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Estimation of stress distribution and risk of failure for maxillary premolar restored by occlusal veneer with different CAD/CAM materials and preparation designs

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Abstract

Objectives

To compare stress distribution and failure probability in maxillary premolars restored by simple occlusal veneer (SOV) and buccal-occlusal veneer (BOV) with 3 different CAD/CAM materials.

Materials and methods

A maxillary premolar was digitized by a micro-CT scanner. Three-dimensional dynamic scan data were transformed, and finite element models of 2 different models (SOV and BOV restored teeth) were designed. Three different CAD/CAM materials, including lithium disilicate glass ceramic (LD) IPS e.max CAD, polymer-infiltrated ceramic-network (PICN) Vita Enamic, and resin nano-ceramic (RNC) Lava Ultimate, were designated to both veneers. Maximum principle stresses were determined by applying a 300-N axial load to the occlusal surface. Weibull analyses were performed to calculate the failure probability of the models.

Results

LD-restored teeth showed the highest stress in the veneer, lowest stress in substrate teeth, and lowest failure probability for the overall system; RNC-restored teeth showed the lowest stress in the veneer, highest stress in substrate teeth, and highest failure probability. No significant differences were found in the cement layer among the different models. No significant differences of stress and failure probability existed between SOV and BOV preparations.

Conclusions

CAD/CAM composite resin occlusal veneers bear lower maximum stress than ceramic veneers. Teeth restored by composite veneers are more prone to failure than those restored by ceramic veneers. Additional reduction of the buccal surface did not increase the stress on the occlusal veneer under axial load.

Clinical relevance

Both occlusal veneers could be used under physiological masticatory force. CAD/CAM glass ceramic was safer than composite resins.

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Funding

This study was supported by the Sun Yat-sen University Clinical Research 5010 Programme (grant number 2016006).

Author information

Correspondence to Shu-yi Wu or Yan Li.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Huang, X., Hong, N., Zou, L. et al. Estimation of stress distribution and risk of failure for maxillary premolar restored by occlusal veneer with different CAD/CAM materials and preparation designs. Clin Oral Invest (2020). https://doi.org/10.1007/s00784-019-03190-7

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Keywords

  • Occlusal veneer
  • CAD/CAM
  • Preparation design
  • Finite element analysis
  • Weibull analysis