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Manaktala M, Taneja S, Bhalla VK. Stress distribution in endodontically treated external cervical resorption lesions restored with MTA and biodentine - A finite element analysis. J Oral Biol Craniofac Res 2024; 14:415-422. [PMID: 38832294 PMCID: PMC11144738 DOI: 10.1016/j.jobcr.2024.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/25/2024] [Accepted: 04/30/2024] [Indexed: 06/05/2024] Open
Abstract
Introduction Root resorption poses a significant challenge in dental practice, with external cervical resorption (ECR) being a common manifestation. ECR is often asymptomatic until advanced stages, complicating its diagnosis and management. Various factors contribute to its etiology, ranging from trauma to orthodontic treatment. The classification system proposed by Patel et al. (2018) offers a comprehensive framework for characterizing ECR lesions based on location and extent. Treatment strategies for ECR involve a combination of endodontic intervention and restorative techniques, with bioactive materials like mineral trioxide aggregate (MTA) and Biodentine emerging as promising options. However, the biomechanical behavior of teeth restored with these materials in the context of ECR remains underexplored. Materials and methods This study utilized finite element analysis (FEA) to assess stress distribution in teeth with simulated ECR lesions of varying sizes and locations, restored with MTA or Biodentine. Three-dimensional models of maxillary central incisors were generated based on CBCT scans, incorporating periodontal ligament and surrounding bone structures. Eight experimental models representing different ECR configurations were created and subjected to FEA using Optistruct software based on dimensional classification given by Patel et al., in 2018, A70 M & A70B: 1Ap, A130 M & A130B: 1Bp, B70 M & B70B: 2Ap, B130 M & B130B: 2Bp. All the models were tested for stress distribution by restoring the lesions with either M: MTA or B: Biodentine. Oblique load of 100 N was applied at 45°angle to the long axis 2 mm lingual to incisal edge. vonMises Stress distribution in enamel, dentine, restoration and at all the interfaces were observed. Results The analysis revealed that both MTA and Biodentine restorations exhibited uniform stress distribution around ECR lesions, with no significant differences based on lesion location or size. Maximum stress concentrations were observed around the restorations, particularly in subcrestal lesions. However, overall stress levels were comparable between MTA and Biodentine restorations, indicating similar biomechanical performance. Conclusion Finite element analysis provides valuable insights into the biomechanical behavior of teeth with ECR lesions restored with MTA and Biodentine. Both materials exhibit similar stress distribution patterns and offer adequate reinforcement against mechanical forces. Clinicians can confidently utilize MTA or Biodentine in the management of ECR, considering their favorable biomechanical properties and clinical outcomes. Further research is necessary to validate these findings and optimize treatment protocols for ECR.
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Affiliation(s)
| | - Sonali Taneja
- Dept. Of Conservative Dentistry and Endodontics, I.T.S Dental College, Ghaziabad, India
| | - Vidhi Kiran Bhalla
- Dept. Of Conservative Dentistry and Endodontics, I.T.S Centre for Dental Studies and Research, Ghaziabad, India
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Aslan T, Esim E, Üstün Y. Finite element evaluation of dentin stress changes following different endodontic surgical approaches. Odontology 2024:10.1007/s10266-023-00882-1. [PMID: 38184512 DOI: 10.1007/s10266-023-00882-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/04/2023] [Indexed: 01/08/2024]
Abstract
The aim was to compare the effect of different endodontic surgical treatments on the stress distributions in dentin of a simulated first mandibular molar tooth using the finite element analysis method. Three surgical endodontic procedures (apical resection, root amputation, and hemisection) were simulated in a first mandibular molar. Biodentine or mineral-trioxide-aggregate was used to repair the surgery site in apical resection and root amputation models; the remaining root canal spaces were filled with gutta-percha. Access cavities were restored using resin composite. In hemisection model, root canal was filled with gutta-percha, and coronal restoration was finished with a monolithic zirconia crown. A sound tooth model was created as a control model. An oblique force of 300 N angled at 45° to the occlusal plane was simulated. Maximum von Mises stresses were evaluated in dentin near the surgery regions and the entire tooth. Apical resection/Biodentine and apical resection/mineral-trioxide-aggregate models generated maximum von Mises stresses of 39.001 MPa and 39.106 MPa, respectively. The recorded maximum von Mises stresses in root amputation models were 66.491 MPa for root amputation/Biodentine and 73.063 MPa for root amputation/mineral-trioxide-aggregate models. The highest maximum von Mises stress value among all models was observed in the hemisection model, measuring 138.87 MPa. Hemisection induced the highest von Mises stresses in dentin, followed by root amputation and apical resection. In apical resection, Biodentine and mineral-trioxide-aggregate did not show a significant difference in stress distribution. Biodentine in root amputation may lead to lower stresses compared to mineral-trioxide-aggregate.
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Affiliation(s)
- Tuğrul Aslan
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Turhan Baytop Street, No. 1, Yenidoğan District, Talas, Kayseri, 38280, Turkey.
| | - Emir Esim
- Department of Mechatronics Engineering, Faculty of Engineering, Erciyes University, Kayseri, Turkey
| | - Yakup Üstün
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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Gontijo IG, Ferretti MA, Caldas RA, Pecorari VGA, França FMG, Oliveira LKN, Aguiar FHB. Biomechanical behavior of weakened roots restored with custom-made post-and-cores of glass fiber and polyetheretherketone. J Prosthodont 2023; 32:807-814. [PMID: 36482016 DOI: 10.1111/jopr.13628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 11/30/2022] [Accepted: 12/02/2022] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To evaluate the influence of post type and mechanical aging on compression force resistance, fracture pattern, and stress distribution in weakened roots. MATERIALS AND METHODS Bovine roots were endodontically treated and widened-and randomly divided into 8 groups (n = 10) according to post type (prefabricated glass fiber post and customized anatomic glass fiber post, milled glass fiber post-and-core, and milled polyetheretherketone post-and-core) and mechanical aging (without and with mechanical aging). Three hundred thousand cycles of mechanical fatigue were performed and compression force resistance (N) was analyzed by two-way ANOVA and Tukey test (α = 0.05). Fracture patterns were reported and stress distribution was analyzed by finite elements analysis. RESULTS There was a significant effect of post type (p = 0.032) and mechanical aging (p = 0.009), but no double interaction (p = 0.879). Higher values were recorded in the milled glass fiber and polyetheretherketone post-and-core groups compared to the prefabricated glass fiber post groups, and no significant difference was found among anatomic glass fiber post groups and other groups. Reparable fractures were predominant in the milled glass fiber and polyetheretherketone post-and-core groups. Prefabricated glass fiber posts and milled polyetheretherketone post-and-cores showed similar stress distribution. CONCLUSIONS Post type and mechanical aging influence the compression force resistance and fracture pattern of weakened roots. Milled glass fiber and polyetheretherketone post-and-cores exhibited higher compression force resistance and more reparable fractures compared to prefabricated glass fiber posts. Prefabricated glass fiber posts and milled polyetheretherketone post-and-cores showed similar stress distribution.
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Affiliation(s)
- Isabela G Gontijo
- Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Marcela A Ferretti
- Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Ricardo A Caldas
- Department of Prosthodontics, Federal University of Santa Catarina - UFSC, Florianópolis, SC, Brazil
| | - Vanessa G A Pecorari
- Department of Dental Materials, Paulista University - UNIP, São Paulo, SP, Brazil
| | - Fabiana M G França
- Department of Restorative Dentistry, São Leopoldo Mandic School of Dentistry - SLMANDIC, Campinas, SP, Brazil
| | - Lorena K N Oliveira
- Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
| | - Flávio H B Aguiar
- Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas - UNICAMP, Piracicaba, SP, Brazil
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Rahmatian M, Jafari Z, Moghaddam KN, Dianat O, Kazemi A. Finite Element Analysis of Fracture Resistance of Mandibular Molars with Different Access Cavity Designs. J Endod 2023; 49:1690-1697. [PMID: 37804945 DOI: 10.1016/j.joen.2023.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 10/09/2023]
Abstract
INTRODUCTION This study aimed to assess the fracture resistance of mandibular first molars after preparation with 3 different access cavity designs and 2 rotary systems using finite element analysis. METHODS Six 3-dimensionally printed mandibular first molars simulating natural teeth received traditional, conservative, and ultraconservative (truss) access cavity preparations. The root canals in each group were instrumented with either XP-Endo Shaper (FKG Dentaire, La Chaux-de-Fonds, Switzerland) or TruNatomy (Dentsply Sirona, Ballaigues, Switzerland) rotary files. The models were individually digitized, and micro-computed tomographic scans were transferred to Mimics software (Materialise NV, Leuven, Belgium) to create a geometric model of the tooth. The designed model was exported to 3-matic software (Materialise NV), and STL files were transferred to Geomagic Design X (3D Systems, Rock Hill, SC). Point cloud data were used for surfacing and transferred to ANSYS software (Ansys, Canonsburg, PA). A 200-N superficial force was applied vertically to the buccal cusps and central fossa, and the maximum and minimum equivalent von Mises stress values were calculated and reported. RESULTS The traditional and ultraconservative access cavity designs yielded the highest and the lowest von Mises stress values, respectively. In the ultraconservative cavity design, the stress values in pericervical dentin were lower in canal preparation with TruNatomy compared with XP-Endo Shaper. In the traditional and conservative cavity designs, stress was lower in the first 2 mm from the cementoenamel junction in the XP-Endo Shaper group and in the next 3 mm in the TruNatomy group. CONCLUSIONS Stress was lower in the ultraconservative and conservative cavity designs compared with the traditional design. Also, root canal preparation with TruNatomy yielded lower stress values in general compared with XP-Endo Shaper.
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Affiliation(s)
| | - Zahra Jafari
- Department of Endodontics, Dental School, Shahed University, Tehran, Iran
| | | | - Omid Dianat
- Endodontic Division, Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, Maryland
| | - Ali Kazemi
- Department of Endodontics, Dental School, Shahed University, Tehran, Iran.
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Marinescu AG, Abuabboud O, Zimbru ȘD, Cîrligeriu LE, Piț BA, Borcean IA, Paven M, Nica LM, Stoia DI. Influence of the Fiber Post Length on the Fracture Strength of Endodontically Treated Teeth. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1797. [PMID: 37893515 PMCID: PMC10608114 DOI: 10.3390/medicina59101797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/08/2023] [Accepted: 10/08/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Although fiber posts are widely used in the restoration of endodontically treated teeth (ETT), their ideal cementation depth into the root canal is still debated in literature. The aim of the present study was to evaluate whether the different intra-radicular insertion lengths of the fiber posts influence the fracture strength of ETT. Materials and Methods: A total of 10 permanent human lower incisors with straight roots of similar length and volume extracted for periodontal reason were sectioned 2 mm above the cement-enamel junction (CEJ) to a total length of 18 mm and endodontically treated in the same manner, then randomly divided into two groups of five each (Groups 1 and 2, n = 5). Two sound incisors, with no endodontic treatment, were used as the control group (Group 3, n = 2). After one week of storage in a humid environment, spaces for fiber post no. 1 (Reforpost, Angelus, Londrina, PR, Brazil) were prepared in the first two groups at a depth of 5 mm (Group 1) and 7 mm (Group 2), and the fiber posts were adhesively cemented using self-adhesive resin cement (Maxcem Elite, Kerr GmbH, Herzogenrath, Germany). After 7 days, the samples were vertically positioned and fixed in a self-curing transparent acrylic resin, up to 2 mm below the CEJ level, and mechanically tested in compression after another week of storage using a displacement-controlled testing machine up to each sample's fracture. The force-displacement curves were recorded for each sample, the means were calculated for each group and a statistical comparative analysis between groups was conducted. Results: Although no statistically significant differences between groups were observed, the highest mean fracture force (N) was recorded in Group 2 (1099.41 ± 481.89) in comparison to Group 1 (985.09 ± 330.28), even when compared to the sound, non-treated teeth (1045.69 ± 146.19). Conclusions: Within the limitations of this in vitro study, teeth where fiber posts were placed deeper into the root canal (7 mm) recorded slightly higher fracture forces in comparison with shorter lengths (5 mm). However, similar biomechanical performances obtained in the mechanical tests showed no statistical differences between the 7 mm and the 5 mm inserted posts.
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Affiliation(s)
- Adrian-George Marinescu
- Department of Restorative Dentistry and Endodontics, Research Center TADERP, Faculty of Dentistry, “Victor Babeș” U.M.Ph.–Timisoara, 300041 Timisoara, Romania; (A.-G.M.); (L.-E.C.); (M.P.)
| | - Osama Abuabboud
- Faculty of Dentistry, “Victor Babeș” U.M.Ph.–Timisoara, 300041 Timisoara, Romania; (O.A.); (Ș.-D.Z.); (B.-A.P.); (I.-A.B.)
| | - Ștefana-Denisa Zimbru
- Faculty of Dentistry, “Victor Babeș” U.M.Ph.–Timisoara, 300041 Timisoara, Romania; (O.A.); (Ș.-D.Z.); (B.-A.P.); (I.-A.B.)
| | - Laura-Elena Cîrligeriu
- Department of Restorative Dentistry and Endodontics, Research Center TADERP, Faculty of Dentistry, “Victor Babeș” U.M.Ph.–Timisoara, 300041 Timisoara, Romania; (A.-G.M.); (L.-E.C.); (M.P.)
| | - Bianca-Adina Piț
- Faculty of Dentistry, “Victor Babeș” U.M.Ph.–Timisoara, 300041 Timisoara, Romania; (O.A.); (Ș.-D.Z.); (B.-A.P.); (I.-A.B.)
| | - Ioana-Amalia Borcean
- Faculty of Dentistry, “Victor Babeș” U.M.Ph.–Timisoara, 300041 Timisoara, Romania; (O.A.); (Ș.-D.Z.); (B.-A.P.); (I.-A.B.)
| | - Mihai Paven
- Department of Restorative Dentistry and Endodontics, Research Center TADERP, Faculty of Dentistry, “Victor Babeș” U.M.Ph.–Timisoara, 300041 Timisoara, Romania; (A.-G.M.); (L.-E.C.); (M.P.)
| | - Luminița-Maria Nica
- Department of Restorative Dentistry and Endodontics, Research Center TADERP, Faculty of Dentistry, “Victor Babeș” U.M.Ph.–Timisoara, 300041 Timisoara, Romania; (A.-G.M.); (L.-E.C.); (M.P.)
| | - Dan Ioan Stoia
- Department of Mechanics and Strength of Materials, Polytechnica University Timisoara, 300006 Timișoara, Romania;
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Koosha S, Jebelizadeh MS, Mostafavi AS. Effect of Ferrule Location on Fracture Resistance of Maxillary Premolars: An In Vitro Study. Int J Dent 2023; 2023:9513804. [PMID: 37593681 PMCID: PMC10432005 DOI: 10.1155/2023/9513804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 06/19/2023] [Accepted: 06/26/2023] [Indexed: 08/19/2023] Open
Abstract
Objectives The present study aimed to assess the effect of ferrule location on fracture resistance of maxillary premolars. Materials and Methods A total of 72 extracted human maxillary premolars were selected and randomly assigned to six groups (n = 12 in each) considering ferrule location: circumferential ferrule (CF), without ferrule (WF), buccal ferrule (BF), lingual ferrule (LF), mesial ferrule (MF), and buccal-lingual ferrule (BLF). Cast posts were cemented into the prepared post spaces. Following conventional impression, Ni-Cr crowns were cemented to the specimens. After thermocycling (5,000 cycles, 5-55°C), the specimens were loaded at 45° in a universal testing machine until fracture. Data were analyzed with one-way ANOVA, Kolmogorov-Smirnov, and Tamhane tests. Results The maximum and minimum mean fracture resistance were related to the CF (1,143.84 N) and WF (514.89 N) groups, respectively, (P = 0.039). Fracture resistance in the BF (933.67 N) and BLF (874.01 N) groups was significantly higher than in the MF group (617.54 N) (P = 0.001). There was no significant difference between the MF, LF (722.89 N), and WF groups in terms of fracture resistance (P > 0.05). Conclusion Teeth with CF showed maximum fracture resistance. The location of the ferrule effects on the fracture resistance of maxillary premolars and also the mode of failure.
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Affiliation(s)
- Sara Koosha
- Department of Prosthodontics, School of Dentistry, Azad Islamic University, Tehran, Iran
| | | | - Azam S. Mostafavi
- Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Lima MO, Ferretti MA, Caldas RA, Barão VAR, França FMG, Lima DANL, Martins LR, Aguiar FHB. Application of polyetheretherketone (PEEK) posts: evaluation of fracture resistance and stress distribution in the root: in vitro and finite element analyses. Braz Oral Res 2023; 37:e047. [PMID: 37255067 DOI: 10.1590/1807-3107bor-2023.vol37.0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 12/06/2022] [Indexed: 06/01/2023] Open
Abstract
To evaluate the feasibility of using a milled polyetheretherketone (PEEK) post and core in endodontically treated teeth with or without a ferrule. Sixty bovine tooth roots were endodontically treated followed by cementation of intraradicular retainers (IR), according to each experimental group: a) non-ferrule glass fiber post (f0FP); b) 2-mm-ferrule glass fiber post (f2FP); c) non-ferrule resized glass fiber post (f0PR); d) 2-mm-ferrule resized glass fiber post (f2PR); e) non-ferrule PEEK post and core (f0PPC); and f) 2-mm-ferrule PEEK post and core (f2PPC). Metal crowns were made and cemented. A periodontal ligament was simulated using polyether. A force was applied to the palatine portion of each sample at 45°, until fracture. Fracture resistance data were submitted to two-way ANOVA and Tukey's test (α = 0.05). Three-dimensional digital models were developed to calculate the tensions formed in the root using finite element analysis. Models of glass fiber posts and PEEK posts and cores were evaluated with or without a ferrule. The results were analyzed by the Mohr-Coulomb criterion. The type of IR was not influenced by fracture strength (p = 0.243). There were significant statistical differences among the remaining factors. Ferrule groups had greater fracture resistance, and the failure mode of teeth with a ferrule was more catastrophic than the non-ferrule group. A ferrule increases fracture resistance and influences failure mode; the PEEK post and core did not modify the biomechanics of endodontically treated teeth, and resembled the glass fiber post results. The crack initiation point differed between the ferrule and non-ferrule groups.
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Affiliation(s)
- Michele Oliveira Lima
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Restorative Dentistry, Piracicaba, SP, Brazil
| | - Marcela Alvarez Ferretti
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Restorative Dentistry, Piracicaba, SP, Brazil
| | - Ricardo Armini Caldas
- Universidade Federal de Santa Catarina - UFSC, Department of Dentistry, Florianópolis, SC, Brazil
| | - Valentim Adelino Ricardo Barão
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Prosthodontics and Periodontology, Piracicaba, SP, Brazil
| | | | - Débora Alves Nunes Leite Lima
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Restorative Dentistry, Piracicaba, SP, Brazil
| | - Luís Roberto Martins
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Restorative Dentistry, Piracicaba, SP, Brazil
| | - Flávio Henrique Baggio Aguiar
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Restorative Dentistry, Piracicaba, SP, Brazil
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Ince Yusufoglu S, Saricam E, Ozdogan MS. Finite Element Analysis of Stress Distribution in Root Canals When Using a Variety of Post Systems Instrumented with Different Rotary Systems. Ann Biomed Eng 2023:10.1007/s10439-023-03145-w. [PMID: 36705864 DOI: 10.1007/s10439-023-03145-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 01/11/2023] [Indexed: 01/28/2023]
Abstract
It is very important for clinicians to provide restorative treatments that provide durability for endodontically treated teeth. Trauma, occlusal premature contact, and features of teeth are some of the issues that can cause vertical root fractures (VRFs) in root canal-treated teeth. The aim of this 3-D study was to compare stress distribution on mandibular premolar teeth when using a variety of post designs instrumented with different rotary systems. Six mandibular premolar teeth were instrumented with the following tools: ProTaper Next, WaveOne (WO), Reciproc (R), ReciprocBlue (RB), F6-Skytaper, and TF-Adaptive. Teeth were scanned using cone beam computed tomography (CBCT) and the images were transferred to the Catia V5R25 software. Data were recorded in a stereolithography (STL) format. Four different post systems were used, fabricated from metal, fiber, zirconia, and titanium, respectively. Dentin, gutta, post, core, and crown models were added to the solid model. ANSYS V17.2 finite element analysis (FEA) software was used to determine stress distribution on each assembly. Finite analysis models were created that allowed for the calculation of stress distribution of 250-N loading at a 45° angle and vertical in relation to the roots. The maximum principal stress and von Mises values were higher under oblique loading on the roots. The F6-Skytaper and WO systems showed lower stress than other systems. The TF-Adaptive instrument showed higher stress distribution than the other models. Fiber and titanium posts showed lower stress than others. The F6-Skytaper, R, and RB instruments were found to be most effective in terms of displacement of the crown, resulting in the lowest stress values. Fiber and titanium posts showed better results than other post systems, while root canals instrumented with the F6-Skytaper and WO instruments were less likely to result in root fractures.
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Affiliation(s)
- Selen Ince Yusufoglu
- Department of Endodontics, Faculty of Dentistry, Ankara Yıldırım Beyazit University, Ankara, Turkey.
| | - Esma Saricam
- Department of Endodontics, Faculty of Dentistry, Ankara Yıldırım Beyazit University, Ankara, Turkey
| | - Mahmut Sertac Ozdogan
- Department of Prosthodontics, Faculty of Dentistry, Ankara Yıldırım Beyazit University, Ankara, Turkey
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Ordinola-Zapata R, Lin F, Nagarkar S, Perdigão J. A critical analysis of research methods and experimental models to study the load capacity and clinical behavior of the root filled teeth. Int Endod J 2022; 55 Suppl 2:471-494. [PMID: 35263455 PMCID: PMC9314814 DOI: 10.1111/iej.13722] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 03/04/2022] [Indexed: 12/04/2022]
Abstract
The prognosis of root‐filled teeth depends not only on a successful root canal treatment but also on the restorative prognosis. This critical review discusses the advantages and limitations of various methodologies used to assess the load capacity or clinical survivability of root‐filled teeth and restorations. These methods include static loading, cyclic loading, finite element analysis and randomized clinical trials. In vitro research is valuable for preclinical screening of new dental materials or restorative modalities. It also can assist investigators or industry to decide whether further clinical trials are justified. It is important that these models present high precision and accuracy, be reproducible, and present adequate outcomes. Although in vitro models can reduce confounding by controlling important variables, the lack of clinical validation (accuracy) is a downside that has not been properly addressed. Most importantly, many in vitro studies did not explore the mechanisms of failure and their results are limited to rank different materials or treatment modalities according to the maximum load capacity. An extensive number of randomized clinical trials have also been published in the last years. These trials have provided valuable insight on the survivability of the root‐filled tooth answering numerous clinical questions. However, trials can also be affected by the selected outcome and by intrinsic and extrinsic biases. For example, selection bias, loss to follow‐up and confounding. In the clinical scenario, hypothesis‐based studies are preferred over observational and retrospective studies. It is recommended that hypothesis‐based studies minimize error and bias during the design phase.
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Affiliation(s)
- Ronald Ordinola-Zapata
- Division of Endodontics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Fei Lin
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, 100081, China.,Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Sanket Nagarkar
- Park Dental Group, Minneapolis, Minnesota, and Clinical Research Assistant Professor (affiliated), Department of Restorative Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jorge Perdigão
- Division of Operative Dentistry, Department of Restorative Sciences, University of Minnesota, Minneapolis, Minnesota, USA
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Yanık D, Turker N. Stress distribution of a novel bundle fiber post with curved roots and oval canals. J ESTHET RESTOR DENT 2021; 34:550-556. [PMID: 34766692 DOI: 10.1111/jerd.12835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/24/2021] [Accepted: 10/26/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of this study was to compare the stress distribution of teeth with curved and straight roots with oval and round canals restored with the bundle and conventional post systems. MATERIAL AND METHODS Six three-dimensional premolars were modeled with round and oval canals, and curved roots using the software. The bundle post and the round posts were modeled. All post models were placed on the canals. The models were subjected to 200 N oblique loading. The results were evaluated by von Mises stresses. RESULTS This study demonstrated that the bundle post showed higher stress values compared to the conventional post. The stresses in the oval canal were higher than those in the round canal. The highest stress values were found in the curved roots. The stress distribution on the curved roots was observed in the middle and apical third of the canal. CONCLUSION The bundle post presented higher stress compared to conventional posts. Besides, a more uniform stress distribution was observed in the bundle groups. CLINICAL SIGNIFICANCE When a post was required in extremely irregular, wide canals and curved roots, the bundle post was the material of choice. Canal and root morphology influenced stress distribution.
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Affiliation(s)
- Deniz Yanık
- Faculty of Dentistry, Department of Endodontics, Antalya Bilim University, Antalya, Turkey
| | - Nurullah Turker
- Faculty of Dentistry, Department of Prosthodontics, Akdeniz University, Antalya, Turkey
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Santos Pantaleón D, Valenzuela FM, Morrow BR, Pameijer CH, García-Godoy F. Effect of Cervical Lesions on Fracture Resistance and Failure Mode of Maxillary Central Incisors Restored with Fiber Posts and Complete Crowns. Oper Dent 2021; 46:669-679. [PMID: 35507904 DOI: 10.2341/20-164-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2021] [Indexed: 11/23/2022]
Abstract
PURPOSE To investigate the effect of a cervical cavity extending 1 mm apical to the cemento-enamel junction (CEJ) on fracture resistance and failure mode of maxillary central incisors that have been treated endodontically, present with complete and incomplete ferrules, and are restored with and without a fiber post. METHODS AND MATERIALS 50 intact human maxillary central incisors were divided into five groups (n=10): CG (control group) 6-mm fer-rule height, no cervical cavity, and without post; (CO) 6-mm ferrule height without post, with a cervical cavity (access to root canal and cervical cavity restored with composite resin), cervical cavity; and post with ferrule heights of 1 mm (CP1), 2 mm (CP2), and 6 mm (CP6) restored with fiberglass post and composite resin core. After complete metal crowns were cemented on all specimens, they were subjected to thermal cycling (6000 cycles, 5°C/55°C), followed by immediate testing of fracture resistance. After failure, the specimens were sectioned buccolingually to evaluate and identify the mode of failure. The data were analyzed with an analysis of variance (ANOVA) and the Student-Newman-Keuls multiple comparison tests (α =0.05). RESULTS A 1-mm ferrule height (CP1) fracture resistance was significantly lower (531±125 N) compared to the 6-mm ferrule height (CP6) (769±175 N) (p<0.05). With respect to the groups with similar residual dentin, with and without a cervical cavity, CG (667±119 N) and CO (668±119 N), the presence of a post (CP6) increased the resistance to fracture, although no statistically significant difference was demonstrated. Partial decementation was observed in all specimens of CG and CP6, in nine of CP1 and CP2, and in three in CO. Root fractures occurred in 23 specimens. The root surface was exposed 2 mm below the CEJ to simulate bone level. Propagation of subosseous cracks occurred in four specimens in CG and CP2, in seven specimens in CP6, in two specimens in CP1, and in six specimens in CO. All were considered catastrophic failures. CONCLUSIONS Within the limitations of this study it is suggested that, when restoring an endodontically treated maxillary central incisor that has a cervical lesion and needs to be restored with a complete crown, a fiber post is cemented to improve fracture resistance.
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Affiliation(s)
- D Santos Pantaleón
- *Domingo Santos Pantaleón, DDS, MSD, PhD, professor (retired) of prosthodontics, School of Dentistry, Autonomous University of Santo Domingo, Santo Domingo, Dominican Republic
| | - F M Valenzuela
- Fabio M. Valenzuela, DDS, associate professor of prosthodontics, School of Dentistry, Autonomous University of Santo Domingo, Santo Domingo, Dominican Republic
| | - B R Morrow
- Brian R. Morrow, MS, research associate, Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
| | - C H Pameijer
- Cornelis H. Pameijer, DMD, MScD, DSc, PhD, professor emeritus, Department of Reconstructive Sciences, University of Connecticut, Farmington, CT, USA
| | - F García-Godoy
- Franklin García-Godoy, DDS, MS, PhD, PhD, professor and director, Bioscience Research Center, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA, and Honorary Professor, School of Dentistry, Autonomous University of Santo Domingo, Santo Domingo, Dominican Republic
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12
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Özarslan M, Büyükkaplan UŞ, Özarslan MM. Comparison of the fracture strength of endodontically treated teeth restored with polyether ether ketone, zirconia and glass-fibre post-core systems. Int J Clin Pract 2021; 75:e14440. [PMID: 34096673 DOI: 10.1111/ijcp.14440] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/25/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE This study aimed to compare the fracture resistance and fracture mode of maxillary central incisors restored with four different sizes and three different post-core systems. MATERIALS AND METHODS One hundred and twenty maxillary incisors were endodontically treated and randomly divided into three groups (12 subgroups). Post cavities for the narrow subgroups were prepared with 1.4-mm-diameter drills in lengths of 7.5 mm (SN) and 10 mm (LN). Post cavities for the wide subgroups were prepared with 1.6-mm-diameter drills in lengths of 7.5 mm (SW) and 10 mm (LW) (n = 10). Group F was restored with glass-fibre post and composite resin core, Group P was restored with custom PEEK post-core and Group Z was restored with custom zirconia post-core. All posts were cemented with a dual-cure resin cement. Zirconia copings were cemented. Specimens were loaded on the palatal surface with a universal testing machine, and the fracture strengths of the teeth were statistically analysed using ANOVA and post hoc Tukey tests. RESULTS Statistically significant differences existed between the fracture strengths of the post materials. The highest fracture strength was in Group F, and the lowest was in Group P. Evaluation of the fracture strengths of the post lengths and diameters demonstrated that the short-narrow group of Group Z had the lowest fracture strength (P < .05). The long-wide group of Group F showed the highest fracture resistance. In Group P, no statistically significant difference existed between the post-cores of different dimensions (P > .05). Irreparable fractures were observed mostly in Group Z, and decementation was more common in Group P. CONCLUSIONS PEEK post-cores showed sufficient fracture strength for the anterior region, similar to the other two post-core materials. PEEK post-cores showed more decementation and repairable fractures at lower forces, while restoration failure was mostly catastrophic for glass-fibre and zirconia posts.
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Affiliation(s)
- Merve Özarslan
- Department of Prosthetic Dentistry, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | | | - Mehmet Mustafa Özarslan
- Department of Prosthetic Dentistry, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
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13
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KÜÇÜKEKENCİ AS, DEDE DÖ. Effect of tribochemical surface treatment technique on the push-out bond strength of novel CAD/CAM post restorations. CUMHURIYET DENTAL JOURNAL 2021. [DOI: 10.7126/cumudj.849157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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14
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Sugano K, Komada W, Okada D, Miura H. Evaluation of composite resin core with prefabricated polyetheretherketone post on fracture resistance in the case of flared root canals. Dent Mater J 2020; 39:924-932. [PMID: 32595188 DOI: 10.4012/dmj.2019-153] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of this study was to use polyetheretherketone (PEEK) for the post material and evaluate the fracture load of six restoration patterns in teeth with flared root canals; composite resin core alone (Group R); glass fiber sleeve (Group S); PEEK post (Group P); glass fiber post (Group F); PEEK post in glass fiber sleeve (Group PS); glass fiber post in glass fiber sleeve (Group FS). In this study, cylindroid specimens were prepared and underwent three-point-bending test in a steady condition and after water immersion. In the loading test, the materials in clinical conditions using bovine teeth were evaluated. In the bending test, groups using glass fiber posts and sleeves decreased in strength after water immersion. In the loading test, Groups F, FS and PS showed higher fracture load than other groups. This study showed PEEK posts and glass fiber sleeves are recommended in the case of flared root canals.
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Affiliation(s)
- Kiriko Sugano
- Department of Fixed Prosthodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU)
| | - Wataru Komada
- Department of Fixed Prosthodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU)
| | - Daizo Okada
- Department of Fixed Prosthodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU)
| | - Hiroyuki Miura
- Department of Fixed Prosthodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU)
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15
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Aslan T, Esim E, Üstün Y, Dönmez Özkan H. Evaluation of Stress Distributions in Mandibular Molar Teeth with Different Iatrogenic Root Perforations Repaired with Biodentine or Mineral Trioxide Aggregate: A Finite Element Analysis Study. J Endod 2020; 47:631-640. [PMID: 33245971 DOI: 10.1016/j.joen.2020.11.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 11/11/2020] [Accepted: 11/16/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION In this study, finite element analysis was used to evaluate the stress distributions in simulated mandibular molar teeth with various iatrogenic root perforation types after reparation with Biodentine (Septodont, Saint-Maur-des-Fossés, France) or mineral trioxide aggregate (MTA). METHODS An extracted human mandibular molar tooth was scanned using a micro-computed tomographic device, and a 3-dimensional solid model was created. Then, 3 different iatrogenic perforation types (furcation perforation [FP], strip perforation [SP], and post drill perforation [PDP]) and 2 different repair materials (MTA and Biodentine [BD]) were simulated on the model. In addition, a sound tooth (ST) model (control) and a model left unrepaired for each type of perforation were created; then, access cavities were restored using resin composite, except for the sound tooth model. Consequently, a total of 10 experimental models were designed. An oblique force of 300 N angled at 45° to the occlusal plane was simulated. Evaluations of von Mises stress were performed in the perforated regions. RESULTS Maximum von Mises stress values were 7.76 MPa for ST/corresponding to the FP region, 8.48 MPa for ST/corresponding to the SP region, 14.20 MPa for ST/corresponding to the PDP region, 10.89 MPa for FP /MTA, 7.65 MPa for FP/BD, 14.67 MPa for FP/unrepaired, 15.92 MPa for SP/MTA, 15.82 MPa for SP/BD, 21.95 MPa for SP/unrepaired, 10.20 MPa for PDP/MTA, 9.17 MPa for PDP/BD, and 17.86 MPa for PDP/unrepaired. CONCLUSIONS The results of this finite element analysis indicated that BD models showed lower maximum von Mises stress values than the MTA models, and SPs exposed higher stress concentrations in root perforation regions than FPs and PDPs. The use of MTA and BD may reduce the risk of potentially harmful stress in root perforation regions.
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Affiliation(s)
- Tuğrul Aslan
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Emir Esim
- Department of Mechatronics Engineering, Faculty of Engineering, Erciyes University, Kayseri, Turkey
| | - Yakup Üstün
- Department of Endodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | - Hicran Dönmez Özkan
- Department of Endodontics, Faculty of Dentistry, Aydın Adnan Menderes University, Aydın, Turkey.
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Li X, Kang T, Zhan D, Xie J, Guo L. Biomechanical behavior of endocrowns vs fiber post-core-crown vs cast post-core-crown for the restoration of maxillary central incisors with 1 mm and 2 mm ferrule height: A 3D static linear finite element analysis. Medicine (Baltimore) 2020; 99:e22648. [PMID: 33120754 PMCID: PMC7581096 DOI: 10.1097/md.0000000000022648] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
To analyze the stress distribution of the maxillary central incisor with oblique fracture, repaired by different methods, using 3-dimensional finite element analysis. From the biomechanical point of view, it is expected to provide a reference for clinical selection of restoration method which is more conducive to stress distribution and preservation of dental tissue as much as possible.Use cone beam CT and finite element software to establish the finite element models of the maxillary central incisor with oblique fracture, and then create models according to 5 repairing methods(A. fiber post-core-crown group; B. cast post-core-crown group; C.3 mm deep endocrown; D.4 mm deep endocrown; E.5 mm deep endocrown)after root canal treatment, and analyze the Von Mises equivalent stress and maximum principal stress distribution and peak value of each model.When the height of dentin ferrule was fixed, the value of the Von Mises equivalent stress and the maximum principal stress in residual tooth tissue: group A was the highest, and there was no significant difference in group B, C, D and E. And the stress distribution area of 5 groups were the same. In prosthodontic layer: group B was the highest, while group A was the lowest, and the stress peak slightly increased with the increase of depth in group C, D and E. And the 5 groups were with the same stress distribution area as well. In adhesive layer: group A was the highest, while group B was the lowest, and there was little difference among group C, D and E. Group A was concentrated in 1/3 of the post tip, while group B,C,D and E were concentrated in 1/3 of the post and the post tips.Complete and high enough dentin ferrule is a requirement for repairing heavily defected maxillary central incisor with fiber post-core crown and cast post-core crown. When the dentin ferrule is incomplete, the stress distribution of the endocrown is more excellent than post-core-crown. And the endocrown with a depth of 3 mm retainer may be the best repair method. As for post-core crown restoration, the cast post-core crown is more favorable for the uniform distribution of residual tooth tissue than the fiber post-core crown.
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Affiliation(s)
- Xixi Li
- Department of prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, Luzhou
- Department of Stomatology, The First People's Hospital of Shuangliu District
| | - Ting Kang
- Chengdu Second People's Hospital, Chengdu
| | - Danting Zhan
- Department of prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, Luzhou, China
| | - Jing Xie
- Department of prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, Luzhou, China
| | - Ling Guo
- Department of prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, Luzhou, China
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17
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Silva CF, Martins VM, Melo ADP, Martins LC, Santos-Filho PCF. The Use of Bulk-Fill Flow in the Customization of Glass Fiber Post. Eur J Dent 2020; 15:139-144. [PMID: 32932532 PMCID: PMC7902113 DOI: 10.1055/s-0040-1716599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objectives
The aim of this study is to evaluate the influence of different composite resin in the customization of glass fiber posts (GFPs) on bond strength and failure mode.
Materials and Methods
Thirty bovine roots were selected. The wall roots were reduced so that each wall had a minimum dentin thickness of 1 mm. Thirty GFPs were divided into three groups (
n
= 10), which received different types of customization. The first had the GFP relined by bulk-fill flowable composite resin (BF), the second group had the GFP customized by conventional regular composite resin (CR), and the third group was cemented with dual resin cements (DRC), without relining. The root were sectioned, resulting in two 1.0-mm thick slices from cervical root regions only and push-out bond strength test was performed (EMIC, Universal testing machine). To determine failure mode, a stereomicroscope was used at ×40 magnification, with a 2.5D analysis.
Statistical Analysis
Data were analyzed using two-way ANOVA (
α
= 0.05) and Tukey’s test.
Results
BF (9.08 ± 1.9) and CR (9.17 ± 3.00) did not show a statistically significant difference (
p
= 0.961), regarding the bond strength test values. However, there was a statistically significant difference between DRC (5.44 ± 1.89) and the others (
p
< 0.05). BF (66.66%) and the CR group (47.61%) presented a predominantly failure mode type 6: mixed between resin cement and composite. While the highest failure index of the DRC group was type 2: adhesive between resin cement and dentin (47.61%).
Conclusion
BF can be an alternative for the customization of fiber posts, since it presented a similar behavior to the established technique with conventional composites.
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Affiliation(s)
- Camila Ferreira Silva
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Victor Mota Martins
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Anahi de Paula Melo
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Laís Carvalho Martins
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
| | - Paulo Cesar Freitas Santos-Filho
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil
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18
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Cosola S, Toti P, Babetto E, Covani U, Peñarrocha-Diago M, Peñarrocha-Oltra D. In-vitro fatigue and fracture performance of three different ferrulized implant connections used in fixed prosthesis. J Dent Sci 2020; 16:397-403. [PMID: 33384826 PMCID: PMC7770321 DOI: 10.1016/j.jds.2020.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 08/03/2020] [Indexed: 11/09/2022] Open
Abstract
Background/purpose The aim of the present in vitro study was to evaluate fatigue resistance of dental fixtures in three different types of fixture/abutment finishing line. Materials and methods Transmucosal dental implants, with or without ferrulized neck, underwent fatigue tests (static and dynamic load) using the following standard protocol: UNI EN ISO 14801:2016. Two types of loading devices (screw- or cement-retained restoration) were also tested, and fatigue cycle tests were run to failure. Data of static and dynamic load tests were analyzed by proper statistical methods. Results Following standard protocol for fatigue testing, the ILC type (Implant Level with ferrulized neck and cement-retained crown) showed a non-significant but higher Ultimate Failure Load (UFL = 445.7 N) compared to AL type (Abutment Level without ferrule effect, 421.6 N) and ILS type (Implant Level with ferrulized neck and Screw-retained crown, 362.8 N). No fracture of the titanium-base was registered in the tested specimens during the static loadings. Permanent deformations of the materials were observed. Conclusion The number of cycles to either fracture or deformation (higher than 4 mm) occurring during fatigue tests showed that the stress rupture curve of the materials in group ILS appeared to be significantly different from those of the ILC and AL groups (p-values < 0.01): much higher life of one-half order of magnitude.
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Affiliation(s)
- Saverio Cosola
- Department of Stomatology, Tuscan Stomatological Institute, Foundation for Dental Clinic, Research and Continuing Education, Forte Dei Marmi, Italy.,Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Paolo Toti
- Department of Stomatology, Tuscan Stomatological Institute, Foundation for Dental Clinic, Research and Continuing Education, Forte Dei Marmi, Italy.,Saint Camillus International University of Health and Medical Sciences, Rome, Italy
| | - Enrico Babetto
- Sweden & Martina's Research and Development Department, Padua, Italy
| | - Ugo Covani
- Saint Camillus International University of Health and Medical Sciences, Rome, Italy
| | - Miguel Peñarrocha-Diago
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - David Peñarrocha-Oltra
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
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Wang Q, Liu Y, Wang Z, Yang T, Liang Y, Gao Z, Fang C, Zhang Y. Effect of Access Cavities and Canal Enlargement on Biomechanics of Endodontically Treated Teeth: A Finite Element Analysis. J Endod 2020; 46:1501-1507. [PMID: 32615176 DOI: 10.1016/j.joen.2020.06.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/18/2020] [Accepted: 06/19/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION The purpose of this study was to investigate the influence of access cavities and tapers of canal preparations on fracture resistance of endodontically treated first molars by finite element method and Weibull analysis. METHODS On the basis of the micro-computed tomography data of maxillary first molar, the models of endodontically treated teeth with conservative endodontic cavity, traditional endodontic cavity, and 4 tapers of canal preparations (0.02, 0.04, 0.06, and 0.08) were created. Four static loads (800 N in total) were applied vertically to the contact points. The stress distributions of maximum principal stress were recorded and analyzed. Weibull analysis was performed to analyze the failure risk in enamel and dentin. RESULTS The stress distributions of maximum principal stress on occlusal surfaces were similar. In cervical region, the tensile stress was mainly concentrated on mesiobuccal root and root furcation. The finite element analysis and Weibull analysis showed that conservative endodontic cavity significantly reduced the maximum principal stress in cervical region and the failure probability, compared with traditional endodontic cavity. No significant difference was detected among tapers of prepared canals. CONCLUSIONS Preserving coronal dentin by using conservative endodontic cavity significantly reduced the concentration of tensile stress and the failure probability of dentin, although the maximum principal stress and failure probability were less affected by taper of canal preparation.
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Affiliation(s)
- Qian Wang
- Department of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yuxuan Liu
- Department of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhihui Wang
- Department of Prosthodontics, Changsha Stomatological Hospital, Changsha, Hunan, China
| | - Tianru Yang
- Department of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ye Liang
- Department of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhengrong Gao
- Department of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Changyun Fang
- Department of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yiyi Zhang
- Department of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
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Durigon M, Cecchin D, de Carli J, Souza MA, Farina A. Could calcium hypochlorite and grape seed extract keep the mechanical properties of root dentin and fracture resistance of weakened roots? J Mech Behav Biomed Mater 2020; 106:103736. [DOI: 10.1016/j.jmbbm.2020.103736] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 03/11/2020] [Accepted: 03/16/2020] [Indexed: 11/28/2022]
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21
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Shaikh SY, Mulani S, Shaikh SS. Stress Distribution on Root Dentin Analogous to Natural Teeth with Various Retentive Channels Design on the Face of the Root with Minimal or No Coronal Tooth Structure: A Finite Element Analysis. Contemp Clin Dent 2019; 9:630-636. [PMID: 31772476 PMCID: PMC6868623 DOI: 10.4103/ccd.ccd_536_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Aim: The aim of this study was to evaluate post-core design on Stress distribution in maxillary central incisor with various designs retentive channels placed on the face of the root with no remaining coronal tooth structure. Materials and Methods: 3 dimensional finite element model of a maxillary central incisor was developed and seven other study modes were developed. Tooth was scanned using CBCT unit, with reverse engineering software. 3D wire mesh, with ten node tetrahedral element, developed was transferred to ANASYS software. Composite was used for post-core-crown as post endodontic restoration. Mechanical properties were assigned to each component for FEA. All the materials were assumed to be isotropic, linearly elastic, homogenous and tightly bonded. A load of 100N were applied from vertical, horizontal and lateral oblique from incisal and palatal surface respectively. Results: Analysis revealed that stresses were concentrated at the point of load application on crown(vertical(V) 14.35MPa, horizontal(H) 27.04 MPa and lateral oblique(L)13.75MPa) and depending on the post core design the stresses were homogenous evenly distributed over the root dentin, core and least over the post. There was variation in stress distribution under vertical horizontal and lateral oblique load. Conclusion: Teeth with no remaining coronal structure and by placing retentive channels on the face of the root will enable homogenous stress distribution, promote mechanical retention and stability to the post core crown post endodontic restoration.
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Affiliation(s)
- Shoeb Yakub Shaikh
- Department of Conservative Dentistry, Pravara Institute of Medical Sciences, Rural Dental College, Loni, Maharashtra, India
| | - Shahnawaz Mulani
- Department of Prosthodontics, Aditya Dental College, Beed, Maharashtra, India
| | - Safia Shoeb Shaikh
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Qassim University, Buraidah, Kingdom of Saudi Arabia
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22
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Reverse Cast Metallic Core Based on the Original Prosthetic Crown. Case Rep Dent 2019; 2019:6936573. [PMID: 31341682 PMCID: PMC6612380 DOI: 10.1155/2019/6936573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/24/2019] [Accepted: 06/10/2019] [Indexed: 11/18/2022] Open
Abstract
The dental crown can be restored using the root in clinical situations where the dental remnant allows adequate anchorage by the use of an intraradicular retainer. After endodontic treatment, reconstruction of the dental anatomy depends on correct planning and the type of restoration to be used. This requires reestablishment of form and function with creation of anchoring features, avoiding detachment and favoring the distribution of forces, thus preventing fracture of the remnant due to functional and parafunctional forces applied on the tooth. This paper reports the clinical case of a patient who sought dental care for a full metal-ceramic crown with a cast metallic core with reduced length that had been detached from tooth 24. After clinical and radiographic examination, root integrity was verified. The patient was offered reconstruction with a cast metallic core of satisfactory length, providing adequate retention and support, with reutilization of the original prosthetic crown, serving as a reverse template of the coronal portion of this new core, providing reduction in costs and operational time.
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23
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Three-dimensional-guided removal and preparation of dental root posts-concept and feasibility. J Prosthodont Res 2019; 64:104-108. [PMID: 31104945 DOI: 10.1016/j.jpor.2019.04.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 02/05/2019] [Accepted: 04/09/2019] [Indexed: 11/20/2022]
Abstract
PATIENTS This case report presents a novel method to remove glass fiber-reinforced composite root posts in a minimally invasive way while simultaneously shaping the canal for a new post-endodontic restoration. A multi-morbid, handicapped 62-year-old patient was referred with a horizontally fractured maxillary incisor presenting approximately 1 mm residual coronal tooth height. Endodontic revision was necessary, which required removal of a glass fiber-reinforced composite post. A cone-beam computed tomography (CBCT) scan was imported into conventional implant-planning software and matched to a stone cast of the intraoral situation. Position, length, and axis of the future post were planned virtually. Based on this planning, a tooth-supported splint was three-dimensionally (3D) printed. This splint allowed use of a 2.2-mm spiral drill for removal of the fractured post and shaping of the root canal for a new cast post-and-core. This metal post-and-core was adhesively cemented and prepared for a zirconia single crown veneered in the labial aspect. DISCUSSION This method currently requires use of CBCT-based, ionizing 3D imaging. Additional refinements to this approach can be made regarding spiral drill design and coating as well as regarding the post-and-core workflow. CONCLUSIONS 3D-guided post-endodontic management is feasible. More research is needed to balance higher radiation doses against therapeutic success.
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Zhang Y, Liu Y, She Y, Liang Y, Xu F, Fang C. The Effect of Endodontic Access Cavities on Fracture Resistance of First Maxillary Molar Using the Extended Finite Element Method. J Endod 2019; 45:316-321. [DOI: 10.1016/j.joen.2018.12.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 11/22/2018] [Accepted: 12/04/2018] [Indexed: 12/17/2022]
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Pang J, Feng C, Zhu X, Liu B, Deng T, Gao Y, Li Y, Ke J. Fracture behaviors of maxillary central incisors with flared root canals restored with CAD/CAM integrated glass fiber post-and-core. Dent Mater J 2019; 38:114-119. [PMID: 30381631 DOI: 10.4012/dmj.2017-394] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The objective was to evaluate the fracture resistance properties of maxillary incisors with flared canals restored with computer aided design and computer aided manufacture (CAD/CAM) integrated glass fiber post-and-core. Thirty prepared flared root canals were selected in vitro and restored with CAD/CAM integrated fiber post-and-core (Group A), prefabricated fiber posts (Group B), and cast gold alloy (Group C), respectively. After submitted to fatigue loading, each specimen was subjected to a static loading until fracture. Analysis of variance (ANOVA) tests were used to determine statistical differences. The mean fracture strengths of Groups A and C were significantly higher than those of Group B, whereas no differences were observed between Groups A and C. In addition, reparable fracture modes were mostly observed in Group A while irreparable and catastrophic fractures were mostly found in Groups B and C. These results demonstrate that, in comparison to traditional treatments, CAD/CAM integrated glass fiber post-and-core restoration significantly enhances the fracture resistance of flared root canals.
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Affiliation(s)
- Jianliang Pang
- Department of Stomatology, The General Hospital of the Air Force P.L.A
| | - Changfen Feng
- Comprehensive Department of Stomatology, Suzhou Dental Hospital
| | - Xiaoru Zhu
- Department of Stomatology, The General Hospital of the Air Force P.L.A
| | - Bing Liu
- Department of Stomatology, The General Hospital of the Air Force P.L.A
| | - Tianzheng Deng
- Department of Stomatology, The General Hospital of the Air Force P.L.A
| | - Yuan Gao
- Department of Stomatology, The General Hospital of the Air Force P.L.A
| | - Ying Li
- Department of Stomatology, The General Hospital of the Air Force P.L.A
| | - Jie Ke
- Department of Stomatology, The General Hospital of the Air Force P.L.A
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Soares CJ, Rodrigues MDP, Faria-e-Silva AL, Santos-Filho PCF, Veríssimo C, Kim HC, Versluis A. How biomechanics can affect the endodontic treated teeth and their restorative procedures? Braz Oral Res 2018; 32:e76. [DOI: 10.1590/1807-3107bor-2018.vol32.0076] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Accepted: 06/13/2018] [Indexed: 11/22/2022] Open
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Maravić T, Vasiljević D, Kantardžić I, Lainović T, Lužanin O, Blažić L. Influence of restorative procedures on endodontically treated premolars: Finite element analysis of a CT-scan based three-dimensional model. Dent Mater J 2018; 37:493-500. [PMID: 29593161 DOI: 10.4012/dmj.2017-064] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
An endodontically treated tooth with mesial-occlusal-distal (MOD) cavity is often restored with composite resin. Palatal and buccal cusp reduction (MODP, MODPB), and/or fiber-reinforced composite posts (P), are used in an attempt to improve the longevity of the restoration. The aim of this study was to determine the effects of these procedures on von Mises stress values and distribution in dental tissues and restorative materials using finite element analysis. Based on CT scans of an extracted second upper premolar, six 3D endodontically treated tooth models (MOD, MODP, MODPB, MOD+P, MODP+P, MODPB+P) were created. Each model was subjected to a summary force of 150 N on the occlusal surface simulating the normal biting pattern and maximal von Mises stresses were calculated. MODP seems to reduce von Mises stress values in dental tissues and P seems to transfer some of the stresses from dental tissues to the composite filling.
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Affiliation(s)
- Tatjana Maravić
- Faculty of Medicine, School of Dentistry, University of Novi Sad.,Department of Biomedical and Neuromotor Sciences, DIBINEM, University of Bologna
| | | | - Ivana Kantardžić
- Faculty of Medicine, School of Dentistry, University of Novi Sad
| | - Tijana Lainović
- Faculty of Medicine, School of Dentistry, University of Novi Sad
| | - Ognjan Lužanin
- Faculty of Technical Sciences, Department of Production Engineering, University of Novi Sad
| | - Larisa Blažić
- Faculty of Medicine, School of Dentistry, University of Novi Sad
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Abdelaziz KM, Keshk CK, Alshadidi A, Mafraq S, Murchison DF. Fracture Resistance of Ceramic Crowns Supported with Indirect Chair-side Composite Cores. J Int Soc Prev Community Dent 2018; 8:34-40. [PMID: 29629327 PMCID: PMC5853040 DOI: 10.4103/jispcd.jispcd_381_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 11/22/2017] [Indexed: 11/04/2022] Open
Abstract
Aims and Objectives To evaluate the influence of indirect chair-side polymerization of resin composite cores on the fracture resistance of overlaying IPS e.max Press crowns. Materials and Methods Root canals of 60 extracted premolars were prepared to receive #2 fiber posts after the crowns were sectioned 2 mm above the cervical line. In Groups 1-3 (n = 10 each), posts were luted to the prepared dowel spaces using self-adhesive resin cement. Resin composite cores were then bonded and incrementally built-up using Filtek Z250 XT, Filtek P60, and Filtek P90 resin composites. In Groups 4-6 (n = 10 each), the fabricated post-core systems were subjected to post-curing heat and pressure treatment before cementation to their respective teeth using self-adhesive resin cement. Another 10 sound premolars served as control. All teeth in the test and control groups were then subjected to standardized preparation to receive IPS e.max Press crowns before testing their fracture resistance and the mode of restorations' failure. The collected results were statistically analyzed using ANOVA, Kruskal-Wallis, and Tukey's tests on the past software used at α = 0.05 to stand on the significance of the detected differences. Results Significant differences were detected between the fracture resistance of teeth in different groups (ANOVA, P = 2.857E-35). Crowns in Groups 4-6 provided higher fracture resistance than those in Groups 1-3 (Tukey's test, P < 0.05). Crowns in Groups 4 and 6 provided higher fracture resistance than the control, while those in Groups 2 and 3 provided lower fracture resistance than the control (Tukey's test, P < 0.05). Conclusion Indirect composite cores improved the fracture resistance of IPS e.max Press crowns when compared to directly fabricated post and cores. The directly and indirectly polymerized nanohybrid, methacrylate-based composite (Filtek Z250 XT) cores yielded the highest fracture resistance for the utilized all-ceramic crowns.
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Affiliation(s)
- Khalid M Abdelaziz
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, KSA
| | - Cinderella K Keshk
- BDS Program, Faculty of Oral and Dental Medicine, Al-Ahram Canadian University, 6 October City, Giza, Egypt
| | - Abdulkhaliq Alshadidi
- Department of Dental Technology, College of Allied Health Sciences, King Khalid University, Abha, KSA
| | | | - David F Murchison
- Department of Diagnostic Sciences, Texas A and M University College of Dentistry, Dallas, Texas, USA
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Allen C, Meyer CA, Yoo E, Vargas JA, Liu Y, Jalali P. Stress distribution in a tooth treated through minimally invasive access compared to one treated through traditional access: A finite element analysis study. J Conserv Dent 2018; 21:505-509. [PMID: 30294111 PMCID: PMC6161525 DOI: 10.4103/jcd.jcd_260_18] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction The purpose of this study was to compare the stress distributions in the teeth treated through minimally invasive access (MIA) designs to those of the teeth treated through traditional straight-line access and their relationship to the final restoration using three-dimensional finite element analysis (FEA). Materials and Methods Four FEA models of an extracted mandibular first molar were constructed. An intact model served as the control, whereas the other three were prepared with either an MIA or traditional straight-line access. Simulated composite access fillings with or without a simulated gold crown were applied to the models, followed by application of an occlusal load of 100 N. Von Mises stresses in the teeth were then calculated and analyzed. Results Stress values within the dentin for baseline, MIA with composite filling, MIA with composite filling and crown, and traditional access with composite filling and crown were 10.14 MPa, 6.98 MPa, 11.79 MPa, and 16.81 MPa, respectively. Higher stress values indicate that the tooth is more prone to fracture. Conclusions A traditional endodontic access cavity may render a tooth more susceptible to fracture compared with an MIA design.
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Affiliation(s)
- Chad Allen
- Department of Endodontics, Texas A and M University College of Dentistry, Richardson, Texas, USA
| | - Clark A Meyer
- Department of Bioengineering, University of Texas at Dallas, Richardson, Texas, USA
| | - Eunguk Yoo
- Department of Bioengineering, University of Texas at Dallas, Richardson, Texas, USA
| | - Jose Aldair Vargas
- Department of Bioengineering, University of Texas at Dallas, Richardson, Texas, USA
| | - Ying Liu
- Department of Biomedical Sciences, Texas A and M University College of Dentistry, Richardson, Texas, USA
| | - Poorya Jalali
- Department of Endodontics, Texas A and M University College of Dentistry, Richardson, Texas, USA
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Moris ICM, Moscardini CA, Moura LKB, Silva-Sousa YTC, Gomes EA. Evaluation of Stress Distribution in Endodontically Weakened Teeth Restored with Different Crown Materials: 3D-FEA Analysis. Braz Dent J 2017; 28:715-719. [PMID: 29211127 DOI: 10.1590/0103-6440201701829] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 10/11/2017] [Indexed: 11/22/2022] Open
Abstract
This study evaluated the stress distribution in endodontically treated teeth, weakened (W) or not weakened (NW), restored with different materials of prosthetic crown using 3D-FEA. Models of a maxillary canine were constructed based on micro-CT images and divided into the groups: G1 (control) - sound tooth; G2 to G7 - endodontically treated teeth restored with glass fiber post (GFP); which G2 to G4 simulated NW root and G5 to G7 simulated W root. For crown material the teeth were restored with: G2 and G5: metallic coping and ceramic veneering, G3 and G6: zirconia coping and ceramic veneering, G4 and G7: alumina coping and ceramic veneering. Load of 180 N was applied at the incisal third of lingual surface at 45º. Models were supported by the periodontal ligament (x=y=z=0). The von Mises stress (VMS) values were calculated. The W teeth presented higher VMS at coping when compared to NW teeth and group G1 showed lower VMS value. For crown material, for both W or NW teeth, increasing VMS was found at metallic, zirconia and alumina coping, respectively. Metallic coping showed a better performance despite its unfavorable esthetics, suggesting as an appropriate material for prosthetic restoration of endodontically treated teeth.
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Affiliation(s)
- Izabela C M Moris
- Dental School, UNAERP - Universidade de Ribeirão Preto, Ribeirão Preto, SP, Brazil
| | | | | | | | - Erica Alves Gomes
- Dental School, UNAERP - Universidade de Ribeirão Preto, Ribeirão Preto, SP, Brazil
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Rodrigues MDP, Soares PBF, Valdivia ADCM, Pessoa RS, Veríssimo C, Versluis A, Soares CJ. Patient-specific Finite Element Analysis of Fiber Post and Ferrule Design. J Endod 2017; 43:1539-1544. [DOI: 10.1016/j.joen.2017.04.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 04/19/2017] [Accepted: 04/22/2017] [Indexed: 11/26/2022]
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Kubo M, Komada W, Otake S, Inagaki T, Omori S, Miura H. The effect of glass fiber posts and ribbons on the fracture strength of teeth with flared root canals restored using composite resin post and cores. J Prosthodont Res 2017; 62:97-103. [PMID: 28843642 DOI: 10.1016/j.jpor.2017.07.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 05/08/2017] [Accepted: 07/11/2017] [Indexed: 11/16/2022]
Abstract
PURPOSE This study evaluated the fracture strength and mode of failure of structurally compromised teeth with flared root canals restored using composite resin with four different systems. METHODS Sixty endodontically treated bovine teeth were uniformly shaped to simulate human mandibular premolars with flared root canals. The roots were divided into four groups of 15 specimens each based on the type of restoration: composite resin core only (control), glass fiber post, cylindroid glass fiber ribbons, and glass fiber post and ribbons. All specimens were loaded until fracture occurred using a universal testing machine. Average fracture loads were compared with a one-way ANOVA and Tukey HSD test (α=.05). The modes of failure were observed and the Fisher exact test and Bonferroni correction were used for statistical analysis. RESULTS The fiber post and ribbon group (1035.70N) and the fiber ribbon group (881.77N) showed significantly higher fracture strength than the controls (567.97N) (p<.05). The fiber post and ribbon group also showed significantly higher fracture strength than the fiber post group (769.40N). Almost all specimens showed unrestorable root fractures (p<.008). The control group had a significantly higher ratio of core sectional fractures (p<.017). CONCLUSIONS Cylindroid glass fiber ribbons significantly increased the fracture strength of the composite resin post and cores in the case of the dentin within the thin root canal wall. Based on the results, this study recommends the combined use of glass fiber post and ribbons.
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Affiliation(s)
- Mariko Kubo
- Fixed Prosthodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.
| | - Wataru Komada
- Fixed Prosthodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.
| | - Shiho Otake
- Fixed Prosthodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.
| | - Tasuku Inagaki
- Fixed Prosthodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.
| | - Satoshi Omori
- Fixed Prosthodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.
| | - Hiroyuki Miura
- Fixed Prosthodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.
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Dablanca-Blanco AB, Blanco-Carrión J, Martín-Biedma B, Varela-Patiño P, Bello-Castro A, Castelo-Baz P. Management of large class II lesions in molars: how to restore and when to perform surgical crown lengthening? Restor Dent Endod 2017; 42:240-252. [PMID: 28808641 PMCID: PMC5553024 DOI: 10.5395/rde.2017.42.3.240] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 07/03/2017] [Indexed: 11/26/2022] Open
Abstract
The restoration of endodontic tooth is always a challenge for the clinician, not only due to excessive loss of tooth structure but also invasion of the biological width due to large decayed lesions. In this paper, the 7 most common clinical scenarios in molars with class II lesions ever deeper were examined. This includes both the type of restoration (direct or indirect) and the management of the cavity margin, such as the need for deep margin elevation (DME) or crown lengthening. It is necessary to have the DME when the healthy tooth remnant is in the sulcus or at the epithelium level. For caries that reaches the connective tissue or the bone crest, crown lengthening is required. Endocrowns are a good treatment option in the endodontically treated tooth when the loss of structure is advanced.
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Affiliation(s)
- Ana Belén Dablanca-Blanco
- Department of Endodontics, University of Santiago de Compostela Facultad de Odontología, Santiago de Compostela, Spain
| | - Juan Blanco-Carrión
- Department of Endodontics, University of Santiago de Compostela Facultad de Odontología, Santiago de Compostela, Spain
| | - Benjamín Martín-Biedma
- Department of Endodontics, University of Santiago de Compostela Facultad de Odontología, Santiago de Compostela, Spain
| | - Purificación Varela-Patiño
- Department of Endodontics, University of Santiago de Compostela Facultad de Odontología, Santiago de Compostela, Spain
| | - Alba Bello-Castro
- Department of Endodontics, University of Santiago de Compostela Facultad de Odontología, Santiago de Compostela, Spain
| | - Pablo Castelo-Baz
- Department of Endodontics, University of Santiago de Compostela Facultad de Odontología, Santiago de Compostela, Spain
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MARCHIONATTI AME, VALLI V, WANDSCHER VF, MONACO C, BALDISSARA P. Influence of elastic modulus of intraradicular posts on the fracture load of roots restored with full crowns. REVISTA DE ODONTOLOGIA DA UNESP 2017. [DOI: 10.1590/1807-2577.01617] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective This study aimed to evaluate the fracture load and displacement of roots restored with posts of different elastic modulus. Material and method Thirty-six replicas of epoxy resin mixed with glass microfibers were made from an endodontically-treated human premolar root prepared to a length of 12 mm with a custom drill, leaving the apical 4 mm unprepared. Replicas were randomly restored with (n = 12): FP-LM (fiber post with low elastic modulus– 50 GPa), FP-HM (fiber post with high elastic modulus – 67 GPa) and MP (metallic post – 208 GPa), using self-curing adhesive and dual resin cement. Cores were built up with composite resin and metallic crowns were cemented in all the roots with self-adhesive resin cement with self-curing mode. Specimens were subjected to a fracture load test (45° inclination/0.5 mm/min) and displacement was registered at 100 N. Result One-way ANOVA showed that elastic modulus of the post did not affect the fracture load means (p = 0.203) (FP-LM: 237.4 ± 65.11 N; FP-HM: 236.7 ± 92.85 N; MP: 295.8 ± 108.7 N) but was statistically significant for the displacement (p < 0.00): Tukey’s test showed that FP-LM displacement mean (0.81 ± 0.15 mm) was significantly higher than those for FP-HM (0.46 ± 0.26 mm; p = 0.00) and MP (0.62 ± 0.07 mm; p = 0.04). Conclusion Posts with different elastic modulus exhibit similar fracture loads, but a lower displacement is achieved when fiber posts with a high elastic modulus and metallic posts are used.
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Mamoun J. Post and core build-ups in crown and bridge abutments: Bio-mechanical advantages and disadvantages. J Adv Prosthodont 2017; 9:232-237. [PMID: 28680556 PMCID: PMC5483411 DOI: 10.4047/jap.2017.9.3.232] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 11/17/2016] [Accepted: 12/07/2016] [Indexed: 12/01/2022] Open
Abstract
Dentists often place post and core buildups on endodontically treated abutments for crown and bridge restorations. This article analyzes the bio-mechanical purposes, advantages and disadvantages of placing a core or a post and core in an endodontically treated tooth and reviews literature on post and core biomechanics. The author assesses the scientific rationale of the claim that the main purpose of a post is to retain a core, or the claim that posts weaken teeth. More likely, the main function of a post is to help prevent the abutment, on which a crown is cemented, from fracturing such that the abutment separates from the tooth root, at a fracture plane that is located approximately and theoretically at the level of the crown (or ferrule) margin. A post essentially improves the ferrule effect that is provided by the partial fixed denture prosthesis. This paper also explores the difference between bio-mechanical failures of crowns caused by lack of retention or excess taper, versus failures due to a sub-optimal ferrule effect in crown and bridge prostheses.
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Affiliation(s)
- John Mamoun
- Sunbeam Dental - General Dentistry, Manalapan, NJ, USA
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Dal Piva AMDO, Tribst JPM, Souza RODAE, Borges ALS. Influence of Alveolar Bone Loss and Cement Layer Thickness on the Biomechanical Behavior of Endodontically Treated Maxillary Incisors: A 3-dimensional Finite Element Analysis. J Endod 2017; 43:791-795. [DOI: 10.1016/j.joen.2016.11.020] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 11/15/2016] [Accepted: 11/24/2016] [Indexed: 10/19/2022]
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A novel anatomical short glass fiber reinforced post in an endodontically treated premolar mechanical resistance evaluation using acoustic emission under fatigue testing. J Mech Behav Biomed Mater 2016; 65:151-159. [PMID: 27572232 DOI: 10.1016/j.jmbbm.2016.08.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Revised: 08/05/2016] [Accepted: 08/08/2016] [Indexed: 11/20/2022]
Abstract
This study evaluates the fracture resistance in an endodontically treated tooth using circular fiber-reinforced composite (FRC) and innovated anatomical short glass fiber reinforced (SGFR) posts under fatigue testing, monitored using the acoustic emission (AE) technique. An anatomical SGFR fiber post with an oval shape and slot/notch design was manufactured using an injection-molding machine. Crown/core maxillary second premolar restorations were executed using the anatomical SGFR and commercial cylindrical fiber posts under fatigue test to understand the mechanical resistances. The load versus AE signals in the fracture and fatigue tests were recorded to evaluate the restored tooth failure resistance. The static fracture resistance results showed that teeth restored using the anatomical SGFR post presented higher resistance than teeth restored using the commercial FRC post. The fatigue test endurance limitation (1.2×106 cycles) was 207.1N for the anatomical SGFR fiber post, higher than the 185.3N found with the commercial FRC post. The average accumulated number of AE signals and corresponding micro cracks for the anatomical SGFR fiber post (153.0 hits and 2.44 cracks) were significantly lower than those for the commercial FRC post (194.7 hits and 4.78 cracks) under 40% of the static maximum resistance fatigue test load (pass 1.2×106 cycles). This study concluded that the anatomical SGFR fiber post with surface slot/notch design made using precise injection molding presented superior static fracture resistance and fatigue endurance limitation than those for the commercial FRC post in an endodontically treated premolar.
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Barbosa Siqueira C, Spadini de Faria N, Raucci-Neto W, Colucci V, Alves Gomes E. Evaluation of Mechanical Properties of Glass Fiber Posts Subjected to Laser Surface Treatments. Photomed Laser Surg 2016; 34:460-466. [PMID: 27564314 DOI: 10.1089/pho.2016.4144] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the influence of laser irradiation on flexural strength, elastic modulus, and surface roughness and morphology of glass fiber posts (GFPs). BACKGROUND DATA Laser treatment of GFPs has been introduced to improve its adhesion properties. MATERIALS AND METHODS A total of 40 GFPs were divided into 4 groups according to the irradiation protocol: GC-no irradiation, GYAG-irradiation with erbium:yttrium-aluminum-garnet [Er:YAG], GCR-irradiation with erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG), and GDI-irradiation with diode laser. The GFP roughness and morphology were evaluated through laser confocal microscopy before and after surface treatment. Three-point bending flexural test measured flexural strength and elastic modulus. Data about elastic modulus and flexural strength were subjected to one-way ANOVA and Bonferroni test (p < 0.05). The effect of roughness was evaluated using the linear mixed effects model and Bonferroni test (p < 0.05). RESULTS Laser treatment changed surface roughness in the groups GCR (p = 0.000) and GDI (p = 0.007). The mean flexural strength in GYAG (995.22 MPa) was similar to that in GC (980.48 MPa) (p = 1.000) but different from that in GCR (746.83 MPa) and that in GDI (691.34 MPa) (p = 0.000). No difference was found between the groups GCR and GDI (p = 0.86). For elastic modulus: GYAG (24.47 GPa) was similar to GC (25.92 GPa) (p = 1.000) but different from GCR (19.88 GPa) (p = 0.002) and GDI (17.20 GPa) (p = 0.000). CONCLUSIONS The different types of lasers, especially Er,Cr:YSGG and 980 ηm diode, influenced the mechanical properties of GFPs.
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Affiliation(s)
| | | | - Walter Raucci-Neto
- School of Dentistry, University of Ribeirão Preto , Ribeirão Preto, Brazil
| | - Vivian Colucci
- School of Dentistry, University of Ribeirão Preto , Ribeirão Preto, Brazil
| | - Erica Alves Gomes
- School of Dentistry, University of Ribeirão Preto , Ribeirão Preto, Brazil
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da Silveira-Pedrosa DM, Martins LR, Sinhoreti MA, Correr-Sobrinho L, Sousa-Neto MD, Costa ED, de F Pedrosa-Filho C, de Carvalho JR. Push-out Bond Strength of Glass Fiber Posts Cemented in Weakened Roots with Different Luting Agents. J Contemp Dent Pract 2016; 17:119-24. [PMID: 27206999 DOI: 10.5005/jp-journals-10024-1813] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM To evaluate the push-out bond strength (BS) of direct anatomic posts (DAPs) and conventional fiber posts (CFPs) cemented with different luting agents in different thirds of flared root canals. MATERIALS AND METHODS A total of 60 human single-rooted canine teeth were transversally sectioned 16 mm from the radicular apex. After endodontic treatment, canals were flared with diamond burs. Samples were divided into six groups according to post type and luting agent: DAP and RelyX U100 (RXU); DAP and RelyX ARC (RXA); DAP and RelyX Luting 2 (RXL); CFP and RXU; CFP and RXA; CFP and RXL. Roots were sectioned transversely into six 1-mm-thick slices. The push-out test was performed and failure modes were observed. RESULTS The DAP groups (7.23 ± 2.05) showed highest BS values (p < 0.05) when compared with CFP (5.93 ± 1.76). RelyX U100 (8.17 ± 1.70) showed higher BS values (p < 0.05) than RXA (6.46 ± 1.38), and RXL (5.10 ± 1.65) showed the lowest values. Bond strength on the apical third was statistically lower (p < 0.05) than that on the other thirds of the root canals. There was a predominance of adhesive failure for all groups. CONCLUSION The DAPs improved retention in flared root canals, and RXU was the most effective luting agent. The apical third showed the lowest BS values. CLINICAL SIGNIFICANCE The relining procedure of fiber posts with composite and the proper selection of luting resin cement are important for increasing bonding effectiveness in flared root canals.
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Affiliation(s)
- Daniele M da Silveira-Pedrosa
- Health Sciences Postgraduate Program, Health Sciences School, University of Brasilia, UnB, Brasilia, Distrito Federal, Brazil
| | - Luis Rm Martins
- Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas, UNICAMP, Piracicaba Sao Paulo, Brazil
| | - Mário Ac Sinhoreti
- Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas, UNICAMP, Piracicaba Sao Paulo, Brazil
| | - Lourenço Correr-Sobrinho
- Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas, UNICAMP, Piracicaba Sao Paulo, Brazil
| | - Manoel D Sousa-Neto
- Department of Restorative Dentistry, Ribeirão Preto Dental School, University of Sao Paulo, USP, Ribeirão Preto, Sao Paulo, Brazil
| | - Edson D Costa
- Department of Dentistry, Health Sciences School, University of Brasilia, UnB, Brasilia, Distrito Federal, Brazil
| | - Celso de F Pedrosa-Filho
- Department of Dentistry, Health Sciences School, University of Brasilia, UnB, Brasilia, Distrito Federal, Brazil
| | - Jacy Ribeiro de Carvalho
- Professor, Department of Dentistry, Health Sciences School, Campus Universitario Darcy Ribeiro, Departamento de Odontologia-FS/UnB. Asa Norte, CEP: 70910-900 Brasilia, DF, Brazil, Phone: +556131071802, e-mail:
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Değer Y, Adigüzel Ö, Özer SY, Kaya S, Polat ZS, Bozyel B. Evaluation of Temperature and Stress Distribution on 2 Different Post Systems Using 3-Dimensional Finite Element Analysis. Med Sci Monit 2015; 21:3716-172. [PMID: 26615495 PMCID: PMC4671455 DOI: 10.12659/msm.896132] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 11/18/2015] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The mouth is exposed to thermal irritation from hot and cold food and drinks. Thermal changes in the oral cavity produce expansions and contractions in tooth structures and restorative materials. The aim of this study was to investigate the effect of temperature and stress distribution on 2 different post systems using the 3-dimensional (3D) finite element method. MATERIAL AND METHODS The 3D finite element model shows a labio-lingual cross-sectional view of the endodontically treated upper right central incisor and supporting periodontal ligament with bone structures. Stainless steel and glass fiber post systems with different physical and thermal properties were modelled in the tooth restored with composite core and ceramic crown. We placed 100 N static vertical occlusal loading onto the center of the incisal surface of the tooth. Thermal loads of 0°C and 65°C were applied on the model for 5 s. Temperature and thermal stresses were determined on the labio-lingual section of the model at 6 different points. RESULTS The distribution of stress, including thermal stress values, was calculated using 3D finite element analysis. The stainless steel post system produced more temperature and thermal stresses on the restorative materials, tooth structures, and posts than did the glass fiber reinforced composite posts. CONCLUSIONS Thermal changes generated stresses in the restorative materials, tooth, and supporting structures.
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Affiliation(s)
- Yalçın Değer
- Department of Prosthodontics, School of Dentistry, University of Dicle, Diyarbakir, Turkey
| | - Özkan Adigüzel
- Department of Endodontics, School of Dentistry, University of Dicle, Diyarbakir, Turkey
| | - Senem Yiğit Özer
- Department of Endodontics, School of Dentistry, University of Adnan Menderes, Aydın, Turkey
| | - Sadullah Kaya
- Department of Endodontics, School of Dentistry, University of Dicle, Diyarbakir, Turkey
| | - Zelal Seyfioğlu Polat
- Department of Prosthodontics, School of Dentistry, University of Dicle, Diyarbakir, Turkey
| | - Bejna Bozyel
- School of Dentistry, University of Dicle, Diyarbakir, Turkey
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Effect of the Size of the Apical Enlargement with Rotary Instruments, Single-cone Filling, Post Space Preparation with Drills, Fiber Post Removal, and Root Canal Filling Removal on Apical Crack Initiation and Propagation. J Endod 2015; 41:253-6. [DOI: 10.1016/j.joen.2014.10.012] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 10/15/2014] [Accepted: 10/18/2014] [Indexed: 11/20/2022]
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Fracture resistance of endodontically treated roots with oval canals restored with oval and circular posts. J Endod 2014; 41:539-43. [PMID: 25498127 DOI: 10.1016/j.joen.2014.11.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 11/01/2014] [Accepted: 11/08/2014] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The aim of the present study was to evaluate the effects of post space preparations with circular and oval post drills and the placement of oval and circular posts on the fracture strength of roots with oval canals. METHODS Seventy mandibular premolars with oval root canals were decoronated. Fourteen teeth were used as a control group (group 1), and the root canals of the remaining teeth were prepared up to size #30. The root canals were filled, and the samples were randomly divided into 4 experimental groups as follows: post space preparation with circular-shaped drills (group 2), post space preparation with oval-shaped drills (group 3), circular post placement (group 4), and oval post placement (group 5). A fracture strength test was performed on each specimen, and the data were statistically evaluated using 1-way analysis of variance and Tukey post hoc tests. RESULTS The fracture strengths of the circular posts-placed group were higher than those of the oval post-placed group (P < .001). The post space preparation using oval-shaped drills significantly decreased the fracture strength of the roots compared with the control group (P < .001). CONCLUSIONS Within the limitations of the present study, oval posts did not provide a higher fracture resistance to endodontically treated roots with oval canals compared with circular posts. Therefore, clinicians should be aware that oval posts are similar to circular posts in terms of enhancing the fracture resistance of roots with oval canals.
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