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Does an Incremental Filling Technique Reduce Polymerization Shrinkage Stresses?
A. Versluis
Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, 515 Delaware Street, SE, 16-212 Moos Tower, Minneapolis, Minnesota 55455, USA
W.H. Douglas
Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, 515 Delaware Street, SE, 16-212 Moos Tower, Minneapolis, Minnesota 55455, USA
M. Cross
Centre for Numerical Modelling and Process Analysis, University of Greenwich, London, UK
R.L. Sakaguchi
Department of Biomaterials and Biomechanics, Oregon Health Sciences University, Portland, OR, USA
It is widely accepted that volumetric contraction and solidification during the polymerization process of restorative composites in combination with bonding to the hard tissue result in stress transfer and inward deformation of the cavity walls of the restored tooth. Deformation of the walls decreases the size of the cavity during the filling process. This fact has a profound influence on the assumption-raised and discussed in this paper-that an incremental filling technique reduces the stress effect of composite shrinkage on the tooth. Developing stress fields for different incremental filling techniques are simulated in a numerical analysis. The analysis shows that, in a restoration with a well-established bond to the tooth-as is generally desired-incremental filling techniques increase the deformation of the restored tooth. The increase is caused by the incremental deformation of the preparation, which effectively decreases the total amount of composite needed to fill the cavity. This leads to a higher-stressed tooth-composite structure. The study also shows that the assessment of intercuspal distance measurements as well as simplifications based on generalization of the shrinkage stress state cannot be sufficient to characterize the effect of polymerization shrinkage in a tooth-restoration complex. Incremental filling methods may need to be retained for reasons such as densification, adaptation, thoroughness of cure, and bond formation. However, it is very difficult to prove that incrementalization needs to be retained because of the abatement of shrinkage effects.
Key Words: shrinkage • incremental filling • resin composites • stress • finite element analysis
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Journal of Dental Research, Vol. 75, No. 3,
871-878 (1996)
DOI: 10.1177/00220345960750030301
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