Farklı post ve kron materyalleri ile restore edilmiş endodontik tedavili maksiller santral kesici dişlerde stres dağılımı

Amaç: Yapılarında meydana gelebilecek kırılmalardan dolayı endodontik olarak tedavi görmüş dişlerin restorasyonu restoratif diş hekimliğinde yaygın bir problemdir. Oklüzal kuvvetlere dayanabilecek uygun post ve kron materyalinin seçilmesi gereklidir. Bu çalışmanın amacı sonlu elemanlar stres analiz yöntemi kullanarak farklı post ve kron materyallerinin diş restorasyon kompleksindeki stres dağılımını incelemektir.Gereç ve Yöntemler: 2 farklı post materyali (everStick ve cosmopost) ve 2 farklı kron materyali ( IPS Empress e.max ve Cercon) içeren endodontik olarak tedavi edilmiş maksiler santral kesici dişi simüle eden 3-boyutlu sonlu elemanlar modelleri hazırlanmıştır. Sonlu elemanlar modellerinde kök yüzeyindeki tüm noktalar sınır koşulları olarak sabit kabul edilmiştir. 300N’luk statik oklüzal yük kronun palatal yüzeyine 135°’lik bir açıyla uygulanmıştır. Modellerin stres transfer karakteristiklerindeki farklılıklar analiz edilmiştir.Bulgular: Bütün modellerde maksimum stres kuvvet uygulanan alanlarda konsantre olmuştur (10MPa). Cosmopost’ta gözlenen maksimum stresler (2.5MPa) everStick’de gözlenenlerden (1.6 MPa) daha yüksek bulunmuştur. Cercon ve e.max kronların her ikisi için de maksimum stresler kronun bukkal ve lingual marjinlerinde yoğunlaşmıştır (5.8 MPa, 5.0 MPa). Fakat e.max’deki stres değer ve dağılımları Cercon kronla karşılaştırıldığında daha homojen ve daha düşük bulunmuştur.Sonuç: Bu çalışmanın sonuçlarına göre endodontik tedavili bir dişe everStick post uygulanarak e.max seramik ile restore edildiğinde restorasyon-diş kompleksindeki von Mises stresleri azalmaktadır.

Stress distribution in endodontically treated maxillary central incisor restored with different post and crown materials

Background: Restoration of endodontically treated teeth is a common problem in restorative dentistry, related to the fractures occurring in such teeth. It is necessary to obtain appropriate post and crown material to withstand occlusal forces. The aim of this study was to evaluate the influence of different post and crown materials on the stress distribution of the restoration tooth complex, using Finite Element Analysis (FEM). Methods: 3-D finite element (FE) models simulating an endodontically treated maxillary central incisor restored with 2 different post materials (everstick and cosmopost) and two different all-ceramic crown materials (IPS Empress e.max and Cercon) were prepared. The nodes of the root surfacein the FE models were fixed in all directions as the boundary conditions. A 300 N static load was applied to the palatal surface of the crown with a 135°angle to the long axis of the tooth. The differences in stress transfer characteristics of the models were analyzed. Results: Maximum stress was concentrated on force application areas for all models (10 MPa). The stress values observed with cosmopost (2.5 MPa) were higher than that of everstick (1.6 MPa). Maximum stresses were observed at buccal and lingual cervical margins of crown for both Cercon and e.max crowns (5.8 MPa, 5.0 MPa). But the stress values and distribution in e.max were more homogeneous and lower than Cercon crown. Conclusion: The result of this study demonstrated that use of an everstick post in endodontically treated teeth restored with e.max ceramic reduces the values of von Mises stresses on tooth-restoration complex.

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