Comparative Finite Element Analysis of Endocrowns and Traditional Restorations for Endodontically Treated Mandibular First Molars

BACKGROUND: This study evaluated 2 endocrown designs and traditional restoration with a conventional crown using post and core to find the best restoration design for endodontically treated mandibular first molars. MATERIAL/METHODS: Three 3D finite element models were constructed: (1) post and core restoration, (2) endocrown butt joint margin design, and (3) endocrown with shoulder finish line. The intact tooth geometry was extracted with computed tomography, then modified to the selected restoration designs. Bone and mucosa geometry was simplified and represented as 3 cylinders. Two loading cases were examined on E-max crowns as 400N and 200N vertically and 45º oblique, respectively, that were located at buccal cusp tips and central fossa by nodal force distributed on circular areas with 0.5-mm diameter in each location. RESULTS: Traditional restoration kept crown deformation and stresses at lower levels than did endocrowns. Results of the butt joint margin design were comparable to that of shoulder finish line design. Cement had the lowest stress values under shoulder finish line design, while the remaining tooth indicated the superiority of butt joint margin design, with less stresses by 20% and 24%, compared with traditional and shoulder finish line restorations, respectively. CONCLUSIONS: The 3 tested restoration designs worked well. Although the differences were small, according to stress analysis results, conventional restoration by post and core achieved the best performance, followed by butt joint margin, which ensures lowest level of stresses on dentine. Finally, the shoulder finish line endocrown can replace the other designs but with higher stress levels.