Mechanical interactions of cuspal-coverage designs and cement thickness in a cusp-replacing ceramic premolar restoration: a finite element study

The aim of this study was to investigate the biomechanical interactions between cuspal preparation designs and cement thickness in a cusp-replacing ceramic premolar restoration. The cavity was designed in a typical MODP (mesial-occlusal-distal- palatal) restoration failure shape when the palatal cusp has been lost. Twelve 3D finite element (FE) models with four cavity preparations (without coverage and with buccal cuspal coverage in 1.0, 1.5 and 2.0 mm reducing in cuspal height) and three cement thicknesses (50, 100 and 150 μm) were constructed to perform the simulations. The results indicated that enamel and cement stresses in designs with no buccal cusp replacement or a 1.0 mm thick buccal cusp replacement were higher than the designs with 1.5 and 2.0 mm thick replacement. No apparent differences were found in the dentin, enamel, and cement stresses based on cement thicknesses of 50, 100, or 150 μm. This study concluded that when cusp replacement is indicated, reduction of the buccal cusp by 1.5 mm at least could reduce stress.