Oral Health and Dental Management

Abstract

Osteoporosis and Endodontic Access: Analysis of Fracture Using Finite Element Method

Aline Batista Gonçalves Franco, Geraldo Alberto Pinheiro De Carvalho, Sérgio Candido Dias, Simone Kreve, Alexandre Sigrist De Martin

Introduction: The aim of this study is to assess the biomechanical behaviour of the first upper premolar, healthy and endodontically treated, with conventional and conservative access, under physiological occlusal load, and that of the surrounding alveolar bone both in normal and osteoporotic conditions. Methods: With this aim, virtual models were developed: M1 - healthy tooth/normal bone; M2 - conservative access/normal bone; M3 - conventional access/normal bone; M4 - healthy tooth/osteoporotic bone; M5 - conservative access/osteoporotic bone; M6 - conventional access/osteoporotic bone. Simulations used Finite Element Method. Results: On the enamel, under axial load, strength peaked around the occlusal contact points and on the sulcus between the cusps under oblique load. On dentin, under axial and oblique loads, peaks were observed in the furcation region, and were more prominent under oblique load. On the bone deformity under axial load, peaks were shown on the furcation region in the normal bone models and on the apical vestibular region in the osteoporotic bone model; under oblique load, peaks were shown in the cervical vestibular region. Greater deformities were found in osteoporotic bone models. Conclusions: The osteoporotic bone showed increased probability of fracture and, if a fracture were to exist, it is likely to occur in the apical and cervical vestibular regions. Simulated dental conditions did not interfere with the occurrence of bone deformities. The type of crown opening had little influence on dental fracture resistance and, if a fracture were to exist, it is likely to occur in the furcation region.