Mesiolingual Cusp Research Articles

Monson’s sphere in Chinese young adult females with individual normal occlusion: a preliminary study using digital models

BackgroundThis study investigated the characteristics of Monson’s sphere in Chinese young adult females with individual normal occlusion to provide a reference for oral rehabilitation in prosthodontic and orthodontic treatments.MethodsPoints at the dental cusps and incisal edges were selected from 51 digital mandibular dental models of Chinese young adult females (aged 18–22 years) with individual normal occlusion. Monson’s spheres were fitted to the selected points based on the least-squares principle and the radii were calculated. The deviation of each selected point from its relative spherical surface was also calculated. The radii and deviations of these points were examined using conventional descriptive statistics and distributions of the most deviated points inside and outside the spheres were analyzed.ResultsThe mean radius of Monson’s sphere in Chinese young adult females was 79.60 ± 14.13 mm. The deviation of each selected point from its relative sphere surface was 0.38 ± 0.30 mm. The maximum deviations inside and outside the sphere were 0.93 ± 0.25 mm and 0.95 ± 0.30 mm, respectively. The most deviated points outside the spheres were mainly distributed at the distolingual cusps of the mandibular second permanent molars (31.37%), while those inside the spheres were mainly distributed at the mesiolingual cusps of the mandibular first permanent molars (45.10%).ConclusionsThe radius of Monson’s sphere in Chinese young adult females was smaller than the classic four-inch value suggested by Monson. Deviation was observed from all selected points to their Monson’s sphere surface, with the most deviated points distributed primarily in the molar region.

Three-Dimensional Determination (Morphometric Study) of Arch Perimeter and Palatal Depth in an Iraqi Sample Aged 17–25 Years with Sickle Cell Anemia: A Cross-Sectional Study

Sickle cell anemia (SCA) is a hereditary disorder caused by the substitution of valine for glutamic acid in position six of globin's beta chain. Segmental arch dimensions, arch perimeter, and palatal depth comparison between SCA and control using the three-dimensional (3D) technique was the aim of this study. This cross-sectional investigation was carried out in Karbala City. The sample consisted of 200 casts (100 SCA and 100 control). Each group consisted of 50 casts upper, and 50 casts lower (25 males and 25 females). The arch perimeter was calculated using two segmented arch lengths bilaterally. Palatal depth was measured from the mesiolingual cusp tip of the upper first permanent molar to the corresponding palatal vault. The difference between the control and SCA groups was calculated using the independent t-test. Except for lower left incisal to canine distance (LLI-C), where p = 0.01 there was no significant difference in segmental arch measurements and perimeter between males in SCA and males in control. There was no significant difference in segmental arch measurements and perimeter between females in SCA and females in control. There was no significant difference in palatal depth between the control and SCA (male and female). SCA did not affect the segmental, arch perimeter, and palatal depth measurements.

Differences in Volumetric Tooth Loss for Monolithic Ceramic Crowns, Occlusal Overlays, and Partial-Coverage Onlays.

To compare the volumetric loss of clinical crown structure in commonly encountered clinical situations for monolithic ceramic crowns, occlusal overlays, and partial-coverage onlays. Typodont teeth made with preexisting mesio-occlusodistal (MOD) preparations for mandibular first molars and maxillary first premolars were prepared with three different preparations: a full-contour monolithic zirconia crown, a lithium disilicate occlusal overlay, and mesio-occlusodistobuccal/mesio-occlusodistolingual (MODB/MODL) lithium disilicate onlays for premolars and molars. 3D-metrologic software was used to evaluate the volumetric loss of clinical crown structure for each preparation type. Subsequently, the mesiolingual cusps of mandibular molars and buccal cusps of maxillary premolars were excluded for a separate analysis to simulate patient presentation with an existing restoration and sheared-off cusp. Full-coverage monolithic zirconia crowns removed 45.37 to 219.53 mm3 of the remaining clinical tooth structure, depending on the clinical scenario and tooth position, while lithium disilicate overlays removed 27.48 to 105.13 mm3 and MODB/MODL lithium disilicate onlays removed 5.48 to 47.45 mm3. In each scenario tested, MODB/MODL onlays removed significantly less clinical crown structure than overlays (P < .001); both MODB/MODL onlays and overlays removed significantly less structure than full-coverage crowns (P < .001). Monolithic zirconia crown restorations require significantly more removal of remaining tooth structure than lithium disilicate occlusal overlays and partial-coverage onlays for commonly occurring clinical situations requiring indirect restorations.

Frequency of cusp of carabelli in maxillary permanent first molars and its association with dental caries in patients visiting Peshawar Dental Hospital, Peshawar.

Objective: To find out the frequency of cusp of Carabelli and its association with dental caries in maxillary permanent first molars in both male and female patients of Peshawar. Study Design: Cross Sectional Study. Setting: OPD of Peshawar Dental Hospital, Peshawar. Period: July 2016 to December 2016. Material &amp; Methods: A total of 300 patients (125 males and 175 females) were selected through consecutive sampling technique and the number of teeth examined was 600 (two teeth per patient). Age group selected for the patients was from 13 to 30 years. Both the genders having fully erupted maxillary permanent first molars on both sides of the jaw were included in the study and the teeth were examined usin0g mouth mirror while the presence of caries in Carabelli groove was checked with the help of dental explorer (probe). Results: Of the total 300 patients, 118 (39.3%) presented the cusp of Carabelli on maxillary permanent first molars and the number of teeth having the cusp was 192 (32%) out of the total 600 among them. 24.7% of the patients had cusp present on both right and left MPFM while 10.3% of patients had CC present only on right maxillary molars and in 4.3% of patients, it was located on left molars. Gender differentiation of the cusp did not show a statistically significant difference (p-value 0.140). The frequency of caries associated with the cusp of Carabelli groove was found to be 17.7%. Out these patients, 8 males (34.7%) and 15 females (65.2%) were affected. P value for this distribution was 0.651, which shows no statistically significant difference between genders for the presence of caries. Conclusion: The cusp of Carabelli is a common finding on the palatal surface of mesiolingual cusp of maxillary permanent first molars in a hospital-based population of Peshawar with no statistically significant difference between males and females. Caries in cusp of Carabelli groove is a common association with the cusp having no significant difference between genders.

Odontometric analysis using CBCT for sexual dimorphism in Egyptian-Fayoum population in case of normal occlusion

Objectives of this study was to evaluate odontometric linear measurements obtained from CBCT software including mesiodistal, tooth length dimensions and enamel thickness of the mandibular canine and mandibular first molar and arch measurements for sexual dimorphism in Egyptian population sample. Material and Methods: The study was carried out on 100 patients who visited the department of oral and maxillofacial radiology, Fayoum University for dental treatments. The study sample were grouped into two groups, group A (50 males) and group B (50 females) aged between 18-25 years old. The teeth which were selected for linear measurements using CBCT in the present study were 100 mandibular permanent canines (Lower 3) and 100 mandibular permanent 1st molar (Lower 6), for each group respectively. The linear measurements were taken on crown width and height, Enamel thickness, arch depth and width. Results: There was a highly significant difference between Male and Female for odontometric measurements of mandibular right and left canines and 1st molars including (CWL3, CLL3, CWL6 and CLL6) while enamel thickness measurements showed non-significant differences between males and females including (ETL3 at cusp tip, ETML6, ETDL6 and ETL6 at mesio-lingual cusp tip). Arch measurements including (ICW, IMW through fossa and IMW through contact) showed high significant differences between males and females. Conclusion: Odontometric parameters including mandibular canine, mandibular first molar crown width and length, inter-canine width and inter-molar width measurements based on CBCT imaging show highly significant gender difference. Thus, the parameters can be simple and reliable sexual dimorphism for medicolegal purpose.

Buccolingual Inclination of Canine and First and Second Molar Teeth and the Curve of Wilson in Different Sagittal Skeletal Patterns of Adults Using Cone-Beam Computed Tomography.

Objectives This study aimed to assess the buccolingual inclination of canine and first and second molar teeth and the curve of Wilson in different sagittal skeletal patterns in untreated adults using cone-beam computed tomography (CBCT). Materials and Methods Sixty-six CBCT scans of adults (mean age: 28.74 ± 5.25 years) were evaluated in this cross-sectional study. The images were standardized using the Frankfurt horizontal plane and the interorbital line. The sagittal skeletal pattern was determined using the ANB angle and Wits appraisal. Inclination angles were measured by NNT Viewer and Mimics software. The curve of Wilson was measured by connecting the tips of mesiobuccal and mesiolingual cusps of maxillary first and second molars along the buccal groove and measuring the formed angle. Data were analyzed using ANOVA. Results The intraobserver agreement was 0.969. The mean inclination of maxillary first and second molars in class I and III patients was significantly higher than that in class II patients (P < 0.05). The mean inclination of mandibular first and second molars in class II patients was significantly higher than that in class I and III patients (P < 0.05). The difference in inclination of maxillary and mandibular canine teeth was not significant (P > 0.05). The mean curve of Wilson in second molars of class II patients was significantly higher than that in class I patients (P < 0.05). Conclusion In different sagittal skeletal patterns, a compensatory relationship exists between the opposing teeth, which, along with the standards of crowns, can be used to determine the appropriate position of teeth in dental arch.

Anatomical insights of the mylohyoid for clinical procedures in dentistry.

The purpose of this study is to provide useful data by conducting a comprehensive study of the mylohyoid muscle and its related structures. Fifty-eight mandibles and 30 mylohyoid muscles from Korean adult cadavers were used. The shape and location of the mylohyoid line were analyzed by using digital calipers. The mylohyoid muscle and its herniation were observed using ultrasonography. After dissection, morphometric measurements of the muscle and herniation were conducted. The distribution pattern of the nerve to mylohyoid muscle was confirmed. The proportion of the distance between the cementoenamel junction and the mylohyoid line decreased from the mesiolingual cusp of the mandibular first molar (1:0.57) to the distolingual cusp of the mandibular second molar (1:0.41). The mylohyoid muscle was large, thick, and deep in men. Herniation was observed in 16 (53.3%) cases, and it was concentrated in the anterior one-third (52.2%) of the muscle. The richest arborization of the nerve to mylohyoid muscle was in the middle one-third (52.9%) of the muscle. The results of the mylohyoid line can be applied in the reconstruction of the occlusal plane in edentulous patients. Differences between the sexes should be considered in the morphological characteristics of the mylohyoid muscle. Differential diagnosis of herniation is particularly important in the anterior one-third of the muscle. In the case of treatment with botulinum toxin in the mylohyoid muscle, it is recommended to inject into the middle one-third area considering the depth and thickness of the muscle in that area.

Fracture Resistance of Cement-retained, Screw-retained, and Combined Cement- and Screw-retained Metal-ceramic Implant-supported Molar Restorations

To compare fracture resistance between the cement-retained (CR), screw-retained (SR), and combined cement- and screw-retained (CCSR) metal-ceramic (MC) implant-supported molar restorations and the fracture mode after vertical loading simulation. Thirty MC molar restorations were fabricated on thirty tilted dental implants that were repositioned using prefabricated or universal castable long abutments (UCLA) with 15° of angulation divided into three groups of ten specimens each. Group C: CR, group S: SR, and group CS: cement- and screw-retained. The crowns in group CS were adhesively bonded extraorally, and composite resin was used to fill the screw access holes (SAHs) in groups S and CS. Subsequently, all the specimens were tested for fracture resistance. A scanning electron microscope (SEM) evaluation of the fracture mode was also performed. Mean values of fracture loads were calculated and compared in Newtons (N) using one-way ANOVA and Tukey post hoc test (p < 0.05) for each group. Mean fracture load values were 2718.00 ± 266.25 N for group C, 2125.10 ± 293.82 N for group S, and 2508.00 ± 153.59 N for group CS. Significant differences were found between group S and the other groups on fracture load values. However, no significant differences were found between groups C and CS (p = 0.154). The failures were at MC framework interfaces on mesiolingual cusps. Cement and CCSR MC molar restorations showed comparable fracture resistance using abutments with 15° of angulation. However, SR design showed significantly the lowest values of resistance. Screw access hole did not significantly affect the fracture resistance of cemented MC molar restorations. All the specimens exhibited mixed adhesive fractures at the mesiolingual cusps. Combined cement- and screw-retained restorations (CCSRRs) incorporate the simplicity of the cement method and the retrievability of the screw method, offering good resistance, allowing the removal of the excess of cement before clinical placement of the restoration, and providing another alternative for dental implant rehabilitation.

Morphological Differences between the First and Second Permanent Upper Molars

AbstractThe dental elements present similar and specific anatomical features, depending on the functions they have in the oral cavity. The permanent molars are the most complex structures, mainly the occlusal face, due to their function of food grinding. The aim of the present article is to present the upper first and second molars morphology, emphasizing the similarities and differences between them. Besides, the upper first and second molars of the collection of the Department of Morphology of Universidade Estadual de Paulista (UNESP), School of Dentistry, Araraquara, were evaluated regarding the presence of the oblique ridge, frequency and classification of the molar tubercle, and the crown morphology (upper second molars). In the 372 evaluated upper first molars, the molar tubercle was absent in most of the teeth. When present, the molar tubercle belonged to the mesiolingual cusp; 8.9% were classified as type I; 9.1% as type II; and 9.4% as type III. The oblique ridge was present in all upper first molars. The morphology of 401 upper second molars was also evaluated; 64.83% were tetracuspid; 35.16% tricuspid; and 17.02% presented compression morphology. In 100 tricuspid teeth, 50% presented oblique ridge, with it being prominent in 30%. No upper second molars presented molar tubercle. Although there are similarities between the upper first and second molars, we must always be aware of the features that differ between them, so their functionality can be restored.

Effect of zirconia substructure thickness on the mechanical properties and adhesion of veneering porcelain

Aim: This study investigated the influence of yttrium-stabilized tetragonal zirconia polycrystals (Y-TZP) thickness on fracture load of porcelain-veneered crowns (FL), fracture toughness of porcelain (FT), and the shear bond strength zirconia/porcelain (SBS). Methods: Artificial first molar was prepared for full crown (N=45) with different occlusal reduction. Y-TZP cores were made with different thickness at the occlusal face (1mm, 2mm and 3mm) (n=15). The cores were veneered with VM9 – Vita porcelain with 1.0 mm layer. For FL testing, axial load was applied to the mesiolingual cusp of the crowns. For FT testing, flat Y-TZP plates (5X5 mm) with 1, 2 or 3 mm thickness were veneered with 1.0 mm porcelain layer (n=10). FT by indentation fracture technique was measured close to the interface and at the top surface. For SBS by knife-edge shearing rod, cylindrical porcelain with 5 mm in diameter and 3 mm was applied on flat Y-TZP plates (1, 2 and 3 mm thickness) (n = 10). Results: Data analyzed by 1-Way ANOVA for FL of crowns and SBS between Y-TZP and porcelain were not significant. Two-way ANOVA for FT was significant for zirconia thickness and measurement area. The post-hoc test showed higher values for the groups with 2 and 3mm, and higher values at the interface, irrespectively of Y-TZP thickness. Conclusion: The zirconia thickness did not affect the FL of veneered crowns and the SBS between the ceramics, but FT of porcelain was lower in thinner zirconia substructure and close to the interface Y-TZP/Porcelain.

Fatigue behavior and crack initiation of CAD/CAM resin composite molar crowns

ObjectiveThe aim of this study was to evaluate long-term fatigue behavior using an in vitro step-stress accelerated life test (SSALT), and to determine the crack initiation point using in silico finite element analysis for computer-aided designed and manufactured (CAD/CAM) molar crowns fabricated from three commercial CAD/CAM resin composite blocks: Cerasmart (CS; GC, Tokyo, Japan), Katana Avencia Block (KA; Kuraray Noritake Dental, Niigata, Japan), and Shofu Block HC (HC; Shofu, Kyoto, Japan). MethodsFifty-one mandibular first molar crowns luted on a resin core die were embedded in acrylic resin and covered with a polyvinyl chloride tube. Single compressive tests were performed for five crowns. SSALT was conducted for 36 crowns using three profiles and reliabilities at 120,000 cycles, and a Weibull analysis was conducted. The maximum principal strain of each CAD/CAM resin composite crown model was analyzed by three-dimensional finite element analysis. ResultsFracture loads of CS and KA (3784±144N and 3915±313N) were significantly greater than that of HC (2767±227N) (p<0.05). Fracture probabilities at 120,000 cycles were 24.6% (CS), 13.7% (KA), and 14.0% (HC). Maximum principal strain was observed around the mesiolingual cusps of CS and KA and the distobuccal cusp of HC. SignificanceCAD/CAM resin composite molar crowns containing nano-fillers with a higher fraction of resin matrix exhibited higher fracture loads and greater longevity, suggesting that these crowns could be used as an alternative to ceramic crowns in terms of fatigue behavior.

Methods for quantitative measurement of tooth wear using the area and volume of virtual model cusps

PurposeClinicians must examine tooth wear to make a proper diagnosis. However, qualitative methods of measuring tooth wear have many disadvantages. Therefore, this study aimed to develop and evaluate quantitative parameters using the cusp area and volume of virtual dental models.MethodsThe subjects of this study were the same virtual models that were used in our former study. The same age group classification and new tooth wear index (NTWI) scoring system were also reused. A virtual occlusal plane was generated with the highest cusp points and lowered vertically from 0.2 to 0.8 mm to create offset planes. The area and volume of each cusp was then measured and added together. In addition to the former analysis, the differential features of each cusp were analyzed.ResultsThe scores of the new parameters differentiated the age and NTWI groups better than those analyzed in the former study. The Spearman ρ coefficients between the total area and the area of each cusp also showed higher scores at the levels of 0.6 mm (0.6A) and 0.8A. The mesiolingual cusp (MLC) showed a statistically significant difference (P<0.01) from the other cusps in the paired t-test. Additionally, the MLC exhibited the highest percentage of change at 0.6A in some age and NTWI groups. Regarding the age groups, the MLC showed the highest score in groups 1 and 2. For the NTWI groups, the MLC was not significantly different in groups 3 and 4. These results support the proposal that the lingual cusp exhibits rapid wear because it serves as a functional cusp.ConclusionsAlthough this study has limitations due to its cross-sectional nature, it suggests better quantitative parameters and analytical tools for the characteristics of cusp wear.

Evolution of the hypercarnivorous dentition in mammals (Metatheria, Eutheria) and its bearing on the development of tribosphenic molars.

One major innovation of mammals is the tribosphenic molar, characterized by the evolution of a neomorphic upper cusp (=protocone) and a lower basin (=talonid) that occlude and provide shearing and crushing functions. This type of molar is an evolutionarily flexible structure that enabled mammals to achieve complex dental adaptations. Among carnivorous mammals, hypercarnivory is a common trend that evolved several times among therians (marsupials, placentals, and stem relatives). Hypercarnivory involves an important simplification of the carnassial molar pattern from the ancestral tribosphenic molar pattern, with the modification of the triangular tooth crown, and the loss of several cusps and cuspids typical of the tribosphenic molar. These losses confer to the molars of the hypercarnivorous mammals a plesiomorphic/paedomorphic morphology that resembles more the earliest mammaliaforms than the earliest therians. Here, we demonstrate that the modification of the molar morphology is fully explained by a patterning cascade mode of cusp development. Contrary to what was previously proposed, our study concludes that the metaconid (mesiolingual cusp of lower molars, associated with a puncturing function) does not influence cusp development of the talonid (distal crushing heel of lower molars). Moreover, it provides a new example of how heterochronic changes were crucial to the evolution of mammal dentition. To overcome the difficulty of applying behavioral or ecological definitions of diets to fossil animals, we characterize hypercarnivorous dentitions on the basis of the molar morphology and more particularly on the loss or retention of crushing structures, each dentition resulting from adaptations to a distinct ecomorphotype. Despite repeated and convergent evolution of hypercarnivorous forms, hypercarnivory appears as a highly constrained specialization (i.e., "dead end") that is unlikely to evolve back to omnivorous dentition, especially when the crushing structures are lost.

Crown morphology of the mandibular first molars with distolingual roots

Background/purposeMost mandibular first molars have two roots. A major common variation of this tooth is the presence of a distolingual root, which is a common Mongoloid trait in certain populations. The aim of this article was to examine crown morphology in relation to the presence of the distolingual root. Materials and methodsUsing dental casts, the crown morphology of 141 mandibular first molars from 71 Taiwanese individuals was analyzed. Periapical radiographs were used to detect distolingual roots. The length and width of the crowns and the crown units (i.e., trigonid and talonid) were measured. Ten intercuspal distances and five cusp angles were examined. ResultsThe buccolingual dimension of the crown and its ratio to the mesiodistal dimension were significantly increased in molars with a distolingual root, compared to molars without a distolingual root. Mesiodistal crown dimensions were similar; however, the crown unit dimensions were different: molars with a distolingual root had a shorter mesiodistal trigonid dimension but a longer talonid dimension, compared to molars without a distolingual root. The intercuspal distances from the three buccal cusps to the distolingual cusp were significantly longer, however, the distance between the mesiobuccal cusp and mesiolingual cusp was significantly shorter in teeth with a distolingual root than in teeth without a distolingual root. A significantly wider mesiolingual angle and narrower distolingual angle were observed in molars with a distolingual root, compared to molars without a distolingual root. ConclusionThe presence of a distolingual root significantly increased the buccolingual dimension of the crown and the location of distolingual cusp is significantly closer to the lingual side.

Focus on the occlusal failure

The success is evidenced by the longevity of aesthetic and functional therapeutic result. The occlusal «postorthodontic» failure could result in dental instability, functional discomfort, dental or musculo-articular complaint. Analysis of the occlusion research potential occlusal pathogenic dysfunction listed in stabilizing (shimming), centering and guiding anomalies. The large capacity of tolerance of the masticatory system makes it difficult to define the border between physiology and pathology but it is necessary to have benchmarks that can be summarized as follows: - shimming: occlusal contact of mesio-lingual cusp of the first maxillary molars (in Class I, II or III) and occlusal contacts between the canines antagonists; - centering: no transversal deflected occlusion between maximal Intercuspation (ICP) and occlusion in Centric Relation (RCP); - guiding: absence of posterior interference, absence of anterior interference (locking).

Splinting of Longitudinal Fracture: An Innovative Approach.

Trauma may result in craze lines on the enamel surface, one or more fractured cusps of posterior teeth, cracked tooth syndrome, splitting of posterior teeth, and vertical fracture of root. Out of these, management of some fractures is of great challenge and such teeth are generally recommended for extraction. Literature search reveals attempts to manage such fractures by full cast crown, orthodontic wires, and so forth, in which consideration was given to extracoronal splinting only. However, due to advancement in materials and technologies, intracoronal splinting can be achieved as well. In this case report, longitudinal fractures in tooth #27, tooth #37, and tooth #46 had occurred. In #27, fracture line was running mesiodistally involving the pulpal floor resulting in a split tooth. In teeth 37 and 46, fractures of the mesiobuccal cusp and mesiolingual cusp were observed, respectively. They were restored with cast gold inlay and full cast crown, respectively. Longitudinal fracture of 27 was treated with an innovative approach using intracanal reinforced composite with Ribbond, external reinforcement with an orthodontic band, and full cast metal crown to splint the split tooth.

Crown shape of maxillary molars with delayed eruption.

The purpose of this study was to explore the crown shapes of maxillary molars with delayed eruption (DEMo1) at the position distal to the maxillary second premolar. Included teeth erupted later than the average for the maxillary first molar eruption in Japanese females (6.58 ± 0.67 years) by more than two standard deviations. Crown shapes of 12 four-cusped left DEMo1 teeth were compared with those of 25 four-cusped left maxillary first molars (U6n) and 25 four-cusped left maxillary second molars (U7n) from different patients with normal eruption. Seven landmarks were established on the reference plane containing the mesiobuccal, distobuccal and mesiolingual cusp tips of the molars; the origin was defined as the center of gravity of these three points. According to the obtained discriminant function (percentage of correct classifications, 84%), five DEMo1 teeth were classified as U6n and the other seven as U7n. The DEMo1 teeth were also classified into two subgroups, the U6n-close and U7n-close groups, according to the location of the distolingual cusp tip. These results suggest that DEMo1 teeth could include U6 and U7 with delayed eruption or could be an intermediate between U6 and U7, according to their crown shapes.

Effects of coping designs on stress distributions in zirconia crowns: Finite element analysis

The purpose of this study was to evaluate the effects of coping designs on the stress distributions in posterior zirconia crowns by non-linear three-dimensional finite element analysis. Three-dimensional finite element models of a mandibular right first molar with layers of veneering porcelain, zirconia coping, cement, and abutment tooth were designed by computer software (HyperWorks 10.0). Ten zirconia crowns with different designs were produced according to various shoulder positions and heights. The shoulders (1-mm width) exhibited incremental height increases of 1mm, 2mm, and 3mm on the buccal, lingual, and proximal sides, respectively. An axial compressive dynamic load simulating the progressive load was applied until a stainless steel ball model (7mm in diameter) deepened the veneer surface to 0.7mm in depth. Loads were placed on the inner inclines of the mesiobuccal, distobuccal, and mesiolingual cusps. Residual maximum principal stresses (MPSs) at the veneer and coping under progressive loading were determined for each zirconia crown. Reinforcements with the shoulders on the buccal, lingual, and proximal axial walls resulted in lower MPSs in the veneering porcelain but higher MPSs in the zirconia coping. As the shoulder height increased, the tensile stresses decreased, while the compressive stresses increased in the veneering porcelains. It can be concluded that the shoulder height and position in the zirconia coping will affect the MPSs of the crown. Our findings conclusively reveal the critical role of the shoulder design of the coping in preventing veneer fracture on posterior zirconia restorations by reducing tensile stresses in veneering porcelain.

An Experimental Study of Arch Perimeter and Arch Width Increase with Mandibular Expansion: A Finite Element Method

The objective of this study was to estimate the increase in arch perimeter associated with mandibular lateral expansion, To estimate the increase in intermolar width with mandibular lateral expansion and to find out the changes of tooth inclination with mandibular expansion. The mandibular bone with dentition of indian skeletal specimen was obtained. The computer tomogram (CT) slices of the mandible were taken. Finite element model (FEM): Numerical representation of the geometry was created by dividing the geometry into finite number of elements and the elements were connected together with nodes at the junction. The result of the study showed when 10° of lateral expansion was applied to the lower buccal segment at the center of rotation found at 4.3 mm below the root apex of first molar, a space of 1.3 mm between the canine and first premolar, and thus an increase in arch perimeter of 2.6 mm. The tip of the mesiolingual cusp of the first molar moved 4.2 mm laterally, resulting in a change in intermolar width by 8.4 mm. Three-dimensional simulation showed that 1 mm of intermolar expansion increased the arch perimeter by 0.30 mm. As the finite element method evolves and scientists are able to more clearly define physical properties of biological tissues, more accurate information can be generated at the level that other analytical methods cannot fully provide data.This result would be of value clinically for prediction of the effects of mandibular expansion.

Effect of core design and veneering technique on damage and reliability of Y-TZP-supported crowns

ObjectivesTo evaluate the effect of framework design modification and veneering techniques in fatigue reliability and failure modes of veneered Yttria-Stabilized Tetragonal Zirconia Polycrystals (Y-TZP) crowns. MethodsA CAD-based mandibular molar crown preparation served as a master die. Y-TZP crown cores (VITA-In-Ceram-YZ, Vita-Zahnfabrik, Bad Säckingen, Germany) in conventional (0.5mm uniform thickness) or anatomically designed fashion (cusp support) were porcelain veneered with either hand-layer (VM9) or pressed (PM9) techniques. Crowns (n=84) were cemented on 30 days aged dentin-like composite dies with resin cement. Crowns were subjected to single load to fracture (n=3 each group) and mouth-motion step-stress fatigue (n=18) by sliding a WC indenter (r=3.18mm) 0.7mm buccally on the inner incline surface of the mesio-lingual cusp. Stress-level curves (use level probability lognormal) and reliability (with 2-sided 90% confidence bounds, CB) for completion of a mission of 50.000 cycles at 200N load were calculated. Fractographic analyses were performed under light-polarized and scanning electron microscopes. ResultsHigher reliability for hand-layer veneered conventional core (0.99, CB 0.98-1) was found compared to its counterpart press-veneered (0.50 CB 0.33-65). Framework design modification significantly increased reliability for both veneering techniques (PM9 [0.98 CB 0.87-0.99], VM9 [1.00 CB 0.99-1]) and resulted in reduced veneer porcelain fracture sizes. Main fracture mode observed was veneer porcelain chipping, regardless of framework design and veneering technique. SignificanceHand-layer porcelain veneered on conventional core designs presented higher reliability than press-veneered with similar core designs. Anatomic core design modification significantly increased the reliability and resulted in reduced chip size of either veneering techniques.