Objective: The aim of the paper is to analyse an influence of the shape of the layers in photo-cured dental restorations of Class I on distribution of shrinkage stresses along the tooth-restoration interface. The study is a continuation of the previous considerations (Kowalczyk and Gambin (2008) [1]), where techniques, which reduce stress concentration at the top of the tooth-restoration interface, were considered. The analysis leads to proposition of new layer forming techniques, which diminish the stress peaks at the interface and prevent the crack propagation process.
Methods: To find the stress distributions in the dental restoration layers and the tooth tissues the finite element method implemented in the ABAQUS (Simulia, Providence, USA) software is used. For Class I restoration of the premolar tooth, the axisymmetrical model is assumed. The restoration is made of four layers of a photo-cured composite. Between the tooth tissues and the restoration, a layer of bonding agent 0.01mm thick is placed and modeled by FEM with help of the cohesive elements. The assumed model takes into account an influence of changes of elastic properties and viscous effects. For each case of the restoration layers system, the Huber-Mises stresses are analysed.
Results: The investigations show that the stresses near the restoration-tooth tissue interface are reduced due to viscous flow of the cured material and due to existence of a thin layer of the bonding agent. However, the stress distribution both, in the restoration and in the tooth tissues, is strongly dependent on a shape of the filling layers. Numerical simulations disclose that stress peaks are located at the top corners of each layer. The top corners of the last layer are the places where microleakage may occur. Stress concentrations at the corners of the preceding layers may lead to a growth of uprising crack. It will be shown that the flat layers in the restoration create relatively high values of the stress peaks. The rounded layers, with shapes close to those used in dental practice, reduce maximal stresses about 40%. According to a common opinion of dentists, the wedge-shaped layers give the best result. In the present paper, another way of the shrinkage stress reduction is proposed. Before the layering, one can cover the surface of the tooth cavity with a thin "pre-layer". Next, the remainder cavity may be filled with flat, rounded or wedged layers. It will be shown, that in the fillings with the pre-layers, stress peaks are reduced up to 75%, with respect to the fillings composed of the rounded layers only. The proposed method considerably reduces the shrinkage stress, both in the tooth restoration, as well as, in the tooth tissues.
Significance: The fillings with the pre-layer are easy in application and its analysis gives promising results. The pre-layer may be applied with other layers of different shapes, and its thickness may vary. The method is recommended for cavities with a great loss of the tooth tissue.