Palatal Root Research Articles

Root canal instrumentation efficacy of non-fused and fused primary molar roots: a micro-computed tomography study.

Pulpectomy may be indicated in restorable primary teeth exhibiting irreversible pulpitis or pulpal necrosis. The purpose of this study was to compare the cleaning and shaping efficacy of NiTi systems (Reciproc® Blue and MTwo®) with manual stainless-steel instrumentation in primary molars using micro-CT analysis. Fifty-seven maxillary second primary molars were scanned using micro-CT. Teeth with three divergent roots were divided randomly (n = 15) according to instrument type (K file, MTwo®, and Reciproc® Blue). Teeth with root fusion were instrumented manually as a separate group (n = 12). Pre- and post-instrumentation micro-CT images were superimposed, and the instrumentation area (IA) and procedural complications were recorded. No statistically significant differences in IA between file systems was observed in the non-fused teeth. The mean IA of fused roots was significantly lower than in the non-fused distobuccal (p = 0.003) and palatal (p < 0.001) roots. The root segment had a significant effect on IA (p < 0.001) and the highest mean IA was observed in the apical third. Manual instrumentation had fewer procedural complications compared with rotary systems. No differences were determined in the cleaning and shaping effectiveness of all systems in non-fused teeth. Uninstrumented areas (> 60%) occurred in both non-fused and fused primary teeth with fewer procedural complications observed after manual instrumentation.

The influence of different root canal irrigants on the push-out bond strength of AH plus and Bioceramic sealers

Background: The bond strength of endodontic sealers with dentin is a very important property for maintaining the integrity and seal of the root canal filling. The aim of this study was to evaluate and compare the effect of various irrigants (QMix, 17% EDTA and 2.5% NaOCl) on the push-out bond strength of AH plus and Bioceramic sealers. Materials and methods: Forty eight freshly extracted maxillary first molars human teeth with striaght palatal root were used in the study. The collected samples were randomly divided into three groups of equal sample size (n=16), according to the final irrigation regimen as follows: Group (1): QMix 2 in 1, Group (2): 17% ethylenediaminetetraacetic acid, Group (3): 2.5% sodium hypochloride. All samples were instrumented using Edge file X7 rotary instrument reaching file size 40/.04 as the final master apical file. After that each group was randomly divided into two subgroups (n=8) according to the type of sealer used: AH Plus and Total Fill BC Sealer. Obturation was conducted using single cone technique with gutta percha (GP) to all experimental roots. Two-millimeter thick slices were obtained from the middle section of the root. Bond strength of sealers was measured via a universal testing machine by using stainless steel plunger. Then, the data were statistically evaluated using two-way analysis of variance (ANOVA) and post hoc test (Bonferroni’s test). Results: The push-out bond strength was significantly increased by the “irrigant” factor (P≤0.05) and by “sealer/irrigation solution” interaction (P≤0.05). Final rinse with QMix solution with BC sealer showed the highest mean value of bond strength (5.976 MPa), with a significant difference with other groups (P≤0.05), while NaOCl with AH Plus sealer showed the lowest mean value of bond strength (3.811 MPa). Conclusion: Final irrigation of the root canals with different irrigants improved the endodontic sealer's bond strength, and QMix had a positive influence on the adhesion of BC sealer.

Effectiveness of an anterior mini-screw in achieving incisor intrusion and palatal root torque for anterior retraction with clear aligners.

To analyze the biomechanical system of anterior retraction with clear aligner therapy (CAT) with and without an anterior mini-screw and elastics. Models including a maxillary dentition (without first premolars), maxilla, periodontal ligaments (PDLs), attachments, and aligners were constructed and imported to finite element software. Three model groups were created: (1) control (CAT alone), (2) labial elastics (CAT with elastics between the anterior mini-screw and buttons on central incisors), and (3) linguoincisal elastics (CAT with elastics between the anterior mini-screw and precision cuts on the lingual sides of the aligner). Elastic forces (0-300 g, in 50 g increments) were applied. CAT alone caused lingual tipping and extrusion of the incisors. Labial elastics caused palatal root torquing and intrusion and mesial tipping of the central incisors, while linguoincisal elastics produced palatal root torquing and intrusion of both central and lateral incisors. Second premolars were intruded in all three groups, with less intrusion in the linguoincisal elastics group. For the control group, stress was concentrated on both labial and lingual root surfaces, alveolar ridge, and cervical and apical PDLs. Stress was more concentrated in the labial elastics group and less concentrated in the linguoincisal elastics group. CAT produced lingual tipping and extrusion of incisors during anterior retraction. Anterior mini-screws and elastics can achieve incisor intrusion and palatal root torquing. Linguoincisal elastics are superior to labial elastics with a lower likelihood of buccal open bite. Root resorption and alveolar defects may occur in CAT, more likely for labial elastics and less likely for linguoincisal elastics.

CBCT-based assessment of the anatomic relationship between maxillary sinus and upper teeth.

ObjectivesTo describe the relationship between maxillary sinus (MS) and upper teeth based on cone beam computed tomographic scans (CBCT).Materials and methodsBased on CBCT maxillary imaging data of 147 patients, distance between MS and apices of canines and posterior maxillary teeth were assessed. Distances between tooth roots and sinus were classified into three groups: distant (>2 mm), close (<2 mm) or in contact with MS. Teeth with apical lesions and uncommon root configurations were excluded.ResultsIn total, 1075 teeth of maxillary canines, upper premolars and upper molars were included in this study. Teeth most often in contact with MS were the second (89%) and first (81%) maxillary molar without any significant difference (p = 0.19). Roots most often in contact with MS were the mesiobuccal and distobuccal root of the second molar (85% and 76%; p = <0.01) followed by the palatal root of the first molar (73%). A fifth of the upper canines are situated less than 2 mm from MS.ConclusionsMore than four out of five upper molars (first and second) are in a close relationship to the MS. Knowledge of the anatomical relationship between posterior maxillary teeth and the MS is important for diagnosis and treatment in this area.

Efficacy of Various Final Irrigant Activation Procedures on Smear Layer Removal - A SEM Study

Background: This in vitro study was intended to compare the removing efficacy of smear layer of the EndoVac , EDDY tip, XP - endo Finisher and conventional needle irrigation in palatal roots of extracted maxillary first molars, at the apical, middle and coronal levels by using scanning electron microscopy. Material and Method: The palatal roots of sixty recently extracted maxillary first molars were selected and divided into four groups (n=15) according to final irrigation agitation systems; EndoVac irrigation system,Eddy tip, XP - endo Finisher and conventional needle irrigation. Each root was prepared to 40/0.06 apical size with EDGEENDO X3 rotary files. Following splitting the root samples, single half of each sample was selected for examination under scanning electron microscope (SEM). The comparisons among irrigation activation devices were done using the Kruskal Wallis test and Mann-Whitney U test at 0.05 significance level. Conclusion: Within the limitations of the present study, no one of the tested systems can remove the smear layer completely. However, EndoVac system , Eddy tip and XP - endo Finisher remove significantly more smear layer than conventional needle irrigation at the apical third but there was no significant difference at middle and coronal thirds.

Expression of Torque and Its Effect on Various Biological Structures Caused by Varying Archwire Material: A 3D FEM Study

Objective: Studying torque expression and biomechanical effects of various wires on giving palatal root torque, using finite element (FE) method (FEM). Conclusion: TMA wires are most favourable for torquing, in terms of torque expression and susceptibility to root resorption. Materials and Method: Geometric model of maxillary right central incisor was developed, using computed tomography (CT) scan. 0.022" × 0.028" Standard edgewise brackets and 10-mm-long stainless steel (SS), titanium molybdenum (TMA) and titanium niobium (TiNb) archwires of dimension 0.019" × 0.025" were modeled and a palatal root torque of 25 degrees was applied on all wires. The angular displacement of the crown and root and nodal displacement at the incisal edge and root apex in y and z axis were analyzed along with stresses on periodontal ligament (PDL), bone, cementum, enamel, and bracket. Results: Buccal crown and palatal root movement was seen, which was maximum for SS and least for TMA. Angular displacement was also highest for SS. Compressive stresses were concentrated at the bucco-cervical and linguo-apical regions in the PDL, cementum, and bone and tensile stresses were concentrated in the linguo-cervical regions. In the enamel, the bracket attachment site showed maximum stresses, and slot base showed higher values of stresses than wings. All stress values were highest for SS and least for TMA.

Maxillary First Molars with Two Palatal Root Canals

Understanding the anatomical variations in the roots and root canal systems of a tooth is important for the success of root canal treatment. The palatal roots of the maxillary molars have fewer anatomical variations than the other roots, and fewer variations occur in the first molars than in the second molars. This case report describes two distinct cases of maxillary first molars with two palatal canals. For the root canal treatment of teeth with anatomical variations, it is essential to plan specific treatment strategies using cone-beam computed tomography and to execute them using a dental operating microscope. Knowledge of the anatomical variations in the palatal roots of maxillary first molars will help to increase the success rate of root canal treatments.

A CBCT based evaluation of root proximity of maxillary posterior teeth to sinus floor in a subset of Pakistani population.

To evaluate the vertical relationship of the roots of maxillary posterior teeth with maxillary sinus floor, and its association with age, gender and bilateral jaw symmetry. The cross-sectional study was conducted at a tertiary care hospital in Karachi from June to December 2018, and comprised patients who visited the dental clinics and underwent cone-beam computed tomography scans. The scans were evaluated in the axial, coronal and sagittal planes and roots were classified using Jungs classification for proximity to maxillary sinus floor. The distance between the sinus floor and the apices of maxillary posterior teeth was measured. Data was analysed using SPSS 23. There were 60 scans with 1066 roots. The most common maxillary tooth root in Type III group of Jung classification was the mesio-buccal root of the 2nd molar with the shortest mean distance of 0.44±3.05mm, followed by palatal roots of the 1st molar with the shortest mean distance of 1.58±4.01mm. The maxillary tooth root most frequent in Type I group was buccal root of 1st premolar with a mean distance of 8.15±6.65mm, and the 2nd premolar with a mean distance of 7.38±6.60mm. No significant difference was found in terms of gender and sides (p ≥0.05). The most common tooth root protruding in the sinus was found to be the mesio-buccal root of the 2nd molar, followed by palatal roots of the 1st molar. The most distant maxillary tooth root from the sinus was the buccal root of 1st and 2nd premolars.

Inhibitory effect of short-term ketogenic diet on cytokine expression during orthodontic movement in a rat model

ABSTRACT Purpose: To compare the change of IL-1β and TNF-α expression during orthodontic tooth movement in rats, which were under regular diet and ketogenic diet (KD). Materials and Methods: The maxillary right first molars of 3-month-old male Sprague-Dawley rats were subjected to mesial movement by 50 g of force for 14 days under ketogenic diet. A control group was also established in which rats were subjected to the same tooth movement conditions but under a regular diet. The distance of tooth movement was measured by using precision electronic calipers. After 14 days, the rats were sacrificed and the mesial surface of the palatal root of the right first molar was analysed to determine the expression levels of IL-1β and TNF-α through immunohistochemical staining. The images obtained were then quantified using ImageJ program. Results: After 14 days of orthodontic tooth movement, the amount of tooth movement in the ketogenic group was lesser by approximately half the distance compared to that of the control group. Moreover, the expression of IL-1β and TNF-α was also lower. Conclusions: Consuming ketogenic diet reduces the expected amount of tooth movement which was evidently shown by a significant lower cytokine expression of IL-1β and TNF-α than the group under regular diet. This suggests that ketogenic diet is a contributing factor in delaying the tooth movement during orthodontic treatment.

Confocal laser scanning microscopic analysis of the penetration of an epoxy resin-based sealer into dentinal tubules after calcium hydroxide dressing.

This study assessed the penetration of an epoxy resin-based sealer into dentinal tubules of root canals previously medicated with calcium hydroxide. Sixteen palatal root canals of upper molars were instrumented and distributed into two groups: (G1) root canals medicated with calcium hydroxide and obturated after its removal; (G2) root canals obturated without the use of dressing. Sealer mixed with rhodamine B provided fluorescence for confocal laser scanning microscopy. Measurements of area and linear penetration of the sealer were assessed in three thirds by ImageJ software. The data were statistically compared by Kruskal-Wallis, Dunn's and Mann-Whitney U tests (P < 0.01). The calcium hydroxide decreased the penetration of the sealer. The coronal and middle thirds had similar areas and linear penetrations in both groups, whereas the apical third had less penetration. In conclusion, the penetration of the epoxy resin-based sealer is influenced by the calcium hydroxide dressing used between appointments.

Maxillary first molar endodontic management with seven root canals diagnosed using CBCT: A case study

The main objective of this case study is to present an unusual maxillary first molar root canal configuration with seven root canals; three mesiobuccal, two distobuccal and two palatal canals diagnosed during treatment procedure confirmed by Cone Beam Computed Tomography. A 26-year-old man with the chief complaint of spontaneous pain in his left posterior maxilla was referred to by his general dentist. From the clinical and radiographic results, a diagnosis of apical periodontitis was made and the patient was recommended for endodontic care. The CBCT axial images of the patient showed that the palatal and distobuccal roots have a type IV and type II canal pattern of Vertucci, respectively, while the mesiobuccal root showed a type XV canal configuration of Sert and Bayirli. Canals have been successfully treated with rotary files and filled using a single-cone technique. In endodontically difficult situations, the use of CBCT imaging will promote a deeper understanding of the intricate root canal anatomy, which essentially helps the clinician to more effectively explore the root canal system and clean, shape, and obturate it. Keywords: Cone Beam Computed Tomography, Maxillary first molar, Root canal anatomy, Seven root canals.

Cone beam computed tomography analysis of residual dentin thickness after virtual post placement in the palatal roots of maxillary first molars

Statement of problemIn endodontically treated maxillary first molars, post space preparations in the palatal roots can compromise the residual dentin thickness (RDT) and increase the risk of perforations or root fractures. This can be attributed to the direction of the buccopalatal curvature that cannot be viewed with conventional 2D imaging. PurposeThe purpose of this clinical study was to investigate the RDT of palatal roots following the placement of digital post analogs of different diameters positioned at various distances from the radiographic apex by using cone beam computed tomography (CBCT). Material and methodsA total of 122 deidentified CBCT data sets containing both maxillary permanent first molars were randomly selected from a private radiology practice. Digital parallel-sided post analogs were superimposed onto the CBCT coronal images at distances of 3 mm, 4 mm, and 5 mm from the radiographic apex and at a depth equal to the height of the anatomic crown (1:1 crown/post ratio). Post analogs of 0.9 mm, 1.0 mm, and 1.14 mm in diameter were matched with safety zone analogs representing 1 mm of circumferential RDT. The minimum RDT for each analog was determined and grouped into 3 categories: RDT≤0 mm, 0 mm<RDT<1 mm, and RDT≥1 mm. The statistical significance between post diameters and post depth was analyzed with the Friedman test and Conover post hoc test (α=.05). ResultsSignificant differences in RDT were found at all tested depths and diameters of post analogs (P<.001). Generally, the amount of RDT increased as the post length was reduced. Most teeth (>50.0%) had inadequate or no RDT. The depth of the post (P<.001) had a greater impact on RDT than the post diameter (P>.017). No similarities were found in the RDT between contralateral molars in 86.9% of the images. ConclusionsThe risk of insufficient RDT (<1 mm) after the placement of parallel-sided posts in the palatal roots of maxillary first molars is minimized if the post is inserted to a depth equaling the height of the crown compared with 3, 4, and 5 mm from the radiographic apex. The RDT of the palatal root of a maxillary first molar is not a reliable predictor of the contralateral palatal root RDT in the same patient.

Maxillary Second Molar with a Rare Palatal Root Canal Morphology: A Case Report

ABSTRACT Knowledge of the root canal anatomy and its variations is essential for successful completion of the endodontic treatment. Root canal treatment of maxillary second molars with aberrant canal configuration can be challenging. The incidence of two palatal canals in a palatal root is quite rare in maxillary molars. The novel diagnostic aids such as cone-beam computed tomography (CBCT) help in the successful management of such cases. This case report describes the successful diagnosis and treatment of a maxillary second molar with two palatal canals, merging at the apical third of the root. How to cite this article: Sen P, Prasad AB, Mital P, et al. Maxillary Second Molar with a Rare Palatal Root Canal Morphology: A Case Report. J Mahatma Gandhi Univ Med Sci Tech 2020;5(1):23–25.

Evaluation of Palatal Furcation Groove and Root Canal Anatomy of Maxillary First Premolar: A CBCT and Micro-CT Study.

Objectives This study is aimed at investigating the root and root canal morphology by cone beam computed tomography (CBCT) and palatal furcation groove of the buccal root by microcomputed tomography (micro-CT) of maxillary first premolars in a Chinese subpopulation. Methods This study assessed CBCT images of 440 patients aged 14-80 years. Based on Vertucci's classification, the number of roots and the canal configuration were determined. Forty-eight maxillary first premolars with furcation grooves were analyzed by micro-CT in patients aged 18-25 years. Results Based on the CBCT assay, 70.22% and 29.32% of maxillary first premolars were 1 root and 2 roots, respectively. The configuration indicated statistical difference (P < 0.05) between male and female patients. The most common canal type was type IV and was found in 44.32% of cases, followed by type I in 27.84%, and then type II in 20.57%. Root bifurcations had 40.13% prevalence which was distributed more in the middle third than in the cervical and the apical third. For the micro-CT study, 95.83% of the furcation groove configuration was found in the bifurcated maxillary first premolars. The length varied from 1.02 to 7.63 mm. The mean depth of this groove was 0.57 mm in the root coronal, 0.47 mm in the root middle, and 0.22 mm in the root apical level. Palatal dentin width was smaller than 1 mm. Conclusion The anatomy of the root and root canal system and the irregular wall width of maxillary first premolars with furcation grooves may help dentists to understand the anatomical morphology and improve the outcomes of endodontic treatment.

Effect of apical size on apical pressure during syringe-needle and multisonic negative pressure irrigation.

Apical pressure during root canal irrigation is regarded as a key factor affecting the risk of irrigant extrusion. The aim of this study wasto examine the effect of apical size on the apical pressure by positive and negative pressure syringe-needle and multisonic negative pressure irrigation. An extracted maxillary first molar with two separate buccal roots, one palatal root and four canals was selected. The roots of the molar were fixed in a specially made apparatus to acquire the apical pressure of the four root canals separately. The apical sizes tested were from sizes 10, 30, 40, 50, 60, 70, 80, 90, 110. Multisonic negative pressure irrigation protocol was as recommended by the manufacturer (45mL/min), syringe-needle irrigation was done using 30-G side-vented needle 3mm from the working length at 5mL/min as a conventional positive pressure irrigation (SNI), and as negative pressure irrigation (NPSNI) using suction. Apical pressure by SNI was measured also at 10mL/min with an open-ended 30G needle, for the smallest and largest apical sizes. Apical pressures by SNI stayed positive, except when suction was used (NPSNI). The apical pressure by multisonic negative pressure irrigation remained negative in all situations. With increasing apical size, apical pressure by SNI decreased, whereas with multisonic negative pressure irrigation and NPSNI, it was not affected by apical size. Large apical size did not result in higher apical pressure values compared to small apical sizes.

Management of Bilateral Maxillary Second Molars with Extra Palatal Root: A Case Report

A crucial understanding of teeth’ internal and external anatomy is critical for the successful outcome of endodontic therapy. The presence of two palatal roots in maxillary molars, particularly in the second molar is rare. The present case report addresses this anatomical variation in an 18-year-old female patient with a chief complaint of severe pain in the upper left back teeth region since one week. Preoperative radiographic evaluation of maxillary second molar did not reveal the aberrant anatomy due to its location and impaction of maxillary third molar onto the roots of the second molar. After access opening, inspection of the pulp chamber floor revealed a slightly deviated location of the palatal canal and a bleeding point mesial to the palatal canal. Intensive exploration for determining any additional canals was done using David Green (DG) 16 endodontic explorer under 3X magnification using dental loupes. A narrow field of view Cone Beam Computed Tomography (CBCT) was obtained to evaluate the unusual root canal morphology. Following a thorough analysis of CBCT, root canal treatment was performed employing a standard protocol. This case report highlights the successful diagnosis and management of the bilateral maxillary second molar with two separate palatal roots. With CBCT and magnification, determining the root morphology and canal configuration will be more accurate, further improving the quality of root canal treatment.

Anatomic Variation in Palatal Root of Maxillary Second Molar: Endodontic Management

The aim of the present clinical case report is to describe the singular root canal anatomy and endodontic management of a maxillary second molar with two palatal roots and two separate canal orifices. A 60 years-old female Hispanic/Latino patient attended the Endodontic Department at University of Buenos Aires School of Dentistry with acute pain in her maxillary left second molar. Clinical radiographs examination revealed unusual root morphology. Cleaning and shaping were completed with 5.25% NaOCl irrigation, 15% EDTA solution and hand/rotary instruments. Filling was performed with gutta-percha points and resin-based sealer. After one year follow-up periapical radiographs and CBCT images showed healing in the area and patient was asymptomatic.

Cone-beam computed tomography evaluation of the root morphology of the maxillary and mandibular premolars in a Moroccan subpopulation: Canal configurations and root curvatures (Part 2)

Introduction: The aim of this study is to investigate canal configurations and root curvatures of maxillary and mandibular premolar teeth in a Moroccan subpopulation using cone-beam computed tomography (CBCT) images. Materials and Methods: The root curvature and canal configuration of 919 CBCT images of maxillary (358) and mandibular (561) premolar teeth were investigated using “Planmeca viewer” software. Data were analyzed using descriptive statistics. Results: About 46.8% of the maxillary first premolars with two roots had Type I canal configuration of each roots and 27.5% of single-rooted ones presented Type VII. The two-rooted maxillary second premolars showed Type I (39.35%) canal configuration. As for the single-rooted premolars, 32.8% showed Type III canal configuration. The distobuccal curvature was the most frequent for the single-rooted teeth (30.4%) as well as for the palatal (32.4%) root of the two-rooted ones. More than 70% of each root, had Type I of the two rooted mandibular first premolars while 41.8% of the single-rooted premolars had Type V. Type I canal configuration was the most revealed in single-rooted mandibular second premolars with a percentage of 60.6%. Few teeth with two and three roots were seen. The distolingual curvature showed the highest incidence among single-rooted premolars (37.8%) as well as the buccal roots of the two-rooted ones (51.8%). Conclusion: The Moroccan subpopulation's premolars showed a high prevalence of Vertucci's canal configuration Type I with distobuccal curvature for maxillary teeth and distolingual for mandibular teeth.

Impaction of maxillary canines and its effect on the position of adjacent teeth and canine development: A cone-beam computed tomography study

The purposes of this study were to characterize the 3-dimensional position of teeth adjacent to impacted canines and examine whether impaction affects canine development using cone-beam computed tomography. Cone-beam computed tomography images of 34 unilateral maxillary impacted canines (12 males, 22 females; mean age, 16.5years) were collected. Twenty-one canines were palatally impacted (PIC), and 13 were buccally impacted (BIC). Angular measurements of lateral incisors (LIs), first premolars, and the impacted canines positions relative to a 3-dimensional coordinate system and canines' volume, length, and shape of the roots, were compared between the affected and contralateral control sides. The influence of canine position and severity of impaction was examined. Statistics included the paired t test, Wilcoxon signed rank test, and McNemar test. In the PIC group, LIs showed significant mesiobuccal rotation (-17.1°), mesial angulation (8.4°), and buccal root torque (5°) and first premolars mesiobuccal rotation (6.1°). In the BIC group, LIs displayed mesiobuccal rotation (-18°) and significant palatal root torque (-5°). The canine volumes were similar in BICs and slightly smaller in PICs. The lengths were shorter in both, but root hooks were more prevalent in BICs. The severity of impaction affected the measured variables. The differential position of the adjacent teeth is pathognomonic for PIC vs BIC, and impaction seems to affect canine development. The findings provide evidence-based clinical and radiographical clues for early diagnosis of canine displacement and planning the most efficient treatment strategy. In addition, they support timely orthodontic eruption before the development of the apical third of the root.

Evaluating the Effect of Oblique Ridge Conservation on Stress Distribution in an Endodontically Treated Maxillary First Molar: A Finite Element Study

IntroductionAlthough the maxillary first molar (MFM) has been frequently subjected to stress analysis in endodontic investigations, the available data about the effect of its oblique ridge are quite sparse. The aim of this study includes evaluating the effect of the residual oblique ridge on the stress distribution after preparing conservative access cavities. MethodsBased on the cone-beam computed tomographic data, the model of an intact MFM and 5 cavity designs were prepared for endodontic treatment, which were consequently filled with gutta-percha and dental resin composite (6 total models). All models were subjected to 4 types of occlusal loading; finite element analysis via ABAQUS CAE software (Dassault Systemes, Vélizy-Villacoublay, France) was accomplished, whereas other software programs such as (Mimics Research Materialise, Leuven, Belgium) and 3-Matic Research (Materialise) were also incorporated in different stages for detecting stress distribution. ResultsThe stress distribution on the MFM is not only dependent on the remaining width of the oblique ridge but also on the type of loading. The most stress on the cervical region was concentrated on the palatal root in some type of loading, whereas the least stress on the occlusal surface was recorded when the whole oblique ridge was replaced by the composite resin. ConclusionsWhen the occlusal contacts are occurring only on the palatal cusp, the stress distribution on the oblique ridge is noticeably affected by the cavity design.