Apical surgery cuts off the apical root and the crown-to-root ratio becomes unfavorable. Crown-to-root ratio has been applied to periodontally compromised teeth. Apical root resection is a different matter from periodontal bone loss. The purpose of this paper is to review the validity of crown-to-root ratio in the apically resected teeth. Most roots have conical shape and the root surface area of coronal part is wider than apical part of the same length. Therefore loss of alveolar bone support from apical resection is much less than its linear length.The maximum stress from mastication concentrates on the cervical area and the minimum stress was found on the apical 1/3 area. Therefore apical root resection is not so harmful as periodontal bone loss. Osteotomy for apical resection reduces longitudinal width of the buccal bone and increases the risk of endo-perio communication which leads to failure. Endodontic microsurgery is able to realize 0 degree or shallow bevel and precise length of root resection, and minimize the longitudinal width of osteotomy. The crown-to-root ratio is not valid in evaluating the prosthodontic prognosis of the apically resected teeth. Accurate execution of endodontic microsurgery to preserve the buccal bone is essential to avoid endo-perio communication.

This study evaluated the influence of the type of restoration and the amount of interdental spacing on the stress distribution in maxillary central incisors restored by means of porcelain laminate veneers and direct composite resin restorations.

Three-dimensional finite element models were fabricated to represent different types of restorations. Four clinical situations were considered. Type I, closing diastema using composite resin. Labial border of composite resin was extended just enough to cover the interdental space; Type II, closing diastema using composite resin without reduction of labial surface. Labial border of composite resin was extended distally to cover the half of the total labial surface; Type III, closing diastema using composite resin with reduction of labial surface. Labial border of the preparation and restored composite resin was extended distally two-thirds of the total labial surface; Type IV, closing diastema using porcelain laminate veneer with a feathered-edge preparation technique. Four different interdental spaces (1.0, 2.0, 3.0, 4.0 mm) were applied for each type of restorations.

For all types of restoration, adding the width of free extension of the porcelain laminate veneer and composite resin increased the stress occurred at the bonding layer. The maximum stress values observed at the bonding layer of Type IV were higher than that of Type I, II and III. However, the increasing rate of maximum stress value of Type IV was lower than that of Type I, II and III.

The aim of this study was to examine that thick dentin bonding agent application or low modulus composite restoration could reduce stresses on dentin bonding agent layer.

A mandibular first premolar with abfraction lesion was modeled by finite element method. The lesion was restored by different composite resins with variable dentin bonding agent thickness (50µm, 100µm, 150µm). 170N of occlusal loading was applied buccally or lingually. Von Mises stress on dentin bonding agent layer were measured.

When thickness of dentin bonding agent was increased von Mises stresses at dentin bonding agent were decreased in both composites. Lower elastic modulus composite restoration showed decreased von Mises stresses. On root dentin margin more stresses were generated than enamel margin.

For occlusal stress relief at dentin boning agent layer to applicate thick dentin bonding agent or to choose low elastic modulus composite is recommended.

The purpose of this study was to evaluate the effect of instrument compliance on the polymerization shrinkage stress measurements of dental composites. The contraction strain and stress of composites during light curing were measured by a custom made stress-strain analyzer, which consisted of a displacement sensor, a cantilever load cell and a negative feedback mechanism. The instrument can measure the polymerization stress by two modes: with compliance mode in which the instrument compliance is allowed, or without compliance mode in which the instrument compliance is not allowed.

A flowable (Filtek Flow: FF) and two universal hybrid (Z100: Z1 and Z250: Z2) composites were studied. A silane treated metal rod with a diameter of 3.0 mm was fixed at free end of the load cell, and other metal rod was fixed on the base plate. Composite of 1.0 mm thickness was placed between the two rods and light cured. The axial shrinkage strain and stress of the composite were recorded for 10 minutes during polymerization, and the tensile modulus of the materials was also determined with the instrument. The statistical analysis was conducted by ANOVA, paired t-test and Tukey's test (α<0.05).

There were significant differences between the two measurement modes and among materials. With compliance mode, the contraction stress of FF was the highest: 3.11 (0.13), followed by Z1: 2.91 (0.10) and Z2: 1.94 (0.09) MPa. When the instrument compliance is not allowed, the contraction stress of Z1 was the highest: 17.08 (0.89), followed by FF: 10.11 (0.29) and Z2: 9.46 (1.63) MPa. The tensile modulus for Z1, Z2 and FF was 2.31 (0.18), 2.05 (0.20), 1.41 (0.11) GPa, respectively. With compliance mode, the measured stress correlated with the axial shrinkage strain of composite; while without compliance the elastic modulus of materials played a significant role in the stress measurement.

The purpose of this study was to evaluate the influence of elastic modulus of restorative materials and the number of interfaces of post and core systems on the stress distribution of three differently restored endodontically treated maxillary second premolars using 3D FE analysis. Model 1, 2 was restored with a stainless steel or glass fiber post and direct composite resin. A PFG or a sintered alumina crown was considered. Model 3 was restored by EndoCrown. An oblique 500 N was applied on the buccal (Load A) and palatal (Load B) cusp. The von Mises stresses in the coronal and root structure of each model were analyzed using ANSYS. The elastic modulus of the definitive restorations rather than the type of post and core system was the primary factor that influenced the stress distribution of endodontically treated maxillary premolars. The stress concentration at the coronal structure could be lowered through the use of definitive restoration of high elastic modulus. The stress concentration at the root structure could be lowered through the use of definitive restoration of low elastic modulus.

The purpose of this study was to investigate the effects of four restorative materials under various occlusal loading conditions on the stress distribution at the CEJ of buccal, palatal surface and central groove of occlusal surface of endodontically treated maxillary second premolar, using a 3D finte element analysis.

A 3D finite element model of human maxillary second premolar was endodontically treated. After endodontic treatment, access cavity was filled with Amalgam, resin, ceramic or gold of different mechanical properties. A static 500N forces were applied at the buccal (Load-1) and palatal cusp (Load-2) and a static 170N forces were applied at the mesial marginal ridge and palatal cusp simultaneously as centric occlusion (Load-3). Under 3-type Loading condition, the value of tensile stress was analyzed after 4-type restoration at the CEJ of buccal and palatal surface and central groove of occlusal surface

Excessive high tensile stresses were observed along the palatal CEJ in Load-1 case and buccal CEJ in Load-2 in all of the restorations. There was no difference in magnitude of stress in relation to the type of restorations. Heavy tensile stress concentrations were observed around the loading point and along the central groove of occlusal surface in all of the restorations. There was slight difference in magnitude of stress between different types of restorations. High tensile stress concentrations around the loading points were observed and there was no difference in magnitude of stress between different types of restorations in Load-3.

The purpose of this study was to compare the stress distributions of NiTi rotary instruments based on their cross-sectional geometries of triangular shape-based cross-sectional design, S-shaped cross-sectional design and modified rectangular shape-based one using 3D FE models.

NiTi rotary files of S-shaped and modified rectangular design of cross-section such as Mtwo or NRT showed larger stress change while file rotation during simulated shaping.

The stress of files with rectangular cross-section design such as Mtwo, NRT was distributed as an intermittent pattern along the long axis of file. On the other hand, the stress of files with triangular cross-section design was distributed continuously.

When the residual stresses which could increase the risk of file fatigue fracture were analyzed after their withdrawal, the NRT and Mtwo model also presented higher residual stresses.

From this result, it can be inferred that S-shaped and modified rectangular shape-based files were more susceptible to file fracture than the files having triangular shape-based one.

The purpose of this study was to investigate the distribution of tensile stress of canal obturated maxillary second premolar with access cavity and notch-shaped class V cavity restored with composite resin using a 3D finite element analysis.

The tested groups were classified as 8 situations by only access cavity or access cavity with notch-shaped class VS cavity (S or N), loading condition (L1 or L2), and with or without glass ionomer cement base (R1 or R2). A static load of 500 N was applied at buccal and palatal cusps. Notch-shaped cavity and access cavity were filled microhybrid composite resin (Z100) with or without GIC base (Fuji II LC). The tensile stresses presented in the buccal cervical area, palatal cervical area and occlusal surface were analyzed using ANSYS.

Tensile stress distributions were similar regardless of base. When the load was applied on the buccal cusp, excessive high tensile stress was concentrated around the loading point and along the central groove of occlusal surface. The tensile stress values of the tooth with class V cavity were slightly higher than that of the tooth without class V cavity. When the load was applied the palatal cusp, excessive high tensile stress was concentrated around the loading point and along the central groove of occlusal surface. The tensile stress values of the tooth without class V cavity were slightly higher than that of the tooth with class V cavity.

This study was conducted to evaluate the influence of the C-factor on the bond strength of a 6th generation self-etching system by measuring the microtensile bond strength of four types of restorations classified by different C-factors with an identical depth of dentin.

Eighty human molars were divided into four experimental groups, each of which had a C-factor of 0.25, 2, 3 or 4. Each group was then further divided into four subgroups based on the adhesive and composite resin used. The adhesives used for this study were AQ Bond Plus (Sun Medical, Japan) and Xeno III (DENTSPLY, Germany). And composite resins used were Fantasista (Sun Medical, Japan) and Ceram-X mono (DENTSPLY, Germany).

The results were then analyzed using one-way ANOVA, a Tukey's test, and a Pearson's correlation test and were as follows.

There was no significant difference among C-factor groups with the exception of groups of Xeno III and Ceram-X mono (p < 0.05).

It was concluded that the C-factor of cavities does not have a significant effect on the microtensile bond strength of the restorations when cavities of the same depth of dentin are restored using composite resin in conjunction with the 6th generation self-etching system.

"Residual stress" can be developed during polymerization of the dental composite and it can be remained after this process was completed. The total amount of the force which applied to the composite restoration can be calculated by the sum of external and internal force. For the complete understanding of the restoration failure behavior, these two factors should be considered. In this experiment, I compared the residual stress of the recently developed nanofilled dental composite by ring slitting methods.

The composites used in this study can be categorized in two groups, one is microhybrid type-Z250, as control group, and nanofilled type-Grandio, Filtek Supreme, Ceram-X, as experimental ones. Composite ring was made and marked two reference points on the surface. Then measure the change of the distance between these two points before and after ring slitting. From the distance change, average circumferential residual stress (σθ) was calculated. In 10 minutes and 1 hour measurement groups, Filtek Supreme showed higher residual stress than Z250 and Ceram-X. In 24 hour group, Filtek showed higher stress than the other groups.

Following the result of this experiment, nanofilled composite showed similar or higher residual stress than Z250, and when comparing the Z250 and Filtek Supreme, which have quite similar matrix components, Filtek Supreme groups showed higher residual stress.

Flexibility and fracture properties determine the performance of NiTi rotary instruments. The purpose of this study was to evaluate how geometrical differences between three NiTi instruments affect the deformation and stress distributions under bending and torsional conditions using finite element analysis.

Three NiTi files (ProFile .06 / #30, F3 of ProTaper and ProTaper Universal) were scanned using a Micro-CT. The obtained structural geometries were meshed with linear, eight-noded hexahedral elements. The mechanical behavior (deformation and von Mises equivalent stress) of the three endodontic instruments were analyzed under four bending and rotational conditions using ABAQUS finite element analysis software. The nonlinear mechanical behavior of the NiTi was taken into account.

The U-shaped cross sectional geometry of ProFile showed the highest flexibility of the three file models. The ProTaper, which has a convex triangular cross-section, was the most stiff file model. For the same deflection, the ProTaper required more force to reach the same deflection as the other models, and needed more torque than other models for the same amount of rotation. The highest von Mises stress value was found at the groove area in the cross-section of the ProTaper Universal.

Under torsion, all files showed highest stresses at their groove area. The ProFile showed highest von Mises stress value under the same torsional moment while the ProTaper Universal showed the highest value under same rotational angle.

The purpose of this study was to investigate the influence of various occlusal loading sites and directions on the stress distribution of the cervical composite resin restorations of maxillary second premolar, using 3 dimensional (3D) finite element (FE) analysis. Extracted maxillary second premolar was scanned serially with Micro-CT (SkyScan1072; SkyScan, Aartselaar, Belgium). The 3D images were processed by 3D-DOCTOR (Able Software Co., Lexington, MA, USA). HyperMesh (Altair Engineering, Inc., Troy, USA) and ANSYS (Swanson Analysis Systems, Inc., Houston, USA) was used to mesh and analyze 3D FE model. Notch shaped cavity was filled with hybrid (Z100, 3M Dental Products, St. Paul, MN, USA) or flowable resin (Tetric Flow, Vivadent Ets., FL-9494-Schaan, Liechtenstein) and each restoration was simulated with adhesive layer thickness (40 µm). A static load of 200 N was applied on the three points of the buccal incline of the palatal cusp and oriented in 20° increments, from vertical (long axis of the tooth) to oblique 40° direction towards the buccal. The maximum principal stresses in the occlusal and cervical cavosurface margin and vertical section of buccal surfaces of notch-shaped class V cavity were analyzed using ANSYS. As the angle of loading direction increased, tensile stress increased. Loading site had little effect on it. Under same loading condition, Tetric Flow showed relatively lower stress than Z100 overall, except both point angles. Loading direction and the elastic modulus of restorative material seem to be important factor on the cervical restoration.

This study was to investigate the influence of combining composite resins with different elastic modulus, and occlusal loading condition on the stress distribution of restored notch-shaped non-carious cervical lesion using 3D finite element (FE) analysis.

The extracted maxillary second premolar was scanned serially with Micro-CT. The 3D images were processed by 3D-DOCTOR. ANSYS was used to mesh and analyze 3D FE model. A notch-shaped cavity was modeled and filled with hybrid, flowable resin or a combination of both. After restoration, a static load of 500N was applied in a point-load condition at buccal cusp and palatal cusp. The stress data were analyzed using analysis of principal stress.

Results showed that combining method such that apex was restored by material with high elastic modulus and the occlusal and cervical cavosurface margin by small amount of material with low elastic modulus was the most profitable method in the view of tensile stress that was considered as the dominant factor jeopardizing the restoration durability and promoting the lesion progression.

This study was to investigate the influence of composite resins with different elastic modulus, cavity modification and occlusal loading condition on the stress distribution of restored notch-shaped noncarious cervical lesion using 3-dimensional (3D) finite element (FE) analysis.

The extracted maxillary second premolar was scanned serially with Micro-CT. The 3D images were processed by 3D-DOCTOR. ANSYS was used to mesh and analyze 3D FE model. A notch-shaped cavity and a modified cavity with a rounded apex were modeled. Unmodified and modified cavities were filled with hybrid or flowable resin. After restoration, a static load of 500N was applied in a point-load condition at buccal cusp and palatal cusp. The stress data were analyzed using analysis of principal stress.

The results were as follows:

In the unrestored cavity, the stresses were highly concentrated at mesial CEJ and lesion apex and the peak stress was observed at the mesial point angle under both loading conditions.

The purpose of this study was to investigate the effects of composite resin restorations on the stress distribution of notch shaped noncarious cervical lesion using three-dimensional (3D) finite element analysis (FEA).

Extracted maxillary second premolar was scanned serially with Micro-CT (SkyScan1072; SkyScan, Aartselaar, Belgium). The 3D images were processed by 3D-DOCTOR (Able Software Co., Lexington, MA, USA). ANSYS (Swanson Analysis Systems, Inc., Houston, USA) was used to mesh and analyze 3D FE model. Notch shaped cavity was filled with hybrid or flowable resin and each restoration was simulated with adhesive layer thickness (40 µM). A static load of 500 N was applied on a point load condition at buccal cusp (loading A) and palatal cusp (loading B). The principal stresses in the lesion apex (internal line angle of cavity) and middle vertical wall were analyzed using ANSYS.

The results were as follows

1. Under loading A, compressive stress is created in the unrestored and restored cavity. Under loading B, tensile stress is created. And the peak stress concentration is seen at near mesial corner of the cavity under each load condition.

2. Compared to the unrestored cavity, the principal stresses at the cemeto-enamel junction (CEJ) and internal line angle of the cavity were more reduced in the restored cavity on both load conditions.

3. In teeth restored with hybrid composite, the principal stresses at the CEJ and internal line angle of the cavity were more reduced than flowable resin.

The objective of this study was to investigate the effects of various occlusal loads on the stress distribution of the buccal cervical region of a normal maxillary second premolar, using a three dimensional finite element analysis (3D FEA).

After 3D FE modeling of maxillary second premolar, a static load of 500N of three load cases was applied. Stress analysis was performed using ANSYS (Swanson Analysis Systems, Inc., Houston, USA). The maximum principal stresses and minimum principal stresses were sampled at thirteen nodal points in the buccal cervical enamel for each four horizontal planes, 1.0 mm above CEJ, 0.5 mm above CEJ, CEJ, 0.5 mm under CEJ.

The results were as follows

1. The peak stress was seen at the cervical enamel surface of the mesiobuccal line angle area, asymmetrically.

2. The values of compressive stresses were within the range of the failure stress of enamel. But the values of tensile stresses exceeded the range of the failure stress of enamel.

3. The tensile stresses from the perpendicular load at the buccal incline of palatal cusp may be shown to be the primary etiological factors of the NCCLs.

The purpose of this study was to analyze the stress distribution aspect of unrestored and restored combined shape (wedge shape occlusally and saucer shape gingivally) class V cavity, which found frequently in clinical cases.

A maxillary second premolar restored with a combined shape class V composite restorations were modeled using the three dimensional finite element method. Static occlusal load of 170 N was applied on lingual incline of buccal cusp at the angle of 45° with the longitudinal axis of the tooth. And three dimensional finite element analysis was taken by ANSYS (Version 6.0, Swanson Analysis System Co., Houston, U.S.A) program which represent the stress distribution on unrestored and restored cavity wall and margin.

The conclusions were as follows.

Compared to the unrestored cavity, Von Mises stress at the cementoenamel junction and line angle of the cavity base were reduced and in restored cavity.

The objective of this study was to investigate the effect of excessive occlusal loading on stress distribution on four type of cervical lesion, using a three dimensional finite element analysis (3D FEA).

The extracted maxillary second premolar was scanned serially with Micro-CT. The 3D images were processed by 3D-DOCTOR. ANSYS was used to mesh and analyze 3D FE model. Four different lesion configurations representative of the various types observed clinically for teeth were studied. A static point load of 500N was applied to the buccal and lingual cusp (Load A and B). The principal stresses in lesion apex, and vertical sectioned margin of cervical wall were analyzed.

The results were as follows

The patterns of stress distribution were similar but the magnitude was different in four types of lesion.

The aim of this study was to evaluate the effect of cavity shape, bond quality of bonding agent and volume of resin composite on shrinkage stress developed at the cavity floor. This was done by measuring the shear bond strength with respect to iris materials (cavity shape; adhesive-coated dentin as a high C-factor and Teflon-coated metal as a low C-factor), bonding agents (bond quality; Scotchbond™ Multi-purpose and Xeno®III) and iris hole diameters (volume; 1 mm or 3 mm in diameter × 1.5 mm in thickness). Ninety-six molars were randomly divided into 8 groups (2 × 2 × 2 experimental setup). In order to simulate a Class I cavity, shear bond strength was measured on the flat occlusal dentin surface with irises. The iris hole was filled with Z250 restorative resin composite in a bulk-filling manner. The data was analyzed using three-way ANOVA and the Tukey test. Fracture mode analysis was also done. When the cavity had high C-factor, good bond quality and large volume, the bond strength decreased significantly. The volume of resin composite restricted within the well-bonded cavity walls is also be suggested to be included in the concept of C-factor, as well as the cavity shape and bond quality. Since the bond quality and volume can exaggerate the effect of cavity shape on the shrinkage stress developed at the resin-dentin bond, resin composites must be filled in a method, which minimizes the volume that can increase the C-factor.

The purpose of present study was to evaluate the polymerization shrinkage stress and cuspal deflection in maxillary premolars resulting from polymerization shrinkage of composites and compomers.

Composites and compomers which were used in this study were as follows: Dyract AP, Z100, Surefil, Pyramid, Synergy Compact, Heliomolar, Heliomolar HB, and Compoglass F. For measuring of polymerization shrinkage stress, Stress measuring machine (R&B, Daejon, Korea) was used. One-way ANOVA analysis with Duncan's multiple comparison test were used to determine significant differences between the materials.

For measuring of cuspal deflection of tooth, MOD cavities were prepared in 10 extracted maxillary premolars. And reduction of intercuspal distance was measured by strain measuring machine (R&B, Daejon, Korea) One-way ANOVA analysis with Turkey test were used to determine significant differences between the materials.

Polymerization shrinkage stress is 『Heliomolar, Z100, Pyramid < Synergy Compact Compoglass F < Dyract AP < Heliomolr HB, surefil』 (P < 0.05). And cuspal delfelction is 『Z100, Heliomolar, Heliomolar HB, Synergy Compact Surefil, < Compoglass F < Pyramid, Dyract AP』 (P < 0.05).

Measurements of ploymerization shrinkage stress and those of cuspal deflection of the teeth was different. There is no correlation between polymerization shrinkage stress and cuspal deflection of the teeth (p > 0.05).

The purpose of present study was to evaluate the polymerization shrinkage stress and amount of linear shrinkage of composites and compomers for posterior restoration.

For this purpose, linear polymerization shrinkage and polymerization stress were measured.

For linear polymerization shrinklage and polymerization stress measurement, custom made Linometer (R&B, Daejon, Korea) and Stress measuring machine was used (R&B, Daejon, Korea). Compositers and compomers were evaluated; Dyract AP (Dentsply Detrey, Gumbh. German) Z100 (3M Dental Products, St. Paul, USA) Surefil (Dentsply Caulk, Milford, USA) Pyramid(Bisco, Schaumburg, USA) Synergy Compact (Coltene, Altstatten, Switzerland), Heliomolar (Vivadent/Ivoclar, Liechtenstein), and Compoglass (Vivadent Ivoclar/Liechtenstein) were used. 15 measurements were made for each material. Linear polymerization shrinkage or polymerization stress for each material was compared with one way ANOVA with Tukey at 95% levels of confidence.

For linear shrinkage; Heliomolar, Surefil<Synergy Compact, Z100<Dyract AP<Pyramid, Compoglass F (p<0.05)

For Shrinkage stress; Heliomolar<Z100, Pyramid<Synergy Compact, Compoglass F<Dyract AP<Heliomolar HB, Surefil (p<0.05)