Investigation of Stress Distribution And Fatique Performance in Restored Teeth Using Different Thickness of Adhesive Materials and Different Restorative Materials:3D Finite Element Analysis (FEM)

Investigation of Stress Distribution And Fatique Performance in Restored Teeth Using Different Thickness of Adhesive Materials and Different Restorative Materials:3D Finite Element Analysis (FEM) | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Investigation of Stress Distribution And Fatique Performance in Restored Teeth Using Different Thickness of Adhesive Materials and Different Restorative Materials:3D Finite Element Analysis (FEM) Reza Mohammadi, Abdulkadir Harmankaya, Hakan Yasin Gönder This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6129157/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: The aim of this study was to compare the stress distributions and fracture life of dental tissues and restorative materials restored using different thicknesses of adhesive materials and different restorative materials. Methos : A tooth number 36 without caries and loss of material was scanned using a CBCT device. The files obtained were transferred to Mimics software. Using this software, enamel tissue, dentin tissue and pulp regions were extracted separately in STL format. STL files were transferred to Geomagic Design X software for surface correction and saved in STP format. The obtained STP files were transferred to the Solidworks programme and 4 different (DO, MO, MOD, O) cavity preparations were made on the models. Each of these cavities was restored with bulk-fill composite, conventional composite and hybrid composite in the computerised environment. A layer of adhesive material with a thickness of 10, 15 and 20 micrometres was applied under all materials and stress distributions and fracture lifetimes were analysed by 3D finite element stress analysis method. Results: When we evaluated the models with different thicknesses of adhesive material, the stress values on enamel, dentin and adhesive material were highest in the models with bulk-fill composite, while the stress values on the restoration were highest in the models with hybrid composite. As the thickness of the adhesive material decreased, the stress values accumulated on the material increased. In addition, the models in which the enamel tissue started to fracture the earliest were the models restored with bulk-fill composite. The models in which the restorative materials started to fracture the earliest were the models restored with hybrid composites, while the models in which the restorative materials started to fracture the latest were the models restored with bulk-fill composites. Conclusion: When materials with low young's modulus are used for restorative purposes, they cause too much stress accumulation on enamel and dentin tissues. Accordingly, these tissues start to fracture early. When materials with large Young's modulus are used, too much stress is applied to the restoration and the restoration fractures prematurely. Adhesion Restorative materials Stress distribution Fracture lifetime Restoration Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 Figure 11 Figure 12 Figure 13 Figure 14 Figure 15 Figure 16 Figure 17 Figure 18 Figure 19 Figure 20 Figure 21 Figure 22 1. BACKGROUND Dental caries is one of the most common and preventable diseases worldwide. People have been sensitive to caries throughout their lives. Without treatment, caries can cause toothache or tooth loss. [ 1 , 2 ] One of the most important properties of restorative materials, which are widely used and continuously developed in dentistry, is their resistance to masticatory forces. The physical, chemical and mechanical properties of restorative materials frequently used in dentistry greatly affect the stress distribution in dental tissues and the durability of the restorations made accordingly. A small stress accumulation in the tooth and restorative materials is a very good indicator for the materials. However, it is often not possible to achieve low stress accumulation in both dental tissues and restorative materials at the same time.[ 3 , 4 ] Careful selection of the restorative materials to be used in the restoration of teeth is essential. When restorative materials cause large amounts and inappropriate stress distribution in dental tissues; they cause the restorations to come out of the cavity and cause retention problems between the tooth and the restoration.[ 5 , 6 ] Many stress distribution analyses are performed in dentistry, but the most widely used method today is the ‘Finite Element Stress Analysis’ method. This analysis method was discovered by Hrennikoff and Courant to analyse stress distribution regions on complex models.[ 7 ] This analysis method was initially used in the field of engineering, but has been increasingly used in dentistry. Determining the stress magnitudes and regions resulting from the forces acting on living tissues is an extremely time-consuming and expensive process. For this reason, it has become very common today to carry out stress distribution analyses by modelling living tissues in computer environment with finite element stress analysis method.[ 8 ] The finite element analysis method has provided researchers with the opportunity to perform a non-invasive analysis in computer environment without the use of living tissues.[ 9 ] In addition to all these good features, this analysis method has some disadvantages such as the difficulties in transferring living tissues to the computer environment by means of programs, the possibility of human errors, the need for experienced engineers and the need for long computation times.[ 10 ] The aim of this study is to compare the stress distributions in tooth tissues and restorative materials restored with different restorative materials and their fracture life. The hypothesis of our study is that when materials with different mechanical properties are used in restoration, the stress values accumulated in dental tissues and restorative materials will change and the fracture life will differ depending on this stress accumulation. 2. METHODS A tooth number 36 with no caries and no loss of material was scanned using CBCT. The size of the imaging volume is a cylinder with a diameter and height of 40 mm at the centre of rotation of the X-ray. Images were acquired at 5 mA (milliampere, electric current value), 90 kVp (Peak kilovoltage, the highest voltage of the X-ray tube) using the parameters 160 qm and exposure time of 17.5 seconds. The obtained DICOM files were transferred to Mimics software (Mimics 12.00, Leuven, Belgium) for segmentation. Using this software, enamel tissue, dentin tissue and pulp regions were extracted separately in STL format. The STL files were transferred to Geomagic Design X software for surface correction and saved in STP format. Then, the obtained tooth model was placed in a box representing the cortical and spongiose bone using SolidWorks programme. A periodontal ligament thickness of 0.2 mm was designed in the prepared models. In the designed tooth model; different cavity designs were made in accordance with class II mesio-occlusal (MO), class II disto-occlusal (DO), class II mesio-occluso-distal (MOD) and class I occlusal (O) cavity principles. In addition, layers of adhesive material with thicknesses of 10, 15 and 20 µm were formed in these models which presented in Fig. 1 – 4 . The restorative materials used in our study were: bulk-fill composite, conventional composite, hybrid composite resin. Finally, these designs were saved in STL format for finite element analysis (FEA). In order to transfer the tooth tissues and the materials to be used to the computer environment, some mechanical values must be known. These values are shown in Table 1 . Table 1 Mechanical properties of dental tissues and restorative materials.[ 11 – 18 ] Young’s Modulus (Mpa) Poisson's Ratio Compressive Strength (MPa) Flexural Strength (MPa) Shear Strength (MPa) Fracture Toughness (Mpa m 1/2 ) Microhardness (HV) Enamel 84.1 0.33 384 11.5 60 0.8 3–6 Dentin 18.6 0.31 297 105.5 12–138 3.08 0.13–0.51 Adhesive Material 1 0.24 Pulp 0.002 0.45 PDL 0.0689 0.45 Cortical bone 13.7 0.3 Spongious bone 1.37 0.3 Bulk-fill Composite 12 0.25 169 42 Conventional Composite 16.6 0.24 294 77 Hybrid Composite 22 0.27 Finite element analysis was performed using Abaqus software (2020 Dassault Systems Simulation Corp., Johnston, RT, USA). Boundary conditions were determined by assigning appropriate material properties to each component in the Abaqus environment. Motion and rotation constraints were applied to the jawbone in all directions and the model was analysed under a vertical load of 600 Newton (N). The loads acting on the tooth surface and boundary conditions are shown in Fig. 5 . The stress values obtained as a result of the analysis were recorded as Von Mises stress values. The amount of force applied to the tooth was selected according to the average fatigue values of restored molars obtained from previous in vitro studies. The criteria for evaluating the fatigue life of the restorative material, enamel and dentin were compared with the maximum principal stress-life (S N) diagram during loading. The S-N curve represents the stress amplitude (𝜎0) as a function of the number of cycles to fracture (N). Fatigue values for the infill materials were determined by three-point bending tests as in previous studies. The fatigue behaviour of the materials was calculated using the non-linear Basquin formula as shown in the equation “ \(\:{\sigma\:}_{a}=A{\left(N\right)}^{B}\) ”. A and B values for restoration materials are shown in Table 2 . Wöhler curves for enamel and dentin are taken from the literature. These were plotted only for reverse loading (𝜎𝑚=0). All other mean stresses (𝜎𝑚≠0) are represented mathematically in the equation “ \(\:{\sigma\:}_{a}=({\sigma\:}_{f}-{\sigma\:}_{m}){\left(2N\right)}^{b}\) ”. Table 2 Coefficient and exponent constants of fatigue curves of restorative materials and dental tissues.[ 19 – 23 ] Material A (MPa) B σ f (MPa) b Enamel 310 -0.111 Dentin -0.111 Bulk-Fill Composite 54 -0.020 Conventional Composite 84 -0.035 Hybrid Composite 182.8 -0.056 3. RESULTS 3.1. Results on Stress Distribution 3.1.1. Results of the model with Class II disto-occlusal cavity When Class II disto-occlusal cavities were restored with bulk-fill composite, the highest stress values on enamel and dentin tissue were observed in the model with 15 micrometre thick adhesive material, while the lowest stress value was observed in the model with 10 micrometre thick adhesive material. When we look at the stress values on the restoration and adhesive material, the highest stress value was observed in the model using 10 micrometre thick adhesive material, while the lowest stress value was observed in the model using 20 micrometre thick adhesive material. When Class II disto-occlusal cavities were restored with conventional composite and hybrid composite, when each restorative material was evaluated within each restorative material; the highest stress values on enamel and dentin tissue were observed in the models using 15 micrometre thick adhesive material, while the lowest stress value was observed in the models using 10 micrometre thick adhesive material. The highest stress values on the restoration and adhesive material were observed in the model using 10 micrometre thick adhesive material, while the lowest stress values were observed in the model using 15 micrometre thick adhesive material for the restoration and 20 micrometre thick adhesive material for the adhesive material. The values of stress magnitudes are shown in Table 3 and stress distribution regions are shown in Figs. 6 – 10 . Table 3 Stress values (MPa) in dental tissues and restorative materials of the model with Class II disto-occlusal cavity. Model with 10 µm thick adhesive material Model with 15 µm thick adhesive material Model with 20 µm thick adhesive material Bulk-Fill Composite Conventional Composite Hybrid Composite Bulk-Fill Composite Conventional Composite Hybrid Composite Bulk-Fill Composite Conventional Composite Hybrid Composite Enamel 44.53 43.47 44.33 61.14 59.67 58.83 44.98 44.86 44.88 Dentin 34.37 31.88 29.96 49.18 46.02 43.44 41.26 38.69 36.63 Restorative Material 19.24 20.99 22.27 17.93 18.51 19.60 16.96 18.52 19.61 Adhesive Material 17.29 14.83 13.08 10.24 10.04 10.06 9.981 9.938 9.854 When the models with different thicknesses of adhesive material were evaluated within themselves, the stress values on enamel, dentin and adhesive material were the highest in the models using bulk-fill composite resin, while the stress values on the restoration were the highest in the models using hybrid composite resin. In addition, as the thickness of the adhesive material decreased, the stress values accumulated on the material increased. 3.1.2. Results of the model with Class II mesio-occlusal cavity When Class II disto-occlusal cavities were restored with bulk-fill composite, conventional composite and hybrid composite, when each restorative material was evaluated within each restorative material; the highest stress values on the enamel tissue were observed in the models using 10 micrometre thick adhesive material, while the lowest stress value was observed in the models using 15 micrometre thick adhesive material. In dentin tissue, the highest stress values were observed in models with 20 micrometre thick adhesive material, while the lowest stress values were observed in models with 15 micrometre thick adhesive material. The highest stress values accumulated on the restorative material were observed in the models with 20 micrometre thick adhesive material, while the lowest stress values were observed in the models with 10 micrometre thick adhesive material. The highest stress values accumulated on the adhesive material were observed in the model with 10 micrometre thick adhesive material, while the lowest stress values were observed in the model with 20 micrometre thick adhesive material. The values of stress magnitudes are shown in Table 4 and stress distribution regions are shown in Figs. 11 – 14 . Table 4 Stress values (MPa) in dental tissues and restorative materials of the model with Class II mesio-occlusal cavity. Model with 10 µm thick adhesive material Model with 15 µm thick adhesive material Model with 20 µm thick adhesive material Bulk-Fill Composite Conventional Composite Hybrid Composite Bulk-Fill Composite Conventional Composite Hybrid Composite Bulk-Fill Composite Conventional Composite Hybrid Composite Enamel 69.06 67.20 65.86 61.26 59.50 58.24 63.21 61.56 60.39 Dentin 28.11 27.62 27.31 27.45 26.95 26.59 30.69 30.13 29.68 Restorative Material 14.70 15.90 16.84 14.80 16.21 17.18 15.55 16.66 17.47 Adhesive Material 18.35 16.08 14.20 9.377 7.946 6.766 8.388 7.096 6.282 When the models with different thicknesses of adhesive material were evaluated within themselves, the stress values on enamel, dentin and adhesive material were the highest in the models using bulk-fill composite resin, while the stress values on the restoration were the highest in the models using hybrid composite resin. In addition, as the thickness of the adhesive material decreased, the stress values accumulated on the material increased. 3.1.3. Results of the model with Class II mesio-occluso-distal (MOD) cavity When Class II MOD cavities were restored with bulk-fill composite, conventional composite and hybrid composite, when each restorative material was evaluated within each restorative material; the highest stress values on the enamel tissue were seen in the models using 10 micrometre thick adhesive material, while the lowest stress value was seen in the models using 20 micrometre thick adhesive material. In dentin tissue, the highest stress values were observed in models with 20 micrometre thick adhesive material, while the lowest stress values were observed in models with 15 micrometre thick adhesive material. The highest stress values accumulated on the restorative material were observed in the models where 15 micrometre thick adhesive material was used, while the lowest stress values were observed in the models where 10 micrometre thick adhesive material was used. The stress values accumulated on the adhesive material were highest in the models where 10 micrometre thick adhesive material was used, while the lowest stress values were seen in the models where 20 micrometre thick adhesive material was used. The values of stress magnitudes are shown in Table 5 and stress distribution regions are shown in Figs. 15 – 18 . Table 5 Stress values (MPa) in dental tissues and restorative materials of the model with Class II mesio-occluso-distal (MOD) cavity. Model with 10 µm thick adhesive material Model with 15 µm thick adhesive material Model with 20 µm thick adhesive material Bulk-Fill Composite Conventional Composite Hybrid Composite Bulk-Fill Composite Conventional Composite Hybrid Composite Bulk-Fill Composite Conventional Composite Hybrid Composite Enamel 71.79 69.04 67.14 71.08 68.42 66.58 66.13 63.80 62.19 Dentin 22.73 22.71 22.70 22.50 22.48 22.47 22.86 22.84 22.82 Restorative Material 15.04 15.95 16.80 16.30 17.07 17.64 15.67 16.48 17.31 Adhesive Material 33.06 30.42 27.16 9.715 8.067 6.765 8.920 7.680 6.761 When the models with different thicknesses of adhesive material were evaluated within themselves, the stress values on enamel, dentin and adhesive material were the highest in the models using bulk-fill composite resin, while the stress values on the restoration were the highest in the models using hybrid composite resin. In addition, as the thickness of the adhesive material decreased, the stress values accumulated on the material increased. 3.1.4. Results for the model with Class I occlusal cavity When Class I occlusal cavities were restored with bulk-fill composite, conventional composite and hybrid composite, when each restorative material was evaluated within each restorative material; the highest stress values on the enamel tissue were observed in the models using 15 micrometre thick adhesive material, while the lowest stress value was observed in the models using 20 micrometre thick adhesive material. In dentin tissue, the highest stress values were observed in the models where 20 micrometre thick adhesive material was used, while the lowest stress values were observed in the models where 15 micrometre thick adhesive material was used. When we used bulk-fill composite as restorative material, the highest stress values on the restorative material were seen when we used adhesive material with a thickness of 10 micrometres, while the lowest stress value was seen in the model with adhesive material with a thickness of 20 micrometres. When we used conventional composite and hybrid composite as restorative materials, the highest stress values on the restorative material were observed when we used adhesive material with a thickness of 20 micrometres, while the lowest stress value was observed in the model where we used adhesive material with a thickness of 15 micrometres. The highest stress values accumulated on the adhesive material were observed in the models where 10 micrometre thick adhesive material was used, while the lowest stress values were observed in the models where 20 micrometre thick adhesive material was used. The values of stress magnitudes are shown in Table 6 and stress distribution regions are shown in Figs. 19 – 22 . Table 6 Stress values (MPa) in dental tissues and restorative materials of the model with Class I occlusal cavity. Model with 10 µm thick adhesive material Model with 15 µm thick adhesive material Model with 20 µm thick adhesive material Bulk-Fill Composite Conventional Composite Hybrid Composite Bulk-Fill Composite Conventional Composite Hybrid Composite Bulk-Fill Composite Conventional Composite Hybrid Composite Enamel 49.76 49.59 49.49 56.55 55.89 55.44 47.68 47.48 47.37 Dentin 31.07 30.56 30.13 30.80 30.35 29.98 35.17 34.54 33.99 Restorative Material 19.24 16.32 17.33 17.39 16.23 17.25 14.90 16.45 17.52 Adhesive Material 12.30 10.20 8.593 9.713 8.181 7.053 7.996 6.882 6.202 When the models with 10 micrometre and 15 micrometre thick adhesive materials were evaluated, the stress values on enamel, dentin, restorative material and adhesive material were the highest in the models with bulk-fill composite resin. When we evaluated the model with 20 micrometre thick adhesive material; the stress values on enamel, dentin and adhesive material were the highest in the models where bulk-fill composite resin was used, while the stress value on the restorative material was the highest in the model where hybrid composite resin was used. In addition, as the thickness of the adhesive material decreased, the stress values accumulated on the material increased. 3.2. Results of Fracture Lifespan 3.2.1. Results of the model with Class II disto-occlusal cavity When Class II disto-occlusal cavities were restored with bulk-fill composite, conventional composite and hybrid composite, when each restorative material was evaluated within each restorative material; the highest number of cycles required for the fracture of enamel tissue was seen when 10 micrometre thick adhesive material was used. The model with the lowest number of cycles required for enamel fracture, i.e. the model with the fastest enamel fracture, was the model with 15 micrometre thick adhesive material. When all restorative materials were considered, the earliest fracture of dentin tissue was observed in the model in which 15 micrometre thick adhesive material was used. When bulk-fill composite and conventional composite were used, the model with 10 micrometre thick adhesive material was the model with the latest dentin tissue breakage. When the hybrid composite was used, the model in which the dentin tissue fractured at the latest was the model in which the adhesive material with a thickness of 20 micrometres was used. When bulk-fill composite and conventional composite were used, the model in which the restorative materials showed the earliest fracture was the model in which 10 micrometre thick adhesive material was used. When hybrid composite was used, the earliest fracture of the restorative material was the model in which 15 micrometre thick adhesive material was used. When bulk-fill composite and hybrid composite were used, the model in which the restorative materials fractured the latest was the model in which 20 micrometre thick adhesive material was used. When hybrid composite resin was used, the model with 15 micrometre thick adhesive material was the model with the latest fracture of the restorative material (Table 7 ). Table 7 The number of cycles required for fracture of dental tissues and restorative materials for the model with Class II disto-occlusal cavity. Model with 10 µm thick adhesive material Model with 15 µm thick adhesive material Model with 20 µm thick adhesive material Bulk-Fill Composite Conventional Composite Hybrid Composite Bulk-Fill Composite Conventional Composite Hybrid Composite Bulk-Fill Composite Conventional Composite Hybrid Composite Enamel 5.382e9 5.486e9 5.528e9 2.3768e8 1.211e9 3.474e8 4.987e9 5.095e9 5.067e9 Dentin 7.441e9 1.5507e10 2,830e9 2.106e8 4.088e8 7.249e8 1.210e9 2.277e9 3.889e9 Restorative Material 5.921e37 9.621e25 6,378e21 5.142e39 6.529e27 3.999e17 7.867e40 5.922e27 9.016e22 When we analysed all adhesive material thicknesses, the models in which the enamel tissue started to fracture the earliest were the models restored with bulk-fill composite resin. In addition, the models in which the restorative materials started to fracture the earliest were the models restored with hybrid composite resin, while the models in which the restorative materials started to fracture the latest were the models restored with bulk-fill composite resin. 3.2.2. Results of the model with Class II mesio-occlusal cavity When Class II mesio-occlusal cavities were restored with bulk-fill composite, conventional composite and hybrid composite, when each restorative material was evaluated within each restorative material; the model in which the enamel tissue fractured the fastest was the model in which 10 micrometre thick adhesive material was used. The model with the slowest fracture of the enamel tissue, i.e. the model with the longest life span, was the model in which the adhesive material with a thickness of 15 micrometres was used. The fastest fracture of dentin tissue was the model in which 20 micrometre thick adhesive material was used. The model with 15 micrometre thick adhesive material was the model with the slowest fracture. The model in which the restorative material fractured the fastest was the model in which 20 micrometre thick adhesive material was used. The model with the slowest fracture, i.e. the model with the longest life, was the model in which 10 micrometre thick adhesive material was used (Table 8 ). Table 8 Number of cycles required for fracture of dental tissues and restorative materials for the model with Class II mesio-occlusal cavity. Model with 10 µm thick adhesive material Model with 15 µm thick adhesive material Model with 20 µm thick adhesive material Bulk-Fill Composite Conventional Composite Hybrid Composite Bulk-Fill Composite Conventional Composite Hybrid Composite Bulk-Fill Composite Conventional Composite Hybrid Composite Enamel 6.802e7 8.976e7 1.102e8 2.280e8 3.056e8 3.776e8 1.667e8 2.167e8 2.628e8 Dentin 5.037e10 5.959e10 6.639e10 6.325e10 7.541e10 8.575e10 2.177e10 2.599e10 3.003e10 Restorative Material 6.242e43 3.132e29 9.761e23 5.345e44 1.286e29 5.976e23 2.482e42 6.565e28 4.629e23 When we analysed all adhesive material thicknesses, in all models; the models in which the enamel and dentin tissue started to fracture the latest, that is, the models with the longest life, were the models restored with hybrid composite. The models in which enamel and dentin tissue started to fracture the earliest were the models restored with bulk-fill composite. The models in which the restorative materials started to fracture the earliest were the models restored with hybrid composite resins, while the models in which the restorative materials started to fracture the latest were the models restored with bulk-fill composites. 3.2.3. Results of the model with class II MOD cavity When Class II MOD cavities were restored with bulk-fill composite, conventional composite and hybrid composite, when we evaluated each restorative material within each restorative material; the model in which the enamel tissue fractured the fastest was the model in which 10 micrometre thick adhesive material was used. The model with the slowest fracture of enamel tissue, i.e. the model with the longest life, was the model in which 20 micrometre thick adhesive material was used. The fastest fracture of dentin tissue was the model in which 20 micrometre thick adhesive material was used. The model with 15 micrometre thick adhesive material was the model with the slowest fracture. The model in which the restorative material fractured the fastest was the model in which 15 micrometre thick adhesive material was used. The model with the slowest fracture, i.e. the model with the longest life, was the model in which 10 micrometre thick adhesive material was used (Table 9 ). Table 9 The number of cycles required for fracture of dental tissues and restorative materials in the model with a Class II mesio-occluso-distal (MOD) cavity. Model with 10 µm thick adhesive material Model with 15 µm thick adhesive material Model with 20 µm thick adhesive material Bulk-Fill Composite Conventional Composite Hybrid Composite Bulk-Fill Composite Conventional Composite Hybrid Composite Bulk-Fill Composite Conventional Composite Hybrid Composite Enamel 4.657e7 6.962e7 9.291e7 5.132e7 7.553e7 9.955e7 1.075e8 1.546e8 2.003e8 Dentin 3.853e11 3.882e11 3.897e11 4.218e11 4.250e11 4.266e11 3.632e11 3.659e11 3.688e11 Restorative Material 1.502e43 2.254e29 9.235e23 2.089e41 3.360e28 4.022e23 1.404e42 8.768e28 5.504e23 When we analysed all models with different adhesive material thicknesses within themselves, the models in which the enamel and dentin tissue started to break down the latest, that is, the models with the longest life, were the models restored with hybrid composite. The models in which enamel and dentin tissue started to fracture the earliest were the models restored with bulk-fill composite. The models in which the restorative materials started to fracture the earliest were the models restored with hybrid composites, while the models in which they started to fracture the latest were the models restored with bulk-fill composites. 3.2.4. Results of the model with Class I occlusal cavity When Class I occlusal cavities were restored with bulk-fill composite, conventional composite and hybrid composite, when we evaluated each restorative material within each restorative material; the model in which the enamel tissue fractured the fastest was the model in which 15 micrometre thick adhesive material was used. The model with the slowest fracture of the enamel tissue, i.e. the model with the longest life span, was the model in which the adhesive material with a thickness of 20 micrometres was used. The fastest fracture of dentin tissue was the model in which 20 micrometre thick adhesive material was used. The model with 15 micrometre thick adhesive material was the model with the slowest fracture. When conventional composite and hybrid composite were used, the model in which the restorative materials fractured the latest was the model in which 15 micrometre thick adhesive material was used. The earliest fracture occurred in the model with 20 micrometre thick adhesive material. When bulk-fill composite resin was used, the model in which the restorative material fractured the latest was the model in which 20 micrometre thick adhesive material was used, while the model in which the restorative material fractured the earliest was the model in which 10 micrometre thick adhesive material was used (Table 10 ). Table 10 Number of cycles required for fracture of dental tissues and restorative materials of the model with Class II mesio-occluso-distal (MOD) cavity. Model with 10 µm thick adhesive material Model with 15 µm thick adhesive material Model with 20 µm thick adhesive material Bulk-Fill Composite Conventional Composite Hybrid Composite Bulk-Fill Composite Conventional Composite Hybrid Composite Bulk-Fill Composite Conventional Composite Hybrid Composite Enamel 1.817e9 1.878e9 1.916e9 5.052e8 5.686e8 6.189e8 2.742e9 2.858e9 2.924e9 Dentin 1.918e10 2.250e10 2.578e10 2.096e10 2.415e10 2.718e10 5.759e9 6.864e9 8.022e9 Restorative Material 4.278e37 1.130e29 5.078e23 6.939e39 1.349e29 5.588e23 1.744e43 9.177e28 4.195e23 When we analysed all models with different adhesive material thicknesses within themselves, the models in which the enamel and dentin tissue started to break down the latest, that is, the models with the longest life, were the models restored with hybrid composite. The models in which enamel and dentin tissue started to fracture the earliest were the models restored with bulk-fill composite. The models in which the restorative materials started to fracture the earliest were the models restored with hybrid composites, while the models in which they started to fracture the latest were the models restored with bulk-fill composites. 4. DISCUSSION In this study, our hypothesis that when materials with different mechanical properties are used in restoration, the stress values accumulated in dental tissues and restorative materials will change and the fracture life will differ depending on this stress accumulation was accepted. In dentistry, many restorative materials have been produced in order to make dental tissues strong, resistant to forces, and resistant, and the materials produced have been improved day by day. A good understanding of the biomechanics in the oral cavity and the design and construction of restorations with this in mind increase the success of restorations.[ 24 ] In 2003, Yaman et al. examined the maxillary central tooth with class V cavity using finite element stress analysis method. They used composite and compomer materials from different brands as restorative materials. As a result of this study, it was understood that the stresses in the restored tooth tissues were inversely proportional to the modulus of elasticity of the restorative materials used. In our study, when bulk-fill composite resin material, which has the lowest elastic modulus, was used as restorative material, high stress accumulation occurred in enamel and dentin tissues. When we look at the stress values accumulated on the restorative materials, similar to our study, the stress values accumulated on the restoration were the highest when the material with the highest young's modulus was used.[ 25 ] Yamanel et al. investigated the effect of restorative material differences and cavity design on the stress distribution on tooth structures and restorative materials using finite element analysis. They used nanofiller composite and 2 different full ceramic materials as restorative materials. As a result, they found that materials with low elastic modulus transferred more stress to the tooth structures, as in our study, i.e. compared to nanofiller-containing composites, the tested full ceramic inlay and onlay materials transferred less stress to the tooth structures. [ 4 ] In 2022, Gönder et al. analysed the stress distributions in teeth restored using different thicknesses of adhesive material. As a result of the study, as the thickness of the adhesive material increased, the amount of stress accumulated on the adhesive material decreased as in our study.[ 27 ] Again in 2023, Gönder et al. restored the molar tooth with different materials after designing a class II cavity. As a result, similar to our results, when the material with low young's modulus was used, the stress values accumulated in the enamel and dentin tissues were the highest and fractures in these tissues occurred earlier.[28] 5. CONCLUSIONS The important findings of this study are as follows: When materials with low Young's modulus, i.e. more flexible materials than others, the stress values accumulated on enamel and dentin tissues increased significantly and these tissues showed early fracture. When materials with large Young's modulus, i.e. more rigid materials were used, the stress values in these tissues were lower. In other words, the stress values accumulated on enamel and dentin tissues were inversely proportional to the Young's modulus of the materials used. When materials with large Young's modulus were used, fractures in restorative materials occurred earlier. As the thickness of the adhesive material increased, the stress values accumulated on the adhesive material decreased. Abbreviations DICOM: Digital Imaging and Communucations in Medicine STL: Standard Tessellation Language FEA: Finite Element Analysis CBCT: Cone Beam Computed Tomography Gpa: Gigapascal Mpa: Megapascal Declarations Ethics approval and consent to participate: Not required. Consent for publication: Not applicable. Availability of data and materials: The data that support the findings of this study are available from the corresponding author upon reasonable request. Competing interests: The authors have no conflict of interest relevant to this article. Funding: This project was funded by the TÜBİTAK 2209-A Research Support Program for University Students 2021/2 (Project No: 1919B012110260). Authors' contributions: RMand HYG participated in designing the study. RM participated in generating the data for the study. RM participated in gathering the data for the study. RM participated in the analysis of the data. RM and HYG have had access to all the raw data of the study. RM, HYG and AH have reviewed the pertinent raw data on which the results and conclusions of this study are based. RM, HYG and AH have approved the final version of this paper. RM, HYG and AH guarantees that all individuals who meet the Journal’s authorship criteria are included as authors of this paper. References Pitts NB (2004) Are we ready to move from operative to non-operative/preventive treatment of dental caries in clinical practice? Caries Res 38:294–304 Featherstone JD (2000) The science and practice of caries prevention. J Am Dent Assoc 131:887–899 Mesquita RV, Axmann D, Geis-Gerstorfer J (2006) Dynamic visco-elastic properties of dental composite resins. Dent Mater 22:258–267 Yamanel K, Caglar A, Gülsahi K, Ozden UA (2009) Effects of different ceramic and composite materials on stress distribution in inlay and onlay cavities: 3-D finite element analysis. Dent Mater J 28:661–670 Lee WC, Eakle WS (1996) Stress-induced cervical lesions: review of advances in the past 10 years. J Prosthet Dent 75:487–494 Mjör IA, Toffenetti F (2000) Secondary caries: a literature review with case reports. Quintessence Int 31:165–179 Rao S (2017) S. The finite element method in engineering Magne P (2007) Efficient 3D finite element analysis of dental restorative procedures using micro-CT data. Dent Mater 23:539–548 Reddy MS, Sundram R, Eid Abdemagyd HA (2019) Application of Finite Element Model in Implant Dentistry: A Systematic Review. J Pharm Bioallied Sci 11:S85–S91 Guler MS, Guler C, Cakici F, Cakici EB, Sen S (2016) Finite element analysis of thermal stress distribution in different restorative materials used in class V cavities. Niger J Clin Pract 19:30–34 Chuang S-F, Chang C-H, Chen TY-F (2011) Contraction behaviors of dental composite restorations–finite element investigation with DIC validation. J Mech Behav Biomed Mater 4:2138–2149 Luo X, Rong Q, Luan Q, Yu X (2022) Effect of partial restorative treatment on stress distributions in non-carious cervical lesions: a three-dimensional finite element analysis. BMC Oral Health 22:607 de Rodrigues M (2020) Direct resin composite restoration of endodontically-treated permanent molars in adolescents: bite force and patient-specific finite element analysis. J Appl Oral Sci 28:e20190544 Jiang W, Bo H, Yongchun G, LongXing N (2010) Stress distribution in molars restored with inlays or onlays with or without endodontic treatment: a three-dimensional finite element analysis. J Prosthet Dent 103:6–12 Ausiello P et al (2017) Mechanical behavior of bulk direct composite versus block composite and lithium disilicate indirect Class II restorations by CAD-FEM modeling. Dent Mater 33:690–701 Juloski J, Apicella D, Ferrari M (2014) The effect of ferrule height on stress distribution within a tooth restored with fibre posts and ceramic crown: a finite element analysis. Dent Mater 30:1304–1315 Çulhaoğlu AK, Terzi̇oğlu PDH (2020) Comparing static, dynamic and impact loading behavior of biomimetic porous dental implants with conventional dental implants (3D finite element analysis). Selcuk Dent J 7:471–480 Homaei E et al (2018) Numerical fatigue analysis of premolars restored by CAD/CAM ceramic crowns. Dent Mater 34:e149–e157 de Abreu RAM et al (2014) Masticatory efficiency and bite force in individuals with normal occlusion. Arch Oral Biol 59:1065–1074 Mutluay MM et al (2013) Fatigue of the resin-dentin interface: a new approach for evaluating the durability of dentin bonds. Dent Mater 29:437–449 Ausiello P, Franciosa P, Martorelli M, Watts DC (2011) Numerical fatigue 3D-FE modeling of indirect composite-restored posterior teeth. Dent Mater 27:423–430 Nalla RK, Kinney JH, Marshall SJ, Ritchie RO (2004) On the in vitro fatigue behavior of human dentin: effect of mean stress. J Dent Res 83:211–215 Zhang Z et al (2015) On the durability of resin-dentin bonds: Identifying the weakest links. Dent Mater 31:1109–1118 Ulusoy M, Aydın K (2010) Diş hekimliğinde hareketli bölümlü protezler, Ankara Üniversitesi Yayınları, s. 94–120 Yaman SD, Sahin M, Aydin C (2003) Finite element analysis of strength characteristics of various resin based restorative materials in Class V cavities. J Oral Rehabil 30:630–641 Yasin Gönder H, Mohammadi R, Harmankaya A, Burak Yüksel İ (2022) & Seda Gültekin, D. Investigation of the effects of adhesive materials of different types and thicknesses on dental tissue stress via FEM analysis. Biomed Res. Int. 8493909 (2022) Gönder HY et al (2023) Teeth restored with bulk-fill composites and conventional resin composites; Investigation of stress distribution and fracture lifespan on enamel, dentin, and restorative materials via three-dimensional finite element analysis. Polym (Basel) 15:1637 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6129157","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":424623179,"identity":"9a9a1541-c26b-4cb5-ae79-99071eb45192","order_by":0,"name":"Reza Mohammadi","email":"data:image/png;base64,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","orcid":"","institution":"Necmettin Erbakan University","correspondingAuthor":true,"prefix":"","firstName":"Reza","middleName":"","lastName":"Mohammadi","suffix":""},{"id":424623180,"identity":"81e1df36-161d-4fbb-93ec-e94d91706e0e","order_by":1,"name":"Abdulkadir Harmankaya","email":"","orcid":"","institution":"Necmettin Erbakan University","correspondingAuthor":false,"prefix":"","firstName":"Abdulkadir","middleName":"","lastName":"Harmankaya","suffix":""},{"id":424623181,"identity":"d1be6106-8b7c-4fcd-910b-71c2acbe4986","order_by":2,"name":"Hakan Yasin Gönder","email":"","orcid":"","institution":"Necmettin Erbakan University","correspondingAuthor":false,"prefix":"","firstName":"Hakan","middleName":"Yasin","lastName":"Gönder","suffix":""}],"badges":[],"createdAt":"2025-02-28 13:53:21","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6129157/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6129157/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":77944570,"identity":"6311fc2b-4568-4c96-8d06-5a0dbf5236f1","added_by":"auto","created_at":"2025-03-07 06:13:49","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":2060731,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eModel with Class II disto-occlusal (DO) cavity design. A) Restoration, B) Enamel, C) Adhesive material, D) Dentin.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"image1.png","url":"https://assets-eu.researchsquare.com/files/rs-6129157/v1/95dad389c3745c9fe1d0040f.png"},{"id":77944575,"identity":"4d2113a9-a4e9-4160-ac85-c91a24b56359","added_by":"auto","created_at":"2025-03-07 06:13:50","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":2222135,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eModel with Class II mesio-occlusal (MO) cavity design. A) Restoration, B) Enamel, C) Adhesive material, D) Dentin.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"image2.png","url":"https://assets-eu.researchsquare.com/files/rs-6129157/v1/eefb20b02952e95ec7bef211.png"},{"id":77943880,"identity":"549cbe54-9d8a-4282-8fa6-d2f109348d12","added_by":"auto","created_at":"2025-03-07 06:05:50","extension":"jpeg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":143683,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eClass II model with mesio-occluso-distal (MOD) cavity design. A) Restoration, B) Enamel, C) Cortical bone, D) Adhesive material, E) Dentin, F) Spongiose bone, G) Pulp, H) Periodontal ligament, I) Completed whole model.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"image3.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-6129157/v1/e31a187a8388aae0e560ac33.jpeg"},{"id":77944580,"identity":"8feb8d2e-87b3-47ef-9297-50edf416b771","added_by":"auto","created_at":"2025-03-07 06:13:50","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":2378225,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eModel with Class I occlusal (O) cavity design. A) Restoration, B) Enamel, C) Adhesive material, D) Dentin.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"image4.png","url":"https://assets-eu.researchsquare.com/files/rs-6129157/v1/f0669dcdc0062bf0a8023163.png"},{"id":77944578,"identity":"b6aea2c6-e85c-46e4-ac06-a6c17e9567aa","added_by":"auto","created_at":"2025-03-07 06:13:50","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":469337,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eLoads acting on the tooth surface and boundary conditions.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"image5.png","url":"https://assets-eu.researchsquare.com/files/rs-6129157/v1/eae72735ae742150df47152e.png"},{"id":77944574,"identity":"866f8b67-119b-477a-b971-0d4bdb1809ac","added_by":"auto","created_at":"2025-03-07 06:13:50","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":2594977,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eStress distribution regions in enamel and dentin tissues of the models in which bulk-fill composite resin was used.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"image6.png","url":"https://assets-eu.researchsquare.com/files/rs-6129157/v1/a70a786bfcd525062a30f9d9.png"},{"id":77943922,"identity":"3ca52d7d-f4bd-4b2a-9547-167d16484bcf","added_by":"auto","created_at":"2025-03-07 06:05:51","extension":"png","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":2494301,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eStress distribution regions in enamel and dentin tissues of the models using conventional composite resin.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"image7.png","url":"https://assets-eu.researchsquare.com/files/rs-6129157/v1/41558ec2ed8b9834658572c8.png"},{"id":77945010,"identity":"165903b2-b427-43b0-a548-cc81c6b3178d","added_by":"auto","created_at":"2025-03-07 06:21:50","extension":"png","order_by":8,"title":"Figure 8","display":"","copyAsset":false,"role":"figure","size":2440558,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eStress distribution regions in enamel and dentin tissues of models using hybrid composite resin.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"image8.png","url":"https://assets-eu.researchsquare.com/files/rs-6129157/v1/8e72bee72bd7c04775bd2b86.png"},{"id":77943887,"identity":"b70ac051-8f1e-435c-8aaa-f0c6baedb032","added_by":"auto","created_at":"2025-03-07 06:05:50","extension":"png","order_by":9,"title":"Figure 9","display":"","copyAsset":false,"role":"figure","size":2383777,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eStress distribution regions in restorative materials of a model with a Class II disto-occlusal cavity.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"image9.png","url":"https://assets-eu.researchsquare.com/files/rs-6129157/v1/ef64714343c79c4cd4149302.png"},{"id":77944584,"identity":"19ffdcbb-58b1-4f93-8e6f-f64c384a9885","added_by":"auto","created_at":"2025-03-07 06:13:51","extension":"png","order_by":10,"title":"Figure 10","display":"","copyAsset":false,"role":"figure","size":2543929,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eStress distribution regions in adhesive materials of a model with a Class II disto-occlusal cavity.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"image10.png","url":"https://assets-eu.researchsquare.com/files/rs-6129157/v1/ddaf61226ca16fe7b98d5a60.png"},{"id":77944577,"identity":"625fac5b-a95e-4a36-9d1a-f21ae5ca063c","added_by":"auto","created_at":"2025-03-07 06:13:50","extension":"png","order_by":11,"title":"Figure 11","display":"","copyAsset":false,"role":"figure","size":2412381,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eStress distribution regions in enamel tissues of a model with a Class II mesio-occlusal cavity.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"image11.png","url":"https://assets-eu.researchsquare.com/files/rs-6129157/v1/db66a5fd516805bedb5b6aa4.png"},{"id":77943874,"identity":"d8a1ec89-2bb3-44a8-a8c6-3a0bfa029b7b","added_by":"auto","created_at":"2025-03-07 06:05:49","extension":"png","order_by":12,"title":"Figure 12","display":"","copyAsset":false,"role":"figure","size":2430052,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eStress distribution regions in dentin tissues of a model with a Class II mesio-occlusal cavity.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"image12.png","url":"https://assets-eu.researchsquare.com/files/rs-6129157/v1/c350cf3a55dc652d89a1f6b9.png"},{"id":77943873,"identity":"2c657c1d-87fd-4e0f-9880-65ed7983da86","added_by":"auto","created_at":"2025-03-07 06:05:49","extension":"png","order_by":13,"title":"Figure 13","display":"","copyAsset":false,"role":"figure","size":1762829,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eStress distribution regions in restorative materials of a model with a Class II mesio-occlusal cavity.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"image13.png","url":"https://assets-eu.researchsquare.com/files/rs-6129157/v1/d0f04f2a8e6aab1e9edad42a.png"},{"id":77943924,"identity":"8ccba115-fa05-4d99-8854-9de244f714a4","added_by":"auto","created_at":"2025-03-07 06:05:51","extension":"png","order_by":14,"title":"Figure 14","display":"","copyAsset":false,"role":"figure","size":2154956,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eStress distribution regions in adhesive materials of a model with a Class II mesio-occlusal cavity.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"image14.png","url":"https://assets-eu.researchsquare.com/files/rs-6129157/v1/6f08ac4159c3abb1fe6ff08f.png"},{"id":77943896,"identity":"8df73355-a735-4256-935e-df55dd93f06c","added_by":"auto","created_at":"2025-03-07 06:05:50","extension":"png","order_by":15,"title":"Figure 15","display":"","copyAsset":false,"role":"figure","size":2194371,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eStress distribution regions in enamel tissues of a model with a Class II mesio-occluso-distal (MOD) cavity.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"image15.png","url":"https://assets-eu.researchsquare.com/files/rs-6129157/v1/8ebd4703c24c4ca0b9a21462.png"},{"id":77944576,"identity":"d0e84d59-0fe8-495c-9fd0-10720ea85707","added_by":"auto","created_at":"2025-03-07 06:13:50","extension":"png","order_by":16,"title":"Figure 16","display":"","copyAsset":false,"role":"figure","size":2434307,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eStress distribution regions in dentin tissues of a model with a Class II mesio-occluso-distal (MOD) cavity.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"image16.png","url":"https://assets-eu.researchsquare.com/files/rs-6129157/v1/72c5463b1e68800e5296e10b.png"},{"id":77943920,"identity":"6dccbf7e-00a0-4884-8f20-d94b5ea87057","added_by":"auto","created_at":"2025-03-07 06:05:51","extension":"png","order_by":17,"title":"Figure 17","display":"","copyAsset":false,"role":"figure","size":1751436,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eStress distribution regions in restorative materials of a Class II mesio-occluso-distal (MOD) cavity model.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"image17.png","url":"https://assets-eu.researchsquare.com/files/rs-6129157/v1/262cc84796102b0a33807486.png"},{"id":77943894,"identity":"c7e32d2e-70ad-4638-b679-77cd08576acc","added_by":"auto","created_at":"2025-03-07 06:05:50","extension":"png","order_by":18,"title":"Figure 18","display":"","copyAsset":false,"role":"figure","size":2068875,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eStress distribution regions in adhesive materials of a model with a Class II mesio-occluso-distal (MOD) cavity.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"image18.png","url":"https://assets-eu.researchsquare.com/files/rs-6129157/v1/64b33f3e8f96c5c4785955d2.png"},{"id":77943937,"identity":"ef85a72d-c9d2-451a-bb2c-3f9cf36808fa","added_by":"auto","created_at":"2025-03-07 06:05:52","extension":"png","order_by":19,"title":"Figure 19","display":"","copyAsset":false,"role":"figure","size":2590875,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eStress distribution regions in enamel tissues of a model with a Class I occlusal cavity.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"image19.png","url":"https://assets-eu.researchsquare.com/files/rs-6129157/v1/ca7e7d1d696d8672d8019daa.png"},{"id":77943905,"identity":"1570f751-5a88-4d06-9379-3e64dd73fc00","added_by":"auto","created_at":"2025-03-07 06:05:51","extension":"png","order_by":20,"title":"Figure 20","display":"","copyAsset":false,"role":"figure","size":2172393,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eStress distribution regions in dentin tissues of a model with a Class I occlusal cavity.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"image20.png","url":"https://assets-eu.researchsquare.com/files/rs-6129157/v1/55a4f0657befaf7f4436d3ae.png"},{"id":77943942,"identity":"7ed87a6e-f3f1-4919-b152-2e7690ab9df8","added_by":"auto","created_at":"2025-03-07 06:05:53","extension":"png","order_by":21,"title":"Figure 21","display":"","copyAsset":false,"role":"figure","size":2651295,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eStress distribution regions in restorative materials of a model with a Class I occlusal cavity.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"image21.png","url":"https://assets-eu.researchsquare.com/files/rs-6129157/v1/7bf850c353690f44425f32e8.png"},{"id":77943925,"identity":"ad045365-8bfd-4636-8f60-31d2dce99c75","added_by":"auto","created_at":"2025-03-07 06:05:51","extension":"png","order_by":22,"title":"Figure 22","display":"","copyAsset":false,"role":"figure","size":2733420,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eStress distribution regions in adhesive materials of the model with Class I occlusal cavity.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"image22.png","url":"https://assets-eu.researchsquare.com/files/rs-6129157/v1/f08de730339062054d4e1ec2.png"},{"id":77946439,"identity":"4e04cd87-1cbf-4e6a-ad5f-0a304bbe3bdf","added_by":"auto","created_at":"2025-03-07 06:38:16","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":48224353,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6129157/v1/84b51b9a-aadd-4073-aeb1-b448212c31b4.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Investigation of Stress Distribution And Fatique Performance in Restored Teeth Using Different Thickness of Adhesive Materials and Different Restorative Materials:3D Finite Element Analysis (FEM)","fulltext":[{"header":"1. BACKGROUND","content":"\u003cp\u003eDental caries is one of the most common and preventable diseases worldwide. People have been sensitive to caries throughout their lives. Without treatment, caries can cause toothache or tooth loss. [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e] One of the most important properties of restorative materials, which are widely used and continuously developed in dentistry, is their resistance to masticatory forces. The physical, chemical and mechanical properties of restorative materials frequently used in dentistry greatly affect the stress distribution in dental tissues and the durability of the restorations made accordingly. A small stress accumulation in the tooth and restorative materials is a very good indicator for the materials. However, it is often not possible to achieve low stress accumulation in both dental tissues and restorative materials at the same time.[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eCareful selection of the restorative materials to be used in the restoration of teeth is essential. When restorative materials cause large amounts and inappropriate stress distribution in dental tissues; they cause the restorations to come out of the cavity and cause retention problems between the tooth and the restoration.[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] Many stress distribution analyses are performed in dentistry, but the most widely used method today is the \u0026lsquo;Finite Element Stress Analysis\u0026rsquo; method. This analysis method was discovered by Hrennikoff and Courant to analyse stress distribution regions on complex models.[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] This analysis method was initially used in the field of engineering, but has been increasingly used in dentistry. Determining the stress magnitudes and regions resulting from the forces acting on living tissues is an extremely time-consuming and expensive process. For this reason, it has become very common today to carry out stress distribution analyses by modelling living tissues in computer environment with finite element stress analysis method.[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e] The finite element analysis method has provided researchers with the opportunity to perform a non-invasive analysis in computer environment without the use of living tissues.[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e] In addition to all these good features, this analysis method has some disadvantages such as the difficulties in transferring living tissues to the computer environment by means of programs, the possibility of human errors, the need for experienced engineers and the need for long computation times.[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eThe aim of this study is to compare the stress distributions in tooth tissues and restorative materials restored with different restorative materials and their fracture life. The hypothesis of our study is that when materials with different mechanical properties are used in restoration, the stress values accumulated in dental tissues and restorative materials will change and the fracture life will differ depending on this stress accumulation.\u003c/p\u003e"},{"header":"2. METHODS","content":"\u003cp\u003eA tooth number 36 with no caries and no loss of material was scanned using CBCT. The size of the imaging volume is a cylinder with a diameter and height of 40 mm at the centre of rotation of the X-ray. Images were acquired at 5 mA (milliampere, electric current value), 90 kVp (Peak kilovoltage, the highest voltage of the X-ray tube) using the parameters 160 qm and exposure time of 17.5 seconds.\u003c/p\u003e \u003cp\u003eThe obtained DICOM files were transferred to Mimics software (Mimics 12.00, Leuven, Belgium) for segmentation. Using this software, enamel tissue, dentin tissue and pulp regions were extracted separately in STL format. The STL files were transferred to Geomagic Design X software for surface correction and saved in STP format. Then, the obtained tooth model was placed in a box representing the cortical and spongiose bone using SolidWorks programme. A periodontal ligament thickness of 0.2 mm was designed in the prepared models.\u003c/p\u003e \u003cp\u003eIn the designed tooth model; different cavity designs were made in accordance with class II mesio-occlusal (MO), class II disto-occlusal (DO), class II mesio-occluso-distal (MOD) and class I occlusal (O) cavity principles. In addition, layers of adhesive material with thicknesses of 10, 15 and 20 \u0026micro;m were formed in these models which presented in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe restorative materials used in our study were: bulk-fill composite, conventional composite, hybrid composite resin. Finally, these designs were saved in STL format for finite element analysis (FEA). In order to transfer the tooth tissues and the materials to be used to the computer environment, some mechanical values must be known. These values are shown in Table \u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMechanical properties of dental tissues and restorative materials.[\u003cspan additionalcitationids=\"CR12 CR13 CR14 CR15 CR16 CR17\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYoung\u0026rsquo;s\u003c/p\u003e \u003cp\u003eModulus (Mpa)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePoisson's\u003c/p\u003e \u003cp\u003eRatio\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCompressive Strength (MPa)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFlexural\u003c/p\u003e \u003cp\u003eStrength (MPa)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eShear Strength\u003c/p\u003e \u003cp\u003e(MPa)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eFracture\u003c/p\u003e \u003cp\u003eToughness (Mpa m\u003csup\u003e1/2\u003c/sup\u003e)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMicrohardness (HV)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEnamel\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e84.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e384\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3\u0026ndash;6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDentin\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e297\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e105.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e12\u0026ndash;138\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.13\u0026ndash;0.51\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAdhesive Material\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePulp\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePDL\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.0689\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCortical bone\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSpongious bone\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBulk-fill Composite\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e169\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eConventional Composite\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e16.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e294\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHybrid Composite\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eFinite element analysis was performed using Abaqus software (2020 Dassault Systems Simulation Corp., Johnston, RT, USA). Boundary conditions were determined by assigning appropriate material properties to each component in the Abaqus environment. Motion and rotation constraints were applied to the jawbone in all directions and the model was analysed under a vertical load of 600 Newton (N). The loads acting on the tooth surface and boundary conditions are shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e. The stress values obtained as a result of the analysis were recorded as Von Mises stress values.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe amount of force applied to the tooth was selected according to the average fatigue values of restored molars obtained from previous in vitro studies. The criteria for evaluating the fatigue life of the restorative material, enamel and dentin were compared with the maximum principal stress-life (S N) diagram during loading. The S-N curve represents the stress amplitude (\u0026#120590;0) as a function of the number of cycles to fracture (N). Fatigue values for the infill materials were determined by three-point bending tests as in previous studies. The fatigue behaviour of the materials was calculated using the non-linear Basquin formula as shown in the equation \u0026ldquo;\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{\\sigma\\:}_{a}=A{\\left(N\\right)}^{B}\\)\u003c/span\u003e\u003c/span\u003e\u0026rdquo;.\u003c/p\u003e \u003cp\u003eA and B values for restoration materials are shown in Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. W\u0026ouml;hler curves for enamel and dentin are taken from the literature. These were plotted only for reverse loading (\u0026#120590;\u0026#119898;=0). All other mean stresses (\u0026#120590;\u0026#119898;\u0026ne;0) are represented mathematically in the equation \u0026ldquo;\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{\\sigma\\:}_{a}=({\\sigma\\:}_{f}-{\\sigma\\:}_{m}){\\left(2N\\right)}^{b}\\)\u003c/span\u003e\u003c/span\u003e\u0026rdquo;.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCoefficient and exponent constants of fatigue curves of restorative materials and dental tissues.[\u003cspan additionalcitationids=\"CR20 CR21 CR22\" citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaterial\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eA (MPa)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eσ\u003csub\u003ef\u003c/sub\u003e (MPa)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eb\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEnamel\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e310\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-0.111\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDentin\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e-0.111\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eBulk-Fill Composite\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.020\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eConventional Composite\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.035\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHybrid Composite\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e182.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.056\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"3. RESULTS","content":"\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e3.1. Results on Stress Distribution\u003c/h2\u003e \u003cdiv id=\"Sec5\" class=\"Section3\"\u003e \u003ch2\u003e3.1.1. Results of the model with Class II disto-occlusal cavity\u003c/h2\u003e \u003cp\u003eWhen Class II disto-occlusal cavities were restored with bulk-fill composite, the highest stress values on enamel and dentin tissue were observed in the model with 15 micrometre thick adhesive material, while the lowest stress value was observed in the model with 10 micrometre thick adhesive material. When we look at the stress values on the restoration and adhesive material, the highest stress value was observed in the model using 10 micrometre thick adhesive material, while the lowest stress value was observed in the model using 20 micrometre thick adhesive material.\u003c/p\u003e \u003cp\u003eWhen Class II disto-occlusal cavities were restored with conventional composite and hybrid composite, when each restorative material was evaluated within each restorative material; the highest stress values on enamel and dentin tissue were observed in the models using 15 micrometre thick adhesive material, while the lowest stress value was observed in the models using 10 micrometre thick adhesive material. The highest stress values on the restoration and adhesive material were observed in the model using 10 micrometre thick adhesive material, while the lowest stress values were observed in the model using 15 micrometre thick adhesive material for the restoration and 20 micrometre thick adhesive material for the adhesive material. The values of stress magnitudes are shown in Table \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e and stress distribution regions are shown in Figs.\u0026nbsp;\u003cspan refid=\"Fig6\" class=\"InternalRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan refid=\"Fig10\" class=\"InternalRef\"\u003e10\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eStress values (MPa) in dental tissues and restorative materials of the model with Class II disto-occlusal cavity.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eModel with 10 \u0026micro;m thick adhesive material\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eModel with 15 \u0026micro;m thick adhesive material\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003eModel with 20 \u0026micro;m thick adhesive material\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBulk-Fill Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eConventional Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHybrid Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eBulk-Fill Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eConventional Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eHybrid Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eBulk-Fill Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eConventional Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eHybrid Composite\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEnamel\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e44.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e43.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e44.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e61.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e59.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e58.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e44.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e44.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e44.88\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDentin\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e34.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e29.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e49.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e46.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e43.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e41.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e38.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e36.63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRestorative Material\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e22.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e17.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e18.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e19.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e16.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e18.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e19.61\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAdhesive Material\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e10.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e10.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e10.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e9.981\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e9.938\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e9.854\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eWhen the models with different thicknesses of adhesive material were evaluated within themselves, the stress values on enamel, dentin and adhesive material were the highest in the models using bulk-fill composite resin, while the stress values on the restoration were the highest in the models using hybrid composite resin. In addition, as the thickness of the adhesive material decreased, the stress values accumulated on the material increased.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e \u003ch2\u003e3.1.2. Results of the model with Class II mesio-occlusal cavity\u003c/h2\u003e \u003cp\u003eWhen Class II disto-occlusal cavities were restored with bulk-fill composite, conventional composite and hybrid composite, when each restorative material was evaluated within each restorative material; the highest stress values on the enamel tissue were observed in the models using 10 micrometre thick adhesive material, while the lowest stress value was observed in the models using 15 micrometre thick adhesive material. In dentin tissue, the highest stress values were observed in models with 20 micrometre thick adhesive material, while the lowest stress values were observed in models with 15 micrometre thick adhesive material. The highest stress values accumulated on the restorative material were observed in the models with 20 micrometre thick adhesive material, while the lowest stress values were observed in the models with 10 micrometre thick adhesive material. The highest stress values accumulated on the adhesive material were observed in the model with 10 micrometre thick adhesive material, while the lowest stress values were observed in the model with 20 micrometre thick adhesive material. The values of stress magnitudes are shown in Table \u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e and stress distribution regions are shown in Figs.\u0026nbsp;\u003cspan refid=\"Fig11\" class=\"InternalRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan refid=\"Fig14\" class=\"InternalRef\"\u003e14\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eStress values (MPa) in dental tissues and restorative materials of the model with Class II mesio-occlusal cavity.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eModel with 10 \u0026micro;m thick adhesive material\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eModel with 15 \u0026micro;m thick adhesive material\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003eModel with 20 \u0026micro;m thick adhesive material\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBulk-Fill Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eConventional Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHybrid Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eBulk-Fill Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eConventional Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eHybrid Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eBulk-Fill Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eConventional Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eHybrid Composite\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEnamel\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e69.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e67.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e65.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e61.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e59.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e58.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e63.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e61.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e60.39\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDentin\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e28.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e27.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e26.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e26.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e30.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e30.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e29.68\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRestorative Material\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e16.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e17.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e15.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e16.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e17.47\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAdhesive Material\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e14.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e9.377\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e7.946\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e6.766\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e8.388\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e7.096\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e6.282\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eWhen the models with different thicknesses of adhesive material were evaluated within themselves, the stress values on enamel, dentin and adhesive material were the highest in the models using bulk-fill composite resin, while the stress values on the restoration were the highest in the models using hybrid composite resin. In addition, as the thickness of the adhesive material decreased, the stress values accumulated on the material increased.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section3\"\u003e \u003ch2\u003e3.1.3. Results of the model with Class II mesio-occluso-distal (MOD) cavity\u003c/h2\u003e \u003cp\u003eWhen Class II MOD cavities were restored with bulk-fill composite, conventional composite and hybrid composite, when each restorative material was evaluated within each restorative material; the highest stress values on the enamel tissue were seen in the models using 10 micrometre thick adhesive material, while the lowest stress value was seen in the models using 20 micrometre thick adhesive material. In dentin tissue, the highest stress values were observed in models with 20 micrometre thick adhesive material, while the lowest stress values were observed in models with 15 micrometre thick adhesive material. The highest stress values accumulated on the restorative material were observed in the models where 15 micrometre thick adhesive material was used, while the lowest stress values were observed in the models where 10 micrometre thick adhesive material was used. The stress values accumulated on the adhesive material were highest in the models where 10 micrometre thick adhesive material was used, while the lowest stress values were seen in the models where 20 micrometre thick adhesive material was used. The values of stress magnitudes are shown in Table \u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e and stress distribution regions are shown in Figs.\u0026nbsp;\u003cspan refid=\"Fig15\" class=\"InternalRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan refid=\"Fig18\" class=\"InternalRef\"\u003e18\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eStress values (MPa) in dental tissues and restorative materials of the model with Class II mesio-occluso-distal (MOD) cavity.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eModel with 10 \u0026micro;m thick adhesive material\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eModel with 15 \u0026micro;m thick adhesive material\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003eModel with 20 \u0026micro;m thick adhesive material\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBulk-Fill Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eConventional Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHybrid Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eBulk-Fill Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eConventional Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eHybrid Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eBulk-Fill Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eConventional Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eHybrid Composite\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEnamel\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e71.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e69.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e67.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e71.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e68.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e66.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e66.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e63.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e62.19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDentin\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e22.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e22.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e22.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e22.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e22.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e22.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e22.82\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRestorative Material\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e16.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e17.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e17.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e15.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e16.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e17.31\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAdhesive Material\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e33.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e9.715\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e8.067\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e6.765\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e8.920\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e7.680\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e6.761\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eWhen the models with different thicknesses of adhesive material were evaluated within themselves, the stress values on enamel, dentin and adhesive material were the highest in the models using bulk-fill composite resin, while the stress values on the restoration were the highest in the models using hybrid composite resin. In addition, as the thickness of the adhesive material decreased, the stress values accumulated on the material increased.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section3\"\u003e \u003ch2\u003e3.1.4. Results for the model with Class I occlusal cavity\u003c/h2\u003e \u003cp\u003eWhen Class I occlusal cavities were restored with bulk-fill composite, conventional composite and hybrid composite, when each restorative material was evaluated within each restorative material; the highest stress values on the enamel tissue were observed in the models using 15 micrometre thick adhesive material, while the lowest stress value was observed in the models using 20 micrometre thick adhesive material. In dentin tissue, the highest stress values were observed in the models where 20 micrometre thick adhesive material was used, while the lowest stress values were observed in the models where 15 micrometre thick adhesive material was used. When we used bulk-fill composite as restorative material, the highest stress values on the restorative material were seen when we used adhesive material with a thickness of 10 micrometres, while the lowest stress value was seen in the model with adhesive material with a thickness of 20 micrometres. When we used conventional composite and hybrid composite as restorative materials, the highest stress values on the restorative material were observed when we used adhesive material with a thickness of 20 micrometres, while the lowest stress value was observed in the model where we used adhesive material with a thickness of 15 micrometres. The highest stress values accumulated on the adhesive material were observed in the models where 10 micrometre thick adhesive material was used, while the lowest stress values were observed in the models where 20 micrometre thick adhesive material was used. The values of stress magnitudes are shown in Table \u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e and stress distribution regions are shown in Figs.\u0026nbsp;\u003cspan refid=\"Fig19\" class=\"InternalRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan refid=\"Fig22\" class=\"InternalRef\"\u003e22\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eStress values (MPa) in dental tissues and restorative materials of the model with Class I occlusal cavity.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eModel with 10 \u0026micro;m thick adhesive material\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eModel with 15 \u0026micro;m thick adhesive material\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003eModel with 20 \u0026micro;m thick adhesive material\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBulk-Fill Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eConventional Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHybrid Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eBulk-Fill Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eConventional Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eHybrid Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eBulk-Fill Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eConventional Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eHybrid Composite\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEnamel\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e49.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e49.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e56.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e55.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e55.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e47.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e47.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e47.37\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDentin\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e31.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e30.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e30.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e29.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e35.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e34.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e33.99\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRestorative Material\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e17.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e16.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e17.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e14.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e16.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e17.52\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAdhesive Material\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8.593\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e9.713\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e8.181\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e7.053\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e7.996\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e6.882\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e6.202\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eWhen the models with 10 micrometre and 15 micrometre thick adhesive materials were evaluated, the stress values on enamel, dentin, restorative material and adhesive material were the highest in the models with bulk-fill composite resin. When we evaluated the model with 20 micrometre thick adhesive material; the stress values on enamel, dentin and adhesive material were the highest in the models where bulk-fill composite resin was used, while the stress value on the restorative material was the highest in the model where hybrid composite resin was used. In addition, as the thickness of the adhesive material decreased, the stress values accumulated on the material increased.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e3.2. Results of Fracture Lifespan\u003c/h2\u003e \u003cdiv id=\"Sec10\" class=\"Section3\"\u003e \u003ch2\u003e3.2.1. Results of the model with Class II disto-occlusal cavity\u003c/h2\u003e \u003cp\u003eWhen Class II disto-occlusal cavities were restored with bulk-fill composite, conventional composite and hybrid composite, when each restorative material was evaluated within each restorative material; the highest number of cycles required for the fracture of enamel tissue was seen when 10 micrometre thick adhesive material was used. The model with the lowest number of cycles required for enamel fracture, i.e. the model with the fastest enamel fracture, was the model with 15 micrometre thick adhesive material. When all restorative materials were considered, the earliest fracture of dentin tissue was observed in the model in which 15 micrometre thick adhesive material was used. When bulk-fill composite and conventional composite were used, the model with 10 micrometre thick adhesive material was the model with the latest dentin tissue breakage. When the hybrid composite was used, the model in which the dentin tissue fractured at the latest was the model in which the adhesive material with a thickness of 20 micrometres was used. When bulk-fill composite and conventional composite were used, the model in which the restorative materials showed the earliest fracture was the model in which 10 micrometre thick adhesive material was used. When hybrid composite was used, the earliest fracture of the restorative material was the model in which 15 micrometre thick adhesive material was used. When bulk-fill composite and hybrid composite were used, the model in which the restorative materials fractured the latest was the model in which 20 micrometre thick adhesive material was used. When hybrid composite resin was used, the model with 15 micrometre thick adhesive material was the model with the latest fracture of the restorative material (Table \u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe number of cycles required for fracture of dental tissues and restorative materials for the model with Class II disto-occlusal cavity.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eModel with 10 \u0026micro;m thick adhesive material\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eModel with 15 \u0026micro;m thick adhesive material\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003eModel with 20 \u0026micro;m thick adhesive material\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBulk-Fill Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eConventional Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHybrid Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eBulk-Fill Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eConventional Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eHybrid Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eBulk-Fill Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eConventional Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eHybrid Composite\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEnamel\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.382e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.486e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.528e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.3768e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.211e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.474e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e4.987e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e5.095e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e5.067e9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDentin\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7.441e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.5507e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2,830e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.106e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.088e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e7.249e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.210e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2.277e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3.889e9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRestorative Material\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.921e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.621e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6,378e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.142e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6.529e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.999e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e7.867e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e5.922e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e9.016e22\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eWhen we analysed all adhesive material thicknesses, the models in which the enamel tissue started to fracture the earliest were the models restored with bulk-fill composite resin. In addition, the models in which the restorative materials started to fracture the earliest were the models restored with hybrid composite resin, while the models in which the restorative materials started to fracture the latest were the models restored with bulk-fill composite resin.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section3\"\u003e \u003ch2\u003e3.2.2. Results of the model with Class II mesio-occlusal cavity\u003c/h2\u003e \u003cp\u003eWhen Class II mesio-occlusal cavities were restored with bulk-fill composite, conventional composite and hybrid composite, when each restorative material was evaluated within each restorative material; the model in which the enamel tissue fractured the fastest was the model in which 10 micrometre thick adhesive material was used. The model with the slowest fracture of the enamel tissue, i.e. the model with the longest life span, was the model in which the adhesive material with a thickness of 15 micrometres was used. The fastest fracture of dentin tissue was the model in which 20 micrometre thick adhesive material was used. The model with 15 micrometre thick adhesive material was the model with the slowest fracture. The model in which the restorative material fractured the fastest was the model in which 20 micrometre thick adhesive material was used. The model with the slowest fracture, i.e. the model with the longest life, was the model in which 10 micrometre thick adhesive material was used (Table \u003cspan refid=\"Tab8\" class=\"InternalRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 8\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eNumber of cycles required for fracture of dental tissues and restorative materials for the model with Class II mesio-occlusal cavity.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eModel with 10 \u0026micro;m thick adhesive material\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eModel with 15 \u0026micro;m thick adhesive material\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003eModel with 20 \u0026micro;m thick adhesive material\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBulk-Fill Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eConventional Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHybrid Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eBulk-Fill Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eConventional Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eHybrid Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eBulk-Fill Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eConventional Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eHybrid Composite\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEnamel\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.802e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.976e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.102e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.280e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.056e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3.776e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.667e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2.167e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2.628e8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDentin\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.037e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.959e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.639e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.325e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7.541e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8.575e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.177e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2.599e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3.003e10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRestorative Material\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.242e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.132e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.761e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.345e44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.286e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5.976e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.482e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e6.565e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e4.629e23\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eWhen we analysed all adhesive material thicknesses, in all models; the models in which the enamel and dentin tissue started to fracture the latest, that is, the models with the longest life, were the models restored with hybrid composite. The models in which enamel and dentin tissue started to fracture the earliest were the models restored with bulk-fill composite. The models in which the restorative materials started to fracture the earliest were the models restored with hybrid composite resins, while the models in which the restorative materials started to fracture the latest were the models restored with bulk-fill composites.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section3\"\u003e \u003ch2\u003e3.2.3. Results of the model with class II MOD cavity\u003c/h2\u003e \u003cp\u003eWhen Class II MOD cavities were restored with bulk-fill composite, conventional composite and hybrid composite, when we evaluated each restorative material within each restorative material; the model in which the enamel tissue fractured the fastest was the model in which 10 micrometre thick adhesive material was used. The model with the slowest fracture of enamel tissue, i.e. the model with the longest life, was the model in which 20 micrometre thick adhesive material was used. The fastest fracture of dentin tissue was the model in which 20 micrometre thick adhesive material was used. The model with 15 micrometre thick adhesive material was the model with the slowest fracture. The model in which the restorative material fractured the fastest was the model in which 15 micrometre thick adhesive material was used. The model with the slowest fracture, i.e. the model with the longest life, was the model in which 10 micrometre thick adhesive material was used (Table \u003cspan refid=\"Tab9\" class=\"InternalRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab9\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 9\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe number of cycles required for fracture of dental tissues and restorative materials in the model with a Class II mesio-occluso-distal (MOD) cavity.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eModel with 10 \u0026micro;m thick adhesive material\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eModel with 15 \u0026micro;m thick adhesive material\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003eModel with 20 \u0026micro;m thick adhesive material\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBulk-Fill Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eConventional Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHybrid Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eBulk-Fill Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eConventional Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eHybrid Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eBulk-Fill Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eConventional Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eHybrid Composite\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEnamel\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.657e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.962e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.291e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.132e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7.553e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e9.955e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.075e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.546e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2.003e8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDentin\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.853e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.882e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.897e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.218e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.250e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4.266e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.632e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3.659e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3.688e11\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRestorative Material\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.502e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.254e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.235e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.089e41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.360e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4.022e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.404e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e8.768e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e5.504e23\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eWhen we analysed all models with different adhesive material thicknesses within themselves, the models in which the enamel and dentin tissue started to break down the latest, that is, the models with the longest life, were the models restored with hybrid composite. The models in which enamel and dentin tissue started to fracture the earliest were the models restored with bulk-fill composite. The models in which the restorative materials started to fracture the earliest were the models restored with hybrid composites, while the models in which they started to fracture the latest were the models restored with bulk-fill composites.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section3\"\u003e \u003ch2\u003e3.2.4. Results of the model with Class I occlusal cavity\u003c/h2\u003e \u003cp\u003eWhen Class I occlusal cavities were restored with bulk-fill composite, conventional composite and hybrid composite, when we evaluated each restorative material within each restorative material; the model in which the enamel tissue fractured the fastest was the model in which 15 micrometre thick adhesive material was used. The model with the slowest fracture of the enamel tissue, i.e. the model with the longest life span, was the model in which the adhesive material with a thickness of 20 micrometres was used. The fastest fracture of dentin tissue was the model in which 20 micrometre thick adhesive material was used. The model with 15 micrometre thick adhesive material was the model with the slowest fracture. When conventional composite and hybrid composite were used, the model in which the restorative materials fractured the latest was the model in which 15 micrometre thick adhesive material was used. The earliest fracture occurred in the model with 20 micrometre thick adhesive material. When bulk-fill composite resin was used, the model in which the restorative material fractured the latest was the model in which 20 micrometre thick adhesive material was used, while the model in which the restorative material fractured the earliest was the model in which 10 micrometre thick adhesive material was used (Table \u003cspan refid=\"Tab10\" class=\"InternalRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab10\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 10\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eNumber of cycles required for fracture of dental tissues and restorative materials of the model with Class II mesio-occluso-distal (MOD) cavity.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eModel with 10 \u0026micro;m thick adhesive material\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eModel with 15 \u0026micro;m thick adhesive material\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003eModel with 20 \u0026micro;m thick adhesive material\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBulk-Fill Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eConventional Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHybrid Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eBulk-Fill Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eConventional Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eHybrid Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eBulk-Fill Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eConventional Composite\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eHybrid Composite\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEnamel\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.817e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.878e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.916e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.052e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.686e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6.189e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.742e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2.858e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2.924e9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDentin\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.918e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.250e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.578e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.096e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.415e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.718e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e5.759e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e6.864e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e8.022e9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRestorative Material\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.278e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.130e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.078e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.939e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.349e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5.588e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.744e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e9.177e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e4.195e23\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eWhen we analysed all models with different adhesive material thicknesses within themselves, the models in which the enamel and dentin tissue started to break down the latest, that is, the models with the longest life, were the models restored with hybrid composite. The models in which enamel and dentin tissue started to fracture the earliest were the models restored with bulk-fill composite. The models in which the restorative materials started to fracture the earliest were the models restored with hybrid composites, while the models in which they started to fracture the latest were the models restored with bulk-fill composites.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"4. DISCUSSION","content":"\u003cp\u003eIn this study, our hypothesis that when materials with different mechanical properties are used in restoration, the stress values accumulated in dental tissues and restorative materials will change and the fracture life will differ depending on this stress accumulation was accepted.\u003c/p\u003e \u003cp\u003eIn dentistry, many restorative materials have been produced in order to make dental tissues strong, resistant to forces, and resistant, and the materials produced have been improved day by day. A good understanding of the biomechanics in the oral cavity and the design and construction of restorations with this in mind increase the success of restorations.[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eIn 2003, Yaman et al. examined the maxillary central tooth with class V cavity using finite element stress analysis method. They used composite and compomer materials from different brands as restorative materials. As a result of this study, it was understood that the stresses in the restored tooth tissues were inversely proportional to the modulus of elasticity of the restorative materials used. In our study, when bulk-fill composite resin material, which has the lowest elastic modulus, was used as restorative material, high stress accumulation occurred in enamel and dentin tissues. When we look at the stress values accumulated on the restorative materials, similar to our study, the stress values accumulated on the restoration were the highest when the material with the highest young's modulus was used.[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eYamanel et al. investigated the effect of restorative material differences and cavity design on the stress distribution on tooth structures and restorative materials using finite element analysis. They used nanofiller composite and 2 different full ceramic materials as restorative materials. As a result, they found that materials with low elastic modulus transferred more stress to the tooth structures, as in our study, i.e. compared to nanofiller-containing composites, the tested full ceramic inlay and onlay materials transferred less stress to the tooth structures. [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eIn 2022, G\u0026ouml;nder et al. analysed the stress distributions in teeth restored using different thicknesses of adhesive material. As a result of the study, as the thickness of the adhesive material increased, the amount of stress accumulated on the adhesive material decreased as in our study.[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e] Again in 2023, G\u0026ouml;nder et al. restored the molar tooth with different materials after designing a class II cavity. As a result, similar to our results, when the material with low young's modulus was used, the stress values accumulated in the enamel and dentin tissues were the highest and fractures in these tissues occurred earlier.[28]\u003c/p\u003e"},{"header":"5. CONCLUSIONS","content":"\u003cp\u003eThe important findings of this study are as follows:\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cp\u003eWhen materials with low Young's modulus, i.e. more flexible materials than others, the stress values accumulated on enamel and dentin tissues increased significantly and these tissues showed early fracture. When materials with large Young's modulus, i.e. more rigid materials were used, the stress values in these tissues were lower. In other words, the stress values accumulated on enamel and dentin tissues were inversely proportional to the Young's modulus of the materials used.\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003eWhen materials with large Young's modulus were used, fractures in restorative materials occurred earlier.\u003c/p\u003e\n\u003c/li\u003e\n\u003cli\u003e\n\u003cp\u003eAs the thickness of the adhesive material increased, the stress values accumulated on the adhesive material decreased.\u003c/p\u003e\n\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eDICOM: Digital Imaging and Communucations in Medicine\u003c/p\u003e\n\u003cp\u003eSTL: Standard Tessellation Language\u003c/p\u003e\n\u003cp\u003eFEA: Finite Element Analysis\u003c/p\u003e\n\u003cp\u003eCBCT: Cone Beam Computed Tomography\u003c/p\u003e\n\u003cp\u003eGpa: Gigapascal\u003c/p\u003e\n\u003cp\u003eMpa: Megapascal\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate:\u003c/strong\u003e Not required.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication:\u003c/strong\u003e Not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials:\u003c/strong\u003e The data that support the findings of this study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u003c/strong\u003e The authors have no conflict of interest relevant to this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e This project was funded by the TÜBİTAK 2209-A Research Support Program for University Students 2021/2 (Project No: 1919B012110260).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions:\u003c/strong\u003e RMand HYG participated in designing the study. RM participated in generating the data for the study. RM participated in gathering the data for the study. RM participated in the analysis of the data. RM and HYG have had access to all the raw data of the study. RM, HYG and AH have reviewed the pertinent raw data on which the results and conclusions of this study are based. RM, HYG and AH have approved the final version of this paper. RM, HYG and AH guarantees that all individuals who meet the Journal’s authorship criteria are included as authors of this paper.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003ePitts NB (2004) Are we ready to move from operative to non-operative/preventive treatment of dental caries in clinical practice? Caries Res 38:294\u0026ndash;304\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFeatherstone JD (2000) The science and practice of caries prevention. J Am Dent Assoc 131:887\u0026ndash;899\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMesquita RV, Axmann D, Geis-Gerstorfer J (2006) Dynamic visco-elastic properties of dental composite resins. Dent Mater 22:258\u0026ndash;267\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYamanel K, Caglar A, G\u0026uuml;lsahi K, Ozden UA (2009) Effects of different ceramic and composite materials on stress distribution in inlay and onlay cavities: 3-D finite element analysis. Dent Mater J 28:661\u0026ndash;670\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLee WC, Eakle WS (1996) Stress-induced cervical lesions: review of advances in the past 10 years. J Prosthet Dent 75:487\u0026ndash;494\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMj\u0026ouml;r IA, Toffenetti F (2000) Secondary caries: a literature review with case reports. Quintessence Int 31:165\u0026ndash;179\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRao S (2017) S. The finite element method in engineering\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMagne P (2007) Efficient 3D finite element analysis of dental restorative procedures using micro-CT data. Dent Mater 23:539\u0026ndash;548\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eReddy MS, Sundram R, Eid Abdemagyd HA (2019) Application of Finite Element Model in Implant Dentistry: A Systematic Review. J Pharm Bioallied Sci 11:S85\u0026ndash;S91\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGuler MS, Guler C, Cakici F, Cakici EB, Sen S (2016) Finite element analysis of thermal stress distribution in different restorative materials used in class V cavities. Niger J Clin Pract 19:30\u0026ndash;34\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChuang S-F, Chang C-H, Chen TY-F (2011) Contraction behaviors of dental composite restorations\u0026ndash;finite element investigation with DIC validation. J Mech Behav Biomed Mater 4:2138\u0026ndash;2149\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLuo X, Rong Q, Luan Q, Yu X (2022) Effect of partial restorative treatment on stress distributions in non-carious cervical lesions: a three-dimensional finite element analysis. BMC Oral Health 22:607\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ede Rodrigues M (2020) Direct resin composite restoration of endodontically-treated permanent molars in adolescents: bite force and patient-specific finite element analysis. J Appl Oral Sci 28:e20190544\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJiang W, Bo H, Yongchun G, LongXing N (2010) Stress distribution in molars restored with inlays or onlays with or without endodontic treatment: a three-dimensional finite element analysis. J Prosthet Dent 103:6\u0026ndash;12\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAusiello P et al (2017) Mechanical behavior of bulk direct composite versus block composite and lithium disilicate indirect Class II restorations by CAD-FEM modeling. Dent Mater 33:690\u0026ndash;701\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJuloski J, Apicella D, Ferrari M (2014) The effect of ferrule height on stress distribution within a tooth restored with fibre posts and ceramic crown: a finite element analysis. Dent Mater 30:1304\u0026ndash;1315\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003e\u0026Ccedil;ulhaoğlu AK, Terzi̇oğlu PDH (2020) Comparing static, dynamic and impact loading behavior of biomimetic porous dental implants with conventional dental implants (3D finite element analysis). Selcuk Dent J 7:471\u0026ndash;480\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHomaei E et al (2018) Numerical fatigue analysis of premolars restored by CAD/CAM ceramic crowns. Dent Mater 34:e149\u0026ndash;e157\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ede Abreu RAM et al (2014) Masticatory efficiency and bite force in individuals with normal occlusion. Arch Oral Biol 59:1065\u0026ndash;1074\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMutluay MM et al (2013) Fatigue of the resin-dentin interface: a new approach for evaluating the durability of dentin bonds. Dent Mater 29:437\u0026ndash;449\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAusiello P, Franciosa P, Martorelli M, Watts DC (2011) Numerical fatigue 3D-FE modeling of indirect composite-restored posterior teeth. Dent Mater 27:423\u0026ndash;430\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNalla RK, Kinney JH, Marshall SJ, Ritchie RO (2004) On the in vitro fatigue behavior of human dentin: effect of mean stress. J Dent Res 83:211\u0026ndash;215\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhang Z et al (2015) On the durability of resin-dentin bonds: Identifying the weakest links. Dent Mater 31:1109\u0026ndash;1118\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUlusoy M, Aydın K (2010) Diş hekimliğinde hareketli b\u0026ouml;l\u0026uuml;ml\u0026uuml; protezler, Ankara \u0026Uuml;niversitesi Yayınları, s. 94\u0026ndash;120\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYaman SD, Sahin M, Aydin C (2003) Finite element analysis of strength characteristics of various resin based restorative materials in Class V cavities. J Oral Rehabil 30:630\u0026ndash;641\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYasin G\u0026ouml;nder H, Mohammadi R, Harmankaya A, Burak Y\u0026uuml;ksel İ (2022) \u0026amp; Seda G\u0026uuml;ltekin, D. Investigation of the effects of adhesive materials of different types and thicknesses on dental tissue stress via FEM analysis. \u003cem\u003eBiomed Res. Int.\u003c/em\u003e 8493909 (2022)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eG\u0026ouml;nder HY et al (2023) Teeth restored with bulk-fill composites and conventional resin composites; Investigation of stress distribution and fracture lifespan on enamel, dentin, and restorative materials via three-dimensional finite element analysis. Polym (Basel) 15:1637\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Adhesion, Restorative materials, Stress distribution, Fracture lifetime, Restoration","lastPublishedDoi":"10.21203/rs.3.rs-6129157/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6129157/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e The aim of this study was to compare the stress distributions and fracture life of dental tissues and restorative materials restored using different thicknesses of adhesive materials and different restorative materials.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethos :\u003c/strong\u003e A tooth number 36 without caries and loss of material was scanned using a CBCT device. The files obtained were transferred to Mimics software. Using this software, enamel tissue, dentin tissue and pulp regions were extracted separately in STL format. STL files were transferred to Geomagic Design X software for surface correction and saved in STP format. The obtained STP files were transferred to the Solidworks programme and 4 different (DO, MO, MOD, O) cavity preparations were made on the models. Each of these cavities was restored with bulk-fill composite, conventional composite and hybrid composite in the computerised environment. A layer of adhesive material with a thickness of 10, 15 and 20 micrometres was applied under all materials and stress distributions and fracture lifetimes were analysed by 3D finite element stress analysis method.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e When we evaluated the models with different thicknesses of adhesive material, the stress values on enamel, dentin and adhesive material were highest in the models with bulk-fill composite, while the stress values on the restoration were highest in the models with hybrid composite. As the thickness of the adhesive material decreased, the stress values accumulated on the material increased. In addition, the models in which the enamel tissue started to fracture the earliest were the models restored with bulk-fill composite. The models in which the restorative materials started to fracture the earliest were the models restored with hybrid composites, while the models in which the restorative materials started to fracture the latest were the models restored with bulk-fill composites.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e When materials with low young's modulus are used for restorative purposes, they cause too much stress accumulation on enamel and dentin tissues. Accordingly, these tissues start to fracture early. When materials with large Young's modulus are used, too much stress is applied to the restoration and the restoration fractures prematurely.\u003c/p\u003e","manuscriptTitle":"Investigation of Stress Distribution And Fatique Performance in Restored Teeth Using Different Thickness of Adhesive Materials and Different Restorative Materials:3D Finite Element Analysis (FEM)","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-03-07 06:05:44","doi":"10.21203/rs.3.rs-6129157/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4322de55-7953-465c-ac3c-a95ced2a4d93","owner":[],"postedDate":"March 7th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-03-07T06:05:44+00:00","versionOfRecord":[],"versionCreatedAt":"2025-03-07 06:05:44","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6129157","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6129157","identity":"rs-6129157","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}