Professional Documents
Culture Documents
available at www.sciencedirect.com
a r t i c l e i n f o a b s t r a c t
Article history: Objectives. This investigation is to understand the role of free water in the dentinal tubules
Received 25 May 2006 on the mechanical integrity of bulk dentine.
Received in revised form Methods. Three different experiments were conducted in this study. In experiment 1,
8 November 2006 three-dimensional models of dentine with gradient elastic modulus, homogenous elastic
Accepted 16 November 2006 modulus, and with and without hydrostatic pressure were simulated using the finite ele-
ment method. Static compressive loads of 15, 50 and 100 N were applied and the distribution
of the principal stresses, von Mises stresses, and strains in loading direction were deter-
Keywords: mined. In experiment 2, experimental compression testing of fully hydrated and partially
Dentine dehydrated dentine (21 ◦ C for 72 h) was conducted using a Universal testing machine. In
Water experiment 3, Fourier transform infrared spectroscopic analysis of hydrated and partially
Dentinal tubules dehydrated dentine was carried out.
Stress Results. The finite element analysis revealed that the dentine model with simulated hydro-
Strain static pressure displayed residual tensile stresses and strains in the inner region adjacent
Hydrostatic pressure to the root canal. When external compressive loads were applied to the model, the resid-
ual stresses and strains counteracted the applied loads. Similarly the hydrated specimens
subjected to experimental compression loads showed greater toughness when compared to
the partially dehydrated specimens. The stress at fracture was significantly higher in par-
tially dehydrated specimens (p = 0.014), while the strain at fracture was significantly higher
in hydrated dentine specimens (p = 0.037).
Significance. These experiments highlighted the distinct role of free water in the dentinal
tubules and hydrostatic pressure on the stress–strain distribution within the bulk dentine.
© 2006 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.
∗
Corresponding author. Tel.: +65 6516 4624; fax: +65 6774 5701.
E-mail address: rsdak@nus.edu.sg (A. Kishen).
0109-5641/$ – see front matter © 2006 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.
doi:10.1016/j.dental.2006.11.018
d e n t a l m a t e r i a l s 2 3 ( 2 0 0 7 ) 1296–1306 1297
increased fracture predilection in endodontically treated teeth to optimize the functionality of the overall tooth structure
is a relentless clinical problem. It is clinically well established [18].
that endodontically treated teeth are more prone to fracture Dentine is a permeable mineralized tissue consisting of
[1–3], but the cause and effect relationship of endodontic thousands of microscopic tubules of diameter 0.5–4.0 m,
treatment and increased fracture predilection is still obscure which extend from the inner pulp space to the outer surface.
[4–6]. It is understood that increased fracture predilection of They have typical densities between 10,000 and 96,000 mm−1
an endodontically treated tooth has a multifactorial incep- [19]. The pulp space in an intact vital tooth is made up
tion; however the precise contribution of different factors is of a connective tissue system consisting of cells and fibers
still not substantiated. Historically the increased susceptibil- both embedded in the extracellular matrix. The extracellu-
ity of fracture in endodontically treated teeth was attributed lar matrix proteins have very high water-holding properties,
to brittleness brought about in dentine due to loss of moisture and the total water content of the pulp is approximately more
[7]. After about a decade of research this theory was aban- than 90%. In addition, a physiological intra-pulpal pressure,
doned in favor of the hypothesis that it is actually the loss of estimated to be at 10–28 mmHg, constantly drives the pulpal
tooth structure which is responsible for the increased fracture fluid outwards along the dentinal tubules [20]. These findings
predilection and there is no significant difference between the emphasize the fact that free water in dentine is a dynamic
moisture content of endodontically treated and vital human phase, and its movement through the porosities and tubules in
teeth [5,8–12]. As demonstrated by the conflicting evidences dentine may influence the response of bulk dentine structure
in the literature, the precise mechanical principles underlying during mechanical functions. Earlier studies have suggested
stress–strain response in tooth structure is still enveloped in that the fluid filled dentinal tubules could function to hydrauli-
ambiguity [13]. cally transfer and dissipate the occlusal forces applied to
The disagreements in literature are to some extent a teeth [21,22]. Paphangkorakit and Osborn have shown that
result of direct comparison of endodontically treated teeth normal chewing forces (20–120 N) could displace fluid out of
with the vital teeth, and due to difficulties in establishing the dentinal tubules (3.5 to 22.2 × 103 pl) when tooth is loaded
appropriate controls and comparable test procedures. Spec- and back into the dentinal tubules when unloaded [23]. Kin-
imen preparations and maintaining the level of hydration ney et al. suggested from a theoretical mechanics perspective
in the test specimens were also overlooked. Jameson et al. that the structural stability of dentine is not only the func-
compared the mechanical properties of fully hydrated den- tion of mineralization but also the moisture content [24,25].
tine bars and dentine bars dehydrated at 20 ◦ C (50% relative Nalla et al. based on experiments carried out on dentine
humidity) for 7 days and reported a total moisture loss of specimens obtained from elephant tusk, highlighted that the
30%. They also found a significant increase in stiffness and presence of fluid was vital for the deformability of dentine
decrease in toughness of dentine after dehydration. Since [26]. Recently, Arola and Zheng suggested that the flexure
removal of tightly bound water from dentine required heat- strength and energy to fracture hydrated dentine increased
ing to more than 600 ◦ C for a considerable period of time, the significantly with increasing stress rate. On the contrary, the
water lost by this approach is said to be mostly the free water flexure strength and energy to fracture of dehydrated dentine
present in the dentine [11]. Kahler et al. studied the work of decreased with increasing stress rate [27]. Nevertheless, very
fracture and fracture patterns in bovine dentine and found few investigations have addressed the role of dentinal tubules,
hydrated dentine to be significantly tougher than dehydrated free water, and hydrostatic pressure on the mechanical behav-
dentine. In this study, the hydrated dentine demonstrated ior of bulk dentine structure.
60% increase in crack-initiation-toughness and crack-growth- The finite element method has been extensively used for
toughness than dehydrated dentine [14]. Their experiments evaluating the stress and strain responses of human tooth
revealed different fracture toughening mechanisms such as under various test conditions. In most of these studies, den-
microcracking, crack deflection and ligament formation in tine has been modeled as a homogeneous and isotropic
fully hydrated dentine [15]. Kishen and Asundi studied the material [28,29]. These studies seem to have ignored the
biomechanical behavior of fully hydrated and dehydrated den- effects of dentinal tubules, intra-pulpal hydrostatic pressure,
tine using moiré interfermometry. The entire plano-parallel and the elastic modulus gradient on the mechanical prop-
facio-lingual section (sagittal section) of the tooth was used erties of dentine. The above mentioned factors can play a
for this experiment and the specimens were dehydrated at key role in the mechanical integrity of dentine structure, and
24 ◦ C, 55% relative humidity for 72 h. It was concluded that are essential to understand how dentine bulk resists phys-
the presence of water in the hydrated dentine resulted in a iological forces. The main goal of this investigation is to
stress strain response characteristic of tough material, while examine the role of free water of hydration within dentinal
the loss of free water resulted in stiffening, and response char- tubules on the mechanical behavior of bulk dentine struc-
acteristic of brittle material [16]. The stiffness of dentine is ture. The following investigations are utilized for this purpose:
contributed by the mineral constituents, and it was shown (1) finite element analysis (FEA) of dentine models, to study
that high value of mineralization produces high values of elas- the effect of material property gradients and intra-pulpal
tic modulus and static strength, though resulting in low values hydrostatic pressure on the stress–strain distribution within
of stored strain energy [17]. The toughness and/or increased dentine. (2) Compression testing of fully hydrated and par-
strain energy is provided by the organic fraction, particularly tially dehydrated dentine sections to study the influence of
the collagen in dentine. The degree of mineralization of col- hydration on the stress–strain response in bulk dentine struc-
lagen substrate in dentine however varies continuously with ture and (3) Fourier transfer Infrared spectroscopy of fully
location, and this gradient in the mineralization is believed hydrated dentine and dehydrated dentine (21 ◦ C for 72 h) to
1298 d e n t a l m a t e r i a l s 2 3 ( 2 0 0 7 ) 1296–1306
examine partial dehydration induced changes in the dentine this model were based on values obtained in our previous
material. investigations. A linear fit was carried out on this data and
the values calculated using the trend line equation was uti-
lized to simulate the spatial gradient in elastic modulus in the
2. Materials and methods cervical dentine section. A Poisson’s ratio of 0.32 was assigned
for the entire dentine structure [30]. A hydrostatic pressure
2.1. Experiment 1: finite element analysis of dentine of 15 cm water was applied on the inner dentine surface
models and within the dentinal tubules to simulate the physiological
intra-pulpal pressure [31]. The pressure applied was assumed
The three-dimensional finite element (FE) models of bulk to be constant and pressure variations due to fluid–structure
dentine were created using ABAQUS/CAE Version 6.4. A three- interactions were neglected. Four different models were sim-
dimensional sectional model of the cervical dentine was ulated in this study: (1) model with gradients in the elastic
used in this analysis because: (1) cervical dentine experi- modulus (Graded Elastic Material (GEM) model) and Hydro-
ences prominent stress and strain distribution during biting, static Pressure (HP) (GEM-HP). (2) Model with constant elastic
(2) dentinal tubules in the cervical dentine are straighter modulus (Homogenous Elastic Modulus (HEM) model), and
when compared to the crown dentine, (3) the distribution of HP (HEM-HP). (3) GEM model without HP (GEM) and (4) HEM
dentinal tubules is indicated to be highly ordered in the cer- model without HP (HEM). An elastic modulus value of 8.02 GPa
vical dentine [19], (4) there are more patent dentinal tubules was assigned to the HEM models. This value was the aver-
and conspicuous elastic modulus gradients in the cervical age of the extreme elastic modulus values used for the GEM
region. The FE models of the dentine had a length 3.5 mm, models.
arc length of 0.1 mm and height of 0.1 mm and included a cir- During testing, the FE model was constrained at the bot-
cular root canal of 1.00 mm diameter along the height of the tom and symmetry boundary conditions were enforced on the
section. Since the diameter of the dentinal tubules decreased two side planes by invoking suitable nodal transformations
from the inner region (adjacent to the root canal lumen) and applying boundary conditions to local directions in this
to outer surface, and the density of the dentinal tubules symmetry plane. Tensile and compressive loads of magnitude
ranged from 7 to 30 tubules per 100 m which corresponds 15, 50, and 100 N were applied on the superior surface in sep-
to 4900 and 90,000 tubules/mm2 [19] in the current model, 10 arate simulations and the stress and strain distributions of
dentinal tubules per 100 m were simulated. The following dentine were recorded. Compressive loads were used to simu-
assumptions were considered during modeling: (1) the sec- late a more physiological loading condition, while tensile loads
tional specimen was considered to be composed of dentine were applied to simulate an extreme failure loading condition.
only as the thickness of cementum layer was relatively negli- The stress and strain values were calculated from the nodal
gible, (2) dentinal tubules were arranged regularly throughout displacement using the stress–strain and strain–displacement
the model, (3) dentinal tubules were regarded as parallel, and relationships. The stress in the loading direction, the von
the root canal was represented by a straight cylinder as only a Mises stress, and the strain in loading direction was deter-
small section was considered, (4) dentinal tubules were repre- mined from all the four numerical models along four lines of
sented by truncated cones, with a decrease in diameter from interest as shown in Fig. 1(b and c).
the inner to outer surface. The tip of tubule was 0.007 mm
from the outer surface, (5) branching of dentinal tubule was 2.2. Experiment 2: mechanical compression testing of
not modeled to simplify geometry. The model constituted of dentine specimens
36 segments along the tubule direction. Each of these 36 seg-
ments was further divided into 4 partitions in order to reduce Twelve freshly extracted single rooted teeth were collected
distortion of elements during meshing. Global seeding of ele- and stored in deionized water. Mid-line bucco-lingual plano-
ment size of 0.008 mm was assigned for the whole model, and parallel, slab shaped sections of 2.5 mm thickness were
at least four elements were used around each dentinal tubule. prepared from these teeth by grinding the mesial and dis-
Four-node linear tetrahedron elements with three degrees of tal aspect of the specimens on wet SiC paper of varying grit
freedom per node were used. Due to periodic symmetry, only a sizes. Enamel was removed from these teeth by grinding on
sector of the whole geometry was represented in the numeri- SiC paper of size 400 and the apical and coronal ends of each
cal simulation. The final assembled model consisted of 250,120 tooth were made flat to facilitate the placement of the speci-
tetrahedral elements and 56,770 nodes (Fig. 1(a–c)). men in the mechanical testing machine. The specimens were
In models simulating the spatial gradients in elastic mod- kept hydrated during the entire stages of specimen prepara-
ulus, a thermal analysis approach was used to achieve a tion. These specimens were then polished with a diamond
smooth linear elastic modulus gradation across the whole paste of particle size 3 m. All the specimens were checked
model. The inner and outer surfaces were fixed at an arbitrary for preexisting cracks. Out of the 12 specimens used 6 spec-
temperatures and constant thermal conductivity is applied. imens were kept fully hydrated while the other 6 specimens
At steady state of the thermal analysis a linear tempera- were allowed to dehydrate at 21 ◦ C and 60% relative humidity
ture profile is obtained. The elastic modulus is provided as for 72 h (partial dehydration). The protocol of partial dehy-
a linear function of temperature to obtain spatial variation dration process induced in this study was similar to earlier
of the modulus. The temperature gradient does not affect experiments [16]. All samples were subjected to a compres-
subsequent stress analysis since thermal expansion is not sion testing using a 5564 Instron Universal testing machine at
considered. The gradients in the elastic modulus applied in the rate of 1 mm/min.
d e n t a l m a t e r i a l s 2 3 ( 2 0 0 7 ) 1296–1306 1299
Fig. 1 – The three-dimensional sectional model of the tooth showing: (a) geometric details of a single dentinal tubule, (b)
solid sector model with four dentinal tubules, and (c) fully meshed finite element model consisting of 250,120 tetrahedral
elements.
2.3. Experiment 3: Fourier transform infrared (FTIR) bur (no: 700). These specimens were divided into two groups
spectroscopic analysis of dentine with equal number of specimens. The specimens in Group
1 were maintained fully hydrated in deionized water, while
Freshly extracted teeth were collected and their enamel and specimens in Group 2 were subjected to room temperature
cementum portions were trimmed using a tapering fissure dehydration at 21 ◦ C (60% relative humidity) (partial dehydra-
1300 d e n t a l m a t e r i a l s 2 3 ( 2 0 0 7 ) 1296–1306
3. Results
Fig. 2 – Comparison of stress distribution from inner to
outer dentine under compressive loads (a) with hydrostatic
3.1. Experiment 1: finite element analysis of dentine
pressure and (b) without hydrostatic pressure.
models
Fig. 4 – Stress contour of plane at 0.0003 mm from the surface of inner dentine under 15 N compressive load: (a) with
hydrostatic pressure and (b) without hydrostatic pressure.
d e n t a l m a t e r i a l s 2 3 ( 2 0 0 7 ) 1296–1306 1301
the GEM model without HP (GEM) displayed relatively con- 3.1.2. Distribution of von Mises stress in dentine
stant compressive stress distribution throughout the dentine, The models with hydrostatic pressure (GEM-HP and HEM-HP)
which increased systematically with increase in compressive demonstrated similar tensile stress distribution in the inner
loads. At higher loads the maximum compressive stresses in dentine adjacent to the root canal. Fig. 5 shows a compari-
the GEM-HP model was observed in the outer region while son of the stress distribution in dentine (GEM-HP) with and
the inner region experienced only a reduction in the preex- without hydrostatic pressure (GEM) for different compressive
isting residual stress. In the GEM model without hydrostatic loads applied along the long axis of the tooth. The von Mises
Fig. 7 – von Mises stress contour of plane at 0.0003 mm from the surface of inner dentine under 15 N compressive load: (a)
with hydrostatic pressure and (b) without hydrostatic pressure.
1302 d e n t a l m a t e r i a l s 2 3 ( 2 0 0 7 ) 1296–1306
Fig. 10 – Strain contour of plane at 0.0003 mm from the surface of inner dentine under 15 N compressive load: (a) with
hydrostatic pressure and (b) without hydrostatic pressure.
d e n t a l m a t e r i a l s 2 3 ( 2 0 0 7 ) 1296–1306 1303
4. Discussions
experiments further highlighted that the fracture surfaces of Hydraulic strengthening (HS) of bone refers to the effect
the old dentine was smoother with very less topographical of the viscous fluid constituent of the bone in reducing bone
variations between the planes of failure of intertubular and stresses during dynamic loading. It is characteristically a
peritubular dentine in comparison to the young hydrated mechanism in bone that increases the upper range of dynamic
dentine. Fracture surface of young hydrated dentine was loads that can be tolerated by the human skeleton [40]. In
found to exhibit evidence of ‘peritubular cuff pull-out’, which the experimental compressive testing conducted in this study,
contributed to energy dissipation during crack extension complete hydration or in other words presence of free water
[36,37]. in the tubulo-canalicular system increased both resilience and
In this study FEA was utilized not to determine the abso- toughness of the dentine. The increased resilience (the capac-
lute values of mechanical stress or strain generated within ity of a material to absorb energy elastically upon loading) and
the dentine bulk, but to understand their distribution pattern. toughness (the ability to resist fracture) imply that the free
The FEA revealed that dentine model with hydrostatic pres- water in the tubulo-canalicular systems provides dentine the
sure exhibited residual principal tensile stresses and strains ability to absorb loads elastically and resist fracture. Further,
in the inner region adjacent to the root canal. This resid- the fully hydrated dentine exhibited a concave stress–strain
ual tensile stresses and strains in the inner region of the curve in the early loading phases, which indicates that for
bulk dentine can be attributed to the effect of hydrostatic initial loads the dentine reacts with increased deformation
pressure on the root canal lumen, large diameter of denti- rather than stress [34]. All the above mechanisms support
nal tubules and higher density of dentinal tubules in the the evidence that the presence of free water in the tubulo-
inner dentine. Interestingly, previous studies have noticed canalicular system of dentine, the hydrostatic pressure and
dehydration induced residual compressive strains in dentine the spatial gradients in the elastic modulus not only increased
structure [16,38]. The maximum residual tensile stress and the upper range of loads that can be tolerated by the bulk den-
strain in the inner region was conspicuously lower in the tine structure but also improved the fatigue performance of
dentine model with gradient elastic modulus than dentine the structure.
model with homogenous elastic modulus. When compressive Having observed the distinct role of dentinal tubules and
loads were applied to the dentine models with hydrostatic hydrostatic pressure on the mechanical stress–strain distri-
pressure, the residual tensile stresses and strains diminished bution in bulk dentine, it becomes imperative to discern the
systematically with increase in loads. In the absence of hydro- type of water contributing to this unique response in dentine.
static pressure, dentine models with gradient elastic modulus It was suggested that free water can be removed by heating
showed relatively constant compressive stresses and strains at 100 ◦ C, but bound water can only be substantially removed
throughout the bulk dentine. The stresses and strains in such by heating at 600 ◦ C [41]. The FTIR analysis did not high-
models without hydrostatic pressure increased, especially in light any significant difference between fully hydrated and
the inner dentine with increase in applied loads. In all speci- partially dehydrated dentine. This finding substantiates the
mens the dentinal tubules adjacent to the root canal lumen earlier understanding that in mineralized tissue collagen, the
exhibited higher circumferential stresses and strains. The intermolecular space is mostly occupied by mineral crystals,
presence of hydrostatic pressure was found to significantly which restricts molecular movement and offers better stabi-
affect the nature of circumferential stress and strain distribu- lization to calcified collagen [42–44]. This finding confirms that
tion around the dentinal tubules in this region. In the presence the mechanical response observed in the fully hydrated den-
of hydrostatic pressure the dentine circumferential to the tine samples was a discrete response produced by the free
dentinal tubules displayed compressive stresses in the load- water in the dentinal tubules and root canal lumen, and is not
ing direction, while tensile stresses were distributed in the caused by any inorganic or organic phase alterations. In addi-
orthogonal direction. This response was similar to cellular tion, previous experiments have highlighted that after 72 h
solids [39], and earlier experiments studying the stress–strain of dehydration, the dentine lost only 5% of water. This water
response of dentine under loads within physiological limits constituted only 30% of the total water in dentine, and was pre-
have highlighted characteristics similar to cellular solids in dominantly from the dentinal tubules and root canal lumen.
dentine [16]. In models with homogeneous elastic modulus It was also shown that rehydration of dentine can completely
(both with and without hydrostatic pressure), compressive reverse the dehydration induced strains and water level in
stresses and strains concentrated in the direction orthogo- dentine. The water lost during this dehydration process was
nal to the loading direction. These findings vividly highlight mostly the ‘free’ or ‘loosely’ bound water that fills the dentinal
that dentine during compressive loading experiences cir- tubules and the root canals [11,45].
cumferential deformations around the dentinal tubules, and It is important to realize that the free water that fills the
hydrostatic pressure was important for their symmetrical dentinal tubules and root canal lumen can form a three-
and homogenous distribution of deformation along the inter- dimensional interconnecting channel system of water, which
tubular dentine. A clinical study highlighting the origin of along with the hydrostatic pressure creates a preexisting
microcracks in the inner dentine adjacent to the root canal tensile stresses and strains in the loading direction, which
in clinically fractured post-endodontically restored teeth was counteracts the compressive loads due to biting acting on the
reported earlier [30]. The dentine models without hydrostatic bulk dentine structure. This effect is largely lost after dehy-
pressure highlighted obvious strain difference between the dration at 20 ◦ C for 72 h. Interestingly, it was also observed that
inner and the outer dentine with increase in applied loads. the hydrostatic pressure had more pronounced effect than the
Corresponding results were reported in earlier investigation elastic modulus gradients on the mechanical stress and strain
[16]. distribution in the bulk dentine.
1306 d e n t a l m a t e r i a l s 2 3 ( 2 0 0 7 ) 1296–1306