Paulo Soares - Academia.edu (original) (raw)

Papers by Paulo Soares

Journal of Prosthodontics, 2011

Purpose: This in vitro study investigated the null hypothesis that metal-free crowns induce fract... more Purpose: This in vitro study investigated the null hypothesis that metal-free crowns induce fracture loads and mechanical behavior similar to metal ceramic systems and to study the fracture pattern of ceramic crowns under compressive loads using finite element and fractography analyses. Materials and Methods: Six groups (n = 8) with crowns from different systems were compared: conventional metal ceramic (Noritake) (CMC); modified metal ceramic (Noritake) (MMC); lithium disilicate-reinforced ceramic (IPS Empress II) (EMP); leucite-reinforced ceramic (Cergogold) (CERG); leucite fluoride-apatite reinforced ceramic (IPS d.Sign) (SIGN); and polymer crowns (Targis) (TARG). Standardized crown preparations were performed on bovine roots containing NiCr metal dowels and resin cores. Crowns were fabricated using the ceramics listed, cemented with dual-cure resin cement, and submitted to compressive loads in a mechanical testing machine at a 0.5-mm/min crosshead speed. Data were submitted to one-way ANOVA and Tukey tests, and fractured specimens were visually inspected under a stereomicroscope (20×) to determine the type of fracture. Maximum principal stress (MPS) distributions were calculated using finite element analysis, and fracture origin and the correlation with the fracture type were determined using fractography. Results: Mean values of fracture resistance (N) for all groups were: CMC: 1383 ± 298 (a); MMC: 1691 ± 236 (a); EMP: 657 ± 153 (b); CERG: 546 ± 149 (bc); SIGN: 443 ± 126 (c); TARG: 749 ± 113 (b). Statistical results showed significant differences among groups (p < 0.05) represented by different lowercase letters. Metal ceramic crowns presented fracture loads significantly higher than the others. Ceramic specimens presented high incidence of fractures involving either the core or the tooth, and all fractures of polymer crown specimens involved the tooth in a catastrophic way. Based on stress and fractographic analyses it was determined that fracture occurred from the occlusal to the cervical direction. Conclusions: Within the limitations of this study, the results indicated that the use of ceramic and polymer crowns without a core reinforcement should be carefully evaluated before clinical use due to the high incidence of failure with tooth involvement. This mainly occurred for the polymer crown group, although the fracture load was higher than normal occlusal forces. High tensile stress concentrations were found around and between the occlusal loading points. Fractographic analysis indicated fracture originating from the load point and propagating from the occlusal surface toward the cervical area, which is the opposite direction of that observed in clinical situations.

Journal of Prosthodontics, 2010

To test the hypothesis that the type of cement used for fixation of cast doweland-cores might inf... more To test the hypothesis that the type of cement used for fixation of cast doweland-cores might influence fracture resistance, fracture mode, and stress distribution of single-rooted teeth restored with this class of metallic dowels. Materials and Methods: The coronal portion was removed from 40 bovine incisors, leaving a 15 mm root. After endodontic treatment and standardized root canal relief at 10 mm, specimens were embedded in polystyrene resin, and the periodontal ligament was simulated with polyether impression material. The specimens were randomly divided into four groups (n = 10), and restored with Cu-Al cast dowel-and-cores cemented with one of four options: conventional glass ionomer cement (GI); resinmodified glass ionomer cement (GR); dual-cure resin cement (RC); or zinc-phosphate cement (ZP). Sequentially, fracture resistance of the specimens was tested with a tangential load at a 135 • angle with a 0.5 mm/min crosshead speed. Data were analyzed using one-way analysis of variance (ANOVA) and the Fisher test. Two-dimensional finite element analysis (2D-FEA) was then performed with representative models of each group simulating a 100 μm cement layer. Results were analyzed based on von Mises stress distribution criteria. Results: The mean fracture resistance values were (in N): RC, 838.2 ± 135.9; GI, 772.4 ± 169.8; GR, 613.4 ± 157.5; ZP, 643.6 ± 106.7. FEA revealed that RC and GR presented lower stress values than ZP and GI. The higher stress concentration was coincident with more catastrophic failures, and consequently, with lower fracture resistance values. Conclusions: The type of cement influenced fracture resistance, failure mode, and stress distribution on teeth restored with cast dowel-and-cores.

Journal of Prosthodontics, 2009

The degree of stress generated in the endodontically treated and restored tooth can be influenced... more The degree of stress generated in the endodontically treated and restored tooth can be influenced by the composition and configuration of the dowels used for the restoration. Using two-dimensional (2D) finite element analysis (FEA), this study tested the hypothesis that the characterization of the stress distribution can be influenced by which evaluation method is employed: protrusion loading and 4-point flexural strength test or varying the type of material (carbon and glass fiber) or the external configuration of the dowel (smooth and serrated). Materials and Methods: For simulation of the protrusion load test, models were generated with Mechanical-AutoCAD V6 software from an image of an anatomical plate, one maxillary central incisor, and two dowels and exported to Ansys 9.0. The bone region model was fixed, and a tangential load of 1 N with a 135 • inclination to the tooth longitudinal axis was applied at the level of the palatal surface of the crown. In the simulation of a 4-point flexural strength test, a 1 N perpendicular load was applied in two points to the dowel. The dental materials and structures were considered elastic, isotropic, homogeneous, and linear, with the exception of the dowel, which was assumed to exhibit orthotropic behavior. Mechanical properties were defined based on a review of the literature, and the model was meshed with an eight node tetrahedral element. Results: The stress results from both tests were analyzed according to von Mises criteria and principal stresses (Sx). Data from the 4-point flexural strength test simulation showed that, for the serrated dowels, a higher stress concentration was found; however, no difference in the occlusal load for material or dowel configuration was found. Conclusions: These results suggest that although the external configuration of the dowel influences direct loading, when the dowel is integrated to the tooth and setting material, the influence on biomechanical behavior disappears.

$Research paper thumbnail of Influence of restorative technique on the biomechanical behavior of endodontically treated maxillary premolars. Part I: Fracture resistance and fracture mode$

Journal of Prosthetic Dentistry, 2008

Unresolved controversy exists concerning the preferred cavity design and restorative technique us... more Unresolved controversy exists concerning the preferred cavity design and restorative technique used to restore endodontically treated maxillary premolars to improve their resistance to fracture under occlusal load.The purpose of this study was to evaluate the fracture resistance, stress distribution, and cusp deformation of endodontically treated human maxillary premolars restored with different materials. The study is divided into 2 parts. In Part I, fracture resistance and fracture mode were determined.Seventy noncarious human maxillary premolars were selected and divided into 7 groups (n=10). The control group, ST, consisted of sound unprepared teeth. Teeth in the other 6 groups were endodontically treated and each received 1 of 2 cavity preparation designs: MODd, direct mesio-occlusal-distal preparation; MODi, indirect mesio-occlusal-distal preparation. Teeth were restored with 4 types of material: AM, MODd restored with amalgam; CR, MODd restored with composite resin; LPR, MODi restored with laboratory-processed composite resin; and LGC, MODi restored with leucite-reinforced glass ceramic. The fracture resistance (N) was assessed under compressive load in a universal testing machine. The data were analyzed by 1-way ANOVA and the Tukey HSD test (α =.05). Fracture modes were recorded based on the degree of tooth structure involvement and restoration damage.Statistical analysis showed that the ST group presented the highest fracture resistance values. The restored groups showed significantly higher fracture resistance values compared to the nonrestored groups. The groups restored with adhesive techniques (LPR, CR, and LGC) presented significantly higher fracture resistance values than the group restored with the nonadhesive technique (AM) (P<.001). The catastrophic fractures were prevalent in MODd, MODi, AM, and LPR groups, and less severe fractures were found in ST and LGC groups. For the CR group, there was no prevalent fracture mode.Teeth with the greatest amount of remaining tooth structure and those restored using adhesive technology showed higher fracture resistance values. There was great variation in the type of fracture among groups.

Clinical Oral Investigations, 2006

The aim of this study was to determine the radiodensity of base, liner and luting dental material... more The aim of this study was to determine the radiodensity of base, liner and luting dental materials and to compare them with human enamel and dentin. Four classes of materials were examined: conventional glass ionomers (CG)—Vitro Cem, Ketac Bond, Vidrion F, Vidrion C; resin-modified glass ionomers (RMGI)—Fuji II LC, Vitrebond; resinous cement (RC)—Rely-X ARC; and zinc phosphate cement (ZP)—Cimento LS. Five 2-mm-thick standard samples of each material and five 2-mm-thick enamel and dentin samples were produced. An aluminum step wedge served as control. Samples were positioned over a phosphor plate of Digora digital system, exposed to X-ray, and the radiodensity obtained in the software Digora for Windows 2.0. Data were submitted to Kruskal–Wallis and Dunnett multiple comparisons test (α=0.05). According to statistical analysis, the following sequence in degree of radiodensity could be seen among the groups: Cimento LS (ZP) > Vitro Cem (CG) = Fuji II LC (RMGI) = Rely-X ARC (RC) = Vitrebond (RMGI) > Ketac Bond (CG) > enamel = Vidrion F (CG) > Vidrion C (CG) = dentin. The presence of radiopaque fillers such as zinc, strontium, zirconium, barium, and lanthanium rather than material type seems to be the most important factor when analyzing material radiodensity. Almost all investigated materials presented an accepted radiodensity.

Journal of Esthetic and Restorative Dentistry, 2005

The clinical longevity of indirect restorations made of ceramics or indirect composite resins dep... more The clinical longevity of indirect restorations made of ceramics or indirect composite resins depends on their successful treatment and cementation. The cementation technique is determined by the type of restorative material—ceramics or indirect composite resins; thus, their intaglio surface treatment should be performed according to their particular compositions. The aim of this literature review was to define surface treatment protocols of different esthetic indirect restorative materials. A PubMed database search was conducted for in vitro studies pertaining to the most common treatment protocols of tooth-colored materials. Articles that described at least the surface treatment procedure, its effects on adhesion, its relationship with the material's composition, clinical aspects, and expected longevity were selected. The search was limited to peer-reviewed articles published in English between 1965 and 2004 in dental journals. Sandblasting, etching techniques, and silane coupling agents are the most common procedures with improved results.

Journal of Endodontics, 2008

The aim of this study was to evaluate the effect of cavity design and glass fiber posts on stress... more The aim of this study was to evaluate the effect of cavity design and glass fiber posts on stress distributions and fracture resistance of endodontically treated premolars. Fifty extracted intact mandibular premolars were divided into 5 groups (n = 10): ST, sound teeth (control); MOD, mesio-occlusal-distal preparation + endodontic treatment (ET) + composite resin restoration (CR); MODP, mesio-occlusal-distal + ET + glass fiber post + CR; MOD2/3, mesio-occlusal-distal + two thirds occlusal-cervical cusp loss + ET + CR; and MODP2/3, mesio-occlusal-distal + two thirds cusp loss + ET + glass fiber post + CR. The specimens were loaded on a cusp slope until fracture. Fracture patterns were classified according to four failure types. Stress distributions were evaluated for each group in a two-dimensional finite element analysis. The fracture resistance of the MODP, MOD2/3, and MODP2/3 groups was significantly lower than the ST and MOD groups (p < 0.05). The loss of dental structure and the presence of fiber post restoration reduced fracture resistance and created higher stress concentrations in the tooth-restoration complex. However, when there was a large loss of dental structure (MODP2/3), the post reduced the incidence of catastrophic fracture types.