Finite Element Analysis in Polymer-Based Adhesive Dental Restorations: Material Behavior, Methodological Validity and Clinical Relevance

Finite element analysis (FEA) is increasingly used in conservative and restorative den-tistry to investigate the mechanical behavior of adhesive direct and indirect poly-meric restorations, although its methodological validity and clinical relevance remain debated. This narrative review critically synthesizes evidence on FEA in adhesive re-storative dentistry, focusing on class I to class V in anterior and posterior teeth restored with direct or indirect polymeric materials, including inlays, onlays, overlays, and tabletop resto-rations. A structured, non-systematic search of major biomedical databases was per-formed, and eligible studies were qualitatively appraised with attention to modeling assumptions, stress patterns, and clinical interpretability. Overall, FEA con-sistently highlights mechanically relevant trends related to cavity configuration, cuspal support, restoration design, material stiffness, polymerization shrinkage, and adhesive interface behavior. These trends help explain clinically observed failure patterns and support minimally invasive, adhesion-driven principles. Nonetheless, simplified mate-rial be-havior, idealized bonding, and mainly static loading limit the ability of FEA to predict long-term clinical performance. When interpreted within these constraints and integrated with experimental and clinical evidence, FEA remains a valuable comple-mentary tool to understand adhesive restorations and support rational restorative deci-sion-making.