Abstract
AIM: The study aimed to compare the effects of endodontic microsurgery, fiber post, horizontal bone loss, and their combinations on the biomechanical behavior of a maxillary central incisor using finite element analysis (FEA). MATERIAL AND METHODS: A maxillary central incisor was modeled along with different variations: one with endodontic treatment (coded E), endodontic microsurgery with 3 mm and 5 mm root-resection (coded R3 and R5), restoration with a fiber post (coded P), 3 mm horizontal bone loss (coded B), and combinations of these parameters. The models were subjected to a 250N load, and von Mises stress distribution was analyzed. RESULTS: Models R3 and R5 showed stress distribution in the coronal third, similar to P.R3 and P.R5. The E.P and P.B models exhibited stress in the coronal and middle thirds. Models with combined parameters (R3.B, R5.B, P.R3.B, P.R5.B) experienced stress throughout the root. The crown-root ratio (CRR) changes did not significantly affect stress values but altered stress distribution. Root-end resection, fiber post, and their combinations did not significantly increase stress. No notable difference was found between 3 and 5 mm resections. Horizontal bone loss, with or without a post, significantly increased stress. The combination of all three parameters resulted in stress throughout the root, but no additive effect on von Mises values was observed. CONCLUSIONS: The presence of bone loss and the decisions to have endodontic microsurgery, and/or post-core restorations are factors that affect the biomechanical behavior of teeth independently or combined. These variables interact and affect stress distribution patterns and values, especially within the investing bone.