Restor Dent Endod.  2019 Aug;44(3):e33. 10.5395/rde.2019.44.e33.

Effect of the restorative technique on load-bearing capacity, cusp deflection, and stress distribution of endodontically-treated premolars with MOD restoration

  • 1Departament of Dentistry, Federal University of Sergipe, Sergipe, Brazil.
  • 2Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, Brazil.
  • 3Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Noord-Holland, The Netherlands.
  • 4Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of Dentistry, University of Naples Federico II, Naples, Italy.
  • 5Department of Pediatric and Social Dentistry, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos, Brazil.


To evaluate the influence of the restorative technique on the mechanical response of endodontically-treated upper premolars with mesio-occluso-distal (MOD) cavity.
Forty-eight premolars received MOD preparation (4 groups, n = 12) with different restorative techniques: glass ionomer cement + composite resin (the GIC group), a metallic post + composite resin (the MP group), a fiberglass post + composite resin (the FGP group), or no endodontic treatment + restoration with composite resin (the CR group). Cusp strain and load-bearing capacity were evaluated. One-way analysis of variance and the Tukey test were used with α = 5%. Finite element analysis (FEA) was used to calculate displacement and tensile stress for the teeth and restorations.
MP showed the highest cusp (p = 0.027) deflection (24.28 ± 5.09 µm/µm), followed by FGP (20.61 ± 5.05 µm/µm), CR (17.72 ± 6.32 µm/µm), and GIC (17.62 ± 7.00 µm/µm). For load-bearing, CR (38.89 ± 3.24 N) showed the highest, followed by GIC (37.51 ± 6.69 N), FGP (29.80 ± 10.03 N), and MP (18.41 ± 4.15 N) (p = 0.001) value. FEA showed similar behavior in the restorations in all groups, while MP showed the highest stress concentration in the tooth and post.
There is no mechanical advantage in using intraradicular posts for endodontically-treated premolars requiring MOD restoration. Filling the pulp chamber with GIC and restoring the tooth with only CR showed the most promising results for cusp deflection, failure load, and stress distribution.


Cusp deflection; Endodontics; Load-bearing; Restorative dentistry; Stress distribution; Finite element analysis

MeSH Terms

Dental Pulp Cavity
Finite Element Analysis
Glass Ionomer Cements
Glass Ionomer Cements
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