The Effects of Using Cements of Different Thicknesses and Amalgam Restorations with Different Young’s Modulus Values on Stress on Dental Tissue: An Investigation Using Finite Element Analysis

Background: In this study, it was aimed to use a finite element stress analysis method to determine the amount of stress on enamel, dentin, restoration, resin cement and glass ionomer cement in amalgam class II disto-occlusal (DO) cavities by using two different cements with different thicknesses and amalgams with different Young’ s modulus values, respectively. Methods: A three-dimensional tooth model was obtained by scanning an extracted human maxillary first molar with dental tomography. A class II DO cavity including 95-degree cavity margin angles was created. Resin cement (RC) and glass ionomer (GI) cement with different Young’ s modulus measures (RC: 7.7 GPa, GI: 10.8 GPa) were used in amalgam. Different thickness combination groups were simulated: 50 μm, 100 μm and 150 μm. Additionally, amalgams with different Young’ s modulus values were used with the same thickness of different cements (Amalgam Young’s modulus: 35 GPa and 50 GPa). A load of 600 N was delivered to the chewing area. The stress distributions on enamel, dentin, restoration, resin cement and class ionomer cement were then analyzed using finite element analysis. Results: The most stress accumulation was observed in the enamel tissue across all groups where resin cement or glass ionomer cement were used in different thicknesses and where amalgam restorations were used with different Young’s modulus values. The least stress accumulation was observed in the cement itself. Conclusions: According to the results obtained, there was no difference between the two cement types in terms of stress accumulations in the models. However, when the same cements with different thicknesses were evaluated, it was concluded that the presence of both glass ionomer and resin cement with a thickness of 150 μm causes less stress on the restoration surface. Furthermore, when the cements were combined with different thicknesses and with different amalgam Young’ s modulus values, it was concluded that 50 GPa causes less stress on restoration surface.