Clinical evaluation of the fiber post and direct composite resin restoration for fixed single crowns on endodontically treated teeth

A Comprehensive Review on Natural Fibers: Technological and Socio-Economical Aspects

Asian countries have abundant resources of natural fibers, but unfortunately, they have not been optimally utilized. The facts showed that from 2014 to 2020, there was a shortfall in meeting national demand of over USD 2.75 million per year. Therefore, in order to develop the utilization and improve the economic potential as well as the sustainability of natural fibers, a comprehensive review is required. The study aimed to demonstrate the availability, technological processing, and socio-economical aspects of natural fibers. Although many studies have been conducted on this material, it is necessary to revisit their potential from those perspectives to maximize their use. The renewability and biodegradability of natural fiber are part of the fascinating properties that lead to their prospective use in automotive, aerospace industries, structural and building constructions, bio packaging, textiles, biomedical applications, and military vehicles. To increase the range of applications, relevant technologies in conjunction with social approaches are very important. Hence, in the future, the utilization can be expanded in many fields by considering the basic characteristics and appropriate technologies of the natural fibers. Selecting the most prospective natural fiber for creating national products can be assisted by providing an integrated management system from a digitalized information on potential and related technological approaches. To make it happens, collaborations between stakeholders from the national R&D agency, the government as policy maker, and academic institutions to develop national bioproducts based on domestic innovation in order to move the circular economy forward are essential.

Retrospective clinical and radiographic evaluation of restored endodontically treated teeth

Objectives

The aim of this study was to perform a clinical and radiographic analysis of endodontically treated teeth (ETT) restored with cast metal posts (CMPs) or prefabricated glass fiber posts (GFPs) and crowns.

Materials and Methods

Fifty ETT were restored with 25 CMPs and 25 GFPs at a private dental clinic between 2001 and 2016. The restorations consisted of 12 all-ceramic crowns, 31 metal-ceramic crowns, and 7 composite resin crowns. Demographic data, type of teeth, type of post-and-core system, time of placement, crown restorations, the number of proximal contacts, the type of antagonist, and reports of any complications after post-and-core placement were recorded for each patient. Assessments were performed at baseline (radiographic) and follow-up (radiographic and clinical). Data were analyzed by the McNemar test, the Pearson χ² test, and Kaplan-Meier survival curves (α = 0.05). The mean follow-up was 67.6 months.

Results

No significant difference was observed for any of the radiographic parameters when the baseline and final radiographs were compared. In the clinical evaluation, anatomical form (p = 0.009) and occlusion (p = 0.001) showed significant differences according to the type of crown restoration; specifically, metal-ceramic and all-ceramic crowns outperformed composite resin crowns.

Conclusions

CMPs and GFPs showed favorable results for restoring ETT after 6 years of follow-up. All-ceramic and metal-ceramic crowns showed higher survival rates and better clinical outcomes.

CUSTOMIZED POST-AND-CORE DESIGN AND STRESS ANALYSIS FOR POSTERIOR TOOTH PROSTHESIS

A post-and-core crown is widely used in prosthetic dentistry; however, in clinical treatment, it easily causes root fracture and tooth penetration. To address these problems, this study aimed to present a customized post-and-core design for the posterior tooth implant. First, a residual tooth and its root canal were reconstructed. Then, the root canal surface was extracted, the surface curvature and length parameters were defined, and the customized post-and-core design was developed. Finally, the tooth, root canal, and post-and-core with different implant lengths in five masticatory directions were analyzed using finite element analysis to evaluate the stress distribution. The results showed that, with the similar shape of the post-and-core structure and the root canal, the tooth stress trend was uniform. When the length of the post-and-core structure [Formula: see text] was 0[Formula: see text]mm, that is, it was two thirds of the root canal length, the root canal stress was minimum. Therefore, the customized design of the post-and-core structure could well adapt to any kind of root canal, and the length of the post-and-core structure [Formula: see text] provided guidance for the post-and-core crown prosthesis in clinic.

Comparison of the clinical efficacy of two different types of post systems which were restored with composite restorations

AIM

To compare the efficacy of resin composite restorations, retained with either polyethylene or zirconia-rich glass fiber posts.

METHODS

Sixty-two single rooted maxillary and mandibular central incisor teeth in forty-four patients (15 males and 29 females; age range 15-32 years) were restored either with an ultrahigh molecular weight polyethylene (UHMWP) fiber post (Bondable Reinforcement Ribbon, DENSE, Ribbond, Seattle, WA, United States) or a zircon-rich glass fiber post (Snowpost, Lot H 040; Carbotech, Ganges, France). Then, direct resin composite restoration (Clearfil AP-X, Kuraray) was performed for both post systems in tooth color suitable. Patients were recalled for routine inspections at 6 mo, 1, 2 and 3 years.

RESULTS

The restorations were assessed during each recall evaluation according to predetermined clinical and radiographic criteria (periapical lesion; marginal leakage and integrity; color stability; surface stain and loss of retention of the post or the composite build-up material). The follow-up data showed no significant difference in these criteria between polyethylene fibre posts and zirconia-rich glass fibre posts.

CONCLUSION

The efficacy of resin composite restorations, retained with either polyethylene or zirconia-rich glass fiber posts were similar, suggesting that both types of fiber post can be used successfully to help retain resin composite restorations.

Fracture Resistance of Endodontically Treated Teeth Restored with Biodentine, Resin Modified GIC and Hybrid Composite Resin as a Core Material

Introduction

The restoration of a severely damaged tooth usually needs a post and core as a part of treatment procedure to provide a corono - radicular stabilization. Biodentine is a class of dental material which possess high mechanical properties with excellent biocompatibility and bioactive behaviour. The sealing ability coupled with optimum physical properties could make Biodentine an excellent option as a core material.

Aim

The aim of the study was to determine the fracture resistance of Biodentine as a core material in comparison with resin modified glass ionomer and composite resin.

Materials and Methods

Freshly extracted 30 human permanent maxillary central incisors were selected. After endodontic treatment followed by post space preparation and luting of Glass fibre post (Reforpost, Angelus), the samples were divided in to three groups based on the type of core material. The core build-up used in Group I was Biodentine (Septodont, France), Group II was Resin-Modified Glass Ionomer Cement (GC, Japan) and Group III was Hybrid Composite Resin (TeEconom plus, Ivoclar vivadent). The specimens were subjected to fracture toughness using Universal testing machine (1474, Zwick/Roell, Germany) and results were compared using One-way analysis of variance with Tukey's Post hoc test.

Results

The results showed that there was significant difference between groups in terms of fracture load. Also, composite resin exhibited highest mean fracture load (1039.9 N), whereas teeth restored with Biodentine demonstrated the lowest mean fracture load (176.66 N). Resin modified glass ionomer exhibited intermediate fracture load (612.07 N). The primary mode of failure in Group I and Group II was favourable (100%) while unfavourable fracture was seen in Group III (30%).

Conclusion

Biodentine, does not satisfy the requirements to be used as an ideal core material. The uses of RMGIC's as a core build-up material should be limited to non-stress bearing areas. Composite resin is still the best core build-up material owing to its high fracture resistance and bonding to tooth.

Retrospective study of combined splinting restorations in the aesthetic zone of periodontal patients

Evaluates the clinical performance of of a fiber-reinforced, composite-resin bonded splint; a bridge; a fiber post; and/or a resin veneer for the restoration of periodontally-involved anterior teeth.

Shows that a combination of approaches is a good choice for minimally invasive prosthodontic treatment in the aesthetic zone in periodontal patients.

Aims This retrospective study evaluated the clinical performance of combining a fiber-reinforced, composite-resin (FRC) bonded splint; bridge; fiber post; and/or resin veneer for the restoration of periodontally-involved anterior teeth.

Methods Sixty-three patients with periodontally-involved anterior teeth each received one of the following splinting restorations: FRC-bonded splint-bridges (SB), a combination of an FRC-bonded splint and resin veneer (SV), or FRC-bonded splints (S). Six patients with healthy periodontal teeth received orthodontic retainers with FRC-bonded splints (OS) as a control. Modified USPHS criteria were used to evaluate the effects of rehabilitation, and the periodontal pocket depth (PPD) and clinical attachment level (CAL) of the natural teeth were measured.

Results All restorations resulted in good aesthetic outcomes. SV, S in combination with fiber posts and OS all resulted in 100% acceptable ratings for each category that was directly evaluated at each follow-up. The mean PPD was 3.5 ± 1.0 mm at baseline, decreased to 3.3 ± 1.0 mm after one year (p <0.05), and subsequently increased to 3.5±1.0 mm again after four years (p >0.05). These changes were similar to those in the mean CAL.

Conclusion A combination of a FRC-bonded splint, bridge, fiber post and/or resin veneer for minimally invasive prosthodontic treatment in the aesthetic zone is a good choice for periodontal patients.