doi:10.1111/j.1365-2591.2012.02092.

The influence of elastic modulus mismatch

between tooth and post and core restorations on
root fracture

M. Ona1, N. Wakabayashi1, T. Yamazaki2, A. Takaichi1 & Y. Igarashi1

1

Department of Removable Partial Prosthodontics, Graduate School, Tokyo Medical and Dental University, Tokyo; and 2School
of Dentistry, Tokyo Medical and Dental University, Tokyo, Japan

Abstract
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. International Endodontic Journal, 46, 4752, 2013.

Aim To investigate the influence of elastic modulus

mismatch between tooth and post and core restorations on mechanisms of root fracture.
Methodology Three-dimensional mathematical models
of a root filled maxillary premolar tooth with supporting periodontium were constructed. The tooth was
restored with a cast NiCr alloy or fibre-reinforced
composite post and core that was bonded or nonbonded to dentine. In the nonbonded simulation, a nonlinear contact analysis was executed to simulate a
friction and a potential sliding phenomenon in the
interface between tooth and post and core. Risks of
root fracture and debonding at the bonded interface
were estimated based on the principal stress of the
root and the shear stress on the interface, respectively.

Introduction
Cast post and core build-ups have long been used to
support fixed restorations in root filled teeth. A 10year retrospective study reported a survival rate of
83.0% using cast post and cores (Gomez-Polo et al.
2010). However, in recent years, this conventional
form of restoration has been replaced gradually by

Correspondence: Noriyuki Wakabayashi, 1-5-45, Yushima,

Bunkyo, Tokyo 113-8549, Japan (Tel.: +81 3 5803 4935;
fax: +81 3 5803 4946; e-mail: wakabayashi.rpro@tmd.ac.jp).

2012 International Endodontic Journal

Results The fracture risk of the bonded cast post

and core was lower than that of the composite post
and core, although the cast restoration exhibited
eight times greater stress than the composite. The risk
of root fracture based on the tensile stress of the tooth
structures was higher with the bonded composite post
and core than that with the cast post and core. These
stresses doubled when the restorations were not
bonded to the tooth structures. The risk of debonding
of the cast post and core based on the shear stress
was approximately twice that of the composite post
and core.
Conclusions The elastic modulus mismatch
appears to be a factor responsible for the debonding of
post and cores from root canals, with the potential to
increase the risk of root fracture indirectly.
Keywords: finite element analysis, fracture, root,
stress.
Received 21 February 2012; accepted 29 May 2012

composite cores that incorporate a glass fibre post or

a metallic post. Improved resistance to root fracture
with the composite restoration has been reported
(Naumann et al. 2008, Salameh et al. 2008) as well
as in short-term retrospective clinical studies (Signore
et al. 2011, Zicari et al. 2011) with survival rates of
91.797.2%. The reduced fracture probability was
reportedly attributed to the elastic moduli of composite and glass fibre that are closer to root dentine in
comparison with cast alloys. However, this argument
is controversial because a metallic restoration with
higher modulus theoretically absorbs a large amount
of stress from the bonded tooth structure, resulting in

International Endodontic Journal, 46, 4752, 2013

47

Elastic modulus mismatch Ona et al.

less stress intensity in the root dentine. In fact, some

clinical studies found no improvement in fracture
resistance when using the fibre-reinforced composite
core (Bitter et al. 2008, Vano et al. 2009, Wu et al.
2009).
Mathematical approaches indicated that the loss of
bonding integrity at the interface could increase the
risk of root fracture of teeth restored with a composite
core incorporating a glass fibre post (Santos et al.
2009, 2010). However, the effect of elastic modulus
mismatch between post and cores and tooth structure
on the root fracture mechanism has not been elucidated in relation to the risk of debonding at the interface. Because of this lack of knowledge, clinical
decision making on the post and core material for
root filled teeth is still controversial.
In this study, the overall risk of root fracture and
the probability of debonding at the interface between
tooth and post and core were estimated based on
stress analyses. The purpose of this study was to test
the effect of the elastic modulus mismatch between
tooth and post and core on root fracture under masticatory force.

Materials and methods

Finite element (FE) models consisted of a root filled
maxillary second premolar tooth, periodontal ligament and the surrounding alveolar bone. A threedimensional intact tooth model was constructed based
on the anatomical image of an adult tooth (Dental
Anatomy & Interactive 3-D Tooth Atlas; Brown &
Herbranson Imaging, Inc, Portola Valley, CA, USA)
(Fig. 1). The pulp chamber was modelled with a simplified oval external cross-section in which the buccopalatal depth was twice the mesio-distal width. The
maxillary bone was modelled as a cancellous block
with 2.0-mm-thick cortical bone. Part of the tooth
structures was replaced by post and core and full coverage ceramic crown, with a 1.0-mm ferrule around
the cervical region of the root. Gutta-percha was
inserted into apical third of the root length. A NiCr
alloy cast post or glass fibre post with resin composite
matrix was used for the post and core restoration.
Each model was meshed by approximately 75 000
hexahedral elements determined by preliminary convergence tests (Al-Sukhun et al. 2007) (ANSYS 11.0;
ANSYS Inc., Canonsburg, PA, USA). All materials
were considered homogeneous, linearly elastic and
isotropic, except for the orthotropic glass fibre post
(Table 1; Friedman et al. 1977, Kse et al. 1985,

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International Endodontic Journal, 46, 4752, 2013

(a)

(b)

(c)

Figure 1 Three-dimensional finite element model of the

maxillary second premolar tooth. (a) Meshed parts of
the tooth model: root (r), post and core foundation (f) and
the crown restoration (c). (b) Assembled premolar model
with increased translucency for visualization. Gutta-percha
(gp) was also modeled in the root canal. (c) The loading and
boundary conditions. The periodontal ligament (pdl) and the
bone block (b) were modeled for support of the tooth structures. Red arrow indicates an off-axis oblique load on the
inner surface of the buccal cusp. The triangles represent the
fixation at the lower surface of the bone.

Farah et al. 1989, Morris 1989, Moroi et al. 1993,

Sano et al. 1994, Lanza et al. 2005). The post and
core was assumed to be perfectly bonded or completely in contact (nonbonded) to the root. In the
nonbonded simulation, nonlinear contact elements
between tooth and foundation were applied to simulate friction and a potential sliding phenomenon, with
a friction coefficient of 0.3. A total axial load of
200 N (Ferrario et al. 2004) was applied to the tip of
the buccal cusp 30 obliquely from palatal to buccal.
In each model, the movement of the outer surface of
bone was restricted.
The principal stress distributions in the tooth and
the post and core, and the shear stress distributions
on the interface surfaces, were calculated for all simulations. The magnitudes of the highest maximum
principal stress in the tooth structures (rt) and in the
foundation (rf), and the highest maximum shear
stress along the interface surfaces (rshear) were calculated. The fracture risks of the tooth root (Rt) and the
post and core foundation (Rf), and the failure risk of
the interfacial adhesion (Rint) were also calculated
using the following equations (Ona et al. 2011):

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Ona et al. Elastic modulus mismatch

Table 1 Material properties used in the study

Elastic
modulus
(GPa)

Poissons
ratio

References

Dentine

14.7*

0.31**

Porcelain
Cortical bone
Cancellous
bone
Gutta-percha

70
14.7
4.9 9 10

0.19
0.30
0.30

1.4 9 10

0.49

Periodontal
ligament
NiCr alloy
Composite
resin
Glass fiber
Transverse
Longitudinal

6.9 9 10

0.45

Friedman et al.
(1977)
Farah et al. (1989)

188
12

0.27
0.33

Morris (1989)
Lanza et al. (2005)

9.5
37

0.27
0.34

*Sano et al. (1994)

**Farah et al.
(1989)
Kse et al. (1985)
Moroi et al. (1993)
Moroi et al. (1993)

Lanza et al. (2005)

Rt = rt/flexural strength of root dentine which is

104 MPa (Sano et al. 1994), Rf = rf/flexural strength
of the foundation material (790 MPa for the cast
model (Morris 1989) and 55 MPa for the composite
model (Yuzugullu et al. 2008)), and Rint = rshear/
Shear bond strength, with a dual-curing resin luting
agent together with a silane-coupling agent, of the
post material to dentine (24.5 MPa for metal (Zhang
& Degrange 2010) and 23.2 MPa for composite
(Scherrer et al. 2010)).

Results
The highest maximum principal tensile stress in the
bonded cast post and core (rf) appeared on the palatal side (tension side) of the post half way along its
length (Fig. 2). Even though the rf for the bonded
cast alloy was approximately eight times higher than
that of the bonded composite (Table 2), the estimated
risk of the post fracture (Rf) was lower for the alloy
(0.18) than for the composite (0.31). The maximum
stress in the post and core for the nonbonded cast
alloy was slightly lower than the bonded cast alloy,
whilst that of the nonbonded composite doubled compared to the bonded condition. The highest risk was
revealed in the nonbonded composite post and core
(0.67).
The highest maximum principal tensile stress in the
tooth structures (rt) was located at the mesio-buccal
cervical region for all the models (Fig. 3). The bonded

2012 International Endodontic Journal

Figure 2 The maximum first principal (tensile) stress distributions on the mesial surfaces of the post and core restorations. The post and core was made of cast alloy (left) or
fiber-reinforced composite (right), and perfectly bonded to
tooth structures. Red areas represent the highest stress, as
indicated by the scale bars.

composite post and core generated the maximum

principal stress of the root at the cervical region
(32.0 MPa) that was approximately twice as much
that of the bonded cast post and core (15.7 MPa).
These maximum stresses doubled, reaching 61.1 MPa
and 39.2 MPa, respectively, when the post and cores
were not bonded to the tooth structures. The estimated risk of tooth fracture was roughly proportional
to the stress.
The highest maximum shear stress at the interfacial
surface (rshear) of the bonded cast post and core was
concentrated at the mesial cervical region and the
region near the edge of the post (Fig. 4). The rshear of
the bonded composite post and core was also concentrated at the cervical region but not at the edge of the
post. The shear stress was higher with the bonded
cast alloy (38.3 MPa) than that with the composite
(18.5 MPa), and the failure risk was roughly proportional to the maximum shear stress.

Discussion
The maximum principal stress was considerably larger in the bonded cast post and core than that in the
bonded fibre-reinforced composite. This was because
the cast alloy post and core, which had a greater
modulus (188 GPa), was likely to receive larger stress
from the root than the composite with a lower modulus (12 GPa). Despite the high stress of the cast

International Endodontic Journal, 46, 4752, 2013

49

Elastic modulus mismatch Ona et al.

Table 2 The maximum principal first (tensile) and shear stresses and the fracture risks for each structure. rf; Maximum principal stress in the post and core (MPa), Rf; Fracture risk of the post and core, rt; Maximum principal stress in the tooth (MPa),
Rt; Fracture risk of the tooth, rshear; Maximum shear stress at the interface between the tooth and the restoration (MPa), and
Rint; Failure risk of the bonded interface

rf (Rf)
rt (Rt)
rshear (Rint)

Cast alloy bonded

Composite bonded

Cast alloy nonbonded

Composite nonbonded

144.7 (0.18)
15.7 (0.15)
38.3 (1.56)

17.3 (0.31)
32.0 (0.30)
18.5 (0.79)

132.4 (0.17)
39.2 (0.37)

36.8 (0.67)
61.1 (0.58)

Figure 3 The maximum first principal (tensile) stress distributions in the cervical root region of the tooth. The cast
(left) or composite (right) post and core was bonded (upper)
or non-bonded (left) to the tooth. The restorations are not
shown in the graphics to highlight the stress distributions of
the root surfaces. Red areas represent the highest tensile
stress, as indicated by the scale bar.

restoration, the failure risk was lower with the cast

than that with the composite. This was because of
the higher strength of the alloy in comparison with
the composite. The composite that has a modulus
close to that of the root dentine flexes under loading
in sync with the root, resulting in larger loading
energy or stress transmitted to the root. In other
words, when the post and core foundation was perfectly bonded to the root, the elastic modulus mismatch between the root and the foundation did not
increase the risk of root fracture.
The elastic modulus mismatch, however, was a
strong potential factor that could cause debonding at
the interface. The stiff cast post was unlikely to distort
under loading, which might create larger shear stress
at the interface (rshear) than the relatively flexible
composite. As the cast post and core was tilted to the

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International Endodontic Journal, 46, 4752, 2013

Figure 4 The shear stress distributions on the mesial surfaces of the post and core restoration. The post and core was
made of cast (left) or composite (right), and perfectly bonded
to tooth structures. The highest shear stress was indicated as
the maximum (red) or the minimum (blue) stresses dependent on the clockwise and couterclockwise directions.

buccal direction (compression side) under an oblique

load, the high maximum shear stresses appeared at
the cervical and apical interfaces (Fig. 4, left). Once
the debonding occurs, the overall risk of root fracture
can be estimated from the Rint multiplied by Rt of the
nonbonded post and core. According to this estimation, the fracture risk following interfacial failure was
higher with the cast restoration (1.56 9 0.37 =
0.58) than that with the composite (0.79 9 0.58 =
0.46). The relative comparison of this risk estimation
was not consistent with that based on the bonded
root stress. It is therefore suggested that adhesion of
the post and core restoration to the tooth structures
played a critical role in the fracture initiation of rootfilled teeth.
The likelihood of fracture initiation at the cervical
region of a root filled premolar root (Lustig et al.
2000) was clearly indicated by the areas of stress
concentration in all models. The maximum principal

2012 International Endodontic Journal

Ona et al. Elastic modulus mismatch

stress was revealed in the mesiobuccal cervical region

where tensile hoop stresses were created as a result
of the impact of the obliquely loaded post, possibly
leading to a vertical root fracture. The relatively thin
mesial root might be another factor for stress concentration. When the post and core is not bonded, the
friction at the contacting interface may result in tilting movement of the restoration. This contact potentially generates greater pressure on the root surface.
Although the maximum stresses were well below the
flexural strength of root dentine, the potential failure
risk cannot be ignored because repetitive fatigue
loading can cause stress accumulation (Nalla et al.
2004).
Limitations of the study design should be noted.
The failure risk was estimated on the basis of the relative comparison of the highest maximum stress with
the strength of the materials or the interface. The
method used was the same as that used in the previous studies, which aimed to assess the effect of interfacial failure on the failure of ceramic restorations
(Ona et al. 2011). Although the results serve to clarify the critical elements of material selection for foundation restorations, the limitation of the method
should be considered, especially if the quantitative
assessment of the stresses is to be emphasized. This
study employed two extreme cases of bonding and
nonbonding conditions for interfacial simulation.
However, the perfect boding is not likely to be
obtained, especially in the bonding of composite
matrix reinforced with the fibre post. Bond strength
in deeper areas of the root canal could not be perfectly obtained because of inadequate visualization
and difficulties in the application procedure of luting
agents (Zicari et al. 2008). Therefore, the influence of
bonding integrity level and debonding process on the
root fracture should be further investigated. In addition, the potential failure at the interface between the
composite and the fibre post was not considered.
Future investigation is encouraged to assess the
mechanism of debonding process at multiple interfacial sites in relation to the root fracture.

Conclusion
The nonlinear contact stress analysis of this study
indicates that the elastic modulus mismatch between
tooth and post and core restoration appears to be a
factor responsible for the debonding of the restoration,
thereby possibly leading to root fracture indirectly.
The mismatch does not increase the risk of root frac-

2012 International Endodontic Journal

ture if the post and core is perfectly bonded to the

tooth structures.

Acknowledgements
This study was supported by a Grant-in-Aid (No:
20592307 to N.W.) for research from the Japan Society for Promotion of Science/MEXT. The authors deny
any conflicts of interest to this study.

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