journal of prosthodontic research 63 (2019) 227–231

Contents lists available at ScienceDirect

Journal of Prosthodontic Research

journal homepage: www.elsevier.com/locate/jpor

Original article

Influence of elastic modulus mismatch between dentin and

post-and-core on sequential bonding failure
Daisuke Teshigawara* , Teruo Ino, Hidetoshi Otsuka, Tomonori Isogai, Masanori Fujisawa
Division of Fixed Prosthodontics, Department of Restorative & Biomaterials Sciences, Meikai University School of Dentistry, Sakado, Japan

A R T I C L E I N F O A B S T R A C T

Article history: Purpose: Clinical failures of teeth restored with post-and-core are critical issues for the survival of teeth
Received 22 November 2016 and maintenance of oral functions. A tooth with post-and-core restoration is a complex structure.
Received in revised form 19 September 2018 Cement adhesion is believed to be the weakest component, and breakage in this component leads to
Accepted 5 December 2018
changes in stress distribution in the complex structure. The tested hypothesis was that cement breaking
Available online 14 January 2019
processes of prosthetic treated teeth were affected by elastic properties of post-and-cores.
Methods: Finite element analysis focused on sequential adhesion failure between the dentin and cement;
Keywords:
the penalty function method was used to analyze stress during each stage of bonding conditions. Failure
Endodontically treated tooth
Finite element analysis (FEA)
patterns of adhesion and stress distribution within dentin under load of different materials of post-and-
Penalty function method core was observed.
Root fracture Results: Although, an initial failure of cement was observed at the palatal crown margin regardless of the
Post materials material. Different patterns of adhesion failure between dentin and post-and-cores were observed by
different elastic properties of post-and-cores. Stress concentration was observed at the corresponding
areas of interface between adhesion failure and continued elements using both post-and-cores.
Conclusions: Using failure criteria for cement adhesion, sequential changes of adhesion failure between
dentin and post-and-cores were observed. Local stress concentrations leading to severe destruction of
dentin were caused by not only materials of post-and-cores but their adhesive conditions to dentin.
Nonlinear finite element analysis (FEA) using complex structure model which deals with alterations of
interfacial condition between components could provide the simulation for the clinical failure of teeth
restored with post-and-cores.
© 2018 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

1. Introduction
Post-and-core is used to restore an endodontically treated tooth
with insufficient coronal structure. Occasionally, clinical compli-
cations such as post debonding and root fractures have been
observed [1,2], and their management is essential for good
prognoses of teeth and maintenance of oral function. Several
studies have reported on various methods of proper preparation of
residual teeth, post design, and use of materials to avoid these
complications [3]. Finite element analysis (FEA) enables analysis of
results without variance, which were observed on numerical
examination, using extracted teeth or standardized models [4].
However, the outcome is also dependent on the processing
method, material properties and interface conditions [5].
* Corresponding author at: Division of Fixed Prosthodontics, Department of
Restorative & Biomaterials Sciences, Meikai University School of Dentistry, 1-1
Keyakidai, Sakado, Saitama 350-0283, Japan.
E-mail address: teshigawarad@dent.meikai.ac.jp (D. Teshigawara).
Versluis et al. in their FEA method took into account the brittle
character of the dentin, i.e., strong in compression but weak in
tension, and the failure criteria of adhesive agents. They succeeded
in formulating a computational behavior corresponding to an
experimental one, which is the cohesive failure of the dentin on
shear-bond strength test [6].
Peters et al. reported that different stress distribution was
observed with varying interface conditions, a perfect bond, and a
friction-fit bond between a tooth and a post-and-core. They also
reported that the interface modeling is the most important
parameter [7].
A post-and-core restoration is a complex structure comprising
the tooth, a post-and-core, and cement. A complex structure
usually tends to break at the weakest component, which in this
case is believed to be the cement adhesion to dentin [8]. Breakage
in this component leads to changes in stress distribution in the
complex structure. Elastic properties of post-and-cores affect their
deflection and stress transmission under load [9]. Cement breaking
processes and stress distribution of prosthetically treated teeth
might be affected by different post-and-cores [10].

https://doi.org/10.1016/j.jpor.2018.12.003
1883-1958/ © 2018 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.
228 D. Teshigawara et al. / journal of prosthodontic research 63 (2019) 227–231
Fig. 1. A three dimensional model. Size (mm) of each part of the model is shown on
the left. Loading condition is shown in the right. Loading point is on the incisal edge
at 45 palatal to the long axis of the model (the arrow). The basal and the lateral
planes of the alveolar bone were restricted to the XYZ-axis direction (surrounded by
the yellow). The median sagittal plane of the model was restricted to the X-axis
direction (surrounded by the red).
Process of adhesion breaking between dentin and cement
under load is unexplained. In our study, therefore, the FEA focused
on adhesion failure between the dentin and cement; the “penalty
function method” was used to observe failure patterns of adhesion
and stress distribution within dentin under load with different
materials of post-and-core. The tested hypothesis was that cement
breaking processes of prosthetic treated teeth were affected by
elastic properties of post-and-cores.
2. Materials and methods
A three-dimensional FEA model of maxillary central incisor
with its surrounding tissues was built (Fig. 1).
To simulate an endodontically-treated tooth, the coronal dentin
was removed at the level of the cervix, and a post-and-core and
porcelain fused to metal crown were set using luting cement. The
tooth preparation included a bevel on the palatal margin, assuming
a slip joint with a height of 0.5 mm, and a shoulder on the labial
margin. An angle of the palatal bevel was 45 to the long axis of the
model. The space for luting cement had a uniform thickness of
100 mm [11]. The post diameter was 1.5 mm at a level of the root
canal orifice. The post length was 8.5 mm and 0.8 for ratio to the
root canal length.
The model was divided into 4517 sections with eight-node
hexahedral elements.
All materials were assumed to be elastic, homogeneous and
isotropic. Elastic properties of materials were used from the
previous report [11] (Table 1).
The nodes on the bottom surface of the model were restricted to
the XYZ-axis direction along the lateral plane, and those on the
median sagittal plane of the tooth were restricted to the X-axis
direction (Fig. 2).
The load was applied on the incisal edge at 45 palatal to the
long axis of the model (Fig. 2).
In order to observe a dramatic change of stress distribution
according to interfacial condition between dentin and cement, the
model was sectioned into two components at the interface
between the luting cement and dentin. One of the components
included the alveolar bone, periodontal ligament, dentin, and
gutta-percha, while the other included the post-and-core,
porcelain-fused metal crown, and luting cement (Fig. 3).
Elements in the same component were perfectly bonded. The
nodes at the interface between the components were on the same
coordinate for both the dentin and cement elements. They
connected each other to simulate the cement-bonding to dentin.
An algorithm of connector condition between the cement and
dentin under load is shown in Fig. 4.
The failure criteria used were 20 MPa and 35 MPa for tensile and
shear strengths, respectively. When four connectors of an interface
between dentin and cement elements were broken, the cement
elements, including their nodes, were painted red as debonded
elements (Fig. 3).
Loading condition was not linear in this study. First, the load
causing initial breakage of the connector was calculated. Thereaf-
ter, stress calculations under the load were repeated until
connector breakages were stopped. When connector breakages
were stopped, loading magnitude was increased until is caused
another connector breakage. This procedure was repeated with
sequential increase in load up to 200 N.
Cumulative stress of maximum principal stress, i.e., the first
principal stress, was calculated under each loading magnitude and
connector condition. Stress calculation of perfect bonding condi-
tion without adhesion failure criteria was considered as the
control.
A work station (Express5800, NEC Corp., Tokyo) was used for
the calculation of analysis, and a soft-ware (KSWAD, Kubota,
Osaka) was used for the image analysis.
3. Results
The processes of adhesion failure are shown in Fig. 5. When a
metal post-and-core was used, the failure initially occurred at the
palatal margin of the crown and extended along the interface of the
crown and/or the core toward the labial side (A). Thereafter,
failures at the palato-coronal post area and at the labial post apex
area were observed (B). Finally, failures at labial cervix and middle
area of post were observed (C). The resin post-and-cores showed
the same initial failure as that of metal post-and-cores (D). Before
initial failure of the post apex area occurred, the failure area on the
surface of the crown and/or core was seen to reach the labial cervix
(E). The adhesion of post failed from a coronal to apical direction,
except in the labial post apex area. Finally, the failure area was
larger than that of metal post-and-cores (F).
Contour figures of maximum principal stress distribution
within dentin were shown in Fig. 6. In the case of perfect bond
condition, the stress was concentrated on the palatal root surface,
regardless of the materials of post-and-core. The highest stress
value with metal post-and-cores was 206 MPa and with resin
post-and-cores was 231 MPa. Once adhesion failure of the nodes
occurred, the increasing stress values of the load were concentrat-
ed in different areas: labial orifice, labial cervix, and palatal root
surfaces in resin post-and-cores, and the post apex, proximal
orifice, labial cervix, and palatal root surface in metal post-and-
cores. The highest values were 270 MPa at post apex area with
metal post-and-cores and 642 MPa at labial cervix with resin
post-and-cores. These stresses were all tensile components of
maximum principal stress. The compressive components were
distributed on the palatal cervix and labial root surface, regardless
of the material of post-and-core.
4. Discussion
Changes in stress distribution within the dentin, related to
cement adhesion failure under load, are thought to influence
clinical complications, e.g., post debonding and rootfractures [1,2].
Although the interface condition between dentin and post-and-
core is thought to be changed by sequential cement breakage
under loading, the behavior of cement breakage and stress
distributions within dentin were unclear.
Previous studies using FEA of post-and-core treated teeth
considered only two extreme conditions; perfect bond or no bond,
in the interface condition. The prediction of the failure risk of a
tooth-restoration complex may be valid considering in relation to
 D. Teshigawara et al. / journal of prosthodontic research 63 (2019) 227–231 229

Table 1. Elastic properties of materials in the FEA model. In this study, a FEA program utilizing the penalty function
Material Young’s modulus Poisson’s ratio method was applied for evaluating dynamic changes of the
(Mpa) interface condition. A pair of nodes between the prosthetic
Porcelain 69,000.00 0.28
component and organic component of the FEA model was
Metal (gold alloy) 95,000.00 0.33 connected under assumed conditions of the bonding interface.
Luting cement 9500.00 0.3 The load direction is vertical to the plane of the palatal margin,
Dentin 18,600.00 0.31 which was the initiation site of adhesion failure. Adhesion between
Cortical bone 13,700.00 0.9
the nodes of dentin and cement persisted when compressive stress
Sponge bone 1370.00 0.9
Periodontal 6.90 0.45 was applied in this study. However, failure still occurred. This
ligament result indicates that the direction of load applied to the incisal edge
Gutta-percha 0.69 0.45 changed during the course of stress transmission. It is believed that
Post-and-core (Metal) 95,000.00 0.33
the adhesion failure is affected by load point [12], load value [13]
(Composite 16,600.00 0.24
resin)
and direction [14].
Higher stress values were observed at the labial cervix and
orifice upon using resin post-and-cores. Stress concentrations
were observed at the area corresponding to intact and broken
cement interface. Less stiffness core materials cause local stress
concentration within dentin due to their flexibility [9]. It is
believed that using a material with a higher modulus of
elasticity for core construction can reduce the deflection of
the core under load, thus reducing the adhesion failure of
cement around it. Because the actual strength theoretically
increases proportionately to the bonding area, a root canal
preparation for post diameter to minimize a bonding area
corresponding to the core–dentin interface and to ensure
palate-labial thickness of the dentin may reduce the stress
concentration and improve the fracture resistance of dentin
when using resin post-and-cores.
The maximum principal stress concentrated at areas corre-
sponding to the post–dentin interface was usually in a direction
Fig. 2. Restrictions of the FEA model and loading condition. Red area was
restricted to the XYZ-axis directions and yellow area was restricted to the X-axis perpendicular to the arrangement of the dentinal tubules. In
direction. Loading direction and terminologies indicating area and directions of addition to the above, local stress concentration associated with
the FEA model was shown in right figure. adhesion failure leads to micro cracks in the dentin [6,15]. In this
study, the stress concentration may lead to root fracture, and the
cracks may form in the corresponding areas, i.e., vertical root
fracture in the case of metal post-and-cores, and horizontal cervix
fracture in the case of resin post-and-cores.
In this study, a fixed bonding strength was set for each
connector of the nodes on the dentin and cement. However, the
actual bonding strength is not constant and differs depending on
the conditions of the dentin, such as degree of decalcification [16]
and/or residual impurities [17,18], and/or the materials used.
Moreover bonding strength might be differ from materials of
post-and-cores. In order to clarify the effect of different material
properties, we used same bonding strength for different
post-and-cores. We set bonding strength to connectors between
nodes. Because the size of bonding interface was zero, it is hard to
Fig. 3. Color coded FEA model by components and schema of cement–dentin
refer measured values from previous studies. We modified values
interface. Components were divided at the interface between luting cement and
dentin. They were connected through nodes at the interface between dentin and
referring previous report used the same FEA model [11] and
cement elements. preliminary experiment.
Variable bond strength may be saliently observed within root
canals, and an interface with weak adhesion may be a source of
cracks. Those factors should be determined in the future.
the propagation of the interfacial failure, which cannot be Since fracture pattern is affected by the bonding strength of the
simulated by a linear static analysis [5]. interface, it is understood that numerical modeling tests and
Penalty function method is a non-linear FEA method that clinical findings showed no significant difference in fracture
considers the contact condition between the materials. It is used patterns with posts of different materials [4,19].
for structural analysis of complex structures comprising compo- A single root canal with a metal post-and-core can displace
nents with different material properties. Changes of contact rotatory movements within the dentin under load. In such cases,
conditions are simulated by arithmetic criteria. In this analysis, stresses related to adhesion failure were concentrated mainly at
Adhesion failure was simulated by changes of adhesion condition the post apex and proximal orifice. Moreover, major displacing
and stress transmission condition between dentin and cement force elements were seen to act in alternate directions. Thus, the
interface. We used a FEA using solid element model and the resulting fracture pattern is in a vertical direction. Ensuring
penalty-function method to simulate the breakage of cement sufficient mesio-distal thickness of dentin in the area would
bonding the dentin. improve fracture resistance in metal post-and-cores.
230 D. Teshigawara et al. / journal of prosthodontic research 63 (2019) 227–231
Fig. 4. Failure criteria of node connectors between luting cement and dentin. The
connection stayed intact against the compressive stress applied but broke when the
tensile stress or the shearing stress exceeded the failure criterion. After the
breakage, only compressive stress was exerted on the connectors.
Fig. 5. Process of adhesion failure between luting cement and dentin. Time course
processes before and after adhesion failure at post apex area are shown ((A,D) initial
condition before adhesion failure at post apex area, (B,E) condition when adhesion
failure at post apex area occurred, (C,F) final condition at 200 N load). Red elements
indicate the area of interference breaking of the cement.
Fig. 6. Maximum principal stress distribution within dentin. Arrows indicate an
element with the highest values in each condition.
For the FEA method, we set pairs of nodes, which were on the
same coordinate to different elements of the dentin and cement, as
connectors. Elements of hexahedron were manually created to
form the first three-dimensional solid element in this
FEA program.
Consequently, the study was performed using large meshes.
Materials were treated as isotropic and linear elastic solids. It has
been reported that dentin is an anisotropic [20] or non-
homogeneous [21] material and possesses higher compressive
strength than tensile strength [6,15,21]; hence, those properties
should be considered in the future.
The results were interpreted not quantitatively, but qualita-
tively. Because sequential changes of stress distribution within
internal dentin were analyzed, FEA, with the penalty function
method utilizing pairs of nodes as the adhesion component, is
effective in understanding the process of clinical failures.
An adhesion failure affects stress distributions within the
dentin and the failure patterns were different according to
materials of post-and-cores. Although different clinical failure
patterns associated with different materials of post-and-cores
have been reported [22,23], the results of this study may resolve
the contradiction that material differences of post-and-cores
slightly affects the behavior of a tooth restored with post-and-
cores under load in previous FEA reports [23–25].
5. Conclusion
An FEA of a single root canal with a metal post-and-core was
undertaken. The penalty function method detected sequential
changes in stress within the dentin under load.
Using the failure criteria of adhesion between dentin and
cement, the method in this study could reveal sequential changes
of the interfacial condition, which were affected by elastic
properties of post-and-cores.
Local stress concentrations leading to severe destruction of
dentin were caused by not only materials of post-and-cores but
their adhesive conditions to dentin.
Nonlinear FEA using complex structure model which deals with
alterations of interfacial condition between components could
provide the simulation for the clinical failure of teeth restored with
post-and-cores.
References
[1] Hikasa T, Matsuka Y, Mine A, Minakuchi H, Hara ES, Van Meerbeek B, et al. A 15-
year clinical comparative study of the cumulative survival rate of cast metal
core and resin core restorations luted with adhesive resin cement. Int J
Prosthodont 2010;23:397–405.
[2] Ploumaki A, Bilkhair A, Tuna T, Stampf S, Strub JP. Success rates of prosthetic
restoration on endodontically treated teeth; a systematic review after 6 years. J
Oral Rehabil 2013;40:618–30.
[3] Qing H, Zhu Z, Chao Y, Zhang W. In vitro evaluation of the fracture resistance of
anterior endodontically treated teeth restored with glass fiber and zircon
posts. J Prosthet Dent 2007;97:93–8.
[4] Sirimai S, Riis DN, Morgano SM. An in vitro study of the fracture resistance and
the incidence ofvertical root fracture of pulpless teeth restored with six post-
and-coresystems. J Prosthet Dent 1999;81:262–9.
[5] Wakabayashi N, Ona M, Suzuki T, Igarashi Y. Nonlinear finite element analyses:
advances and challenges in dental applications. J Dent 2008;36:463–71.
[6] Versluis A, Tantbirojin D, Douglas WH. Why do shear bond tests pull out
dentin? J Dent Res 1997;76:1298–307.
[7] Peters MC, Poort HW, Farah JW, Craig RG. Stress analysis of a tooth restored
with a post and core. J Dent Res 1983;62:760–3.
[8] Libman WJ, Nicholls JI. Load fatigue of teeth restored with cast posts and cores
and complete crowns. Int J Prosthodont 1995;8:155–61.
[9] Pegoretti A, Fambri L, Zappini G, Bianchetti M. Finite element analysis of a glass
fibre reinforced composite endodontic post. Biomaterials 2002;23:2667–82.
[10] Ona M, Wakabayashi N, Yamazaki T, Takaichi A, Igarashi Y. The influence of
elastic modulus mismatch between tooth and post and core restorations on
root fracture. Int Endod J 2013;46:47–52.
 D. Teshigawara et al. / journal of prosthodontic research 63 (2019) 227–231
[11] Okamoto K, Ino T, Iwase N, Shimizu E, Suzuki M, Satoh G, et al. Three-
dimensional finite element analysis of stress distribution in composite resin
cores with fiber posts of varying diameters. Dent Mater J 2008;27:49–55.
[12] Okuma M, Nakajima M, Hosaka K, Itoh S, Ikeda M, Foxton RM, et al. Effect of
composite post placement on bonding to root canal dentin using 1-step self-
etch dual-cure adhesive with chemical activation mode. Dent Mater J
2010;29:642–8.
[13] Stankiewicz NR, Wilson PR. The ferrule effect: a literature review. Int Endod J
2002;35:575–81.
[14] Korioth TW, Waldron TW, Versluis A, Schulte JK. Forces and moments
generated at the dental incisors during forceful biting in humans. J Biomech
1997;30:631–3.
[15] Rasmussen ST, Patchin RE, Scott DB, Heuer AH. Fracture properties of human
enamel and dentin. J Dent Res 1976;55:154–64.
[16] Johnson JK, Schwartz NL, Blackwell RT. Evaluation and restoration of
endodontically treated posterior teeth. J Am Dent Assoc 1976;93:597–605.
[17] Kishen A. Mechanisms and risk factors for fracture predilection in
endodontically treated teeth. Endod Top 2006;13:57–83.
[18] Perdigão J. Dentin bonding-variables related to the clinical situation and the
substrate treatment. Dent Mater 2010;26:e24–37.
231
[19] Figueiredo FE, Martins-Filho PR, Faria-E-Silva AL. Do metal post-retained
restorations result in more root fractures than fiber post-retained restora-
tions? A systematic review and meta-analysis. J Endod 2015;41:309–16.
[20] Kinney JH, Marshall SJ, Marshall GW. The mechanical properties of human
dentin: a critical review and re-evaluation of the dental literature. Crit Rev Oral
Biol Med 2003;14:13–29.
[21] Grandini S, Goracci C, Tay FR, Grandini R, Ferrari M. Clinical evaluation of the
use of fiber posts and direct resin restorations for endodontically treated teeth.
Int J Prosthodont 2005;18:399–404.
[22] Cormier CJ, Burns DR, Moon P. In vitro comparison of the fracture resistance
and failure mode of fiber, ceramic, and conventional post systems at various
stages of restoration. J Prosthodont 2001;10:26–36.
[23] Eraslan O, Aykent F, Yücel MT, Akman S. The finite element analysis of the
effect of ferrule height on stress distribution at post-and-core-restored all-
ceramic anterior crowns. Clin Oral Investig 2009;13:223–7.
[24] de Castro Albuquerque R, Polleto LT, Fontana RH, Cimini CA. Stress analysis of
an upper central incisor restored with different posts. J Oral Rehabil
2003;30:936–43.
[25] Lanza A, Aversa R, Rengo S, Apicella D, Apicella A. 3D FEA of cemented steel,
glass and carbon posts in a maxillary incisor. Dent Mater 2005;21:709–15.