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Haridy MF, Ahmed HS, Ahmed RN, Elhusseiny SE. Effect of different cavity designs and CAD/CAM blocks on fracture resistance of maxillary premolars with MOD cavities. Odontology 2025:10.1007/s10266-025-01079-4. [PMID: 40100538 DOI: 10.1007/s10266-025-01079-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2024] [Accepted: 02/18/2025] [Indexed: 03/20/2025]
Abstract
The aim of the study was to evaluate the fracture resistance of maxillary premolars restored by different CAD/CAM blocks with different MOD cavity designs. A total of 56 maxillary premolars were selected and randomly divided into 4 groups. I: intact teeth as a positive control group. Standardized MOD cavities were prepared in the remaining group specimens. II: teeth had MOD cavities but were left unrestored as a negative control group. III: MOD preparations restored with inlays with no cusp reduction. IV: MOD preparations restored with overlays with cusp reduction. Group III and IV were further subdivided into two subgroups according to material used, i.e., either lithium disilicate or composite CAD/CAM blocks. All specimens were subjected to 5000 cycles of thermocycling and then tested for fracture resistance. Failure patterns were also examined. Data were statistically analyzed using Welch one-way ANOVA followed by Games-Howell's post hoc test. The results showed significant differences among the experimental groups (p < 0.001). The highest fracture resistance value was observed in positive control group, followed by overlays restored with lithium disilicate blocks. This was followed by overlays restored with composite blocks, then inlays restored by lithium disilicate blocks, inlays restored with composite blocks, while the lowest fracture resistance value was found in negative control group. Regarding failure modes, there was a significant difference between different groups (p < 0.001). The conclusion was that fracture resistance of maxillary premolars restored by CAD/CAM inlays and overlays are greatly affected by the cavity design and material type.
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Affiliation(s)
- Mohamed F Haridy
- Department of Conservative Dentistry, Faculty of Dentistry, The British University, Al Shorouk City, Egypt.
- Department of Conservative Dentistry, Faculty of Dentistry, Cairo University, Cairo, Egypt.
| | - Hend S Ahmed
- Department of Conservative Dentistry, Faculty of Dentistry, The British University, Al Shorouk City, Egypt
| | - Radwa Nagy Ahmed
- Department of Conservative Dentistry, Faculty of Dentistry, The British University, Al Shorouk City, Egypt
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Alenezi AA, Alyahya SO, Aldakhail NS, Alsalhi HA. Clinical behavior and survival of endodontically treated teeth with or without post placement: a systematic review and meta-analysis. J Oral Sci 2024; 66:207-214. [PMID: 39231718 DOI: 10.2334/josnusd.24-0098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2024]
Abstract
PURPOSE Non-vital teeth usually exhibit substantial loss of coronal and radicular tooth structure, and use of posts after root canal treatment is controversial. This review examined whether placement of posts influences clinical behavior and survival probability of endodontically treated teeth (ETT). METHODS An electronic search, without time restrictions, for publications written in English was undertaken in PubMed, Scopus, and Web of Science. Terms related to four main components (endodontically treated teeth, fixed prosthesis, post restoration, and survival rate) were used for the database search strategies. RESULTS 57 studies met the inclusion criteria and were included in the qualitative analysis. Of the publications chosen for qualitative analysis, 17 clinical studies (11 prospective and 6 retrospective studies) were found to be suitable for quantitative analysis. These studies included 7,278 patients (7,330 ETT), with a mean age ± standard deviation (SD) of 45.46 ± 12.1 years. There was a statistically significant difference in survival rate between ETT with or without posts (P < 0.001). CONCLUSION As compared with teeth with no posts, post placement on ETT may improve clinical performance and survival probability of endodontically treated teeth.
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Affiliation(s)
- Ali A Alenezi
- Department of Prosthetic Dental Sciences, College of Dentistry, Qassim University
| | | | | | - Hanin A Alsalhi
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University
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Ostapiuk M, Tarczydło J, Kamińska K, Surowska B, Tarczydło B. Compressive Strength Testing of Glass-Fibre-Reinforced Tooth Crown Tissues After Endodontic Treatment. Ann Biomed Eng 2024; 52:318-326. [PMID: 37794298 PMCID: PMC10808276 DOI: 10.1007/s10439-023-03377-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/27/2023] [Indexed: 10/06/2023]
Abstract
The objective of this study was to compare the effects of using short and continuous fibres for repairing compression-induced tooth crown damage. Human teeth were used for the study. They were upper medial incisors and maxillary first premolars lost due to periodontal causes. The teeth were divided into two groups with Hahnenkratt and short glass fibres. Teeth compressive strength tests were carried out. Then micro-CT imaging of the teeth and their fractures obtained after compression was performed. The teeth restored with Hahnenkratt's glass fibre posts showed higher compressive strength than the teeth restored using the EverX Posterior material. The tooth's most weakened and sensitive point after endodontic treatment was the cervical area of the tooth. All cracks were parallel to the root canal.
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Affiliation(s)
- Monika Ostapiuk
- Department of Materials Engineering, Faculty of Mechanical Engineering, Lublin University of Technology, Nadbystrzycka St. 36, 20-618, Lublin, Poland.
| | - Janusz Tarczydło
- Faculty of Medicine, Dentistry, Medical University of Lublin, Chodźki St. 6, 20-093, Lublin, Poland
| | - Katarzyna Kamińska
- Department of Materials Engineering, Faculty of Mechanical Engineering, Lublin University of Technology, Nadbystrzycka St. 36, 20-618, Lublin, Poland
| | - Barbara Surowska
- Department of Materials Engineering, Faculty of Mechanical Engineering, Lublin University of Technology, Nadbystrzycka St. 36, 20-618, Lublin, Poland
| | - Bożena Tarczydło
- Department of Conservative Dentistry with Endodontics, Medical University of Lublin, Chodźki St. 6, 20-950, Lublin, Poland
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Fráter M, Grosz J, Jakab A, Braunitzer G, Tarjányi T, Gulyás G, Bali K, Villa-Machado PA, Garoushi S, Forster A. Evaluation of microhardness of short fiber-reinforced composites inside the root canal after different light curing methods - An in vitro study. J Mech Behav Biomed Mater 2024; 150:106324. [PMID: 38113823 DOI: 10.1016/j.jmbbm.2023.106324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 12/06/2023] [Accepted: 12/11/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVES Short fiber-reinforced composite (SFRC) materials make it possible to reinforce root canal treated teeth with individualized, directly layered intraradicular posts (the Bioblock technique). The question arises, however, as to whether the photopolymerization of the material is sufficient deep within the root canal space and if it can be improved through different light-conducting options. Our study aimed to investigate the hardness of intraradicular SFRC material applied using the Bioblock technique and cured with various illumination methods, as measured through nanoindentation. MATERIALS AND METHODS For this investigation, thirty plastic artificial teeth that had undergone root canal treatment were selected. These teeth were randomly divided into six study groups (Group 1-6; each group consisting of 5 teeth). The restoration procedures involved the use of SFRC or conventional composite materials, placed 6 mm apically from the root canal orifice. In Group 1 and 2, a conventional composite was used, whereas in Group 3-6, SFRC was employed for interradicular reinforcement (with a layered technique in Group 3 and 4 and a bulk-fill technique in Group 5 and 6). A modified light source was utilized for photopolymerization in Group 2, 4, and 6, whereas in Group 3 and 5, the polymerization light was directed through a prefabricated glass fiber posts. The control group (Group 1) utilized conventional composite material with a standard light-curing method. Following embedding and sectioning, the hardness of the composite materials was measured at 2 mm intervals within the root canal (1st, 2nd, 3rd measurements, in the coronal to apical direction). RESULTS During the 1st measurement, light curing conducted through the glass fiber posts (Group 3 and 5) led to markedly higher hardness levels compared to the groups restored with conventional composite (control group with p = 0.002, p = 0.001, and Group 2 with p = 0.043, p = 0.034, respectively). In the 2nd measurement, only Group 5 demonstrated significantly greater hardness in comparison to the control group (p = 0.003) and Group 2 (p = 0.015). However, in the 3rd measurement, no statistically significant differences were observed among the groups. CONCLUSION light curing through the glass fiber post provides outstanding hardness for the SFRC material in the apical layer in the root canal.
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Affiliation(s)
- Márk Fráter
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, Szeged, Hungary.
| | - János Grosz
- Urban Regeneration Institute, Budapest, Hungary
| | - András Jakab
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, Szeged, Hungary
| | | | - Tamás Tarjányi
- SEMILAB Semiconductor Physics Laboratory Co. Ltd., Budapest, Hungary; Department of Medical Physics and Informatics, University of Szeged, Szeged, Hungary
| | - Gábor Gulyás
- SEMILAB Semiconductor Physics Laboratory Co. Ltd., Budapest, Hungary
| | - Krisztián Bali
- SEMILAB Semiconductor Physics Laboratory Co. Ltd., Budapest, Hungary
| | | | - Sufyan Garoushi
- Department of Biomaterials Science, Turku Clinical Biomaterials Center -TCBC, Institute of Dentistry, University of Turku, Turku, Finland
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Fousekis E, Lolis A, Marinakis E, Oikonomou E, Foros P, Koletsi D, Eliades G. Short fiber-reinforced composite resins as post-and-core materials for endodontically treated teeth: A systematic review and meta-analysis of in vitro studies. J Prosthet Dent 2023:S0022-3913(23)00643-1. [PMID: 37919126 DOI: 10.1016/j.prosdent.2023.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 09/23/2023] [Accepted: 09/25/2023] [Indexed: 11/04/2023]
Abstract
STATEMENT OF PROBLEM As the use of traditional posts has been associated with complications and failure outcomes, the introduction of novel materials and minimally invasive dentistry has shifted toward the use of composite resin post-and-core restorations for endodontically treated teeth. As a further process, to improve stress absorption environment in restored teeth, the invention of short fiber-reinforced composite resins (SFRCs) as post-and-core restorations has recently emerged. However, evidence regarding its performance is still scarce, and a synthesis of existing data is lacking. PURPOSE The purpose of this systematic review and meta-analysis was to assess the performance of SFRC post-and-core restorations, regarding fracture resistance and failure mode and considering both cyclic and static loading. MATERIAL AND METHODS An electronic search in 5 databases was conducted up to August 2022, and the protocol of the study was registered a priori. The search terms included "fiber reinforced composite," "core build-up," and "post." Studies were considered if they compared SFRC restorations with other types of conventional posts and teeth restored using bulk fill composite resin. The internal validity of the studies was assessed by using a custom-made risk of bias tool. RESULTS A total of 1271 records were identified, of which 13 were considered for full-text assessment. Eight were ultimately included, all being in vitro studies, and 7 of them were deemed eligible for quantitative syntheses. The results varied considerably across studies with divergent fracture resistance values and percentages of catastrophic failure being reported. Standard depth (6 mm) SFRCs presented fewer repetitions until fracture on average, compared with the individually made FRCs (3 studies: mean difference (MD): -4062; 95% CI: -6148, -1975; P<.001) under cyclic loading. Under static loading, SFRCs (standard depth) presented a nearly 300 N lower fracture force compared with that of intact teeth, (3 studies: MD: -297; 95%CI: -378, -216; P<.001). CONCLUSIONS Evidence on the laboratory fracture and failure performance of SFRCs is limited, and future studies should incorporate more standardized experimental conditions, as well as SFRCs with limited sacrifice of tooth substrate within the root canal of endodontically treated teeth.
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Affiliation(s)
- Ektoras Fousekis
- Researcher, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Andreas Lolis
- Researcher, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Emmanouil Marinakis
- Researcher, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Elissaios Oikonomou
- Researcher, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
| | - Petros Foros
- Researcher, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Despina Koletsi
- Senior Teaching and Research Staff, Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zürich, Zürich, Switzerland; and Research Affiliate, Meta, Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, Calif
| | - George Eliades
- Professor and Director, Department of Dental Materials, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
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Post-Fatigue Fracture Resistance of Lithium Disilicate and Polymer-Infiltrated Ceramic Network Indirect Restorations over Endodontically-Treated Molars with Different Preparation Designs: An In-Vitro Study. Polymers (Basel) 2022; 14:polym14235084. [PMID: 36501478 PMCID: PMC9739407 DOI: 10.3390/polym14235084] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 11/11/2022] [Accepted: 11/18/2022] [Indexed: 11/25/2022] Open
Abstract
The aim of the present study was to evaluate the fatigue to cyclic and static resistance of indirect restorations with different preparation designs made either of lithium disilicate (LS) or polymer-infiltrated ceramic network (PICN). Eighty-four (n = 84) molars were chosen, endodontically treated, and prepared with standardized MOD cavities. The molars were randomly divided into 6 study groups (n = 14) taking into account the "preparation design'' (occlusal veneer with 1.2 mm occlusal thickness; overlay with 1.6 mm occlusal thickness; adhesive crown with 2 mm occlusal thickness) and the "CAD/CAM material'' (E-max CAD, Ivoclar vivadent; Vita Enamic, Vita). A fatigue test was conducted with a chewing simulator set at 50 N for 1,500,000 cycles. Fracture resistance was assessed using a universal testing machine with a 6 mm diameter steel sphere applied to the specimens at a constant speed of 1 mm/min. A SEM analysis before the fracture test was performed to visually analyze the tooth-restoration margins. A statistical analysis was performed with a two-way ANOVA and a post-hoc pairwise comparison was performed using the Tukey test. The two-way ANOVA test showed that both the preparation design factor (p = 0.0429) and the CAD/CAM material factor (p = 0.0002) had a significant influence on the fracture resistance of the adhesive indirect restorations. The interaction between the two variables did not show any significance (p = 0.8218). The occlusal veneer had a lower fracture resistance than the adhesive crown (p = 0.042) but not lower than the overlay preparation (p = 0.095). LS was more resistant than PICN (p = 0.002). In conclusion, in the case of endodontically treated teeth, overlay preparation seems to be a valid alternative to the traditional full crown preparation, while occlusal veneers should be avoided in restoring non-vital molars with a high loss of residual tooth structure. LS material is more resistant compared to PICN.
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Jakab A, Volom A, Sáry T, Vincze-Bandi E, Braunitzer G, Alleman D, Garoushi S, Fráter M. Mechanical Performance of Direct Restorative Techniques Utilizing Long Fibers for “Horizontal Splinting” to Reinforce Deep MOD Cavities—An Updated Literature Review. Polymers (Basel) 2022; 14:polym14071438. [PMID: 35406311 PMCID: PMC9002665 DOI: 10.3390/polym14071438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/23/2022] [Accepted: 03/29/2022] [Indexed: 02/04/2023] Open
Abstract
Excessive cavity preparation and root canal treatment leads to a weakened tooth structure with a lower resistance to fracture. Fiber reinforcement is frequently used to reinforce such teeth, and multiple fiber types and possible applications exist. Various methods for utilizing long fibers to internally splint the remaining cavity walls in the case of large mesio-occluso-distal (MOD) cavities have been proposed; however, no summary of their performance has been written up to now. Our study aims to review the available literature to evaluate and compare the mechanical performance of the different materials and methods utilized for horizontal splinting in large MOD cavities. Three independent authors performed a thorough literature search using PubMed, ScienceDirect, and Google Scholar up until January 2022. The authors selected in vitro studies that used long fibers placed horizontally in posterior teeth with large MOD cavities to reinforce these teeth. From 1683 potentially relevant articles, 11 publications met our inclusion criteria. Seven out of eleven studies showed that horizontal splinting with long fibers improved the fracture resistance of the restored teeth. Three articles showed no significant difference between the fracture resistance of the restored groups. Only one article reported a lower fracture resistance to the horizontally splinted group, compared to conventional direct composite restoration. Within the limitations of this review, evidence suggests that long fiber reinforcement could be used to improve the fracture resistance of heavily restored teeth.
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Affiliation(s)
- András Jakab
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, H-6720 Szeged, Hungary; (A.J.); (T.S.); (E.V.-B.)
| | | | - Tekla Sáry
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, H-6720 Szeged, Hungary; (A.J.); (T.S.); (E.V.-B.)
| | - Eszter Vincze-Bandi
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, H-6720 Szeged, Hungary; (A.J.); (T.S.); (E.V.-B.)
| | | | - David Alleman
- The Alleman Center for Biomimetic Dentistry, South Jordan, UT 84095, USA;
| | - Sufyan Garoushi
- Department of Biomaterials Science and Turku Clinical Biomaterials Center-TCBC, Institute of Dentistry, University of Turku, FI-20520 Turku, Finland;
| | - Márk Fráter
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, H-6720 Szeged, Hungary; (A.J.); (T.S.); (E.V.-B.)
- Correspondence:
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Usta SN, Cömert-Pak B, Karaismailoğlu E, Eymirli A, Deniz-Sungur D. Patterns of Post-Endodontic Restoration: A Nationwide Survey of Dentists in Turkey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031794. [PMID: 35162816 PMCID: PMC8834666 DOI: 10.3390/ijerph19031794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/17/2022] [Accepted: 02/01/2022] [Indexed: 02/05/2023]
Abstract
Developments in materials and techniques, geographical locations, age, specialty, and affiliations of dental practitioners affect the preference of post-endodontic restoration. Thus, this survey aimed to evaluate the trends of dentists in Turkey in terms of post-endodontic restorations. An anonymous survey containing 10 questions regarding demographics, post-endodontic restoration patterns, and factors affecting restoration selection was electronically delivered to the dentists registered in the database of the Turkish Dental Association. The data were analyzed using by a chi-square test and ordinal logistic regression analysis. A total of 1093 surveys from 20,564 participants were collected with a response rate of 5.3%. Half of the participants (52%) preferred composite resins for post-endodontic restorations. Usage of posts was less prevalent amongst prosthodontists and dentists with clinical experience of more than 20 years compared to endodontists (p < 0.001) and dentists with clinical experience of less than 5 years (p = 0.004). More than half of the participants (56%) utilized fiber posts. Composite resins and fiber posts were the most common preferences in post-endodontic restoration. Endodontists had a higher tendency to use posts than prosthodontists and general dental practitioners.
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Affiliation(s)
- Sıla Nur Usta
- Department of Endodontics, Faculty of Dentistry, University of Hacettepe, Ankara 06230, Turkey; (B.C.-P.); (A.E.); (D.D.-S.)
- Correspondence:
| | - Begüm Cömert-Pak
- Department of Endodontics, Faculty of Dentistry, University of Hacettepe, Ankara 06230, Turkey; (B.C.-P.); (A.E.); (D.D.-S.)
| | - Eda Karaismailoğlu
- Department of Medical Informatics, Gulhane Faculty of Medicine, University of Health Sciences, Ankara 06018, Turkey;
| | - Ayhan Eymirli
- Department of Endodontics, Faculty of Dentistry, University of Hacettepe, Ankara 06230, Turkey; (B.C.-P.); (A.E.); (D.D.-S.)
| | - Derya Deniz-Sungur
- Department of Endodontics, Faculty of Dentistry, University of Hacettepe, Ankara 06230, Turkey; (B.C.-P.); (A.E.); (D.D.-S.)
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Silva EJNL, De-Deus G, Souza EM, Belladonna FG, Cavalcante DM, Simões-Carvalho M, Versiani MA. Present status and future directions - Minimal endodontic access cavities. Int Endod J 2022; 55 Suppl 3:531-587. [PMID: 35100441 DOI: 10.1111/iej.13696] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 11/29/2022]
Abstract
In the last decades, the move of Medicine towards minimally invasive treatments is notorious and scientifically grounded. As Dentistry naturally follows its footsteps, minimal access preparation also became a trend topic in the endodontic field. This procedure aims to maximize preservation of dentine tissue, backed up by the idea that this is an effective way to reduce the incidence of post-treatment tooth fracture. However, with the assessment of the body of evidence on this topic, it is possible to observe some key-points (a) the demand for nomenclature standardization, (b) the requirement of specific tools such as ultra-flexible instruments, visual magnification, superior illumination, and three-dimensional imaging technology, (c) minimally invasive treatment does not seem to affect orifice location and mechanical preparation when using adequate armamentarium, but it (d) may impair adequate canal cleaning, disinfection, and filling procedures, and also (e) it displays contradictory results regarding the ability to increase the tooth strengthen compared to the traditional access cavity. In spite of that, it is undeniable that methodological flaws of some benchtop studies using extracted teeth may be responsible for the conflicting data, thus triggering the need for more sophisticated devices/facilities and specifically designed research in an attempt to make it clear the role of the access size/design on long-term teeth survival. Moreover, it is inevitable that a clinical approach like minimal endodontic access cavities that demands complex tools and skilled and experienced operators bring to the fore doubts on its educational impact mainly when confronted with the conflicting scientific output, ultimately provoking a cost-benefit analysis of its implementation as a routine technique. In addition, this review discusses the ongoing scientific and clinical status of minimally invasive access cavities aiming to input an in-depth and unbiased view over the rationale behind them, uncovering not only the related conceptual and scientific flaws, but also outlining future directions for research and clinical practices. The conclusions attempt to skip from passionate disputes highlighting the current body of evidence as weak and incomplete to guide decision making, demanding the development of a close-to-in-situ laboratory model or a large and well-controlled clinical trial to solve this matter.
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Affiliation(s)
- Emmanuel João Nogueira Leal Silva
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.,Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gustavo De-Deus
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Erick Miranda Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Maranhão
| | | | | | - Marco Simões-Carvalho
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
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Fatigue performance of endodontically treated premolars restored with direct and indirect cuspal coverage restorations utilizing fiber-reinforced cores. Clin Oral Investig 2021; 26:3501-3513. [PMID: 34846558 PMCID: PMC8979888 DOI: 10.1007/s00784-021-04319-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 11/23/2021] [Indexed: 01/11/2023]
Abstract
Objectives The aim of this in vitro study was to investigate the fatigue survival and fracture behavior of endodontically treated (ET) premolars restored with different types of post-core and cuspal coverage restorations. Materials and methods MOD cavities were prepared on 108 extracted maxillary premolars. During the endodontic treatment, all teeth were instrumented with rotary files (ProTaper Universal) to the same apical enlargement (F2) and were obturated with a matched single cone obturation. After the endodontic procedure, the cavities were restored with different post-core and overlay restorations (n = 12/group). Three groups (A1–A3) were restored with either conventional composite core (PFC; control) or flowable short-fiber-reinforced composite (SFRC) core with/without custom-made fiber posts and without overlays. Six groups had similar post-core foundations as described above but with either direct PFC (B1–B3) or indirect CAD/CAM (C1–C3) overlays. Fatigue survival was tested for all restorations using a cyclic loading machine until fracture occurred or 50,000 cycles were completed. Kaplan-Meyer survival analysis was conducted, followed by pairwise post hoc comparisons. Results None of the restored teeth survived all 50,000. Application of flowable SFRC as luting-core material with fiber post and CAD/CAD overlays (Group C3) showed superior performance regarding fatigue survival (p < 0.05) to all the other groups. Flowable SFRC with fiber post and direct overlay (Group B3) showed superior survival compared to all other direct techniques (p < 0.05), except for the same post-core foundation but without cuspal coverage (Group A3). Conclusions Custom-made fiber post and SFRC as post luting core material with or without cuspal coverage performed well in terms of fatigue resistance and survival when used for the restoration of ET premolars. Clinical relevance The fatigue survival of direct and indirect cuspal coverage restorations in ET MOD premolars is highly dependent on whether the core build-up is fiber-reinforced or not. The combination of short and long fibers in the form of individualized post-cores seems to offer a favorable solution in this situation.
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11
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Baldi A, Comba A, Ferrero G, Italia E, Michelotto Tempesta R, Paolone G, Mazzoni A, Breschi L, Scotti N. External gap progression after cyclic fatigue of adhesive overlays and crowns made with high translucency zirconia or lithium silicate. J ESTHET RESTOR DENT 2021; 34:557-564. [PMID: 34783440 PMCID: PMC9298883 DOI: 10.1111/jerd.12837] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/16/2021] [Accepted: 10/26/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate three-dimensional external gap progression after chewing simulation of high translucency zirconia (HTZ) and zirconia-reinforced lithium silicate (ZLS) applied on endodontically treated teeth with different preparation designs. MATERIALS AND METHOD Endodontically treated molars were prepared with low-retentive (adhesive overlay) and high-retentive (full crown) designs above cementum-enamel junction and restored with HTZ and ZLS. Micro-computed tomography analysis was assessed before and after chewing simulation to evaluate three-dimensionally the external gap progression. Results were statistically analyzed with two-way ANOVA and post-hoc Tukey test. RESULTS High-retentive preparation design had a significantly inferior gap progression compared to the overlay preparation (p < 0.01); ZLS exhibited a significant inferior gap progression compared to HTZ (p < 0.01). CONCLUSIONS High-retentive preparations restored with ZLS seem to better perform in maintaining the sealing of the external margin after cyclic fatigue. CLINICAL SIGNIFICANCE The clinician should pay attention to the proper combination of preparation designs and ceramic material selection for an endodontically treated molar restoration. HTZ seems to perform worse than lithium silicate in terms of marginal sealing, still showing lacks in resistance to cyclic fatigue when adhesive preparations are performed.
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Affiliation(s)
- Andrea Baldi
- Department of Surgical Sciences, Dental School Lingotto, Turin
| | - Allegra Comba
- Department of Surgical Sciences, Dental School Lingotto, Turin
| | - Giorgio Ferrero
- Department of Surgical Sciences, Dental School Lingotto, Turin
| | - Edoardo Italia
- Department of Surgical Sciences, Dental School Lingotto, Turin
| | | | - Gaetano Paolone
- Department of Dentistry, IRCCS San Raffaele Hospital and Dental School, Vita Salute University, Milan, Italy
| | - Annalisa Mazzoni
- Department of Biomedical and Neuromotor Sciences, DIBINEM, University of Bologna, Alma Mater Studiorum, Bologna, Italy
| | - Lorenzo Breschi
- Department of Biomedical and Neuromotor Sciences, DIBINEM, University of Bologna, Alma Mater Studiorum, Bologna, Italy
| | - Nicola Scotti
- Department of Surgical Sciences, Dental School Lingotto, Turin
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12
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Bialy M, Targonska S, Szust A, Wiglusz RJ, Dobrzynski M. In Vitro Fracture Resistance of Endodontically Treated Premolar Teeth Restored with Prefabricated and Custom-Made Fibre-Reinforced Composite Posts. MATERIALS (BASEL, SWITZERLAND) 2021; 14:6214. [PMID: 34683806 PMCID: PMC8537123 DOI: 10.3390/ma14206214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 11/17/2022]
Abstract
(1) Background: The study aimed to compare and analyse the differences between the features of prefabricated fibre-reinforced composite (FRC) posts and custom-made FRC posts in the form of a tape and confirm the necessity of using FRC posts in teeth treated endodontically in comparison to direct reconstruction with a composite material. (2) Methods: Sixty premolars after endodontic treatment were used. The teeth were divided into four groups (n-15). Group 1: teeth with embedded prefabricated posts (Mirafit White); group 2: teeth with embedded prefabricated posts (Rebilda); group 3 teeth with embedded custom-made posts in the form of a tape (EverStick); group 4: teeth without a post restored with composite material. The compressive strength of the teeth was tested using the Instron-5944 testing machine until the sample broke. The crystal structure of the investigated posts was detected with the X-ray diffractometer (3) Results: During the experiment, the maximum values of forces at which the damage of the restored premolar teeth after endodontic treatment occurred were obtained. The best results were obtained for teeth rebuilt with Rebilda Posts (1119 N), while teeth with cemented Mirafit White posts were the weakest (968 N). Teeth without an embedded FRC post, rebuilt only with light-cured composite material, obtained the lowest value-859 N. (4) Conclusions: The use of FRC posts increases the resistance to damage of an endodontically treated tooth when compared to direct restoration with light-cured composite material.
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Affiliation(s)
- Michal Bialy
- Department of Pediatric Dentistry and Preclinical Dentistry, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland; (M.B.); (M.D.)
| | - Sara Targonska
- Institute of Low Temperature and Structure Research, Polish Academy of Sciences, Okolna 2, 50-422 Wroclaw, Poland
| | - Agnieszka Szust
- Faculty of Mechanical Engineering, Wroclaw University of Science and Technology, Wybrzeze Wyspianskiego 27, 50-370 Wroclaw, Poland;
| | - Rafal J. Wiglusz
- Institute of Low Temperature and Structure Research, Polish Academy of Sciences, Okolna 2, 50-422 Wroclaw, Poland
| | - Maciej Dobrzynski
- Department of Pediatric Dentistry and Preclinical Dentistry, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland; (M.B.); (M.D.)
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13
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Baldi A, Comba A, Michelotto Tempesta R, Carossa M, Pereira GKR, Valandro LF, Paolone G, Vichi A, Goracci C, Scotti N. External Marginal Gap Variation and Residual Fracture Resistance of Composite and Lithium-Silicate CAD/CAM Overlays after Cyclic Fatigue over Endodontically-Treated Molars. Polymers (Basel) 2021; 13:polym13173002. [PMID: 34503042 PMCID: PMC8434150 DOI: 10.3390/polym13173002] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 08/27/2021] [Accepted: 08/28/2021] [Indexed: 11/16/2022] Open
Abstract
The purpose of this in vitro study was to evaluate the external marginal gap variation with a 3D quantitative method and the residual fracture resistance after cyclic fatigue in endodontically treated molars restored with overlays of different materials, with and without fiber posts-supported buildups. Forty-eight human maxillary molars were selected, endodontically treated, prepared with standardized MOD cavities and randomly allocated into 6 study groups considering the "core strategy" (build-up with composite resin; build-up with composite resin supported by a fiber post); and the "restorative material" of the indirect adhesive overlay (GrandioBlocks, Voco; Cerasmart, GC; CeltraDuo, Dentsply). All procedures were executed according with manufacturers guidelines. Micro-CT analysis prior and after cyclic fatigue were executed, followed by scanning electron microscope analysis and fracture resistance test. The Two-Way ANOVA analysis showed that interfacial gap progression was significantly influenced by the "core strategy" (p < 0.01) but not of "restorative material" (p = 0.59). Concerning fracture resistance, "restorative material" was statistically significant (p < 0.01), while "core strategy" (p = 0.63) and the interaction (p = 0.84) were not. In conclusion, the fiber post presence within the build-up promoted a lower interfacial gap opening after fatigue, evaluated through micro-CT scans. In terms of fracture resistance, teeth restored with Cerasmart and Celtra Duo were statistically similar, but superior to GrandioBlocks.
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Affiliation(s)
- Andrea Baldi
- Department of Surgical Sciences, Dental School Lingotto, University of Turin, 10126 Turin, Italy; (A.B.); (A.C.); (R.M.T.); (M.C.)
| | - Allegra Comba
- Department of Surgical Sciences, Dental School Lingotto, University of Turin, 10126 Turin, Italy; (A.B.); (A.C.); (R.M.T.); (M.C.)
| | - Riccardo Michelotto Tempesta
- Department of Surgical Sciences, Dental School Lingotto, University of Turin, 10126 Turin, Italy; (A.B.); (A.C.); (R.M.T.); (M.C.)
| | - Massimo Carossa
- Department of Surgical Sciences, Dental School Lingotto, University of Turin, 10126 Turin, Italy; (A.B.); (A.C.); (R.M.T.); (M.C.)
| | - Gabriel Kalil Rocha Pereira
- Department of Restorative Dentistry, Division of Prosthodontics, Federal University of Santa Maria, Santa Maria 97105-900, Brazil; (G.K.R.P.); (L.F.V.)
| | - Luiz Felipe Valandro
- Department of Restorative Dentistry, Division of Prosthodontics, Federal University of Santa Maria, Santa Maria 97105-900, Brazil; (G.K.R.P.); (L.F.V.)
| | - Gaetano Paolone
- Department of Dentistry, IRCCS San Raffaele Hospital and Dental School, Vita Salute University, 20158 Milan, Italy;
| | - Alessandro Vichi
- Dental Academy, University of Portsmouth, William Beatty Building, Hampshire Terrace, Portsmouth PO1 2QG, UK;
| | - Cecilia Goracci
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy;
| | - Nicola Scotti
- Department of Surgical Sciences, Dental School Lingotto, University of Turin, 10126 Turin, Italy; (A.B.); (A.C.); (R.M.T.); (M.C.)
- Correspondence: ; Tel.: +39-340-2861-799
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14
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Iaculli F, Rengo C, Lodato V, Patini R, Spagnuolo G, Rengo S. Fracture resistance of endodontically-treated maxillary premolars restored with different type of posts and direct composite reconstructions: A systematic review and meta-analysis of in vitro studies. Dent Mater 2021; 37:e455-e484. [PMID: 34148785 DOI: 10.1016/j.dental.2021.06.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To conduct a systematic review and meta-analysis to assess if the presence of an endodontic post may increase the fracture resistance of endodontically-treated maxillary premolars directly restored with composite. METHODS A comprehensive systematic literature search according to the PRISMA statement was conducted to assess in vitro studies including endodontically-treated maxillary premolars, restored with different type of posts supporting direct composite reconstructions. Two groups of meta-analyses were performed using fixed effects model and additional Trial Sequential Analysis (TSA) was carried out. Moreover, risk of bias was conducted and quality of evidence for any performed meta-analysis was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS Twenty-four articles met the inclusion criteria and 13 studies also underwent quantitative evaluation. Fracture resistance of endodontically-treated premolars restored with fiber posts was significantly less than sound teeth (p value: < 0.00001), however endodontically-treated premolars with a fiber post provided an increase in fracture resistance when compared to equivalent teeth restored without post (p value: 0.003). TSA revealed high power of both meta-analyses. Moderate risk of bias was reported in 23/24 studies; only 1 study showed high risk of bias. GRADE system showed moderate strength of evidence due to the presence of a study with high risk of bias and to wide confidence intervals. SIGNIFICANCE Within the limitation of the present systematic review and meta-analysis, it can be concluded that endodontically-treated maxillary premolars restored with a fiber post and direct composite restoration demonstrated increased fracture resistance when compared to equivalent teeth without post.
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Affiliation(s)
- Flavia Iaculli
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
| | - Carlo Rengo
- Department of Prosthodontics and Dental Materials, School of Dental Medicine, University of Siena, Siena, Italy
| | - Vincenzo Lodato
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
| | - Romeo Patini
- Department of Head, Neck and Sense Organs "Fondazione Policlinico Universitario A. Gemelli- IRCCS", School of Dentistry, Rome, Italy
| | - Gianrico Spagnuolo
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy.
| | - Sandro Rengo
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
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Lima CO, Barbosa AFA, Ferreira CM, Ferretti MA, Aguiar FHB, Lopes RT, Fidel SR, Silva EJNL. Influence of ultraconservative access cavities on instrumentation efficacy with XP-endo Shaper and Reciproc, filling ability and load capacity of mandibular molars subjected to thermomechanical cycling. Int Endod J 2021; 54:1383-1393. [PMID: 33811762 DOI: 10.1111/iej.13525] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 03/31/2021] [Indexed: 12/18/2022]
Abstract
AIM To evaluate the influence of ultraconservative access cavities (UltraAC) on canal shaping and filling ability and load capacity of mandibular molars after root canal preparation with XP-endo Shaper (XP) or Reciproc (RC), under simulated clinical conditions. Traditional access cavities (TradAC) were used for comparison. METHODOLOGY Forty extracted mandibular molars were scanned by micro-computed tomographic and, based on similar anatomical features, were divided into four groups (n = 10), according to the type of access cavity and canal instrumentation protocol: TradAC/RC, TradAC/XP, UltraAC/RC and UltraAC/XP. All root canal procedures were performed with the teeth placed in a dental mannequin. Teeth were scanned after root canal instrumentation and filling. Unprepared canal area, dentine removed, accumulated hard tissue debris (AHTD), canal transportation, presence of voids and filling material remnants within the pulp chamber were analysed. After restorative procedures, the teeth were subjected to thermomechanical cycling and to a load capacity test. Statistical analyses were performed using two-way anova test, considering the randomized blocks design (P < 0.05). RESULTS The percentage of unprepared canal area was significantly lower in TradAC groups when compared to UltraAC groups (P < 0.05), regardless of the instrument used. The UltraAC/XP group had significantly lower percentage of root dentine removed when compared to other groups (P < 0.05). UltraAC/XP and TradAC/XP groups had significantly lower percentages of AHTD than UltraAC/RC and TradAC/RC groups (P < 0.05). Regarding canal transportation, in the MB root canals, the TradAC/XP group had significantly lower values than other groups (P < 0.05). In general, in ML and distal root canals, TradAC/XP and UltraAC/XP groups had significantly lower values of canal transportation when compared to other groups (P < 0.05). Moreover, the UltraAC/RC had the greatest canal transportation values in MB and distal canals. The UltraAC groups had significantly greater percentages of voids and volume of remaining root filling material within the pulp chamber after cleaning procedures than TradAC groups (P < 0.05). There was no difference in the load capacity amongst groups (P < 0.05). CONCLUSION The UltraAC/XP and UltraAC/RC groups had significantly greater areas of unprepared canal walls, significantly more voids and volume of root filling material remnants within the pulp chamber after canal filling. UltraAC/XP was associated with significantly less root dentine removal and significantly more AHTD whilst TradAC/XP had overall significantly less canal transportation. No differences were observed in the load capacity amongst groups.
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Affiliation(s)
- C O Lima
- Department of Endodontics, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - A F A Barbosa
- Department of Endodontics, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - C M Ferreira
- Department of Endodontics, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - M A Ferretti
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Campinas, Brazil
| | - F H B Aguiar
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Campinas, Brazil
| | - R T Lopes
- Nuclear Engineering Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - S R Fidel
- Department of Endodontics, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - E J N L Silva
- Department of Endodontics, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.,Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
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16
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Comba A, Baldi A, Saratti CM, Rocca GT, Torres CRG, Pereira GKR, Valandro FL, Scotti N. Could different direct restoration techniques affect interfacial gap and fracture resistance of endodontically treated anterior teeth? Clin Oral Investig 2021; 25:5967-5975. [PMID: 33860368 PMCID: PMC8443477 DOI: 10.1007/s00784-021-03902-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 03/19/2021] [Indexed: 01/11/2023]
Abstract
Objectives To evaluate different direct restoration techniques on various cavity designs in anterior endodontically treated teeth (ETT). Materials and methods Ninety upper central incisors (n = 90) were selected, endodontically treated, and divided into three groups (n = 30) accordingly to the cavity design: minimal endodontic cavity access (group A), endodontic access + mesial class III cavity (group B), and endodontic access + two class III cavities (group C). Three subgroups (n = 10) were then created accordingly to the restoration technique: nano hybrid composite restoration (subgroup a), glass fiber post + dual-cure luting cement (subgroup b), and bundled glass fiber + dual-cure luting cement (subgroup c). Samples underwent micro-CT scan, chewing simulation, and a second micro-CT scan. 3D quantification (mm3) of interfacial gap progression was performed; then, samples underwent fracture resistance test. Data were statistically analyzed setting significance at p < 0.05. Results Groups A and B showed significantly lower interfacial gap progression compared with group C. Subgroup b performed significantly better compared with subgroups a and c. Improved fracture strength was reported for group C compared with group A, while both subgroups b and c performed better than subgroup a. Conclusions Cavity design significantly influenced interfacial gap progression and fracture resistance. Fiber posts significantly lowered gap progression and improved fracture resistance while bundled fibers only increased fracture resistance. A significant reduction of non-repairable fractures was recorded when fibers were applied. Clinical relevance A minimally invasive approach, conserving marginal crests, should be applied whenever possible. Inserting a fiber post is indicated when restoring anterior ETT, in order to reduce gap progression, improve fracture resistance, and avoid catastrophic failures.
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Affiliation(s)
- Allegra Comba
- Department Surgical Sciences, Dental School, University of Turin, Turin, Italy
| | - Andrea Baldi
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy
| | - Carlo Massimo Saratti
- Division of Cariology and Endodontology, School of Dentistry, University of Geneva, Geneva, Switzerland
| | - Giovanni Tommaso Rocca
- Division of Cariology and Endodontology, School of Dentistry, University of Geneva, Geneva, Switzerland
| | - Carlos Rocha Gomes Torres
- Institute of Science and Technology, Department of Restorative Dentistry, São Paulo State University-UNESP, São José dos Campos, SP, Brazil
| | - Gabriel Kalil Rocha Pereira
- Department of Restorative Dentistry, Division of Prosthodontics, Federal University of Santa Maria, Santa Maria, Brazil
| | - Felipe Luiz Valandro
- Department of Restorative Dentistry, Division of Prosthodontics, Federal University of Santa Maria, Santa Maria, Brazil
| | - Nicola Scotti
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy.
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17
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Fatigue behavior of endodontically treated premolars restored with different fiber-reinforced designs. Dent Mater 2021; 37:391-402. [DOI: 10.1016/j.dental.2020.11.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 11/26/2020] [Indexed: 11/22/2022]
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18
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Tosco V, Vitiello F, Furlani M, Gatto ML, Monterubbianesi R, Giuliani A, Orsini G, Putignano A. Microleakage Analysis of Different Bulk-Filling Techniques for Class II Restorations: µ-CT, SEM and EDS Evaluations. MATERIALS (BASEL, SWITZERLAND) 2020; 14:E31. [PMID: 33374708 PMCID: PMC7793523 DOI: 10.3390/ma14010031] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/18/2020] [Accepted: 12/21/2020] [Indexed: 12/29/2022]
Abstract
This study aimed to compare two different bulk-filling techniques, evaluating the internal and external adaptation of class II resin-composite restorations, by analysing the gap formation using microcomputed tomography (µ-CT) and scanning electronic microscopy (SEM) coupled with energy-dispersive X-ray spectroscopy (EDS). Two standardized mesio/disto-occlusal (MO/DO) cavities were prepared in eight extracted human third molars that were divided, according to the filling technique used, in the following two groups (n = 4): BG (Bulk&Go group) and BT (Bulk Traditional group). After universal bonding application, followed by the light curing, all teeth were restored using a bulk-fill composite. Specimens were scanned with µ-CT to evaluate 3D interfacial gaps. Acquired µ-CT data were analysed to quantify the gap formation. Complementary information to the µ-CT analysis were obtained by SEM. Thereafter, the chemical composition of tooth-restoration interface was analysed using EDS. The µ-CT analysis revealed gaps formation at the tooth-restoration interface for both the BG and BT groups, while within the restoration, only in the BT group there was evidence of microleakage formation. The scanning electron micrographs of both groups showed that the external marginal integrity of the restoration was preserved, while EDS showed the three different structures (tooth surface, adhesive layer and resin composite) of the tooth-restoration interface, highlighting the absence of gap formation. In both BG and BT, the two filling techniques did not show significant differences regarding the internal and external marginal adaptation of the restoration. To achieve a successful restoration, the clinician could be advised to restore a class II cavity using a single increment bulk-filling technique (BG), thus treating it as a class I cavity.
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Affiliation(s)
- Vincenzo Tosco
- Department of Clinical Sciences and Stomatology (DISCO), Polytechnic University of Marche, 60126 Ancona, Italy; (V.T.); (F.V.); (M.F.); (R.M.); (A.P.)
| | - Flavia Vitiello
- Department of Clinical Sciences and Stomatology (DISCO), Polytechnic University of Marche, 60126 Ancona, Italy; (V.T.); (F.V.); (M.F.); (R.M.); (A.P.)
| | - Michele Furlani
- Department of Clinical Sciences and Stomatology (DISCO), Polytechnic University of Marche, 60126 Ancona, Italy; (V.T.); (F.V.); (M.F.); (R.M.); (A.P.)
| | - Maria Laura Gatto
- Department of Materials, Environmental Sciences and Urban Planning (SIMAU), Polytechnic University of Marche, 60131 Ancona, Italy;
| | - Riccardo Monterubbianesi
- Department of Clinical Sciences and Stomatology (DISCO), Polytechnic University of Marche, 60126 Ancona, Italy; (V.T.); (F.V.); (M.F.); (R.M.); (A.P.)
| | - Alessandra Giuliani
- Department of Clinical Sciences and Stomatology (DISCO), Polytechnic University of Marche, 60126 Ancona, Italy; (V.T.); (F.V.); (M.F.); (R.M.); (A.P.)
| | - Giovanna Orsini
- Department of Clinical Sciences and Stomatology (DISCO), Polytechnic University of Marche, 60126 Ancona, Italy; (V.T.); (F.V.); (M.F.); (R.M.); (A.P.)
| | - Angelo Putignano
- Department of Clinical Sciences and Stomatology (DISCO), Polytechnic University of Marche, 60126 Ancona, Italy; (V.T.); (F.V.); (M.F.); (R.M.); (A.P.)
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Fracture resistance and marginal gap formation of post-core restorations: influence of different fiber-reinforced composites. Clin Oral Investig 2019; 24:265-276. [PMID: 31098711 PMCID: PMC7822803 DOI: 10.1007/s00784-019-02902-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 04/04/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The aim was to explore the fracture behavior and marginal gap within the root canal of endodontically treated (ET) premolars restored with different fiber-reinforced post-core composites (FRCs). Further aim was to evaluate the composite curing at different depths in the canal. MATERIALS AND METHODS Eighty-seven intact upper premolars were collected and randomly divided into six groups. After endodontic procedure, standard MOD cavities were prepared and restored with their respective fiber-reinforced post-core materials: group 1: prefabricated unidirectional FRC-post + conventional composite core; group 2: prefabricated unidirectional FRC-post + short fiber composite (SFRC) core; group 3: individually formed unidirectional FRC-post + conventional composite core; group 4: randomly oriented SFRC directly layered as post and core; group 5: individually formed unidirectional FRC + randomly oriented SFRC as post and core. After restorations were completed, teeth (n = 3/group) were sectioned and then stained. Specimens were viewed under a stereo microscope and the percentage of microgaps within the root canal was calculated. Fracture load was measured using universal testing machine. RESULTS SFRC application in the root canal (groups 4 and 5) showed significantly higher fracture load (876.7 N) compared to the other tested groups (512-613 N) (p < 0.05). Post/core restorations made from prefabricated FRC-post (group 1) exhibited the highest number of microgaps (35.1%) at the examined interphase in the root canal. CONCLUSIONS The restoration of ET premolars with the use of SFRC as post-core material displayed promising performance in matter of microgap and load-bearing capacity. CLINICAL SIGNIFICANCE Fracture resistance of ET premolar restored by bilayered composite restoration that includes both SFRC as post-core material and surface conventional resin seems to be beneficial.
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20
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Yikilgan İ, Uzun O, Gürel M, Bala O, Ömürlü H, Kayaoglu G. Volumetric Evaluation of Void/Gap Formation and Microleakage Cementing Fiber Posts on Extracted Teeth with Three Different Cements. J Prosthodont 2019; 28:e222-e228. [DOI: 10.1111/jopr.12662] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2017] [Indexed: 12/01/2022] Open
Affiliation(s)
- İhsan Yikilgan
- Department of Restorative Dentistry, Faculty of Dentistry; Gazi University; Ankara Turkey
| | - Ozgur Uzun
- Department of Endodontics, Faculty of Dentistry; Gazi University; Ankara Turkey
| | - Mügem Gürel
- Department of Endodontics, Faculty of Dentistry; Gazi University; Ankara Turkey
| | - Oya Bala
- Department of Restorative Dentistry, Faculty of Dentistry; Gazi University; Ankara Turkey
| | - Hüma Ömürlü
- Department of Restorative Dentistry, Faculty of Dentistry; Gazi University; Ankara Turkey
| | - Guven Kayaoglu
- Department of Endodontics, Faculty of Dentistry; Gazi University; Ankara Turkey
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21
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Gaintantzopoulou MD, Farmakis ET, Eliades GC. Effect of Load Cycling on the Fracture Strength/Mode of Teeth Restored with FRC Posts or a FRC Liner and a Resin Composite. BIOMED RESEARCH INTERNATIONAL 2018; 2018:9054301. [PMID: 30186870 PMCID: PMC6112082 DOI: 10.1155/2018/9054301] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 07/15/2018] [Indexed: 01/11/2023]
Abstract
The aim of the study was to comparatively evaluate the fracture strength and mode of root canal treated teeth restored with resin composites with and without posts. The lingual cusps of root canal treated first upper premolars (n = 10/group) were removed down to cervical enamel and restored with the following: group A: glass-fiber post (Glassix) followed by a particulate-filled composite resin (PFC, G-aenial posterior, 3 × 2 mm layers); group B: glass-fiber reinforced composite bulk fill liner (EverX posterior, 4 mm layer) with the PFC (2 mm layer). Specimens were immersed in H2O (1 w/37°C), then subjected to load cycling (50 N/0.2 Hz/200k cycles), and fractured under compressive loading. Failure mode was characterized by stereomicroscopy. Statistical analysis was performed by Mann-Whitney (load) and Chi-square (mode) at a = 0.05. No statistically significant differences (p = 0.273) were found in fracture load between median values of groups A (860 N) and B (1059 N). In group A, 60% of the specimens demonstrated catastrophic root fractures and 40% mixed crown fractures (tooth cusp and restoration), whereas in group B, no root fractures were found, and the failure modes were equally distributed between mixed fractures as above and fracture of the buccal cusp. These differences were statistically significant (p = 0.004). The combination of the glass-FRC bulk fill liner with the PFC diminished the catastrophic root fractures induced by FRC posts, at a similar or higher fracture load.
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Affiliation(s)
- Maria D. Gaintantzopoulou
- Department of Biomaterials, School of Dentistry, National and Kapodistrian University of Athens, 11521 Athens, Greece
| | - Eleftherios T. Farmakis
- Department of Biomaterials, School of Dentistry, National and Kapodistrian University of Athens, 11521 Athens, Greece
| | - George C. Eliades
- Department of Biomaterials, School of Dentistry, National and Kapodistrian University of Athens, 11521 Athens, Greece
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Maravić T, Vasiljević D, Kantardžić I, Lainović T, Lužanin O, Blažić L. Influence of restorative procedures on endodontically treated premolars: Finite element analysis of a CT-scan based three-dimensional model. Dent Mater J 2018; 37:493-500. [PMID: 29593161 DOI: 10.4012/dmj.2017-064] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
An endodontically treated tooth with mesial-occlusal-distal (MOD) cavity is often restored with composite resin. Palatal and buccal cusp reduction (MODP, MODPB), and/or fiber-reinforced composite posts (P), are used in an attempt to improve the longevity of the restoration. The aim of this study was to determine the effects of these procedures on von Mises stress values and distribution in dental tissues and restorative materials using finite element analysis. Based on CT scans of an extracted second upper premolar, six 3D endodontically treated tooth models (MOD, MODP, MODPB, MOD+P, MODP+P, MODPB+P) were created. Each model was subjected to a summary force of 150 N on the occlusal surface simulating the normal biting pattern and maximal von Mises stresses were calculated. MODP seems to reduce von Mises stress values in dental tissues and P seems to transfer some of the stresses from dental tissues to the composite filling.
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Affiliation(s)
- Tatjana Maravić
- Faculty of Medicine, School of Dentistry, University of Novi Sad.,Department of Biomedical and Neuromotor Sciences, DIBINEM, University of Bologna
| | | | - Ivana Kantardžić
- Faculty of Medicine, School of Dentistry, University of Novi Sad
| | - Tijana Lainović
- Faculty of Medicine, School of Dentistry, University of Novi Sad
| | - Ognjan Lužanin
- Faculty of Technical Sciences, Department of Production Engineering, University of Novi Sad
| | - Larisa Blažić
- Faculty of Medicine, School of Dentistry, University of Novi Sad
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Chan T, Küçükkaya Eren S, Wong R, Parashos P. In vitro fracture strength and patterns in root-filled teeth restored with different base materials. Aust Dent J 2017; 63:99-108. [PMID: 28941281 DOI: 10.1111/adj.12570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is little research on the effects of an intermediate base on the fracture strength of root-filled teeth. This study compared the fracture strengths and patterns of root-filled teeth restored with intermediate bases of glass-ionomer cement (GIC), zinc polycarboxylate cement (ZPC), dual-cured resin composite (DCRC) and Biodentine® under resin composite. METHODS Standardized cavities were prepared in 100 extracted human maxillary and mandibular premolars, and root canal treatment was performed. The teeth were stratified and randomly allocated to five groups (n = 20): (i) GIC; (ii) ZPC; (iii) DCRC; (iv) Biodentine; and (v) prepared but unrestored (control). The teeth were subjected to an oblique, ramped load until fracture. The fracture loads, level, mode and location were recorded. RESULTS Mean fracture strengths of all restored groups were not significantly different amongst the groups. There were significant overall effects on mean fracture strength for tooth type (P = 0.002) and buccolingual width of the crown (P = 0.001). CONCLUSIONS The four materials were appropriate intermediate bases. The laminate restorative technique promoted fracture strengths that are likely to withstand normal and maximum masticatory function. The base material can influence failure mode, which may have implications for the clinical presentation of fractures of root-filled teeth.
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Affiliation(s)
- T Chan
- The Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia
| | - S Küçükkaya Eren
- Department of Endodontics, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - R Wong
- The Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia
| | - P Parashos
- The Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia
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Daher R, Feilzer AJ, Krejci I. Novel non-invasive reinforcement of MOD cavities on endodontically treated teeth. J Dent 2016; 54:77-85. [DOI: 10.1016/j.jdent.2016.09.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 09/03/2016] [Accepted: 09/20/2016] [Indexed: 10/21/2022] Open
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Scotti N, Forniglia A, Tempesta RM, Comba A, Saratti CM, Pasqualini D, Alovisi M, Berutti E. Effects of fiber-glass-reinforced composite restorations on fracture resistance and failure mode of endodontically treated molars. J Dent 2016; 53:82-7. [PMID: 27492772 DOI: 10.1016/j.jdent.2016.08.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 07/17/2016] [Accepted: 08/01/2016] [Indexed: 01/11/2023] Open
Abstract
OBJECTIVES The study evaluated the fracture resistance and fracture patterns of endodontically treated mandibular first molars restored with glass-fiber-reinforced direct composite restorations. METHODS In total, 60 extracted intact first molars were treated endodontically; a mesio-occluso-distal (MOD) cavity was prepared and specimens were then divided into six groups: sound teeth (G1), no restoration (G2), direct composite restoration (G3), fiber-post-supported direct composite restoration (G4), direct composite reinforced with horizontal mesio-distal glass-fibers (G5), and buccal-palatal glass-fibers (G6). Specimens were subjected to 5000 thermocycles and 20,000 cycles of 45° oblique loading force at 1.3Hz and 50N; they were then loaded until fracture. The maximum fracture loads were recorded in Newtons (N) and data were analyzed with one-way ANOVA and post-hoc Tukey tests (p<0.05). Fractured specimens were analyzed with a scanning electron microscope (SEM). RESULTS The mean static loads (in Newtons) were: G1, 831.83; G2, 282.86; G3, 364.18; G4, 502.93; G5, 499.26; and G6, 582.22. Fracture resistance did not differ among G4, G5, and G6, but was significantly higher than G3 (p=0.001). All specimens fractured in a catastrophic way. In G6, glass fibers inducted a partial deflection of the fracture, although they were not able to stop crack propagation. CONCLUSIONS For the direct restoration of endodontically treated molars, reinforcement of composite resins with glass-fibers or fiber posts can enhance fracture resistance. The SEM analysis showed a low ability of horizontal glass-fibers to deviate the fracture, but this effect was not sufficient to lead to more favorable fracture patterns above the cement-enamel junction (CEJ). CLINICAL SIGNIFICANCE The fracture resistance of endodontically treated molars restored with direct composite restorations seems to be increased by reinforcement with fibers, even if it is insufficient to restore sound molar fracture resistance and cannot avoid vertical fractures.
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Affiliation(s)
- Nicola Scotti
- Department of Surgical Sciences, Dental School Lingotto, University of Turin, Via Nizza 230, Turin, Italy.
| | - Alberto Forniglia
- Department of Surgical Sciences, Dental School Lingotto, University of Turin, Via Nizza 230, Turin, Italy
| | | | - Allegra Comba
- Department of Surgical Sciences, Dental School Lingotto, University of Turin, Via Nizza 230, Turin, Italy
| | - Carlo Massimo Saratti
- Division of Cariology and Endodontology, School of Dentistry, University of Geneva, Rue Barthèlemy-Menn, Geneva, Switzerland
| | - Damiano Pasqualini
- Department of Surgical Sciences, Dental School Lingotto, University of Turin, Via Nizza 230, Turin, Italy
| | - Mario Alovisi
- Department of Surgical Sciences, Dental School Lingotto, University of Turin, Via Nizza 230, Turin, Italy
| | - Elio Berutti
- Department of Surgical Sciences, Dental School Lingotto, University of Turin, Via Nizza 230, Turin, Italy
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MIAO Y, LIU T, LEE W, FEI X, JIANG G, JIANG Y. Fracture resistance of palatal cusps defective premolars restored with polyethylene fiber and composite resin. Dent Mater J 2016; 35:498-502. [DOI: 10.4012/dmj.2015-394] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Yanyu MIAO
- Department of Dental Endodontics, School of Dentistry, Xi’an Jiaotong University
| | - Tiao LIU
- State Key Laboratory of Military Stomatology, Department of Orthodontics, School of Stomatology, the Fourth Military Medical University
| | - Wanwan LEE
- Department of Dental Endodontics, School of Dentistry, Xi’an Jiaotong University
| | - Xiuzhi FEI
- Department of Dental Endodontics, School of Dentistry, Xi’an Jiaotong University
| | - Guotao JIANG
- Department of Dental Endodontics, School of Dentistry, Xi’an Jiaotong University
| | - Yuegui JIANG
- Department of Dental Endodontics, School of Dentistry, Xi’an Jiaotong University
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Aurélio IL, Fraga S, Rippe MP, Valandro LF. Are posts necessary for the restoration of root filled teeth with limited tissue loss? A structured review of laboratory and clinical studies. Int Endod J 2015; 49:827-835. [PMID: 26331486 DOI: 10.1111/iej.12538] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 08/26/2015] [Indexed: 11/29/2022]
Abstract
Guidelines for post placement are lacking in respect of the amount of tooth structure, particularly in cases in which ≥50% of coronal structure is preserved. The aim of this review was to provide evidence-based principles for the use of posts in the restoration of root filled teeth with limited tissue loss. A literature search of laboratory and clinical studies published between 2000 and 2014 was conducted in PubMed. Included studies contained at least one study group with root filled teeth restored without a post, presented at least one group with root filled teeth with limited tissue loss, and, in the case of laboratory studies, performed mechanical cycling prior to a fracture resistance test. Based on the evidence from laboratory studies, root filled premolars and molars with limited tissue loss can be restored without posts, particularly when total coverage is planned. However, when no cusp protection is provided, post placement appears to be beneficial in premolars. Evidence regarding the best restoration option for root filled incisors with limited tissue loss remains controversial. When total coverage is intended, reconstruction seems to be successfully performed by restoration with composite. However, some reports consider that post insertion increases fracture loads. The review of clinical studies demonstrated that survival of teeth with substantial tooth tissue is not influenced by the use of posts. Exceptions were found when only premolars were investigated; in these cases, post placement was associated with greater survival rates in crowned teeth and fewer root fractures in teeth without cusp protection.
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Affiliation(s)
- I L Aurélio
- Dental Science Post Graduate Program, Santa Maria, Rio Grande do Sul, Brazil
| | - S Fraga
- Dental Science Post Graduate Program, Santa Maria, Rio Grande do Sul, Brazil
| | - M P Rippe
- Department of Restorative Dentistry Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - L F Valandro
- Department of Restorative Dentistry Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
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Scotti N, Eruli C, Comba A, Paolino DS, Alovisi M, Pasqualini D, Berutti E. Longevity of class 2 direct restorations in root-filled teeth: A retrospective clinical study. J Dent 2015; 43:499-505. [PMID: 25701467 DOI: 10.1016/j.jdent.2015.02.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 01/22/2015] [Accepted: 02/09/2015] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES To evaluate retrospectively the longevity of endodontically treated teeth restored with direct resin composite without cusp coverage, with or without the insertion of fibre posts. The null hypothesis was that direct restorations with fibre posts perform better than those without fibre posts. METHODS Patients recruited for this study were treated in the Department of Cariology and Operative Dentistry, University of Turin, between 2008 and 2011. In total, 247 patients with 376 root treated posterior teeth, restored with direct resin composite, were recalled for a control visit. Only second-class cavities were considered. Two groups were defined based on the absence (Group A) or presence (Group B) of fibre post. Failures and complications, such as periodontal failure, endodontic failure, tooth extraction, root fracture, post fracture, post debonding, replacement of restoration, crown displacement, and coronal-tooth fracture, were noted. Functional restoration quality was evaluated following the modified USPHS criteria. Data were evaluated statistically with ANOVA. RESULTS Group A consisted of 128 patients with 178 restorations (88 premolars, 90 molars) with a median follow-up of 34.44 months. Group B consisted of 119 patients with 198 teeth (92 premolars, 106 molars) with a median follow-up of 35.37 months. Direct restorations with fibre posts were statistically significantly more functional (95.12% success) than those without fibre posts (80% success) because of less marginal discolouration, better marginal integrity, and higher restoration integrity. CONCLUSIONS The null hypothesis was accepted because direct post-endodontic restorations with fibre posts performed better than restorations without posts after 3 years of masticatory function. CLINICAL SIGNIFICANCE An evaluation of the longevity of post endodontic direct restoration would seem to enhance the fiber post insertion within a composite restoration to reduce clinical failures.
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Affiliation(s)
- N Scotti
- University of Turin Dental School, Department of Surgical Sciences, via Nizza 230, 10126 Turin, Italy.
| | - C Eruli
- University of Turin Dental School, Department of Surgical Sciences, via Nizza 230, 10126 Turin, Italy
| | - A Comba
- University of Turin Dental School, Department of Surgical Sciences, via Nizza 230, 10126 Turin, Italy
| | - D S Paolino
- Department of Mechanics, Politecnico di Torino, Turin, Italy
| | - M Alovisi
- University of Turin Dental School, Department of Surgical Sciences, via Nizza 230, 10126 Turin, Italy
| | - D Pasqualini
- University of Turin Dental School, Department of Surgical Sciences, via Nizza 230, 10126 Turin, Italy
| | - E Berutti
- University of Turin Dental School, Department of Surgical Sciences, via Nizza 230, 10126 Turin, Italy
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Tanomaru-Filho M, Sivieri-Araujo G, Guerreiro-Tanomaru JM, Bortoluzzi EA, Jorge EG, Abi-Rached FO, Reis JMSN. Resistance of teeth with simulated incomplete rhizogenesis with intraradicular post or root canal filling. J Contemp Dent Pract 2014; 15:413-416. [PMID: 25576105 DOI: 10.5005/jp-journals-10024-1554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM The aim of this study was to evaluate the fracture strength (FS) of bovine incisors with simulated incomplete rhizogenesis (IR) after different intraradicular treatments. MATERIALS AND METHODS Incomplete rhizogenesis was simulated by sectioning the crowns and roots of 40 bovine incisors. Root canal preparation was performed and the samples divided into 4 groups (n = 10): GI-negative control with intra-radicular preparation; GII-positive control without intra-radicular preparation; GIII-glass fiber post cemented with resin cement and GIV-root canal obturation with Epiphany/Resilon system. In GIII and GIV, 4.0 mm apical plugs of mineral trioxide aggregate (MTA) were done. The samples were embedded into cylinders with polystyrene resin, and the periodontal ligament was simulated with a medium-viscosity polyether-based impression material (Impregum Soft). The specimens were submitted to compressive fracture strength test (0.5 mm/min at 135° in relation to the long axis of the tooth) in a mechanical testing machine MTS 810. Data were submitted to ANOVA and Tukey's test (α = 0.05). RESULTS GIII produced the highest FS values (p < 0.05). GI and GIV showed similar FS results (p > 0.05) but smaller than GII (p < 0.05). CONCLUSION Glass fiber intraradicular posts provided the FS increase of teeth with simulated incomplete rhizogenesis. Epiphany/Resilon root canal flling with MTA plug did not provide the increase of the fracture strength to teeth with simulated incomplete rhizogenesis. CLINICAL SIGNIFICANCE The fiber post reinforces the root structure of teeth with incomplete rhizogenesis.
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Affiliation(s)
- Mario Tanomaru-Filho
- Professor, Department of Restorative Dentistry, Araraquara Dental School, Araraquara, São Paulo, Brazil, e-mail:
| | - Gustavo Sivieri-Araujo
- Professor, Department of Restorative Dentistry, Araçatuba Dental School Araçatuba, Sao Paulo, Brazil
| | | | - Eduardo A Bortoluzzi
- Professor, Department of Dentistry, Santa Catarina Federal University Santa Catarina, Brazil
| | - Erica G Jorge
- Doctor, Department of Restorative Dentistry, Araraquara Dental School, Araraquara, São Paulo, Brazil
| | - Filipe O Abi-Rached
- Professor, Department of Prosthodontics, Araraquara Dental School Araraquara, São Paulo, Brazil
| | - José Mauricio S N Reis
- Professor, Department of Prosthodontics, Araraquara Dental School Araraquara, São Paulo, Brazil
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Shafiei F, Tavangar MS, Ghahramani Y, Fattah Z. Fracture resistance of endodontically treated maxillary premolars restored by silorane-based composite with or without fiber or nano-ionomer. J Adv Prosthodont 2014; 6:200-6. [PMID: 25006384 PMCID: PMC4085244 DOI: 10.4047/jap.2014.6.3.200] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 03/11/2014] [Accepted: 03/17/2014] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This in vitro study investigated the fracture resistance of endodontically treated premolars restored using silorane- or methacrylate-based composite along with or without fiber or nano-ionomer base. MATERIALS AND METHODS Ninety-six intact maxillary premolars were randomly divided into eight groups (n = 12). G1 (negative control) was the intact teeth. In Groups 2-8, root canal treatment with mesio-occlusodistal preparation was performed. G2 (positive control) was kept unrestored. The other groups were restored using composite resin as follows: G3, methacrylate-based composite (Z250); G4, methacrylate composite (Z250) with polyethylene fiber; G5 and G6, silorane-based composite (Filtek P90) without and with the fiber, respectively; G7 and G8, methacrylate- and silorane-based composite with nano-ionomer base, respectively. After aging period and thermocycling for 1000 cycles, fracture strength was tested and fracture patterns were inspected. The results were analyzed using ANOVA and Tukey HSD tests (α=0.05). RESULTS Mean fracture resistance for the eight groups (in Newton) were G1: 1200 ± 169a, G2: 360 ± 93b, G3: 632 ± 196c, G4: 692 ± 195c, G5: 917 ± 159d, G6: 1013 ± 125ad, G7: 959 ± 148d, G8: 947 ± 105d (different superscript letters revealed significant difference among groups). Most of the fractures in all the groups were restorable, except Group 3. CONCLUSION Silorane-based composite revealed significantly higher strength of the restored premolars compared to that of methacrylate one. Fiber insertion demonstrated no additional effect on the strength of both composite restorations; however, it increased the prevalence of restorable fracture of methacrylate-based composite restored teeth. Using nano-ionomer base under methacrylate-based composite had a positive effect on fracture resistance and pattern. Only fiber-reinforced silorane composite restoration resulted in a strength similar to that of the intact teeth.
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Affiliation(s)
- Fereshteh Shafiei
- Department of Operative Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Sadat Tavangar
- Department of Operative Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran. ; Biomaterial Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Yasamin Ghahramani
- Department of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Fattah
- Department of Operative Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Scotti N, Bergantin E, Alovisi M, Pasqualini D, Berutti E. Evaluation of a Simplified Fiber Post Removal System. J Endod 2013; 39:1431-4. [DOI: 10.1016/j.joen.2013.08.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 08/01/2013] [Accepted: 08/01/2013] [Indexed: 10/26/2022]
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Scotti N, Rota R, Scansetti M, Paolino DS, Chiandussi G, Pasqualini D, Berutti E. Influence of adhesive techniques on fracture resistance of endodontically treated premolars with various residual wall thicknesses. J Prosthet Dent 2013; 110:376-82. [PMID: 24095213 DOI: 10.1016/j.prosdent.2013.08.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
STATEMENT OF PROBLEM The choice of restorative method is commonly based on the cavity configuration and the residual number of cavity walls. However, the residual wall thickness could be a valuable clinical parameter in the choice of restoration for endodontically treated teeth. PURPOSE The fracture resistance of endodontically treated premolars was compared with different wall thicknesses restored with direct composite resin with and without cuspal coverage and with and without fiber post insertion. MATERIAL AND METHODS This study included 104 intact human maxillary premolars extracted for periodontal or orthodontic reasons. Standardized mesio-occluso-distal cavities were prepared with different palatal wall thicknesses (1.5, 2, and 2.5 mm) and a buccal wall thickness of 2 mm. Teeth were restored with or without a fiber post and with or without cuspal coverage. Specimens were subjected to thermocycling (3000 cycles, 5 to 55°C) and embedded in polymerized acrylic resin. Teeth were submitted to cyclic fatigue followed by a static fatigue test with a universal testing machine; a compressive force was applied 30 degrees to the long axis of the teeth until fracture. The results were statistically analyzed by 3-way ANOVA (α=.05). RESULTS Residual wall thickness (P=.004), the type of adhesive restoration (P<.001), and fiber post insertion (P<.001) significantly influenced the fracture resistance of endodontically treated premolars. CONCLUSIONS In specimens with a cavity wall thickness >2 mm, direct intracuspal composite resin restorations supported by a fiber post achieved comparable fracture resistance. With a residual wall thickness <2 mm, only cuspal coverage with or without a fiber post provided satisfactory fracture resistance.
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Affiliation(s)
- Nicola Scotti
- Assistant Professor, Department of Cariology and Operative Dentistry, Dental School Lingotto, University of Turin, Turin, Italy.
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How can stress be controlled in endodontically treated teeth? A 3D finite element analysis. ScientificWorldJournal 2013; 2013:426134. [PMID: 23956694 PMCID: PMC3730192 DOI: 10.1155/2013/426134] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Accepted: 06/29/2013] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to analyze the stresses that develop by oblique and vertical forces in endodontically treated maxillary second premolars that were restored with resin composite. Additionally, in our study the effects of the different restorative approaches and use of different base materials on stress formation were analyzed using three-dimensional finite element stress analysis. For restoration, the models representing both cusp capping, palatinal cusp capping, standard MOD restoration, and use of woven fiber in occlusal part were prepared. In all models, oblique forces caused more stress than did vertical forces. Materials with low elastic moduli cause high amounts of stress, whereas materials with elastic moduli similar to that of dental tissues cause low amounts of stress. Additional approaches such as cusp capping, functional cusp capping, and woven fiber use do not affect stress formation on the tooth after endodontic treatment.
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Adhesive restoration of anterior endodontically treated teeth: influence of post length on fracture strength. Clin Oral Investig 2013; 18:545-54. [PMID: 23604697 DOI: 10.1007/s00784-013-0978-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2012] [Accepted: 04/04/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES This study aims to evaluate the fracture resistance of endodontically treated anterior teeth restored with crowns made of composite or ceramic and retained without the use of a post (endocrowns) or with posts of 5 mm (short) and 10 mm in length (long). MATERIAL AND METHODS Forty-eight intact maxillary incisors were selected for the study. After endodontic treatment, the crowns were sectioned 2 mm coronally to the cementoenamel junction provided with a ferrule of 2 mm. The roots were randomly divided into six groups (n = 8) according to the post length and type of coronary restoration. The crowns were fabricated with the chairside economical restoration of esthetic ceramics system. Group 1 was restored with a 10-mm glass fiber post, composite core, and a full-coverage ceramic crown (LPCer); group 2, with a 5-mm glass fiber post, composite core, and a full-coverage ceramic crown (SPCer); group 3, with a 10-mm glass fiber post, composite core, and a full-coverage composite crown (LPCpr); group 4, with a 5-mm glass fiber post, composite core, and a full-coverage composite crown (SPCpr); and groups 5 (EndoCer) and 6 (EndoCpr) were restored with ceramic and composite endocrowns, respectively. The teeth were then thermomechanically loaded in a chewing machine. After fatigue, the specimens were loaded to fracture. Data were analyzed with ANOVA and chi-square test. Mode of failure was defined as repairable or non-repairable. RESULTS Presence of post, post length, and crown material had no significant effect on the fracture resistance. Groups restored with endocrowns presented a higher number of repairable fractures in respect to the other groups. CONCLUSIONS Presence of a post had no effect on the restorations' fracture strength. CLINICAL RELEVANCE Although this in vitro study has some limitations in respect to its clinical relevance, the restoration of largely destroyed anterior teeth with the use of an endocrown or a short glass fiber post might have advantages over a large glass fiber post.
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Seto B, Chung KH, Johnson J, Paranjpe A. Fracture resistance of simulated immature maxillary anterior teeth restored with fiber posts and composite to varying depths. Dent Traumatol 2012; 29:394-8. [DOI: 10.1111/edt.12020] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2012] [Indexed: 11/26/2022]
Affiliation(s)
- Brandon Seto
- Department of Endodontics; University of Washington; Seattle; WA; USA
| | - Kwok-Hung Chung
- Department of Restorative Dentistry; University of Washington; Seattle; WA; USA
| | - James Johnson
- Department of Endodontics; University of Washington; Seattle; WA; USA
| | - Avina Paranjpe
- Department of Endodontics; University of Washington; Seattle; WA; USA
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Scotti N, Coero Borga FA, Alovisi M, Rota R, Pasqualini D, Berutti E. Is fracture resistance of endodontically treated mandibular molars restored with indirect onlay composite restorations influenced by fibre post insertion? J Dent 2012; 40:814-20. [PMID: 22743344 DOI: 10.1016/j.jdent.2012.06.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 04/26/2012] [Accepted: 06/15/2012] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate the influence of post placement on fracture resistance of endodontically treated mandibular molars restored with adhesive overlay restorations. METHODS Endodontically treated human molars with two- and one-wall cavities either underwent or did not undergo fibre post insertion within composite build-up before cementation of indirect composite onlay restorations. The specimens were thermocycled, exposed to cyclic loading, and submitted to the static fracture resistance test. Fracture loads and mode of failure were evaluated. RESULTS Statistical analysis revealed that specimens with fibre posts demonstrated similar failure loads (p=0.065) but more favourable fracture patterns compared with specimens without fibre posts. No difference was found between two- and one-wall cavities. CONCLUSIONS Within the limitations of this study, the insertion of fibre posts did not improve support under indirect composite overlays. CLINICAL SIGNIFICANCE When restoring heavily broken down endodontically treated mandibular molars with an indirect overlay composite restoration, the fibre post inserted within the composite build-up do not provide any increase in fracture resistance.
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Affiliation(s)
- Nicola Scotti
- University of Turin Dental School, Department of Cariology and Operative Dentistry, via Nizza 230, 10126 Turin, Italy.
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