Rundquist B D, Versluis A
Restorative Sciences-Endodontics, School of Dentistry, University of Minnesota, Minneapolis, USA.
Int Endod J. 2006 Mar;39(3):226-37. doi: 10.1111/j.1365-2591.2006.01078.x.
To examine the effect of specific tapers on root stresses and thus vertical root fracture.
The effect of taper on root stresses was calculated during simulated warm vertical compaction of gutta-percha in a straight rooted premolar for three tapers (0.04, 0.06 and 0.12 mm mm(-1)) using finite element analysis. Stresses in the dentine were observed whilst the root was filled with three subsequent gutta-percha increments. Each increment was compacted at 10 or 15 N and the gutta-percha cooled down to 37 degrees C. After filling, composite was polymerized in the access space. A functional occlusal load of 50 N was then applied on the buccal cusp incline. The stress distribution in the root during the occlusal loading was compared with the stresses during filling.
During filling, the highest stresses were found: (a) at the canal surface; (b) using the smallest taper; (c) in the apical third; and (d) during the first gutta-percha increment. The root stress distribution changed when the functional post-filling load was applied. It generated the highest stresses at the external root surface, with a tensile stress concentration at the lingual surface of the cervical third. Since the stresses during simulated masticatory loading concentrated on the external surface, an increased taper size caused only slightly higher root stress levels.
With increasing taper, root stresses decreased during root filling but tended to increase for masticatory loading. Root fracture originating at the apical third is likely initiated during filling, whilst fracture originating in the cervical portion is likely caused by occlusal loads.