Role of multiple cusps in tooth fracture

The biomechanics of tooth strength: testing the utility of simple models for predicting fracture in geometrically complex teeth

Teeth must fracture foods while avoiding being fractured themselves. This study evaluated dome biomechanical models used to describe tooth strength. Finite-element analysis (FEA) tested whether the predictions of the dome models applied to the complex geometry of an actual tooth. A finite-element model was built from microCT scans of a human M3. The FEA included three loading regimes simulating contact between (i) a hard object and a single cusp tip, (ii) a hard object and all major cusp tips and (iii) a soft object and the entire occlusal basin. Our results corroborate the dome models with respect to the distribution and orientation of tensile stresses, but document heterogeneity of stress orientation across the lateral enamel. This implies that high stresses might not cause fractures to fully propagate between cusp tip and cervix under certain loading conditions. The crown is most at risk of failing during hard object biting on a single cusp. Geometrically simple biomechanical models are valuable tools for understanding tooth function but do not fully capture aspects of biomechanical performance in actual teeth whose complex geometries may reflect adaptations for strength.

Study on fracture behavior of molars based on three-dimensional high-precision computerized tomography scanning and numerical simulation

A series of three-dimensional (3D) numerical simulations are conducted to investigate the gradual failure process of molars in this study. The real morphology and internal mesoscopic structure of a whole tooth are implemented into the numerical simulations through computerized tomography scanning, digital image processing, and 3D matrix mapping. The failure process of the whole tooth subject to compressions including crack initiation, crack propagation, and final failure pattern is reproduced using 3D realistic failure process analysis (RFPA3D) method. It is concluded that a series of microcracks are gradually initiated, nucleated, and subsequently interconnect to form macroscopic cracks when the teeth are under over-compressions. The propagation of the macroscopic cracks results in the formation of fracture surfaces and penetrating cracks, which are essential signs and manifestations of the tooth failure. Moreover, the simulations reveal that, the material heterogeneity is a critical factor that affects the mechanical properties and fracture modes of the teeth, which vary from crown fractures to crown-root fractures and root fractures depending on different homogeneity indices.

Mechanical failure of posterior teeth due to caries and occlusal wear- A modelling study

OBJECTIVES

The purpose of the present work is to explore the effect of occlusal wear and different types and degrees of caries on the mechanical performance and structural integrity of posterior teeth.

METHODS

Three-dimensional (3D) computational models with different combinations of caries parameters (caries location, caries size and caries induced pulp shrinkage) and occlusal wear factors (enamel thickness, marginal ridge height and cuspal slope) were developed and analyzed using the extended finite element method (XFEM) to identify the stress distribution, crack initiation load and ultimate fracture load values. The effect of a non-drilling conservative treatment using resin infiltration on the recovery of mechanical properties of carious molar teeth was also investigated.

RESULTS

Presence of fissural caries, worn proximal marginal ridge and decreased enamel thickness due to occlusal wear, imparted a significant negative effect on the crack initiation load value of the lower molar models. Accordingly, models with intact and strong proximal marginal ridge, generally exhibited higher crack initiation loading, regardless of caries size and location. Presence of fissure caries drastically decreased (55%-70%) the crack initiation load compared to sound teeth. The depth of the fissural lesion and the presence of proximal caries did not have a major effect on crack initiation load values. However, increasing the caries size resulted in lower final fracture load values in most of the cases. Accordingly, the groups with combined and connected large fissural and proximal lesions experienced the largest drop in the fracture load values compared to sound tooth models. The worst condition consisted of two connected large proximal and fissural caries with no proximal marginal ridge, in which the fracture load dramatically decreased to only 25% of that for sound teeth with intact marginal ridge. On the other hand, decreased cuspal slope due to occlusal wear and shrinkage of the pulp due to caries appeared to have a protective role and a direct relation with the fracture resistance of the tooth. Following the application of resin infiltration on the carious models, the crack initiation load and the fracture load could recover up to 75% and 90% of the values for the corresponding sound tooth models, respectively.

SIGNIFICANCE

Presence of fissural caries, if not treated (either with remineralization, resin infiltration or restoration), can be a major risk factor in the initiation of tooth fracture. When combined with decreased enamel thickness and loss of proximal marginal ridge due to mechanical or chemical wear, the weakening effect of the caries will be amplified specially in teeth with steep cuspal slopes. The application of a conservative treatment with resin infiltration can be an effective approach in prevention of further mechanical failure of demineralized enamel. The findings of this study emphasize the importance of early interventions in the management of caries for the prevention of future cuspal or tooth fracture especially in subjects with higher risk factors for tooth fracture such as caries, wear and bruxism.

Fundamental mechanics of tooth fracture and wear: implications for humans and other primates

Until recently, there had been little attempt in the literature to identify and quantify the underlying mechanics of tooth durability in terms of materials engineering concepts. In humans and most mammals, teeth must endure a lifetime of sustained occlusal mastication-they have to resist fracture and wear. It is well documented that teeth are resilient, but what are the unique features that make this possible? The present article surveys recent materials engineering research aimed at addressing this fundamental question. Elements that determine the mechanics and micromechanics of tooth fracture and wear are analysed: at the macrostructural level, the geometry of the enamel shell and cuspal configuration; and at the microstructural level, interfacial weakness and property gradients. Inferences concerning dietary history in relation to evolutionary pressures are discussed.

Shape-preserving erosion controlled by the graded microarchitecture of shark tooth enameloid

The teeth of all vertebrates predominantly comprise the same materials, but their lifespans vary widely: in stark contrast to mammals, shark teeth are functional only for weeks, rather than decades, making lifelong durability largely irrelevant. However, their diets are diverse and often mechanically demanding, and as such, their teeth should maintain a functional morphology, even in the face of extremely high and potentially damaging contact stresses. Here, we reconcile the dilemma between the need for an operative tooth geometry and the unavoidable damage inherent to feeding on hard foods, demonstrating that the tooth cusps of Port Jackson sharks, hard-shelled prey specialists, possess unusual microarchitecture that controls tooth erosion in a way that maintains functional cusp shape. The graded architecture in the enameloid provokes a location-specific damage response, combining chipping of outer enameloid and smooth wear of inner enameloid to preserve an efficient shape for grasping hard prey. Our discovery provides experimental support for the dominant theory that multi-layered tooth enameloid facilitated evolutionary diversification of shark ecologies.

Shark teeth have short lifespans yet can be subject to significant mechanical damage. Here, the authors report on a site-specific damage mechanism in shark teeth enameloid, which maintains tooth functional shape, providing experimental evidence that tooth architecture may have influenced the diversification of shark ecologies over evolution.

On the evolutionary advantage of multi-cusped teeth

A hallmark of mammalian evolution is a progressive complexity in postcanine tooth morphology. However, the driving force for this complexity remains unclear: whether to expand the versatility in diet source, or to bolster tooth structural integrity. In this study, we take a quantitative approach to this question by examining the roles of number, position and height of multiple cusps in determining sustainable bite forces. Our approach is to use an extended finite-element methodology with due provision for step-by-step growth of an embedded crack to determine how fracture progresses with increasing occlusal load. We argue that multi-cusp postcanine teeth are well configured to withstand high bite forces provided that multiple cusps are contacted simultaneously to share the load. However, contact on a single near-wall cusp diminishes the strength. Location of the load points and cusp height, rather than cusp number or radius, are principal governing factors. Given these findings, we conclude that while complex tooth structures can enhance durability, increases in cusp number are more likely to be driven by the demands of food manipulation. Structural integrity of complex teeth is maintained when individual cusps remain sufficiently distant from the side walls and do not become excessively tall relative to tooth width.

Fracture-resistant monolithic dental crowns

OBJECTIVE

To quantify the splitting resistance of monolithic zirconia, lithium disilicate and nanoparticle-composite dental crowns.

METHODS

Fracture experiments were conducted on anatomically-correct monolithic crown structures cemented to standard dental composite dies, by axial loading of a hard sphere placed between the cusps. The structures were observed in situ during fracture testing, and critical loads to split the structures were measured. Extended finite element modeling (XFEM), with provision for step-by-step extension of embedded cracks, was employed to simulate full failure evolution.

RESULTS

Experimental measurements and XFEM predictions were self-consistent within data scatter. In conjunction with a fracture mechanics equation for critical splitting load, the data were used to predict load-sustaining capacity for crowns on actual dentin substrates and for loading with a sphere of different size. Stages of crack propagation within the crown and support substrate were quantified. Zirconia crowns showed the highest fracture loads, lithium disilicate intermediate, and dental nanocomposite lowest. Dental nanocomposite crowns have comparable fracture resistance to natural enamel.

SIGNIFICANCE

The results confirm that monolithic crowns are able to sustain high bite forces. The analysis indicates what material and geometrical properties are important in optimizing crown performance and longevity.

Mechanics analysis of molar tooth splitting

A model for the splitting of teeth from wedge loading of molar cusps from a round indenting object is presented. The model is developed in two parts: first, a simple 2D fracture mechanics configuration with the wedged tooth simulated by a compact tension specimen; second, a full 3D numerical analysis using extended finite element modeling (XFEM) with an embedded crack. The result is an explicit equation for splitting load in terms of indenter radius and key tooth dimensions. Fracture experiments on extracted human molars loaded axially with metal spheres are used to quantify the splitting forces and thence to validate the model. The XFEM calculations enable the complex crack propagation, initially in the enamel coat and subsequently in the interior dentin, to be followed incrementally with increasing load. The fracture evolution is shown to be stable prior to failure, so that dentin toughness, not strength, is the controlling material parameter. Critical conditions under which tooth splitting in biological and dental settings are likely to be met, however rare, are considered.

The wear and tear of teeth

A review is presented of the mechanical damage suffered by tooth crowns. This has been the subject of much recent research, resulting in a need to revise some of the thinking about the mechanisms involved. Damage is classified here by scale into macro-, meso- and microfracture. The focus is on the outer enamel coat because this is the contact tissue and where most fractures start. Enamel properties appear to be tailored to maximize hardness, but also to prevent fracture. The latter is achieved by the deployment of developmental flaws called enamel tufts. Macrofractures usually appear to initiate as extensions of tufts on the undersurface of the enamel adjacent to the enamel-dentine junction and extend from there into the enamel. Cracks that pass from the tooth surface tend to be deflected by an enamel region of high toughness; if they find the surface again, a chip (mesofracture) is produced. The real protection of the enamel-dentine junction here is the layer of decussating inner enamel. Finally, a novel analysis of mechanical wear (microfracture) suggests that the local toughness of the enamel is very important to its ability to resist tissue loss. Enamel and dentine have contrasting behaviours. Seen on a large scale, dentine is isotropic (behaving similarly in all directions) while enamel is anisotropic, but vice versa on a very small scale. These patterns have implications for anyone studying the fracture behaviour of teeth.