Tooth-composite Interface Research Articles

The Influence of Posterior Class II Composite Restoration Location and Techniques on Marginal Sealing.

Background/Objectives: The success of treatment and prevention for secondary caries hinges significantly on the techniques employed in Class II composite restoration. Additionally, the location of the restored tooth within the oral cavity has emerged as a potential factor determining the quality of the restoration. A comprehensive understanding of these interrelated variables is crucial for advancing the efficacy and durability of dental composite restorations. The aim of this study was to assess how various restoration techniques and the specific location of the tooth restoration in the oral cavity affect marginal sealing, verified by the gap created in the tooth-restoration interface. Methods: Sixty extracted human teeth that had been indicated for orthodontic extraction were collected and embedded into a custom-made holder that was located in one of the four quadrants of a laboratory phantom head. Class II resin composite restorations, using flowable and packable composites, were performed on all teeth using two techniques: Pre-cure and Co-cure. The aging of the restored teeth was conducted using cyclic loading and thermocycling. After aging, the teeth were examined under a scanning electron microscope to measure the gap within the tooth-composite interface. Kolmogorov-Smirnov tests were used to assess the data distribution. Unpaired T-tests were employed to compare the mean gaps between the Pre-cure and Co-cure techniques. Additionally, unpaired T-tests were utilized to compare the mean gaps between the mesial and distal parts of the teeth. The Kruskal-Wallis test was used to compare the mean gaps among the four quadrants. The statistical significance was set at p = 0.05. Results: No significant difference in the gaps between the Pre-cure and Co-cure techniques was found (p = 0.212). The tooth's location did not generally affect the restoration's gap interface (p = 0.136). Conclusions: Flowable composites aid in restoring the deep margins of Class II composite restoration. Thus, the potential for further microleakage is similar for both the Pre-cure and Co-cure restoration techniques. The marginal seal of Class II composite restorations is effective when using both Pre-cure and Co-cure techniques, and the restoration site within the oral cavity does not significantly influence the tooth-composite interface seal.

The Influence of Adhesive Strategy, Type of Dental Composite, and Polishing Time on Marginal Gap Formation in Class I-like Cavities

Even after more than six decades of dental composite invention (1962), there is still controversial information about the time in which composite restorations should be polished in order to avoid marginal gap formation at the tooth–composite interface. The aim of the present study was to analyze the influence of adhesive strategy, the type of dental composite, and polishing time on marginal gap formation (%MG) at the tooth–composite interface. Class I-like cavities were hybridized with a universal adhesive system (Single Bond Universal) through two strategies: selective enamel etching (SEE) or self-etching mode (SEM). Cavities were filled with two types of dental composites: nanofilled (Z350) or bulk fill (Filtek One Bulk Fill—ONE), and polishing was performed immediately or delayed for 7 days (n = 5). %MG was evaluated by using a 3D laser confocal microscope. As flexural modulus (FM) and degree of conversion (DC%) are determinants of marginal integrity in dental composite restorations, these properties were evaluated for both composites. Data were analyzed by ANOVA and Tukey’s HSD test (α = 0.05). Cavities hybridized following the SEE strategy presented lower %MG (p < 0.05). Z350 showed higher %MG than ONE (p < 0.05). There was no difference in %MG between the polishing times when the SEE strategy was used (p > 0.05). Z350 presented higher FM than ONE (p < 0.05). DC% was found to be not significant (p > 0.05). The results suggest that selective enamel etching (SEE) is a better strategy for producing less %MG in composite restorations with enamel margins irrespective of the time in which the restoration is polished.

Evaluation of microtensile bond strength of nanoclay modified adhesive systems using bulk fill resin composite

Background: Composite polymerization creates internal stresses that cause bond loss at the tooth composite interface, cuspal deflection, and enamel crack formation; that are potential restoration failure. Aims: The aim of the present study was to evaluate micro-tensile bond strength of bulk-fill resin composite to human dentine of extracted teeth using nanoclay modified adhesive system (with and without organic modifier). Materials and Methods: A total of 120 caries-free permanent human posterior teeth were used and classified three groups according to adhesive system (each with 40 teeth); including Prime&Bond universalTM, Dellite®43B and Dellite®LVF modified adhesive systems. Each group was subdivided into two equal subgroups whether thermocycling was conducted or not. Results: Result revealed that there was a significant difference in mean microtensile bond strength of the three tested materials The best results achieved by Dellite®43B followed by Dellite®LVF modified adhesive system finally conventional Prime&Bond universal adhesive system. Difference in Microtensile bond strength between thermocycled and Nonthermocycled was highly significant. Conclusion: Addition of Nanoclay (montmorillonite) with organic modifier to universal adhesive material is valuable to augment the bond strength of bulk fill resin composite to human dentition. (2) Thermocycling adversely affect the bond strength of nanoclay /adhesive system complex to tooth tissue.

Consideration of Dental Tissues and Composite Mechanical Properties in Secondary Caries Development: A Critical Review.

Different kinds of interactions between the restorative material and mineralized dental tissues result in secondary caries around dental composites. Of these, the mechanical interactions have to be carefully investigated. Due to the elastic mismatch between dental tissues and the composite restoration, complex stresses and strains develop at their interface. This complex mechanical environment disturbs the demineralization-remineralization equilibrium of dental hard tissues. The fluid flow both over and within enamel and dentin, associated with their complex ultrastructure and mechanical behavior, is a key factor. It is known that external mechanical loading can indirectly promote the dissolution of enamel and dentin through a pumping action of cariogenic fluids in and out of microgaps at the interface between mineralized tissues and composite. Mechanical loading can also directly influence the physicochemical behavior of dental hard tissues by inducing complex strain and stress fields on the crystal scale. It is important to consider both the direct and indirect paths by which mechanical loading can influence the apatite dissolution kinetics. Therefore, a systematic approach should be used to investigate the mechanism of secondary caries formation considering the tooth-composite interface as a unique complex in which each element has an influence on the other.

One-Year Clinical Aging of Low Stress Bulk-Fill Flowable Composite in Class II Restorations: A Case Report and Literature Review

Bulk-fill flowable composites provide functional and aesthetic restorations while eliminating incremental composite layering and saving time. The degradation of the adhesive interface with subsequent gap formation is a concern when adhesively luted restorations are placed. Moreover, the number of adhesive interface failures increases when they are exposed to long-term water storage. The aim of the present study was to evaluate the morphological characteristics of the tooth-composite interface in class II cavities restored with a low stress bulk-fill flowable composite after aging in an oral environment. We describe a case of a patient with class II cavities in four premolars restored with a low stress bulk-fill flowable composite Surefil SDR (Dentsply DeTrey GmbH, Konstanz, Germany). The occlusal part was restored with nano-hybrid resin composite Ceram X Mono (Dentsply DeTrey GmbH). After one year of clinical function, the teeth were extracted and examined in a scanning electron microscope (SEM). It can be concluded that the application of bulk-fill covered with conventional composite seems to provide the homogeneous and stable bond to tooth structure after one year of aging in an oral environment. However, some defects within the dentin-resin composite interface were observed.

Targeting the oral plaque microbiome with immobilized anti-biofilm peptides at tooth-restoration interfaces.

Recurrent caries, the development of carious lesions at the interface between the restorative material and the tooth structure, is highly prevalent and represents the primary cause for failure of dental restorations. Correspondingly, we exploited the self-assembly and strong antibiofilm activity of amphipathic antimicrobial peptides (AAMPs) to form novel coatings on dentin that aimed to prevent recurrent caries at susceptible cavosurface margins. AAMPs are alternative to traditional antimicrobial agents and antibiotics with the ability to target the complex and heterogeneous organization of microbial communities. Unlike approaches that have focused on using these AAMPs in aqueous solutions for a transient activity, here we assess the effects on microcosm biofilms of a long-acting AAMPs-based antibiofilm coating to protect the tooth-composite interface. Genomewise, we studied the impact of AAMPs coatings on the dental plaque microbial community. We found that non-native all D-amino acids AAMPs coatings induced a marked shift in the plaque community and selectively targeted three primary acidogenic colonizers, including the most common taxa around Class II composite restorations. Accordingly, we investigated the translational potential of our antibiofilm dentin using multiphoton pulsed near infra-red laser for deep bioimaging to assess the impact of AAMPs-coated dentin on plaque biofilms along dentin-composite interfaces. Multiphoton enabled us to record the antibiofilm potency of AAMPs-coated dentin on plaque biofilms throughout exaggeratedly failed interfaces. In conclusion, AAMPs-coatings on dentin showed selective and long-acting antibiofilm activity against three dominant acidogenic colonizers and potential to resist recurrent caries to promote and sustain the interfacial integrity of adhesive-based interfaces.

Optical and mechanical factors in the temporal development of tooth–composite bond

ObjectivesTo obtain an accurate picture of the temporal development of bond strength between resin composites and tooth structures during cure for assessing debonding at the tooth–composite interface. MethodsAn assembly of uncured composite sandwiched between a glass block and a dentin slab with a layer of pre-cured adhesive was used in this study. A conventional composite was compared against a bulk-fill composite. The rate of bond formation was determined by measuring the tensile bond strength of specimens of different thicknesses at different time points during cure. The changing light irradiance exiting the composite as it cured was also recorded. Mode of fracture was analyzed by examining the fracture surfaces. ResultsPhoto-bleaching occurred in both resin composites. The development of the dentin–composite bond strength was initially dictated by the developing cohesive strength of the resin composite, and its final value was capped by the strength of the preformed dentin–adhesive bond. The higher interfacial irradiance in the bulk-fill composite did not lead to faster development of the overall bond strength. This was caused by its slower rate of cohesive strength development as reflected in the longer time for its interfacial irradiance to plateau and the greater proportion of cohesive failure seen in the initial stage of polymerization. The law of reciprocity did not hold for the development of dentin bond strength. SignificanceThe results from this study, when compared with the development of shrinkage stress, can be used as a basis for ensuring the integrity of the dentin–composite interface during cure.

Effect of vibration on adaptation of dental composites in simulated tooth cavities

This research investigated the effects of vibration on the rheological properties of dental composites and the adaptation of tooth cavity-composite interfaces. A portable vibratory packing device and two composites, micro-hybrid dental composite (MC) and nano-hybrid dental composite (NC), were evaluated. The frequency and amplitude of the vibratory packing device were measured. Dynamic oscillatory shear tests were conducted with varying frequency to examine the rheological properties of the composites. Twenty identical composite teeth with a Class I cavity were prepared and filled with one of the two composites. The composite was placed into a cavity using the vibratory packing device operating in either ON or OFF mode. After light-curing of the composite, the gap between the tooth and the composite was evaluated using micro-computed tomography. Two-way ANOVA was used to evaluate the effects of vibration and composite type on tooth-composite adaptation. The frequency of the vibratory packing device was 66.8 Hz. The complex viscosity, η*, of NC was higher than that of MC, and η* of both composites significantly decreased with increasing oscillation frequency. However, the application of vibration did not enhance adaptation at the tooth-composite interface.

A new arginine-based dental adhesive system: formulation, mechanical and anti-caries properties

Secondary caries at the margins of composite restorations has been attributed to adhesive failure and consequent accumulation of cariogenic biofilms. ObjectivesTo develop and evaluate an etch-and-rinse adhesive system containing arginine for sustainable release and recharge without affecting its mechanical properties. Arginine metabolism by oral bacteria generates ammonia, which neutralizes glycolytic acids and creates a neutral environmental pH that is less favorable to the growth of caries pathogens, thus reducing the caries risk at the tooth-composite interface. MethodsExperimental adhesives were formulated with methacrylate monomers and arginine at 5%, 7%, and 10% or no arginine (control). Adhesives were tested for: (i) mechanical properties of true stress (FS and UTS), modulus of elasticity (E), degree of conversion (DC), Knoop hardness number (KHN) and dentin microtensile bond strength (μ-TBS), (ii) arginine release and recharge, and (iii) antibacterial activities. Data was analyzed by t-test, one-way ANOVA and Tukey’s tests. ResultsFS and UTS results showed no statistically significant differences between the 7% arginine-adhesive and control, while the results for E, DC, KHN and μ-TBS showed no difference among all groups. The 7% arginine-adhesive showed a high release rate of arginine (75.0μmol/cm2) at 2h, and a more sustainable, controlled release rate (up to 0.2μmol/cm2) at 30days. ConclusionsIncorporation of 7% arginine did not affect the physical and mechanical properties of the adhesive. Arginine was released from the adhesive at a rate and concentration that exhibited antibacterial effects, regardless of shifts in biofilm conditions such as sugar availability and pH. Clinical significanceSecondary caries is recognized as the main reason for failure of dental restorations. The development of an arginine-based adhesive system has the potential to dramatically reduce the incidence and severity of secondary caries in adhesive restorations in a very economical fashion.

Engineered Peptide Repairs Defective Adhesive-Dentin Interface.

Failure of dental composite restorations is primarily due to recurrent decay at the tooth-composite interface. At this interface, the adhesive and its bond with dentin is the barrier between the restored tooth and the oral environment. In vivo degradation of the bond formed at the adhesive/dentin (a/d) interface follows a cascade of events leading to weakening of the composite restoration. Here, a peptide-based approach is developed to mineralize deficient dentin matrices at the a/d interface. Peptides that have an inherent capacity to self-assemble on dentin and to induce calcium-phosphate remineralization are anchored at the interface. Distribution of adhesive, collagen, and mineral is analyzed using micro-Raman spectroscopy and fluorescence microscopy. The analysis demonstrates remineralization of the deficient dentin matrices achieved throughout the interface with homogeneous distribution of mineral. The peptide-based remineralization demonstrated here can be an enabling technology to design integrated biomaterial-tissue interfaces.

A Brief Review on the Relationship Between Gap Size of Composite Restoration and Secondary Caries

Objective To evaluate the influence of gap size between tooth-composite interface in developing secondary carious lesion.

Immediate endodontic access cavity sealing: fundamentals of a new restorative technique.

Endodontic access cavity sealing is conventionally performed after endodontic irrigation, referred to as delayed endodontic sealing (DES). Evidence shows that endodontic irrigation with NaOCl decreases dentinal bond quality and could cause coronal leakage. Access cavity sealing before endodontic irrigation is a new restorative approach, referred to as immediate endodontic sealing (IES). The primary aim of this in vitro study was to investigate whether IES improved internal adaptation. The secondary aim was to investigate the influence of the viscosity of the composite used to seal the dentine, on the internal adaptation in both IES and DES groups. Third molars (n= 40) with fully developed apices were used. The teeth were prepared into standard Class II MO cavities, and divided in 4 groups according to the approach, and composite viscosity was used for sealing. Group 1: IES + low viscosity composite; group 2: IES + high viscosity composite; group 3: DES + low viscosity composite; and group 4: DES + high viscosity composite. Samples were then sectioned axially for observation using scanning electron microscopy. Outcome was evaluated by determining the internal adaptation of the samples, which was judged based on the percentage of a continuous margin at the tooth-composite interface. The results were analyzed using a two-way analysis of variance and Mann-Whitney test. IES groups exhibited significantly greater internal adaptation (p = 0.000) as compared with DES groups. Composite viscosity did not significantly affect internal adaptation in either IES or DES groups (p > 0.005).

Acoustic emission analysis of the effect of simulated pulpal pressure and cavity type on the tooth–composite interfacial de-bonding

ObjectiveThe aim of this study was to evaluate the influence of in vitro pulpal pressure and cavity type on the tooth–composite bonding interface by means of acoustic emission (AE) analysis. MethodsClasses I and II cavities on extracted third molars were prepared and assigned to four groups of seven teeth each: (1) direct composite restoration without simulated pulpal pressure (SPP) in class I cavity, (2) direct composite restoration with SPP in class I cavity, (3) direct composite restoration without SPP in class II cavity, (4) direct composite restoration with SPP in class II cavity. The teeth were restored with Filtek Z250 composite and Adper Scotchbond Multi-Purpose adhesive system (3M ESPE, St. Paul, MN, USA). AE events were recorded for 2000s during light-curing. Groups 2 and 4 were subjected to 20cm H2O hydrostatic pressure throughout the procedures. The data were analyzed with two-way ANOVA. After the AE test, teeth were sectioned longitudinally in mesio-distal direction, the tooth–composite interface was examined using SEM. ResultsSPP in Groups 2 (4.57±1.40) and 4 (3.43±1.13) yielded significantly higher AE events number than those of Groups 1 (3.43±1.51) and 3 (1.71±0.95) where the SPP was not applied (p<0.05). The number of AE events of class I cavity in Groups 1 and 2 were significantly higher than those of class II cavity in Groups 3 and 4 (p<0.05). SEM examination showed that all groups had intact enamel–composite interface, while micro-gaps were observed at the dentin–composite interface, mainly at the pulpal floor of the cavity. The class I cavities with SPP in Group 2 showed wider gaps more frequently than class II cavities without SPP in Group 3. SignificanceThe SPP and class I cavity with high C-factor triggered more AE events, confirming its negative impact on the bonding interface.

Acoustic Emission Analysis of Tooth-Composite Interfacial Debonding

This study detected tooth-composite interfacial debonding during composite restoration by means of acoustic emission (AE) analysis and investigated the effects of composite properties and adhesives on AE characteristics. The polymerization shrinkage, peak shrinkage rate, flexural modulus, and shrinkage stress of a methacrylate-based universal hybrid, a flowable, and a silorane-based composite were measured. Class I cavities on 49 extracted premolars were restored with 1 of the 3 composites and 1 of the following adhesives: 2 etch-and-rinse adhesives, 2 self-etch adhesives, and an adhesive for the silorane-based composite. AE analysis was done for 2,000 sec during light-curing. The silorane-based composite exhibited the lowest shrinkage (rate), the longest time to peak shrinkage rate, the lowest shrinkage stress, and the fewest AE events. AE events were detected immediately after the beginning of light-curing in most composite-adhesive combinations, but not until 40 sec after light-curing began for the silorane-based composite. AE events were concentrated at the initial stage of curing in self-etch adhesives compared with etch-and-rinse adhesives. Reducing the shrinkage (rate) of composites resulted in reduced shrinkage stress and less debonding, as evidenced by fewer AE events. AE is an effective technique for monitoring, in real time, the debonding kinetics at the tooth-composite interface.

Imaging in vivo secondary caries and ex vivo dental biofilms using cross-polarization optical coherence tomography

ObjectiveConventional diagnostic methods frequently detect only late stage enamel demineralization under composite resin restorations. The objective of this study is to examine the subsurface tooth–composite interface and to assess for the presence of secondary caries in pediatric patients using a novel Optical Coherence Tomography System with an intraoral probe. MethodsA newly designed intraoral cross polarization swept source optical coherence tomography (CP-OCT) imaging system was used to examine the integrity of the enamel–composite interfaces in vivo. Twenty-two pediatric subjects were recruited with either recently placed or long standing composite restorations in their primary teeth. To better understand how bacterial biofilms cause demineralization at the interface, we also used the intraoral CP-OCT system to assess ex vivo bacterial biofilm growth on dental composites. ResultsAs a positive control, cavitated secondary carious interfaces showed a 18.2dB increase (p<0.001), or over 1–2 orders of magnitude higher, scattering than interfaces associated with recently placed composite restorations. Several long standing composite restorations, which appeared clinically sound, had a marked increase in scattering than recently placed restorations. This suggests the ability of CP-OCT to assess interfacial degradation such as early secondary caries prior to cavitation. CP-OCT was also able to image ex vivo biofilms on dental composites and assess their thickness. SignificanceThis paper shows that CP-OCT imaging using a beam splitter based design can examine the subsurface interface of dental composites in human subjects. Furthermore, the probe dimensions and acquisition speed of the CP-OCT system allowed for analysis of caries development in children.

A method of improving marginal adaptation by elimination of singular stress point in composite restorations during resin photo-polymerization

Objectives To reduce the effect of stresses due to volumetric shrinkage the authors propose an incremental technique for placing composite restorations. Methods The goal of the method is to reduce the volume of the resin that is polymerized and eliminate a stress singular point in the resin that is positioned at the geometric center of the cavity. This is achieved by a two step type incremental technique. In the first step the resin is placed in the cylindrical cavity with a metal pin embedded in the middle of the composite restoration. After polymerization, the metal pin is removed and the cylindrical hole is filled with the second layer of composite. Finally, the second layer in the center of the composite restoration is polymerized. Results This study confirmed that the proposed incremental type placement technique reduces marginal debonding. Significance The main hypothesis is that the elimination of a stress singular point at the center of the restoration results in the reduction of stresses at tooth–composite interface and therefore improve the marginal adaptation (reduces length of the contraction gap at tooth–composite interface).

Nondestructive quantification of leakage at the tooth–composite interface and its correlation with material performance parameters

Current methods to determine debonding/leakage at the tooth–composite interface are qualitative or semi-quantitative. Our previous work introduced a 3D imaging technique to determine and visualize leakage and its distribution at the interface of cavity wall and composite restoration in model cavities. In this study, an automated program was developed to quantify leakage in terms of area and volume. 3D leakage distribution obtained via the image analysis program was shown to have excellent agreement with leakage visualized by dye penetration. The relationship between leakage and various material performance parameters including processability, shrinkage, stress, and shrinkage strain-rate was determined using a series of experimental composites containing different filler contents. Results indicate that the magnitude of leakage correlated well with polymerization stress, confirming the validity of the common approach utilizing polymerization stress to predict bonding durability. 3D imaging and image analysis provide insight to help understand the relations between leakage and material properties.

Bond strengths of an antibacterial monomer-containing adhesive system applied with and without acid etching for lingual retainer bonding

The aim of this study was to test the null hypothesis that there is no significant difference in bond strength and failure site location of composite bonded to etched and unetched enamel with an antibacterial monomer-containing adhesive and a conventional lingual retainer adhesive system. The crowns of 60 extracted lower human incisors were mounted in acrylic resin leaving the lingual surface of the crowns parallel to the base of the moulds. The teeth were randomly divided into three equal groups: two experimental and a control. Conventional lingual retainer composite (Transbond LR) and antibacterial monomer-containing adhesive (Clearfil Protect Bond), with or without prior etching, were applied to the lingual surface of the teeth by packing the material into cylindrical plastic matrices (Ultradent) with an internal diameter of 2.34 mm and a height of 3 mm to simulate lingual retainer bonding. The shear bond data were analysed using analysis of variance and Tukey's tests. Fracture modes were analysed by chi-square test. Statistical analysis showed that the bond strengths of the control (Transbond LR, mean: 24.77 +/- 9.25 MPa) and Clearfil Protect Bond with etching, (mean: 20.24 +/- 8.5 MPa) were significantly higher than Clearfil Protect Bond without etching, (mean: 12.56 +/- 6.93 MPa). In general, a greater percentage of the fractures were adhesive, at the tooth-composite interface (60-65 per cent). No statistically significant difference was found among the groups. The hypothesis is thus rejected. Within the limits of this in vitro model, antibacterial monomer-containing self-etch adhesive with acid etching did not significantly affect shear bond strength when compared with the control. However, the same adhesive used without acid etching resulted in a significant decrease in bond strength.

Evaluation of dental composite shrinkage and leakage in extracted teeth using X-ray microcomputed tomography

Objective Use X-ray microcomputed tomography (μCT), to test the hypothesis that composite shrinkage and sites of potential leakage in human teeth are non-uniformly distributed and depend on cavity geometry and C-factor. Methods Two holes of equal volume but different dimensions were drilled into the exposed dentin of extracted human molars. The cavities were filled with composite and teeth were scanned, before and after curing, using μCT. Three-dimensional (3D) reconstructions of the data were prepared and analyzed using image analysis software. Results 3D reconstructions showed that cavity geometry did not affect the polymerization shrinkage. The shrinkage for all restorations was 2.66 ± 0.59%, and cavity dimensions did not affect the volume lost, either in quantity or location on the sample. Potential leakage sites were identified by gap formations and found to be non-uniformly distributed along the tooth–composite interface. Leakage in regions calculated by μCT was confirmed by visualization of sectioned samples with confocal laser scanning microscopy. Significance μCT evaluation will add tremendous value as part of a suite of tests to characterize various properties of dental materials. The non-uniform distribution of potential leakage sites about the cavities that was determined by μCT emphasizes the inadequacy of traditional methods of determining leakage, which are capable of analyzing only limited areas. Additionally, μCT evaluation can produce quantitative analyses of shrinkage and leakage, compared to the conventional methods, which are qualitative or semi-quantitative. Finally, experimentally determined shrinkage and leakage of composite in extracted teeth agrees with the results of similar experiments in model cavities, confirming the validity of those models.

Sequential software processing of micro-XCT dental-images for 3D-FE analysis

Objectives The aim was to describe a sequential software processing of μ-XCT molar-images for 3D-FE tooth/restoration model geometries based on a representative molar tooth, giving attention on each step of data-processing. This paper first gives an overview of a sequential processing and then applies the resulting model to the particular case. Methods An intact mandibular molar was scanned using a micro-XCT instrument (1072, SkyScan, Belgium) in which 960 slices were obtained. Sixty-three non-adjacent bitmap slices were then optimally selected for model-creation. Enamel/dentin boundaries were clarified, for each slice, using image control-system software (ScanIP, Simpleware), generated a file which was sequentially converted into a mesh in a reconstruction software (ScanFE, Simpleware) and posteriorly converted into a STL-file (triangulated-2D-stereolithography). This was imported into a FE-software package (Patran, MSC.Software, USA) and all elements were re-meshed. From these elements, surfaces were created and exported to another FE-software (Hypermesh, Altair Hyperworks) to build the dental-cavities. Finally, the volumetric-mesh was created and the model was imported back to FE-software to apply the boundary-conditions, material-properties and initiate post-processing (using Patran and Marc, MSC Software). To demonstrate the use of the resulting model, this was applied to the particular case of a Class I restoration subjected to distributed loading. The analysis was performed as linear and structural and outputs of maximum principal (MP) and maximum shear (MS) stresses were then evaluated. Results A 3D-model of a mandibular molar was processed without generating errors in the FE-package used. The maximum deviation between the tooth and the model was less than 0.1%. Stress concentrations were found at the surface where the load was applied and in the vicinity of the tooth–composite interface. Significance The described procedure is a successful method able to produce a highly detailed 3D finite element model of restored molar teeth with any cavity configuration and combination of restorative materials and this method can also be used for other biological or biomaterials applications.