Dentina cariada como substrato para restaurações adesivas – uma análise por elementos finitos

Abstract

The aim of this study was to analyze, using finite element method (FEM), stresses generated in composite restorations on different dentin substrates: infected carious dentin, affected carious dentin and sound dentin. Three-dimensional model composed by a mandibular left first molar, showing a cavitated carious lesions in dentin on the occlusal surface was developed by the scanner Roland MDX-20 3D Milling, Dr. Picza® 3 and Rhinoceros 5.0 softwares and finite element analysis was obtained by NeiNastran® 10.0.3.7 software. The experiment included four distinct situations: Case 1) Cavitated carious lesion in enamel/dentin, not restored (infected dentin thickness: 1.25 mm; affected dentin: 0.75mm); Case 2) Composite restoration (2.0mm) performed on infected and affected carious dentin (infected dentin: 0.75mm; affected dentin: 0.75mm); Case 3) Composite restoration (2.0mm) held on affected carious dentin (affected dentin: 0.75mm); Case 4) Resin restoration (2.0mm) performed on sound dentin. In all simulations enamel thickness was 1.5 mm, and in all restored cases, a thickness of 0.5mm of affected and infected carious dentin was removed from dentinoenamel junction. The affected dentin Poisson's ratio was tested in: hypothesis 1 in 0.45, and assumed a value of 0.25 in hypothesis 2. The total load on models was 100 N, by applying four force points distributed over the adhesive restoration. Results were interpreted based on a color map and maximum tensile stresses obtained were compared using non-parametric analysis (Kruskal-Wallis test, followed by Dunn's test, and Mann-Whitney test). In all simulations, the regions of restoration that focused greater tensile stresses were the area next to dentinoenamel junction and the floor/base restoration. When infected dentin was maintained as substrate, the build-up of stresses in these restoration regions was significantly higher. Maintaining only affected carious dentin did not significantly alter stresses generated in restoration when compared to sound dentin (p> 0.05). The result of this biomechanical analysis strengthens the favorable evidence to the maintenance of affected carious dentin under restorations.