{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T09:28:14Z","timestamp":1784366894831,"version":"3.55.0"},"reference-count":34,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T00:00:00Z","timestamp":1724630400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>This study aimed to examine the effect of the force applied by rubber dam clamps made from different materials on mandibular first molar teeth with various designs of endodontic access cavities using finite element analysis.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>A intact tooth (IT) and seven different endodontic access cavities namely, a traditional endodontic cavity (TRADAC), a guided endodontic cavity (GEC), a conservative endodontic cavity (CAC), an ultra-conservative access cavity (UAC), a truss access endodontic cavity (TRSAC), a mesial caries access cavity (MCAC), and a distal caries access cavity (DCAC), along with two different clamp finite element models, were created. The clamp models were made of polyether ether ketone (PEEK) and stainless steel (SS). The forces applied by the clamps were calculated based on the axial section distance of the tooth, and these forces were applied to the contact areas on the tooth. Stress distribution models were calculated using maximum von Mises (vM) stress.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The lowest vM stress under the forces applied by the SS and PEEK clamps was found in the IT model (80.914 MPa) with the PEEK clamp. The highest vM stress was found in the DCAC model (759.49 MPa) applied with the SS clamp. The forces applied by SS clamps resulted in higher vM stress values in every cavity design than those applied by PEEK clamps.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>PEEK clamps generated less force than SS clamps. However, clinicians should follow various isolation strategies (clamp made of different materials, split dam, <jats:italic>etc<\/jats:italic>.) according to different cavity types of the tooth.<\/jats:p>\n<\/jats:sec>","DOI":"10.7717\/peerj.17921","type":"journal-article","created":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T06:49:10Z","timestamp":1724654950000},"page":"e17921","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of the forces applied by rubber dam clamps on mandibular first molar teeth with different endodontic access cavities: a 3D FEA study"],"prefix":"10.7717","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0183-3824","authenticated-orcid":true,"given":"Mehmet","family":"Eskiba\u011flar","sequence":"first","affiliation":[{"name":"Department of Endodontics, Faculty of Dentistry, Firat (Euphrates) University, Elaz\u0131\u011f, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serkan","family":"Erdem","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Engineering Faculty, Firat (Euphrates) University, Elaz\u0131\u011f, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B\u00fc\u015fra","family":"Karaa\u011fa\u00e7 Eskiba\u011flar","sequence":"additional","affiliation":[{"name":"Department of Pediatric Dentistry, Faculty of Dentistry, Firat (Euphrates) University, Elaz\u0131\u011f, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mete Onur","family":"Kaman","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Engineering Faculty, Firat (Euphrates) University, Elaz\u0131\u011f, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4443","published-online":{"date-parts":[[2024,8,26]]},"reference":[{"issue":"11","key":"10.7717\/peerj.17921\/ref-1","doi-asserted-by":"publisher","first-page":"963","DOI":"10.1111\/j.1365-2591.2009.01623.x","article-title":"Rubber dam usage for endodontic treatment: a review","volume":"42","author":"Ahmad","year":"2009","journal-title":"International Endodontic Journal"},{"issue":"3","key":"10.7717\/peerj.17921\/ref-2","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1111\/iej.13013","article-title":"Effect of perforation size and furcal lesion on stress distribution in mandibular molars: a finite element analysis","volume":"52","author":"Askerbeyli \u00d6rs","year":"2019","journal-title":"International Endodontic Journal"},{"issue":"4","key":"10.7717\/peerj.17921\/ref-3","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1016\/j.joen.2020.11.018","article-title":"Evaluation of stress distributions in mandibular molar teeth with different iatrogenic root perforations repaired with biodentine or mineral trioxide aggregate: a finite element analysis study","volume":"47","author":"Aslan","year":"2021","journal-title":"Journal of Endodontics"},{"issue":"2","key":"10.7717\/peerj.17921\/ref-4","first-page":"131","article-title":"Rubber dam in clinical practice","volume":"2","author":"Bhuva","year":"2008","journal-title":"Endodontic Practice Today"},{"issue":"5","key":"10.7717\/peerj.17921\/ref-5","doi-asserted-by":"publisher","first-page":"e12802","DOI":"10.1111\/eos.12802","article-title":"Finite element analysis of rotary nickel-titanium endodontic instruments: a critical review of the methodology","volume":"129","author":"Chien","year":"2021","journal-title":"European Journal of Oral Sciences"},{"issue":"11","key":"10.7717\/peerj.17921\/ref-6","doi-asserted-by":"publisher","first-page":"1681","DOI":"10.2217\/nnm.14.75","article-title":"Finite-element modeling and analysis in nanomedicine and dentistry","volume":"9","author":"Choi","year":"2014","journal-title":"Nanomedicine"},{"issue":"9","key":"10.7717\/peerj.17921\/ref-7","doi-asserted-by":"publisher","first-page":"1539","DOI":"10.1016\/j.joen.2017.04.024","article-title":"Patient-specific finite element analysis of fiber post and ferrule design","volume":"43","author":"de Paula Rodrigues","year":"2017","journal-title":"Journal of Endodontics"},{"issue":"9","key":"10.7717\/peerj.17921\/ref-8","doi-asserted-by":"publisher","first-page":"1472","DOI":"10.1016\/j.joen.2021.06.009","article-title":"Impact of canal taper and access cavity design on the life span of an endodontically treated mandibular molar: a finite element analysis","volume":"47","author":"Elkholy","year":"2021","journal-title":"Journal of Endodontics"},{"key":"10.7717\/peerj.17921\/ref-9","doi-asserted-by":"publisher","DOI":"10.1080\/10255842.2023.2254882","article-title":"Evaluation of the effect of different rubber dam clamps on the mandibular first molar with Finite element analysis","author":"Eskiba\u011flar","year":"2023","journal-title":"Computer Methods in Biomechanics and Biomedical Engineering"},{"issue":"3","key":"10.7717\/peerj.17921\/ref-10","doi-asserted-by":"publisher","first-page":"875","DOI":"10.15311\/selcukdentj.755821","article-title":"Di\u015f Hekimli\u011fi Prati\u011finde Rubber Dam ve Uygulama Y\u00f6ntemleri","volume":"8","author":"Eskiba\u011flar","year":"2021","journal-title":"Selcuk Dental Journal"},{"issue":"5","key":"10.7717\/peerj.17921\/ref-11","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1016\/j.joen.2023.03.003","article-title":"Rubber dam clamp may cause cortical necrosis: a case report","volume":"49","author":"Gozon","year":"2023","journal-title":"Journal of Endodontics"},{"issue":"8","key":"10.7717\/peerj.17921\/ref-12","doi-asserted-by":"publisher","first-page":"1283","DOI":"10.1016\/j.joen.2018.04.004","article-title":"Biomechanical properties of first maxillary molars with different endodontic cavities: a finite element analysis","volume":"44","author":"Jiang","year":"2018","journal-title":"Journal of Endodontics"},{"issue":"4","key":"10.7717\/peerj.17921\/ref-13","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1097\/00029330-200602020-00007","article-title":"Three-dimensional finite element analysis of weakened roots restored with different cements in combination with titanium alloy posts","volume":"119","author":"Li","year":"2006","journal-title":"Chinese Medical Journal"},{"issue":"10","key":"10.7717\/peerj.17921\/ref-14","doi-asserted-by":"publisher","first-page":"1337","DOI":"10.1016\/j.joen.2023.07.022","article-title":"Effect of proximal caries-driven access on the biomechanical behavior of endodontically treated maxillary premolars","volume":"49","author":"Nawar","year":"2023","journal-title":"Journal of Endodontics"},{"issue":"2","key":"10.7717\/peerj.17921\/ref-15","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1016\/j.joen.2017.10.010","article-title":"Does the orifice-directed dentin conservation access design debride pulp chamber and mesial root canal systems of mandibular molars similar to a traditional access design?","volume":"44","author":"Neelakantan","year":"2018","journal-title":"Journal of Endodontics"},{"issue":"5","key":"10.7717\/peerj.17921\/ref-16","doi-asserted-by":"publisher","first-page":"800","DOI":"10.1016\/j.joen.2018.01.020","article-title":"The effects of endodontic access cavity preparation design on the fracture strength of endodontically treated teeth: traditional versus conservative preparation","volume":"44","author":"\u00d6zy\u00fcrek","year":"2018","journal-title":"Journal of Endodontics"},{"issue":"3","key":"10.7717\/peerj.17921\/ref-17","doi-asserted-by":"publisher","first-page":"105422","DOI":"10.1016\/j.jmbbm.2022.105422","article-title":"Biomechanical performance of Ti-PEEK dental implants in bone: an in-silico analysis","volume":"134","author":"Ouldyerou","year":"2022","journal-title":"Journal of the Mechanical Behavior of Biomedical Materials"},{"issue":"6","key":"10.7717\/peerj.17921\/ref-18","doi-asserted-by":"publisher","first-page":"995","DOI":"10.1016\/j.joen.2017.01.022","article-title":"Fracture strength of endodontically treated teeth with different access cavity designs","volume":"43","author":"Plotino","year":"2017","journal-title":"Journal of Endodontics"},{"issue":"2","key":"10.7717\/peerj.17921\/ref-19","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1016\/j.cmpb.2011.03.017","article-title":"2D and 3D finite element analysis of central incisor generated by computerized tomography","volume":"104","author":"Poiate","year":"2011","journal-title":"Computer Methods and Programs in Biomedicine"},{"issue":"6","key":"10.7717\/peerj.17921\/ref-20","doi-asserted-by":"publisher","first-page":"2547","DOI":"10.3390\/app11062547","article-title":"3D finite element analysis of rotary instruments in root canal dentine with different elastic moduli","volume":"11","author":"Prati","year":"2021","journal-title":"Applied Sciences"},{"issue":"11","key":"10.7717\/peerj.17921\/ref-21","doi-asserted-by":"publisher","first-page":"1675","DOI":"10.1016\/j.joen.2020.06.040","article-title":"The effect of access cavity designs and sizes of root canal preparations on the biomechanical behavior of an endodontically treated mandibular first molar: a finite element analysis","volume":"46","author":"Saber","year":"2020","journal-title":"Journal of Endodontics"},{"issue":"9","key":"10.7717\/peerj.17921\/ref-22","doi-asserted-by":"publisher","first-page":"1402","DOI":"10.1016\/j.joen.2018.05.006","article-title":"Impact of access cavity design and root canal taper on fracture resistance of endodontically treated teeth: an ex vivo investigation","volume":"44","author":"Sabeti","year":"2018","journal-title":"Journal of Endodontics"},{"issue":"9","key":"10.7717\/peerj.17921\/ref-23","doi-asserted-by":"publisher","first-page":"1496","DOI":"10.1016\/j.joen.2021.06.020","article-title":"Influence of minimally invasive access cavity designs on the fracture resistance of endodontically treated mandibular molars subjected to thermocycling and dynamic loading","volume":"47","author":"Santosh","year":"2021","journal-title":"Journal of Endodontics"},{"issue":"S3","key":"10.7717\/peerj.17921\/ref-24","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1111\/iej.13696","article-title":"Present status and future directions-Minimal endodontic access cavities","volume":"55","author":"Silva","year":"2022","journal-title":"International Endodontic Journal"},{"issue":"3","key":"10.7717\/peerj.17921\/ref-25","doi-asserted-by":"publisher","first-page":"736","DOI":"10.5395\/rde.2021.46.e42","article-title":"Ten years of minimally invasive access cavities in Endodontics: a bibliometric analysis of the 25 most-cited studies","volume":"46","author":"Silva","year":"2021","journal-title":"Restorative Dentistry & Endodontics"},{"issue":"12","key":"10.7717\/peerj.17921\/ref-26","doi-asserted-by":"publisher","first-page":"1618","DOI":"10.1111\/iej.13391","article-title":"Current status on minimal access cavity preparations: a critical analysis and a proposal for a universal nomenclature","volume":"53","author":"Silva","year":"2020","journal-title":"International Endodontic Journal"},{"issue":"8","key":"10.7717\/peerj.17921\/ref-27","doi-asserted-by":"publisher","first-page":"983","DOI":"10.1016\/j.dental.2006.08.006","article-title":"Three-dimensional finite element analysis of strain and stress distributions in endodontically treated maxillary central incisors restored with diferent post, core and crown materials","volume":"23","author":"Sorrentino","year":"2007","journal-title":"Dental Materials"},{"issue":"5","key":"10.7717\/peerj.17921\/ref-28","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1111\/j.1365-2591.1996.tb01394.x","article-title":"Effect of various irrigant and autoclaving regimes on the fracture resistance of rubber dam clamps","volume":"29","author":"Sutton","year":"1996","journal-title":"International Endodontic Journal"},{"issue":"7","key":"10.7717\/peerj.17921\/ref-29","doi-asserted-by":"publisher","first-page":"1157","DOI":"10.1016\/j.joen.2021.04.016","article-title":"Dentinal microcracks induced by endodontic procedures: suggested design for experimental studies using micro-computed tomography and strain gauges","volume":"47","author":"Tonelli","year":"2021","journal-title":"Journal of Endodontics"},{"issue":"11","key":"10.7717\/peerj.17921\/ref-30","doi-asserted-by":"publisher","first-page":"1512","DOI":"10.1016\/j.joen.2011.07.002","article-title":"Analysis of reasons for extraction of endodontically treated teeth: a prospective study","volume":"37","author":"Tour\u00e9","year":"2011","journal-title":"Journal of Endodontics"},{"issue":"3","key":"10.7717\/peerj.17921\/ref-31","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1016\/j.jobcr.2014.11.008","article-title":"Finite element analysis: a boon to dentistry","volume":"4","author":"Trivedi","year":"2014","journal-title":"Journal of Oral Biology and Craniofacial Research"},{"issue":"1","key":"10.7717\/peerj.17921\/ref-32","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1186\/s12903-023-02878-3","article-title":"Effect of access cavities on the biomechanics of mandibular molars: a finite element analysis","volume":"23","author":"Wang","year":"2023","journal-title":"BMC Oral Health"},{"key":"10.7717\/peerj.17921\/ref-33","first-page":"377","article-title":"Topical anesthesia for rubber dam clamp placement in sealant placement: comparison of lidocaine\/prilocaine gel and benzocaine","volume":"31","author":"Yoon","year":"2009","journal-title":"Pediatric Dentistry"},{"issue":"5","key":"10.7717\/peerj.17921\/ref-34","doi-asserted-by":"publisher","first-page":"e31","DOI":"10.1016\/j.tripleo.2008.06.017","article-title":"Analysis of factors related to extraction of endodontically treated teeth","volume":"106","author":"Zadik","year":"2008","journal-title":"Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology"}],"container-title":["PeerJ"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/peerj.com\/articles\/17921.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/17921.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/17921.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/peerj.com\/articles\/17921.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T06:49:15Z","timestamp":1724654955000},"score":1,"resource":{"primary":{"URL":"https:\/\/peerj.com\/articles\/17921"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,26]]},"references-count":34,"alternative-id":["10.7717\/peerj.17921"],"URL":"https:\/\/doi.org\/10.7717\/peerj.17921","archive":["CLOCKSS","LOCKSS","Portico"],"relation":{},"ISSN":["2167-8359"],"issn-type":[{"value":"2167-8359","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,26]]},"article-number":"e17921"}}