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Chen S, Ye Z, Hong X, Chen L, Wu L, Wang Y, Chen Y, Wu M, Wang J, Zhang Q, Wu Y, Sun X, Ding X, Huang S, Zhao S. The effect of periapical bone defects on stress distribution in teeth with periapical periodontitis: a finite element analysis. BMC Oral Health 2023; 23:980. [PMID: 38066540 PMCID: PMC10709972 DOI: 10.1186/s12903-023-03546-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 10/17/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Apical periodontitis directly affects the stress state of the affected tooth owing to the destruction of the periapical bone. Understanding the mechanical of periapical bone defects/tooth is clinically meaningful. In this study, we evaluate the effect of periapical bone defects on the stress distribution in teeth with periapical periodontitis using finite element analysis. METHODS Finite element models of normal mandibular second premolars and those with periapical bone defects (spherical defects with diameters of 5, 10, 15, and 20 mm) were created using a digital model design software. The edges of the mandible were fixed and the masticatory cycle was simplified as oblique loading (a 400 N force loaded obliquely at 45° to the long axis of the tooth body) to simulate the tooth stress state in occlusion and analyze the von Mises stress distribution and tooth displacement distribution in each model. RESULTS Overall analysis of the models: Compared to that in the normal model, the maximum von Mises stresses in all the different periapical bone defect size models were slightly lower. In contrast, the maximum tooth displacement in the periapical bone defect model increased as the size of the periapical bone defect increased (2.11-120.1% of increase). Internal analysis of tooth: As the size of the periapical bone defect increased, the maximum von Mises stress in the coronal cervix of the tooth gradually increased (2.23-37.22% of increase). while the von Mises stress in the root apical region of the tooth showed a decreasing trend (41.48-99.70% of decrease). The maximum tooth displacement in all parts of the tooth showed an increasing trend as the size of the periapical bone defect increased. CONCLUSIONS The presence of periapical bone defects was found to significantly affect the biomechanical response of the tooth, the effects of which became more pronounced as the size of the bone defect increased.
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Affiliation(s)
- ShuoMin Chen
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China
- Department of Prosthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - ZhangYan Ye
- Department of Stomatology, Pingyang Hospital Affiliated of Wenzhou Medical University, Wenzhou, China
| | - XinHua Hong
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China
| | - Liang Chen
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China
| | - LinMei Wu
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China
| | - Yilin Wang
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China
| | - YuGe Chen
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China
- Department of Dentistry, University of Alberta, Edmonton, Canada
| | - MengHan Wu
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China
- Department of Prosthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Jun Wang
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China
- Department of Prosthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - QinHui Zhang
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China
- Department of Prosthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - YuTian Wu
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China
- Department of Prosthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - XiaoYu Sun
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China
- Department of Periodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China
| | - Xi Ding
- Department of Stomatology, the First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, PR China.
| | - ShengBin Huang
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China.
- Department of Prosthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China.
| | - ShuFan Zhao
- Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China.
- Department of Oral Maxillofacial Surgery, School and Hospital of Stomatology, Wenzhou Medical University, No. 373, West Xueyuan Road, Lucheng District, Wenzhou, PR China.
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Naumann M, Adali U, Rosentritt M, Happe A, Frankenberger R, Sterzenbach G. Effect of apical root resection, orthodontic extrusion, and surgical crown lengthening on load capability. Clin Oral Investig 2023; 27:4379-4387. [PMID: 37162571 PMCID: PMC10415504 DOI: 10.1007/s00784-023-05057-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 04/30/2023] [Indexed: 05/11/2023]
Abstract
OBJECTIVES This study aims to investigate the load-to-fracture of procedures changing crown-to-root ratio (RCRR) aimed to restore severely damaged upper central incisors to avoid tooth extraction compared to implant placement. There is no evidence on load capability after apical root resection (AR), orthodontic extrusion (OE), and surgical crown lengthening (SCL) in respect to RCRR, respectively. MATERIAL AND METHODS Human maxillary central incisors were endodontically treated, decoronated, and divided into 4 groups (n = 48). The following specimen preparation was performed: (I) adhesive core-and-post build-up (control), (II) as (I) and 2 mm apical root resection (AR), (III) before adhesive core-and-post build-up teeth were shortened 2 mm coronally (OE) (IV) as (I), but specimens were embedded 4 mm instead of 2 mm below the CEJ (SCL), group (V) implant-borne restoration with individual all-ceramic abutments (n = 12; ∅4.1/l = 12 mm) (IBR). All specimens received all-ceramic crowns, thermo-mechanical (TML), and subsequent linear loading (LL) until failure. RCRR were calculated and log-rank, Kruskal-Wallis, Mann-Whitney U, ANOVA, and chi-square tests applied (p = 0.05). RESULTS Fracture loads after subsequent LL differed significantly (p = 0.001) between groups, while implants showed the highest values. Fmax median (min/max) were as follows: (I) 252 (204/542), (II) 293 (243/443), (III) 253 (183/371), (IV) 195 (140/274), and (V) 446 (370/539). Pair-wise comparison showed significant differences (p = 0.001) between group I/IV and group V, I, and IV (p = 0.045), II and IV (p = 0.001), and III compared to IV (p = 0.033), respectively. RCRR below 1 significantly increased load capability compared to RCRR = 1. CONCLUSIONS OE appears to preferably ensure biomechanical stability of teeth that are endodontically treated and receive core-and-post and crown placement compared to SCL. AR has no adverse biomechanical impact. RCRR < 1 is biomechanically beneficial. CLINICAL RELEVANCE For endodontically treated and restored teeth, orthodontic extrusion should be preferred compared to surgical crown lengthening prior single-crown restoration. As orthodontic extrusion, apical root resection has no adverse effect on load capability. Single-crown implant-borne restorations are most load capable.
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Affiliation(s)
- M Naumann
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular, Disorders, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany.
| | - U Adali
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular, Disorders, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - M Rosentritt
- Department of Prosthetic Dentistry, Regensburg University Medical Center, Regensburg, Germany
| | - A Happe
- Department of Prosthetic Dentistry, University of Ulm, Ulm, Germany
| | - R Frankenberger
- Department of Operative Dentistry and Endodontology, University of Marburg, Georg-Voigt-Str. 3, 35039, Marburg, Germany
| | - G Sterzenbach
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular, Disorders, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
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Li F, Shao Y, Han T, Li J, Yan X. Finite element analysis of endodontically treated premolars without ferrule restored with one-piece glass fiber post and core in combination with different inner shoulder retention form systems. J Mech Behav Biomed Mater 2023; 143:105912. [PMID: 37270902 DOI: 10.1016/j.jmbbm.2023.105912] [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: 03/29/2023] [Revised: 05/12/2023] [Accepted: 05/14/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The current study was performed to explore the impact of post materials as well as the inner shoulder retention form (ISRF) design on the biomechanical behavior of endodontically treated premolars without ferrule restoration using a method of mathematical three-dimensional (3D) finite element analysis (FEA). METHODS Based on the tooth anatomy and our previous research, eight mandibular second premolar FEA models representing different restorative situations were built: teeth with (a) 2.0 mm height ferrule (DF), (b) no ferrule (NF), (c) 0.5 mm width and 0.5 mm depth ISRF (ISRFW0.5D0.5), (d) 0.5 mm width and 1.0 mm depth ISRF (ISRFW0.5D1.0), (e) 0.5 mm width and 1.5 mm depth ISRF (ISRFW0.5D1.5), (f) 1.0 mm width and 0.5 mm depth ISRF (ISRFW1.0D0.5), (g) 1.0 mm width and 1.0 mm depth ISRF (ISRFW1.0D1.0), (h) 1.0 mm width and 1.5 mm depth ISRF (ISRFW1.0D1.5). All groups were restored with prefabricated glass fiber post and resin composite core (PGF), one-piece glass fiber post-and-core (OGF) and cast Co-Cr alloy (Co-Cr) respectively, and the zirconia crown was restored. Load (180N) was subjected to the buccal cusp at 45° to the tooth's long axis. Stress pattern, maximum principal stress values (MPS), and maximum displacement values on root, post and core, cement layer were calculated for each model. RESULTS Stress distributions were similar while the values were different among groups. Regardless of restorative approaches, roots restored with PGF showed the highest MPS values, followed by OGF and Co-Cr groups. Regardless of post materials, NF groups resulted in the highest MPS values and maximum displacement values, while ISRF and DF groups exhibited similar results. Compared with PGF groups in association with ISRF, except for OGF with ISRFW0.5D0.5, the remaining OGF groups with ISRF and all Co-Cr groups in association with ISRF presented lower values than that of DF groups. And among different ISRF systems, roots restored with ISRFW1.0D1.0 presented the lowest stress (PGF: 32.96 MPa, OGF: 31.69 MPa, Co-Cr: 29.66 MPa). CONCLUSIONS For endodontically treated premolars without ferrule, restored with OGF in combination with ISRF preparation could effectively enhanced its load-bearing capacity. Furthermore, the ISRF with a depth and width of 1.0 mm is recommended.
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Affiliation(s)
- Feiming Li
- The VIP Department, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, No. 117 North Street Nanjing Road, Shenyang, 110002, Liaoning, China
| | - Ying Shao
- The VIP Department, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, No. 117 North Street Nanjing Road, Shenyang, 110002, Liaoning, China
| | - Tongtong Han
- The VIP Department, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, No. 117 North Street Nanjing Road, Shenyang, 110002, Liaoning, China
| | - Jian Li
- The VIP Department, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, No. 117 North Street Nanjing Road, Shenyang, 110002, Liaoning, China
| | - Xu Yan
- The VIP Department, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, No. 117 North Street Nanjing Road, Shenyang, 110002, Liaoning, China.
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Implications of Post-Traumatic Treatment of Immature Maxillary Incisors. Int Dent J 2023; 73:337-345. [PMID: 36804746 DOI: 10.1016/j.identj.2023.01.005] [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: 12/12/2022] [Revised: 01/15/2023] [Accepted: 01/17/2023] [Indexed: 02/20/2023] Open
Abstract
The aim of this review was to discuss traumatic dental injuries in view of their treatment implications to provide an evidence-based resource for clinicians when planning treatment for traumatised immature maxillary incisors. Dental trauma to immature maxillary incisors can result in various complications, such as critical fractures, resorptions, or ankylosis, and might lead to tooth loss. Traumatised teeth may exhibit various unaesthetic discolourations as a result of different dental trauma sequelae or materials used for treatment. All of the above can influence patients' social experience, including self-esteem, confidence, eating and speaking abilities, as well as proper development and growth of the jaw bones. Treatment of traumatised immature incisors should focus not only on the acute phase but on the long-term consequences. Any time gained with the tooth in the jaw bone, free of infection, is an achievement, as it allows normal growth and development. All these aspects are discussed in this narrative review, and an evidence-based summary resource is suggested for clinicians to use when planning treatment for traumatised immature maxillary incisors.
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Gontijo IG, Ferretti MA, Monteiro LC, Caldas RA, Pecorari VGA, França FMG, Aguiar FHB. Influence of alveolar bone height on the biomechanical behavior of roots restored with custom-made posts-and-cores. J ESTHET RESTOR DENT 2023; 35:677-686. [PMID: 36602235 DOI: 10.1111/jerd.13010] [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: 11/08/2022] [Revised: 12/16/2022] [Accepted: 12/23/2022] [Indexed: 01/06/2023]
Abstract
OBJETIVE This study evaluated the influence of alveolar bone height and post type on compressive force resistance, fracture pattern, and stress distribution in endodontically treated teeth. MATERIALS AND METHODS Bovine roots were endodontically treated and divided into eight groups (n = 10) according to alveolar bone height (normal alveolar bone and alveolar bone loss - 2 and 5 mm from the margin of the crown, respectively) and post type (prefabricated glass fiber post, anatomic glass fiber post, customized milled glass fiber post-and-core and customized milled polyetheretherketone (PEEK) post-and-core). Mechanical fatigue was simulated (300.000 cycles/50 N/1.2 Hz). Compression force resistance (N) was analyzed by two-way ANOVA and Tukey test (α = 0.05). Fracture patterns were described as percentages. Stress distribution was analyzed by finite element analysis. RESULTS Significant diferences were found for alveolar bone height (P < 0.0001): normal alveolar bone groups showed higher mean values of compression force resistance compared to alveolar bone loss groups, while no significant differences were found for post type (P = 0.4551), and there was no double interaction between them (P = 0.5837). Reparable fractures were more predominant in normal alveolar bone groups, especially in the milled glass fiber and PEEK post-and-core groups. Stress distribution was similar in groups with prefabricated glass fiber posts and milled PEEK posts-and-cores, and the alveolar bone loss condition significantly increased stress concentration and strain values, mainly on apical dentin. CONCLUSIONS Alveolar bone loss due to physiological aging and/or periodontal disease may lead to increased risk of restored tooth failure, although milled glass fiber and PEEK posts-and-cores provide more reparable fractures. CLINICAL SIGNIFICANCE Custom-made glass fiber and PEEK post-and-cores are interesting options, since they enable clinicians to work with a single-body post-and-core system that avoid several materials interfaces and fits well in the root canal provided promising results to improve the failure behavior of restored roots, as they offer more reparable fractures even in situations of alveolar bone loss.
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Affiliation(s)
- Isabela Guerra Gontijo
- Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, São Paulo, Brazil
| | - Marcela Alvarez Ferretti
- Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, São Paulo, Brazil
| | - Lara Christie Monteiro
- Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, São Paulo, Brazil
| | - Ricardo Armini Caldas
- Department of Prosthodontics, Federal University of Santa Catarina - UFSC, Florianópolis, Santa Catarina, Brazil
| | | | | | - Flávio Henrique Baggio Aguiar
- Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, São Paulo, Brazil
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Boonrawd N, Rungsiyakull P, Rungsiyakull C, Louwakul P. Effects of composite resin core level and periodontal pocket depth on crack propagation in endodontically treated teeth: An extended finite element method study. J Prosthet Dent 2022; 128:195.e1-195.e7. [PMID: 35779973 DOI: 10.1016/j.prosdent.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 04/30/2022] [Accepted: 05/03/2022] [Indexed: 10/17/2022]
Abstract
STATEMENT OF PROBLEM Preserving teeth with radicular cracks with or without a periodontal pocket is an alternative to extraction. However, an effective protocol for the restoration of radicular cracks is lacking. PURPOSE The purpose of this study was to examine the composite resin core level and periodontal pocket depth effects on stress distribution, maximum von Mises stress, and crack propagation in endodontically treated teeth by using the extended finite element (FE) method. MATERIAL AND METHODS Four 3-dimensional models of a cracked endodontically treated mandibular first molar were constructed: PP2C2 (periodontal pocket depth, 2 mm; composite resin core level, 2 mm below the canal orifice level); PP2C4 (periodontal pocket depth, 2 mm; composite resin core level, 2 mm below the crack level); PP4C2 (periodontal pocket depth, 4 mm; composite resin core level, 2 mm below the canal orifice level); and PP4C4 (periodontal pocket depth, 4 mm; composite resin core level, 2 mm below the crack level). The crack initiation was at the same level in all models. A static 700-N load was applied to the models in a vertical direction. RESULTS The highest stress in dentin was observed in PP2C2, whereas PP2C4 exhibited the lowest stress and least crack propagation. Stress was high in the dentin and supporting bone. No reduction in crack propagation was observed in the PP4 models, regardless of the composite resin core level. CONCLUSIONS The periodontal pocket depth (2 mm and 4 mm) and composite resin core level (2 mm below the crack level and 2 mm below the canal orifice level) affected stress concentration in dentin, resulting in different patterns of crack propagation in the FE models.
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Affiliation(s)
- Narissara Boonrawd
- Graduate student, Department of Restorative Dentistry and Periodontology, Endodontic Division, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Pimduen Rungsiyakull
- Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| | - Chaiy Rungsiyakull
- Assistant Professor, Department of Mechanical Engineering, Faculty of Engineering, Chiang Mai University, Chiang Mai, Thailand
| | - Phumisak Louwakul
- Assistant Professor, Department of Restorative Dentistry and Periodontology, Endodontic Division, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand.
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Özarslan M, Büyükkaplan UŞ, Özarslan MM. Comparison of the fracture strength of endodontically treated teeth restored with polyether ether ketone, zirconia and glass-fibre post-core systems. Int J Clin Pract 2021; 75:e14440. [PMID: 34096673 DOI: 10.1111/ijcp.14440] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/25/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE This study aimed to compare the fracture resistance and fracture mode of maxillary central incisors restored with four different sizes and three different post-core systems. MATERIALS AND METHODS One hundred and twenty maxillary incisors were endodontically treated and randomly divided into three groups (12 subgroups). Post cavities for the narrow subgroups were prepared with 1.4-mm-diameter drills in lengths of 7.5 mm (SN) and 10 mm (LN). Post cavities for the wide subgroups were prepared with 1.6-mm-diameter drills in lengths of 7.5 mm (SW) and 10 mm (LW) (n = 10). Group F was restored with glass-fibre post and composite resin core, Group P was restored with custom PEEK post-core and Group Z was restored with custom zirconia post-core. All posts were cemented with a dual-cure resin cement. Zirconia copings were cemented. Specimens were loaded on the palatal surface with a universal testing machine, and the fracture strengths of the teeth were statistically analysed using ANOVA and post hoc Tukey tests. RESULTS Statistically significant differences existed between the fracture strengths of the post materials. The highest fracture strength was in Group F, and the lowest was in Group P. Evaluation of the fracture strengths of the post lengths and diameters demonstrated that the short-narrow group of Group Z had the lowest fracture strength (P < .05). The long-wide group of Group F showed the highest fracture resistance. In Group P, no statistically significant difference existed between the post-cores of different dimensions (P > .05). Irreparable fractures were observed mostly in Group Z, and decementation was more common in Group P. CONCLUSIONS PEEK post-cores showed sufficient fracture strength for the anterior region, similar to the other two post-core materials. PEEK post-cores showed more decementation and repairable fractures at lower forces, while restoration failure was mostly catastrophic for glass-fibre and zirconia posts.
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Affiliation(s)
- Merve Özarslan
- Department of Prosthetic Dentistry, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | | | - Mehmet Mustafa Özarslan
- Department of Prosthetic Dentistry, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
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Meng Q, Ma Q, Wang T, Chen Y. An in vitro study evaluating the effect of ferrule design on the fracture resistance of endodontically treated mandibular premolars after simulated crown lengthening or forced eruption methods. BMC Oral Health 2018; 18:83. [PMID: 29747611 PMCID: PMC5946484 DOI: 10.1186/s12903-018-0549-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 05/01/2018] [Indexed: 04/02/2024] Open
Abstract
Background The purpose of this study was to evaluate the effect of ferrule design on the fracture resistance of endodontically treated mandibular first premolars after simulated crown lengthening and orthodontic forced eruption methods restored with a fiber post-and-core system. Methods Forty extracted and endodontically treated mandibular first premolars were decoronated to create lingual-to-buccal oblique residual root models, with a 2.0 mm height of the lingual dentine wall coronal to the cemento-enamel junction, and the height of buccal surface at the cemento-enamel junction. The roots were divided randomly into five equal groups. The control group had undergone incomplete ferrule preparation in the cervical root, with 0.0 mm buccal and 2.0 mm lingual ferrule lengths (Group F0). Simulated surgical crown lengthening method provided ferrule preparation of 1.0 mm (Group CL/F1) and 2.0 mm (Group CL/F2) on the buccal surface, with ferrule lengths of 3.0 mm and 4.0 mm on the lingual surface, respectively. Simulated orthodontic forced eruption method provided ferrule preparation of 1.0 mm (Group OE/F1) and 2.0 mm (Group OE/F2) on the buccal surface and ferrule lengths of 3.0 mm and 4.0 mm on the lingual surface, respectively. After restoration with a glass fiber post-and-core system and a cast Co-Cr alloy crown, each specimen was embedded in an acrylic resin block to a height on the root 2.0 mm from the apical surface of the crown margin and loaded to fracture at a 135° angle to its long axis in a universal testing machine. Data were analyzed statistically using two-way ANOVA with Tukey HSD tests and Fisher’s test, with α = 0.05. Results Mean fracture loads (kN) for groups F0, CL/F1, CL/F2, OE/F1 and OE/F2 were as follows: 1.01 (S.D. = 0.26), 0.91 (0.29), 0.73 (0.19), 0.96 (0.25) and 0.76 (0.20), respectively. Two-way ANOVA revealed significant differences for the effect of ferrule lengths (P = 0.012) but no differences for the effect of cervical treatment methods (P = 0.699). The teeth with no buccal ferrule preparation in control group F0 had the highest fracture resistance. In contrast, the mean fracture loads for group CL/F2 with a 2.0-mm buccal and 4.0-mm lingual ferrule created by simulated crown lengthening method were lowest (P = 0.036). Conclusions Increased apically complete ferrule preparation resulted in decreased fracture resistance of endodontically treated mandibular first premolars, regardless of whether surgical crown lengthening or orthodontic forced eruption methods been used.
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Affiliation(s)
- Qingfei Meng
- Department of Stomatology, Xuzhou Central Hospital, Xuzhou, 221009, Jiangsu Province, China.,College of Stomatology, Nanjing Medical University, 136 Hanzhong Road, Nanjing, 210029, Jiangsu Province, China
| | - Qian Ma
- College of Stomatology, Nanjing Medical University, 136 Hanzhong Road, Nanjing, 210029, Jiangsu Province, China.
| | - Tianda Wang
- College of Stomatology, Nanjing Medical University, 136 Hanzhong Road, Nanjing, 210029, Jiangsu Province, China
| | - Yaming Chen
- College of Stomatology, Nanjing Medical University, 136 Hanzhong Road, Nanjing, 210029, Jiangsu Province, China
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Naumann M, von Stein-Lausnitz M, Rosentritt M, Walter C, Meyer-Lückel H, Sterzenbach G. Impact of simulated reduced alveolar bone support, increased tooth mobility, and distal post-supported, root-treated abutment tooth on load capability of all-ceramic zirconia-supported cantilever FDP. Clin Oral Investig 2018; 22:2799-2807. [PMID: 29404813 DOI: 10.1007/s00784-018-2366-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 01/25/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of this in vitro study was an analysis of the impact of simulated reduced alveolar bone support and post-restored, endodontically treated distal abutment tooth on load capability of all-ceramic zirconia-based cantilever-fixed dental prosthesis (CFDP). MATERIAL AND METHODS The roots of human lower sound premolars (n = 80) were divided into five experimental groups to be restored with all-ceramic zirconia-supported three-unit CFDP regarding bone loss (BL) relative to the cement-enamel junction (CEJ): 2 mm below CEJ = 0% BL (control group), group 25% distal BL, group 50% distal BL, group 50% mesial and distal BL, and group 50% distal BL and adhesive post-supported restoration. Specimens were exposed to simulated clinical function by thermo-mechanical loading (6.000 cycles 5°-55°; 1.2 × 106 cycles 0-50 N) and subsequent linear loading until failure. RESULTS Tooth mobility increased significantly for groups with simulated bone loss (p < 0.001). Four specimens failed during thermal cycling and mechanical loading (TCML). The maximum load capability ranged from 350 to 569 N, and did not differ significantly between experimental groups (p = 0.095). Groups with simulated bone loss revealed more tooth fractures at distal abutment teeth, whereas technical failures were more frequent in the control group (p = 0.024). CONCLUSIONS Differences of alveolar bone support and respectively increased tooth mobility between mesial and distal abutments did not influence load capability. A distal adhesively post-and-core-supported, root-treated abutment tooth did not increase risk of three-unit CFDP failure. CLINICAL RELEVANCE CFDPs are a treatment option used with caution when reduced alveolar bone support, increased tooth mobility, and distal post-supported, root-treated abutment teeth are involved.
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Affiliation(s)
- M Naumann
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany.
| | - M von Stein-Lausnitz
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - M Rosentritt
- Department of Prosthetic Dentistry, Regensburg University Medical Center, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - C Walter
- Department of Periodontlogy, Cariology, and Endodontology, University of Basel, Hebelstr. 3, 4056, Basel, Switzerland
| | - H Meyer-Lückel
- Department of Restorative, Preventive and Pediatric Dentistry, ZMK Bern, University of Bern, Hochschulstrasse 6, 3012, Bern, Switzerland
| | - G Sterzenbach
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
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Zarow M, Ramírez-Sebastià A, Paolone G, de Ribot Porta J, Mora J, Espona J, Durán-Sindreu F, Roig M. A new classification system for the restoration of root filled teeth. Int Endod J 2017; 51:318-334. [DOI: 10.1111/iej.12847] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 08/23/2017] [Indexed: 12/28/2022]
Affiliation(s)
| | - A. Ramírez-Sebastià
- Department of Restorative Dentistry and Endodontics; School of Dentistry; Universitat Internacional de Catalunya; Barcelona Spain
| | - G. Paolone
- Dental School; Universitá Vita e Salute San Raffaele; Milan Italy
| | - J. de Ribot Porta
- Department of Restorative Dentistry and Endodontics; School of Dentistry; Universitat Internacional de Catalunya; Barcelona Spain
| | - J. Mora
- Department of Restorative Dentistry and Endodontics; School of Dentistry; Universitat Internacional de Catalunya; Barcelona Spain
| | - J. Espona
- Department of Restorative Dentistry and Endodontics; School of Dentistry; Universitat Internacional de Catalunya; Barcelona Spain
| | - F. Durán-Sindreu
- Department of Restorative Dentistry and Endodontics; School of Dentistry; Universitat Internacional de Catalunya; Barcelona Spain
| | - M. Roig
- Department of Restorative Dentistry and Endodontics; School of Dentistry; Universitat Internacional de Catalunya; Barcelona Spain
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Dal Piva AMDO, Tribst JPM, Souza RODAE, Borges ALS. Influence of Alveolar Bone Loss and Cement Layer Thickness on the Biomechanical Behavior of Endodontically Treated Maxillary Incisors: A 3-dimensional Finite Element Analysis. J Endod 2017; 43:791-795. [DOI: 10.1016/j.joen.2016.11.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 11/15/2016] [Accepted: 11/24/2016] [Indexed: 10/19/2022]
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Effect of fibre posts, bone losses and fibre content on the biomechanical behaviour of endodontically treated teeth: 3D-finite element analysis. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 74:334-346. [PMID: 28254302 DOI: 10.1016/j.msec.2016.12.022] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 10/20/2016] [Accepted: 12/05/2016] [Indexed: 11/22/2022]
Abstract
The aim of this work was to evaluate the stress distribution inside endodontically treated teeth restored with different posts (glass fibre, carbon fibre and steel posts) under different loading conditions by using a 3D-finite element analysis. The effect of masticatory and impact forces on teeth with different degrees of bone loss was analysed. The model consists of: dentine, post, cement, gutta-percha, core and crown. Four simulations were conducted with two static forces (170N horizontal and 100N oblique) and two sections constrained: 1mm (alveolar bone position in a normal periodontium) and 6mm (middle of root) below the crown. Von Mises and the principal stresses were evaluated and analysed with a 3-way ANOVA and Tukey test (α=0.05) and the effect of fibre percentage analysed. Significant differences were found among the stress values for all conditions (p<0.05). Impact load was always responsible for the most critical situation especially when the bone loss was more evident. The system with steel posts showed the highest principal stresses at the post-cement interface with horizontal load and top constraints (compressive stress of 121MPa and tensile stress of 115MPa). The use of glass posts provides a more homogeneous behaviour of the system with lower stresses. Higher fibre percentages gave higher stress in the posts. Moreover, larger bone losses are responsible for important increase in stress. Thus, this work demonstrated that periodontal disease has an important role in the success of tooth restoration after endodontic therapy, influencing the choice of post material and depth.
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Nawafleh N, Hatamleh M, Elshiyab S, Mack F. Lithium Disilicate Restorations Fatigue Testing Parameters: A Systematic Review. J Prosthodont 2015; 25:116-26. [PMID: 26505638 DOI: 10.1111/jopr.12376] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2015] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To review laboratory studies that investigated fatigue resistance of lithium disilicate (LD) crowns and fixed dental prostheses (FDPs) to elucidate study designs and testing parameters. METHODS An electronic search was performed in PubMed, Scopus, and Ovid to identify in vitro studies that investigated fatigue resistance of LD crowns and FDPs. The search included all studies published in English in peer-reviewed journals in the period from 1998 to June 2014. The search followed a specific strategy that included combination of the following keywords: lithium disilicate, e.max, empress, all-ceramic, all ceramic, glass ceramic, fatigue, cyclic loading, dynamic loading, chewing simulator, fracture resistance, thermocycling, laboratory simulation, aging, crown, FDPs, FPDs, fixed partial denture, fixed dental prosthesis, and bridge. Studies were selected if mechanical and thermal loading parameters were clearly identified. Search results with abstracts were transferred into Endnote reference system, and duplicates were deleted. The remaining studies were then reviewed at three levels (title, abstract, full text) to further refine the articles. RESULTS The initial search retrieved 1044 eligible studies. After deduplication, 864 records were examined by titles and then abstracts; 826 were excluded, and 38 were assessed by full-text reading. In total, 19 articles met inclusion criteria and were included in this study. CONCLUSION The studies reviewed showed a level of heterogeneity, as testing parameters were considered through different setups. The current study demonstrated that various setting of the testing parameters and having a lack of testing standardization has likely led to inconsistency in the reported results. The obvious heterogeneity in the setting of testing variables-especially the magnitude of load and number of cycles applied-made it impractical to run direct comparisons between the reviewed studies. Therefore, specific international standardization of fatigue testing of dental restorations is urgently needed to ensure the delivery of consistent, indicative, and comparable data.
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Affiliation(s)
- Noor Nawafleh
- School of Dentistry and Oral Health, Griffith University, Queensland, Australia
| | - Muhanad Hatamleh
- Cranio-Maxillofacial Prosthetics Unit, King's College Hospital NHS Foundation Trust, London, UK
| | - Shareen Elshiyab
- School of Dentistry and Oral Health, Griffith University, Queensland, Australia
| | - Florian Mack
- School of Dentistry and Oral Health, Griffith University, Queensland, Australia
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Singh SV, Bhat M, Gupta S, Sharma D, Satija H, Sharma S. Stress distribution of endodontically treated teeth with titanium alloy post and carbon fiber post with different alveolar bone height: A three-dimensional finite element analysis. Eur J Dent 2015; 9:428-432. [PMID: 26430375 PMCID: PMC4569998 DOI: 10.4103/1305-7456.163228] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective: A three-dimensional (3D) finite element analysis (FEA) on the stress distribution of endodontically treated teeth with titanium alloy post and carbon fiber post with different alveolar bone height. Materials and Methods: The 3D model was fabricated using software to represent an endodontically treated mandibular second premolar with post and restored with a full ceramic crown restoration, which was then analyzed using FEA using FEA ANSYS Workbench V13.0 (ANSYS Inc., Canonsburg, Pennsylvania, U.S.A) software. Results: The FEA showed the maximum stresses of 137.43 Mpa in dentin with alveolar bone height of 4 mm when the titanium post was used, 138.48 Mpa when carbon fiber post was used as compared to 105.91 Mpa in the model with alveolar bone height of 2 mm from the cement enamel junction (CEJ) when the titanium post was used and 107.37 Mpa when the carbon fiber post was used. Conclusions: Stress was observed more in alveolar bone height level of 4 mm from CEJ than 2 mm from CEJ. Stresses in the dentin were almost similar when the carbon fiber post was compared to titanium post. However, stresses in the post and the cement were much higher when titanium post was used as compared to carbon fiber post.
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Affiliation(s)
- S Vijay Singh
- Department of Conservative Dentistry and Endodontics, D.A.V (c) Dental College and Hospital, Yamunanagar, Haryana, India
| | - Manohar Bhat
- Department of Conservative Dentistry and Endodontics, Jaipur Dental College and Hospital, Jaipur, Rajasthan, India
| | - Saurabh Gupta
- Department of Conservative Dentistry and Endodontics, D.A.V (c) Dental College and Hospital, Yamunanagar, Haryana, India
| | - Deepak Sharma
- Department of Conservative Dentistry and Endodontics, Jaipur Dental College and Hospital, Jaipur, Rajasthan, India
| | - Harsha Satija
- Department of Conservative Dentistry and Endodontics, D.A.V (c) Dental College and Hospital, Yamunanagar, Haryana, India
| | - Sumeet Sharma
- Department of Conservative Dentistry and Endodontics, Institute of Dental Science, Muradnagar, Uttar Pradesh, India
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Wang CH, Du JK, Li HY, Chang HC, Chen KK. Factorial analysis of variables influencing mechanical characteristics of a post used to restore a root filled premolar using the finite element stress analysis combined with the Taguchi method. Int Endod J 2015; 49:690-9. [DOI: 10.1111/iej.12499] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 07/03/2015] [Indexed: 11/29/2022]
Affiliation(s)
- C. H. Wang
- Department of Dentistry; Kaohsiung Medical University Hospital; Kaohsiung Taiwan
- School of Dentistry; College of Dental Medicine; Kaohsiung Medical University; Kaohsiung Taiwan
| | - J. K. Du
- Department of Dentistry; Kaohsiung Medical University Hospital; Kaohsiung Taiwan
- School of Dentistry; College of Dental Medicine; Kaohsiung Medical University; Kaohsiung Taiwan
| | - H. Y. Li
- Department of Mold and Die Engineering; National Kaohsiung University of Applied Science; Kaohsiung Taiwan
| | - H. C. Chang
- Department of Biomedical Engineering; National Cheng Kung University; Tainan Taiwan
| | - K. K. Chen
- Department of Dentistry; Kaohsiung Medical University Hospital; Kaohsiung Taiwan
- School of Dentistry; College of Dental Medicine; Kaohsiung Medical University; Kaohsiung Taiwan
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Sterzenbach G, Franke A, Naumann M. Rigid versus flexible dentine-like endodontic posts--clinical testing of a biomechanical concept: seven-year results of a randomized controlled clinical pilot trial on endodontically treated abutment teeth with severe hard tissue loss. J Endod 2013; 38:1557-63. [PMID: 23146637 DOI: 10.1016/j.joen.2012.08.015] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 08/21/2012] [Accepted: 08/21/2012] [Indexed: 11/28/2022]
Abstract
INTRODUCTION This is the first clinical long-term pilot study that tested the biomimetic concept of using more flexible, dentine-like (low Young modulus) glass fiber-reinforced epoxy resin posts (GFREPs) compared with rather rigid, stiff (higher Young modulus) titanium posts (TPs) in order to improve the survival rate of severely damaged endodontically treated teeth. METHODS Ninety-one subjects in need of postendodontic restorations in teeth with 2 or less remaining cavity walls were randomly assigned to receive either a tapered TP (n = 46) or a tapered GFREP (n = 45). The posts were adhesively luted using self-adhesive resin cement. The composite core build-ups were prepared ensuring a circumferential 2-mm ferrule. The primary endpoint was a loss of restoration for any reason. To study group differences, the log-rank test was calculated (P < .05). Hazard plots were constructed. RESULTS After 84 months of observation (mean = 71.2 months), 7 restorations failed (ie, 4 GFREPs and 3 TPs). The failure modes were as follows: GFREP:root fracture (n = 3), core fracture (n = 1) and TP:endodontic failure (n = 3). No statistical difference was found between the survival rates (GFREPs = 90.2%, TPs = 93.5%, P = .642). The probability of no failure was comparable for both post materials (risk ratio; 95% confidence interval, 0.965-0.851/1.095). CONCLUSIONS When using self-adhesive luted prefabricated posts in severely destroyed abutment teeth with 2 or less cavity walls and a 2-mm ferrule, postendodontic restorations achieved high long-term survival rates irrespective of the post material used (ie, glass fiber vs titanium).
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Affiliation(s)
- Guido Sterzenbach
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Berlin, Germany.
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Sterzenbach G, Tunjan R, Rosentritt M, Naumann M. Increased tooth mobility because of loss of alveolar bone support: a hazard for zirconia two-unit cantilever resin-bonded FDPs in vitro? J Biomed Mater Res B Appl Biomater 2013; 102:244-9. [PMID: 23997026 DOI: 10.1002/jbm.b.33001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Revised: 05/03/2013] [Accepted: 06/10/2013] [Indexed: 11/12/2022]
Abstract
This study evaluates in vitro the impact of increased abutment tooth mobility on survival of zirconia-based two-unit cantilever resin-bonded fixed dental prosthesis (RB-FDP) by long-term dynamic loading in a chewing simulator. Human maxillary central incisors (n = 32) were endodontically treated and alveolar bone loss was simulated: 0% (group B), 25% (group C), and 50% (group D). RB-FDPs were adhesively luted. Zirconia full crown two-unit FDPs served as control (group A). Specimens were exposed to simulated clinical function by two subsequent sequences of thermal-cycling (2 × 3.000) parallel to mechanical loading (1.2 × 10(6) load cycles) (TCML; first sequence: load 1-25 N; second sequence: load 1-50 N). Tooth mobility increased significantly as the simulated bone level decreased (p < 0.001). Log-rank tests revealed no significant differences between experimental groups (p = 0.479). The results support the assumption that zirconia-based two-unit cantilever RB-FDPs may be an appropriate treatment option, even if abutment tooth mobility increase because of alveolar bone loss. However, debonding of zirconia-based two-unit RB-FDPs will be a likely event, whereas fatal failures of the abutment teeth may not occur.
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Affiliation(s)
- Guido Sterzenbach
- Charité - Universitätsmedizin Berlin, CC3, Deparment of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Berlin, Germany
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Melani RFH, Turbino ML, Ramos DLDP, Bombana AC, Dias PEM. Dental fracture and chocolate candies: Case report. J Forensic Leg Med 2013; 20:350-4. [DOI: 10.1016/j.jflm.2012.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Revised: 06/20/2012] [Accepted: 09/07/2012] [Indexed: 11/30/2022]
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MOBILIO N, BORELLI B, SORRENTINO R, CATAPANO S. Effect of fiber post length and bone level on the fracture resistance of endodontically treated teeth. Dent Mater J 2013; 32:816-21. [DOI: 10.4012/dmj.2013-069] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Zicari F, Van Meerbeek B, Scotti R, Naert I. Effect of ferrule and post placement on fracture resistance of endodontically treated teeth after fatigue loading. J Dent 2012; 41:207-15. [PMID: 23069329 DOI: 10.1016/j.jdent.2012.10.004] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2011] [Revised: 06/15/2012] [Accepted: 10/06/2012] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES To evaluate the influence of the ferrule effect (1) and the fibre-post placement (2) on the fracture resistance of endodontically treated teeth subjected to cyclic fatigue loading. METHODS 40 extracted single-rooted upper pre-molars were sectioned at the CEJ (groups a and b) or 2mm above the CEJ (groups c and d), and subsequently endodontically treated. After 24-h water storage at 37°C, specimens were restored according to four build-up approaches (n=10 per group): (a) NF-NP (no ferrule, no post), (b) NF-P (no ferrule, fibre-post), (c) F-NP (ferrule, no post) and (d) F-P (ferrule, fibre post). RelyX Posts (3M-ESPE) were used in groups NF-P and F-P, and were cemented with Panavia F 2.0 (Kuraray). A standardized composite core was built, after which specimens were restored with an all-ceramic crown (IPS Empress CAD, Ivoclar-Vivadent) Specimens were fatigued by exposure to 1,200,000 cycles using a chewing simulator (Willytech). All specimens that survived fatigue loading were fractured using a universal loading device (Micro-Tester, Instron). A two-way analysis of variance was used to determine the statistical significance of the factors ferrule and post on fracture resistance. RESULTS Only one NF-NP specimen failed under fatigue. The ferrule effect significantly enhanced the fracture resistance of the restored teeth, regardless the use of a post (p=0.003). F-NP obtained the highest fracture resistance (758.52±121.89N), which was not significantly different from F-P (647.58±132.95N); NF-NP presented the lowest fracture resistance (361.52±151.69N). For all groups, only 'repairable' failures were recorded. CONCLUSIONS Avoiding extra-removal of sound tooth structure, rather than placing a fibre post, can protect endodontically treated teeth against catastrophic failure. However, when any ferrule can be preserved, a fibre-post may improve the retention and fatigue resistance of the restoration.
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Affiliation(s)
- F Zicari
- Leuven BIOMAT Research Cluster, Department of Prosthetic Dentistry, School of Dentistry, Oral Pathology and Maxillo-Facial Surgery, Catholic University of Leuven, Belgium.
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Zicari F, Van Meerbeek B, Scotti R, Naert I. Effect of fibre post length and adhesive strategy on fracture resistance of endodontically treated teeth after fatigue loading. J Dent 2012; 40:312-21. [DOI: 10.1016/j.jdent.2012.01.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Revised: 01/10/2012] [Accepted: 01/11/2012] [Indexed: 11/16/2022] Open
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Tunjan R, Rosentritt M, Sterzenbach G, Happe A, Frankenberger R, Seemann R, Naumann M. Are endodontically treated incisors reliable abutments for zirconia-based fixed partial dentures in the esthetic zone? J Endod 2012; 38:519-22. [PMID: 22414841 DOI: 10.1016/j.joen.2011.12.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Revised: 12/16/2011] [Accepted: 12/19/2011] [Indexed: 02/06/2023]
Abstract
INTRODUCTION This ex vivo pilot study tested the influence of defect extension and quartz-fiber post placement (QFP) on the ex vivo survival rate and fracture resistance of root-treated upper central incisors served as abutments for zirconia 2-unit cantilever fixed partial dentures (2U-FPDs) exposed to 10 years of simulated clinical function. METHODS Human maxillary central incisors were endodontically treated and divided into the following 5 groups (n = 8): (1) access cavity filled with core build-up composite, (2) biproximal class III cavities filled as in group 1, (3) specimens restored as in group 2 with QFP placed, (4) specimens decoronated and core buildup as in group 1, and (5) specimens restored as in group 4 but with QFP as in group 3. On all specimens, 2U-FPDs were placed with dual-curing resin cement. In order to simulate 10 years of clinical function, specimens were exposed to thermal cycling and mechanical loading with subsequent loading to failure. Kaplan-Meier curves were constructed, and log-rank tests were performed. Fracture force and patterns were compared by means of Kruskal-Wallis, Mann-Whitney U (post hoc), and Fisher exact tests, respectively (P = .05). RESULTS For specimens only with an access cavity, it was observed that 25% had catastrophic tooth fractures and the lowest load-to-fracture values. In all other groups, chipping combined with or without debonding occurred. Groups did not differ significantly regarding the survival rate (P = .603) and fracture patterns (P = .633), but they did for fracture load including technical failures (P = .017). CONCLUSIONS After 10 years of simulated clinical function, both defect extension and placement of QFP had no significant influence on survival of root-treated upper central incisors as abutments restored with zirconia-based 2U-FPDs.
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Affiliation(s)
- René Tunjan
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Ma J, Miura H, Okada D, Yusa K. Photoelastic stress analysis of endodontically treated teeth restored with different post systems: normal and alveolar bone resorption cases. Dent Mater J 2011; 30:806-13. [PMID: 22123004 DOI: 10.4012/dmj.2011-070] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The present study examined the influence of different post materials and their lengths on the mechanical stress of endodontically treated incisor roots in two alveolar bone conditions. Two-dimensional photoelastic models were fabricated to simulate the endodontically treated maxillary central incisors restored with three kinds of posts materials (low Young's modulus glass fiber post, high Young's modulus glass fiber post, and prefabricated stainless steel post) and two post lengths (8 and 4 mm). Completed models were placed in a transmission polariscope and loaded with a static force of 150 N at 45° to the tooth axis. Photoelastic photographs and the magnitudes of fringe order revealed stress distribution in the root, and suggest that the glass fiber post with a low Young's modulus and long length can reduce the stress concentration both in normal and alveolar bone resorption conditions.
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Affiliation(s)
- Jinbao Ma
- Fixed Prosthodontics, Department of Restorative Sciences, Graduate School, Tokyo Medical and Dental University
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Sterzenbach G, Kalberlah S, Beuer F, Frankenberger R, Naumann M. In-vitro simulation of tooth mobility for static and dynamic load tests: a pilot study. Acta Odontol Scand 2011; 69:316-8. [PMID: 21375428 DOI: 10.3109/00016357.2011.563244] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Simulation of tooth mobility in vitro with or without reduced bone support is an aspect of particular interest from the clinical perspective. To elucidate adequate simulation of the periodontal ligament in terms of tooth mobility, three materials were investigated. METHODS Human lower sound premolars were selected and randomly assigned to six groups (n = 5) and stored at 37°C in a 0.5%-chloramine solution. For tooth mobility simulation, roots were covered with a thin layer of three types of material: (i) polyurethane elastomeric material, (ii) polyether impression material and (iii) A-polysiloxane soft cushion material. Teeth were embedded in an acrylic resin block simulating no and 50% bone loss, respectively. Specimens were statically subjected up to a maximum load of 30 N perpendicular to tooth axis (crosshead speed = 1 mm/min) in a universal material testing machine. Load-deflexion curves and periotest values were recorded. Statistical analysis was performed using 2-way Anova and post-hoc Bonferroni Test (p = 0.05). The Pearson's correlation coefficient between deflexion and periotest values was calculated. RESULTS Median horizontal deflexion values (μm) of specimen crowns with no bone loss were significant higher for polysiloxane (210) compared to polyurethan (24) (p < 0.001). The tooth deflexion, e.g. tooth mobility, increased significantly as the bone level decreased only when specimens were embedded in polysiloxane (iii) (1150) (p = 0.045). All specimens with reduced bone support layered with polyether were dislocated. Deflexion was significantly positive correlated with periotest values (p = 0.01). CONCLUSION Using A-polysiloxane soft cushion material combined with autopolymerizing acrylic resin may be suitable to simulate increased tooth mobility in vitro.
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Affiliation(s)
- Guido Sterzenbach
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, Germany
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Watzke R, Frankenberger R, Naumann M. Different scanning electron microscopic evaluation methods of cement interface homogeneity of adhesively luted glass fiber posts. Acta Odontol Scand 2011; 69:101-7. [PMID: 21319942 DOI: 10.3109/00016357.2010.536909] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To compare two methods used to examine the cement interface homogeneity of adhesively luted glass fiber posts (GFPs). MATERIAL AND METHODS GFPs were divided into four groups (n = 5 in each) and inserted into artificial root canals under standardized conditions: Group I = RelyX Unicem, application with application aid; Group II = RelyX Unicem; Group III = Panavia F 2.0; and Group IV = Variolink II. Posts in Groups II-IV were cemented without using an appliance. All specimens were sectioned at three levels (cervical, middle and apical) perpendicularly to the post's long axis and examined and photographed (n = 60) using scanning electron microscopy (SEM). Cement interface inhomogeneities were (A) measured by means of SEM software and (B) estimated using a graphics program with SEM images being divided into 72 equal circle segments to calculate a percentage value of inhomogeneities of the 360° circumference. RESULTS Median values of inhomogeneities (A/B; %) within the cement interface for the cervical, middle and apical levels of analysis, respectively were 1.4/2.1, 2.2/4.2 and 1.9/2.1 for Group I; 21.0/20.1, 24.8/23.6 and 27.0/24.3 for Group II; 1.5/1.7, 5.5/6.3 and 19.4/20.8 for Group III; and 18.1/16.7, 16.1/15.3 and 27.2/25.7 for Group IV. The two methods correlated very well (0.994), with a value of one indicating a 100% correlation. CONCLUSION Both evaluation methods were found to be equally appropriate for quantifying the cement interface homogeneity of SEM cross-sections of adhesively luted GFPs.
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Affiliation(s)
- Ronny Watzke
- Department of Dental Prosthodontics and Material Science, University of Leipzig, Leipzig, Germany.
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Al-Omiri MK, Mahmoud AA, Rayyan MR, Abu-Hammad O. Fracture Resistance of Teeth Restored with Post-retained Restorations: An Overview. J Endod 2010; 36:1439-49. [PMID: 20728706 DOI: 10.1016/j.joen.2010.06.005] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Revised: 05/29/2010] [Accepted: 06/20/2010] [Indexed: 11/30/2022]
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NAUMANN M, METZDORF G, FOKKINGA W, WATZKE R, STERZENBACH G, BAYNE S, ROSENTRITT M. Influence of test parameters onin vitrofracture resistance of post-endodontic restorations: a structured review. J Oral Rehabil 2009; 36:299-312. [DOI: 10.1111/j.1365-2842.2009.01940.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Beuer F, Steff B, Naumann M, Sorensen JA. Load-bearing capacity of all-ceramic three-unit fixed partial dentures with different computer-aided design (CAD)computer-aided manufacturing (CAM) fabricated framework materials. Eur J Oral Sci 2008; 116:381-6. [PMID: 18705807 DOI: 10.1111/j.1600-0722.2008.00551.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Florian Beuer
- Department of Prosthodontics, Ludwig-Maximilians-University, Munich, Germany.
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Nothdurft F, Seidel E, Gebhart F, Naumann M, Motter P, Pospiech P. The fracture behavior of premolar teeth with class II cavities restored by both direct composite restorations and endodontic post systems. J Dent 2008; 36:444-9. [DOI: 10.1016/j.jdent.2008.03.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2008] [Revised: 02/29/2008] [Accepted: 03/04/2008] [Indexed: 10/22/2022] Open
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Valandro LF, Baldissara P, Galhano GA, Melo RM, Mallmann A, Scotti R, Bottino MA. Effect of Mechanical Cycling on the Push-out Bond Strength of Fiber Posts Adhesively Bonded to Human Root Dentin. Oper Dent 2007; 32:579-88. [DOI: 10.2341/06-165] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Clinical Relevance
When adhesively cemented, tested fiber posts are fatigue resistant and appear to have no affect on bond strength to root dentin. Thus, the retention strength of these fiber posts could be maintained for an extended period; however, further studies should be conducted.
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