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Ağaccıoğlu M, Sirin Karaarslan E, Aytac Bal F, Benli İ. Bond strength comparison of a fiber-reinforced composite resin: Different dentin conditions and preparation techniques. Microsc Res Tech 2024; 87:1250-1261. [PMID: 38339919 DOI: 10.1002/jemt.24515] [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: 09/01/2023] [Revised: 12/31/2023] [Accepted: 02/01/2024] [Indexed: 02/12/2024]
Abstract
This study aimed to compare the bond strength of a fiber-reinforced composite resin with traditional and bulk-fill composite resins under different dentin conditions and preparation techniques. Eighty molar teeth, excluding the mesio-distal half of the occlusal dentin surfaces of each teeth, were isolated with acid-resistant nail varnish and stored in a demineralisation solution (pH 4.5). After mechanical removal of the varnish, the teeth were buried in acrylic resin blocks. In every composite resin group, one-half of the specimens were prepared with a diamond bur and another half with Er: YAG laser. Then, the specimens were divided into four groups of composite resins (Filtek Z250, G-aenial Posterior, SonicFill 2, Ever X Posterior) (n = 10). Shear bond strengths were measured using a universal testing device, and failure types were determined with stereomicroscope images. SEM images were obtained at 1000× magnification. Data were analyzed using a three-way analysis of variance (ANOVA), and Bonferroni correction was used for multiple comparisons (p = .05). Differences in the dentin surface affected the bond strength results (p < .05), whereas there was no significant difference between cavity preparation methods (p > .05). EverX Posterior showed the highest bond strength results. Within the limitations of this study, fiber-reinforced composite resin exhibited successful bond strength results in addition to improved mechanical properties. RESEARCH HIGHLIGHTS: Fiber-reinforced composite had successful bond strength values. Bond strength values of sound dentin groups were higher than those of caries-affected dentin groups. The use of an Er: YAG laser for preparation did not lead to insufficient bond strength results.
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Affiliation(s)
- Merve Ağaccıoğlu
- Department of Restorative Dentistry, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Emine Sirin Karaarslan
- Department of Restorative Dentistry, Faculty of Dentistry, Tokat Gaziosmanpasa University, Tokat, Turkey
| | - Fatma Aytac Bal
- Department of Restorative Dentistry, Faculty of Dentistry, Biruni University, Istanbul, Turkey
| | - İsmail Benli
- Laboratory Specialist, Sugenomics Biotechnology, Ankara, Turkey
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Jadhav GR, Mittal P, Shinde S, Al-Qarni MA, Al-Obaid M, Abullais SS, Cicciù M, Minervini G. Biomimetic approach to strengthen the incisal fracture composite build-up: an in vitro study. BMC Oral Health 2024; 24:42. [PMID: 38191343 PMCID: PMC10773035 DOI: 10.1186/s12903-023-03679-4] [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: 09/28/2023] [Accepted: 11/20/2023] [Indexed: 01/10/2024] Open
Abstract
OBJECTIVE Incisal composite build-up shows a high failure susceptibility. The incorporation of fiber-reinforced composite (FRC) during composite restoration could improve its strength. Hence the study was planned to compare the effect of various positions of FRC on the strength of composite resin incisal build-ups. METHODS In maxillary incisors (n = 90), 3 mm of the incisal edge was cut and teeth were categorized into three groups based on the location and number of fibers used during incisal composite build-up - Group I: composite resin; Group II: composite resin and a single fiber palatally and Group III: composite resin along with two fibers palatally. RESULTS The data showed that group II had the maximum load-bearing values followed by group I and group III. CONCLUSION Within the confines of our study, it can be concluded that the addition of FRC to the conventional incisal composite build-up increased the overall strength restoration. Such composite restoration reinforced with a single fiber on the palatal side showed the highest load-bearing capacity compared to two fibers reinforced and unreinforced composites. The common mode of failure in group I was in composite resin, in two fibers reinforced at fibers-composite junction, and in one fiber reinforced composite was in the remaining part of the tooth.
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Affiliation(s)
| | - Priya Mittal
- Department of Conservative Dentistry and Endodontics, Swargiya Dadasaheb Kalmegh Smruti Dental College & Hospital, Nagpur, India.
| | - Siddharth Shinde
- Department of Orthodontics and Dentofacial Orthopedics, Bharati Vidyapeeth (Deemed to be University) Dental College and Hospital, Pune, Maharashtra, India
| | - Mohammed A Al-Qarni
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, 61471, Saudi Arabia
| | - Mohammed Al-Obaid
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, 61471, Saudi Arabia
| | - Shahabe Saquib Abullais
- Department of Periodontics and Community Dental Sciences, King Khalid University, 61421, Abha, KSA, Saudi Arabia
| | - Marco Cicciù
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, Catania, 95123, Italy
| | - Giuseppe Minervini
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India.
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Caserta, 81100, Italy.
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Garoushi S, Akbaşak-Sungur AÖ, Erkut S, Vallittu PK, Uctasli S, Lassila L. Evaluation of fracture behavior in short fiber-reinforced direct and indirect overlay restorations. Clin Oral Investig 2023; 27:5449-5458. [PMID: 37477724 PMCID: PMC10492695 DOI: 10.1007/s00784-023-05164-2] [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: 05/29/2023] [Accepted: 07/13/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVES The aim was to assess how incorporating a short-fiber composite (SFC) core would affect the fracture behavior of direct and indirect overlays. Furthermore, to examine the relationship between the thickness ratio of SFC core to particulate-filled composite (PFC) veneering and the fracture-behavior of bilayered-structured restorations. MATERIALS AND METHODS A total of 120 molars were used to create MOD cavities, with palatal cusps removed. Four different groups of direct overlays were then made (n = 15/group), all of which featured a SFC core (everX Flow) with varying thicknesses (0, 1, 4, and 5 mm), as well as a surface layer of PFC (G-aenial Posterior), with the overall thickness of the bilayered-structured restoration set at 5 mm. Additionally, four groups of CAD/CAM restorations were created (Cerasmart 270 and Initial LiSi Block), with or without 2 mm of SFC core reinforcement. Following the fabrication of these restorations, cyclic fatigue aging was carried out for a total of 500,000 cycles, with an applied maximum load (Fmax) of 150 N. Subsequently, each restoration underwent quasi-static loading until fracture. The fracture mode was subsequently evaluated using optical microscopy and SEM. RESULTS There were no statistically significant differences (p > 0.05) observed in the fracture resistance of indirect overlays reinforced with a 2-mm SFC core compared to those made solely from restorative materials. Direct overlays constructed using plain SFC or with a 4-mm layer thickness of SFC core exhibited significantly higher fracture resistance values (2674 ± 465 and 2537 ± 561 N) (p < 0.05) when compared to all other groups tested, according to the statistical analysis ANOVA. CONCLUSIONS The most effective method for restoring large MOD cavities was found to be direct restoration using SFC either alone or as a bulk core in combination with PFC composite. CLINICAL RELEVANCE The use of SFC as bulk reinforcing base will significantly improve the loading performance of directly layered restorations.
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Affiliation(s)
- S Garoushi
- Department of Biomaterials Science and Turku Clinical Biomaterial Center -TCBC, Institute of Dentistry, University of Turku, Turku, Finland.
| | - A Ö Akbaşak-Sungur
- Department of Prosthetic Dentistry, Faculty of Dentistry, Baskent University, Ankara, Turkey
| | - S Erkut
- Department of Prosthetic Dentistry, Faculty of Dentistry, Baskent University, Ankara, Turkey
| | - P K Vallittu
- Department of Biomaterials Science and Turku Clinical Biomaterial Center -TCBC, Institute of Dentistry, University of Turku, Turku, Finland
- Wellbeing Services County of Southwest Finland, Turku, Finland
| | - S Uctasli
- Department of Prosthodontics, Faculty of Dentistry, University of Ankara, Ankara, Turkey
| | - L Lassila
- Department of Biomaterials Science and Turku Clinical Biomaterial Center -TCBC, Institute of Dentistry, University of Turku, Turku, Finland
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Selvaraj H, Krithikadatta J. Fracture Resistance of Endodontically Treated Teeth Restored With Short Fiber Reinforced Composite and a Low Viscosity Bulk Fill Composite in Class II Mesial-Occlusal-Distal Access Cavities: An Ex-vivo Study. Cureus 2023; 15:e42798. [PMID: 37664325 PMCID: PMC10470020 DOI: 10.7759/cureus.42798] [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: 07/08/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023] Open
Abstract
Background Teeth undergoing endodontic therapy are prone to structural weakening and increased risk of fractures. The absence of marginal ridges and pericervical dentin further compromises the fracture resistance. The choice of the post-endodontic coronal seal is crucial for the effectiveness of endodontic therapy. Aim and Objectives This study compared the fracture resistance and fracture modes of endodontically treated teeth (ETT) with mesial-occlusal-distal (MOD) cavities restored with two different posterior composite resins: e-glass fiber reinforced composite (FRC) (everX Posterior) and flowable bulk fill composite (SDR Flow+). Materials and Methods Sixty human maxillary first bicuspids were divided into four groups: Group PC- positive control (intact teeth), Group NC- negative control (unrestored endodontically treated teeth), Group EXP- samples restored with everX Posterior and nano-hybrid composite, and Group SDR- samples restored with SDR Flow+ and nano-hybrid composite. The NC, EXP, and Smart Dentin Replacement (SDR) samples underwent endodontic procedures and MOD cavity preparation. The samples from EXP and SDR groups were restored with composite resins as post-endodontic coronal seals. The fracture resistance was evaluated using a Universal Testing Machine (UTM), and fracture modes were examined under a dental operating microscope (DOM) at 6x magnification. Statistical tests were performed using One-way ANOVA and Tukeys' post hoc tests. Results The mean fracture resistance of the experimental groups was as follows: PC- 880.1 ± 209.3 N; NC- 238.1 ± 15.4 N; EXP- 766.1 ± 50.2 N; SDR- 540.8 ± 49.4 N. The highest fracture resistance values were observed in the PC group, whereas the NC group showed the least. The EXP group exhibited significantly higher fracture resistance than the SDR group. Adhesive failure was observed in most samples in the EXP group, whereas samples in the SDR group showed more cohesive failures. Favorable fractures were more prevalent in samples restored with EverX posterior. Conclusion The study findings suggest that everX Posterior can enhance the fracture resistance of structurally compromised ETT. Samples restored with everX Posterior showed a favorable mode of fracture, which can be restored. Applying FRCs can contribute to the longevity and success of endodontic treatment by reinforcing the weakened tooth structure and preventing fractures.
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Affiliation(s)
- Harish Selvaraj
- Conservative Dentistry and Endodontics, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Jogikalmat Krithikadatta
- Conservative Dentistry and Endodontics, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
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Lakshmi Durga I, Varma KM, Sajjan G, Satish RK, Praveen G. Comparative evaluation of the effect of adhesive restorative composite resins on the reinforcement of peri-cervical dentin: An in vitro study. J Conserv Dent 2022; 25:151-155. [PMID: 35720820 PMCID: PMC9205346 DOI: 10.4103/jcd.jcd_487_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/22/2021] [Accepted: 12/25/2021] [Indexed: 11/27/2022] Open
Abstract
Background: Peri-cervical dentin (PCD) and its reinforcement play a crucial role in the fracture resistance of root canal-treated teeth. Aims: The aim of this study was to compare the fracture resistance of dual-cure, nano-hybrid, and short-fiber reinforced composite resins restored PCD with conventional hybrid composite (CHC) resin restored endodontically treated mandibular premolars. Settings and Design: Academic, in vitro study. Materials and Methods: The prepared mandibular premolar samples were randomly divided into five groups of 10 each. In Group 1, teeth were left intact. The remaining 40 teeth were endodontically treated and obturated as follows: In Group 2, teeth were obturated with gutta-percha till cementoenamel junction and restored with CHC. Teeth in Groups 3, 4, and 5 were obturated to a depth of 5 mm from the cervical line and restored with dual-cure, nano-hybrid, and short-fiber reinforced composite resins, respectively. Fracture resistance was tested using a universal testing machine. Statistical Analysis Used: One-way analysis of variance and post hoc Tukey's test. Results: Short-fiber reinforced composite resin showed a significantly higher mean fracture resistance value compared with other experimental groups. The mean fracture resistance values were obtained as Group 1 > Group 5 > Group 4 > Group 3 > Group 2. Conclusions: Reinforcement with short-fiber reinforced composite showed significantly higher fracture resistance compared with nano-hybrid and dual-cure composite resins.
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Baldi A, Comba A, Michelotto Tempesta R, Carossa M, Pereira GKR, Valandro LF, Paolone G, Vichi A, Goracci C, Scotti N. External Marginal Gap Variation and Residual Fracture Resistance of Composite and Lithium-Silicate CAD/CAM Overlays after Cyclic Fatigue over Endodontically-Treated Molars. Polymers (Basel) 2021; 13:polym13173002. [PMID: 34503042 PMCID: PMC8434150 DOI: 10.3390/polym13173002] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 08/27/2021] [Accepted: 08/28/2021] [Indexed: 11/16/2022] Open
Abstract
The purpose of this in vitro study was to evaluate the external marginal gap variation with a 3D quantitative method and the residual fracture resistance after cyclic fatigue in endodontically treated molars restored with overlays of different materials, with and without fiber posts-supported buildups. Forty-eight human maxillary molars were selected, endodontically treated, prepared with standardized MOD cavities and randomly allocated into 6 study groups considering the "core strategy" (build-up with composite resin; build-up with composite resin supported by a fiber post); and the "restorative material" of the indirect adhesive overlay (GrandioBlocks, Voco; Cerasmart, GC; CeltraDuo, Dentsply). All procedures were executed according with manufacturers guidelines. Micro-CT analysis prior and after cyclic fatigue were executed, followed by scanning electron microscope analysis and fracture resistance test. The Two-Way ANOVA analysis showed that interfacial gap progression was significantly influenced by the "core strategy" (p < 0.01) but not of "restorative material" (p = 0.59). Concerning fracture resistance, "restorative material" was statistically significant (p < 0.01), while "core strategy" (p = 0.63) and the interaction (p = 0.84) were not. In conclusion, the fiber post presence within the build-up promoted a lower interfacial gap opening after fatigue, evaluated through micro-CT scans. In terms of fracture resistance, teeth restored with Cerasmart and Celtra Duo were statistically similar, but superior to GrandioBlocks.
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Affiliation(s)
- Andrea Baldi
- Department of Surgical Sciences, Dental School Lingotto, University of Turin, 10126 Turin, Italy; (A.B.); (A.C.); (R.M.T.); (M.C.)
| | - Allegra Comba
- Department of Surgical Sciences, Dental School Lingotto, University of Turin, 10126 Turin, Italy; (A.B.); (A.C.); (R.M.T.); (M.C.)
| | - Riccardo Michelotto Tempesta
- Department of Surgical Sciences, Dental School Lingotto, University of Turin, 10126 Turin, Italy; (A.B.); (A.C.); (R.M.T.); (M.C.)
| | - Massimo Carossa
- Department of Surgical Sciences, Dental School Lingotto, University of Turin, 10126 Turin, Italy; (A.B.); (A.C.); (R.M.T.); (M.C.)
| | - Gabriel Kalil Rocha Pereira
- Department of Restorative Dentistry, Division of Prosthodontics, Federal University of Santa Maria, Santa Maria 97105-900, Brazil; (G.K.R.P.); (L.F.V.)
| | - Luiz Felipe Valandro
- Department of Restorative Dentistry, Division of Prosthodontics, Federal University of Santa Maria, Santa Maria 97105-900, Brazil; (G.K.R.P.); (L.F.V.)
| | - Gaetano Paolone
- Department of Dentistry, IRCCS San Raffaele Hospital and Dental School, Vita Salute University, 20158 Milan, Italy;
| | - Alessandro Vichi
- Dental Academy, University of Portsmouth, William Beatty Building, Hampshire Terrace, Portsmouth PO1 2QG, UK;
| | - Cecilia Goracci
- Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy;
| | - Nicola Scotti
- Department of Surgical Sciences, Dental School Lingotto, University of Turin, 10126 Turin, Italy; (A.B.); (A.C.); (R.M.T.); (M.C.)
- Correspondence: ; Tel.: +39-340-2861-799
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Evaluation of two CAD/CAM materials for Nayyar core and post-retained restorations: Three dimensional stress analysis. J Mech Behav Biomed Mater 2021; 117:104381. [PMID: 33582503 DOI: 10.1016/j.jmbbm.2021.104381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/27/2021] [Accepted: 01/31/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES The aim of this study is to assess the stress distribution of a nanoceramic resin CAD/CAM material, Lava Ultimate (LU) and a polymer-infiltrated hybrid ceramic CAD/CAM material, Vita Enamic (VE) for enamel replacement for Nayyar core (corono-radicular dowel and core) or post-retained restoration designs of a maxillary first premolar tooth with missing palatal cusp. MATERIALS AND METHODS A three dimensional finite element (FE) modelof maxillary first premolar with two roots was modeled. A mesial-occlusal-distal-palatal (MODP) cavity was designed with cavity floor above cemento-enamel junction and including buccal cuspal reduction. Restoration designs consisted of Nayyar core restoration (NCR) and post-retained restoration (PRR) with a glass fiber post. Vita Enamic (VE), Lava Ultimate (LU) were used for enamel and everX Posterior was used for dentin replacement. Vertical occlusal load (100 N) was applied on a spherical solid rigid material simulating the food stuff. Von Mises (VM) and maximum principle stress values were evaluated separately for the remaining enamel, remaining dentin and restorative material in megapascal (MPa). RESULTS The analysis of both VM and maximum principle stress values revealed that the most intense stress accumulation was in the cervical region of enamel for both designs. For VM, similar stress values were observed only in dentin. Stress analysis of restorative materials showed that everX Posterior had the highest stress accumulation. CONCLUSIONS The comparison of the two techniques showed that PRR had better stress distribution than NCR. NCR or PRR with LU or VE exhibited similar VM stress accumulation in dentin. Maximum principle stress analyses showed that PRR with LU transmitted the least stress to enamel and dentin indicating that when LU is the material of choice, post-retained restoration would be a satisfactory design. VM stress values of enamel revealed that VE absorbed the stress in itself and transferred less stress to dentin. This could point out that for the restoration of maxillary first premolar tooth with missing palatal cusp, VE may be a suitable material for NCR and PRR restoration techniques. HIGHLIGHTS When fiber reinforced composite is used as dentin replacement in combination with VE as enamel replacement; any technique; PRR or NCR, may be preferred in the restoration of MODP cavities of endodontically treated maxillary premolars. The clinical relevance has to be further studied in-vivo.
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Garoushi S, Sungur S, Boz Y, Ozkan P, Vallittu PK, Uctasli S, Lassila L. Influence of short-fiber composite base on fracture behavior of direct and indirect restorations. Clin Oral Investig 2021; 25:4543-4552. [PMID: 33417063 PMCID: PMC8310497 DOI: 10.1007/s00784-020-03768-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 12/28/2020] [Indexed: 11/29/2022]
Abstract
Objectives The aim was to examine the influence of short-fiber composite (SFC) core on the fracture-behavior of different types of indirect posterior restorations. In addition, the effect of thickness ratio of SFC-core to the thickness of the veneering conventional composite (PFC) on fracture-behavior of bi-structured composite restorations was evaluated. Materials and methods MOD cavities with removed palatal cusps were prepared on 90 intact molars. Five groups of direct overlay restorations (n = 10/group) were fabricated having a SFC-core (everX Flow) with various thicknesses (0, 1, 2, 3, 4 mm) and layer of surface PFC (G-aenial Anterior), remaining the thickness of the bi-structure restoration to be 5 mm. Four groups of CAD/CAM-made restorations (Cerasmart 270 and e-max CAD) were fabricated either with 2-mm layer of SFC-core or without fiber reinforcement. Intact teeth (n = 10) were used as control group. Restorations were statically loaded until fracture. Fracture patterns were evaluated visually. Data were analyzed using ANOVA (p = 0.05). Results With indirect overlay restorations, no statistically significant differences (p > 0.05) were observed in the load-bearing capacities between restorations reinforced by 2-mm SFC-core (bi-structured) and those fabricated from plain restorative materials. ANOVA displayed that direct overlay restorations made from 4-mm layer thickness of SFC-core had significantly higher load-bearing capacities (3050 ± 574 N) (p < 0.05) among all the groups tested. Conclusions Restorations (direct/indirect) combining SFC-core and a surface layer of conventional material demonstrated encouraging achievement in reference to fracture behavior. Clinical relevance The use of flowable short-fiber composite as reinforcing base with large direct and indirect restorations may result in more repairable failure.
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Affiliation(s)
- S Garoushi
- Department of Biomaterials Science and Turku Clinical Biomaterial Center-TCBC, Institute of Dentistry, University of Turku, Turku, Finland.
| | - S Sungur
- Department of Prosthodontics, Faculty of Dentistry, University of Ankara, Ankara, Turkey
| | - Y Boz
- Department of Prosthodontics, Faculty of Dentistry, University of Ankara, Ankara, Turkey
| | - P Ozkan
- Department of Prosthodontics, Faculty of Dentistry, University of Ankara, Ankara, Turkey
| | - P K Vallittu
- Department of Biomaterials Science and Turku Clinical Biomaterial Center-TCBC, Institute of Dentistry, University of Turku, Turku, Finland.,City of Turku Welfare Division, Oral Health Care, Turku, Finland
| | - S Uctasli
- Department of Prosthodontics, Faculty of Dentistry, University of Ankara, Ankara, Turkey
| | - L Lassila
- Department of Biomaterials Science and Turku Clinical Biomaterial Center-TCBC, Institute of Dentistry, University of Turku, Turku, Finland
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Lassila L, Säilynoja E, Prinssi R, Vallittu PK, Garoushi S. Bilayered composite restoration: the effect of layer thickness on fracture behavior. Biomater Investig Dent 2020; 7:80-85. [PMID: 33015638 PMCID: PMC7521310 DOI: 10.1080/26415275.2020.1770094] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 05/11/2020] [Indexed: 10/26/2022] Open
Abstract
Purpose: By combining the increased toughness of a resin composite reinforced with discontinuous fibers and the surface wear resistance of a particulate filler composite (PFC), a bilayered composite technique was recently introduced. This study aimed to evaluate the effect of the thickness of the overlaying PFC placed over a fiber-reinforced composite (FRC) core, on the fracture-behavior of direct crown restorations. Methods: Six groups of posterior crown restorations (n = 8/group) were fabricated having a discontinuous FRC-core (everX Flow) and a layer of surface PFC (Essentia U) with various thicknesses (0.5, 1.0, 1.5, 2.0 mm), with the remaining thickness of the bilayered being 6 mm. Control groups were only made of PFC or FRC materials. Restorations were statically loaded until fracture. Failure-modes were visually examined. Data were analyzed using ANOVA (p = .05) and regression analysis. Results: The regression analysis showed that by decreasing the thickness of PFC layer, the load bearing capacity of restorations increased linearly (R2=0.7909). ANOVA revealed that crown restorations made only from everX Flow composite had significantly higher load-bearing capacities (3990 ± 331 N) (p < .05) among all the groups tested. With regard to the failure-mode analysis, crowns that had a FRC core material of everX Flow revealed delamination of the PFC surface composite from the core. Crowns which were made only of PFC i.e. with no fiber reinforcement, showed a crushing-like fracture pattern. Conclusions: Restorations combining a thick FRC-core and a thin surface layer of PFC (0.5-1 mm), displayed promising performance related to fracture-behavior and load-bearing capacity.
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Affiliation(s)
- Lippo Lassila
- Department of Biomaterials Science and Turku Clinical Biomaterial Center - TCBC, Institute of Dentistry, University of Turku, Turku, Finland
| | - Eija Säilynoja
- Department of Biomaterials Science and Turku Clinical Biomaterial Center - TCBC, Institute of Dentistry, University of Turku, Turku, Finland.,Research Development and Production Department, Stick Tech Ltd - Member of GC Group, Turku, Finland
| | - Roosa Prinssi
- Research Development and Production Department, Stick Tech Ltd - Member of GC Group, Turku, Finland
| | - Pekka K Vallittu
- Department of Biomaterials Science and Turku Clinical Biomaterial Center - TCBC, Institute of Dentistry, University of Turku, Turku, Finland.,City of Turku Welfare Division, Oral Health Care, Turku, Finland
| | - Sufyan Garoushi
- Department of Biomaterials Science and Turku Clinical Biomaterial Center - TCBC, Institute of Dentistry, University of Turku, Turku, Finland
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OMRAN TA, GAROUSHI S, LASSILA L, SHINYA A, VALLITTU PK. Bonding interface affects the load-bearing capacity of bilayered composites. Dent Mater J 2019; 38:1002-1011. [DOI: 10.4012/dmj.2018-304] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Tarek A. OMRAN
- Department of Biomaterials Science and Turku Clinical Biomaterials Center-TCBC, Institute of Dentistry, University of Turku
| | - Sufyan GAROUSHI
- Department of Biomaterials Science and Turku Clinical Biomaterials Center-TCBC, Institute of Dentistry, University of Turku
| | - Lippo LASSILA
- Department of Biomaterials Science and Turku Clinical Biomaterials Center-TCBC, Institute of Dentistry, University of Turku
| | - Akikazu SHINYA
- Department of Crown and Bridge, School of Life Dentistry at Tokyo, The Nippon Dental University
| | - Pekka K. VALLITTU
- Department of Biomaterials Science and Turku Clinical Biomaterials Center-TCBC, Institute of Dentistry, University of Turku
- City of Turku Welfare Division, Oral Health Care
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Fracture behavior of Bi-structure fiber-reinforced composite restorations. J Mech Behav Biomed Mater 2019; 101:103444. [PMID: 31561057 DOI: 10.1016/j.jmbbm.2019.103444] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 09/12/2019] [Accepted: 09/19/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the fracture-behavior of direct composite restorations made with two different composite-core materials. In addition, fracture toughness (FT), flexural strength (FS) and flexural modulus (FM) of tested composites were evaluated. METHODS Twenty groups of posterior crown restorations were fabricated (n = 6/group). The groups were made of a 4-5 mm layer of composite-core materials (everX Flow and SDR Flow+) and covered by a 2 mm layer of conventional composite (G-aenial Anterior & Posterior, G-aenial Universal Injectable, Essentia, CeramX, Filtek Z500). Control groups were only made of conventional composites or composite-core materials. Crowns were statically loaded until fracture. Failure-modes were then visually examined. FT, FS and FM were determined for each tested composite (n = 6). RESULTS ANOVA revealed that crown restorations made only from everX Flow composite had significantly higher load-bearing capacities (3866 ± 263 N) (p < 0.05) among all the groups tested. No statistically significant differences were found in the load-bearing capacities between crowns made with different composite-core materials (p > 0.05). everX Flow exhibited the highest FT (2.8 MPa m1/2) and Z500 presented the highest FS values (197 MPa) (p < 0.05) among tested composites. With regard to the failure-mode analysis, crowns that had a fiber-reinforced core material of everX Flow revealed delaminating of surface conventional composite from the substructure layer. While in crowns that had a core material of SDR Flow+ or having only conventional composites with no fiber reinforcement, showed a crushing fracture pattern. CONCLUSION Restorations combining a fiber-reinforced composite core and a surface layer of conventional composite, displayed promising performance related to fracture-behavior.
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Limjeerajarus N, Dhammayannarangsi P, Phanijjiva A, Tangsripongkul P, Jearanaiphaisarn T, Pittayapat P, Limjeerajarus CN. Comparison of ultimate force revealed by compression tests on extracted first premolars and FEA with a true scale 3D multi-component tooth model based on a CBCT dataset. Clin Oral Investig 2019; 24:211-220. [PMID: 31079245 DOI: 10.1007/s00784-019-02919-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 04/29/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The aim of this study was to develop a new method for creating a multi-component and true scale 3-dimensional (3D) model of a human tooth based on cone-beam computed tomography (CBCT) images. MATERIALS AND METHODS First maxillary premolar tooth model was reconstructed from a patient's CBCT images. The 2D serial sections were used to create the 3D model. This model was used for finite element analysis (FEA). Model validation was performed by comparing the ultimate compressive force (UF) obtained experimentally using a universal testing machine and from simulation. The simulations of three component-omitting models (silicone, cementum, and omitting both) were performed to analyze the maximum (max.) principal stress and stress distribution. RESULTS The simulation-based UF indicating tooth fracture was 637 N, while the average UF in the in vitro loading was 651 N. The discrepancy between the simulation-based UF and the experimental UF was 2.2%. From the simulation, the silicone-omitting models showed a significant change in max. principal stress, resulting in a UF error of 26%, whereas there was no notable change in the cementum-omitting model. CONCLUSION This study, for the first time, developed a true scale multi-component 3D model from CBCT for predicting stress distribution in a human tooth. CLINICAL RELEVANCE This study proposed a method to create 3D modeling from CBCT in a true scale and multi-component manner. The PDL-like component-omitting simulation led to a higher error value of UF, indicating the importance of multi-component tooth modeling in FEA. Tooth 3D modeling could help determine mechanical failure in dental treatments in a more precise manner.
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Affiliation(s)
- Nuttapol Limjeerajarus
- Research Center for Advanced Energy Technology, Faculty of Engineering, Thai-Nichi Institute of Technology, Bangkok, 10250, Thailand
| | - Phetcharat Dhammayannarangsi
- Research Center for Advanced Energy Technology, Faculty of Engineering, Thai-Nichi Institute of Technology, Bangkok, 10250, Thailand
| | - Anon Phanijjiva
- Research Center for Advanced Energy Technology, Faculty of Engineering, Thai-Nichi Institute of Technology, Bangkok, 10250, Thailand
| | - Pavita Tangsripongkul
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Thanomsuk Jearanaiphaisarn
- Department of Operative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Pisha Pittayapat
- Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Chalida Nakalekha Limjeerajarus
- Department of Physiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand. .,Center of Excellence for Regenerative Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand.
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Kanat-Ertürk B, Saridağ S, Köseler E, Helvacioğlu-Yiğit D, Avcu E, Yildiran-Avcu Y. Fracture strengths of endocrown restorations fabricated with different preparation depths and CAD/CAM materials. Dent Mater J 2018; 37:256-265. [PMID: 29311428 DOI: 10.4012/dmj.2017-035] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The objectives of this study were to compare the fracture strength of endocrown restorations fabricated with different preparation depth and various CAD/CAM ceramics, and to assess the fracture types. Endodontically treated 100 extracted human permanent maxillary centrals were divided into two preparation depth groups as short (S: 3-mm-deep) and long (L: 6-mm-deep), then five ceramic subgroups, namely: feldspathic-ceramic (Vita Mark II-VM2), lithium-disilicate glass-ceramic (IPS e.max CAD-E.max), resin-ceramic (LAVA Ultimate-LU), polymer infiltrated ceramic (Vita Enamic-VE) and monoblock zirconia (inCoris TZI-TZI) (n=10/subgroup). The endocrowns were fabricated by CAD/CAM and were cemented with resin cement (RelyX U200). The teeth were thermally cycled (5,000cycles) and fracture tests were performed at 45º angle to the teeth. The data were statistically analyzed (Kruskal-Wallis, Mann Whitney U), failure modes were evaluated with stereomicroscopy. Zirconia group provided the statistically highest fracture strength, but also exhibited non-repairable failures. Preparation depth has an effect on the fracture strength only for feldspathic ceramic.
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Affiliation(s)
| | - Serkan Saridağ
- Department of Prosthodontics, Kocaeli University, Faculty of Dentistry
| | - Ege Köseler
- Department of Prosthodontics, Kocaeli University, Faculty of Dentistry
| | | | - Egemen Avcu
- Department of Machine and Metal Technologies, Kocaeli University, Ford Otosan İhsaniye Automotive Vocational School
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Garoushi S, Gargoum A, Vallittu PK, Lassila L. Short fiber‐reinforced composite restorations: A review of the current literature. ACTA ACUST UNITED AC 2018; 9:e12330. [DOI: 10.1111/jicd.12330] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 01/03/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Sufyan Garoushi
- Department of Biomaterials Science and Turku Clinical Biomaterial CenterUniversity of Turku Turku Finland
| | - Ausama Gargoum
- Department of Restorative DentistryLibyan InternationalMedical University Benghazi Libya
| | - Pekka K. Vallittu
- Department of Biomaterials Science and Turku Clinical Biomaterial CenterUniversity of Turku Turku Finland
- City of Turku Welfare DivisionOral Health Care Turku Finland
| | - Lippo Lassila
- Department of Biomaterials Science and Turku Clinical Biomaterial CenterUniversity of Turku Turku Finland
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Maas MS, Alania Y, Natale LC, Rodrigues MC, Watts DC, Braga RR. Trends in restorative composites research: what is in the future? Braz Oral Res 2017; 31:e55. [PMID: 28902235 DOI: 10.1590/1807-3107bor-2017.vol31.0055] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 05/22/2017] [Indexed: 01/12/2023] Open
Abstract
Clinical trials have identified secondary caries and bulk fracture as the main causes for composite restoration failure. As a measure to avoid frequent reinterventions for restoration replacement, composites with some sort of defense mechanism against biofilm formation and demineralization, as well as materials with lower susceptibility to crack propagation are necessary. Also, the restorative procedure with composites are very time-consuming and technically demanding, particularly concerning the application of the adhesive system. Therefore, together with bulk-fill composites, self-adhesive restorative composites could reduce operator error and chairside time. This literature review describes the current stage of development of remineralizing, antibacterial and self-healing composites. Also, an overview of the research on fiber-reinforced composites and self-adhesive composites, both introduced for clinical use in recent years, is presented.
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Affiliation(s)
- Mariel Soeiro Maas
- Universidade de São Paulo - USP, School of Dentistry,Department of Biomaterials and Oral Biology, São Paulo, SP, Brazil
| | - Yvette Alania
- Universidade de São Paulo - USP, School of Dentistry,Department of Biomaterials and Oral Biology, São Paulo, SP, Brazil
| | - Livia Camargo Natale
- Universidade de São Paulo - USP, School of Dentistry,Department of Biomaterials and Oral Biology, São Paulo, SP, Brazil
| | - Marcela Charantola Rodrigues
- Universidade de São Paulo - USP, School of Dentistry,Department of Biomaterials and Oral Biology, São Paulo, SP, Brazil
| | - David Christopher Watts
- University of Manchester School of Medical Sciences, Division of Dentistry, Manchester, United Kingdom
| | - Roberto Ruggiero Braga
- Universidade de São Paulo - USP, School of Dentistry,Department of Biomaterials and Oral Biology, São Paulo, SP, Brazil
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Biomechanical behavior of endodontically treated premolars using different preparation designs and CAD/CAM materials. J Dent 2017; 59:54-61. [PMID: 28214537 DOI: 10.1016/j.jdent.2017.02.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 02/07/2017] [Accepted: 02/13/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To evaluate the effect of restoration design ('2.5-mm deep endocrown', '5-mm deep endocrown' or '5-mm deep post&crown') and CAD/CAM material type (composite or lithium disilicate glass-ceramic) on the load-to-failure of endodontically treated premolars in absence of any ferrule. METHODS The crowns of 48 single-rooted premolars were cut and the roots were endodontically treated. Teeth were randomly divided into six groups (n=8); teeth in each group were restored using one of the two tested materials with standardized CAD/CAM fabricated endocrowns (with either 2.5-mm or 5-mm deep intra-radicular extension) or conventional crowns (5-mm deep post&crown). After cementation using luting composite, the specimens were immersed in distilled water and subjected to 1,200,000 chewing cycles with a load of 50N applied parallel to the long axis of the tooth (0°). After cyclic loading, a compressive load was applied at 45° to the tooth's long axis using a universal testing machine until failure. Load-to-failure was recorded (N) and the specimens were examined under a stereomicroscope with 3.5x magnification to determine the mode of failure. RESULTS All specimens survived the 1,200,000 chewing cycles. A significant interaction between restoration design and CAD/CAM material was found using two-way ANOVA. In the '2.5-mm deep endocrown' groups, the composite achieved a significantly higher load-to-failure than the lithium disilicate glass-ceramic, while no differences between materials were found in the '5-mm deep endocrown' and '5-mm deep post&crown' groups. More unfavorable failures (root fractures) were observed for higher load-to-failure values. CONCLUSIONS Only following a '2.5-mm deep endocrown' design, composite appeared more favorable than lithium disilicate glass-ceramic as crown material; this may be explained by their difference in elastic modulus. CLINICAL SIGNIFICANCE Shallow endocrown preparations on premolars present less surface for adhesive luting and a difference in crown material becomes apparent in terms of load-to-failure. The use of a more flexible composite crown material appeared then a better option.
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Gürel MA, Helvacioğlu Kivanç B, Ekıcı A, Alaçam T. Fracture Resistance of Premolars Restored Either with Short Fiber or Polyethylene Woven Fiber-Reinforced Composite. J ESTHET RESTOR DENT 2016; 28:412-418. [DOI: 10.1111/jerd.12241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Mügem Asli Gürel
- Faculty of Dentistry, Department of Endodontics; Gazi University; Ankara Turkey
| | | | - Adil Ekıcı
- Faculty of Dentistry, Department of Endodontics; Gazi University; Ankara Turkey
| | - Tayfun Alaçam
- Faculty of Dentistry, Department of Endodontics; Gazi University; Ankara Turkey
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Replacement of glass particles by multidirectional short glass fibers in experimental composites: Effects on degree of conversion, mechanical properties and polymerization shrinkage. Dent Mater 2016; 32:e204-10. [PMID: 27372238 DOI: 10.1016/j.dental.2016.06.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 01/22/2016] [Accepted: 06/16/2016] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To test the null hypothesis that the replacement of a small fraction of glass particles with random short glass fibers does not affect degree of conversion (DC), flexural strength (FS), fracture toughness (FT) and post-gel polymerization shrinkage (PS) of experimental composites. METHODS Four experimental photocurable composites containing 1 BisGMA:1 TEGDMA (by weight) and 60vol% of fillers were prepared. The reinforcing phase was constituted by barium glass particles (2μm) and 0%, 2.5%, 5.0% or 7.5% of silanated glass fibers (1.4mm in length, 7-13μm in diameter). DC (n=4) was obtained using near-FTIR. FS (n=10) was calculated via biaxial flexural test and FT (n=10) used the "single edge notched beam" method. PS at 5min (n=8) was determined using the strain gage method. Data were analyzed by ANOVA/Tukey test (DC, FS, PS) or Kruskal-Wallis/Dunn's test (FT, alpha: 5% for both tests). RESULTS DC was similar among groups (p>0.05). Only the composite containing 5.0% of fibers presented lower FS than the control (p<0.001). FT increased significantly between the control (1.3±0.17MPam(0.5)) and the composites containing either 5.0% (2.7±0.6MPam(0.5)) or 7.5% of fibers (2.8±0.6MPam(0.5), p<0.001). PS in relation to control was significantly reduced at 2.5% fibers (from 0.81±0.13% to 0.57±0.13%) and further reduced between 5.0% and 7.5% (from 0.42±0.12% to 0.23±0.07%, p<0.001). SIGNIFICANCE The replacement of a small fraction of filler particles with glass fibers significantly increased fracture toughness and reduced post-gel shrinkage of experimental composites.
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