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Stoilov M, Boehmer T, Stoilov L, Stark H, Marder M, Enkling N, Kraus D. Influence of Cementation Mode and Ferrule Design on the Fatigue Resistance of Monolithic Zirconia Endocrowns. J Clin Med 2024; 13:1165. [PMID: 38398475 PMCID: PMC10889707 DOI: 10.3390/jcm13041165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/13/2024] [Accepted: 02/17/2024] [Indexed: 02/25/2024] Open
Abstract
Background: Classic endocrowns made of dental ceramics are considered a promising alternative to traditional post-endodontic restorations. The use of circular ferrules in endocrowns is a topic of controversial discussion. Therefore, the present study aims to evaluate the effect of ferrule design and cementation mode on the fatigue resistance of zirconia endocrowns. Methods: Eighty human molars were divided into four groups (n = 20): NFC (no-ferrule, conventional cementation), NFA (no-ferrule, adhesive luting), FC (ferrule, conventional cementation) and FA (ferrule, adhesive luting). Both the classic and the modified endocrown preparation with a two-millimeter ferrule design were carried out. Endocrowns were fabricated from zirconia using the CEREC system. After thermocycling, specimens were loaded according to the step-stress test up to 1500 N. Results: Failure rate was low; 88.8% of total specimens passed the step-stress test. Fractures were distributed between all groups; no significant differences in fatigue resistance were detected for preparation design and cementation mode. Conclusions: Endocrowns appear to be a promising concept for endodontically treated molars. Ferrule and also cementation mode have only a minor influence on fatigue resistance of zirconia endocrowns. However, at very high forces, the marginal area of the ferrule represents a weak point.
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Affiliation(s)
- Milan Stoilov
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
| | - Tobias Boehmer
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
| | - Lea Stoilov
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
| | - Helmut Stark
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
| | - Michael Marder
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
| | - Norbert Enkling
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
- Department of Reconstructive Dentistry and Gerodontology, Bern University, 3012 Bern, Switzerland
| | - Dominik Kraus
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
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Lenz U, Bacchi A, Della Bona A. Biomechanical performance of endocrown and core-crown restorations: A systematic review. J ESTHET RESTOR DENT 2024; 36:303-323. [PMID: 37571973 DOI: 10.1111/jerd.13119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/26/2023] [Accepted: 07/29/2023] [Indexed: 08/13/2023]
Abstract
OBJECTIVE To assess and compare, through a systematic review of the literature, the biomechanical performance of endocrowns and traditional core-crowns (with and without intracanal post) for the rehabilitation of endodontically treated teeth with severe coronal structure damage. MATERIALS AND METHODS A systematic search was performed in MEDLINE/PubMed, Scopus, and Web of Science databases. In-vitro studies comparing endocrowns with (post-)core-crown restorations were selected and screened by two independent reviewers. The included studies were submitted to the risk of bias analysis using the RoBDEMAT tool and the biomechanical outcomes were collected for qualitative analysis. The extracted data were presented based on comparative analyses among the included studies. RESULTS Thirty-one studies were included: 9 studies evaluated restorations of molars, 14 for premolars, and 8 studies evaluated anterior restorations. For the majority of the studies, endocrowns showed either similar or greater survival rates under fatigue and monotonic load than (post-)core-crown restorations, irrespectively of the tooth. The endocrowns showed more favorable failure patterns than (post-)core-crowns, irrespectively of the tooth. Endocrowns produced lower stresses in the restorative material for molars and premolars and in the luting material for premolars than (post-)core-crown restorations. The included studies presented adequate information for most items of the RoBDEMAT risk of bias tool. CONCLUSION Endocrowns showed similar or greater biomechanical performance than the traditional (post-)core-crown restorations in most of the evaluated studies. CLINICAL SIGNIFICANCE This systematic review showed that endocrowns present either similar or greater biomechanical performance than core-crown restorations for anterior and posterior endodontically treated teeth with severe structural damage.
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Affiliation(s)
- Ulysses Lenz
- Postgraduate Program in Dentistry, University of Passo Fundo, Passo Fundo, Brazil
| | - Atais Bacchi
- Postgraduate Program in Dentistry, Paulo Picanço School of Dentistry, Fortaleza, Brazil
| | - Alvaro Della Bona
- Postgraduate Program in Dentistry, University of Passo Fundo, Passo Fundo, Brazil
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Michaud PL, Dort H. Do onlays and crowns offer similar outcomes to posterior teeth with mesial-occlusal-distal preparations? A systematic review. J ESTHET RESTOR DENT 2024; 36:295-302. [PMID: 37497796 DOI: 10.1111/jerd.13114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 05/22/2023] [Accepted: 07/14/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVE Teeth prepared for mesial-occlusal-distal (MOD) restorations have a significant risk of cusp fracture. Crowns and onlays can provide cusp coverage to reinforce posterior teeth at risk. Onlays are often more conservative of tooth structure which may be an advantage for teeth with large MOD preparations. It remains uncertain how onlays and crowns compare for posterior teeth with MOD tooth structure loss. The purpose of this systematic review was to compare the resistance to fracture, success rate, survival rate, and failure rate of teeth with MOD preparations restored with onlays or crowns. MATERIALS AND METHODS An electronic search queried Medline (PubMed), Embase (Ovid), Scopus, the Cochrane Library, and grey literature (OpenGrey) from database inception through April 29, 2023. RESULTS After eliminating duplicates and irrelevant records, 32 manuscripts were assessed. Only three publications met the criteria for inclusion. Most exclusions were due to poor reporting of restorative design and the amount of tooth structure remaining, or due to combining various restorative designs. Due to the limited sample size and high heterogeneity, no meta-analysis was conducted. One study observed a better outcome for onlays and two observed no difference. All three studies reported the mode of failure for crowns as more catastrophic whereas teeth with onlays could be salvaged. CONCLUSIONS Onlays may be an advantageous alternative to crowns for teeth with MOD preparations, but the level of evidence is insufficient to draw meaningful conclusions. CLINICAL SIGNIFICANCE Current evidence is insufficient to determine whether onlays or crowns are providing a different outcome when used to restore posterior teeth with MOD tooth structure loss. However, the fracture of teeth with MOD tooth structure loss restored with onlays appears to be less catastrophic than when restored with crowns.
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Affiliation(s)
- Pierre-Luc Michaud
- Department of Dental Clinical Sciences, Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Hillary Dort
- Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia, Canada
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Abbas MH, Elerian FA, Elsherbiny AA, Elgohary NMM, Atout A. Influence of occlusal reduction design on the fracture resistance and biomechanical behavior of endocrowns restoring maxillary premolars. BMC Oral Health 2024; 24:113. [PMID: 38243249 PMCID: PMC10799380 DOI: 10.1186/s12903-023-03688-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/21/2023] [Indexed: 01/21/2024] Open
Abstract
PURPOSE To investigate the effect of different occlusal reduction design on stress distribution and fracture resistance of different endocrown systems. MATERIAL AND METHODS Sixty-four maxillary human premolars with endodontic treatment, prepared for endocrowns were divided into 2 groups (n = 32) according to the occlusal design: Butt joint preparation (B group) and Anatomical preparation (A group). Each group were subdivided into four groups according to ceramic systems: IPS E max CAD (EM group), monolithic zirconia (ZR group), Nacera Hyprid (NH group) and PEKKTON (PE group). After manufacturing of endocrowns and adhesive bonding the specimens were thermomechanically loaded and subsequently they were tested in a universal testing machine for evaluating the fracture resistance. The specimens failure mode was qualitatively assessed. The stress distribution in each group was assessed using three-dimensional finite element analysis (FEA). 1-way ANOVA and the Post Hoc Tukey HSD test were used to evaluate the data (a = .05). RESULTS The fracture resistance values between the groups showed statistically significant variations. The B PE and A PE groups had a higher ratio of fracture resistance values. Regarding failure mode, ceramic endocrowns recorded mainly irreparable failures. FEA showed that anatomical occlusal preparation have reduced the stress concentration under all endocrown systems. CONCLUSION Endocrowns could be used to restore endodontically treated maxillary premolars. PEKKTON endocrowns with anatomical preparations revealed most appropriate restoration. The tested new endocrown systems enhanced the biomechanical performance of the tooth. CLINICAL SIGNIFICANCE The innovative endocrown systems (PEKK, Nacera Hyprid) can be seen as a promising choice for restoration of severely-destructed endodontic treated premolars, with less stress transmit to the residual tooth structure. Although the traditional endocrown technology might increase the longevity of tooth bonding, it shouldn't be used for clenching cases since the risk of failure is too great overall.
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Affiliation(s)
- Mahy Hassouna Abbas
- Fixed Prosthodontics Dept, Faculty of Dentistry, Mansoura University and Delta University for Science and Technology, Mansoura, Egypt.
| | - Fatma Abdallah Elerian
- Department of Mechanical Engineering, College of Engineering, University of Bisha, P.O. Box 001, Bisha, 67714, Saudi Arabia
- Mansoura University, Mansoura, Egypt
| | - Abdallah Ahmed Elsherbiny
- Production Engineering and Mechanical Design Department, Faculty of Engineering, Mansoura University, Mansoura, Egypt
| | | | - Abeer Atout
- Department of prosthetic dental sciences , College of Dentistry, Jazan University, KSA and Fixed Prosthodontics Dept, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Al Fodeh RS, Al-Johi OS, Alibrahim AN, Al-Dwairi ZN, Al-Haj Husain N, Özcan M. Fracture strength of endocrown maxillary restorations using different preparation designs and materials. J Mech Behav Biomed Mater 2023; 148:106184. [PMID: 37839334 DOI: 10.1016/j.jmbbm.2023.106184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/07/2023] [Accepted: 10/10/2023] [Indexed: 10/17/2023]
Abstract
PURPOSE This study investigated the impact of preparation design and material types on fracture strength in maxillary premolars endocrowns after thermodynamic aging. MATERIALS AND METHODS Eighty two-rooted maxillary premolar crowns underwent endodontic treatment (N = 80, n = 10). The teeth were categorized into ten groups (4-mm deep with no intracanal extension lithium disilicate glass ceramic & multilayer zirconia endocrowns (LE0 & ZE0); 4-mm deep with 4-mm intracanal extension in one canal (LE1 & ZE1); 4-mm deep with 2-mm intracanal extensions in both canals (LE2 & ZE2); flat overlays with no endocore (LO & ZO); glass fiber reinforced post & core and crown (LC & ZC)). After cementation, all specimens were subjected to 1500 thermocycles and 1,200,000 chewing cycles with an axial occlusal load of 49 N. A static loading test was performed at a non-axial 45° loading using a universal testing machine and failure modes (Type I: restoration debonding; Type II: restoration fracture; Type III: restoration/tooth complex fracture above bone level; Type IV: restoration/tooth complex fracture below bone level) were evaluated using a stereoscope. Data were ananalzed using 2-way ANOVA and Tukey's tests (alpha = 0.05). RESULTS The endocrowns manufactured from multilayered zirconia and pressed lithium disilicate glass ceramic exhibited a fracture load ranging between 1334 ± 332 N and 756 ± 150 N, with ZC presenting the highest and LE2 the lowest values. The differences were not statistically significant (p > 0.05). CONCLUSION All endocrowns tested in this study performed similar considering the different designs and materials tested. The distribution of fracture modes did not differ significantly depending on the design of the restoration and the type of material used.
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Affiliation(s)
- Rami S Al Fodeh
- Department of Prosthodontics, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Omer S Al-Johi
- Department of Prosthodontics, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Anas N Alibrahim
- Department of Prosthodontics, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Ziad N Al-Dwairi
- Department of Prosthodontics, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Nadin Al-Haj Husain
- Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland; Clinic of Masticatory Disorders and Dental Biomaterials, Center of Dental Medicine, University of Zurich, Zurich, Switzerland; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Mutlu Özcan
- Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland; Clinic of Masticatory Disorders and Dental Biomaterials, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
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Saratti CM, Scotti N, Comba A, Bijelic-Donova J, Suchy T, Abdelaziz M, Leprince JG, Rocca GT. Exploring the influence of placing bi-directional E-glass fibers as protective layer under a CAD-CAM resin composite on the fracture pattern. Dent Mater 2023; 39:986-993. [PMID: 37734973 DOI: 10.1016/j.dental.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 08/17/2023] [Accepted: 09/15/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVES To investigate the influence of the presence and position of bidirectional E-glass fibers under a CAD-CAM resin composite on the fracture pattern evaluated both after quasi-static mechanical loading and after fatigue. METHODS Rectangular specimens (10 mm-long, 5 mm-large and 4.2 mm-thick) were prepared and divided into four groups (n = 30/group). The control group (C-Group) consisted of a 4.2 mm-thick layer of monolithic CAD/CAM resin composite resin (Cerasmart, GC). In the 3 other groups including the placement of a fiber layer (F-Groups), the CAD/CAM resin composite layer was reduced to 3-, 2- and 1-mm thickness (F3-, F2- and F1-Groups, respectively). Two bonded layers of bidirectional E-glass FRC (Dentapreg, ADM A.S.) were bonded underneath and a light-curable resin composite base (Gaenial Posterior, GC) was then added to reach a total thickness of 4.2 mm for all samples. In each group, half of the specimens (n = 15) were submitted to quasi-static mechanical loading to failure in a universal testing machine. The other half (n = 15) was subjected to cyclic isometric stepwise loading until failure or completion of 105000 cycles (5000 cycles at 500 N, followed by five stages of 20000 cycles at 750 N, 1000 N, 1250 N, 1500 N, and 1750 N). The data were analyzed by Weibull statistics for quasi-static loading, and by the Kaplan-Meier product limit estimation procedure after fatigue. All fractured specimens were studied using light and electron microscopy techniques, and the types of fracture were determined. RESULTS For quasi-static mechanical loading, significant differences were observed for Weibull modulus and characteristic strength between groups, with values ranging from 10.8 to 22.4 for the former and from 2336.6 to 2974.7 for the latter. Also, survival after stepwise fatigue revealed statistically significant differences between groups (p < 0.05), the lowest values of cycles before failure being observed for F1-Group - Median = 61223 (50415; 65446) - as compared to the other groups - C-Group: Median = 89005 (86189; 98195); F3-Group: Median = 85198 (77279; 87860); F2-Group: Median = 89306 (87454; 97024). Both in quasi-static loading and after fatigue, the observation of fracture modes revealed major differences. While all fractures were vertical (split) in C-Group, the majority of the specimens in F-Groups presented some degree of horizontal deflection of the crack. In all deviated fractures, fractographic analysis confirmed a toughening effect of the fiber layer. SIGNIFICANCE The present in vitro work tends to show that the fracture pattern of CAD-CAM resin composites is favorably affected by the presence and position of an underlying bidirectional E-glass fiber layer. The placement of E-glass fibers under a CAD-CAM resin composite may therefore represent an interesting strategy to reduce the risk of catastrophic restoration failure, which could be integrated in the development of the new generation of indirect materials, possibly in 3D-printing approaches.
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Affiliation(s)
- C M Saratti
- Division of Cariology and Endodontology, School of Dentistry, University of Geneva, Geneva, Switzerland.
| | - N Scotti
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy
| | - A Comba
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy
| | - J Bijelic-Donova
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku, Lemminkäisenkatu 2, Turku, Finland
| | - T Suchy
- Department of Composites and Carbon Materials, Institute of Rock Structure and Mechanics, Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - M Abdelaziz
- Division of Cariology and Endodontology, School of Dentistry, University of Geneva, Geneva, Switzerland
| | - J G Leprince
- Division of Cariology and Endodontology, School of Dentistry, University of Geneva, Geneva, Switzerland
| | - G T Rocca
- Division of Cariology and Endodontology, School of Dentistry, University of Geneva, Geneva, Switzerland
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Veselinova M, Diamantopoulou S, Paximada C, Papazoglou E. In-Vitro Comparison of Fracture Strength of Endocrowns and Overlays in Endodontically Treated Teeth Manufactured with Monolithic Lithium Disilicate and Zirconia. J Funct Biomater 2023; 14:422. [PMID: 37623666 PMCID: PMC10455451 DOI: 10.3390/jfb14080422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/25/2023] [Accepted: 08/08/2023] [Indexed: 08/26/2023] Open
Abstract
To evaluate the fracture strength and the failure mode of endodontically treated molars restored with monolithic lithium disilicate and zirconia endocrowns and overlays. A total of 48 extracted mandibular molars were endodontically treated, decoronated 2 mm above the cementoenamel junction and divided into four 12-specimen groups. Group ELD: lithium disilicate endocrowns. Group EZ: monolithic zirconia endocrowns. Group OLD: lithium disilicate overlays. Group OZ: monolithic zirconia overlays. Overlays did not extend in the pulp chamber and endocrowns extended in the pulp chamber 2 mm. After adhesive bonding of the restorations, the specimens were subjected to thermocycling (×5000 cycles) and then to fracture resistance testing at lateral static loading (1 mm/min) at a universal testing machine. The failure mode of the specimens was qualitatively evaluated. Differences in means were compared using with t-tests for independent samples or Mann-Whitney test (p < 0.05). Weibull distribution analysis was also performed. Group ELD showed significantly higher fracture strength than all other groups (p = 0.001), and the highest Weibull modulus. Conclusions: Lithium disilicate endocrowns exhibit higher fracture strength and are more reliable compared to the other types of restorations examined. Endocrowns had more catastrophic failures compared to overlays.
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Affiliation(s)
| | | | | | - Efstratios Papazoglou
- Department of Operative Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.V.); (S.D.); (C.P.)
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El-Farag SAA, Elerian FA, Elsherbiny AA, Abbas MH. Impact of different CAD/CAM materials on internal and marginal adaptations and fracture resistance of endocrown restorations with: 3D finite element analysis. BMC Oral Health 2023; 23:421. [PMID: 37357307 DOI: 10.1186/s12903-023-03114-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 06/06/2023] [Indexed: 06/27/2023] Open
Abstract
PURPOSE To assess and compare the impact of various computers aided design/manufacturing (CAD/CAM) materials on internal and marginal discrepancies, fracture resistance and failure probability of Endocrown restorations with 3D Finite Element analysis. MATERIAL AND METHODS Forty devitalized human maxillary first molars were collected. After endodontic treatment, they classified into 4 groups (n = 10) based on the materials used for endocrown fabrication. Group V (Vita-Enamic), Group N (Nacera Hybrid), Group T (Translucent Prettau Zirconia) and Group P (Pekkton ivory). All samples were exposed to artificial aging method simulating one year of clinical service. Silicone replica technique and stereomicroscope (25X) utilized to evaluate the marginal and internal gaps of endocrowns at different areas. Fracture resistance test used for cemented specimens followed by qualitative investigation utilizing Stereomicroscopy. Four models representing four endocrown systems used for restoration of severely-damaged endodontically treated upper first molar were generated for finite element analysis (FEA). Axially and centrally static occlusal compressive load was applied. Modified Von Mises and maximum principal stress values on the remaining tooth structure, cement lines and restorative materials were assessed independently. Resulted data were statistically analyzed at P-value ≤ 0.05. RESULTS In the current study, the highest mean values of internal and marginal discrepancies (μm) among studied groups were reported for Zirconia group (100.300 and 102.650) respectively, while the lowest mean value of internal discrepancy (μm) was observed for Nacera group (69.275) and the lowest mean value of marginal discrepancy (μm) was observed for PEKK group (78.4750). Regarding internal discrepancy, Vita-Enamic and PEKK groups did not exhibit any statistically significant differences (P = 0.293), however zirconia and the other tested groups exhibited statistically significant differences in the mean values of the marginal gap region (p 0.05).On the other hand, PEKK group showed the highest mean value of fracture resistance (1845.20 N) and the lowest value was observed for Vita-Enamic group (946.50 N). Regarding to stress distributions through 3D FEA, and according to modified von Mises (mvM) analysis, the greatest possible stress values were noticed in PEKK model in relation to tooth structure, cement line, and flowable composite as the following: (93.1, 64.5, 58.4 MPa) respectively, while Zirconia revealed lower maximum stress values (11.4, 13.6, 11.6 MPa) respectively. CONCLUSIONS Statistically excellent marginal and internal fit was observed for PEKK in relation to other used endocrown materials. Also, PEKK material explained fracture resistance comparable to zirconia value while the lowest value was detected for Vita Enamic material.
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Affiliation(s)
- Shaimaa Ahmed Abo El-Farag
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University and Horus University (HUE), Mansoura, Egypt
| | - Fatma Abdallah Elerian
- Production and Mechanical Design Department, Faculty of Engineering, Mansoura University, Mansoura, 35516, Egypt
| | - Abdallah Ahmed Elsherbiny
- Production and Mechanical Design Department, Faculty of Engineering, Mansoura University, Mansoura, 35516, Egypt
| | - Mahy Hassouna Abbas
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University and Delta University for Science and Technology, Mansoura, Egypt.
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Qamar Z, Alghamdi AMS, Haydarah NKB, Balateef AA, Alamoudi AA, Abumismar MA, Mathur A, Minervini G. In Vitro Evaluation of Lithium Disilicate Endocrowns and Post and Core Crowns-A Systematic Review. J Funct Biomater 2023; 14:jfb14050276. [PMID: 37233386 DOI: 10.3390/jfb14050276] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/25/2023] [Accepted: 05/08/2023] [Indexed: 05/27/2023] Open
Abstract
The aim of this systematic review was to summarize the results of the studies that have compared the physical and mechanical properties of lithium disilicate (LDS) endocrowns constructed for posterior teeth to those retained by post-and-core retention systems. The review was conducted following the PRISMA guidelines. The electronic search process was conducted on PubMed-Medline, Scopus, Embase and ISI Web of Knowledge (WoS) from the earliest available date till 31 January 2023. Additionally, the studies were assessed for their overall quality and risk of bias using the Quality Assessment Tool For In Vitro Studies (the QUIN). The initial search resulted in 291 articles, out of which, only 10 studies met the eligibility criteria. In all studies LDS endocrowns were compared with various kinds of endodontic posts and crowns made from other materials. There were no definite pattern or trends observed in the fracture strengths of tested specimens. There was no predilection observed in failure patters among the experimental specimens. No predilection was observed in the fracture strengths of LDS endocrowns when compared to post-and-core crowns. Furthermore, no differences in failure patterns could be observed when both types of restorations were compared. The authors propose standardized testing of endocrowns against post-and-core crowns in future studies. In conclusion, long-term clinical trials are advocated to compare the survival, failure and complication rates of LDS endocrowns and post-and-core restorations.
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Affiliation(s)
- Zeeshan Qamar
- Department of O&MFS and Diagnostic Sciences, Faculty of Dentistry, Riyadh Elm University, Riyadh 13244, Saudi Arabia
| | | | | | | | | | | | - Ankita Mathur
- STAT SENSE, Srushti 10, Sector 1 D, Amba Township Pvt. Ltd., Trimandir, Adalaj 382421, Gujarat, India
- Department of Periodontology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune 411018, Maharashtra, India
| | - Giuseppe Minervini
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
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Tribst JPM, Dal Piva AMDO, Muris J, Kleverlaan CJ, Feilzer AJ. Endocrown fixed partial denture: Is it possible? J Prosthet Dent 2023:S0022-3913(23)00052-5. [PMID: 36801103 DOI: 10.1016/j.prosdent.2023.01.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/18/2023] [Accepted: 01/18/2023] [Indexed: 02/18/2023]
Abstract
STATEMENT OF PROBLEM Whether the replacement of a missing tooth with a fixed partial denture supported by an endodontically treated abutment could be improved with endocrowns is unclear. PURPOSE The purpose of the study was to evaluate the mechanical behavior of a fixed partial denture (FPD) according to the preparation of the abutment teeth (endocrown or complete crown) in terms of stress magnitude in the prosthesis, cement layer, and tooth. MATERIAL AND METHODS A posterior model with 2 abutment teeth (first molar and first premolar) was modeled with a computer-aided design (CAD) software program for conducting a 3-dimensional finite element analysis (FEA). To replace the missing second premolar, the model was replicated in different possible FPDs according to the abutment preparation design (complete crown [Conventional], 2 endocrowns [EC]) or an endocrown on one of the abutment teeth (first molar [ECM] and first premolar [ECP]) for a total of 4 designs. All FPDs were in lithium disilicate. The solids were imported to an analysis software program (ANSYS 19.2) in the standard for the exchange of product data (STEP) format. The mechanical properties were considered isotropic and the materials to show linear elastic and homogeneous behavior. An axial load (300 N) was applied at the occlusal surface of the pontic. The results were evaluated by colorimetric stress maps of von Mises and maximum principal stress in the prosthesis, maximum principal stress and shear stresses on the cement layer, and maximum principal stress in the abutment teeth. RESULTS The von Mises stresses revealed that all FPD designs behaved similarly and that, considering the maximum principal stress criteria, the pontic was the most stressed region. For the cement layer, the combined designs presented an intermediate behavior, with the ECM more suitable to reducing the stress peak. The conventional preparation allowed less stress concentration in both teeth, and higher stress concentration in the premolar was observed with an endocrown. The endocrown decreased the risk of fracture failure. Considering the risk of debonding failure for the prosthesis, the endocrown preparation was only able to decrease the failure risk when the EC design was used and when only the shear stress was considered. CONCLUSIONS Performing endocrown preparations to retain a 3-unit lithium disilicate FPD is an alternative to conventional complete crown preparations.
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Affiliation(s)
- João Paulo M Tribst
- Assistant Professor, Department of Oral Regenerative Medicine, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands
| | - Amanda Maria de O Dal Piva
- Assistant Professor, Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands.
| | - Joris Muris
- Assistant Professor, Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands
| | - Cornelis J Kleverlaan
- Professor, Department of Dental Materials Science, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam & Vrije Universiteit, Amsterdam, the Netherlands
| | - Albert J Feilzer
- Professor, Department of Oral Regenerative Medicine, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam & Vrije Universiteit, Amsterdam, the Netherlands
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Demachkia AM, Velho HC, Valandro LF, Dimashkieh MR, Samran A, Tribst JPM, de Melo RM. Endocrown restorations in premolars: influence of remaining axial walls of tooth structure and restorative materials on fatigue resistance. Clin Oral Investig 2023:10.1007/s00784-023-04895-6. [PMID: 36781479 DOI: 10.1007/s00784-023-04895-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 02/01/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVES To evaluate the effect of the remaining tooth structure and different CAD/CAM materials on the fatigue performance and failure mode of endodontically treated premolars restored with endocrowns. MATERIALS AND METHODS Ninety maxillary premolars were endodontically treated and assigned into 6 groups (n = 15) according to the number of remaining axial walls (four, three, and two) and restorative materials (ultra-translucent zirconia 5Y-PSZ [KATANA UTML] and lithium disilicate [IPS e.max-CAD]). The specimens were subjected to cyclic fatigue loading test (initial load 200 N; 20 Hz). An incremental step load of 100 N per 10,000 cycles was applied until failure. The fatigue failure load (FFL) and number of failure cycles (CFFs) data were statistically analyzed with two-way ANOVA and Kaplan-Meier test (α = 0.05). Failed specimens were examined under a stereomicroscope 25 × and failure modes were determined. RESULTS FFL and CFF were significantly influenced by restorative material (p < 0.05). 5Y-PSZ endocrowns showed significantly higher FFL when compared with lithium disilicate. The number of remaining walls did not affect the fatigue behavior or failure mode of the specimens. Of the lithium disilicate restorations, 51% had repairable failures, while 95% 5Y-PSZ restorations had non-repairable failures. CONCLUSIONS Zirconia endocrowns showed better FFL than lithium disilicate endocrowns, regardless of the number of remaining axis walls. Lithium disilicate and 5Y-PSZ endocrowns showed FFL higher than the normal masticatory loads. CLINICAL RELEVANCE Restoring endodontically treated premolars with endocrown could be a promising treatment, regardless of the remaining axial walls. However, precaution should be taken in material selection since it affects the fatigue resistance and failure mode.
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Affiliation(s)
- Amir Mohidin Demachkia
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (UNESP), Av. Engenheiro Francisco José Longo,777. 12245000, São José Dos Campos, São Paulo, Brazil.
| | - Helder Callegaro Velho
- Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande Do Sul State, Brazil
| | - Luiz Felipe Valandro
- Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande Do Sul State, Brazil
| | - Mohiddin Rida Dimashkieh
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, Dar Al-Uloom University, Riyadh, Saudi Arabia
| | - Abdulaziz Samran
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, Dar Al-Uloom University, Riyadh, Saudi Arabia
| | - João Paulo Mendes Tribst
- Department of Oral Regenerative Medicine, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Renata Marques de Melo
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (UNESP), Av. Engenheiro Francisco José Longo,777. 12245000, São José Dos Campos, São Paulo, Brazil
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Kaya Büyükbayram I, Güven ME, Ayman D, Şener Yamaner ID, Cakan EF. Fracture resistance of resin endocrowns with and without fiber reinforced composite base material: A preliminary study. J Appl Biomater Funct Mater 2023; 21:22808000231151832. [PMID: 36708253 DOI: 10.1177/22808000231151832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE The aim of this study was to investigate the effects of fiber-reinforced composite base material on fracture resistance and fracture pattern of endodontically treated maxillary premolars restored with endocrowns using two different resin nanoceramic computer-aided design and computer-aided manufacturing (CAD/CAM) restorative material. METHODS Forty extracted sound maxillary premolars with an occlusal reduction of 2 mm above the cementoenamel junction (CEJ) was performed following root canal treatment. Mesial interproximal box was prepared for each tooth at the margin of the CEJ and randomly distributed into four groups (n = 10) as follows: Group A, no resin build-up in the pulp chamber; Group B, 2 mm of fiber-reinforced composite (FRC) build-up (EverX Posterior, GC).; Group C, no resin build-up in pulp chamber; Group D, 2 mm of FRC build-up. Groups A and B were prepared with resin nanoceramic (RNC) consisting ceramic nanofillers (Lava Ultimate 3 M ESPE), while Group C and D were prepared with RNC consisting ceramic nanohybrid fillers (Cerasmart GC Corp). All samples were subjected to 1,200,000 chewing cycles (1.6 Hz, 50 N) and 5000 thermal cycles (5°C-55°C) for artificial aging on a chewing simulator with thermal cycles (CSTC). Samples that survived the CSTC test without being damaged were subjected to a load-to-fracture test. RESULTS The highest mean fracture strength was found in Group D (936.0 ± 354.7) and lowest in Group A (684.2 ± 466.9). Fracture strength was higher in groups where FRC was used as a base material than plain restorations. However, there were no significant differences between the Lava and Cerasmart groups with and without FRC (p > 0.05). Most of the samples were irreparably fractured under CEJ. CONCLUSION Using short FRCs as a resin base material did not significantly improve fracture resistance. Cerasmart and Lava blocks had similar fracture resistance and fracture pattern.
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Affiliation(s)
- Işıl Kaya Büyükbayram
- Department of Endodontics, School of Dentistry, İstanbul Aydın University, Küçükçekmece, İstanbul, Turkey
| | - Mehmet Esad Güven
- Department of Prosthodontics, School of Dentistry, Necmettin Erbakan University, Konya, İstanbul, Turkey
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Scholz KJ, Sim W, Bopp S, Hiller KA, Galler KM, Buchalla W, Widbiller M. Impact of access cavity cleaning on the seal of postendodontic composite restorations in vitro. Int Endod J 2022; 55:950-963. [PMID: 35768890 DOI: 10.1111/iej.13792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 11/29/2022]
Abstract
AIM To investigate the influence of cavity cleaning and conditioning on marginal integrity of directly placed postendodontic composite class-I-restorations in vitro. METHODOLOGY 168 fully intact teeth without caries or fillings received preendodontic composite restorations (class-II) after their extraction. Occlusal endodontic access-cavities were prepared, root-canals were instrumented and filled with guttapercha and an epoxy-resin based sealer. Prior to postendodontic class-I-restoration, access cavities were completely contaminated with sealer, cleaned with alcohol and pretreated as follows: Cleaner only (alcohol), glycine-polishing, Al2 O3 -sandblasting, carbide bur (immediate as well as delayed restoration). A positive control (not contaminated with sealer and adhesive used) and negative control (cleaner used but no adhesive) were established. Half of the teeth from each group were subjected to thermocycling and mechanical loading (TCML). Marginal integrity of postendodontic restoration was evaluated in oro-vestibular or mesio-distal sections after AgNO3 -dye-penetration (DP) by standardized photomacroscopic imaging and expressed in percent of margin length along all segments and separately for enamel, dentine and composite, respectively. Results were analyzed non-parametrically (α=0.05). RESULTS No restorations or teeth fractured or debonded completely. Without TCML, the median DP of all segments was significantly higher for the negative control compared to all other groups in oro-vestibular cutting direction (53%; P=0.002) and in mesio-distal cutting direction (51%; P≤0.041). The other groups without TCML revealed 16-24% DP (oro-vestibular) and 12-24% DP (mesio-distal). With TCML, the median DP in oro-vestibular cutting direction for all segments ranged between 48-62% for all groups, a significant difference was only observed between glycine-polishing and carbide bur (P=0.041). In mesio-distal cutting direction, the median DP in negative control was 69% with TCML and significantly higher compared to all other groups (P=0.002). For all other groups, the median DP of all segments ranged between 28% and 40% with TCML without significant differences. Error rates method (k=7) revealed a significant influence of TCML in general on penetration of all segments in both, oro-vestibular and mesio-distal cutting directions. CONCLUSION Additional access cavity pretreatment after alcohol cleaning did not improve the marginal integrity of postendodontic composite restorations. Thorough cleaning of the access cavity with alcohol seems to assure an acceptable marginal integrity to the tooth and restorative composite.
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Affiliation(s)
- Konstantin J Scholz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Woocheol Sim
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Silvio Bopp
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Karl-Anton Hiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Kerstin M Galler
- Department of Operative Dentistry and Periodontology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Wolfgang Buchalla
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Matthias Widbiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
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Barallat L, Arregui M, Fernandez-Villar S, Paniagua B, Pascual-La Rocca A. Fracture Resistance in Non-Vital Teeth: Absence of Interproximal Ferrule and Influence of Preparation Depth in CAD/CAM Endocrown Overlays-An In Vitro Study. Materials (Basel) 2022; 15:ma15020436. [PMID: 35057154 PMCID: PMC8778771 DOI: 10.3390/ma15020436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 12/27/2021] [Accepted: 01/04/2022] [Indexed: 02/04/2023]
Abstract
There is ample evidence to support the use of endocrowns to restore endodontic teeth. However, the influence of the position of the interproximal margins on fracture strength has not yet been studied. The aim was to determine the relationship between the apicocoronal position of the interproximal restorative margins and fracture resistance in nonvital teeth restored with CAD/CAM endocrown overlays. Forty extracted human maxillary premolars were prepared for endocrown overlay restorations without ferrule on the interproximal aspects and classified according to the position of the interproximal restoration margins in relation to the alveolar crest: 2 mm (group A), 1 mm (group B), 0.5 mm (group C), and 0 mm (group D). Fracture strength was measured using a universal testing machine applying a compressive force to the longitudinal tooth axis. Group A had a mean fracture resistance of 859.61 (±267.951) N, group B 1053.9 (±333.985) N, group C 1124.6 (±291.172) N, and group D 780.67 (±183.269) N, with statistical differences between groups. Group C had the highest values for fracture strength compared to the other groups (p < 0.05). The location of the interproximal margins appears to influence the fracture resistance of CAD/CAM endocrown overlays. A distance of 0.5 mm between the interproximal margin and the alveolar crest was associated with increased fracture resistance.
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Affiliation(s)
- Lucía Barallat
- Department of Periodontics, Faculty of Dentistry, Universitat Internacional de Catalunya, 08195 Sant Cugat del Valles, Spain; (L.B.); (B.P.); (A.P.-L.R.)
| | - María Arregui
- Department of Dentistry, Faculty of Dentistry, Universitat Internacional de Catalunya, 08195 Sant Cugat del Valles, Spain
- Correspondence: ; Tel.: +34-93504200
| | - Sandra Fernandez-Villar
- Department of Restorative Dentistry, Faculty of Dentistry, Universitat Internacional de Catalunya, 08195 Sant Cugat del Valles, Spain;
| | - Blanca Paniagua
- Department of Periodontics, Faculty of Dentistry, Universitat Internacional de Catalunya, 08195 Sant Cugat del Valles, Spain; (L.B.); (B.P.); (A.P.-L.R.)
| | - Andrés Pascual-La Rocca
- Department of Periodontics, Faculty of Dentistry, Universitat Internacional de Catalunya, 08195 Sant Cugat del Valles, Spain; (L.B.); (B.P.); (A.P.-L.R.)
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Shams A, Elsherbini M, Elsherbiny AA, Özcan M, Sakrana AA. Rehabilitation of severely-destructed endodontically treated premolar teeth with novel endocrown system: Biomechanical behavior assessment through 3D finite element and in vitro analyses. J Mech Behav Biomed Mater 2021; 126:105031. [PMID: 34922296 DOI: 10.1016/j.jmbbm.2021.105031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/30/2021] [Accepted: 12/06/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Rehabilitation of endodontically treated premolars with extensive coronal destruction through endocrown approach remains a controversial topic in reconstructive dentistry. There is no clear consensus in the literature which endocrown design with which material is the most effective restoration option for severely-destructed endodontically treated premolars. The aim of this study was to assess the biomechanical behavior of endodontically treated maxillary first premolars restored with a novel endocrown system compared to the conventional one varying the applied load type through finite element and in vitro analyses. MATERIALS AND METHODS For finite element analysis, two models representing two endocrown systems used for restoration of severely-destructed endodontically treated maxillary first premolar tooth were generated: Model C for the conventional monolithic IPS e.max CAD endocrown and Model P for the novel bi-layered endocrown (PEKKTON ivory coping veneered with cemented IPS e.max CAD). Modified von Mises stress values on the remaining tooth structure, cement lines and restorative materials were evaluated separately under axial and oblique loading of 450 N. For in vitro analysis, forty sound human bifurcated maxillary first premolars were collected, endodontically-treated, and divided into 2 main groups (n = 20) according to the system used for endocrown fabrication; Group C: the conventional monolithic endocrowns and Group P: the novel bi-layered endocrowns. All specimens were subjected to an artificial thermomechanical aging protocol. Each main group was subdivided into two subgroups (n = 10) according to the loading type (axial and oblique) applied during the fracture resistance test. Qualitative analysis using Stereomicroscopy and Scanning Electron Microscopy was performed. Data were statistically analyzed at p-value ≤ 0.05. RESULTS Regarding stress distribution pattern of remaining tooth structure (enamel and dentin), both endocrown systems and cement lines under both axial and oblique load application, Model P resulted in lower stresses than Model C. The oblique stress values of all analyzed structures were higher than corresponding values resulted axially. Considering failure load, a significantly higher load was recorded for Group P when axial or oblique loading was applied (p = 0.00). A significantly higher failure load was recorded with axial loading for both main groups. With regard to failure mode, a statistically significant difference was observed between main groups (p = 0.033), with more favorable failures detected for Group P axially. CONCLUSIONS Compared to the conventional endocrown system, the studied novel system improved the biomechanical behavior within tooth/restoration complex of the restored severely-destructed endodontically treated maxillary first premolar teeth, whatever the applied load type. CLINICAL SIGNIFICANCE The novel endocrown system using a PEKK coping veneered with cemented IPS e.max CAD can be considered a favorable promising option for restoration of severely-destructed endodontically treated premolar teeth, with more protection for residual tooth structure. It can be considered as a conservative alternative option to the conventional treatment modalities not only for normal clinical conditions, but also for parafunctional cases.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Rocca GT, Canneto JJ, Scotti N, Daher R, Feilzer A, Saratti CM, Krejci I. Restoration of Severely Damaged Endodontically Treated Premolars: Influence of the Ferrule Effect on Marginal Integrity and Fracture Load of Resin Nano-ceramic CAD-CAM Endocrowns. Oper Dent 2021; 46:650-660. [PMID: 35507906 DOI: 10.2341/20-081-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To explore the ferrule effect on Resin Nano-Ceramic (RNC) premolar endocrown marginal integrity and fracture resistance. METHODS Thirty-six root-canal-treated premolars were cut 2 mm above the cemento-enamel junction (CEJ). They were restored with standardized RNC computer-aided design/computer-aided manufacturing (CAD/CAM) restorations (Lava Ultimate, 3M Oral Care, St. Paul, MN, USA) and divided into three groups (n=12): endocrowns with a 3-mm endo-core (Group 1), endocrowns with a 3-mm endo-core and a 2-mm ferrule (Group 2), and conventional post-and-core crowns with a 2-mm ferrule (Group 3). All specimens were submitted to thermo-mechanical cycling loading (TMCL) (1.7 Hz, 49 N, 600 000 cycles, 1500 thermocycles). Margins were analyzed before and after the TMCL. In the second part of the experiment, the surviving specimens were submitted to unidirectional monotonic loading until fracture. Fragments were then analyzed using scanning electron microscopy (SEM) and the fracture mode was established. RESULTS Endocrowns of Groups 1 and 2 performed better than conventional crowns (Group 3) in terms of marginal continuity. Differences in fracture load values within all groups were not statistically significant. Most of the specimens fractured in a non-repairable way. CONCLUSIONS The present test failed to provide evidence of any kind of difference between endocrowns with and without a ferrule in terms of load-bearing capacity and marginal integrity after fatigue. Further studies are needed to confirm the role of the ferrule in adhesive restorations of endodontically treated teeth.
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Affiliation(s)
- G T Rocca
- *Giovanni Tommaso Rocca, Department of Cariology and Endodontics, School of Dentistry, University of Geneva, Switzerland
| | - J J Canneto
- Jean Jacques Canneto, DMD, Department of Cariology and Endodontics, School of Dentistry, University of Geneva, Switzerland
| | - N Scotti
- Nicola Scotti, DMD, Department of Cariology and Operative Dentistry, School of Dentistry, University of Turin, Italy
| | - R Daher
- Rene Daher, DMD, Department of Cariology and Endodontics, School of Dentistry, University of Geneva, Switzerland
| | - A Feilzer
- Albert Feilzer, professor, Department of Dental Materials, Academisch Centrum Tandheelkunde Amsterdam, Amsterdam, The Netherlands
| | - C M Saratti
- Carlo Massimo Saratti, DMD, Department of Cariology and Endodontics, School of Dentistry, University of Geneva, Switzerland
| | - I Krejci
- Ivo Krejci, Professor, Department of Cariology and Endodontics, School of Dentistry, University of Geneva, Switzerland
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Meng Q, Zhang Y, Chi D, Gong Q, Tong Z. Resistance fracture of minimally prepared endocrowns made by three types of restorative materials: a 3D finite element analysis. J Mater Sci Mater Med 2021; 32:137. [PMID: 34716807 PMCID: PMC8557147 DOI: 10.1007/s10856-021-06610-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/28/2021] [Indexed: 06/13/2023]
Abstract
A thin endocrown restoration was often applied in endodontically treated teeth with vertical bite height loss or inadequate clinical crown length. A model of mandibular molars made by endocrown restoration with 1 mm thickness and 2 mm depth of pulp chamber was constructed and imported into FEA ANSYS v18.0 software. The three CAD/CAM materials, feldspathic (Mark2), lithium disilicate (EMAX), and lava ultimate (LU), were assigned, and the five load indenters were loaded on the full occlusal (FO), occlusal center (OC), central fossa (CF), buccal groove (BG), and mesiobuccal cusp (MC) of restoration in the model. The MinPS and MaxPS of the thin endocrown were significantly higher than those of tooth tissue in five types of loads except for the LU endocrown loaded in the FO group. The smaller the contact surface of the load was, the higher MaxPS and MinPS were. MaxPS and MinPS of the MC were the highest, followed by the BG and CF in the restoration. In the stress distribution of tooth tissue, MaxPS in the LU endocrown accumulated at the external edge of enamel and was significantly higher than MaxPS in Mark2 and EMAX endocrown concentrated on the chamber wall of dentin under OC, CF and BG loads. Within the limitations of this FEA study, the LU endocrown transferred more stress to tooth tissue than Mark2 and EMAX, and the maximum principal stress on endocrown restoration and tooth tissue at the mesiobuccal cusp load was higher than that at the central fossa and buccal groove load.
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Affiliation(s)
- Qingzhen Meng
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Yuejiao Zhang
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Danlu Chi
- The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Qimei Gong
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhongchun Tong
- Department of Operative Dentistry and Endodontics, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China.
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China.
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Sichi LGB, Pierre FZ, Arcila LVC, de Andrade GS, Tribst JPM, Ausiello P, di Lauro AE, Borges ALS. Effect of Biologically Oriented Preparation Technique on the Stress Concentration of Endodontically Treated Upper Central Incisor Restored with Zirconia Crown: 3D-FEA. Molecules 2021; 26:6113. [PMID: 34684695 PMCID: PMC8538003 DOI: 10.3390/molecules26206113] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/03/2021] [Accepted: 10/04/2021] [Indexed: 01/19/2023] Open
Abstract
The aim of this study was to evaluate the effect of biologically oriented preparation technique on the stress concentration of endodontically treated upper central incisors restored with zirconia crown (yttria-stabilized zirconia polycrystalline ceramic) through finite element analysis (FEA). Four models of maxillary central incisors containing enamel, dentin, periodontal ligament, cortical and medullary bone were created in CAD. Each model received a polymeric core-build up with nanofilled dental resin composite. The evaluated models were SM-preparation in shoulder 90°; CM-chamfer preparation; BOPT-biologically oriented preparation technique and BOPTB-BOPT preparation 1 mm below the cement-enamel junction. All models received zirconia crowns (5Y-TZP), fiberglass post and 1 mm ferrule. The models were imported into the analysis software with parameters for mechanical structural testing using the maximum principal stress and the tensile strength as the analysis criteria. Then, load of 150 N was applied at the cingulum with 45° slope to the long axis of the tooth, with the fixed base for each model. The type of marginal preparation affected the stresses concentration in endodontically treated teeth and in the zirconia crown margin. Considering the stress magnitude only, BOPT is a viable option for anterior monolithic zirconia crowns; however, with the highest stress magnitude at the restoration margin.
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Affiliation(s)
- Luigi Giovanni Bernardo Sichi
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil
| | - Fernanda Zapater Pierre
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil
| | - Laura Viviana Calvache Arcila
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil
| | | | | | - Pietro Ausiello
- School of Dentistry, University of Naples Federico II, via S. Pansini 5, 80131 Naples, Italy
| | | | - Alexandre Luiz Souto Borges
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos 12245-000, Brazil
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Shams A, Sakrana AA, Abo El-Farag SA, Elerian FA, Özcan M. Biomechanical behavior of endodontically treated premolar teeth restored with novel endocrown system: 3D Finite Element and Weibull analyses. J Mech Behav Biomed Mater 2021; 124:104853. [PMID: 34600429 DOI: 10.1016/j.jmbbm.2021.104853] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To date, there is no clear consensus in the literature which endocrown design with which material is the most effective treatment option to restore endodontically treated maxillary premolars with extensive loss of tooth structure. The aim of this study was to evaluate the stress distribution pattern and failure probability of maxillary first premolars restored with a novel endocrown system compared to the conventional one by means of Finite Element and Weibull analyses. MATERIALS AND METHODS Two finite element (FE) models representing two endocrown systems used for restoration of severely-destructed endodontically treated maxillary first premolar tooth were generated: model C for the conventional monolithic IPS e.max CAD endocrown and model P for the novel bi-layered endocrown (PEKKTON ivory coping veneered with cemented IPS e.max CAD). A static occlusal compressive load was axially and centrally-applied. Modified von Mises and maximum principal stress values on the remaining tooth structure, cement lines and restorative materials were evaluated separately. Weibull function was incorporated with FE analysis to calculate the long term failure probability. RESULTS Regarding stresses occurred in the remaining tooth structure (enamel and dentin), model P transmitted less stresses than model C. The individual enamel of model C showed about 5% and 40% risk of failure at normal and maximum occlusal load values, respectively, while for model P, it had no failure risk at both values. For dentin, model C showed about 13% failure risk at the normal masticatory force, while model P showed only 2%. At clenching value, model C dentin showed about 44% failure risk, while only 9% was resulted for model P. CONCLUSIONS Compared to the conventional endocrown system, the positive impact of the studied novel endocrown system on the stress distribution pattern and also on the survival/failure probability of the restored severely-destructed endodontically treated maxillary first premolar teeth was reflected (more tooth-friendly), not only at normal masticatory forces but also at the maximum functional loads. CLINICAL SIGNIFICANCE The novel endocrown system using a PEKK coping veneered with cemented IPS e.max CAD can be considered a favorable option for restoration of severely-destructed endodontically treated premolar teeth, with more protection for residual tooth structure. Despite the conventional endocrown system may benefit the durability of tooth bonding, it should not be selected for restoration of clenching cases because of the too high overall failure risk.
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Yanakiev SS, Marinova-Takorova MB. Silane Heat Treatment Could Eliminate the Hydrofluoric Acid Etching of Lithium Disilicate Overlays: A Four-Year Follow-Up. Case Rep Dent 2021; 2021:9961621. [PMID: 34258078 DOI: 10.1155/2021/9961621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/12/2021] [Indexed: 11/18/2022] Open
Abstract
A four-year follow-up of a novel silane heat treatment method for bonding lithium disilicate overlays to tooth structures without hydrofluoric acid etching of the ceramic surface is presented in this case report. Silane heat treatment modifies the silane layer and thus enhances resin ceramic bond strength without hydrofluoric acid etching. The standard ceramic preparation technique prior to bonding silicate ceramics to tooth structure is hydrofluoric acid etching and applying a silane coupling agent, followed by dental adhesive. In this case, the micromechanical roughening of the ceramic surface was performed by air abrasion with Al2O3. Silane heat treatment with constant 120°C airflow, applied for 60 sec, followed by dental adhesive application enhanced the resin-ceramic bond strength. After a four-year follow-up, the restorations' clinical appearance could be defined as excellent/very good according to the FDI clinical criteria for the evaluation of direct and indirect restorations. This clinical result supports many in vitro studies regarding the resin-ceramic bond strength and durability obtained through postsilanization heat treatment.
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Gupta R, Thakur S, Pandey NK, Roopa B, Fares KT. Endocrown - A Paradigm Shift in Rehabilitation: A Report of Two Cases. Contemp Clin Dent 2021; 12:195-198. [PMID: 34220164 PMCID: PMC8237820 DOI: 10.4103/ccd.ccd_557_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/01/2020] [Accepted: 09/26/2020] [Indexed: 11/12/2022] Open
Abstract
Along with the advent of dentistry, the ideal restoration of an endodontically treated tooth has been a widely discussed and controversial topic. Coronal rehabilitation of an endodontically treated tooth is quite a challenge for clinicians as considerations should be taken for its minimally invasive preparation and the retention and stability of the restoration. With the development of adhesive systems, the need for intraradicular anchorage and thus the post-core system is greatly reduced. Endocrown is a restorative option for an endodontically treated tooth, and it serves as a suitable alternative to the conventional post-core restoration and full-coverage restoration. This novel approach promotes the stability and retention of the indirect restoration without the need of a cast metal core or reconstruction with intracanal post, thereby reducing the treatment time. Thus, endocrown has become a promising alternative in the esthetic and functional rehabilitation of an endodontically treated tooth.
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Affiliation(s)
- Rahul Gupta
- Department of Conservative Dentistry and Endodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Sophia Thakur
- Department of Conservative Dentistry and Endodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Nitish Kumar Pandey
- Department of Conservative Dentistry and Endodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - B Roopa
- Department of Conservative Dentistry and Endodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - K T Fares
- Department of Conservative Dentistry and Endodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
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Anton Y Otero C, Bijelic-Donova J, Saratti CM, Vallittu PK, di Bella E, Krejci I, Rocca GT. The influence of FRC base and bonded CAD/CAM resin composite endocrowns on fatigue behavior of cracked endodontically-treated molars. J Mech Behav Biomed Mater 2021; 121:104647. [PMID: 34171717 DOI: 10.1016/j.jmbbm.2021.104647] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 05/07/2021] [Accepted: 06/09/2021] [Indexed: 02/06/2023]
Abstract
Cracked endodontically treated molars (ETMs) are commonly treated with full crowns. Less invasive techniques could include fiber-reinforced composite (FRC) base and adhesively bonded endocrowns. The purpose of this study was to assess the fatigue resistance of ETMs restored with CAD/CAM resin composite endocrowns and reinforced with different FRC bases. Cracks were simulated in fifty mandibular molars by cutting the teeth longitudinally and reassembling the two parts. After performing endodontic treatments and preparing cavities, teeth were restored in one of the following methods (n = 10). In Group 1, cavity floors were lined with 0.5 mm of flowable composite (Universal Injectable; GUI, shade A2). In Groups 2 and 3, the cavity floors were covered with one and three layers of FRC-net (ES Net) respectively, whereas in Groups 4 and 5 with 1 mm and 2 mm of flowable FRC-resin (EverX Flow Dentin; EXFD) respectively. Endocrowns (Cerasmart 270; CE, A2 HT) with 5 mm thickness were adhesively luted with preheated composite and all specimens were subjected to cyclic loading in water at 5 Hz, starting with a load of 600 N (5000 cycles), followed by stages of 1000, 1300, 1600, 1900, 2200 and 2500 at a maximum of 20 000 cycles each. Results were analyzed using Kaplan-Meier survival analysis and the Log-Rank test (p = 0.05). The fatigue failure load of ES Net applied in three layers (1617 N ± 371) or in one layer (1499 N ± 306), as well as EXFD applied in 2 mm (1496 N ± 264) or in 1 mm (1434 N ± 372) did not differ significantly (p > 0.05). Control teeth fractured at 1255 N ± 350 (p > 0.05). In the fiber-reinforced groups, restorable fractures were observed in 50%-80%, with only 30% deemed restorable in the control group. The fractures originated mainly at the occlusal contact points and the main crack propagated in the corono-apical direction. No crack origin (primary or secondary) starting from the artificial pre-existing crack was observed in fractured specimens. FRC bases did not improve the fatigue resistance of cracked ETMs, but favorably influenced the failure mode.
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Ahmed MAA, Kern M, Mourshed B, Wille S, Chaar MS. Fracture resistance of maxillary premolars restored with different endocrown designs and materials after artificial ageing. J Prosthodont Res 2021; 66:141-150. [PMID: 34108294 DOI: 10.2186/jpr.jpr_d_20_00082] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To evaluate the effect of three different designs and two monolithic ceramic materials on the durability and fracture resistance of endocrowns on maxillary first premolars, in comparison to post-and-core crowns. METHODS Fifty-six maxillary premolars were endodontically treated and shortened to a level of 2 mm from the cervical line, and randomly categorized into six endocrown groups and post-and-core crown control group (n=8); E1; endocrowns with flat occlusal table (without ferrule), E2; endocrowns with 1.5 mm circumferential ferrule, E3; endocrowns with 1.5 mm buccal ferrule preparation. Two materials were used for endocrowns: zirconia (4YSZ; Z), and lithium disilicate (L). The control group was restored with zirconia posts, and lithium disilicate crowns. All restorations were bonded using Panavia V5 and its respective primers and underwent thermo-mechanical fatigue with a 10 kg dynamic load for 1,200,000 cycles and thermocycling between 5 and 55 °C. Thereafter all survived specimens were loaded to fracture. The results were statistically analyzed using ANOVA and T-Test. RESULTS None of the specimens showed any signs of debonding or fracture caused by the fatigue test. The PC control group showed no statistically significant difference in comparison to groups ZE1, ZE2 and LE2 ( p > 0.05 ). However, it was significantly different from groups LE1, LE3, and ZE3 ( p ≤ 0.05 ). CONCLUSIONS Preparation designs and materials affected the fracture resistance of endocrowns. The results showed a superiority of the post-and-core crowns,zirconia/lithium disilicate endocrowns with 1.5 mm circumferential ferrule, and zirconia endocrowns with the flat occlusal table.
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Affiliation(s)
- Mohamed A A Ahmed
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel.,Department of Prosthodontics, College of Dentistry, Ibb University, Ibb
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel
| | - Bilal Mourshed
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel
| | - Sebastian Wille
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel
| | - Mohamed Sad Chaar
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel
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Topkara C, Keleş A. Examining the adaptation of modified endocrowns prepared with CAD-CAM in maxillary and mandibular molars: A microcomputed tomography study. J Prosthet Dent 2021; 127:744-749. [PMID: 33454117 DOI: 10.1016/j.prosdent.2020.12.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 11/27/2020] [Accepted: 12/01/2020] [Indexed: 10/22/2022]
Abstract
STATEMENT OF PROBLEM Endocrowns have been reported to be successful restorations for endodontically treated molars. However, comparisons between maxillary and mandibular molars, with different pulp chamber configurations are lacking. Information on the influence of venting on the adaptation of endocrowns is also lacking. PURPOSE The purpose of this in vitro study was to evaluate the adaptation of endocrowns in maxillary and mandibular molars by means of microcomputed tomography (μCT). MATERIAL AND METHODS Mandibular and maxillary first molars were divided into 4 groups (n=10): ManE: mandibular endocrown; ModManE: modified mandibular endocrown; MaxE: maxillary endocrown; and ModMaxE: modified maxillary endocrown. Endocrowns were produced by using computer-aided design and computer-aided manufacture (CAD-CAM). Modification was carried out on the part of the endocrown that extended into the pulp chamber by preparing vents. The specimens were cemented and scanned by using μCT, the images reconstructed, and the internal and marginal adaptation examined. Statistical analyses were performed by using a 3-way ANOVA, 2-way ANOVA, and the independent samples t test (α=.05). RESULTS ManE displayed better mean ±standard deviation internal adaptation (182 ±59 μm) than MaxE (215 ±55 μm) (P<.01). Regardless of the groups, the pulpal floor was the area with the poorest fit (P<.001). The marginal gap of mandibular molars (91 ±20 μm) was lower than that of maxillary molars (110 ±26 μm) (P<.05). The effect of modifying endocrowns on the marginal gap was not found to be statistically significant (P>.05). CONCLUSIONS Internal and marginal adaptation of endocrowns differ between maxillary and mandibular molars.
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Affiliation(s)
- Can Topkara
- Research Assistant, Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
| | - Ali Keleş
- Associate Professor, Department of Endodontics, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey.
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Kassis C, Khoury P, Mehanna CZ, Baba NZ, Bou Chebel F, Daou M, Hardan L. Effect of Inlays, Onlays and Endocrown Cavity Design Preparation on Fracture Resistance and Fracture Mode of Endodontically Treated Teeth: An In Vitro Study. J Prosthodont 2020; 30:625-631. [PMID: 33219727 DOI: 10.1111/jopr.13294] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2020] [Indexed: 12/22/2022] Open
Abstract
PURPOSE To evaluate the fracture resistance and failure modes of endodontically treated mandibular molars restored with different designs of inlays, onlays and endocrowns. MATERIALS AND METHODS Extracted mandibular third molars (n = 180) were used. An access cavity was prepared on the occlusal surface of each tooth and the roots were obturated with gutta percha. All specimens were randomly divided into 6 groups (n = 30/group) according to the cavity design and the restoration material used. C: control group without access cavity preparation. IE: MOD inlay preparation with EverX Posterior (GC Europe) in the pulp chamber. IG: MOD inlay preparation with G-aenial Universal Flo (GC America) in the pulp chamber. OE: onlay preparation with EverX Posterior (GC Europe) in the pulp chamber. OG: onlay preparation with G-aenial Universal Flo (GC America) in the pulp chamber. EC: endocrown with an empty pulp chamber. All restorations were fabricated with CAD/CAM system using CERASMART® (GC Dental products Europe, Belgium) CAD/CAM blocks. Specimens were thermal-cycled and were subjected to a compressive load applied at 30° angle relative to the long axis of the tooth with a universal testing machine. Results were statistically analyzed by ANOVA followed by Tukey post hoc tests. Chi-square test and Fisher Exact tests were used for the comparisons among groups. RESULTS The mean fracture strength was significantly different between the groups (p < 0.001); it was significantly highest for intact teeth, followed by endocrowns (p = 0.021). The strength was significantly lower for inlays (with G-aenial Universal Flo and EverX Posterior), intermediate for onlays with EverX Posterior followed by onlays with G-aenial Universal Flo. CONCLUSIONS Endocrowns exhibited higher fracture resistance than other tested composite resin groups. Endocrowns and onlays showed a more favorable failure mode than inlay restorations.
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Affiliation(s)
- Cynthia Kassis
- Department of Esthetic and Restorative Dentistry, Saint-Joseph University, School of Dentistry, Beirut, Lebanon
| | - Pierre Khoury
- Department of Prosthodontics, Lebanese University, School of Dentistry, Beirut, Lebanon
| | - Carina Z Mehanna
- Department of Esthetic and Restorative Dentistry, Saint-Joseph University, School of Dentistry, Beirut, Lebanon
| | - Nadim Z Baba
- Advanced Education Program in Implant Dentistry, Loma Linda University, School of Dentistry, Loma Linda, CA
| | - Fadi Bou Chebel
- Esthetic and Restorative Dentistry, Saint-Joseph University, School of Dentistry, Beirut, Lebanon
| | - Maha Daou
- Dental Materials, Saint-Joseph University, School of Dentistry, Beirut, Lebanon
| | - Louis Hardan
- Esthetic and Restorative Dentistry, Saint-Joseph University, School of Dentistry, Beirut, Lebanon
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Haralur SB, Alamrey AA, Alshehri SA, Alzahrani DS, Alfarsi M. Effect of different preparation designs and all ceramic materials on fracture strength of molar endocrowns. J Appl Biomater Funct Mater 2020; 18:2280800020947329. [DOI: 10.1177/2280800020947329] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: The aim was to compare the fracture strength of Molar endocrowns fabricated from different all-ceramic materials and various preparation designs. Materials and methods: Ninety extracted human molar teeth were root canal treated and randomly divided into three groups according to the all ceramic materials used for fabrication of the endocrowns ( n = 30): (1) Lithium disilicate (IPS e.max Press); (2) Polymer infiltrated ceramic (Vita Enamic); (3) High translucency zirconia (Ceramill Zolid HT). Each group was subdivided into 3 subgroups ( n = 10) according to the preparation design as 2 mm occlusal reduction, 4.5 mm occlusal reduction, and 4.5 mm occlusal reduction with 2 mm radicular extension. The endocrowns from each material were fabricated and surface treated according to the manufacturer’s recommendations. After cementation with self-adhesive resin luting cement, the specimens were stored in a humid environment for 72 hours and subsequently subjected to 5000 thermal cycles. After, a compressive, static-axial load was applied using a universal testing machine until failure. Load-to-failure was recorded (N) and the specimens were examined under a stereomicroscope to determine the failure type. The data was statistically analyzed using One-way ANOVA and Tukey HSD tests at p < 0.05. Results: The Lithium Disilicate endocrowns recorded the higher mean fracture strength for 4.5 mm occlusal thickness and 2 mm radicular extension at 3770.28 N and 3877.40 correspondingly. The High translucency zirconia endocrowns at conventional 2 mm thickness showed the highest mean fracture load (3533.34 N). Even though polymer infiltrated ceramic endocrowns displayed comparatively lesser fracture load; they recorded the predominantly favorable fractures. Conclusions: Increased occlusal thickness showed a significant improvement in fracture strength of lithium disilicate and polymer infiltrated ceramic molar endocrowns. Although the 2 mm radicular extension had the substantial enhancement of fracture strength in high translucency zirconia, it resulted in more unfavorable failure types.
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Affiliation(s)
- Satheesh B Haralur
- Department of Prosthodontics, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Alaa Ali Alamrey
- College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | | | | | - Mohammed Alfarsi
- Department of Prosthodontics, College of Dentistry, King Khalid University, Abha, Saudi Arabia
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Elashmawy Y, Elshahawy W, Seddik M, Aboushelib M. Influence of fatigue loading on fracture resistance of endodontically treated teeth restored with endocrowns. J Prosthodont Res 2020; 65:78-85. [PMID: 32938873 DOI: 10.2186/jpr.jpor_2019_485] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE This in vitro study aimed to evaluate the influence of fatigue loading on fracture resistance of endodontically treated molars restored with endocrowns using different machinable blocks. METHODS Endodontically treated mandibular first molars were prepared using a standardized method. Specimens were divided into 4 groups (n = 10).Anatomically shaped endocrowns groups were manufactured using VITA ENAMIC (VE) and KATANA Zirconia (KZ). Layered endocrowns groups were manufactured using IPS e.max CAD (EM) and BioHPP (BH). Half of the specimens of each group were subjected to fracture resistance test, while the other half were subjected to thermocycling and chewing simulation. After fatigue loading, specimens were loaded until failure. Specimens were examined using stereomicroscopy. Data were analyzed using ANOVA analysis of variance and Bonferroni post hoc test (α=0.05). RESULTS KZ group had the highest initial fracture resistance value (1810.20± 119.56 N) and BH had the lowest value (579.50± 76.15 N). The reduction of fracture resistance after fatigue loading was significant for KZ group (1588.30±216.25 N) and BH group (502.60±11.53 N) and non-significant to VE group (1101.70±77.05 N) and EM group (1112.10±74.12 N). Failure modes of KZ and EM groups showed high percentage of non-restorable fractures, while VE and BH groups showed high percentage of restorable fractures. CONCLUSIONS Within the limitations of this study, the following can be concluded: Poly infiltrated ceramics should be considered as a proper material to be used as an endocrown material because of its ability to be restorable if failure occurred.
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Affiliation(s)
- Yasmin Elashmawy
- Department of Fixed Prosthodontics, University of Tanta Faculty of dentistry, Tanta
| | - Waleed Elshahawy
- Department of Fixed Prosthodontics, University of Tanta Faculty of dentistry, Tanta
| | - Mohamed Seddik
- Department of Fixed Prosthodontics, University of Tanta Faculty of dentistry, Tanta
| | - Moustafa Aboushelib
- Department of Dental Materials, University of Alexandria Faculty of dentistry, Alexandria
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Scholz KJ, Hinderberger M, Widbiller M, Federlin M, Hiller KA, Buchalla W. Influence of selective caries excavation on marginal penetration of class II composite restorations in vitro. Eur J Oral Sci 2020; 128:405-414. [PMID: 32749026 DOI: 10.1111/eos.12726] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2020] [Indexed: 11/29/2022]
Abstract
Selective caries excavation may support pulp preservation. This in vitro study investigated the influence of selective removal of demineralized dentin on marginal integrity of composite restorations as determined by dye penetration. Dentinal caries-like lesions were produced in the approximal surfaces of 40 extracted human molars (ethylenediaminetetraacetate, 0.5 M, 96 h). The following test procedures were established: complete excavation, selective excavation, and caries-free control. Two class II cavities with enamel at the cervical margins were prepared per tooth and demineralization volume was determined by micro-computed tomography for the purpose of a stratified distribution to receive complete excavation or selective excavation. After complete or selective excavation (30 cavities each), adhesive composite restorations were placed. Cavities without demineralized dentin (20 cavities) served as control. The marginal integrity of restorations was evaluated by dye penetration with and without thermocycling or mechanical loading. Results were analyzed by non-parametrical statistical tests (Mann-Whitney U Test) with an α = 0.05 level of significance. Dye penetration did not differ significantly among completely excavated, selectively excavated, or undemineralized teeth, but was increased by thermocycling and mechanical loading in all experimental groups. Selective caries removal did not increase marginal penetration in class II restorations. The presence of remaining demineralized dentin surrounded by sound dentin did not impair marginal integrity of restorations with margins placed in sound enamel.
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Affiliation(s)
- Konstantin J Scholz
- Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg, Regensburg, Germany
| | - Michael Hinderberger
- Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg, Regensburg, Germany
| | - Matthias Widbiller
- Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg, Regensburg, Germany
| | - Marianne Federlin
- Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg, Regensburg, Germany
| | - Karl-Anton Hiller
- Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg, Regensburg, Germany
| | - Wolfgang Buchalla
- Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg, Regensburg, Germany
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Mishra L, Khan AS, Velo MMAC, Panda S, Zavattini A, Rizzante FAP, Arbildo Vega HI, Sauro S, Lukomska-Szymanska M. Effects of Surface Treatments of Glass Fiber-Reinforced Post on Bond Strength to Root Dentine: A Systematic Review. Materials (Basel) 2020; 13:E1967. [PMID: 32340106 DOI: 10.3390/ma13081967] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 04/18/2020] [Accepted: 04/20/2020] [Indexed: 11/30/2022]
Abstract
The objective of this systematic review was to determine the influence of surface treatment of glass fiber posts on bond strength to dentine. Laboratory studies were searched in MEDLINE, PubMed, Embase, PubMed Central, Scopus, and Web of Science search engine. All authors interdependently screened all identified articles for eligibility. The included studies were assessed for bias. Because of the considerable heterogeneity of the studies, a meta-analysis was not possible. Twelve articles were found eligible and included in the review. An assessment of the risk of bias in the included studies provided a result that classified the studies as low, medium, and high risk of bias. The available evidence indicated that the coronal region of the root canal bonded better to the glass fiber post than apical regions. Phosphoric acid, hydrogen peroxide, and silane application enhance post’s retentiveness. In light of the current evidence, surface treatment strategies increase the bond strength of glass fiber post to dentine. However, recommendations for standardized testing methods and reporting of future clinical studies are required to maintain clinically relevant information and to understand the effects of various surface treatment of glass fiber post and their bond strength with dentine walls of the root canal.
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Haralur SB, Alamri AA, Alshehri SA, Alzahrani DS, Alfarsi M. Influence of Occlusal Thickness and Radicular Extension on the Fracture Resistance of Premolar Endocrowns from Different All-Ceramic Materials. Applied Sciences 2020; 10:2696. [DOI: 10.3390/app10082696] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Endocrowns are primarily recommended in a molar region with a standardized preparation design. The aim of the study was to evaluate the effect of different occlusal preparation depths, pulp chamber-radicular extension, and all-ceramic materials on the fracture resistance of premolar endocrowns. Ninety human premolar teeth were root canal treated, randomly divided into three main groups according to all-ceramic material used for fabrication as Lithium Disilicate (LD) ceramic, Polymer infiltrated ceramic (PIC) and High translucency zirconia (HTZ). They were further subdivided into three subgroups (n = 10) according to preparation design of 2 mm occlusal reduction, 4.5 mm occlusal reduction and 4.5 mm occlusal reduction with 2 mm radicular extension. The endocrowns from respective restorative materials were fabricated, surface conditioned, and cemented with self-adhesive resin cement. All samples were thermocycled for 5000 cycles and subjected to compressive static load at 45° angluation with the cross-head speed of 0.5 mm/minute until the fracture. The mean fracture resistance of LD ceramic at 2 mm, 4.5 mm thickness and radicular extension was 62.55 MPa, 45.80 MPa, 74.27 MPa respectively. The corresponding values for the PIC and HTZ ceramics were 26.30 MPa, 21.65 MPa, 25.66 Mpa and 23.47 MPa, 27.30 MPa, 37.29 MPa respectively. The LD ceramic and greater extension inside the pulp chamber had higher fracture resistance.
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Al-Dabbagh RA. Survival and success of endocrowns: A systematic review and meta-analysis. J Prosthet Dent 2020; 125:415.e1-415.e9. [PMID: 32197821 DOI: 10.1016/j.prosdent.2020.01.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 01/10/2020] [Accepted: 01/10/2020] [Indexed: 10/24/2022]
Abstract
STATEMENT OF PROBLEM Endocrowns are a monoblock type of restoration that use the pulp chamber and remaining coronal tooth structure as a means of retention. However, data on their long-term survival and success rates as compared with conventional crowns are lacking. PURPOSE The purpose of this systematic review and meta-analysis was to collate published work on endocrowns to assist clinicians in making decisions on when and whether they are an appropriate restorative option with a predictable outcome for extensively damaged endodontically treated teeth. MATERIAL AND METHODS Databases such as PubMed (MEDLINE), Scopus, EMBASE, Cochrane library, and Google Scholar were searched up to June 2019 for clinical and in vitro studies on endocrown survival and success rates. For the meta-analysis, endocrown and conventional crown survival and success rates were compared, and the pooled effects were presented as relative risks and 95% confidence intervals using a random effects model. RESULTS Ten studies fulfilled the inclusion criteria (3 clinical and 7 in vitro) and were included in the systematic review. The meta-analysis of the clinical studies showed an estimated overall 5-year survival rate of 91.4% for endocrowns and 98.3% for conventional crowns. The estimated overall 5-year success rates were 77.7% for endocrowns and 94% for conventional crowns. There were no significant differences in overall survival or success estimates between the assessed restorations (P>.05). CONCLUSIONS Additional well-designed clinical studies with long-term assessment are needed; however, endocrowns appear to be a promising conservative restorative option with acceptable long-term survival for endodontically treated posterior teeth in selected patients.
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Affiliation(s)
- Raghad A Al-Dabbagh
- Assistant Professor and Consultant in Prosthodontics, Oral and Maxillofacial Rehabilitation Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
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Govare N, Contrepois M. Endocrowns: A systematic review. J Prosthet Dent 2020; 123:411-418.e9. [DOI: 10.1016/j.prosdent.2019.04.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 04/14/2019] [Accepted: 04/15/2019] [Indexed: 11/18/2022]
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Zhu J, Wang D, Rong Q, Qian J, Wang X. Effect of central retainer shape and abduction angle during preparation of teeth on dentin and cement layer stress distributions in endocrown-restored mandibular molars. Dent Mater J 2020; 39:464-470. [PMID: 32092721 DOI: 10.4012/dmj.2019-050] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
To study the effect of central retainer shape and abduction angle during tooth preparation on stress distribution in endocrown-restored molars via finite element (FE) analysis, we constructed five FE models with different central retainer shapes and abduction angles. Under an oblique load, the distributions of maximum tensile stress in cervical dentin around the endocrown and on the cement layer, as well as maximum shear stress on the cement layer, were more balanced in the FE model in which the central retainer shape was generated based on the anatomical form of the pulp chamber. Moreover, there were no differences in stress distributions among FE models with different abduction angles. Therefore, the shape of the central retainer should be designed on the basis of the anatomical form of the pulp chamber; abduction angle during tooth preparation does not influence the repair effect of endocrown-restored mandibular molars.
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Affiliation(s)
- Junxin Zhu
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology
| | - Dongmei Wang
- 2nd Dental Center, Peking University School and Hospital of Stomatology
| | - Qiguo Rong
- Department of Mechanics and Engineering Science, College of Engineering, Peking University
| | - Jun Qian
- 2nd Dental Center, Peking University School and Hospital of Stomatology
| | - Xiaoyan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology
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de Kuijper MCFM, Cune MS, Tromp Y, Gresnigt MMM. Cyclic loading and load to failure of lithium disilicate endocrowns: Influence of the restoration extension in the pulp chamber and the enamel outline. J Mech Behav Biomed Mater 2020; 105:103670. [PMID: 32090891 DOI: 10.1016/j.jmbbm.2020.103670] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 02/02/2020] [Accepted: 02/03/2020] [Indexed: 01/22/2023]
Affiliation(s)
- Maurits C F M de Kuijper
- The University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry and Biomaterials, Groningen, the Netherlands.
| | - Marco S Cune
- The University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry and Biomaterials, Groningen, the Netherlands; St. Antonius Hospital Nieuwegein, Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, Nieuwegein, the Netherlands; University Medical Center Utrecht, Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, Utrecht, the Netherlands
| | - Youp Tromp
- The University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry and Biomaterials, Groningen, the Netherlands
| | - Marco M M Gresnigt
- The University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry and Biomaterials, Groningen, the Netherlands; Martini Hospital, Department of Special Dental Care, Groningen, the Netherlands
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Tribst JPM, Dal Piva AMDO, Madruga CFL, Valera MC, Bresciani E, Bottino MA, de Melo RM. The impact of restorative material and ceramic thickness on CAD\CAM endocrowns. J Clin Exp Dent 2019; 11:e969-e977. [PMID: 31700569 PMCID: PMC6825739 DOI: 10.4317/jced.56002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 09/09/2019] [Indexed: 12/01/2022] Open
Abstract
Background Endocrown restorations as a conservative approach to restore endodontically treated teeth still need in vitro investigation under fatigue and made in different materials. This study evaluated the effect of restorative material and restoration thickness on the maximum fracture load of endocrowns subjected to cyclic loading. Material and Methods Sixty (60) third molar teeth received an endocrown preparation with three different heights of remaining dental tissue (1.5, 3.0 or 4.5 mm). A leucite-based ceramic (LEU) and a lithium disilicate (LD) based ceramic were selected to manufacture the CAD/CAM endocrown restorations, totaling 6 groups (n=10). The specimens were subjected to fatigue loading (200N, 2 x 106 cycles, water) and then to the single load to failure test (1 mm/min crosshead speed). Data were analyzed by using two-way ANOVA and Tukey tests (p< 0.05). Results All endocrowns survived the fatigue test. The thickness did not influence the restoration’s fracture load (p=0.548) instead the restorative material (p=0.003). LD showed higher mean values (1714.43 N)A than LEU (1313.47 N)B. Conclusions Endocrowns manufactured with CAD/CAM lithium disilicate blocks showed superior fracture load than the leucite-based blocks after mechanical fatigue. Nevertheless, both materials presented acceptable survival and fracture load as long as the material’s minimum thickness and the enamel adhesion are respected. Key words:Endocrown, CAD/CAM, Endodontically treated teeth, Failure load, Minimal intervention dentistry.
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Affiliation(s)
- João-Paulo-Mendes Tribst
- DDs, MSc, PhD Student in Prosthodontics, Department of Dental Materials and Proshodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos / SP, Brazil
| | - Amanda-Maria-de Oliveira Dal Piva
- DDs, MSc, PhD Student in Prosthodontics, Department of Dental Materials and Proshodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos / SP, Brazil
| | - Camila-Ferreira-Leite Madruga
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), Institute of Science and Technology, Av. Eng. Francisco José Longo, n° 777, Jardim São Dimas, 12245-000 São José dos Campos, SP, Brazil
| | - Marcia-Carneiro Valera
- Department of Restorative Dentistry, São Paulo State University (Unesp), Institute of Science and Technology, Av. Eng. Francisco José Longo, n° 777, Jardim São Dimas, 12245-000 São José dos Campos, SP, Brazil
| | - Eduardo Bresciani
- Department of Restorative Dentistry, São Paulo State University (Unesp), Institute of Science and Technology, Av. Eng. Francisco José Longo, n° 777, Jardim São Dimas, 12245-000 São José dos Campos, SP, Brazil
| | - Marco-Antonio Bottino
- DDs, MSc, PhD, Professor, Department of Dental Materials and Proshodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos / SP, Brazil
| | - Renata-Marques de Melo
- DDs, MSc, PhD, Researcher III, Department of Dental Materials and Proshodontics, São Paulo State University (Unesp), Institute of Science and Technology, São José dos Campos / SP, Brazil
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Mondelli J, Rizzante FAP, Valera FB, Roperto R, Mondelli RFL, Furuse AY. Assessment of a conservative approach for restoration of extensively destroyed posterior teeth. J Appl Oral Sci 2019; 27:e20180631. [PMID: 31411263 PMCID: PMC9648951 DOI: 10.1590/1678-7757-2018-0631] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 01/14/2018] [Indexed: 05/30/2023] Open
Abstract
Extensive restorations in posterior teeth always bring doubts to the clinicians regarding the best protocol, mainly when structures of reinforcement were lost.
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Affiliation(s)
- José Mondelli
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, São Paulo, Brasil
| | | | | | - Renato Roperto
- Case Western Reserve University, School of Dental Medicine, Cleveland, Ohio, United States of America
| | - Rafael Francisco Lia Mondelli
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, São Paulo, Brasil
| | - Adilson Yoshio Furuse
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos, Bauru, São Paulo, Brasil
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Ghajghouj O, Taşar-Faruk S. Evaluation of Fracture Resistance and Microleakage of Endocrowns with Different Intracoronal Depths and Restorative Materials Luted with Various Resin Cements. Materials (Basel) 2019; 12:E2528. [PMID: 31398883 DOI: 10.3390/ma12162528] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 07/28/2019] [Accepted: 08/06/2019] [Indexed: 11/18/2022]
Abstract
The aim of this study was to determine the effect of restoration design on the fracture resistance of different computer-aided design/computer-aided manufacturing (CAD/CAM) ceramics and investigate the marginal leakage of endocrowns according to different types of cement. In total, 96 extracted mandibular first premolars were used for fabrication of endocrowns; 48 of the endocrowns were divided into 6 groups (n = 8) according to intracoronal cavity depth (2 and 3 mm) and CAD/CAM ceramics (lithium disilicate IPS e.max-CAD, zirconia-reinforced glass-ceramic Vita Suprinity, and poly-ether-ether-ketone (PEEK)). Teeth were subjected to a fracture resistance test with a universal test machine following thermo-cycling. Failure modes were determined by stereomicroscope after the load test. The rest of the endocrowns (n = 48) were produced by Vita Suprinity ceramic and divided into 6 groups (n = 8) according to the cement used (Panavia V5, Relyx Ultimate, and GC cement) with intracoronal cavity depths of 2 and 3 mm. Microleakage tests were performed using methylene blue with stereomicroscope after thermo-cycling. Numerical data for both fracture resistance and microleakage tests were obtained and evaluated by three-way ANOVA. PEEK endocrowns had higher fracture resistance compared to lithium disilicate and Vita Suprinity. Panavia V5 cement had the lowest degree of microleakage, while GC cement had the highest. Different intracoronal cavity depths had no correlation with fracture resistance and microleakage.
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El Ghoul W, Özcan M, Silwadi M, Salameh Z. Fracture resistance and failure modes of endocrowns manufactured with different CAD/CAM materials under axial and lateral loading. J ESTHET RESTOR DENT 2019; 31:378-387. [DOI: 10.1111/jerd.12486] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 01/28/2019] [Accepted: 04/09/2019] [Indexed: 01/10/2023]
Affiliation(s)
- Wiam El Ghoul
- Lebanese UniversityFaculty of Dental Medicine, Department of Prosthodontics Beirut Lebanon
| | - Mutlu Özcan
- University of ZurichCenter for Dental and Oral Medicine, Division of Dental Biomaterials Zurich Switzerland
| | - Munir Silwadi
- Lebanese UniversityFaculty of Dental Medicine, Department of Prosthodontics Beirut Lebanon
| | - Ziad Salameh
- Lebanese UniversityFaculty of Dental Medicine, Department of Prosthodontics Beirut Lebanon
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Madruga CFL, Bueno MG, Dal Piva AMDO, Prochnow C, Pereira GKR, Bottino MA, Valandro LF, de Melo RM. Sequential usage of diamond bur for CAD/CAM milling: Effect on the roughness, topography and fatigue strength of lithium disilicate glass ceramic. J Mech Behav Biomed Mater 2019; 91:326-334. [DOI: 10.1016/j.jmbbm.2018.12.037] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 12/24/2018] [Accepted: 12/27/2018] [Indexed: 11/15/2022]
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Dogui H, Abdelmalek F, Amor A, Douki N. Endocrown: An Alternative Approach for Restoring Endodontically Treated Molars with Large Coronal Destruction. Case Rep Dent 2018; 2018:1581952. [PMID: 30228915 DOI: 10.1155/2018/1581952] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 07/20/2018] [Accepted: 08/14/2018] [Indexed: 12/03/2022] Open
Abstract
Rehabilitation of endodontically treated molar still remains a challenge. After endodontic treatment, molars lost their mechanical characteristics. In fact, they became fragile and that is in relation with the removal of pulp and surrounding dentin tissues. Endocrown which is a single partial restoration could be considered as a good alternative for restoring molars having large coronal destruction and presenting endodontic treatment difficulties. Through this work, we discuss the indication and use of endocrown to replace single crowns with intraradicular retention and to present a clinical case report of an endocrown-type restoration, fabricated from lithium disilicate ceramic (IPS e.Max CAD) in a mandibular first molar with extensive coronal destruction.
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