The Effect of Cavity Shape and Hybrid Layer on the Stress Distribution of Cervical Composite Restorations

Objectives: The aim of this finite elemental stress analysis study was to evaluate the effect of cavity shape and hybrid layer on the stress distribution of the mandibular premolar tooth under occlusal loading. Methods: The mandibular premolar tooth was selected as the model based on the anatomical measurements suggested by Wheeler. Four different mathematical models were evaluated: 1) a saucer-shaped non-carious cervical lesion restored with a composite without a hybrid layer, 2) a saucer-shaped non-carious cervical lesion restored with a composite with a hybrid layer, 3) a wedge-shaped non-carious cervical lesion restored with a composite without a hybrid layer, and 4) a wedge-shaped non-carious cervical lesion restored with a composite with a hybrid layer. A 200 N force was applied from the buccal tubercule and central fossa of the premolar tooth. The findings were drawn by the SAPLOT program. Results: In models 2 and 4, the output showed that a hybrid layer acts as a stress absorber. Additionally, when the cavity shape was changed, the stress distribution was very different. Conclusions: Cavity shape and hybrid layer play an important role in stress distribution in cervical restorations. (Eur J Dent 2011;5:180-185)

Changes in the surface of bone and acid-etched and sandblasted implants following implantation and removal

Objective:

The aim of this study was to determine whether there are any changes in the surface of bone or implant structures following the removal of a screwed dental implant.

Materials and Methods:

For this, six individual samples of acid-etched and sandblasted implants from three different manufacturers’ implant systems were used. They were screwed in a D1 bovine bone, and they were removed after primary stabilization. The bone and implant surfaces are evaluated with scanning electron microscope.

Results:

Through examination of the surfaces of the bone prior to implantation and of the used and unused implant surfaces, it was found that inhomogeneity in the implant surface can cause microcracking in the bone.

Conclusions:

This is attributed to the stress induced during the implantation of self-tapping implants and suggests that a tap drill may be required in some instances to protect the implant surface.

Micro-shear bond strength of resin cement to dentin after application of desensitizing toothpastes

OBJECTIVES

The aim of the study was to evaluate the effect of three desensitizing toothpastes on bonding of resin cements to dentin.

MATERIALS AND METHODS

The occlusal surfaces of 72 maxillary third molars were ground to obtain flat dentin surfaces and then divided into three groups according to three desensitizing toothpastes used: Sensodyne Rapid Relief (GlaxoSmithKline, SmithKline Beecham Ltd., Slough, UK), Signal Sensitive Expert (Unilever Sanayi ve Ticaret Türk A.Ş., Ümraniye, İstanbul, Turkey) and Colgate Sensitive Pro-Relief (Colgate Palmolive, New York, NY). Following bonding of the resin cement (Clearfil™ SA Cement, Kuraray Co, Osaka, Japan) to dentin, the specimens were light cured for 40 s with a LED (Elipar S10, 3M Espe, St. Paul, MN). The strength measurements were accomplished with a micro-shear testing machine (Bisco, Schaumburg, IL) at a cross-head speed of 0.5 mm/min until the failure occurs. Failure modes were examined using a stereomicroscope and scanning electron microscope. The data were analyzed with one-way analysis of variance (ANOVA) and Tukey HSD test (α = 0.05).

RESULTS AND CONCLUSION

ANOVA revealed that the application of desensitizing toothpastes had significant effects on bond strength of the resin cement tested to dentin (p < 0.05). Mixed failures were observed in all of the groups.

CLINICAL SIGNIFICANCE

The use of a desensitizing toothpaste before cementation might alter the bond strength of adhesively luted restorations.

Monoblocks in root canals: a finite elemental stress analysis study

AIM

To investigate using finite element stress analysis (FEA) primary, secondary and tertiary monoblocks created either by adhesive resin sealers or by different adhesive posts and to evaluate the effect of interfaces on stress distribution in incisor models.

METHODOLOGY

Seven maxillary incisor FEA models representing different monoblocks using several materials were created as follows: (a) primary monoblock with Mineral Trioxide Aggregate; (b) secondary monoblock with sealer (MetaSEAL) and Resilon; (c) tertiary monoblock with EndoREZ; (d) primary monoblock with polyethylene fibre post-core (Ribbond); (e) secondary monoblock with glass-fibre post and resin cement; (f) tertiary monoblock with bondable glass-fibre post; (g) tertiary monoblock with silane-coated ceramic post. A 300 N load was applied from the palatal surface of the crown with a 135° angle to the tooth long axis. Materials used in the study were assumed to be homogenous and isotropic except the glass-fibre post; the results are expressed in terms of von Mises criteria.

RESULTS

Maximum stresses were concentrated on force application areas (18-22.1 MPa). The stresses within the models increased with the number of interfaces both for the monoblocks created by the sealers (1.67-8.33 MPa) and for the monoblocks created by post-core systems (1.67-11.7 MPa).

CONCLUSIONS

Stresses within roots increased with an increase in the number of the adhesive interfaces. Creation of a primary monoblock within the root canal either by an endodontic sealer or with an adhesive post-core system can reduce the stresses that occur inside the tooth structure.

The effect of cavity shape and hybrid layer on the stress distribution of cervical composite restorations

OBJECTIVES

The aim of this finite elemental stress analysis study was to evaluate the effect of cavity shape and hybrid layer on the stress distribution of the mandibular premolar tooth under occlusal loading.

METHODS

The mandibular premolar tooth was selected as the model based on the anatomical measurements suggested by Wheeler. Four different mathematical models were evaluated: 1) a saucer-shaped non-carious cervical lesion restored with a composite without a hybrid layer, 2) a saucer-shaped non-carious cervical lesion restored with a composite with a hybrid layer, 3) a wedge-shaped non-carious cervical lesion restored with a composite without a hybrid layer, and 4) a wedge-shaped non-carious cervical lesion restored with a composite with a hybrid layer. A 200 N force was applied from the buccal tubercule and central fossa of the premolar tooth. The findings were drawn by the SAPLOT program.

RESULTS

In models 2 and 4, the output showed that a hybrid layer acts as a stress absorber. Additionally, when the cavity shape was changed, the stress distribution was very different.

CONCLUSIONS

Cavity shape and hybrid layer play an important role in stress distribution in cervical restorations.

Influence of several fibre-reinforced composite restoration techniques on cusp movement and fracture strength of molar teeth

AIM

To compare mean cusp movement in molar teeth with endodontic access and mesial-occlusal-distal (MOD) cavities before and after restoration with several fibre-reinforced composite restoration techniques under loading and to evaluate the effect of restoration technique on fracture strength.

METHODOLOGY

Reference points were marked at the mesial cusp ridges of extracted human mandibular molar teeth. Digital images were taken under loading (300 N) using a stereomicroscope (Leica MZ16A; Wetzlar, Germany). Three-dimensional (3D) distances between the reference points were recorded (Leica, Stereo-Explorer, 2.1) as controls. Standard MOD cavities were prepared and restored as follows (n = 10), group 1: composite restoration (Clearfil AP-X; Kuraray, Tokyo, Japan); group 2: cavity lined with polyethylene fibre (Ribbond, Ribbond Inc., Seattle, WA, USA) in combination with flowable resin (Protect-Liner F; Kuraray, Tokyo, Japan) before composite restoration; group 3: polyethylene fibre inserted on occlusal surface of the tooth from buccal to lingual after finishing the composite restoration; group 4: missing walls were restored with composite resin and inner surfaces of the axial walls were then reinforced with polyethylene fibre placed circumferentially before the composite restoration. The restored teeth were re-loaded, digital images were re-taken and the 3D distance between the reference points was recorded in μm. Comparisons of the restoration techniques, the effectiveness of restoration for each group were analysed statistically (Kruskall-Wallis, paired-samples t-test). The teeth were then loaded until failure (5 mm min(-1) ), the data were recorded (N) and analysed statistically (Kruskall-Wallis test).

RESULTS

A significant difference occurred amongst the groups in terms of cusp movement (P = 0.018). All the groups revealed a decrease in inter-cuspal width when compared to their initial records. The mean values of these decreases were as follows: group 1 17.6 (P = 0.003), group 2 6.7 (not sig), group 3 6.6 (not sig) and group 4 0.85 (not sig) μm. No significant difference was found amongst the fracture strength values (P = 0.22). In group 1, 90% of the fractures were non-restorable, whereas in group 3 100% of the fractures were restorable.

CONCLUSIONS

Regardless of restoration technique, fibre reinforcement of composite restorations decreased cusp movement in molar teeth with MOD and endodontic access cavities but did not affect fracture strength.

The effect of different posts on fracture strength of roots with vertical fracture and re-attached fragments

The aim of this in vitro study was to test the effect of different post systems on fracture strength of roots with re-attached fragments. Root canals of eighty extracted single-rooted human teeth were instrumented (ProFile) and randomly divided into two groups. The roots in the first group were vertically cracked, and the fragments were re-attached using Super Bond C&B (Sun Medical, Tokya, Japan). The roots in the second group were kept sound. Obturation of the roots was performed with MetaSEAL (Sun Medical) and gutta-percha. Post spaces were prepared, and the roots were restored with one of the followings: UniCore (Ultradent), Everstick (Stick Tech), Ribbond (Ribbond), ParaPost (Coltene/Whaledent) (n = 10). Four mm high build-ups were created (Clearfil DC Bond Core; Kuraray, Tokyo, Japan). Compressive loading of the samples was performed after 24 h (1 mm min(-1)). Mean load necessary to fracture each sample was recorded (Newton) and statistically analysed (One-way anova, t-tests). ParaPost showed the highest fracture strength among the roots with re-attached fragments (P < 0.05). UniCore and ParaPost systems showed similar fracture strength in the sound roots (P > 0.05). Re-attached fragments significantly reduced the fracture strength of roots in UniCore group (P = 0.000). Ribbond post showed mostly repairable fractures. Metal post (ParaPost) showed the highest fracture strength in the roots with re-attached fragments; however, fracture pattern was 41% non-repairable. Re-attached fragments significantly reduced the fracture strength of the roots in UniCore group. Prefabricated posts showed similar fracture strength in the sound roots. Customized post systems EverStick and Ribbond showed mostly repairable failure after loading in sound roots or roots with re-attached fragments.

Effect of Surface Treatments and Different Adhesives on the Hybrid Layer Thickness of Non-carious Cervical Lesions

The quality of the hybrid layer created in non-carious cervical sclerotic lesions may determine the longevity of cervical composite restorations.

Bond strength between root dentin and three glass-fiber post systems

STATEMENT OF PROBLEM

Glass-fiber posts were introduced for use after endodontic therapy instead of metal alloy and ceramic posts. There are several new types of glass-fiber post systems available, but little is known about how well these posts bond to the root surface.

PURPOSE

The purpose of this in vitro study was to compare the bond strengths of 3 different types of glass-fiber post systems-opaque, translucent, and electrical glass-in 3 different locations of prepared post spaces.

MATERIAL AND METHODS

Sixty human intact single-rooted extracted teeth were used. The root canals were prepared using a step-back technique and obturated with gutta-percha using lateral condensation. The roots were divided into 3 experimental groups and further divided into 2 subgroups according to testing time (n=10). Roots were restored with 1 of the following post systems according to the manufacturer's instructions: opaque glass-fiber posts (Snowpost), translucent glass-fiber posts (FiberMaster), and electrical glass-fiber posts (Everstick). A self-etching primer (Clearfil Liner Bond) was applied to the walls of the post spaces, allowed to etch for 30 seconds, and gently air dried. A dual-polymerized bonding agent (Clearfil Liner Bond, Bond A and B) was then applied to the same walls. A dual-polymerizing resin luting agent (Panavia F) was mixed for 20 seconds and then placed in the post spaces using a lentulo spiral instrument. The roots were placed in light-protected cylinders; then the light source was placed directly on the flat cervical tooth surfaces and the cement was polymerized. Specimens were stored in light-proof boxes for 24 hours or 1 week after the polymerization procedure. Each root was cut horizontally, and six 1-mm-thick root segments (2 apical, 2 middle, and 2 cervical) were prepared. Using a push-out test, the bond strength between post and dentin was measured after 24 hours or 1 week using a universal testing machine. Statistical analysis was performed with 3-way ANOVA followed by independent t tests (alpha=.05) to detect differences between groups defined by the specific interacting variables. The different combinations of posts and luting material from the cervical segments were analyzed with SEM.

RESULTS

The 3-way ANOVA indicated that push-out test values varied significantly according to the post system used (opaque, electrical, and translucent) (P<.01); the root segments (cervical, middle, and apical) (P<.01), however, did not vary statistically according to the time of testing (24 hours and 1 week). Opaque and electrical glass-fiber posts showed higher bond strength values than translucent posts (P<.01). Push-out bond strength values of cervical segments were significantly higher than the middle and apical segments in translucent and electrical glass-fiber post groups (P<.01). In the opaque glass-fiber post group, there were no significant differences between cervical and middle segments. In SEM analysis, a distinct hybrid zone with long, numerous resin tags located between luting material and dentin was exhibited in all post systems.

CONCLUSION

The opaque and electrical glass-fiber posts exhibited similar bond strengths, and translucent posts exhibited the lowest bond strength. The highest bond strength was observed in the cervical third of the post spaces for translucent and electrical glass-fiber post groups.

Finite element analysis of stress distribution of 2 different tooth preparation designs in porcelain-fused-to-metal crowns

PURPOSE

The aim of this clinical simulation study was to investigate the effect of anatomic and nonanatomic occlusal preparation design on stress distribution in different metal-ceramic crowns and tooth and bone.

MATERIALS AND METHODS

For the finite element analysis method, a 2-dimensional mathematical model of a mandibular second premolar tooth and its supporting tissues was used. The analysis was performed by using a structural analysis program. Four groups were designed: gold-palladium alloy/anatomic occlusal preparation (Au-Pd/A), Au-Pd alloy/nonanatomic (flat) occlusal preparation (Au-Pd/N), nickel-chromium alloy/anatomic occlusal preparation (Ni-Cr/A), and Ni-Cr alloy/nonanatomic occlusal preparation (Ni-Cr/N). A distributed type load of 400 N (total) was applied to the centric stop points on the tip of the buccal cusp and on the central developmental groove in centric occlusion to all types of restorations.

RESULTS

The results demonstrated that shear stresses in the dentin tissues and restorations in Au-Pd/A and Ni-Cr/A were similar. The shear stresses within the restorations in Au-Pd/N and Ni-Cr/N were similar.

CONCLUSION

Anatomic occlusal preparation designs were advantageous in stress distribution in the dentin tissue. Nonanatomic occlusal preparation designs were found to be advantageous in the stress amount and distribution in the porcelain structure. Occlusal preparation designs and restorative materials showed no differences in stress distribution and amount in the pulp tissue and bone tissues.

Effects of cantilever design and material on stress distribution in fixed partial dentures - a finite element analysis

The purpose of this study was to examine the stress distribution in distal cantilevered fixed partial dentures (FPDs) that are designed with different cantilever morphology and made from different restorative materials. The finite element (FE) method was used to create models of two restoration types; metal-ceramic and an all-ceramic FPDs. Both models were designed with distal cantilevers involving the first and second premolars as abutments and cantilever extension involving at the premolar or molar. The width of connector between the cantilever and the primary abutment restoration was 2.25 mm. The load applied during the FE analysis was positioned at the cusp tips of all teeth. The FE analysis of the models revealed that Von Mises stress values with maximum stress concentrations were observed on connectors of distal cantilevers. Stress concentration sites were also observed at the distal cervical area of the second premolar tooth. Models with premolar cantilever extensions restored with all-ceramic induced lower Von Mises stress values than metal-ceramic restorations, however models with molar cantilever extensions restored with all-ceramic restorations induced higher Von Misses stress values than metal-ceramic restorations. If the distal cantilever length and restorative material is appropriately chosen, the failure frequency may be reduced. All ceramic can be used as restorative material, when the cantilevers length is not more than the mesiodistal dimension of a premolar tooth and metal-ceramic restorations can be used in longer situations.

Three-dimensional finite element analysis of the effect of different bone quality on stress distribution in an implant-supported crown

STATEMENT OF PROBLEM

Primary implant stability and bone density are variables that are considered essential to achieve predictable osseointegration and long-term clinical survival of implants. Information about the influence of bone quality on stress distribution in an implant-supported crown is limited.

PURPOSE

The purpose of this study was to investigate the effect of 4 different bone qualities on stress distribution in an implant-supported mandibular crown, using 3-dimensional (3-D) finite element (FE) analysis.

MATERIAL AND METHODS

A 3-D FE model of a mandibular section of bone with a missing second premolar tooth was developed, and an implant to receive a crown was developed. A solid 4.1 x 10-mm screw-type dental implant system (ITI; solid implant) and a metal-ceramic crown using Co-Cr (Wiron 99) and feldspathic porcelain were modeled. The model was developed with FE software (Pro/Engineer 2000i program), and 4 types of bone quality (D1, D2, D3, and D4) were prepared. A load of 300 N was applied in a vertical direction to the buccal cusp and distal fossa of the crowns. Optimal bone quality for an implant-supported crown was evaluated.

RESULTS

The results demonstrated that von Mises stresses in D3 and D4 bone quality were 163 MPa and 180 MPa, respectively, and reached the highest values at the neck of the implant. The von Mises stress values in D1 and D2 bone quality were 150 MPa and 152 MPa, respectively, at the neck of the implant. A more homogenous stress distribution was seen in the entire bone. Conclusion For the bone qualities investigated, stress concentrations in compact bone followed the same distributions as in the D3 bone model, but because the trabecular bone was weaker and less resistant to deformation than the other bone qualities modeled, the stress magnitudes were greatest for D3 and D4 bone.

The effect of fibre insertion on fracture resistance of root filled molar teeth with MOD preparations restored with composite

AIM

To evaluate the effect of using flowable composite with or without leno woven ultra high modulus polyethylene fibre reinforcement on fracture resistance of root filled mandibular molars with mesio-occlusodistal (MOD) preparations.

METHODOLOGY

Sixty sound extracted human mandibular molars were randomly assigned to five groups (n = 12). Group 1 did not receive any preparation. From groups 2 to 5, the teeth were root filled and MOD preparations were created. Group 2 remained unrestored. Group 3 was restored with a dentine bonding system (DBS; SE Bond, Kuraray, Japan) and composite resin (CR) (AP-X; Kuraray). In group 4, flowable composite resin (Protect Liner F; Kuraray) was used before restoring teeth with CR. In group 5, leno woven ultra high modulus polyethylene ribbon fibre (Ribbond, Seattle, WA, USA) was inserted into the cavities in a buccal to lingual direction and the teeth were then restored with DBS and CR. After finishing and polishing, the specimens were stored in 100% humidity at 37 degrees C for 1 day. Compressive loading of the teeth was performed using a universal testing machine at a crosshead speed of 0.5 mm min(-1). The mean load necessary to fracture the samples were recorded in newtons (N) and were subjected to analysis of variance (ANOVA) and Tukey post-hoc test.

RESULTS

The mean load necessary to fracture the samples in each group were (in N): group 1: 1676.75 +/-154.63(a), group 2: 376.51 +/- 37.36(b), group 3: 733.23 +/- 133.33(c), group 4: 786.48 +/- 145.34(c), group 5: 943.63 +/- 121.15(d). There were statistically significant differences between the groups annotated with different letters.

CONCLUSIONS

(i) Use of flowable composite resin under composite restorations had no effect on fracture resistance of root filled molar teeth with MOD preparations, (ii) use of polyethylene ribbon fibre under composite restorations in root filled teeth with MOD preparations significantly increased fracture strength.

The influence of various occlusal materials on stresses transferred to implant-supported prostheses and supporting bone: A three-dimensional finite-element study

The aim of this numerical analysis was to evaluate the amount and localization of stress that occurs with various materials used in implant-crown design under functional forces. Computer-aided design techniques and a finite-element stress analysis method were used for evaluation. A 4.1 x 10-mm implant placed in the mandibular second premolar area was simulated and analyzed. Simulation and analysis were performed with the use of COSMOS/M software and Pro/Engineer 2000i on a Dual Pentium III 1-GHz computer. Crown designs were as follows: porcelain fused to noble metal crown, porcelain fused to base metal crown, In-Ceram porcelain crown, and IPS Empress 2 porcelain crown. A 300-N vertical force was applied to the centric relation stop points of the crowns. The results of this study indicated that different types of restorative materials play an important role in the amount and distribution of the stresses in the superstructure and the implant. The highest stress values were observed in the IPS Empress 2 porcelain crown design (600 MPa). Porcelain fused to base metal and In-Ceram framework designs transferred less stress to abutment. Type of restorative materials used in implant crown designs are significant factors in the amount and distribution of the stresses on superstructure and implant under functional forces. Porcelain fused to base metal (149 MPa) and In-Ceram (173 MPa) crown designs induced higher von Mises stress values within the framework than porcelain fused to noble metal (108 MPa) and IPS Empress 2 (119 MPa) porcelain crown designs.

Three-dimensional finite-element analysis of functional stresses in different bone locations produced by implants placed in the maxillary posterior region of the sinus floor

STATEMENT OF PROBLEM

Implants placed in the posterior maxilla have lower success rates compared to implants placed in other oral regions. Inadequate bone levels have been suggested as a reason for this differential success rate.

PURPOSE

The purpose of this study was to determine the amount and localization of functional stresses in implants and adjacent bone locations when the implants were placed in the posterior maxilla in proximity to the sinus using finite element analysis (FEA).

MATERIAL AND METHODS

A 3-dimensional finite element model of a maxillary posterior section of bone (Type 3) was used in this study. Different bony dimensions were generated to perform nonlinear calculations. A single-piece 4.1x10-mm screw-shaped dental implant system (ITI solid implant) was modeled and inserted into atrophic maxillary models with crestal bone heights of 4, 5, 7, 10, or 13 mm. In some models the implant penetrated the sinus floor. Cobalt-Chromium (Wiron 99) was used as the crown framework material placed onto the implant, and porcelain was used for occlusal surface of the crown. A total average occlusal force (vertical load) of 300 N was applied at the palatal cusp (150 N) and mesial fossa (150 N) of the crown. The implant and superstructure were simulated in finite element software (Pro/Engineer 2000i program).

RESULTS

For the porcelain superstructure for bone levels, maximum von Mises stress values were observed on the mesial fossae and palatal cusp. For the bone structure, the maximum von Mises stress values were observed in the palatal cortical bone adjacent to the implant neck. There was no stress within the spongy bone. High stresses occurred within the implants for all bone levels.

CONCLUSION

The maximum von Mises stresses in the implants were localized in the neck of implants for 4- and 5-mm bone levels, but for 7-, 10-, and 13-mm bone levels more even stresses occurred within the implants.

Nasal prosthesis rehabilitation: a case report

A nasal prosthesis can reestablish esthetic form and anatomic contours for midfacial defects often more effectively than can surgical reconstruction. This case report describes the clinical and laboratory procedures for fabricating a nasal prosthesis.

Microleakage of endodontically treated teeth with different dowel systems

STATEMENT OF PROBLEM

Several new esthetic dowel systems are available for the restoration of endodontically treated teeth, but little is known about how effectively these dowels seal the restored teeth.

PURPOSE

The purpose of this in vitro study was to compare microleakage of 3 esthetic, adhesively luted dowel systems with a conventional dowel system.

MATERIAL AND METHODS

The root canals of 41 human intact single-rooted extracted teeth were prepared using a step-back technique. The teeth were randomly divided into 4 experimental groups (n=10), and 1 tooth served as a positive control. The decoronated roots were obturated with gutta-percha using lateral condensation. Roots were restored with 1 of the following dowel systems according to the manufacturer's instructions: (1) stainless steel dowels (ParaPost), (2) glass fiber dowels (Snowpost), (3) resin-supported polyethylene fiber (Ribbond) dowels, or (4) zirconia dowels (Cosmopost). Using a fluid filtration method, coronal leakage of the specimens along the dowel space and root canal restorative material was measured. Fluid movement measurements were made at 2-minute intervals for 8 minutes to measure the presence of voids existing in the obturated canals, at 1 week, 3 months, and 6 months following dowel insertion. A repeated-measures analysis of variance (ANOVA) was used to analyze logarithmic transformations of data (time and dowel material) for significant differences. The Tukey HSD test and paired 2-tailed tests were used to perform multiple comparisons (alpha=.05).

RESULTS

The data indicated that the leakage values varied according to the dowel system used (P<.01). There was significant interaction between dowel systems and time of testing (P<.01). The sealing ability of zirconia dowels decreased over time (P<.01), but sealing abilities of stainless steel and resin-supported polyethylene fiber dowels remained constant (P>.05). The sealing ability of glass fiber dowels increased at 3 months (P=.032) and remained constant over the next 3 months (P=.758). Statistically, resin-supported polyethylene fiber and glass fiber dowels showed the lowest coronal leakage when compared with stainless steel and zirconia dowels at all time periods (P<.01). There were no significant differences between resin-supported polyethylene fiber and glass fiber dowels at any time period. The initial leakage measurement in zirconia dowel and stainless steel dowels were similar (P=.914), but became significantly different at 3 and 6 months (P<.01).

CONCLUSION

Resin-supported polyethylene fiber dowels and glass fiber dowels tested exhibited less microleakage compared to zirconia dowel systems. The latter system should be further evaluated because of its unacceptable level of leakage.

The in vitro effect of pulpal pressure and luting agent on tensile bond strength of complete cast crowns

STATEMENT OF PROBLEM

The degree to which pulpal pressure may affect bond strength of complete cast crowns is unknown.

PURPOSE

The aim of this in vitro study was to evaluate the effect of simulated pulpal pressure on the tensile bond strength of complete cast crowns luted with 2 different cements.

MATERIAL AND METHODS

Forty-eight human mandibular canine teeth were cleaned and stored in saline solution. The crowns were prepared by 1 investigator, and standardization of the preparation was accomplished by fixing a dental handpiece in a parallelometer. Uniform grooves, 0.5 mm in depth, were prepared with burs with depth guides. The complete crowns were prepared with a 0.5-mm shoulder margin. Teeth were randomly divided into 2 groups of 24 teeth each (Group I and Group II). In Group I, bonding and tensile test procedures of the teeth were carried out under simulated pulpal pressure (15 cm of saline solution). In Group II, simulated pulpal pressure was not used. The roots were removed 1 mm below the cementoenamel junction to create direct communication with the pulp chamber. The remaining pulpal tissues were carefully removed, and crowns were embedded in acrylic resin. The acrylic resin was then penetrated by a stainless steel tube that connected the pulp chamber and the barrel of a disposable plastic 5-ml syringe. The pulp chambers were filled with physiological saline solution under elevated pressure to locate the area of greatest permeability on the dentinal surface. Crowns were cast (Co-Cr alloy) with a 20-mm bar to allow testing of the bond strength. Each of the 2 groups were further divided into 2 luting cement groups of 12 each (Group I, A and B, and Group II, A and B). Group IA/IIA and Group IB/IIB specimens were luted with a polycarboxylate luting cement (Poly-F Plus) and an adhesive luting cement (Superbond C&B), respectively. After storage in distilled water for 24 hours, all specimens were subjected to a tensile bond test in a universal testing machine at a crosshead speed of 0.5 mm/min until failure. The maximum load at fracture (Newton) was recorded. The results were then evaluated with 2-way analysis of variance and Tukey's honestly significant difference tests (alpha=.05).

RESULTS

Simulated pulpal pressure increased the bond strength of cast complete crowns cemented with an adhesive luting agent (P=.01). No significant difference was found in the bond strength of complete cast crowns cemented with polycarboxylate cement with or without pulpal pressure. Superbond C&B adhesive luting agent showed significantly higher bond strength values for Group I (388.9+/-32.7) and Group II (300.9+/-66.8), when compared with polycarboxylate cement for Group I (221.3+/-17.3) and Group II (186.8+/-38.5) (P=.001).

CONCLUSION

Simulated pulpal pressure had a positive effect on the retention of complete cast crowns when cemented with Superbond C&B adhesive luting agent. Superbond C&B significantly increased the retention of crowns in either the presence or absence of pulpal pressure.

The influence of occlusal loading location on stresses transferred to implant-supported prostheses and supporting bone: a three-dimensional finite element study

STATEMENT OF PROBLEM

Information about the influence of occlusal loading by location on the stress distribution in an implant-supported fixed partial denture and supporting bone tissue is limited.

PURPOSE

The purpose of this study was to investigate the effect of loading at 1 to 3 different locations on the occlusal surface of a tooth on the stress distributions in an implant-supported mandibular fixed partial denture (FPD) and surrounding bone, using 3-dimensional finite element analysis.

MATERIAL AND METHODS

A 3-dimensional finite element model of a mandibular section of bone (Type 2) with missing second premolar and its superstructures were used in this study. A 1-piece 4.1 x 10-mm screw-shape ITI dental implant system (solid implant) was modeled for this study. Cobalt-Chromium (Wiron 99) was used as the crown framework material and porcelain was used for occlusal surface. The implant and its superstructure were simulated in a Pro/Engineer 2000i program. Total loads at 300 N were applied at the following locations: 1) tip of buccal cusp (300 N); 2) tip of buccal cusp (150 N) and distal fossa (150 N); or 3) tip of buccal cusp (100 N), distal fossa (100 N), and mesial fossa (100 N).

RESULTS

The results demonstrated that vertical loading at 1 location resulted in high stress values within the bone and implant. Close stress levels were observed within the bone for loading at 2 locations and 3 locations; the former created the most extreme stresses and the latter the most even stresses within the bone. With loading at 2 or 3 locations, stresses were concentrated on the framework and occlusal surface of the FPD, and low stresses were distributed to the bone.

CONCLUSION

For the loading conditions investigated, the optimal combination of vertical loading was found to be loading at 2 or 3 locations which decreased the stresses within the bone. In this situation, von Mises stresses were concentrated on the framework and occlusal surface of the FPD.