The Impact of Perforation Presence, Preparation Design, and Prosthetic Treatment Options on Crack Propagation: A Finite Element Analysis Study

Background: The aim of this study is to investigate the impact of restoration type and material on stress distribution in molar teeth with furcal perforations, as well as to evaluate the prognosis of cracks originating from the perforation site. Methods: The molar tooth with a furcal perforation was restored using post-core restorations containing 1, 2, and 3 posts, as well as two different endocrown designs with and without a ferrule. Lithium disilicate (LDS) and polymer-infiltrated ceramic network (PICN) materials were used as the restoration materials. After modeling, von Mises values generated in the components were recorded using XFEM, and the progression of cracks originating from the perforation site was also examined. Fatigue values for dentin and crown were predicted. Results: The investigations revealed that the LDS material exhibited better fatigue performance in all groups. Increasing the number of posts showed positive results for the perforation prognosis. Additionally, the presence of a ferrule in endocrown restorations improved the restoration's success. Conclusion: In the presence of perforation, increasing the number of posts in post-core applications, when combined with ceramic restorations, is likely to result in a more successful prognosis in terms of survival. If endocrown restorations are to be chosen, the presence of a ferrule positively influences the success.