doi:10.1111/j.1365-2591.2010.01739.

Effect of anti-rotation devices on biomechanical

behaviour of teeth restored with cast post-andcores

L. H. A. Raposo1, G. R. Silva1, P. C. F. Santos-Filho1, P. V. Soares1, P. B. F. Soares1, P. C.

Simamoto-Junior2, A. J. Fernandes-Neto3 & C. J. Soares1
1

Department of Operative Dentistry and Dental Materials, Biomechanics Group, Federal University of Uberlandia, Minas Gerais,
Brazil; 2Healthy Technical School, Federal University of Uberlandia, Minas Gerais, Brazil; and 3Department of Fixed Prosthodontics
and Dental Materials, Biomechanics Group, School of Dentistry, Federal University of Uberlandia, Minas Gerais, Brazil

Abstract
Raposo LHA, Silva GR, Santos-Filho PCF, Soares PV,
Soares PBF, Simamoto-Junior PC, Fernandes-Neto AJ,
Soares CJ. Effect of anti-rotation devices on biomechanical
behaviour of teeth restored with cast post-and-cores. International Endodontic Journal, 43, 681691, 2010.

Aim To test the hypothesis that the presence of an

anti-rotation device (ARD) and its location can influence the biomechanical behaviour of root filled teeth
restored with cast post-and-cores and metallic crowns.
Methodology Fifth two bovine incisor roots were
selected and divided into four groups (n = 13): Ndwithout ARD; Bd- buccal ARD; Ld- lingual ARD; BLdbuccal and lingual ARD. The specimens were restored
with cast post-and-cores and metallic crowns. After a
fatigue process (3 105 50 N), three strain gauges
were attached on the buccal, lingual and proximal
surfaces and the samples of each group (n = 3) were
submitted to a 0100 N load. Fracture resistance was
assessed in a mechanical testing machine (n = 10).
Strain values and fracture resistance data were anal-

Introduction
With the development of endodontic therapy, recovery
and maintenance of severely damaged teeth became

Correspondence: Carlos Jose Soares, Faculdade de Odontologia

rea de Dentstica e
Universidade Federal de Uberlandia, A
Materiais Odontologicos, Av. Para, no 1720, Campus Umuarama, Bloco 2B, Sala 2B-24, CEP: 38405-902, Uberlandia,
Minas Gerais, Brazil (Tel.: +55 34 32182255; fax: +55 34
32182279; e-mail: carlosjsoares@umuarama.ufu.br).

2010 International Endodontic Journal

ysed by one-way anova and Tukey Honestly Significant Difference (HSD) test (a = 0.05). The failure mode
was then evaluated under an optical stereomicroscope.
Bidimensional models of each group were generated for
finite element analysis (FEA) and analysed using the
von Mises criteria.
Results No significant difference in fracture resistance values and fracture modes occurred between the
four groups. The BLd group had higher stress concentrations in the buccal dentine and higher strain values
on the proximal surfaces.
Conclusions The anti-rotation devices did not influence significantly the fracture resistance and fracture
mode. However, the stressstrain values were increased
when the anti-rotation device was prepared on the
buccal and lingual faces concomitantly.
Keywords: anti-rotation device, cast post-and-core,
finite element analysis, fracture mode, fracture resistance, strain gauge test.
Received 20 October 2009; accepted 2 April 2010

possible. However, there can be a major challenge in

restoring these teeth. Structural loss means that postand-cores are often required to maintain the restoration in place (Papa et al. 1993, Morgano & Brackett
1999, Joshi et al. 2001). Root canal preparation results
in dentine removal and increases the risk of fracture
when compared to intact teeth, because the resistance
of root filled teeth is directly related to the amount and
quality of the remaining tooth tissue (Reeh et al. 1989,
Morgano & Brackett 1999, Heydecke et al. 2001). Moreover, the posts do not increase the tooth-restoration

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Anti-rotation devices biomechanics Raposo et al.

complex resistance (Sorensen & Martinoff 1984,

Trope et al. 1985, Assif & Gorfil 1994), providing
enough retention and stability only for the prosthesis or
coronal restorative material (Christensen 1996). In
addition, the geometry, extension and mechanical
properties of the post (Caputo & Hokama 1984, Sirimai
et al. 1999, Fokkinga et al. 2006) could have an effect
on dentine stress distribution, reducing the risk of root
fracture.
Posts with mechanical properties similar to dentine,
which may distribute homogenously the stresses
induced by occlusal forces, are favourable in reducing
the likelihood of tooth fracture (Caputo & Hokama
1987, Boschian Pest et al. 2002). However, in
extensive restorative procedures, materials that offer
longevity and avoid subsequent interventions are
commonly chosen by the clinicians. Cast post-andcores have been used routinely to restore root filled
teeth with moderate to severe destruction, especially
in single rooted teeth (Ross et al. 1991, Morgano &
Brackett 1999). On the other hand, some forces could
reach the tooth-restoration complex, generating stress
concentrations in this system when the tooth is
under function (Kumagai et al. 1999, Sirimai et al.
1999, Akkayan & Gulmez 2002, Torbjorner &
Fransson 2004, Genovese et al. 2005). These stresses
could be responsible for fractures and subsequent loss
of the tooth (Assif & Gorfil 1994, Pegoretti et al.
2002).
Internal boxes in the mesial and distal faces or in the
greatest bulk of dentine (Tjan & Miller 1984, Hemmings et al. 1991) during root canal preparation for
cast post-and-core have been proposed as a way of
dissipating stresses in the longitudinal axis of the tooth
and work as an anti-rotation device (ARD). Shillingburg et al. (1997) stated that these devices should be
performed only on the lingual face of incisors with
conical or cylindrical root canals and extensive coronal
destruction.
Destructive mechanical tests, such as fracture tests,
are important for biomechanical analysis of tooth and
restorative materials, as they enhance understanding of
the behaviour of teeth in high loading situations.
However, these tests have limited capacity to clarify the
stressstrain relationship in the tooth-restoration complex (Soares et al. 2006, 2008c). The use of nondestructive tests, such as strain gauge tests (Ross et al.
1991, Sakaguchi et al. 1991), and finite element
analysis (FEA) (Kishen et al. 2004, Romeed et al.
2004, Jacobsen et al. 2006) is more suitable for
understanding the failure characteristics of the restor-

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International Endodontic Journal, 43, 681691, 2010

ative procedures (Ausiello et al. 2001, Lin et al. 2001,

Magne & Belser 2003, Soares et al. 2008b). Several
studies have made comparative investigations using
only FEA (Lin et al. 2001, Pierrisnard et al. 2002,
Magne & Belser 2003, Romeed et al. 2004, Lanza et al.
2005, Jacobsen et al. 2006, Toksavul et al. 2006),
however, this methodology is more representative
when associated with destructive tests (Fennis et al.
2005), or with non-destructive assays such as the
strain gauge test (Palamara et al. 2002, Lertchirakarn
et al. 2003, Soares et al. 2008d).
The aim of this study was to assess ex vivo the
fracture resistance, the strain of the buccal, lingual and
proximal root dentine and the stress distribution of root
filled bovine incisors restored with cast post-and-cores.
The study tested the hypothesis that the presence of
ARDs and their location influences the biomechanical
behaviour of incisors restored with cast post-and-cores
and metallic crowns.

Materials and methods

Tooth selection, preparation and embedding
Fifty-two similar bovine incisor teeth were selected, 40
for fracture resistance and fracture mode evaluation
and 12 for strain measurement tests. External debris
were removed with hand scalers, and teeth were stored
in 0.2% thymol solution (Soares et al. 2007). Teeth of
similar size and shape were selected by crown dimensions after measuring the buccolingual and mesiodistal
widths in millimetres, allowing a maximum deviation
of 10% from the average. The crowns of all the teeth
were sectioned horizontally to the long axis, 15 mm
from the apex, with a water-cooled diamond disk (No.
7020; KG Sorensen, Barueri, SP, Brazil). The roots were
divided into four groups (n = 13): Nd control without
ARD; Bd buccal ARD; Ld lingual ARD; BLd buccal
and lingual ARD.
Root canals were instrumented with size 50 master
apical files (K-files; Dentsply Maillefer, Ballaigues,
Switzerland) in association with 1.0% sodium hypochlorite (Cloro Rio 1.0%; Sao Jose do Rio Preto, SP,
Brazil), filled with gutta-percha and calcium hydroxide-based cement (Sealer 26; Dentsply, Petropolis, RJ,
Brazil). The post space was created initially with a
heated instrument and the residual gutta-percha
was then removed with Gattes-Gliden burs (2, 3, 4,
Dentsply Maillefer), standardizing the post space to
10 mm and preserving 5 mm of root filling at
the apex. Root canal walls were then enlarged with

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Raposo et al. Anti-rotation devices biomechanics

a 1.5-mm-diameter bur (Largo Peeso Reamer, No. 5,

Dentsply Maillefer).
The selected roots were embedded in self-polymerizing
polystyrene resin (AM 190 Resin; AeroJet, Santo Amaro,
SP, Brazil) to a level 2 mm below the coronal margin.
The periodontal ligament was simulated, using a polyether-based impression material (Impregum Soft; 3MESPE, Saint Paul, MN, USA). To carry out this procedure
root surfaces were dipped into molten wax 2 mm
apically to the coronal surface, resulting in a 0.2 to
0.3mm-thick wax layer. A radiographic film with a
centralized circular hole was used to stabilize teeth for
the embedding procedure. This assembly was placed
with the crown faced down into a hole in a wooden
board leaving the root in a vertical position perpendicular to the supporting radiographic film. Then, a plastic
cylinder (25 mm diameter) was placed around the root
and fixed in position with cyanoacrylate-based adhesive
(Super Bonder; Loctite, Itapev, SP, Brazil) and wax. The
resin was manipulated according to manufacturers
instructions and inserted into the cylinder. After resin
polymerization, the teeth were removed from the cylinder and the wax was removed from both root surface and
the cylinder. The impression material was placed into
the resin cylinders, thus the tooth was re-inserted and
the excess of polyether material was removed with a
scalpel blade (Soares et al. 2005).

Anti-rotation device, post-and-core and crown

restoration
The ARDs box preparations were performed in a cavity
preparation machine (Soares et al. 2008a) consisting of
a high-speed handpiece coupled to a mobile base. The
mobile base moves vertically and horizontally with
three precision micrometric heads (152-389; Mitutoyo,
Suzano, SP, Brazil), with a 0.002 mm level of accuracy.
For the preparations, a smooth tapered carbide bur (No.
170; KG Soresen), 1.6 mm diameter and 4.0 mm
depth, was used with its whole active point (Shillingburg et al. 1997), following each group designation:
Nd- without ARD; Bd- buccal ARD; Ld- lingual ARD;
BLd- buccal and lingual ARD.
For the cast post-and-core fabrication, pre-fabricated
ngelus,
polycarbonate patterns were used (Nucleojet; A
Londrina, PR, Brazil). Reline of patterns was carried out
using autopolymerizing acrylic resin in the individual
root canal (Duralay; Reliance Dental Mfg. Co., Worth,
IL, USA) until passive retention was achieved. Subsequently, the individual patterns were adjusted in each
respective specimen, standardizing their height at

2010 International Endodontic Journal

6.0 mm. The patterns were invested, cast in copperaluminium alloy (Cu-Al alloy; Goldent, Sao Paulo, SP,
Brazil) and sandblasted with aluminium oxide particles
(50 lm) under two bars pressure for 10 s (Fig. 1). Prior
to cementation, the root canals were cleaned with
distilled water and dried with absorbent paper points
(Dentsply Maillefer). The cast post-and-cores were
cemented with zinc-phosphate cement (Zinc Cement;
SS White, Rio de Janeiro, RJ, Brazil) under a constant
pressure of 50 N for 10 min.
Impressions of the coronal portion of the specimens
were taken with a 2-step technique, using a polyether
impression material (Impregum Soft; 3M-ESPE). After
1 h, the impressions were poured with a type IV dental
stone (Durone IV, Dentsply). A standard crown with a
lingual plateau 1.0 mm in thickness for load application was constructed in composite resin (Filtek Z250;
3M-ESPE) and from which a laboratory silicone matrix
was produced (IQ 428 Rubber, Aerojet). Heated liquid
wax (Green wax; Kota Imports, Sao Paulo, SP, Brazil)
was inserted in this matrix, followed by one of the
individual stone casts, resulting in the formation of the
crown wax pattern. The patterns were invested and
cast in nickel-chromium alloy (Kromalit; Knebel, Porto
Alegre, RS, Brazil). The crowns were adjusted and then
cemented with zinc-phosphate cement (Zinc cement, SS
White), under a constant pressure of 50 N for 10 min.
To simulate the fatigue and mechanic deterioration of
the restorative materials (Huysmans et al. 1993, Isidor
et al. 1996, Mannocci et al. 1999, Reagan et al. 1999),
the specimens were submitted to a cyclical loading of
50 N directed at 135  to the lingual elevation of the
metallic crowns. At a frequency of 1.25 Hz, 3 105
cycles were undertaken (Isidor et al. 1996, Naumann
et al. 2007) using a fatigue-testing machine (ER-LA-11000;

Figure 1 Experimental groups: Nd- control without ARD; Bd-

buccal ARD; Ld- lingual ARD; BLd- buccal and lingual ARD.

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Anti-rotation devices biomechanics Raposo et al.

ERIOS, Sao Paulo, SP, Brazil) with a constant temperature of 37 C in 100% of humidity (Fig. 2).

Strain measurement tests

For strain measurements tests, three strain gauges (PA06-060OBG-350LEN; Excel Sensores, Sao Paulo, Brazil)
were fixed on three samples per group, 1.0 mm below
the crown cervical limit of each specimen, two parallel
to the root long axis (one on the buccal root surface
and the other on the lingual root surface) and one
transversely to the root, on the proximal root surface
(Fig. 3). According to the manufacturer, the base
material of these gauges consists of a polyimide and
metal constantan film, with temperature self-compensation for steel. The strain gauge grid had an area of
4.1 mm2 and an electrical resistance of 350 X. The
gauge factor is a proportional constant between electrical resistance variation and strain, and the strain
gauges used for this study had a gauge factor of 2.12
(Santos-Filho et al. 2008, Soares et al. 2008b). For the
strain gauge attachment, the root surface was etched
with 37% phosphoric acid for 15 s (Cond AC 37; FGM,
Joinville, SC, Brazil), rinsed with water and air-dried.
Sequentially, the strain gauges were bonded with a
cyanoacrylate-based adhesive (Super Bonder, Loctite)
and connected to a data acquisition system (ADS0500IP; Lynx, Sao Paulo, Brazil). A control specimen,
with three strain gauges attached but not subjected to
load application, was mounted adjacent to the test
tooth as a compensator for temperature fluctuations
because of the gauge electrical resistance or local
environment.
The specimens fitted with strain gauges were subjected to a non-destructive ramp-load from 0 to 100 N

Figure 3 Strain gauges attached to buccal (A) lingual (B) and

proximal (C) faces.

at a cross-head speed of 0.5 mm per min using a

mechanical testing machine (EMIC DL-2000; EMIC,
Sao Jose dos Pinhais, PR, Brazil). The load was applied
at the lingual elevation with a wedge-shaped tip. The
data obtained were transferred to a computer using
specific acquisition, signal transformation and data
analysis software (AqDados 7.02 and AqAnalisys;
Lynx). During load application, one strain value was
recorded for each strain gauge every 0.3 s until a
maximum load was attained. Data for each region
showed normal and homogenous distribution and were
statistically analysed by one-way analysis of variance
(anova) and Tukey Honestly Significant Difference test
(HSD).

Fracture tests
Fracture resistance tests were performed in all specimens using the same compressive design used for the
strain gauge test (Fig. 4). The results were obtained in

Figure 2 Mechanical fatigue: cyclical loading of 50 N directed

at 135  to the lingual elevation of the metallic crowns.

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International Endodontic Journal, 43, 681691, 2010

Figure 4 Fracture resistance set up.

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Raposo et al. Anti-rotation devices biomechanics

Newtons (N) showed normal and homogenous distribution and were submitted to one-way anova and
Tukey HSD tests. For all tests, an alpha level of 0.05
was used. The failed samples were analysed under an
optical stereomicroscope to determine the fracture
mode according to the location of the failure in the
tooth structure (Akkayan & Gulmez 2002, Toksavul
et al. 2006, Naumann et al. 2007). Fractures were
classified as type I, proximal to buccal coronal third
fracture; type II, proximal coronal third fracture; type
III, proximal to buccal medium or apical third fracture
and type IV, proximal medium or apical third fracture
(Fig. 5).

Table 1 Mechanical properties of dental structures and

restorative materials
Structure/Material
Dentine (Ko et al. 1992)
Ligament (Holmes et al. 1996)
Cortical bone (Ko et al. 1992)
Cancellous bone (Ko et al. 1992)
Gutta-percha (Ko et al. 1992)
Zinc-phosphate cement
(Farah et al. 1975)
NiCr alloy (Suansuwan
& Swain 2001)
CuAl alloya
a

Finite elements analysis

Bidimensional models were created from a longitudinal
cut of one tooth of each experimental groups simulating the dimensions of the dental structure, using
computer-aided design software (Mechanical Desktop,
AutoCAD 6; Autodesk Inc, San Rafael, CA, USA)
(Soares et al. 2008b). The external outline of the tooth
and its support structures were included in the model.
The data obtained were exported to a software application (ANSYS 9.0; ANSYS Inc, Canonsburg, PA,
USA). In this software, the areas corresponding to each
structure were plotted and then meshed with isoparametric elements (Plane183). This element is defined by
eight nodes having two degrees of freedom at each
node: translations in the nodal X and Y directions. The
mechanical properties of each structure and materials
used in the analysis are described in Table 1 (Farah
et al. 1975, Ko et al. 1992, Holmes et al. 1996,
Suansuwan & Swain 2001). All tooth structures and
materials used in the models were considered isotropic, elastic, linear and homogeneous. The boundary

Youngs
modulus (MPa)

Poissons
ratio

18600
68.9
13700
1.370
6.9
22000

0.31
0.45
0.30
0.30
0.45
0.35

203600

0.30

109080

0.33

Manufacturers information.

conditions were defined with a 10 N load applied at a

135  angle in the centre of the concavity formed on
the lingual face, 1.0 mm bellow the incisal edge,
simulating the load application used on the fracture
resistance test (Lanza et al. 2005). Model displacements
were restricted at the external lateral and top outlines.
Stress distribution analysis was performed by means of
the quantitative association of the main maximum
stress by von Mises criteria. In 10 monitoring points
positioned among the restorative system, the quantitative stress were obtained (Fig. 6).

Results
The one-way anova indicated no significant difference
between the groups in the fracture resistance test

Figure 5 Schematic representation of the failure mode: Type

I- proximal to buccal coronal third fracture; Type II- proximal

coronal third fracture; Type III- proximal to buccal medium or
apical third fracture; and Type IV- proximal medium or apical
third fracture.

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Figure 6 Monitoring points to quantify the von Mises stress

values (MPa).

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Anti-rotation devices biomechanics Raposo et al.

(P = 0.605). The mean fracture resistance values are

shown in Table 2. Fracture mode distribution is
described in Table 3. Prevalence of types III and IV
(catastrophic fractures) was observed in all groups.
One-way anova revealed no significant difference in
the strain values recorded on the buccal (P = 0.43) and
lingual (P = 0.54) surfaces. However, on the proximal
surface, significant difference between groups was
observed with high strain values for the BLd group,
followed by Bd and Ld groups, and lowest values for Nd
group (Table 4).
Finite element analysis showed greater similarity in
the stress distribution levels within tooth structure
between Nd, Ld and Bd groups, which presented lower
stress concentration into buccal dentine than BLd
group. Bd group showed a stress concentration area on
the buccal face, near to the ARD. The BLd group
presented the higher stresses between all groups
(Fig. 7). In the quantitative analysis, lower stresses
were observed in the Ld and Nd groups, while Bd group
presented a similar pattern to Nd group with higher
stress. The BLd group showed the highest stress
concentration (Fig. 8).

Discussion
The hypothesis of this study was partially supported by
the results. The presence and location of ARDs did not
influence the fracture resistance and fracture mode of
incisors restored with cast post-and-cores. However,
the ARDs influenced the strain values at the proximal
face and the stress distribution within tooth structure,
mainly with its application on the buccal face (Bd) or
simultaneously on the buccal and lingual faces (BLd
group).
Anti-rotation devices have been described as important means to avoid dislodgment of cast posts-and-cores
in teeth with round root canals (Tjan & Miller 1984,
Hemmings et al. 1991, Shillingburg et al. 1997). Previous studies, concluded that this class of devices could
indeed increase the torsion resistance of teeth submitTable 2 Mean fracture resistance values (SDs) and results of
Tukey Honestly Significant Difference (HSD) test (n = 10)
Groups

Fracture resistance (N)

Tukey Categorya

Nd
Bd
Ld
BLd

708.6 (110.1)
716.8 (217.3)
766.9 (270.0)
823.80 (221.9)

A
A
A
A

Tukey categories with same uppercase letters are not statistically significant from each other (P < 0.05)

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International Endodontic Journal, 43, 681691, 2010

Table 3 Fracture mode distribution among the groups

Fracture type
Group

II

III

IV

Nd
Bd
Ld
BLd
Total (%)

1
0
0
1
5%

0
0
0
1
2.5%

5
6
4
4
47.5%

4
4
6
4
45%

ted to these forces (Tjan & Miller 1984, Hemmings et al.

1991, Joshi et al. 2001) and improve stress distribution
over the restorative system (Shillingburg et al. 1997).
Despite the fact of the fracture resistance of root filled
teeth being proportional to the remaining structure
(Assif & Gorfil 1994), the tooth loss caused by the ARD
preparation did not affect the fracture resistance of
incisor roots. This probably occurred because of the low
sensitivity of the fracture resistance test, which is not
capable of measuring adequately the influence of such
small alterations.
Despite significant differences on the proximal
strains, the results of this region were lower than the
buccal and lingual ones. This occurred probably
because of the core and crown major supporting area,
which is located mainly at the buccal and lingual faces
of the root, instead of the proximal sites, where the
dentinal support for the metallic components is considerably reduced. This can result in high strain values
in the referred areas during the specimen loading. The
reduced amount of dentine of the proximal regions and
the ARD preparation could explain the differences in
the strain values between groups. The fracture mode
analysis showed failures starting mainly on the proximal faces, continuing normally towards the buccal
face. The removal of sound tooth structure in the
preparation of the anti-rotation increased dentine
strain, favouring higher strains on the proximal site.
However, strain gauge method records the strains on a
surface just before these forces dissipate throughout the
whole body. Consequently, strains that occur inside a
body with load application reach higher values than
those measured on its surface.
The post inserted into the root canal modifies the
tooth stressstrain distribution (Assif & Gorfil 1994).
Under loading, stress will concentrate in the more rigid
material in a system with materials that present
different stiffness. A cast post-and-core presents different mechanical properties when compared to a
non-metallic post system and to the inner dentine
(Pierrisnard et al. 2002, Toksavul et al. 2006). The

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Raposo et al. Anti-rotation devices biomechanics

Table 4 Mean values and standard deviations of strain values (lS) for the groups, maximum loading of 100 N
Buccal

Groups

lS

Nd
Bd
Ld
BLd

549.9
386.5
562.5
345.4

(74.2)
(216.1)
(266.2)
(145.9)

Lingual
Tukey
Categorya

lS

A
A
A
A

346.9
333.7
472.9
363.7

Proximal

(263.6)
(159.9)
(380.4)
(110.3)

Tukey
Categorya

lS

A
A
A
A

125.5
144.9
133.9
311.5

Tukey
Categorya
(16.5)
(16.5)
(65.9)
(244.7)

B
AB
AB
A

Tukey categories with same uppercase letters are not statistically significant to each other into the same region (P = 0.0001).

Figure 7 von Mises stress values (MPa):

Nd control without anti-rotation device

(ARD); Bd buccal ARD; Ld lingual
ARD; BLd buccal and lingual ARD.

stiffness imposed on the root by the metallic post does

not allow the root structure to flex and consequently
increases the stress concentration along the whole
system. On this way, the stress primary distributed to
the root periphery concentrate inside the regions where
the micro-dislodgment is restricted as in the dentinecement-post interfaces (Genovese et al. 2005, Lanza
et al. 2005). The collapse of the interface induces
dissipation of the energy accumulated in the metallic
post to the dentine. This could explain the strains
observed on the proximal surface, predominantly when
anti-rotations devices are used on the buccal and
lingual faces. Strain values on proximal surfaces seem
to be particularly more important when comparing the
fracture resistance and fracture mode. This tensile
strain starts inside the root canal and can spread
through the cracks leading to catastrophic fractures of
the structure (Santos-Filho et al. 2008).
In a normal occlusion, the dentine exhibits considerable flexibility to elastic strains, withstanding several

2010 International Endodontic Journal

forces applied from different angles (Kishen et al. 2004,

Naumann et al. 2007). However, these forces could
exceed the dentine strength as well as the proportional
limit, and fracture may occur (Kishen et al. 2004).
Besides the metallic post stiffness, root canal dentine is
arranged radially and the stress tends to be parallel to
the tubules direction, generating a wedge effect and
consequent root failures. Catastrophic fractures (types
III and IV) occurred in all groups, mainly in the Bd
group samples. This probably happened because of the
load applied on the lingual face, which concentrates
compressive stresses on the buccal face (Assif & Gorfil
1994), increasing the fractures on this region. FEA
showed a high stress concentration on the buccal
dentine in the BLd model. The increase in the volume of
the metallic post may explain this behaviour. This
finding did not have a direct effect on the fracture
resistance. However, as shown previously, this could
explain the highest strain values on the proximal
surface during strain gauge tests verified on this group.

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Anti-rotation devices biomechanics Raposo et al.

Figure 8 von Mises stress distribution quantitative analysis.

The fracture resistance values of all groups are higher

than the incident anterior forces of the oral cavity,
quoted in the literature between 27.8 and 65.3 N
(Kumagai et al. 1999). In addition, the failures that
occur in restorative procedures involving cast post-andcores are frequently related to fractures because of the
mechanical fatigue of the system, caused by the forces
concentrated out of the long axis of the tooth (Torbjorner
& Fransson 2004). Consequently, a well planned and
developed prosthesis with favourable biomechanics is
crucial to the longevity of root filled teeth. To conserve
intact dental structure, ARDs should only be realized
when really necessary. Moreover, the lingual face should
be the unique region of choice because of the lower
strains and stress values were observed on this area.
This study was conducted in laboratorial conditions
and it presents some intrinsic limitations, such as the
static loading and absence of thermal cycling. Despite
using bovine teeth, several studies show large acceptance of these teeth for laboratory investigations
because of its similarity to human dentine and
geometric root configuration (Schilke et al. 2000,

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International Endodontic Journal, 43, 681691, 2010

Fonseca et al. 2008). Additionally, as bovine teeth

have greater availability, it is possible to standardize
specimen size and shape (Santos-Filho et al. 2008,
Soares et al. 2008c), which is essential when obtaining
comparable results as deformation and fracture resistance are dependent on tooth geometry.
The FEA analysis also had limitations, such as the
bidimensional models and the materials assumed as
being elastic and isotropic. The linear elastic analysis is
also another limitation, because the periodontal ligament and interfaces behaviour differently when analysed using non-linear analysis. However, the
combination of non-destructive (strain gauge) and
destructive experimental mechanical tests (fracture
resistance) with numerical analyses (FEA) can be
effective in predicting the biomechanical behaviour of
dental restorative procedures. FEA using 3D models is
recommended, as it allows anatomic alterations and
devicesample contact to be shown with greater
accuracy (Soares et al. 2008b). Further clinical evaluations, taking into account the remaining dentine
thickness and the presence and location of ARDs,

2010 International Endodontic Journal

Raposo et al. Anti-rotation devices biomechanics

would be of benefit. In addition, the use of restorative

materials that could resemble the mechanical behaviour of sound teeth should be incorporated into the
clinical choices when indicated.

Conclusions
Within the limitations of this laboratory study, the
following conclusions were drawn:
1. The presence and location of an ARD did not affect
significantly the fracture resistance and fracture mode
of tooth restored with cast post-and-core;
2. Higher strains were observed on the proximal
surface of teeth in the presence of ARDs. The association of buccal and lingual ARDs produced the highest
strains;
3. Lower stresses were observed when the ARD was
positioned on the lingual face; despite higher stress
concentrations being observed when this feature was
positioned concomitantly on the buccal and lingual
faces.

Acknowledgements
This study was supported by the Research Support
Foundation of the State of Minas Gerais (FAPEMIG\
Brazil).

References
Akkayan B, Gulmez T (2002) Resistance to fracture of
endodontically treated teeth restored with different post
systems. Journal of Prosthetic Dentistry 87, 4317.
Assif D, Gorfil C (1994) Biomechanical considerations in
restoring endodontically treated teeth. Journal of Prosthetic
Dentistry 71, 5657.
Ausiello P, Apicella A, Davidson CL, Rengo S (2001) 3D-finite
element analyses of cusp movements in a human upper
premolar, restored with adhesive resin-based composites.
Journal of Biomechanics 34, 126977.
Boschian Pest L, Cavalli G, Bertani P, Gagliani M (2002)
Adhesive post-endodontic restorations with fiber posts:
push-out tests and SEM observations. Dental Materials 18,
596602.
Caputo AA, Hokama SN (1984) Retention and stress-distributing characteristics of a new dowel system. Journal of
Prosthetic Dentistry 51, 6525.
Caputo AA, Hokama SN (1987) Stress and retention properties of a new threaded endodontic post. Quintessence
International 18, 4315.
Christensen GJ (1996) Posts: necessary or unnecessary?
Journal of the American Dental Association 127, 15224.

2010 International Endodontic Journal

Farah JW, Hood JA, Craig RG (1975) Effects of cement bases

on the stresses in amalgam restorations. Journal of Dental
Research 54, 105.
Fennis WM, Kuijs RH, Barink M, Kreulen CM, Verdonschot N,
Creugers NH (2005) Can internal stresses explain the
fracture resistance of cusp-replacing composite restorations?
European Journal of Oral Sciences 113, 4438.
Fokkinga WA, Kreulen CM, Le Bell-Ronnlof AM, Lassila LV,
Vallittu PK, Creugers NH (2006) In vitro fracture behavior
of maxillary premolars with metal crowns and several postand-core systems. European Journal of Oral Sciences 114,
2506.
Fonseca RB, Haiter-Neto F, Carlo HL et al. (2008) Radiodensity
and hardness of enamel and dentin of human and bovine
teeth, varying bovine teeth age. Archives of Oral Biology 53,
10239.
Genovese K, Lamberti L, Pappalettere C (2005) Finite element
analysis of a new customized composite post system for
endodontically treated teeth. Journal of Biomechanics 38,
237589.
Hemmings KW, King PA, Setchell DJ (1991) Resistance to
torsional forces of various post and core designs. Journal of
Prosthetic Dentistry 66, 3259.
Heydecke G, Butz F, Strub JR (2001) Fracture strength and
survival rate of endodontically treated maxillary incisors
with approximal cavities after restoration with different post
and core systems: an in-vitro study. Journal of Dentistry 29,
42733.
Holmes DC, Diaz-Arnold AM, Leary JM (1996) Influence of
post dimension on stress distribution in dentin. Journal of
Prosthetic Dentistry 75, 1407.
Huysmans MC, Peters MC, Van der Varst PG, Plasschaert AJ
(1993) Failure behaviour of fatigue-tested post and cores.
International Endodontic Journal 26, 294300.
Isidor F, Odman P, Brondum K (1996) Intermittent loading of
teeth restored using prefabricated carbon fiber posts. International Journal of Prosthodontics 9, 1316.
Jacobsen PH, Wakefieldt AJ, ODoherty DM, Rees JS (2006)
The effect of preparation height and taper on cement lute
stress: a three-dimensional finite element analysis. The
European Journal of Prosthodontics and Restorative Dentistry
14, 1517.
Joshi S, Mukherjee A, Kheur M, Mehta A (2001) Mechanical
performance of endodontically treated teeth. Finite Elements
in Analysis and Design 37, 587601.
Kishen A, Kumar GV, Chen NN (2004) Stress-strain response
in human dentine: rethinking fracture predilection in
postcore restored teeth. Dental Traumatology 20, 90100.
Ko CC, Chu CS, Chung KH, Lee MC (1992) Effects of posts on
dentin stress distribution in pulpless teeth. Journal of
Prosthetic Dentistry 68, 4217.
Kumagai H, Suzuki T, Hamada T, Sondang P, Fujitani M,
Nikawa H (1999) Occlusal force distribution on the dental
arch during various levels of clenching. Journal of Oral
Rehabilitation 26, 9325.

International Endodontic Journal, 43, 681691, 2010

689

Anti-rotation devices biomechanics Raposo et al.

Lanza A, Aversa R, Rengo S, Apicella D, Apicella A (2005) 3D

FEA of cemented steel, glass and carbon posts in a maxillary
incisor. Dental Materials 21, 70915.
Lertchirakarn V, Palamara JE, Messer HH (2003) Finite
element analysis and strain-gauge studies of vertical root
fracture. Journal of Endodontics 29, 52934.
Lin CL, Chang CH, Ko CC (2001) Multifactorial analysis of an
MOD restored human premolar using auto-mesh finite
element approach. Journal of Oral Rehabilitation 28, 576
85.
Magne P, Belser UC (2003) Porcelain versus composite inlays/
onlays: effects of mechanical loads on stress distribution,
adhesion, and crown flexure. The International Journal of
Periodontics & Restorative Dentistry 23, 54355.
Mannocci F, Ferrari M, Watson TF (1999) Intermittent
loading of teeth restored using quartz fiber, carbon-quartz
fiber, and zirconium dioxide ceramic root canal posts.
Journal of Adhesive Dentistry 1, 1538.
Morgano SM, Brackett SE (1999) Foundation restorations in
fixed prosthodontics: current knowledge and future needs.
Journal of Prosthetic Dentistry 82, 64357.
Naumann M, Preuss A, Frankenberger R (2007) Reinforcement effect of adhesively luted fiber reinforced composite
versus titanium posts. Dental Materials 23, 13844.
Palamara JE, Palamara D, Messer HH (2002) Strains in the
marginal ridge during occlusal loading. Australian Dental
Journal 47, 21822.
Papa J, Wilson PR, Tyas MJ (1993) Pins for direct restorations.
Journal of Dentistry 21, 25964.
Pegoretti A, Fambri L, Zappini G, Bianchetti M (2002) Finite
element analysis of a glass fibre reinforced composite
endodontic post. Biomaterials 23, 266782.
Pierrisnard L, Bohin F, Renault P, Barquins M (2002) Coronoradicular reconstruction of pulpless teeth: a mechanical
study using finite element analysis. Journal of Prosthetic
Dentistry 88, 4428.
Reagan SE, Fruits TJ, Van Brunt CL, Ward CK (1999) Effects of
cyclic loading on selected post-and-core systems. Quintessence International 30, 617.
Reeh ES, Messer HH, Douglas WH (1989) Reduction in tooth
stiffness as a result of endodontic and restorative procedures.
Journal of Endodontics 15, 5126.
Romeed SA, Fok SL, Wilson NH (2004) The mechanical
behaviour of cantilever fixed partial dentures in shortened
dental arch therapy: a 2-D finite element analysis. The
European Journal of Prosthodontics and Restorative Dentistry
12, 217.
Ross RS, Nicholls JI, Harrington GW (1991) A comparison of
strains generated during placement of five endodontic posts.
Journal of Endodontics 17, 4506.
Sakaguchi RL, Brust EW, Cross M, DeLong R, Douglas WH
(1991) Independent movement of cusps during occlusal
loading. Dental Materials 7, 18690.
Santos-Filho PC, Castro CG, Silva GR, Campos RE, Soares CJ
(2008) Effects of post system and length on the strain and

690

International Endodontic Journal, 43, 681691, 2010

fracture resistance of root filled bovine teeth. International

Endodontic Journal 41, 493501.
Schilke R, Lisson JA, Bauss O, Geurtsen W (2000) Comparison
of the number and diameter of dentinal tubules in human
and bovine dentine by scanning electron microscopic
investigation. Archives of Oral Biology 45, 35561.
Shillingburg HT, Hobo S, Whitsett LD (1997) Fundamentals of
fixed prosthodontics., 3rd edn. Chicago: Quintessence Publishing Co, Inc.
Sirimai S, Riis DN, Morgano SM (1999) An in vitro study of the
fracture resistance and the incidence of vertical root fracture
of pulpless teeth restored with six post-and-core systems.
Journal of Prosthetic Dentistry 81, 2629.
Soares CJ, Pizi EC, Fonseca RB, Martins LR (2005) Influence of
root embedment material and periodontal ligament simulation on fracture resistance tests. Brazilian Oral Research 19,
116.
Soares CJ, Martins LR, Fonseca RB, Correr-Sobrinho L,
Fernandes Neto AJ (2006) Influence of cavity preparation
design on fracture resistance of posterior Leucite-reinforced
ceramic restorations. Journal of Prosthetic Dentistry 95,
4219.
Soares CJ, Santana FR, Silva NR, Preira JC, Pereira CA (2007)
Influence of the endodontic treatment on mechanical
properties of root dentin. Journal of Endodontics 33, 6036.
Soares CJ, Fonseca RB, Gomide HA, Correr-Sobrinho L
(2008a) Cavity preparation machine for the standardization
of in vitro preparations. Brazilian Oral Research 22, 2817.
Soares PV, Santos-Filho PC, Gomide HA, Araujo CA, Martins
LR, Soares CJ (2008b) Influence of restorative technique on
the biomechanical behavior of endodontically treated maxillary premolars Part II: strain measurement and stress
distribution. Journal of Prosthetic Dentistry 99, 11422.
Soares PV, Santos-Filho PC, Martins LR, Soares CJ (2008c)
Influence of restorative technique on the biomechanical
behavior of endodontically treated maxillary premolars Part
I: fracture resistance and fracture mode. Journal of Prosthetic
Dentistry 99, 307.
Soares PV, Santos-Filho PC, Queiroz EC et al. (2008d) Fracture
resistance and stress distribution in endodontically treated
maxillary premolars restored with composite resin. Journal of
Prosthodontics 17, 1149.
Sorensen JA, Martinoff JT (1984) Intracoronal reinforcement
and coronal coverage: a study of endodontically treated
teeth. Journal of Prosthetic Dentistry 51, 7804.
Suansuwan N, Swain MV (2001) Determination of elastic
properties of metal alloys and dental porcelains. Journal of
Oral Rehabilitation 28, 1339.
Tjan AH, Miller GD (1984) Comparison of retentive properties
of dowel forms after application of intermittent torsional
forces. Journal of Prosthetic Dentistry 52, 23842.
Toksavul S, Zor M, Toman M, Gungor MA, Nergiz I, Artunc C
(2006) Analysis of dentinal stress distribution of maxillary
central incisors subjected to various post-and-core applications. Operative Dentistry 31, 8996.

2010 International Endodontic Journal

Raposo et al. Anti-rotation devices biomechanics

Torbjorner A, Fransson B (2004) A literature review on the

prosthetic treatment of structurally compromised teeth.
International Journal of Prosthodontics 17, 36976.

2010 International Endodontic Journal

Trope M, Maltz DO, Tronstad L (1985) Resistance to fracture

of restored endodontically treated teeth. Endodontics &
Dental Traumatology 1, 10811.

International Endodontic Journal, 43, 681691, 2010

691

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