Multi-factorial retainer design analysis of posterior resin-bonded fixed partial dentures: A finite element study

Objectives: Biomechanical aspects related to prosthesis design of RBFPD have been proposed as the predominant contributor to unpredictable clinical retention. The aim of this study was to investigate the biomechanics of multiple posterior retainer designs and their interactions using three-dimensional finite element analysis. Methods: To understand the interactions among the retainer design factors, three values of retainer thicknesses (1.2, 0.8 and 0.4 mm), heights (100, 75 and 50% of the distance from 2 mm above the CEJ to the occlusal surface) and angle of the axial surface extensions (150, 180 and 210°) were selected as the design parameters. Twenty-seven RBFPD FE models with three retainer-design parameters were created by image processing, contour stacking, and mapping mesh procedures. The maximum principal and von Mises stresses in remaining tooth and prosthesis, respectively, were recorded in 54 FE analyses (27 FE models with axial and lateral occlusal loadings). Results: The simulated results showed that the averaged stress values of the remaining tooth and prosthesis decreased with greater retainer thickness and height as a result of increasing prosthesis stiffness and maximizing of the bonding area between the enamel and the retainer, respectively. However, no significant stress differences were found according to the angle of the retainer extension because stress transmission was concentrated at the connectors. Conclusions: The stress elevation rate (termed as VSR-stress elevation by decreasing one unit volume of the remaining tooth) addresses that the height was the most influential factor for the remaining tooth structure, followed by retainer thickness and extension angle.