Impact of treatment modalities on stress distribution in maxillary incisors with varying levels of external cervical resorption: a finite element analysis

Abstract

Background: The aim of this study was to evaluate the impact of various treatment modalities on the mechanical behaviour of a simulated maxillary central incisor with external cervical resorption (ECR) at different progression levels using finite element analysis (FEA). Methods: A three-dimensional (3D) model of a maxillary central incisor and surrounding tissues was created. The model was modified to include vestibular or palatal ECR defects of varying heights and circumferential angles. The root canal and the resorption defect were restored using gutta-percha and various repair materials. The models underwent simulated oblique loading of 100 N on the palatal surface. Von Mises stresses within the dentin were evaluated through FEA. Results: The mean maximum stress for models with vestibular ECR defects was greater than that for palatinal defects. Complete filling of both the root canal and defect with BioAggregate resulted in the lowest average dentin stresses (5.79 ± 0.11 MPa), while filling the root canal with gutta-percha and the ECR cavity with glass ionomer cement resulted in the highest (6.19 ± 0.05 MPa). Conclusions: From a mechanical standpoint, filling the root canal with gutta-percha and repairing the resorption defect with Biodentine is the appropriate management option when ECR occurs on the vestibular surface.