Stress analysis of endodontically treated teeth restored with post-retained crowns: A finite element analysis study

Background. The authors conducted a study to analyze the stress concentration areas in a tooth restored with a post-retained crown under various conditions. Materials and Methods. The authors constructed a three-dimensional finite element model describing a maxillary second premolar restored with an all-ceramic crown supported by a titanium post and a resin-based composite core. They applied static vertical and horizontal loads of 100 newton to the cusp tip of the crown and recorded Von Mises and tensile stress values. The variables investigated were the presence of the post, coronal and apical post extensions, post diameter, post shape, and post and core material. Results. The study results showed that horizontal loading generated higher levels of stress than did vertical loading. The greatest stress levels were concentrated at the cervical region and at the post-dentin interface in all models. Under both loads, a higher modulus of elasticity of the post material and a wider post diameter were associated with increased stress values at the post-dentin interface. Reduction of the post extension above the level of bone was associated with increased dentinal stresses near the apex of the post. Conclusions. Although endodontic posts provide retention for coronal restorations, they result in dentinal stress values higher than those of crowns without posts. Posts that had a similar modulus of elasticity to dentin and smaller diameters were associated with better stress distribution. Resting coronal restorations on sound dental tissues affected stress distribution more than did the core material or the length of the coronal post extension. Clinical Implications. Many factors influence the distribution of stress within dentin and, consequently, the fracture resistance of teeth restored with post-retained crowns. Clinicians need to keep these factors in mind when performing endodontic procedures that involve placement of post-retained crowns to ensure optimal success.