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Ciora E, Miron M, Lungeanu D, Igna A, Jivanescu A. Analysis of the Pulpal Blood Flow Microdynamics during Prosthetic Tooth Preparation Using Diamond Burs with Different Degrees of Wear. Dent J (Basel) 2024; 12:178. [PMID: 38920879 PMCID: PMC11202490 DOI: 10.3390/dj12060178] [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: 04/22/2024] [Revised: 05/29/2024] [Accepted: 06/04/2024] [Indexed: 06/27/2024] Open
Abstract
Pulpal modifications taking place during prosthetic tooth preparation using worn-out burs may represent a risk for the vitality of the dental pulp. The aim of this in vivo study was to evaluate whether the wear of diamond burs has an influence on the vascular microdynamics at the level of the dental pulp, during vertical preparation for zirconia crowns. The study was performed with a split-mouth design and included 32 vital permanent monoradicular teeth (20 maxillary and 12 mandibular), from six subjects, aged between 20 and 50 years. The teeth were randomly assigned to two study groups of 16 teeth each. For prosthetic preparation, new burs were used in the first group, and burs at their 5th use were used in the second group. Four consecutive determinations of the pulpal blood flow by Laser Doppler flowmetry (LDF-laser Doppler MoorLab instrument VMS-LDF2, Moor Instruments Ltd., Axminster, UK) were taken for each tooth included in the study: before the preparation (control values), immediately, at 24 h, and at 7 days after the prosthetic preparation. A four-way ANOVA statistical analysis was applied to analyze the effect of four considered factors (bur wear degree, time of measurement, tooth number, and tooth location) on the pulpal blood flow (PBF). A significant increase in pulpal blood flow compared to the baseline was recorded immediately after preparation (p < 0.01), at 24 h (p < 0.01), and at 7 days (p < 0.05) in both groups, but more pronounced in the case of burs at the 5th use. The blood flow was significantly higher in upper jaw teeth, irrespective of the measurement time. In conclusion, the use of worn-out diamond burs produces lasting modifications in the pulpal blood flow of teeth that undergo prosthetic crown preparation. ISRCTN registry: ISRCTN49594720.
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Affiliation(s)
- Edmond Ciora
- Department of Oral Rehabilitation and Dental Emergencies, Faculty of Dentistry, “Victor Babes” University of Medicine and Pharmacy, P-ta Eftimie Murgu 2, 300041 Timisoara, Romania;
- Digital and Advanced Technique for Endodontic, Restorative and Prosthetic Treatment TADERP, 300070 Timisoara, Romania;
| | - Mariana Miron
- Department of Oral Rehabilitation and Dental Emergencies, Faculty of Dentistry, “Victor Babes” University of Medicine and Pharmacy, P-ta Eftimie Murgu 2, 300041 Timisoara, Romania;
- Interdisciplinary Research Center for Dental Medical Research, Lasers and Innovative Technologies, 300070 Timisoara, Romania
| | - Diana Lungeanu
- Center for Modeling Biological Systems and Data Analysis, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Department of Functional Sciences, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Andreea Igna
- Department of Pediatric Dentistry, Pediatric Dentistry Research Center, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Anca Jivanescu
- Digital and Advanced Technique for Endodontic, Restorative and Prosthetic Treatment TADERP, 300070 Timisoara, Romania;
- Department of Prosthodontics, Faculty of Dentistry, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
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Ciora E, Miron M, Bojoga D, Lungeanu D, Jivanescu A. Evaluation of the Pulp Chamber Temperature during Tooth Veneer Preparation Using Burs with Different Degrees of Wear-A Preliminary In Vitro Study. Dent J (Basel) 2023; 11:197. [PMID: 37623293 PMCID: PMC10453045 DOI: 10.3390/dj11080197] [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: 07/07/2023] [Revised: 08/08/2023] [Accepted: 08/11/2023] [Indexed: 08/26/2023] Open
Abstract
The heat produced during tooth preparation could be a source of damage for dental pulp, and many variables are involved in this process. The aim of this in vitro study was to evaluate whether the different degrees of wear of the diamond burs significantly influenced the temperature changes in the pulp chamber during tangential veneer preparation. The sample comprised 30 intact permanent monoradicular teeth, randomly assigned to three study groups of 10 teeth each, of which 5 had the pulp tissue preserved and 5 had thermoconductive paste in the pulp chamber. For prosthetic preparation, we used new burs in the first group, burs at their fifth use in the second group, and burs at their eighth use for the third group. The pulp chamber temperature was evaluated at the start, after one minute, and after three minutes of preparation, using a k-type thermocouple. The results of the three-way ANOVA and Tukey post hoc comparisons showed a highly significant effect of the time of measurement, while the pulp condition and the degree of wear of the burs had no effect. In conclusion, the different degrees of wear of conventional diamond burs do not produce statistically significant different changes in the pulp chamber temperature.
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Affiliation(s)
- Edmond Ciora
- Department of Oral Rehabilitation and Dental Emergencies, Faculty of Dentistry, “Victor Babes” University of Medicine and Pharmacy, P-ta Eftimie Murgu 2, 300041 Timisoara, Romania; (E.C.); (D.B.)
- Digital and Advanced Technique for Endodontic, Restorative and Prosthetic Treatment TADERP, 300070 Timisoara, Romania;
| | - Mariana Miron
- Department of Oral Rehabilitation and Dental Emergencies, Faculty of Dentistry, “Victor Babes” University of Medicine and Pharmacy, P-ta Eftimie Murgu 2, 300041 Timisoara, Romania; (E.C.); (D.B.)
- Interdisciplinary Research Center for Dental Medical Research, Lasers and Innovative Technologies, 300070 Timisoara, Romania
| | - Daliana Bojoga
- Department of Oral Rehabilitation and Dental Emergencies, Faculty of Dentistry, “Victor Babes” University of Medicine and Pharmacy, P-ta Eftimie Murgu 2, 300041 Timisoara, Romania; (E.C.); (D.B.)
- Interdisciplinary Research Center for Dental Medical Research, Lasers and Innovative Technologies, 300070 Timisoara, Romania
| | - Diana Lungeanu
- Center for Modeling Biological Systems and Data Analysis, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
- Department of Functional Sciences, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Anca Jivanescu
- Digital and Advanced Technique for Endodontic, Restorative and Prosthetic Treatment TADERP, 300070 Timisoara, Romania;
- Department of Prosthodontics, Faculty of Dentistry, Victor Babes, University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
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Falahchai M, Musapoor N, Mokhtari S, Babaee Hemmati Y, Neshandar Asli H. Fracture resistance and failure mode of endodontically treated premolars reconstructed by different preparation approaches: Cervical margin relocation and crown lengthening with complete and partial ferrule with three different post and core systems. J Prosthodont 2023. [PMID: 37505114 DOI: 10.1111/jopr.13741] [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: 06/15/2023] [Revised: 07/14/2023] [Accepted: 07/23/2023] [Indexed: 07/29/2023] Open
Abstract
PURPOSE To assess the fracture resistance and failure mode of endodontically treated premolars reconstructed by different preparation approaches: cervical margin relocation (CMR) and crown lengthening (CL) with complete ferrule (CLF) and partial ferrule (CLPF) with three different post and core systems. MATERIALS AND METHODS In this in vitro study, 100 maxillary premolars were assigned to the following 10 groups according to their preparation approach and type of post and core system (n = 10): (I) control (intact teeth), (II) prefabricated fiber post (PFP) and composite core with CMR (PFP-CMR), (III) polyethylene fiber-reinforced composite (PEFRC) with CMR (PEFRC-CMR), (IV) casting post (CP) and core with CMR (CP-CMR), (V) PFP-CLPF, (VI) PEFRC-CLPF, (VII) CP-CLPF, (VIII) PFP-CLF, (IX) PEFRC-CLF, and (X) CP-CLF. After thermomechanical loading, the fracture resistance and failure mode were assessed. Data were analyzed statistically (α = 0.05). RESULTS In all post and core systems, the CLPF approach had lower fracture resistance than CMR (p < 0.05); CLF showed higher fracture resistance than CLPF only in the PFP system (p = 0.038). In PEFRC and CP systems, the difference between CLF and CLPF was not significant (p > 0.05). No significant difference was found in fracture resistance of different post and core systems with the same preparation approach (p > 0.05). CLPF showed the highest frequency of favorable, and CLF showed the highest frequency of unfavorable fractures. CONCLUSION CLPF yielded lower fracture resistance than CMR. The difference in fracture resistance was not significant between CLF and CMR but the frequency of unfavorable fractures was higher in CLF than in other groups.
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Affiliation(s)
- Mehran Falahchai
- Department of Prosthodontics, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Naghmeh Musapoor
- Department of Prosthodontics, School of Dentistry, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Soroosh Mokhtari
- Department of Prosthodontics, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Yasamin Babaee Hemmati
- Department of Orthodontics, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Hamid Neshandar Asli
- Department of Prosthodontics, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
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Demachkia AM, Velho HC, Valandro LF, Dimashkieh MR, Samran A, Tribst JPM, de Melo RM. Endocrown restorations in premolars: influence of remaining axial walls of tooth structure and restorative materials on fatigue resistance. Clin Oral Investig 2023:10.1007/s00784-023-04895-6. [PMID: 36781479 DOI: 10.1007/s00784-023-04895-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 02/01/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVES To evaluate the effect of the remaining tooth structure and different CAD/CAM materials on the fatigue performance and failure mode of endodontically treated premolars restored with endocrowns. MATERIALS AND METHODS Ninety maxillary premolars were endodontically treated and assigned into 6 groups (n = 15) according to the number of remaining axial walls (four, three, and two) and restorative materials (ultra-translucent zirconia 5Y-PSZ [KATANA UTML] and lithium disilicate [IPS e.max-CAD]). The specimens were subjected to cyclic fatigue loading test (initial load 200 N; 20 Hz). An incremental step load of 100 N per 10,000 cycles was applied until failure. The fatigue failure load (FFL) and number of failure cycles (CFFs) data were statistically analyzed with two-way ANOVA and Kaplan-Meier test (α = 0.05). Failed specimens were examined under a stereomicroscope 25 × and failure modes were determined. RESULTS FFL and CFF were significantly influenced by restorative material (p < 0.05). 5Y-PSZ endocrowns showed significantly higher FFL when compared with lithium disilicate. The number of remaining walls did not affect the fatigue behavior or failure mode of the specimens. Of the lithium disilicate restorations, 51% had repairable failures, while 95% 5Y-PSZ restorations had non-repairable failures. CONCLUSIONS Zirconia endocrowns showed better FFL than lithium disilicate endocrowns, regardless of the number of remaining axis walls. Lithium disilicate and 5Y-PSZ endocrowns showed FFL higher than the normal masticatory loads. CLINICAL RELEVANCE Restoring endodontically treated premolars with endocrown could be a promising treatment, regardless of the remaining axial walls. However, precaution should be taken in material selection since it affects the fatigue resistance and failure mode.
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Affiliation(s)
- Amir Mohidin Demachkia
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (UNESP), Av. Engenheiro Francisco José Longo,777. 12245000, São José Dos Campos, São Paulo, Brazil.
| | - Helder Callegaro Velho
- Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande Do Sul State, Brazil
| | - Luiz Felipe Valandro
- Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande Do Sul State, Brazil
| | - Mohiddin Rida Dimashkieh
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, Dar Al-Uloom University, Riyadh, Saudi Arabia
| | - Abdulaziz Samran
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, Dar Al-Uloom University, Riyadh, Saudi Arabia
| | - João Paulo Mendes Tribst
- Department of Oral Regenerative Medicine, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Renata Marques de Melo
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (UNESP), Av. Engenheiro Francisco José Longo,777. 12245000, São José Dos Campos, São Paulo, Brazil
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