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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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Süsgün Yıldırım Z, Batmaz SG. Monomer release, cell adhesion, and cell viability of indirect restorative materials manufactured with additive, subtractive, and conventional methods. J Oral Sci 2024; 66:9-14. [PMID: 37866923 DOI: 10.2334/josnusd.23-0238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
PURPOSE The aim of this study was to measure residual monomer, cell adhesion, and cell viability of 3-dimensional printable permanent resin (PR), hybrid ceramic block (HCB), and indirect composite (IC) produced with additive, subtractive, and conventional techniques. METHODS Five 8 × 8 × 2 mm3 samples of each material were prepared for each experiment. In a 24-h period, monomer release was analyzed with high-performance liquid chromatography, and cell viability and adhesion were evaluated with the water-soluble tetrazolium salt test. Data were analyzed with IBM SPSS Statistics 26.0 statistical software, and results were regarded as significant at α = 0.05. RESULTS Monomer release (triethylene glycol dimethacrylate, urethane dimethacrylate, and Bisphenol A glycerolate dimethacrylate) was significantly higher in the IC group. Mean cell viability was significantly lower in the HCB group than in the IC group. CONCLUSION All monomers in the tested materials were released at rates that were below clinical significance. Cell adhesion rates in the groups were similar. Cytotoxic response was classified as minor in the HCB and PR groups and non-cytotoxic in the IC group.
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Affiliation(s)
| | - Sevde Gül Batmaz
- Department of Restorative Dentistry, Faculty of Dentistry, Cukurova University
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Fatigue performance of endodontically treated molars reinforced with different fiber systems. Clin Oral Investig 2023:10.1007/s00784-023-04934-2. [PMID: 36862198 DOI: 10.1007/s00784-023-04934-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 02/24/2023] [Indexed: 03/03/2023]
Abstract
OBJECTIVE The aim was to investigate the fatigue performance of root canal-treated (RCT) molars restored with different direct restorations utilizing discontinuous and continuous fiber-reinforced composite (FRC) systems. The impact of direct cuspal coverage was also evaluated. MATERIALS AND METHODS One hundred and twenty intact third molars extracted for periodontal or orthodontic reasons were randomly divided into six groups (n=20). Standardized MOD, regular cavities for direct restorations were prepared in all specimens, and subsequently, root canal treatment and root canal obturation was carried out. After the endodontic treatment, the cavities were restored with different fiber-reinforced direct restorations as follows: SFC group (control), discontinuous short fiber-reinforced composite (SFC) without cuspal coverage (CC); SFC+CC group, SFC with cuspal coverage; PFRC group, transcoronal fixation with continuous polyethylene fibers without CC; PFRC+CC group, transcoronal fixation with continuous polyethylene fibers with CC; GFRC group, continuous glass FRC post without CC; and GFRC+CC, continuous glass FRC post with CC. All specimens underwent a fatigue survival test in a cyclic loading machine until fracture occurred or 40,000 cycles were completed. The Kaplan-Meier survival analysis was conducted, followed by pairwise log-rank post hoc comparisons between the individual groups (Mantel-Cox). RESULTS The PFRC+CC group was characterized by significantly higher survival compared to all the groups (p < 0.05), except for the control group (p = 0.317). In contrast, the GFRC group showed significantly lower survival compared to all the groups (p < 0.05), except for the SFC+CC group (p = 0.118). The control group (SFC) showed statistically higher survival than the SFRC+CC group (p < 0.05) and GFRC group (p < 0.05), but it did not differ significantly from the rest of the groups in terms of survival. CONCLUSIONS Direct restorations utilizing continuous FRC systems (in the form of polyethylene fibers or FRC post) to restore RCT molar MOD cavities performed better in terms of fatigue resistance when CC was performed compared to the same FRC restorations without CC. On the contrary, teeth restored with SFC restorations performed better without CC compared to the ones where SFC was covered. CLINICAL RELEVANCE In the case of fiber-reinforced direct restorations for MOD cavities in RCT molars, direct CC is recommended when utilizing long continuous fibers for reinforcement, however, should be avoided when only SFC is used for their reinforcement.
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Doğramacı EJ, Rossi-Fedele G. Patient-related outcomes and Oral Health-Related Quality of Life in endodontics. Int Endod J 2023; 56 Suppl 2:169-187. [PMID: 36102371 DOI: 10.1111/iej.13830] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/08/2022] [Accepted: 09/09/2022] [Indexed: 11/30/2022]
Abstract
There is increased interest in outcome measures that complement the classic goal of endodontics, being the prevention and healing of apical periodontitis. Possible outcome measures can be subdivided into patient-centred outcomes (PCOs), encompassing data collected by nonpatients aiming to assess the effectiveness of an intervention and patient-reported outcomes (PROs), which are reported directly by the patient. PROs can be subsequently classed into PRO measures that ascertain patients' view of their symptoms, their functional status, and their health-related quality of life, and patient-reported experience measures that focus on aspects including the humanity of care, patient satisfaction, patient preference and adherence, personal costs, expectation fulfilment, and decision regrets. The present review aims to define various patient-related outcomes and discuss the literature available regarding PCOs and PROs in endodontics. This includes those proposed to assess the effectiveness of endodontic treatment for pulpitis and apical periodontitis for use in the development of European Society of Endodontology S3-level clinical practice guidelines that have been included by all working groups, except for the radiographic assessment of apical periodontitis. Based on limited evidence in the field, it can be summarized that after recall periods of various lengths, endodontic treatment is associated with a high likelihood of tooth survival and limited need for further intervention, including extraction and further restorative procedures. Oral Health-Related Quality of Life (OHRQoL) is likely to improve following the completion of treatment. Nonetheless, the literature assessing the association between OHRQoL and endodontics is hampered by the use of instruments that have not been previously validated. Amongst the remaining outcome measures discussed in the present review, it is worth highlighting that there is only one study assessing exacerbations in teeth with the presence of endodontic pathosis, which suggests a very low incidence of this adverse effect following endodontic treatment. Patients' expectation fulfilment, adherence, and satisfaction are closely inter-related and depend also on various nonclinical factors. Further studies assessing PCOs and PROs, in association with healing and prevention of apical periodontitis, are required to better understand endodontic treatment from the perspective of patients.
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Affiliation(s)
- Esma J Doğramacı
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Giampiero Rossi-Fedele
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
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Mario D, Mario A, Allegra C, Andrea B, Giuseppe T, Milena C, Annalisa M, Lorenzo B, Lorenzo LM, Nicola S. The influence of indirect bonded restorations on clinical prognosis of endodontically treated teeth: A systematic review and meta-analysis. Dent Mater 2022; 38:e203-e219. [PMID: 35835608 DOI: 10.1016/j.dental.2022.06.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 05/10/2022] [Accepted: 06/05/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE The loss of the dental coronal portion following carious lesions or fractures leads to endodontic treatment with subsequent restoration to ensure correct anatomy and function. Recently, partial adhesive restorations have been widely proposed to increase the survival rate of endodontically treated teeth. The primary purpose of this review is to assess the failure rate of indirect partial adhesive restorations on endodontically treated teeth (ETT), considering the follow-up period. METHODS The indications reported in the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) were used to draft the present review. The study was constructed on PICO questions: population (patients who need indirect adhesive restorative treatment on endodontically treated teeth with onlay and overlay), intervention (onlay and overlay), control (patients with onlay and overlay on endodontically treated teeth) and outcome (failure rate and types of failure for onlay and overlay). The asked scientific question was: what are the failure rate and types of failure for adhesive indirect partial restorations on ETT? RESULTS The overall failure rate that emerges is 0.087 with a ratio of 121/1254, I2 80 % p-value< 0.001. Moreover, by meta-regression with covariates the follow-up period reports a coefficient of 0.013 with a P-value< 0.001. In conclusion, the indirect partial restorations on endodontically treated teeth displayed overall acceptable outcomes in terms of success from 2 to 4 years after their placement with only 4.32 % of failure. Failures increase after 7 years up to 12-30 years with failure rates of approximatively 10.65 % and 20.94 %. The analysis of the included articles reporting the causes of restorations failures showed that 15.51 % of cases were related to the loss of dental element. SIGNIFICANCE Besides the survival rates of indirect adhesive restorations on endodontically treated posterior teeth, it was highlighted that the majority of failures appeared restorable. Thus, partial restorations seemed able to prevent the ETT tooth loss.
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Affiliation(s)
- Dioguardi Mario
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Alovisi Mario
- Department of Surgical Sciences, Dental School, Turin, Italy
| | - Comba Allegra
- Department of Surgical Sciences, Dental School, Turin, Italy
| | - Baldi Andrea
- Department of Surgical Sciences, Dental School, Turin, Italy
| | - Troiano Giuseppe
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Cadenaro Milena
- Department of Medical Sciences, University of Trieste, Trieste, Italy; Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", Trieste, Italy
| | - Mazzoni Annalisa
- Department for Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Breschi Lorenzo
- Department for Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Lo Muzio Lorenzo
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy(;)
| | - Scotti Nicola
- Department of Surgical Sciences, Dental School Lingotto, University of Turin, Turin, Italy.
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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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Reframing Perceptions in Restorative Dentistry: Evidence-Based Dentistry and Clinical Decision-Making. Int J Dent 2022; 2021:4871385. [PMID: 35003262 PMCID: PMC8741395 DOI: 10.1155/2021/4871385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 12/21/2021] [Indexed: 12/02/2022] Open
Abstract
Objectives The worldwide interest of both dentists and patients in esthetic dentistry has affected decision-making in dental practice. The aim of this study was to investigate contemporary dental practice in restorative dentistry and the relationship between evidence-based dentistry in caries research and decision-making in clinical practice in restorative dentistry. Methods The study was conducted through a structured questionnaire distributed randomly at the Jordanian Dental Association registered dentists in Jordan. The questionnaire aimed to clarify the degree of knowledge and practice of evidence-based dentistry in caries research the dentists hold regarding clinical decision-making in restorative dentistry. Results The majority of the surveyed dentists (77%) treat teeth with irreversible pulpitis with root canal treatment rather than vital pulp therapy. 13.8% routinely insert a post and 23% routinely crown the tooth after root canal treatment regardless of the remaining tooth structure. Badly damaged teeth are treated with full crowns in 72% of the cases. Regarding Hollywood smile or smile makeover, the majority of dentists choose conservative approaches, and implants were the first choice to replace missing teeth for 93.8% of the surveyed dentists. Conclusion A higher degree of implementation of evidence-based dentistry in clinical decision-making was found in Prosthetic Dentistry than in Endodontics. Yet, the gap between evidence-based data and clinical practice needs bridging. More emphasis on communicating these data to educators to integrate them into the dental curriculum is a must.
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Dioguardi M, Alovisi M, Troiano G, Caponio CVA, Baldi A, Rocca GT, Comba A, Lo Muzio L, Scotti N. Clinical outcome of bonded partial indirect posterior restorations on vital and non-vital teeth: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:6597-6621. [PMID: 34628547 PMCID: PMC8602142 DOI: 10.1007/s00784-021-04187-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 09/20/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The survival rate of indirect partial adhesive restorations on vital versus endodontically treated teeth is still controversial. The hypothesis is that there may be a difference in the survival rate of partial adhesive restorations performed on non-vital teeth compared to vital teeth. MATERIALS AND METHODS This systematic review was conducted following the PRISMA guidelines. The considered clinical studies investigated the outcomes of adhesive inlays, onlays, and overlays conducted over the past 40 years, focusing on Kaplan-Meier survival curves to calculate the hazard ratio (primary objective) and the survival rate (secondary objective) between vital and non-vital teeth. The risk of bias was assessed using the Newcastle-Ottawa Scale. Studies included in the review were identified through bibliographic research on electronic databases ("PubMed," "Scopus," "Cochrane Central Register of Controlled Trial," and "Embase"). The K agreement between the two screening reviewers was evaluated. RESULTS A total of 55,793 records were identified on PubMed, Scopus, and other bibliographic sources, and after the application of the eligibility and inclusion criteria, eight articles were included for qualitative analysis and six for quantitative analysis. The meta-analysis of the primary and secondary outcomes demonstrated that hazard ratios (HR = 8.41, 95% CI: [4.50, 15.72]) and survival rates (OR = 3.24, 95% CI: [1.76, 5.82]) seemed more favorable for indirect partial adhesive restorations on vital teeth than for those on endodontically treated teeth. CONCLUSIONS Within the limits of this study, these findings suggest that the risk of failure of indirect partial adhesive restorations on endodontically treated teeth is higher than on vital teeth. CLINICAL RELEVANCE The use of partial adhesive restorations on vital and endodontically treated teeth showed different long-term clinical outcomes.
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Affiliation(s)
- Mario Dioguardi
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy
| | - Mario Alovisi
- Department of Surgical Sciences, Dental School, University of Turin, Via Nizza 230, 10100, Turin, Italy
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy
| | - Carlo Vito Alberto Caponio
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy
| | - Andrea Baldi
- Department of Surgical Sciences, Dental School, University of Turin, Via Nizza 230, 10100, Turin, Italy
| | - Giovanni Tommaso Rocca
- Division of Cariology and Endodontology, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Allegra Comba
- Department of Surgical Sciences, Dental School, University of Turin, Via Nizza 230, 10100, Turin, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy
| | - Nicola Scotti
- Department of Surgical Sciences, Dental School, University of Turin, Via Nizza 230, 10100, Turin, Italy.
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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: 2.0] [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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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: 22] [Impact Index Per Article: 7.3] [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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Stress Concentration of Endodontically Treated Molars Restored with Transfixed Glass Fiber Post: 3D-Finite Element Analysis. MATERIALS 2021; 14:ma14154249. [PMID: 34361443 PMCID: PMC8347937 DOI: 10.3390/ma14154249] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 06/30/2021] [Accepted: 07/02/2021] [Indexed: 01/08/2023]
Abstract
The loss of dental structure caused by endodontic treatment is responsible for a decrease in tooth resistance, which increases susceptibility to fracture. Therefore, it is important that minimally invasive treatments be performed to preserve the dental structure and increase the resistance to fracture of endodontically treated posterior teeth. To evaluate under axial loads, using the finite element method, the stress distribution in endodontically treated molars restored with both transfixed or vertical glass fiber posts (GFP) and resin composite. An endodontically treated molar 3D-model was analyzed using finite element analyses under four different conditions, class II resin composite (G1, control model), vertical glass fiber post (G2), transfixed glass fiber posts (G3) and vertical and transfixed glass fiber posts (G4). Ideal contacts were considered between restoration/resin composite and resin composite/tooth. An axial load (300 N) was applied to the occlusal surface. The resulting tensile stresses were calculated for the enamel and dentin tissue from five different viewports (occlusal, buccal, palatal, mesial and distal views). According to the stress maps, similar stress trends were observed, regardless of the glass fiber post treatment. In addition, for the G1 model (without GFP), a high-stress magnitude can be noticed in the proximal faces of enamel (7.7 to 14 MPa) and dentin (2.1 to 3.3 MPa) tissue. The use of transfixed glass fiber post is not indicated to reduce the stresses, under axial loads, in both enamel and dentin tissue in endodontically treated molar with a class II cavity.
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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: 1.0] [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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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: 4.0] [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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Wan S, Tan Y, Xie J, Huang X, Guo L. The effect of a root-dentin pretreatment technique combining PIPS with MTAD aiming to improve the bond strength of glass fiber post. Microsc Res Tech 2020; 83:824-833. [PMID: 32187772 DOI: 10.1002/jemt.23474] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 02/16/2020] [Accepted: 03/08/2020] [Indexed: 11/07/2022]
Abstract
The aim of this study was to evaluate the combined effect of MTAD and photon-induced photoacoustic streaming (PIPS) technique on the smear layer removal and the bond strength of glass fiber post. Fifty-five human mandibular premolars were chosen. After root canal therapy and post space preparation, the teeth were equally divided to five groups according to the methods of root-dentin pretreatment: G1: distilled water (control); G2: 2.5% NaOCl+17% EDTA; G3: MTAD; G4: PIPS; G5: MTAD+PIPS. One sample was randomly selected from each group, and scanning electron microscope (SEM) was used to observe the microscopic morphology of the coronal, middle and apical level of the root-dentin. The remaining ten samples from each group were glued to glass fiber posts, and the bond strength was assessed by push-out test. SEM evaluation showed that the most complete smear layer removal was found in MTAD + PIPS group, especially in coronal third. Push-out test results exhibited that there was a statistically significant interaction between the experimental groups and root canal third (p < .0005). Significant differences could be found among five groups (p < .05): G5 > G4 > G3 > G2 > G1. G5 had the highest bond strength. In conclusion, post space pretreatments with MTAD or PIPS technique can significantly remove smear layer and improve the bond strength of glass fiber post, and combination of them works best.
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Affiliation(s)
- Shu Wan
- Department of prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, LuZhou, China
| | - Yujie Tan
- Department of prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, LuZhou, China
| | - Jing Xie
- Department of prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, LuZhou, China
| | - Xiaoyu Huang
- Department of prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, LuZhou, China
| | - Ling Guo
- Department of prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, LuZhou, China
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Patient history as a predictor of future treatment need? Considerations from a dataset containing over nine million courses of treatment. Br Dent J 2020; 228:345-350. [PMID: 32170254 DOI: 10.1038/s41415-020-1305-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Aim It is the aim of this paper to consider whether overall patient treatment history per se and what length of patient history, matters in predicting future treatment need.Methods This study used a data set (SN7024, available from UKDataService), consisting of treatment records for General Dental Services' (GDS) patients, this being obtained from all items of service payment records for patients treated in the GDS of England and Wales between 1990 and 2006. For the purpose of this study, the GDS dataset for patients attending in 2003 was restricted to adult patients (aged 18 or over on 31 December 1990; that is, year of birth earlier than 1973) who attended in both two-year periods 1991/2 and 2004/5. Each course of treatment was classified as 'active' (eg restoration, extraction, prosthesis) or 'not active' (eg prevention, diagnosis). Treatment costs for 2001-2005 (outcome), 2000 (one-year history), 1999-2000 (two-year history) and so on until 1991-2000 (ten-year history) were determined, and history and outcome correlated.Results A total of 455,844 patients met the inclusion criteria, namely adults with a full history. They received 9,341,583 courses of treatment, of which 49% were classified as 'active' and 51% as 'not active'. The analysis indicated that both total costs and active treatment costs are positively correlated with their historical values, with the correlation coefficients increasing from 0.24 and 0.25 with one year of history to 0.42 and 0.44 with ten years of history. Overall, therefore, future treatment cost is correlated with past treatment costs.Conclusions Treatment history may provide an important correlate of future dental treatment needs and the more history the better, at least up to five years. However, active treatment is the important component and should be distinguished from preventive and diagnostic treatments.
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Garcia PP, Cappoani A, Schelbauer RS, Correr GM, Gonzaga CC. Retrospective clinical and radiographic evaluation of restored endodontically treated teeth. Restor Dent Endod 2020; 45:e49. [PMID: 33294414 PMCID: PMC7691265 DOI: 10.5395/rde.2020.45.e49] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/10/2020] [Accepted: 06/16/2020] [Indexed: 11/11/2022] Open
Abstract
Objectives The aim of this study was to perform a clinical and radiographic analysis of endodontically treated teeth (ETT) restored with cast metal posts (CMPs) or prefabricated glass fiber posts (GFPs) and crowns. Materials and Methods Fifty ETT were restored with 25 CMPs and 25 GFPs at a private dental clinic between 2001 and 2016. The restorations consisted of 12 all-ceramic crowns, 31 metal-ceramic crowns, and 7 composite resin crowns. Demographic data, type of teeth, type of post-and-core system, time of placement, crown restorations, the number of proximal contacts, the type of antagonist, and reports of any complications after post-and-core placement were recorded for each patient. Assessments were performed at baseline (radiographic) and follow-up (radiographic and clinical). Data were analyzed by the McNemar test, the Pearson χ2 test, and Kaplan-Meier survival curves (α = 0.05). The mean follow-up was 67.6 months. Results No significant difference was observed for any of the radiographic parameters when the baseline and final radiographs were compared. In the clinical evaluation, anatomical form (p = 0.009) and occlusion (p = 0.001) showed significant differences according to the type of crown restoration; specifically, metal-ceramic and all-ceramic crowns outperformed composite resin crowns. Conclusions CMPs and GFPs showed favorable results for restoring ETT after 6 years of follow-up. All-ceramic and metal-ceramic crowns showed higher survival rates and better clinical outcomes.
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Affiliation(s)
- Paula Pontes Garcia
- School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, Curitiba, PR, Brazil
| | - Aline Cappoani
- School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, Curitiba, PR, Brazil
| | - Ricardo Susin Schelbauer
- School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, Curitiba, PR, Brazil
| | - Gisele Maria Correr
- School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, Curitiba, PR, Brazil
| | - Carla Castiglia Gonzaga
- School of Health Sciences, Graduate Program in Dentistry, Universidade Positivo, Curitiba, PR, Brazil
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Szabó B, Garoushi S, Braunitzer G, Szabó P B, Baráth Z, Fráter M. Fracture behavior of root-amputated teeth at different amount of periodontal support - a preliminary in vitro study. BMC Oral Health 2019; 19:261. [PMID: 31775721 PMCID: PMC6882155 DOI: 10.1186/s12903-019-0958-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 11/13/2019] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this study was to evaluate the effect of the amount of periodontal support on the fracture resistance of root-amputated maxillary molar teeth restored with either direct class. I. restorations or class II. mesio-occluso-distal (MOD) indirect overlay restorations with cuspal coverage. Methods Sixty sound maxillary first molars were collected and randomly divided into four groups. In Groups 1 and 2, MOD cavities were prepared and all cusps were reduced by 2 mm, whereas in Group 3 and 4, only a conservative Class I. cavity was prepared. Subsequently, root canal treatment was performed and the mesio-buccal roots were amputated. Groups 1 and 2 were restored with indirect composite overlay, while Groups 3 and 4 received direct composite fillings. After restoration, teeth were embedded as follows: Groups 1 and 3: normal bone level, Groups 2 and 4: furcation involvement. The specimens were submitted to static fracture resistance testing. Fracture thresholds and fracture patterns were measured and evaluated. Results Group 1 had the highest fracture resistance (2311,6 N) among the restored groups and showed statistically significant difference compared to Group 2 (p = 0.038) and Group 4 (p = 0.011). There was no statistically significant difference in terms of fracture resistance between the rest of the groups. In terms of the fracture patterns, Group 3 was characterized by the highest percentage (60%) of mostly favorable fractures, while the rest of the groups showed predominantly unfavorable ones. Conclusions The amount of periodontal support seems to influence the fracture resistance of root-amputated and restored maxillary molars.
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Affiliation(s)
- Balázs Szabó
- Department of Periodontology Faculty of Dentistry, University of Szeged, Szeged, Hungary
| | - Sufyan Garoushi
- Department of Biomaterials Science and Turku Clinical Biomaterials Center -TCBC Institute of Dentistry, University of Turku, Turku, Finland
| | | | - Balázs Szabó P
- Department of Food Engineering Faculty of Engineering, University of Szeged, Szeged, Hungary
| | - Zoltán Baráth
- Department of Prosthodontics Faculty of Dentistry, University of Szeged, Szeged, Hungary
| | - Márk Fráter
- Department of Operative and Esthetic Dentistry Faculty of Dentistry, University of Szeged, Tisza Lajos Krt., 64-66, Szeged, H-6720, Hungary.
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Lempel E, Lovász BV, Bihari E, Krajczár K, Jeges S, Tóth Á, Szalma J. Long-term clinical evaluation of direct resin composite restorations in vital vs. endodontically treated posterior teeth — Retrospective study up to 13 years. Dent Mater 2019; 35:1308-1318. [DOI: 10.1016/j.dental.2019.06.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/17/2019] [Accepted: 06/17/2019] [Indexed: 01/11/2023]
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Abu‐Awwad M. Dentists' decisions regarding the need for cuspal coverage for endodontically treated and vital posterior teeth. Clin Exp Dent Res 2019; 5:326-335. [PMID: 31452943 PMCID: PMC6704031 DOI: 10.1002/cre2.185] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 03/22/2019] [Accepted: 03/26/2019] [Indexed: 11/12/2022] Open
Abstract
Objectives Deciding when cuspal coverage is needed for posterior teeth is considered a challenge for dentists. The aims were to assess dentists' decision making regarding the need for cuspal coverage for vital teeth (VT) and endodontically treated teeth (ETT) with varying amounts of tooth structure loss and to identify clinical situations of dissimilarity and uncertainty in decision making. Materials and Methods A random sample of 182 dentists were invited to participate in the survey. The survey included photos of 13 posterior teeth: six VT and seven ETT. The clinical situations selected were based on a hypothetical scale of typodont teeth with ascending amounts of tooth structure loss. A brief description of each situation was provided. Each dentist was asked to decide whether cuspal coverage is needed, not needed, or unsure. Descriptive analyses using SPSS were conducted. Seventy-five percent was chosen as a cutoff point for assessing similarity in decision making. The unsure answer reflected uncertainty. Associations were assessed using chi-square test. Results One hundred twenty dentists participated (65.9% response rate, 70 females). Median for years of experience was 3.5 (interquartile range 1.1-10.8). Analyses revealed a similarity percentage of <75% in decision making among dentists for six clinical situations: four VT and two ETT. More similarity was observed for situations at both ends of the scale with minimal and severe amounts of tooth structure loss and more for ETT than for VT. The highest percentages of uncertainty were more for VT than for ETT. Clinical conditions of VT were more likely to receive the "not sure" decision compared with those of ETT (χ2, P < .001). No association was detected with gender (χ2, P = .509) or years of experience (χ2, P = .223). Conclusions Dissimilarity and uncertainty in deciding when cuspal coverage is needed were observed especially for VT and teeth with a moderate amount of structure loss.
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Affiliation(s)
- Motasum Abu‐Awwad
- Department of Prosthodontics, School of DentistryUniversity of JordanAmmanJordan
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20
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Garcia PP, Wambier LM, de Geus JL, da Cunha LF, Correr GM, Gonzaga CC. Do anterior and posterior teeth treated with post-and-core restorations have similar failure rates? A systematic review and meta-analysis. J Prosthet Dent 2019; 121:887-894.e4. [DOI: 10.1016/j.prosdent.2018.08.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 08/10/2018] [Accepted: 08/13/2018] [Indexed: 01/11/2023]
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Bakaus TE, Gruber YL, Reis A, Gomes JC, Gomes GM. Bonding properties of universal adhesives to root canals prepared with different rotary instruments. J Prosthet Dent 2019; 121:298-305. [DOI: 10.1016/j.prosdent.2018.02.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 02/10/2018] [Accepted: 02/12/2018] [Indexed: 11/30/2022]
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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: 3] [Impact Index Per Article: 0.5] [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: 6] [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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von Stein-Lausnitz M, Bruhnke M, Rosentritt M, Sterzenbach G, Bitter K, Frankenberger R, Naumann M. Direct restoration of endodontically treated maxillary central incisors: post or no post at all? Clin Oral Investig 2018; 23:381-389. [PMID: 29713887 DOI: 10.1007/s00784-018-2446-6] [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: 09/28/2017] [Accepted: 04/12/2018] [Indexed: 12/23/2022]
Abstract
OBJECTIVES The aim of this ex-vivo study was to evaluate the impact of cavity size and glass-fiber post (GFP) placement on the load capability of endodontically treated maxillary incisors directly restored with resin composite. MATERIALS AND METHODS Ninety-six extracted human maxillary central incisors were endodontically treated and distributed to four groups (n = 24): access cavity (A), access cavity and uni-proximal class III cavity (U), access cavity and bi-proximal class III cavity (B), and decoronated tooth (D). Specimens were restored with resin composite, and 12 specimen of each group received an adhesively placed glass-fiber post (P). Prior to linear loading, specimens were exposed to thermo-mechanical loading (TCML). Statistical analysis was performed using log-rank test after TCML, Kruskall-Wallis and Mann-Whitney U test to compare load capabilities (Fmax). RESULTS Significantly more failures occurred in group D for specimens without GFP during TCML (p = 0.001). Fmax (mean (SD) in N was (A) 513 (124), (AP) 554 (201), (U) 438 (171), (UP) 537 (232) (B) 483 (219), (BP) 536 (281), D 143 (181), and DP 500 (331), and differed significantly among groups (p = 0.003). Pair-wise comparison revealed lower Fmax values for group D compared to all other groups (p < 0.034) except group DP. CONCLUSIONS Endodontically treated maxillary central incisors with cavity sizes up to bi-proximal class III may be successfully directly restored with resin composite. Post placement shows no additional effect except for decoronated endodontically treated incisors. CLINICAL RELEVANCE Endodontically treated incisors with access cavities to class III cavities can be successfully restored with resin composite. Post placement for decoronated ETT is recommended.
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Affiliation(s)
- Manja von Stein-Lausnitz
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197, Berlin, Germany.
| | - M Bruhnke
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 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
| | - G Sterzenbach
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - K Bitter
- Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - R Frankenberger
- Department of Operative Dentistry and Endodontics, University of Marburg, Georg-Voigt-Str. 3, 35039, Marburg, Germany
| | - M Naumann
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
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25
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Ayna B, Ayna E, Çelenk S, Başaran EG, Yılmaz BD, Tacir İH, Tuncer MC. Comparison of the clinical efficacy of two different types of post systems which were restored with composite restorations. World J Clin Cases 2018; 6:27-34. [PMID: 29564355 PMCID: PMC5852396 DOI: 10.12998/wjcc.v6.i3.27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Revised: 01/05/2018] [Accepted: 02/05/2018] [Indexed: 02/05/2023] Open
Abstract
AIM To compare the efficacy of resin composite restorations, retained with either polyethylene or zirconia-rich glass fiber posts.
METHODS Sixty-two single rooted maxillary and mandibular central incisor teeth in forty-four patients (15 males and 29 females; age range 15-32 years) were restored either with an ultrahigh molecular weight polyethylene (UHMWP) fiber post (Bondable Reinforcement Ribbon, DENSE, Ribbond, Seattle, WA, United States) or a zircon-rich glass fiber post (Snowpost, Lot H 040; Carbotech, Ganges, France). Then, direct resin composite restoration (Clearfil AP-X, Kuraray) was performed for both post systems in tooth color suitable. Patients were recalled for routine inspections at 6 mo, 1, 2 and 3 years.
RESULTS The restorations were assessed during each recall evaluation according to predetermined clinical and radiographic criteria (periapical lesion; marginal leakage and integrity; color stability; surface stain and loss of retention of the post or the composite build-up material). The follow-up data showed no significant difference in these criteria between polyethylene fibre posts and zirconia-rich glass fibre posts.
CONCLUSION The efficacy of resin composite restorations, retained with either polyethylene or zirconia-rich glass fiber posts were similar, suggesting that both types of fiber post can be used successfully to help retain resin composite restorations.
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Affiliation(s)
- Buket Ayna
- Department of Pedodontics, Faculty of Dentistry, Dicle University, Diyarbakır 21280, Turkey
| | - Emrah Ayna
- Department of Prosthodontics, Faculty of Dentistry, Dicle University, Diyarbakır 21280, Turkey
| | - Sema Çelenk
- Department of Pedodontics, Faculty of Dentistry, Dicle University, Diyarbakır 21280, Turkey
| | - Emine Göncü Başaran
- Department of Prosthodontics, Faculty of Dentistry, Dicle University, Diyarbakır 21280, Turkey
| | - Berivan Dündar Yılmaz
- Department of Prosthodontics, Faculty of Dentistry, Dicle University, Diyarbakır 21280, Turkey
| | - İbrahim Halil Tacir
- Department of Prosthodontics, Faculty of Dentistry, Dicle University, Diyarbakır 21280, Turkey
| | - Mehmet Cudi Tuncer
- Department of Anatomy, Faculty of Medicine, Dicle University, Diyarbakır 21280, Turkey
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Forster A, Braunitzer G, Tóth M, Szabó BP, Fráter M. In Vitro Fracture Resistance of Adhesively Restored Molar Teeth with Different MOD Cavity Dimensions. J Prosthodont 2018; 28:e325-e331. [DOI: 10.1111/jopr.12777] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2017] [Indexed: 11/30/2022] Open
Affiliation(s)
- András Forster
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry; University of Szeged; Szeged Hungary
| | - Gábor Braunitzer
- Department of Oral Surgery; Faculty of Dentistry University of Szeged; Szeged Hungary
| | - Máté Tóth
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry; University of Szeged; Szeged Hungary
| | - Balázs P. Szabó
- Faculty of Engineering, Department of Food Engineering; University of Szeged; Szeged Hungary
| | - Márk Fráter
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry; University of Szeged; Szeged Hungary
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Barcelos LM, Bicalho AA, Veríssimo C, Rodrigues MP, Soares CJ. Stress Distribution, Tooth Remaining Strain, and Fracture Resistance of Endodontically Treated Molars Restored Without or With One or Two Fiberglass Posts And Direct Composite Resin. Oper Dent 2017; 42:646-657. [DOI: 10.2341/16-224-l] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
ABSTRACT
Objectives:
To evaluate the effects of direct composite resin without a post or with one or two fiberglass posts on the restoration of severely compromised endodontically treated molars.
Methods and Materials:
Forty-five molars with 2 mm of “remaining tooth structure” were divided into three groups: Wfgp, restored with Filtek Z350XT without a fiberglass post; 1fgp, restored with Z350XT with one fiberglass post in the distal root canal; and 2fgp, restored with Z350XT with two fiberglass posts, one in the distal root canal and the other in the mesial-buccal root canal. The teeth were load cycled. Tooth remaining strain was measured using strain gauges (n=10) at two moments: TrSt-100 N, during 100 N occlusal loading, and TrSt-Fr, at fracture load. Fracture resistance was calculated, and fracture mode was classified. The elastic modulus and Vickers hardness were calculated using dynamic indentation (n=5). Stress distribution was analyzed by three-dimensional finite element analysis.
Results:
The use of two fiberglass posts resulted in lower fracture resistance than was noted in the groups with one fiberglass post and without fiberglass posts. The lingual surface of the remaining tooth had higher strain values than the buccal surface, regardless of the restorative technique and moment of evaluation. The absence of a fiberglass post resulted in significantly higher strain values and more irreparable fracture modes than were noted in the other groups. The use of one fiberglass post had a better strain/fracture resistance ratio. Stresses were concentrated in the occlusal portion of the post and in the furcation region. The presence of one fiberglass post resulted in better stress distribution in the entire distal root dentin, reducing stress on the critical areas.
Conclusions:
The use of one fiberglass post for restoring molars with direct composite resin resulted in higher fracture resistance than did the use of two fiberglass posts; it also resulted in better tooth remaining strain and stress distribution and more reparable fracture modes than were seen in the group without a fiberglass post.
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Affiliation(s)
- LM Barcelos
- Luciana Mendes Barcelos, Department of Operative Dentistry and Dental Materials, Dental School, Federal University of Uberlândia, Minas Gerais, Brazil
| | - AA Bicalho
- Aline Aredes Bicalho, Technical Health School, Federal University of Uberlândia, Minas Gerais, Brazil
| | - C Veríssimo
- Crisnicaw Veríssimo, School of Dentistry, University of Uberaba, Uberaba, Minas Gerais, Brazil
| | - MP Rodrigues
- Monise de Paula Rodrigues, Department of Operative Dentistry and Dental Materials, Dental School, Federal University of Uberlândia, Minas Gerais, Brazil
| | - CJ Soares
- Carlos Jose Soares, Department of Operative Dentistry and Dental Materials, Dental School, Federal University of Uberlândia, Minas Gerais, Brazil
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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: 3.5] [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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Skupien JA, Opdam NJ, Winnen R, Bronkhorst EM, Kreulen CM, Pereira-Cenci T, Huysmans MC. Survival of Restored Endodontically Treated Teeth in Relation to Periodontal Status. Braz Dent J 2016; 27:37-40. [DOI: 10.1590/0103-6440201600495] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 01/12/2016] [Indexed: 11/22/2022] Open
Abstract
Abstract The aim of the present study was to investigate the success and survival of restored endodontically treated teeth (ETT) in a general practice environment related to periodontal parameters. Data from 360 restored ETT treated between 2000 and 2011 were collected. Dates of interventions like restorations, repairs, replacements and extractions were recorded. Additionally, general information about patients and dentitions as well as periodontal status was recorded. Success was analyzed using Kaplan-Meier statistics and a multivariate Cox regression analysis was performed to assess variables influencing success and survival. After a mean observation time of 4.34 years (range 0.6 - 11.6 years), 19 teeth were extracted and 27 restorations needed repair or replacement. According to the Cox regression, increasing maximum pocket depth of the tooth resulted in a higher risk for failure (p=0.012). In conclusion, periodontal pocket depth was found to be a significant factor in the survival of restored ETT.
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Frankenberger R, Zeilinger I, Krech M, Mörig G, Naumann M, Braun A, Krämer N, Roggendorf MJ. Stability of endodontically treated teeth with differently invasive restorations: Adhesive vs. non-adhesive cusp stabilization. Dent Mater 2015; 31:1312-20. [PMID: 26411645 DOI: 10.1016/j.dental.2015.08.160] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 08/11/2015] [Accepted: 08/17/2015] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Aim of the present study was to evaluate fracture strength of endodontically treated molars with different preparations/restorations after thermomechanical loading in vitro. METHODS 264 extracted human third molars were used. Beside the control group, 256 teeth in 32 test groups (n=8) received root canal treatment (MTwo #40/.6) and root canal obturation with AH Plus and Guttapercha. After postendodontic sealing and build-up (Syntac, SDR), specimens were additionally prepared MO or MOD. Postendodontic restorations were: Direct restorations (Tetric EvoCeram Bulk Fill bonded with Syntac; as filling or direct partial crown (PC) after reducing the cusps 3mm; amalgam as filling or direct pin-retained partial crown (PC)), vs. indirect adhesive restorations (I: Inlay vs. PC; IPS Empress I/PC; Celtra Duo I/PC; e.max CAD I/PC; Lava Ultimate I/PC; Enamic I/PC - all inserted with Syntac/Variolink) vs. cemented cast gold I/PC. After 300,000 thermocycles (5/55°C) and 1.2 Mio. 100N load cycles, specimens were loaded until fracture. RESULTS Whereas IPS Empress showed no difference between I and PC (p>0.05), in all other groups PC were significantly more stable than fillings/inlays (p<0.05), this effect was more pronounced after MOD preparations. Cast gold PC exhibited the highest fracture strengths (p<0.05), inlays the lowest (p<0.05). IPS Empress was generally inferior to the other bonded materials under investigation (p<0.05) which as PC almost reached the level of control specimens. Amalgam fillings showed the worst outcome (p<0.05). SIGNIFICANCES Less invasive preparation designs were not beneficial for the stability of postendodontic restorations. Except for IPS Empress, PC were generally more successful in restabilization of weakened cusps after endodontic treatment and preparation. Cast gold PC remain the ultimate stabilization tool for ETT in terms of fracture resistance.
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Affiliation(s)
- Roland Frankenberger
- Department of Operative Dentistry and Endodontics, Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Marburg, Georg-Voigt-Str. 3, D-35039 Marburg, Germany.
| | - Inka Zeilinger
- Department of Operative Dentistry and Endodontics, Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Marburg, Georg-Voigt-Str. 3, D-35039 Marburg, Germany
| | - Michael Krech
- Department of Operative Dentistry and Endodontics, Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Marburg, Georg-Voigt-Str. 3, D-35039 Marburg, Germany
| | - Gernot Mörig
- Department of Operative Dentistry and Endodontics, Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Marburg, Georg-Voigt-Str. 3, D-35039 Marburg, Germany; Private Practice, Düsseldorf, Germany
| | - Michael Naumann
- Department of Prosthetic Dentistry, University of Ulm, Albert-Einstein-Allee 11, D-89081 Ulm, Germany
| | - Andreas Braun
- Department of Operative Dentistry and Endodontics, Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Marburg, Georg-Voigt-Str. 3, D-35039 Marburg, Germany
| | - Norbert Krämer
- Department of Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Giessen, Schlangenzahl 14, D-35392 Giessen, Germany
| | - Matthias J Roggendorf
- Department of Operative Dentistry and Endodontics, Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Marburg, Georg-Voigt-Str. 3, D-35039 Marburg, Germany
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