showed that stress in chamfer and stair-step chamfer models was University, Chengdu, Sichuan, China 610041
more homogenously distributed, while stress in bevel models was relatively con-
centrated at lingual regions. Fracture resistance of a 1-mm bevel preparation was Telefax: +86–28–85582167
E-mail: qinsu_hx@yahoo.com.cn
lower than for the 2-mm bevel, plain chamfer, and stair-step chamfer preparations,
but was higher than for butt joints. The stair-step chamfer group presented the Key words: composite resin; dental cavity
most favorable failure pattern. Considering biomechanics and esthetics, the present preparation; finite element analysis; fracture
study indicates that the stair-step chamfer and 2-mm bevel should be recommended resistance; incisor
for clinical restoration. Accepted for publication December 2011

Traumatic dental injuries are a frequent problem among
children and teenagers (1–4), resulting in a range of
possible functional, esthetic, psychological, and social
impairments (5). The teeth most affected are the upper
incisors (6). If the fractured fragments of the tooth are
well preserved, immediate reattachment may be possible
(7, 8). However, fragments are not always available and
often a restorative procedure is necessary to regain
functional integrity of the tooth.
While the esthetic outcome of restorative materials has
been the focus of widespread attention, it is the biome-
chanics of restorations that determine their functional-
ity, retention, and functional lifetime. In anterior teeth
where high-impact stresses are experienced, restorations
require high fracture resistance. Approaches to enhance
the biomechanics of restorations involve the use of a
suitable restoration compound and an appropriate
adhesive, and optimal preparation of the dental cavity.
As a restoration compound, composite resin provides
excellent esthetic and mechanical results (9, 10). Com-
pared with full-crown restorations, composite resin does
not require excessive preparation of the dentition.
Moreover, it has the advantages of low cost and a short
treatment course. Therefore, composite resin is an
optimal restoration compound in dental practice.
A number of dental cavity-preparation designs cur-
rently exist. The preparation of a bevel on the cavity
margin has been widely used to enhance retention of
the restoration (11, 12). Plain chamfers, prepared to
half the depth of the enamel on the labial and lingual
surface, have been shown to improve fracture resis-
tance (13). The stair-step chamfer technique is a new
design involving the preparation of a 1-mm-long (or
half the length of the fracture) chamfer (11). Hori-
zontal and vertical lines are concealed within the nat-
ural anatomy of the tooth to achieve an acceptable
esthetic outcome.
Previous research has demonstrated that bevel,
chamfer, and stair-step chamfer preparations exhibit
similar fracture resistance (14, 15). However, failure
mode evaluation revealed that the stair-step chamfer
gave significantly better results than other designs. The
stair-step chamfer was recommended because of its
superior fracture resistance, better esthetics, and minimal
sacrifice of tooth structure compared with the chamfer
(14, 15). Additional research demonstrated that the
162 Xu et al.

buccal stair-step chamfer preparation had significantly Material and methods

higher shear strength and fracture resistance compared
with a plain chamfer or the buccal and lingual stair-step
chamfer preparations (16). However, biomechanical
reasoning suggests that during preparation of the stair-
step chamfer and plain chamfer sharp line angles in the
cavity are created, which could result in areas of high
stress concentration (17).
Several studies have analyzed the fracture resistance
of direct composite resin restorations in Class IV
preparations (12, 14–16). However, fracture resistance
does not confer a complete understanding of the
biomechanical performance of restorations influenced
by different cavity designs. It is also necessary to ana-
lyze the interfacial stress produced in the tooth and the
restoration by occlusal loads during mastication, as
stress concentration initiates crack propagation,
compromises the marginal integrity of composite res-
torations, and causes fractures or debonding of the
restoration (17–19).
The influence of cavity design on restoration can be
assessed by in vitro laboratory investigations or ana-
lytical methods such as finite element analysis (FEA).
Finite element analysis offers several advantages over
laboratory testing, such as accurate modeling of com-
plex geometries, simulation of mechanical events, and
access to and analysis of the stress–strain patterns
induced in internal structures upon loading (20–22).
Using the FEA method, some investigators have
demonstrated the influence of cavity shape on the
magnitude of interfacial stress between the tooth and
the restoration (23, 24). However, to the best of our
knowledge, no studies have analyzed the stress distri-
bution of direct composite resin restorations in Class
IV cavity preparations. Therefore, the present study
used FEA and in vitro testing to evaluate stress dis-
tribution and fracture resistance of direct composite
resin restorations in Class IV preparations to identify
cavity designs with optimal performance. The null
hypothesis was that chamfer and stair-step chamfer
preparations provide favorable biomechanics for Class
IV restorations. Combining in vitro tests with
FEA improves the understanding of biomechanical
conditions that lead to tooth/restoration fracture (21,
22, 25).
Finite element analysis
An intact, cavity-free maxillary central incisor was scanned
using 16-slice spiral computed tomography (Sensation 16,
120kV, 100 mA; Siemens, Erlangen, Germany) in incre-
ments of 0.6 mm. The scanned slices were imported into
Materialise Mimics 8.1 software (Materialise, Leuven,
Belgium), which allows extended visualization and seg-
mentation. The three-dimensional (3D) architecture (enamel
and dentin) was automatically created in the form of masks
by growing a threshold region on the entire stack of scans.
The objects were converted into stereolithography files
(STL) using a Mimics STL+ module and imported into
Magics of Materialise to produce a watertight model.
The solid model was transferred into a FEM program,
Ansys 10.0 (Swanson Analysis, Houston, PA, USA), where
the volumes were redefined and meshed with
four node tetrahedral elements. The alveolar bone was
modeled and the Class IV cavity designs were then
constructed as shown in Table 1 and Fig. 1.
All materials were considered homogenous, linearly
elastic, and isotropic. Their mechanical properties are
summarized in Table 2 (26–29). It was assumed that the
effect of the pulp was negligible as a result of its low
Young!s modulus (30, 31) and the limited load it supports
(23, 31). The effects of the periodontal ligament and
cementum were disregarded because of their small dimen-
sions (24, 30, 32). In addition, the interfacial stress in Class
IV cavities, which was the primary focus of this paper,
existed a considerable distance from the periodontal liga-
ment (31). The alveolar bone that supports the tooth was
presumed rigid. In this study, the bond layer, which is able
to partially absorb the composite deformation and limit the
intensity of the stress transmitted to the remaining natural
tooth tissues (33), was not modeled. This made the dis-
tinction between the interfacial stresses of each of the
models more significant. The model was fully constrained
at the lower boundary and received a static load of 100 N
at an angle of 45" to the longitudinal axis, which was in-
tended to simulate a mastication load. As shown in Fig. 1,
two loading conditions were performed in the models: (1)
load applied at the junction between the upper third and
middle third of the palatal surface of the crown (central
occlusion) (34), or (2) load applied at the incisal tip angled
labially and apically (protrusive articulation) (35). The
stress distribution was analyzed according to the von Mises
(equivalent stresses) energetic criterion by measuring nodes,
where:

Table 1
Description of cavity design groups used in finite element analysis (FEA) modeling, summarizing the number of mesh elements and nodes
used in the models

Model Description Elements Nodes

1 mm bevel 45" bevel extending 1 mm beyond the fracture line 40,068 7,911
2 mm bevel 45" bevel extending 2 mm beyond the fracture line 40,947 8,005
Plain chamfer Facial plain chamfer (1 mm deep) extending 2 mm beyond 43,280 8,471
the fracture line and half the enamel
thickness in depth with a lingual 2-mm bevel
Stair-step chamfer Facial stair-step chamfer following the 42,236 8,276
anatomical contour and extending
2 mm beyond the fracture line with a lingual 2-mm bevel
Butt joint Incisal fracture tooth as control 44,921 8,672

Fig. 1. Finite element models of the five tooth preparations and loading conditions. (A) 1-mm bevel, (B) 2-mm bevel, (C) plain
chamfer, (D) stair-step chamfer, and (E) butt joint. (F) Two loading conditions were performed in the models: (i) load applied at the
junction between the upper third and the middle third of the palatal surface of the crown (central occlusion) or (ii) load applied at the
incisal tip angled labially and apically (protrusive articulation).
Table 2
Summary of tooth material mechanical properties
Young!s Poisson
Material modulus (GPa) ratio
Enamel 82.5 0.33
Dentin 18.6 0.31
Composite 13.0 0.30
sffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffi
ðr1 # r2 Þ2 þ ðr2 # r3 Þ2 þ ðr3 # r1 Þ2
r¼
2
Here, r1, r2, and r3 are known as the principal stresses
and r is the von Mises stress. The principal stresses are, in
fact, normal stresses acting on principal planes on which the
shearing stresses are zero. The von Mises criterion, which
results in a tensile-type normal stress, was selected as brittle
tooth failure that occurs primarily as a result of tensile-type
normal stresses (30).
Fracture resistance tests
Sixty recently extracted bovine mandibular central incisors
were selected from cows killed when 30 months of age. The
mesiodistal tooth size, measured using a digital caliper,
ranged from 12 to 14 mm. After removal of soft tissue, the
teeth were disinfected for 1 wk in 0.5% chloramine-T
solution. Thereafter they were stored in distilled water at
4"C and used within 6 months. The storage medium was
replaced periodically. The teeth were randomly divided into
six groups (n = 10 each group). Each tooth was embedded
in self-curing acrylic resin up to 2.0 mm from the cemento–
enamel junction. During the embedding procedure, teeth
were stabilized by insertion into a hole in the centre of an
X-ray film (Kodak, Rochester, NY, USA). Ten teeth were
tested intact and without treatments as a positive control
group. In the remaining teeth, standardized incisal fractures
were prepared using a water-cooled high-speed diamond
saw. The prepared fractures were located 4 mm gingivally
and 4 mm distally from the incisal angle and about one-
third of the tooth mesiodistally. The fractured teeth were
prepared in a manner consistent with the experimental
Optimal cavity design for clinical restorations 163
models investigated using FEA. However, the stair-step
chamfer was modified by preparing a facial chamfer half the
length of the fracture with a lingual 2-mm bevel.
Before placement of the restoration, all specimens received
prophylactic treatment with pumice. Enamel and dentin
Reference
were etched with 37% phosphoric acid gel (Total Etch;
Farah et al. (26) Ivoclar Vivadent, Schaan, Liechtenstein) for 30 s and then
Farah et al. (26) and washed with water. An etch-and-rinse single-component
Coelho et al.(27) bonding agent (Tetric N-Bond; Ivoclar Vivadent) was then
Emami et al. (28) and applied with a microbrush and photoactivated for 10 s using
Chung et al. (29) a light-curing unit (bluephase C8; Ivoclar Vivadent) with an
intensity of at least 800 mW cm)2. The cavity was filled with
nano-hybrid composite (Tetric N-Cream; Ivoclar Vivadent)
in increments and each was photoactivated for 20 s. A
polyvinyl siloxane index was used to control the anatomy of
ð1Þ incisal edges. Samples were polished immediately.
After storage for 24 h in distilled water, specimens were
thermocycled between 5"C and 55"C for 500 cycles, with a
dwell time of 30 s (12, 36). The specimens were subjected to
a load with a 1 mm min)1 crosshead speed in a universal
testing machine (Instron 5565; Instron, Canton, MA, USA)
using a small stainless steel ball. The loading head, with a
diameter of 4 mm, was placed at the end of a jig held in the
cross head of the test machine. The specimens were fixed at
an angle 90" to the load application. The loading point was
maintained in contact with the composite resin restorations
(or in corresponding position for intact teeth) and near the
adhesive interface. The force required to fracture a sample
was recorded.
Results were analyzed by one-way anova followed by a
Student-Newman-Keuls (SNK) test. For all tests, the level
of significance was P < 0.05.
Fracture patterns were evaluated under a stereomicroscope
(SMZ1000; Nikon, Tokyo, Japan) and categorized as fol-
lows: adhesive failure at the interface, cohesive failure of the
restorative material, cohesive failure of the dental structure,
or mixed failure involving more than one of these patterns.
Results
FEA stress distribution
Figures 2–4 show the interfacial stress distributions and
displacements at different loading conditions. Along the
loading direction, the interfacial von Mises stress
decreased labially and apically. Stress in the chamfer and
stair-step chamfer models was homogenously distrib-
164 Xu et al.

Fig. 2. Stress distribution in the interface of resin restorations and teeth at central occlusion (view from the interfacial perspective).
Stress magnitude is represented in color with blue indicating the lowest stress and red the highest stress.

Fig. 3. Stress distribution in the interface of resin restorations and teeth at protrusive articulation (view from the interfacial
perspective). Stress magnitude is represented in color with blue indicating the lowest stress and red the highest stress.

uted, while stress in the bevel models was relatively
concentrated in lingual regions (Figs 2 and 3). The
interfacial displacement of restorations decreased grad-
ually from the incisal edge down to the gingiva (Fig. 4).
The maximum von Mises stresses at protrusive artic-
ulation were higher than at central occlusion for all
models. Stress was highest in the control group. At
central occlusion, the stresses of the four experimental
models were similar. At protrusive articulation, the
maximum von Mises stresses of the two-chamfer models
were higher than those of the two bevel models (Fig. 5).
Fracture resistance tests
Table 3 presents the mean ± SD fracture resistance for
the test groups. A significant between-group difference
was found (anova; P < 0.05). The highest failure loads
were obtained in intact teeth, while the lowest were
observed in the butt joint group (the positive control and
the negative control, respectively). The 1-mm bevel
preparation showed a significantly lower fracture resis-
tance than the 2-mm bevel, plain chamfer, or stair-step
chamfer preparations. There was no significant difference
between the 2-mm bevel, plain chamfer, and stair-step
chamfer preparations (P > 0.05).
The fracture patterns for different groups are shown in
Fig. 6. Adhesive failure occurred mostly in the butt joint
group (Fig. 7A), followed by the 1-mm bevel prepara-
tion. Mixed failure occurred mainly in the 2-mm bevel,
plain chamfer, and stair-step chamfer preparations
(Fig. 7B). The stair-step chamfer technique gave signifi-
cantly better results because cohesive failure of the dental
 Optimal cavity design for clinical restorations 165

Fig. 4. Interfacial displacement distribution of resin restorations at the two loading conditions (view from the interfacial perspective).
The displacement is represented in color with blue indicating the lowest displacement and red the highest displacement.

structure appeared instead of adhesive failure. Debond- Table 3

ing or fracture of the restorations usually originated at Fracture resistance for different groups (n = 10)
the incisal edge near the adhesive interface (Fig. 7C,D).
Groups Fracture resistance (N) SNK category*

1-mm bevel 160 ± 29 C

Discussion 2-mm bevel 270 ± 20 B
Plain chamfer 294 ± 25 B
The retention of composite resin restorations is deter- Stair-step chamfer 283 ± 36 B
mined by stress conditions in combination with the Butt joint 111 ± 30 D
bonding strength between the tooth and the restoration. Intact teeth 333 ± 29 A
The lifetime of a restoration can be prolonged only when
Fracture resistance is given as mean ± SD. The results were
the interfacial stresses are lower than the mechanical analyzed by one-way anova followed by a Student–Newman–
strength of the bond (24). Because of the great signifi- Keuls (SNK) test.
cance of stress, this study used 3D FEA to visualize stress *SNK categories with different letters are significantly different
conditions in various resin restorations. Two loading from each other (P < 0.05), while SNK categories with the
conditions were performed to simulate the physiologi- same letters are not significantly different.
cally realistic conditions of protrusive articulation and
central occlusion. In addition, the fracture resistance of tested in vitro, and the results are reported in terms of
restorations, which is determined by stress state, bonding force (N). In vitro fracture patterns were also assessed.
strength, and the mechanical properties of individual The FEA and in vitro testing methodologies of this
materials, was also required to assess restoration bio- study indicated that chamfer and stair-step chamfer
mechanical performance effectively. In this study, frac- preparations provide favorable biomechanics for Class
ture resistance was assessed using shear-bond strength IV restorations. The 2-mm bevel, chamfer, and stair-step
chamfer preparations showed similar capacities to rein-
force fracture resistance, while the stair-step chamfer
preparation presented the most favorable failure pattern.
1.60
At central occlusion At protrusive articulation Considering both biomechanics and esthetics, the stair-
von Mises stress (MPa)

1.40
1.20 step chamfer and 2-mm bevel should be recommended
1.00 for clinical restorations.
0.80
Using FEA, the previously unclear interfacial stress
0.60
0.40 states of composite restorations in different Class IV
0.20 preparations were interpreted. The bevel or chamfer
0.00 techniques were each found to offer their own advanta-
1-mm bevel 2-mm bevel Plain Stair-step Butt joint
chamfer chamfer ges under stress. Stress in the bevel models was concen-
Model groups
trated to a greater degree in the lingual regions, while
Fig. 5. The maximum von Mises stress on the resin restoration interfacial maximum von Mises stress was higher in
interface. chamfer models. These results can be explained by the
166 Xu et al.
100%
MI CD
80%
Percentage
60%
40%
20%
0%
1-mm bevel 2-mm bevel Plain
chamfer
Groups
Fig. 6. Failure patterns observed in the five different cavity-
design groups for in vitro testing. AD, adhesive failure at the
interface; CD, cohesive failure of the dental structure; CM,
cohesive failure of the restorative material; MI, mixed failure
involving more than one of these patterns.
A B
C D
Fig. 7. Fracture patterns. (A) Adhesive failure at the interface
(AD; butt joint). (B) Mixed failure involving more than one
pattern (MI; stair-step chamfer, the fractured resin was located
in the groove). (C) Cohesive failure of the restorative material
(CM; plain chamfer). (D) Mixed failure involving more than
one pattern (MI; 2-mm bevel, restorations fractured in the
incisal edge near the adhesive interface).
more conservative nature of bevel preparations, which
maintain more dental structure for load bearing (18).
Consequently, the stress diminishes quickly in the load-
ing direction. At protrusive articulation the interfacial
maximum von Mises stress in bevel models was lower
than in chamfer models, which might also be attributed
to a structure with more residual teeth that can distribute
the stress more widely. At central occlusion, the maxi-
mum stress level differences amongst the four design
groups were not obvious. The stress condition is complex
and affected by many factors, such as the quality and
quantity of the remaining tooth structure, the shape and
area of the interface, and the distortion of materials
under loading conditions.
The in vitro fracture-resistance tests revealed that all of
the cavity design techniques studied here had an
increased fracture resistance compared with the butt
joint group. Bevels have been reported to enhance
retention as a result of removal of the superficial enamel
layer (which increases the surface area of adhesion and
CM AD increases wettability by the adhesive agent) and also
because of better marginal sealing (12, 37). Similarly,
the chamfer preparation can also effectively remove the
acid-resistant superficial enamel layer and expose more
reactive subsurface enamel for acid etching. Coelho-
de-Souza et al. (12) arrived at the same conclusions.
Stair-step Butt joint Intact
However, Tan & Tjan (13) reported no significant
chamfer teeth difference between the butt joint and the 1-mm bevel or
1-mm chamfer margin. This may have been caused by
different loading conditions. Nevertheless Tan & Tjan
(13) also found that the 2-mm bevel and chamfer mar-
gins yielded higher fracture resistance than the butt joint.
Generally speaking, there was no significant difference
in shear-bond strength of the 2-mm bevel, chamfer, and
stair-step chamfer preparations. However, chamfer
preparations showed slightly higher fracture resistance
than the 2-mm bevel group. This result is consistent with
previous studies (14) and may be related to the fact that
chamfer preparations provide a larger volume of com-
posite resin at the restoration margin and provide a resin
lap joint (15). The slightly smaller failure load values of
stair-step chamfer preparations compared with chamfer
preparations might be caused by decreased exposure of
enamel rods for bonding (15). According to the failure
modes, the stair-step chamfer technique yielded the more
desirable result of cohesive failure of the dental structure
instead of adhesive failure at the interface.
The results from our FEA are in accordance with those
of the in vitro resistance tests. Numeric analysis indicated
that the stress distribution and maximum von Mises
stresses of the 1-mm and 2-mm bevels were similar.
However, the in vitro tests indicated that the 1-mm bevel
technique achieved a significantly lower fracture resis-
tance than the 2-mm bevel. This is probably because the
1-mm bevel has less enamel surface available for acid
etching, and thus a lower bonding strength is obtained in
the restoration. The slightly higher stress value in the
1-mm bevel, although not obvious, might also be caused
by the smaller area bearing force.
In terms of esthetics, the bevel exhibited a more nat-
ural appearance by masking the transition between the
native tooth enamel and the restoration. On the other
hand, the chamfer appears less esthetic as a result of the
existence of most of the composite resin at the chamfered
margin. To solve this problem, Donly et al. (38) sug-
gested preparation of a bevel on the cavosurface margin
of the chamfer. The use of a stair-step chamfer in the
labial enamel helps to achieve a more esthetic result by
masking the chamfer margins within the natural
anatomical horizontal and vertical lines of the tooth.
As inferred from the FEA in this study, stress condi-
tions may change greatly depending on loading loca-
tions. Loading directions may also have great effect on
stress distributions, and thus on fracture resistance (26).
From this study, a clinical suggestion can be made:
patients with composite resin restorations of Class IV
cavities should avoid edge-to-edge bite, in which the
incisal edge is directly impacted. On the one hand, the
interfacial stress at protrusive articulation was obviously
higher than that at central occlusion. On the other hand,
the interfacial displacement of restorations and fracture

patterns of cohesive failure of the restorative material or
mixed failure revealed that debonding of the resin
restoration usually initiated at the incisal edge.
In the present study, the effects of the periodontal
ligament and the pulp were assumed to be negligible as
they were far from the primary focus of this study.
However, a more comprehensive 3D FEA model would
address these features as the periodontal ligament makes
the fracture resistance test more substantial. These are
limitations of the present study.
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