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Caussin E, Izart M, Ceinos R, Attal JP, Beres F, François P. Advanced Material Strategy for Restoring Damaged Endodontically Treated Teeth: A Comprehensive Review. MATERIALS (BASEL, SWITZERLAND) 2024; 17:3736. [PMID: 39124400 PMCID: PMC11313123 DOI: 10.3390/ma17153736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 07/22/2024] [Accepted: 07/25/2024] [Indexed: 08/12/2024]
Abstract
The restoration of endodontically treated teeth (ETT) remains a significant challenge in modern dentistry. These teeth often suffer from substantial structural damage due to both the original pathology and the invasive nature of endodontic procedures. Consequently, ETT are more susceptible to fractures compared to vital teeth, necessitating restorative strategies that can effectively restore both function and aesthetics while minimizing the risk of failure. In recent years, advances in adhesive dentistry and the development of high-strength ceramics have further expanded the restorative options for ETT. Bonded restorations have gained popularity as they preserve more tooth structure and enhance the overall strenght of the tooth-restoration complex. The choice of restorative material and technique is influenced by numerous factors, including the amount of remaining tooth structure, the functional requirements of the tooth, and the aesthetic demands of the patient. Despite the plethora of available materials and techniques, the optimal approach to restoring ETT remains a topic of ongoing research and debate. In this comprehensive review, the current state of and recent advances in restoring damaged endodontically treated teeth are explored. Numerous therapeutic options exist, involving a wide range of materials. This article aims to present the biomaterial advancements of the past decade and their applications, offering alternative approaches to treating damaged ETT with the goal of prolonging their retention on the dental arch and serving as a valuable resource for dental practitioners who face this issue daily.
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Affiliation(s)
- Elisa Caussin
- Faculty of Dental Surgery, University of Paris Cité, 75006 Paris, France
- Bretonneau Hospital, Assistance Publique des Hôpitaux de Paris, 75018 Paris, France
- URB2i, Université of Paris Cité, 92100 Montrouge, France
| | - Mathieu Izart
- Faculty of Dental Surgery, University of Paris Cité, 75006 Paris, France
- Bretonneau Hospital, Assistance Publique des Hôpitaux de Paris, 75018 Paris, France
| | - Romain Ceinos
- URB2i, Université of Paris Cité, 92100 Montrouge, France
- Faculty of Dental Surgery, Côte d’Azur University, 06000 Nice, France
| | - Jean-Pierre Attal
- Faculty of Dental Surgery, University of Paris Cité, 75006 Paris, France
- URB2i, Université of Paris Cité, 92100 Montrouge, France
- Charles Foix Hospital, Assistance Publique des Hôpitaux de Paris, 94200 Ivry-Sur-Seine, France
| | - Fleur Beres
- Faculty of Dental Surgery, University of Paris Cité, 75006 Paris, France
- Bretonneau Hospital, Assistance Publique des Hôpitaux de Paris, 75018 Paris, France
| | - Philippe François
- Faculty of Dental Surgery, University of Paris Cité, 75006 Paris, France
- Bretonneau Hospital, Assistance Publique des Hôpitaux de Paris, 75018 Paris, France
- URB2i, Université of Paris Cité, 92100 Montrouge, France
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Dotto L, Girotto LPS, Correa Silva Sousa YT, Pereira GKR, Bacchi A, Sarkis-Onofre R. Factors influencing the clinical performance of the restoration of endodontically treated teeth: An assessment of systematic reviews of clinical studies. J Prosthet Dent 2024; 131:1043-1050. [PMID: 35527069 DOI: 10.1016/j.prosdent.2022.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 10/18/2022]
Abstract
STATEMENT OF PROBLEM How best to restore endodontically treated teeth is still unclear because many types of material and techniques are involved. PURPOSE The purpose of this overview of systematic reviews of clinical studies was to assess the available evidence-based literature on the influence of associated clinical factors on the clinical performance (survival, failure rate, or success) of restored endodontically treated teeth. MATERIAL AND METHODS PubMed, Scopus, and Web of Science were searched from inception until September 27, 2021, to identify systematic reviews. Two reviewers independently screened titles, abstracts, and full-text articles, and each reviewer extracted the data of half of the included studies. A single reviewer with an independent verifier completed the quality appraisal. A descriptive analysis of the collected data was made. RESULTS A total of 36 systematic reviews fulfilled the inclusion criteria. The factors most assessed were the type of coronal restorative technique (n=22) and type of post (n=22). The results indicated that metal and fiber posts seem to present similar clinical performance, 1-piece endodontic crowns could be a suitable restorative option, there is no evidence to confirm whether single crowns are better or worse than direct restoration, the maintenance of the coronal structure is a fundamental factor, and the ferrule effect is still a controversial topic. Most of the studies (n=30, 81%) presented a final Grading of Recommendations, Assessment, Development and Evaluations (GRADE) rating of "critically low." CONCLUSIONS The post type does not appear to influence the clinical performance of restored endodontically treated teeth. However, conclusive evidence to suggest how different materials or techniques for restoring coronal tooth structure affect the clinical performance of such restorations, as well as the impact of the ferrule effect, is still lacking.
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Affiliation(s)
- Lara Dotto
- PhD student, School of Dentistry, Regional Integrated University of Upper Uruguai and Missions (URI), Erechim, RS, Brazil; and Master Student, Graduate Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Luiza Paloma S Girotto
- Master Student, Graduate Program in Dentistry, Meridional Faculty (IMED), Passo Fundo, RS, Brazil
| | | | - Gabriel Kalil Rocha Pereira
- Associate Professor, Post-Graduate Program in Oral Sciences, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Ataís Bacchi
- Associate Professor, Post-Graduate Program in Dentistry, Paulo Picanço School of Dentistry, Fortaleza, CE, Brazil
| | - Rafael Sarkis-Onofre
- Associate Professor, Graduate Program in Dentistry, Meridional Faculty (IMED), Passo Fundo, RS, Brazil.
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Tsintsadze N, Margvelashvili-Malament M, Natto ZS, Ferrari M. Comparing survival rates of endodontically treated teeth restored either with glass-fiber-reinforced or metal posts: A systematic review and meta-analyses. J Prosthet Dent 2024; 131:567-578. [PMID: 35430048 DOI: 10.1016/j.prosdent.2022.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 01/04/2022] [Accepted: 01/04/2022] [Indexed: 10/18/2022]
Abstract
STATEMENT OF PROBLEM When restoring endodontically treated teeth, a post system is indicated to retain a core. Clinicians can choose from different post materials and types. However, the literature is inconclusive on the long-term clinical performance of available post systems. PURPOSE The purpose of this systematic review and meta-analysis was to analyze the survival and failure rates of endodontically treated teeth restored either with glass-fiber-reinforced or metal posts. MATERIAL AND METHODS The research question was formulated by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines by using the Population, Intervention, Comparison, Outcome, Study Type (PICOS) tool. Medline (PubMed), Embase, and Scopus searches complemented by manual search were performed for randomized controlled clinical trials with a follow-up of at least 2 years. Two independent authors performed screening and data extraction of the articles. Meta-analyses were performed with the RevMan software program. Homogeneity was checked by using chi2 and I2 tests, and random-effects meta-analyses were applied. Odds ratio and 95% confidence interval were calculated (α=.05). The publication bias was evaluated by using funnel plots and the Begg and Egger tests. RESULTS A total of 184 studies were retrieved through the electronic searches, and an additional 4 through the hand search. After title- and abstract-level exclusion, 23 studies remained for full-text analyses, of which 7 were selected for data extraction. Meta-analyses revealed an overall survival rate of 92.8% for endodontically treated teeth restored with glass-fiber-reinforced posts compared with 78.1% of those restored with metal posts. No statistically significant difference (P>.05) was found in the survival, success, or failure rates. CONCLUSIONS No statistically significant differences were found between the survival and failure rates of endodontically treated teeth restored either with glass-fiber-reinforced or metal posts. The overall survival rate was 92.8% for glass fiber posts and 78.1% for metal posts. Both are reliable materials when a significant amount of coronal tooth structure is missing and treatment with a post is indicated.
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Affiliation(s)
- Nino Tsintsadze
- PhD student, Department of Medical Biotechnologies, University of Siena, Policlinico Le Scotte, Viale Bracci, Siena, Italy.
| | | | - Zuhair S Natto
- Associate Professor, Department of Dental Public Health, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; Adjunct Assistant Professor, Department of Periodontology, Tufts University School of Dental Medicine, Boston, Mass
| | - Marco Ferrari
- Chair and Full Professor, Department of Medical Biotechnologies, University of Siena, Policlinico Le Scotte, Viale Bracci, Siena, Italy
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Alshehri T, Aly NM, Altayyar R, Alghamdi D, Alotaibi S, Ellakany P. Radiographic assessment of dental post and core placement at different educational levels in an undergraduate student clinic: a 4-year retrospective study. F1000Res 2024; 12:976. [PMID: 38826572 PMCID: PMC11143398 DOI: 10.12688/f1000research.137421.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/08/2024] [Indexed: 06/04/2024] Open
Abstract
Background Dental post and core is one of the common procedures performed after endodontic treatment. The aim of this study was to radiographically assess the quality of post and core procedures performed by dental students at different education levels in addition to determining the most critical errors encountered during their clinical practice. Methods A retrospective cross-sectional study design was conducted in the College of Dentistry, Imam Abdulrahman Bin Faisal University. A total of 550 periapical radiographs (PAs) of cemented posts were retrieved from the records of patients treated by dental students. Parameters and guidelines for assessing the quality of post treatment have been determined and statistically analyzed. A P value <0.05 was considered statistically significant. Results The study included 502 students and most of them were females (66.5%). Data were obtained from 502 patients (62% females) with fiber posts used in 98.2% of the cases. About 50% of the posts were inserted in premolars, 62.9% in the upper arch, and 66.7% were restored with crowns as a final restoration. Regarding the quality of posts, 98.4% showed good preparation quality and 98% showed good radiographic quality. The post diameter was equal to 1/3 of the root diameter in 31.9% of the cases; post length was equal to 2/3 of root length in 5% of the cases and equal to or more than crown height in all cases (100%). Length of the remaining gutta percha (GP) was between 3-5 mm in 38.8%, and there was no gap between the post and remaining GP in 95.6% of the cases. There were no statistically significant differences between dental students at different clinical educational levels regarding the quality of post placement. Conclusions The quality of post and core procedures performed by students showed acceptable radiographic quality and were within the recommended standards.
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Affiliation(s)
- Turki Alshehri
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia
| | - Nourhan M. Aly
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Raand Altayyar
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia
| | - Deena Alghamdi
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia
| | - Shahad Alotaibi
- College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia
| | - Passent Ellakany
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Sayed M, Alahmad AM, Alhajji KS, Alenezi AY, Elkholy MA, Shreif MARE, Farag RA, Basta DG, Rifai H, Rayyan M. Removal Efficiency and Effectiveness of Four Different Fiber Posts Using Five Different Drill Systems in Multirooted Teeth. J Contemp Dent Pract 2024; 25:72-78. [PMID: 38514435 DOI: 10.5005/jp-journals-10024-3629] [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] [Indexed: 03/23/2024]
Abstract
AIM In comparing the effectiveness and efficiency of different types of post removal systems in removing different types of fiber posts (FPs), this study aims to shed light on the success of removal by currently available drill systems. MATERIALS AND METHODS A total of 200 maxillary first molars, were root canal treated and prepared to receive posts. The molars were divided into four groups corresponding to four different FPs: Group RX, Radix FP; Group RF, Reforpost Glass Fiber; Group HI; Hi-Rem Endodontic Post; and Group DT, D.T. Light-Post Illusion X-RO. Fiber posts were done with luting by Gradia Core (GC America, Inc.). Groups were again divided into five subgroups corresponding to the technique by which the FP was removed into as follows: Subgroup P, PD-25-1.1 Drill; subgroup G, GC FP Drill; subgroup E, EasyPost Precision Drill; subgroup R, Reaccess Carbide Double Taper Kit; and subgroup H; H-Endodontic Drill. After posts were removed, effectiveness and efficiency were documented. Data were tabulated and statistically analyzed. RESULTS Strong significant differences regarding efficiency among groups (FP type) and subgroups (drills used) (p = 0.00) were shown by the one-way analysis of variance (ANOVA) test. Subgroup DT-G scored the longest mean removal time (20.9 minutes) while Subgroup RX-R scored the shortest mean removal time (1.4 minutes) Regarding effectiveness, strong significant differences among groups (p = 0.00) and subgroups (p = 0.00) were shown by one-way ANOVA. Subgroup RF-G scored the highest scale (5.2) whereas subgroup HI-R scored the lowest mean scale (1.2). CONCLUSION The difference was strongly significant between tested post-removal kits and between tested FPs. Re-access Carbide Double Taper Kit performed superiorly in both effectiveness and efficiency, followed by PD-25-1.1 Drill. Hi-Rem post showed the best retrieving results among other FPs. CLINICAL SIGNIFICANCE Knowing the best technique and tools for post removal could spare the practitioner any unwanted complications during post removal. How to cite this article: Sayed M, Alahmad AM, Alhajji KS, et al. Removal Efficiency and Effectiveness of Four Different Fiber Posts Using Five Different Drill Systems in Multirooted Teeth. J Contemp Dent Pract 2024;25(1):72-78.
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Affiliation(s)
- Mohamed Sayed
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ahram Canadian University, Egypt
| | - Ahmad M Alahmad
- Department of Primary Care, Alahmadi Dental Administration, Ministry of Health, Kuwait
| | - Khaled S Alhajji
- Department of Primary Care, Alahmadi Dental Administration, Ministry of Health, Kuwait
| | - Abdullah Y Alenezi
- Department of Primary Care, Alahmadi Dental Administration, Ministry of Health, Kuwait
| | | | | | - Rehab Ali Farag
- Department of Endodontics, Faculty of Oral and Dental Surgery, Misr University for Science and Technology, Giza, Egypt
| | - Doaa Gamal Basta
- Department of Endodontics, Faculty of Dentistry, Saini University, Kantara Campus, Egypt
| | | | - Mohammad Rayyan
- Department of Prosthodontics, Sinai University, Kantara Campus, Sinai, Egypt, Phone: +20 1001623392, e-mail:
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Beh YH, Halim MS, Ariffin Z. The load capacity of maxillary central incisor with simulated flared root canal restored with different fiber-reinforced composite post and cementation protocols. PeerJ 2023; 11:e16469. [PMID: 38025677 PMCID: PMC10658903 DOI: 10.7717/peerj.16469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Background This study aimed to evaluate the load capacity of maxillary central incisors with simulated flared root canal restored with different fiber-reinforced composite (FRC) post cemented with either self-adhesive or self-etch resin cement and its mode of fracture. Methods Sixty-five extracted maxillary incisors were decoronated, its canal was artificially flared and randomly categorized into group tFRC (tapered FRC post) (n = 22), mFRC (multi-FRC post) (n = 21), and DIS-FRC (direct individually shaped-FRC (DIS-FRC) post) (n = 22), which were further subdivided based on cementation resin. The posts were cemented and a standardized resin core was constructed. After thermocycling, the samples were loaded statically and the maximum load was recorded. Results The load capacity of the maxillary central incisor was influenced by the different FRC post system and not the resin cement (p = 0.289), and no significant interaction was found between them. Group mFRC (522.9N) yielded a significantly higher load capacity compared to DIS-FRC (421.1N). Overall, a 55% favorable fracture pattern was observed, and this was not statistically significant. Conclusion Within the limitation of the study, it can be concluded that prefabricated FRC posts outperform DIS-FRC posts in terms of the load capacity of a maxillary central incisor with a simulated flared root canal. The cementation methods whether a self-adhesive or self-etch resin cement, was not demonstrated to influence the load capacity of a maxillary central incisor with a flared root canal. There were no significant differences between the favorable and non-favorable fracture when FRC post systems were used to restored a maxillary central incisor with a flared root canal.
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Affiliation(s)
- Yew Hin Beh
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohamad Syahrizal Halim
- Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
| | - Zaihan Ariffin
- Prosthodontics Unit, School of Dental Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia
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de Morais DC, Butler S, Santos MJMC. Current Insights on Fiber Posts: A Narrative Review of Laboratory and Clinical Studies. Dent J (Basel) 2023; 11:236. [PMID: 37886921 PMCID: PMC10605739 DOI: 10.3390/dj11100236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/21/2023] [Accepted: 10/07/2023] [Indexed: 10/28/2023] Open
Abstract
PURPOSE The aim of this study was to review the literature related to the clinical performance and laboratory findings regarding fiber posts, as well as the cementation technique employed with their use. MATERIALS AND METHODS A literature search was performed using an electronic database, PubMed/Medline, between 2010 and 2023. The terms used were "intra coronal post, fiber post, post cementation, and post length". Titles and abstracts were initially screened, and a full-text assessment was conducted for those that fulfilled the inclusion criteria. The reference list of the collected papers was also screened for further relevant citations. RESULTS In this work, 135 potentially eligible studies were analyzed. Titles and abstracts of 90 studies followed the inclusion criteria and were selected for a full-text assessment, resulting in 50 studies selected. Moreover, additional studies from relevant citations were included, totaling 57 studies. CONCLUSION According to the laboratory and clinical studies revised, the survival rate between fiber and prefabricated and cast metal posts was similar, and failures were mainly related to the loss of retention. The intra-canal post length of less than two-thirds of the root length presented successful results when ferrule was present. Furthermore, the ferrule increased the longevity of teeth restored with fiber posts. Additionally, the use of a surface treatment protocol for fiber posts and the adhesive cementation technique both contributed to the clinical success and longevity of the intra-canal post.
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Giok KC, Veettil SK, Menon RK. Comparative effectiveness of fiber and metal posts in the restoration of endodontically treated teeth: A systematic review with network meta-analysis. J Prosthet Dent 2023:S0022-3913(23)00569-3. [PMID: 37827970 DOI: 10.1016/j.prosdent.2023.08.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 10/14/2023]
Abstract
STATEMENT OF PROBLEM Different varieties of fiber and metal intraradicular posts have been used for the restoration of endodontically treated teeth with insufficient sound tooth structure. Evidence on the comparative efficacy of posts in a clinical setting is insufficient to provide clear clinical guidelines and recommendations. PURPOSE The purpose of this systematic review with network meta-analysis was to assess the comparative efficacy of fiber and metal posts used for the restoration of endodontically treated teeth. MATERIAL AND METHODS A search was conducted for trials published in Medline, Scopus, PubMed, and Cochrane Central Register of Controlled Trials from inception until November 2022. The study was registered with the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42022384340). A network meta-analysis was performed on data from randomized controlled trials that assessed the comparative efficacy of fiber posts and metal posts for the restoration of endodontically treated teeth. Subgroup analyses were performed to compare all the varieties of fiber and metal posts. The types of posts were ranked according to their efficacy using the Surface Under the Cumulative Ranking (SUCRA) system. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was used to assess the level of certainty of evidence. RESULTS Twenty-five articles were included in the quantitative analysis. Fiber posts (RR=0.15 [95% CI: 0.06, 0.33]) significantly prevented tooth fracture as compared with no posts. Prefabricated carbon fiber posts (RR=0.06 [95% CI: 0, 0.54]) ranked highest followed by custom glass fiber posts (RR=0.15 [95% CI: 0.04, 0.52]) and prefabricated glass fiber posts (RR=0.22 [95% CI: 0.07, 0.62]) in the outcome of tooth fracture. Metal posts (RR=0.24 [95% CI: 0.12, 0.46]) ranked higher than fiber posts (RR=0.39 [95% CI: 0.27, 0.56]) in the outcome of debonding. Custom gold alloy posts (RR=0.12 [95% CI: 0.03, 0.48]), prefabricated gold alloy posts (RR=0.04 [95% CI: 0.00, 0.87]), and prefabricated titanium posts (RR=0.21 [95% CI: 0.10, 0.45]) had higher rankings in the outcome of debonding or loss of retention of a post followed by custom glass fiber posts (RR=0.37 [95% CI: 0.21, 0.63]) and prefabricated glass fiber posts (RR=0.38 [95%CI: 0.25, 0.58]). Prefabricated glass fiber posts (RR=0.40 [95% CI: 0.20, 0.81]) had statistically significant differences in the outcome of secondary caries. The GRADE approach determined a moderate level of certainty of evidence. CONCLUSIONS The use of a fiber post when indicated results in reduced risk of tooth fracture as compared with no post. Prefabricated carbon fiber posts, prefabricated glass fiber posts, and custom glass fiber posts reveal a lower risk of tooth fracture. Overall, the use of prefabricated glass fiber posts had a lower risk of tooth fracture, debonding, and secondary caries. However, more trials with longer follow-up periods are recommended to enhance the certainty of evidence.
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Affiliation(s)
- Koay Chun Giok
- Predoctoral student, School of Dentistry, International Medical University, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Sajesh K Veettil
- Research Associate, Department of Pharmacotherapy, College of pharmacy, University of Utah, Salt Lake City, Utah
| | - Rohit Kunnath Menon
- Assistant Professor of Prosthodontics, College of Dentistry, Ajman University, Ajman, United Arab Emirates..
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Ferrari M, Lettieri E, Pontoriero DIK, Vallittu P, Ferrari Cagidiaco E. Particulate Filler and Discontinuous Fiber Filler Resin Composite's Adaptation and Bonding to Intra-Radicular Dentin. Polymers (Basel) 2023; 15:3180. [PMID: 37571074 PMCID: PMC10421007 DOI: 10.3390/polym15153180] [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: 02/26/2023] [Revised: 07/06/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
The aim of this study was to assess adaptation and bonding to root canal dentin of discontinuous (short) glass fiber-reinforced composite to intra-radicular dentin (DSGFRC). METHODS Seventy virgin human teeth were extracted and then endodontically treated; then samples were randomly divided into 7 groups (n = 10), based on the materials' combinations as follows: Group 1, a two-bottle universal adhesive + DSGFRC; Group 2, a single-component universal adhesive + DSGFRC; Groups 3 and 4, the same materials of Goups 1 and 2 were used but after cleaning of the canal walls with 17% EDTA and final irrigation with 5.25% NaOCl Ultrasound Activated (UA); Group 5, traditional prefabricated fiber posts were luted after being silanized with G-Multi Primer; Groups 6 and 7, like Group 5 but after ultrasonic irrigation (UA). All sample roots were cut 1 mm thick (n = 10) to be evaluated regarding root canal adaptation using a light microscope and scanning electron microscope (SEM) and push-out bond strength. These results were statistically analyzed by Kruskal-Wallis analysis of variance by ranks. The level of significance was set at p < 0.05. RESULTS Bond strength forces varied between 6.66 and 8.37 MPa and no statistically significant differences were recorded among the groups. By microscopic examination, it was noted that ultrasonic irrigation increased the adaptation of the materials to the dentin surface. CONCLUSIONS Within the limitations of this in vitro study, it may be concluded that when DSGFRC was used for intracanal anchorage in the post-endodontic reconstruction, similar push-out retentive force and strength to those of traditional fiber posts cemented with particulate filler resin composite cements were achieved.
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Affiliation(s)
- Marco Ferrari
- Department of Prosthodontics and Biomaterials, University of Siena, 53100 Siena, Italy
| | - Eugenia Lettieri
- Department of Oral Surgery, University of Siena, 53100 Siena, Italy
| | | | - Pekka Vallittu
- Department of Biomaterials Science, University of Turku, Wellbeing Services County of South-West Finland Turku, 20014 Turku, Finland
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Josic U, Mazzitelli C, Maravic T, Comba A, Cadenaro M, Radovic I, Sebold M, Turco G, Breschi L, Mazzoni A. The effect of carbodiimide on push-out bond strength of fiber posts and endogenous enzymatic activity. BMC Oral Health 2023; 23:399. [PMID: 37328778 PMCID: PMC10276460 DOI: 10.1186/s12903-023-03067-y] [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: 02/09/2023] [Accepted: 05/21/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND To investigate the effect of 0.3 M 1-ethyl-3(3-dimethylaminopropyl) carbodiimide (EDC) aqueous solution pretreatment on push-out bond strength (PBS) and matrix-metalloproteinases (MMPs) activity within radicular dentin when different post cementation strategies were employed. METHODS One hundred and twenty monoradicular human teeth were endodontically treated and randomly divided into six groups, depending on the cementation strategy and root dentin pretreatment (n = 20): EAR: cementation with an etch-and-rinse adhesive (LuxaBond Total Etch, DMG) and resin cement (LuxaCore Z Dual, DMG); EAR/EDC: 1 min EDC pretreatment after etching + EAR; SE: cementation with a self-etch primer (Multilink Primer, Ivoclar Vivadent) and corresponding cement (Multilink Automix, Ivoclar Vivadent); SE/EDC: self-etch primer + EDC pretreatment + SE; SA: cementation with a universal self-adhesive cement (RelyX Universal, 3 M); SA/EDC: EDC pretreatment + SA. Slices were submitted to PBS test and interfacial nanoleakage evaluation 24 h after cementation or after thermocycling (40.000 cycles, 5-55 °C). To investigate the effect of EDC on MMPs activity, 4 additional first maxillary premolars per group were processed for in situ zymography analysis. Multivariate ANOVA and post hoc Tukey tests were used to analyze PBS values. The data from in situ zymography were analyzed with Kruskal-Wallis test and Dunn's pairwise multiple comparison procedures (α = 0.05). RESULTS The variables "EDC pretreatment", "root region" and "thermocycling" significantly influenced PBS (p < 0.05), while the variable "cementation strategy" had no influence (p > 0.05). Thermocycling significantly reduced PBS in SE and SA groups (p < 0.05). EDC was effective in preserving PBS after artificial aging. EDC pretreatment significantly reduced enzymatic activity at baseline in EAR and SE groups, and in SA group after thermocycling (p < 0.05). CONCLUSIONS The use of EDC prevents the reduction of bond-strength values after artificial aging and silences endogenous enzymatic activity within radicular dentin when different cementation strategies were employed.
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Affiliation(s)
- Uros Josic
- Department for Biomedical and Neuromotor Sciences, Dental Clinic, DIBINEM, University of Bologna, Via San Vitale 59, Bologna, 40125, Italy
| | - Claudia Mazzitelli
- Department for Biomedical and Neuromotor Sciences, Dental Clinic, DIBINEM, University of Bologna, Via San Vitale 59, Bologna, 40125, Italy
| | - Tatjana Maravic
- Department for Biomedical and Neuromotor Sciences, Dental Clinic, DIBINEM, University of Bologna, Via San Vitale 59, Bologna, 40125, Italy
| | - Allegra Comba
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Milena Cadenaro
- Department of Medical Sciences, University of Trieste, Trieste, Italy
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo,", Trieste, Italy
| | - Ivana Radovic
- Clinic for Paediatric and Preventive Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Maicon Sebold
- Department of Restorative Dentistry, Operative Dentistry Division, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Gianluca Turco
- Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Lorenzo Breschi
- Department for Biomedical and Neuromotor Sciences, Dental Clinic, DIBINEM, University of Bologna, Via San Vitale 59, Bologna, 40125, Italy
| | - Annalisa Mazzoni
- Department for Biomedical and Neuromotor Sciences, Dental Clinic, DIBINEM, University of Bologna, Via San Vitale 59, Bologna, 40125, Italy.
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Kharouf N, Pedullà E, Plotino G, Jmal H, Alloui MEH, Simonis P, Laquerriere P, Macaluso V, Abdellatif D, Richert R, Haikel Y, Mancino D. Stronger than Ever: Multifilament Fiberglass Posts Boost Maxillary Premolar Fracture Resistance. J Clin Med 2023; 12:jcm12082975. [PMID: 37109310 PMCID: PMC10143755 DOI: 10.3390/jcm12082975] [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: 03/15/2023] [Revised: 04/11/2023] [Accepted: 04/18/2023] [Indexed: 04/29/2023] Open
Abstract
This paper investigates the influence of cavity configuration and post-endodontic restoration on the fracture resistance, failure mode and stress distribution of premolars by using a method of fracture failure test and finite elements analysis (FEA) coupled to Weibull analysis (WA). One hundred premolars were divided into one control group (Gcontr) (n = 10) and three experimental groups, according to the post-endodontic restoration (n = 30), G1, restored using composite, G2, restored using single fiber post and G3, restored using multifilament fiberglass posts (m-FGP) without post-space preparation. Each experimental group was divided into three subgroups according to the type of coronal cavity configuration (n = 10): G1O, G2O, and G3O with occlusal (O) cavity configuration; G1MO, G2MO, and G3MO with mesio-occlusal (MO); and G1MOD, G2MOD, and G3MOD with mesio-occluso-distal (MOD). After thermomechanical aging, all the specimens were tested under compression load, and failure mode was determined. FEA and WA supplemented destructive tests. Data were statistically analyzed. Irrespective of residual tooth substance, G1 and G2 exhibited lower fracture resistance than Gcontr (p < 0.05), whereas G3 showed no difference compared to Gcontr (p > 0.05). Regarding the type of restoration, no difference was highlighted between G1O and G2O, G1MO and G2MO, or G1MOD and G2MOD (p > 0.05), whereas G3O, G3MO, and G3MOD exhibit higher fracture resistance (p < 0.05) than G1O and G2O, G1MO and G2MO, and G1MOD and G2MOD, respectively. Regarding cavity configuration: in G1 and G2, G1O and G2O exhibited higher fracture resistance than G1MOD and G2MOD, respectively (p < 0.05). In G3, there was no difference among G3O, G3MO and G3MOD (p > 0.05). No difference was found among the different groups and subgroups regarding the failure mode. After aging, premolars restored with multifilament fiberglass posts demonstrated fracture resistance values comparable to those of an intact tooth, irrespective of the different type of cavity configuration.
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Affiliation(s)
- Naji Kharouf
- Department of Biomaterials and Bioengineering, INSERM UMR_S, Strasbourg University, 67000 Strasbourg, France
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
| | - Eugenio Pedullà
- Department of General Surgery and Medical Surgical Specialties, University of Catania, 95128 Catania, Italy
| | - Gianluca Plotino
- Private Practice, Grande Plotino & Torsello-Studio di Odontoiatria, 00187 Rome, Italy
| | - Hamdi Jmal
- ICube Laboratory, UMR 7357 CNRS, Mechanics Department, University of Strasbourg, 67000 Strasbourg, France
| | - Mohammed-El-Habib Alloui
- Department of Biomaterials and Bioengineering, INSERM UMR_S, Strasbourg University, 67000 Strasbourg, France
| | - Philippine Simonis
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
| | | | | | - Dina Abdellatif
- Department of Endodontics, Alexandria University, Alexandria 5424041, Egypt
| | - Raphaël Richert
- Hospices Civils de Lyon, PAM Odontologie, 69100 Lyon, France
- Laboratoire de Mécanique des Contacts et Structures, UMR 5259 CNRS/INSA Lyon, 69100 Lyon, France
| | - Youssef Haikel
- Department of Biomaterials and Bioengineering, INSERM UMR_S, Strasbourg University, 67000 Strasbourg, France
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, 67000 Strasbourg, France
| | - Davide Mancino
- Department of Biomaterials and Bioengineering, INSERM UMR_S, Strasbourg University, 67000 Strasbourg, France
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, 67000 Strasbourg, France
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12
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Comparing the Long-Term Success Rates of Tooth Preservation and Dental Implants: A Critical Review. J Funct Biomater 2023; 14:jfb14030142. [PMID: 36976066 PMCID: PMC10055991 DOI: 10.3390/jfb14030142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 02/23/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
Implant therapy is considered a predictable, safe, and reliable rehabilitation method for edentulous patients in most clinical scenarios. Thus, there is a growing trend in the indications for implants, which seems attributable not only to their clinical success but also to arguments such as a more “simplified approach” based on convenience or the belief that dental implants are as good as natural teeth. Therefore, the objective of this critical literature review of observational studies was to discuss the evidence concerning the long-term survival rates and treatment outcomes, comparing endodontically or periodontally treated teeth with dental implants. Altogether, the evidence suggests that the decision between keeping a tooth or replacing it with an implant should carefully consider the condition of the tooth (e.g., amount of remaining tooth and degree of attachment loss and mobility), systemic disorders, and patient preference. Although observational studies revealed high success rates and long-term survival of dental implants, failures and complications are common. For this reason, attempts should be made to first save maintainable teeth over the long-term, instead of immediately replacing teeth with dental implants.
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13
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The Influence on Fracture Resistance of Different Composite Resins and Prefabricated Posts to Restore Endodontically Treated Teeth. Polymers (Basel) 2023; 15:polym15010236. [PMID: 36616585 PMCID: PMC9823756 DOI: 10.3390/polym15010236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 12/23/2022] [Indexed: 01/05/2023] Open
Abstract
Recent formulations of resin-based composites have incorporated different combinations of materials. However, the mechanical and bonding behavior of these materials with intraradicular posts are unclear. This study aimed to evaluate the effect of light-cure and dual-cure resin composite posts on the fracture resistance of endodontically-treated teeth. Materials and Methods: Ninety extracted human upper canines were selected and randomly divided into nine groups (n=10): (G1) endodontically treated teeth without endodontic posts; (G2) glass-fiber post cemented with glass-ionomer cement; (G3) endodontic post by dual-cure composite resin (Rebilda DC); (G4) endodontic post by dual-cure composite resin (Cosmecore); (G5) endodontic post by dual-cure composite resin (Bis-Core); (G6) endodontic post by light-cure composite resin; (G7) glass-fiber post customized with flowable composite resin; (G8) glass-fiber post cemented with light-cure composite resin; (G9) glass-fiber post cemented with self-adhesive resin cement. After the post insertion, all specimens were subjected to mechanical (250,000 cycles) and thermocycling (6000 cycles, 5 °C/55 °C) and immediate loading at 45 degrees in a universal testing machine until fracture. The data were analyzed by one-way ANOVA and multiple comparisons using the Fisher LSD Method (p < 0 05). Results: The mean failure loads (±SD) for the groups ranged from 100.7 ± 22.6 N to 221.9 ± 48.9 N. The G1 group (without endodontic posts) had a higher fracture strength than all experimental groups (p < 0.001). Conclusions: Within the limitations, the light- and dual-cure post technique did not present lower fracture resistance values as compared to the conventional glass-fiber post.
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14
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Bergamo ETP, Lopes ACO, Campos TMB, Amorim PH, Costa F, Benalcázar Jalkh EB, Carvalho LFD, Zahoui A, Piza MMT, Gutierres E, Witek L, Bonfante EA. Probability of survival and failure mode of endodontically treated incisors without ferrule restored with CAD/CAM fiber-reinforced composite (FRC) post-cores. J Mech Behav Biomed Mater 2022; 136:105519. [PMID: 36279744 DOI: 10.1016/j.jmbbm.2022.105519] [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: 08/07/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE This study evaluated the probability of survival and failure mode of endodontically treated incisors without ferrule restored with CAD/CAM FRC post-cores. METHODS Root canals of bovine incisors were treated, leaving post preparations of ∼10 mm. Teeth were allocated into three groups: (i) cast metal post-core, (ii) FRC prefabricated post with a direct resin core build-up, and (iii) CAD/CAM FRC post-core. Posts and zirconia crowns were cemented using resin cement. Specimens were subjected to step-stress accelerated-life fatigue testing in water. Use level probability Weibull curves, probability of survival for a mission of 100,000 cycles at 25, 50, and 100 N, Weibull modulus, and characteristic strength were calculated and plotted. Failure mode was examined under a stereomicroscope. RESULTS Restored incisors demonstrated high probability of survival (93-100%) for missions estimated at 25 and 50 N, irrespective of post-core foundation. At 100 N, incisors restored with metal posts presented significantly higher probability of survival (99%) relative to CAD/CAM posts (79%), whereas FRC groups demonstrated no significant difference. Weibull analysis indicated no significant difference on the Weibull modulus (m = 3.38-5.92). Incisors reconstructed with metal post-cores (431 N) presented significantly higher characteristic strength relative to prefabricated (200 N) and CAD/CAM (202 N) FRC post-cores. While post fracture was the chief failure mode for prefabricated and CAD/CAM FRC post-cores, post and/or root fracture were the main event for metal post-cores. CONCLUSION Endodontically treated incisors without ferrule restored with CAD/CAM FRC post-cores presented promising probability of survival for loads compatible with anterior masticatory forces and favorable failure modes.
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Affiliation(s)
- Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, 9-75 Octavio Pinheiro Brizolla, Bauru, SP, Brazil, 17012-901
| | - Adolfo C O Lopes
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, 9-75 Octavio Pinheiro Brizolla, Bauru, SP, Brazil, 17012-901
| | - Tiago M B Campos
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, 9-75 Octavio Pinheiro Brizolla, Bauru, SP, Brazil, 17012-901
| | - Pedro Henrique Amorim
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, 9-75 Octavio Pinheiro Brizolla, Bauru, SP, Brazil, 17012-901
| | - Fábio Costa
- dOne 3D, 2625 José Adolfo Bianco Molina, Ribeirão Preto, SP, 14024-210, Brazil
| | - Ernesto B Benalcázar Jalkh
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, 9-75 Octavio Pinheiro Brizolla, Bauru, SP, Brazil, 17012-901
| | - Laura F de Carvalho
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, 9-75 Octavio Pinheiro Brizolla, Bauru, SP, Brazil, 17012-901.
| | - Abbas Zahoui
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, 9-75 Octavio Pinheiro Brizolla, Bauru, SP, Brazil, 17012-901
| | - Mariana M T Piza
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, 9-75 Octavio Pinheiro Brizolla, Bauru, SP, Brazil, 17012-901
| | - Eliezer Gutierres
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, 9-75 Octavio Pinheiro Brizolla, Bauru, SP, Brazil, 17012-901
| | - Lukasz Witek
- Department of Biomaterials, New York University College of Dentistry, NY, 10012, New York, USA; Department of Biomedical Engineering, New York University Tandon Scholl of Engineering, Brooklyn, USA
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, 9-75 Octavio Pinheiro Brizolla, Bauru, SP, Brazil, 17012-901
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15
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Goto M, Oki K, Koyano K, Ayukawa Y. The 3-year cumulative survival rates of posterior monolithic zirconia crowns and their antagonist teeth, and their influencing factors. J Oral Sci 2022; 64:286-289. [PMID: 36104182 DOI: 10.2334/josnusd.22-0221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the 3-year cumulative survival rates of posterior single monolithic zirconia crowns (MZCs) and their antagonists, and to analyze the influencing factors. METHODS The clinical outcomes of posterior single MZCs and their abutment teeth with antagonists, and the antagonists between April 2014 and September 2020 were evaluated retrospectively. The 3-year cumulative survival rates were calculated and associations between the survival time and predictor variables ("Jaw", "Tooth", and "Pulpal condition") were also verified using Cox proportional hazards models and hazard ratios (HRs). RESULTS The 3-year cumulative survival rate of single MZCs was 89.8% (9 of 177 MZCs, 95% confidence interval (CI): 80.0-95.1%). Cox proportional hazards models showed non-vital teeth were significantly associated with failure (HR: 2.76e + 9, P = 0.012). The 3-year cumulative survival rate of antagonists was 94.8% (7 of 171 antagonists, 95% CI: 89.3-97.6%). Non-vital antagonists were also identified as an independent predictor for failure in Cox proportional hazards models (HR: 7.83, P = 0.03). CONCLUSION Although posterior single MZCs were clinically acceptable, non-vital pulpal condition could be a potential risk factor for failures in the abutment and antagonist teeth of MZCs.
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Affiliation(s)
- Midori Goto
- Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
| | - Kyosuke Oki
- Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
| | - Kiyoshi Koyano
- Division of Advanced Dental Devices and Therapeutics, Faculty of Dental Science, Kyushu University
| | - Yasunori Ayukawa
- Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University
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An Umbrella Review of Systematic Reviews and Meta-Analyses Evaluating the Success Rate of Prosthetic Restorations on Endodontically Treated Teeth. Int J Dent 2022; 2022:4748291. [PMID: 35242190 PMCID: PMC8888057 DOI: 10.1155/2022/4748291] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/20/2022] [Accepted: 02/03/2022] [Indexed: 01/08/2023] Open
Abstract
Materials and Methods The electronic search was conducted in the MEDLINE/PubMed, Cochrane, and Google Scholar databases until November 2020, regardless of language limitations. The inclusion criterion was as follows: S/M-R regarding prosthetic restorations in endodontically treated teeth. Three qualified researchers evaluated the inclusion criteria and bias risk. The fourth investigator was referred to when facing any doubtfulness. Results From 43 achieved S/M-R, 14 studies were selected for this inquiry. Primary extracted information included success rate, survival rate, and postendodontic failure rate. Five S/M-R had a moderate risk of bias, and nine S/M-R had a low risk of bias and were considered strong clinical evidence in this examination. According to the low-risk reports, the success rate of fiber posts was higher than that of metal posts; the rate of root fracture in metallic and fiber posts was alike; the failure rate for fiber posts was comparable to fixed partial dentures or single crowns; the construction of endocrowns was likely to perform better than intracanal posts, composite resin, or inlay/onlay restorations. Conclusion It appears that with practice and experience, deciding which type of restoration to choose changes. In dental restorations associated with root canal therapy, the single crowns are likely to be a proper option. Nevertheless, due to the heterogeneity of the studies, more clinical assessments are required to achieve more specific findings in this field.
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17
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Survival Rates of Endodontically Treated Posterior Teeth Restored with All-Ceramic Partial-Coverage Crowns: When Systematic Review Fails. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19041971. [PMID: 35206160 PMCID: PMC8871862 DOI: 10.3390/ijerph19041971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/06/2022] [Accepted: 02/07/2022] [Indexed: 11/17/2022]
Abstract
Background: To determine the survival rates of endodontically treated posterior teeth (EDPT) restored with partial coverage all-ceramic crowns with or without the use of fiber posts. Methods: MEDLINE and Cochrane searches were conducted in order to identify Randomized Clinical Trials (RCTs) related to endodontically treated posterior teeth restored with partial coverage crowns. The search period was extended until February 2020 and only in vivo, human, and studies in the English language were included. A manual search was also conducted and additional articles, if found, were included in the database. Results: The initial search for the selected databases identified 495 studies, which were all screened for inclusion through titles, abstracts and full-text reading. Out of these 495 studies, only one article met the eligibility criteria and was included in this systematic review. Statistical analysis could not be performed. Conclusions: Only one RCT was identified in this systematic review. More clinical evidence is necessary to assess the survival rate of EDPT with partial-coverage crowns. This systematic review failed because it did not find scientific evidence to support the use of indirect bonded restorations on EDPT.
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Bruhnke M, Wierichs RJ, von Stein-Lausnitz M, Meyer-Lückel H, Beuer F, Naumann M, Sterzenbach G. Long-term survival of adhesively post-endodontically restored teeth. J Endod 2022; 48:606-613. [DOI: 10.1016/j.joen.2022.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/25/2022] [Accepted: 02/08/2022] [Indexed: 01/04/2023]
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Andrade SA. Cast metal posts versus glass fibre posts: which treatment of choice based on cost-minimisation analysis? Evid Based Dent 2021; 22:128-129. [PMID: 34916635 DOI: 10.1038/s41432-021-0226-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 09/28/2021] [Indexed: 06/14/2023]
Abstract
Aim The aim of this randomised clinical trial based on cost-minimisation analysis was to assess and compare four post-retained restorative strategies for endodontically treated teeth.Methods A total of 225 endodontically treated teeth in 141 patients were evaluated annually between 2009 and 2018. In this sense, the teeth were divided into four groups according to the treatment strategy, where three groups were treated with glass fibre posts in combination with composite resin restorations or single metal-ceramic crown with or without ferrules, and one group was treated with cast metal posts with metal-ceramic crowns. According to the outcome of the treatment during follow-up, the teeth received additional treatments, which ranged from restoration repair, re-cementation, endodontic retreatment, apical surgery, post/crown replacement to tooth extraction and replacement through metal-ceramic implant-supported crown. Thus, cost-minimisation analysis was based on November 2018 values from the Brazilian Public Health System, considering the primary costs related to the post, restoration or crown, and incremental costs related to the outcomes during follow-up.Results Primary treatment costs were lower for the group using glass fibre posts in combination with composite resin restorations (US$27.11), while the highest costs were for the group using cast metal post with metal-ceramic crown (US$153,14). In turn, the incremental costs due to tooth removal, implant placement and metal-ceramic crown (US$363.92) were the highest, while the lowest costs were related to procedures for crown re-cementation (US$6.11) followed by repair of the resin restoration (US$16.47). In this regard, the highest percentage of failures was related to restoration fractures in the glass fibre posts in combination with the composite resin restorations group. However, the average annual cost was significantly lower in the group that used glass fibre posts in combination with composite resin restorations (p <0.001) when compared to the other groups, with or without ferrules.Conclusions The treatment of endodontically treated teeth using glass fibre posts in combination with composite resin restorations presented a significantly lower average annual cost when compared to treatments that consider the use of cast metal posts, metal-ceramic crowns, with or without ferrules.
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Affiliation(s)
- Sérgio Araújo Andrade
- Professor, Faculty of Dentistry, University of Itaúna (UIT), Itaúna, MG, Brazil; Researcher, Research Centre on Biological Chemistry (NQBio), Federal University of São João del-Rei (UFSJ), Divinópolis, MG, Brazil; Researcher, Optics and Photonics Research Centre (CEPOF), Physics Institute of São Carlos of the University of São Paulo (IFSC-USP), São Carlos, SP, Brazil.
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Dioguardi M, Alovisi M, Troiano G, Caponio CVA, Baldi A, Rocca GT, Comba A, Lo Muzio L, Scotti N. Clinical outcome of bonded partial indirect posterior restorations on vital and non-vital teeth: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:6597-6621. [PMID: 34628547 PMCID: PMC8602142 DOI: 10.1007/s00784-021-04187-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 09/20/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The survival rate of indirect partial adhesive restorations on vital versus endodontically treated teeth is still controversial. The hypothesis is that there may be a difference in the survival rate of partial adhesive restorations performed on non-vital teeth compared to vital teeth. MATERIALS AND METHODS This systematic review was conducted following the PRISMA guidelines. The considered clinical studies investigated the outcomes of adhesive inlays, onlays, and overlays conducted over the past 40 years, focusing on Kaplan-Meier survival curves to calculate the hazard ratio (primary objective) and the survival rate (secondary objective) between vital and non-vital teeth. The risk of bias was assessed using the Newcastle-Ottawa Scale. Studies included in the review were identified through bibliographic research on electronic databases ("PubMed," "Scopus," "Cochrane Central Register of Controlled Trial," and "Embase"). The K agreement between the two screening reviewers was evaluated. RESULTS A total of 55,793 records were identified on PubMed, Scopus, and other bibliographic sources, and after the application of the eligibility and inclusion criteria, eight articles were included for qualitative analysis and six for quantitative analysis. The meta-analysis of the primary and secondary outcomes demonstrated that hazard ratios (HR = 8.41, 95% CI: [4.50, 15.72]) and survival rates (OR = 3.24, 95% CI: [1.76, 5.82]) seemed more favorable for indirect partial adhesive restorations on vital teeth than for those on endodontically treated teeth. CONCLUSIONS Within the limits of this study, these findings suggest that the risk of failure of indirect partial adhesive restorations on endodontically treated teeth is higher than on vital teeth. CLINICAL RELEVANCE The use of partial adhesive restorations on vital and endodontically treated teeth showed different long-term clinical outcomes.
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Affiliation(s)
- Mario Dioguardi
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy
| | - Mario Alovisi
- Department of Surgical Sciences, Dental School, University of Turin, Via Nizza 230, 10100, Turin, Italy
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy
| | - Carlo Vito Alberto Caponio
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy
| | - Andrea Baldi
- Department of Surgical Sciences, Dental School, University of Turin, Via Nizza 230, 10100, Turin, Italy
| | - Giovanni Tommaso Rocca
- Division of Cariology and Endodontology, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Allegra Comba
- Department of Surgical Sciences, Dental School, University of Turin, Via Nizza 230, 10100, Turin, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122, Foggia, Italy
| | - Nicola Scotti
- Department of Surgical Sciences, Dental School, University of Turin, Via Nizza 230, 10100, Turin, Italy.
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Pontons-Melo JC, Garcia IM, Melo MA, Collares FM. Single-Tooth Rehabilitation Combining Root Displacement and Crown Lengthening Two-Year Follow-Up: A Case Report. Oper Dent 2021; 46:246-254. [PMID: 34242393 DOI: 10.2341/20-110-s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2020] [Indexed: 11/23/2022]
Abstract
CLINICAL RELEVANCE Combined techniques to expose circumferential tooth structure associated with subsequent restoration may represent a valid option in many situations. This case provides an example of the successful management of the anterior tooth rehabilitation combining root displacement and crown lengthening. SUMMARY Rehabilitation of an extensively compromised single anterior tooth represents an intriguing challenge for dentists, particularly when the rehabilitation involves esthetic, psychosocial, and functional requirements. The success in rehabilitating a patient with a conservative approach depends on a critical evaluation of the remaining structures, precise treatment plan, systematic treatment strategies, and patient compliance. In this case, the patient's chief complaint was the undesirable appearance of the maxillary right lateral, caused by the displacement of the post and crown. Clinical examination revealed a remaining tooth with coronal fracture, severe loss of tissue due to caries, and absence of ferrule effect. Radiographic examination revealed that the fracture margin was located subgingival. This case report describes a single-tooth rehabilitation involving a combination of root displacement via orthodontic extrusion and crown lengthening. The rehabilitation was followed by post-and-core restoration using a prefabricated glass fiber post associated with a disilicate lithium crown. The clinical decision making and combined effect of both treatment strategies are explained in this report. The treatment required three months, including recovery times after surgery and the placement of the provisional crown. The patient was esthetically and functionally satisfied with the restoration. Patient follow-up examination was performed 24 months after the treatment. This clinical report contributes to the clinical practice and exemplifies the possibility of rehabilitating the natural tooth using combined techniques, which may offer particular advantages regarding prognosis and invested efforts.
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Gré CP, Lise DP, Ramos RQ, Van Meerbeck B, Vieira L, Lopes GC. Better Glass-fiber Post Preservation in Teeth with Ferrule When Subjected to Chewing. Oper Dent 2021; 46:419-427. [PMID: 34624104 DOI: 10.2341/20-186-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To evaluate the influence of ferrule effect and mechanical fatigue aging on glass-fiber post push-out bond strength (PBS) to root-canal dentin at different root thirds of premolars. METHODS AND MATERIALS Thirty-two sound maxillary premolar teeth were collected, and randomly assigned to two experimental groups (n=16): 'Remaining Dentin Ferrule' (RDF) = coronal crown cut 2.0 mm above the cementoenamel junction (CEJ); 'Without Dentin Ferrule' (WDF) = coronal crown cut at the cemento-enamel junction. Teeth were endodontically treated, post spaces were prepared up to 10.0-mm depth from CEJ, and glass-fiber posts were cemented using a dual-cure self-adhesive composite cement. Standardized cores were built using a light-cure composite, upon which tooth cores were prepared using a 1.5-mm taper ogival-end diamond bur. Crowns were handmade using self-cure acrylic resin and cemented using the aforementioned composite cement. Half of the specimens were subjected to 1,200,000 cycles of mechanical fatigue in a chewing simulator (F = 'Fatigue'), while the other half were stored in distilled water at 37°C for 1 week (C = 'Control'). All specimens were horizontally sectioned into 1.0-mm thick slices prior to PBS test; the failure modes were assessed using stereomicroscopy and scanning electron microscopy (SEM). Data were analyzed for each root third using two-way analysis of variance (ANOVA) followed by Tukey HSD post-hoc test; frequency distribution was compared by Chi-square test (α=0.05) and post-hoc comparisons with Bonferroni. RESULTS The mean PBS in MPa (SD) were = RDF_F = 10.4 (2.9); WDF_F = 6.9 (1.7); RDF_C = 14.5 (2.7); WDF_C = 14.2 (2.9). Similar PBS were found for the root thirds. For all root thirds, significant differences were found for both the factors Dentin Ferrule and Fatigue, and their interaction (p<0.05). The lowest PBS was found for specimens without dentin ferrule subjected to chewing fatigue (p<0.001). Most failures occurred at the composite cement/dentin interface, followed by mixed and composite cement/glass-fiber post interfacial failures. There was a significant increase in mixed failures for the WDF_F group (p<0.001). CONCLUSION Absence of 2.0-mm remaining dentin ferrule in premolars resulted in a higher decrease of the glass-fiber posts' PBS to dentin after mechanical fatigue, irrespective of root third.
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Iaculli F, Rengo C, Lodato V, Patini R, Spagnuolo G, Rengo S. Fracture resistance of endodontically-treated maxillary premolars restored with different type of posts and direct composite reconstructions: A systematic review and meta-analysis of in vitro studies. Dent Mater 2021; 37:e455-e484. [PMID: 34148785 DOI: 10.1016/j.dental.2021.06.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To conduct a systematic review and meta-analysis to assess if the presence of an endodontic post may increase the fracture resistance of endodontically-treated maxillary premolars directly restored with composite. METHODS A comprehensive systematic literature search according to the PRISMA statement was conducted to assess in vitro studies including endodontically-treated maxillary premolars, restored with different type of posts supporting direct composite reconstructions. Two groups of meta-analyses were performed using fixed effects model and additional Trial Sequential Analysis (TSA) was carried out. Moreover, risk of bias was conducted and quality of evidence for any performed meta-analysis was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS Twenty-four articles met the inclusion criteria and 13 studies also underwent quantitative evaluation. Fracture resistance of endodontically-treated premolars restored with fiber posts was significantly less than sound teeth (p value: < 0.00001), however endodontically-treated premolars with a fiber post provided an increase in fracture resistance when compared to equivalent teeth restored without post (p value: 0.003). TSA revealed high power of both meta-analyses. Moderate risk of bias was reported in 23/24 studies; only 1 study showed high risk of bias. GRADE system showed moderate strength of evidence due to the presence of a study with high risk of bias and to wide confidence intervals. SIGNIFICANCE Within the limitation of the present systematic review and meta-analysis, it can be concluded that endodontically-treated maxillary premolars restored with a fiber post and direct composite restoration demonstrated increased fracture resistance when compared to equivalent teeth without post.
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Affiliation(s)
- Flavia Iaculli
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
| | - Carlo Rengo
- Department of Prosthodontics and Dental Materials, School of Dental Medicine, University of Siena, Siena, Italy
| | - Vincenzo Lodato
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
| | - Romeo Patini
- Department of Head, Neck and Sense Organs "Fondazione Policlinico Universitario A. Gemelli- IRCCS", School of Dentistry, Rome, Italy
| | - Gianrico Spagnuolo
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy.
| | - Sandro Rengo
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
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Fatigue behavior of endodontically treated premolars restored with different fiber-reinforced designs. Dent Mater 2021; 37:391-402. [DOI: 10.1016/j.dental.2020.11.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 11/26/2020] [Indexed: 11/22/2022]
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BELL-RÖNNLÖF AMLE, JAATINEN J, LASSILA L, NÄRHI T, VALLITTU P. Transmission of light through fiber-reinforced composite posts. Dent Mater J 2019; 38:928-933. [DOI: 10.4012/dmj.2018-217] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
| | - Jenni JAATINEN
- Department of Prosthetic Dentistry and Stomatognathic Physiology, University of Turku
- Department of Biomaterials Science and Turku Clinical Biomaterials Center - TCBC, University of Turku
| | - Lippo LASSILA
- Department of Biomaterials Science and Turku Clinical Biomaterials Center - TCBC, University of Turku
| | - Timo NÄRHI
- Department of Prosthetic Dentistry and Stomatognathic Physiology, University of Turku
| | - Pekka VALLITTU
- Department of Biomaterials Science and Turku Clinical Biomaterials Center - TCBC, University of Turku
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Gulabivala K, Ng YL. Value of root-filled teeth in maintaining a functional dentition for life. Br Dent J 2019; 226:769-784. [DOI: 10.1038/s41415-019-0313-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Fracture resistance and marginal gap formation of post-core restorations: influence of different fiber-reinforced composites. Clin Oral Investig 2019; 24:265-276. [PMID: 31098711 PMCID: PMC7822803 DOI: 10.1007/s00784-019-02902-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 04/04/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The aim was to explore the fracture behavior and marginal gap within the root canal of endodontically treated (ET) premolars restored with different fiber-reinforced post-core composites (FRCs). Further aim was to evaluate the composite curing at different depths in the canal. MATERIALS AND METHODS Eighty-seven intact upper premolars were collected and randomly divided into six groups. After endodontic procedure, standard MOD cavities were prepared and restored with their respective fiber-reinforced post-core materials: group 1: prefabricated unidirectional FRC-post + conventional composite core; group 2: prefabricated unidirectional FRC-post + short fiber composite (SFRC) core; group 3: individually formed unidirectional FRC-post + conventional composite core; group 4: randomly oriented SFRC directly layered as post and core; group 5: individually formed unidirectional FRC + randomly oriented SFRC as post and core. After restorations were completed, teeth (n = 3/group) were sectioned and then stained. Specimens were viewed under a stereo microscope and the percentage of microgaps within the root canal was calculated. Fracture load was measured using universal testing machine. RESULTS SFRC application in the root canal (groups 4 and 5) showed significantly higher fracture load (876.7 N) compared to the other tested groups (512-613 N) (p < 0.05). Post/core restorations made from prefabricated FRC-post (group 1) exhibited the highest number of microgaps (35.1%) at the examined interphase in the root canal. CONCLUSIONS The restoration of ET premolars with the use of SFRC as post-core material displayed promising performance in matter of microgap and load-bearing capacity. CLINICAL SIGNIFICANCE Fracture resistance of ET premolar restored by bilayered composite restoration that includes both SFRC as post-core material and surface conventional resin seems to be beneficial.
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Soares CJ, Rodrigues MDP, Faria-e-Silva AL, Santos-Filho PCF, Veríssimo C, Kim HC, Versluis A. How biomechanics can affect the endodontic treated teeth and their restorative procedures? Braz Oral Res 2018; 32:e76. [DOI: 10.1590/1807-3107bor-2018.vol32.0076] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Accepted: 06/13/2018] [Indexed: 11/22/2022] Open
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Impact of endodontic post material on longitudinal changes in interproximal bone level: a randomized controlled pilot trial. Clin Oral Investig 2018; 23:2303-2311. [PMID: 30293188 DOI: 10.1007/s00784-018-2698-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 10/02/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Aim was to evaluate the impact of glass fiber versus titanium endodontic posts on the interproximal bone level around severely damaged endodontically treated teeth. MATERIALS AND METHODS Thirty-eight participants of a randomized controlled trial on glass fiber (n = 18) and titanium post-endodontic restorations (n = 20) received radiographs at two different times after post placement (T0 = <12 months and T1 = 36-72 months after post placement). A total of 76 radiographs were analyzed with an image-editing software. Medians of changes in mesial and distal interproximal bone level (∆MBL, ∆DBL) were calculated and tested for statistical significance with respect to post material using Mann-Whitney U test (p < 0.05). Impact of post material on bone level changes was assessed in multilevel mixed-effect linear regression models. RESULTS The mean observation period was 54 months for glass fiber and 50 months for titanium posts. Interproximal bone loss was small in both groups during the study period with no significant differences between groups (glass-fiber group, ∆MBL = - 0.03 mm and ∆DBL = - 0.06 mm; titanium group, ∆MBL = - 0.07 mm and ∆DBL = - 0.17 mm; both p > 0.05). Overall, impact of post material on bone loss was almost negligible with a nonsignificant difference between materials of 0.10 mm during the entire study period. CONCLUSION The rigidity of endodontic post material has no impact on the level of alveolar bone support of severely damaged endodontically treated teeth. CLINICAL RELEVANCE Post-endodontic restorations of severely damaged teeth can achieve steady levels of periodontal bone support as a parameter of periodontal health, irrespective of post material.
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Caldas RA, Bacchi A, Barão VA, Versluis A. Should adhesive debonding be simulated for intra-radicular post stress analyses? Dent Mater 2018; 34:1331-1341. [DOI: 10.1016/j.dental.2018.06.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 05/11/2018] [Accepted: 06/07/2018] [Indexed: 11/16/2022]
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Richert R, Robinson P, Viguie G, Farges JC, Ducret M. Multi-Fiber-Reinforced Composites for the Coronoradicular Reconstruction of Premolar Teeth: A Finite Element Analysis. BIOMED RESEARCH INTERNATIONAL 2018; 2018:4302607. [PMID: 29984233 PMCID: PMC6011147 DOI: 10.1155/2018/4302607] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 05/08/2018] [Indexed: 11/17/2022]
Abstract
A coronoradicular reconstruction (CRR) has conventionally used a metallic inlay core (MIC) or a single-fiber-reinforced composite (sFRC) but extensive dentin removal can lead to root fracture. We propose herein a multi-fiber-reinforced composite (mFRC) based on a bundle of thin flexible fibers that can be adapted to the root anatomy without removing additional dentin. The aim of this study was to compare the mechanical behavior of the root reconstructed with mFRC, MIC, or sFRC using a finite element analysis (FEA). Models with or without a ferrule effect were created using Autodesk© software and divided into four parts: root, post, bonding composite or cement, and zirconia crown. For both models, extreme stress values (ESV), stress distribution, and risk of fracture were calculated for an oblique force (45°) of 100 N applied to the top of the buccal cusp. Results indicated that mFRC and mFRCG present a lower risk of fracture of the root and of the CRR without ferrule and thus could be valuable alternatives for premolar CRR. Further studies are necessary to evaluate the clinical success of these CRR.
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Affiliation(s)
- Raphaël Richert
- Université de Lyon, Université Lyon 1, Faculté d'Odontologie, Lyon, France
- Hospices Civils de Lyon, Service de Consultations et Traitements Dentaires, Lyon, France
| | | | - Gilbert Viguie
- Université de Lyon, Université Lyon 1, Faculté d'Odontologie, Lyon, France
- Hospices Civils de Lyon, Service de Consultations et Traitements Dentaires, Lyon, France
| | - Jean-Christophe Farges
- Université de Lyon, Université Lyon 1, Faculté d'Odontologie, Lyon, France
- Hospices Civils de Lyon, Service de Consultations et Traitements Dentaires, Lyon, France
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR5305 CNRS/Université Lyon 1, UMS3444 BioSciences Gerland-Lyon Sud, Lyon, France
| | - Maxime Ducret
- Université de Lyon, Université Lyon 1, Faculté d'Odontologie, Lyon, France
- Hospices Civils de Lyon, Service de Consultations et Traitements Dentaires, Lyon, France
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR5305 CNRS/Université Lyon 1, UMS3444 BioSciences Gerland-Lyon Sud, Lyon, France
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Vallittu PK. An overview of development and status of fiber-reinforced composites as dental and medical biomaterials. ACTA BIOMATERIALIA ODONTOLOGICA SCANDINAVICA 2018; 4:44-55. [PMID: 29707613 PMCID: PMC5917305 DOI: 10.1080/23337931.2018.1457445] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 03/20/2018] [Indexed: 01/11/2023]
Abstract
Fibr-reinforced composites (FRC) have been used successfully for decades in many fields of science and engineering applications. Benefits of FRCs relate to physical properties of FRCs and versatile production methods, which can be utilized. Conventional hand lamination of prefabricated FRC prepregs is utilized still most commonly in fabrication of dental FRC devices but CAD-CAM systems are to be come for use in certain production steps of dental constructions and medical FRC implants. Although metals, ceramics and particulate filler resin composites have successfully been used as dental and medical biomaterials for decades, devices made out of these materials do not meet all clinical requirements. Only little attention has been paid to FRCs as dental materials and majority of the research in dental field has been focusing on particulate filler resin composites and in medical biomaterial research to biodegradable polymers. This is paradoxical because FRCs can potentially resolve many of the problems related to traditional isotropic dental and medical materials. This overview reviews the rationale and status of using biostable glass FRC in applications from restorative and prosthetic dentistry to cranial surgery. The overview highlights also the critical material based factors and clinical requirement for the succesfull use of FRCs in dental reconstructions.
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Affiliation(s)
- Pekka K. Vallittu
- Department of Biomaterials Science, Turku Clinical Biomaterials Centre – TCBC, Institute of Dentistry, University of Turku, Welfare Division, Turku, Finland
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Mechanical properties and superficial characterization of a milled CAD-CAM glass fiber post. J Mech Behav Biomed Mater 2018; 82:187-192. [PMID: 29609139 DOI: 10.1016/j.jmbbm.2018.03.035] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 03/26/2018] [Indexed: 11/23/2022]
Abstract
Computer-aided design and computer-aided manufacturing (CAD-CAM) technology may be used to produce custom intraradicular posts, but studies are lacking. The purpose of this in vitro study was to evaluate the flexural properties (strength and modulus), failure mode, superficial morphology, and roughness of two CAD-CAM glass fiber posts (milled at different angulations) compared with a commercially available prefabricated glass fiber post. Three groups were tested (n = 10): PF (control group)- prefabricated glass fiber post; C-Cd-diagonally milled post; and C-Cv-vertically milled post. A 3-dimensional virtual image was obtained from a prefabricated post, which guided the posterior milling of posts from a glass fiber disk (Trilor Blanks; Bioloren). Surface roughness and morphology were evaluated using confocal laser microscopy. Flexural strength and modulus were evaluated with the 3-point bend test. Data were submitted to one-way analysis of variance followed by the Student-Newman-Keuls post hoc test (α = 0.05). The fractured surfaces were evaluated with scanning electron microscopy. The superficial roughness was highest for PF and similar for the experimental groups. Morphological analysis shows different sizes and directions of the glass fibers along the post. The flexural strength was highest for PF (900.1 ± 30.4 > C-Cd - 357.2 ± 30.7 > C-Cv 101.8 ± 4.3 MPa) as was the flexural modulus (PF 19.3 ± 2.0 GPa > C-Cv 10.1 ± 1.9 GPa > C-Cd 7.8 ± 1.3 GPa). A CAD-CAM milled post seems a promising development, but processing requires optimizing, as the prefabricated post still shows better mechanical properties and superficial characteristics.
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Naumann M, Schmitter M, Frankenberger R, Krastl G. "Ferrule Comes First. Post Is Second!" Fake News and Alternative Facts? A Systematic Review. J Endod 2017; 44:212-219. [PMID: 29229457 DOI: 10.1016/j.joen.2017.09.020] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Revised: 09/28/2017] [Accepted: 09/28/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Both the role of an endodontic post and the ferrule effect have been discussed for decades. The clinical impact of endodontic posts compared with post-free restoration with or without ferrule support was not systematically reviewed so far. It was assumed that the effect of an endodontic post compared with a post-free restoration can be evaluated only when at the same time a ferrule or no-ferrule situation was clinically compared. METHODS The specific PICO question was as follows: Patient: adults with sufficient endodontic treatment needing a core or post; Intervention: post-endodontic treatment using posts with or without ferrule; Comparison: post-endodontic treatment without posts with or without ferrule; Outcomes: failure rates of post/core complexes with or without ferrule support. A Medline search was performed via PubMed in June 2017 using relevant electronic databases. Additionally, hand search was performed. Only prospective clinical studies in humans comparing the success/survival of teeth restored with or without posts over a minimum time of observation of 5 years were included. RESULTS In total, 7 randomized controlled trials and 1 prospective clinical trial met inclusion criteria. Cochrane rating showed high risk of bias in 5 studies. Two of 3 studies support the ferrule-effect concept. Seven of 8 show no post effect. Clinical evidence regarding the influence of tooth location on its survival is scarce. CONCLUSION Ferrule effect and maintaining cavity walls are the predominant factors with regard to tooth and restoration survival of endodontically treated teeth. Most studies do not confirm a positive effect of post placement.
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Affiliation(s)
- Michael Naumann
- Department of Prosthodontics, Geriatric Dentistry, and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | - Marc Schmitter
- Department of Prosthodontics, University Hospital of Würzburg, Würzburg, Germany
| | - Roland Frankenberger
- Department of Operative Dentistry and Endodontology, University of Marburg, Marburg, Germany
| | - Gabriel Krastl
- Department of Conservative Dentistry and Periodontology, University Hospital of Würzburg, Würzburg, Germany
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Moris ICM, Moscardini CA, Moura LKB, Silva-Sousa YTC, Gomes EA. Evaluation of Stress Distribution in Endodontically Weakened Teeth Restored with Different Crown Materials: 3D-FEA Analysis. Braz Dent J 2017; 28:715-719. [PMID: 29211127 DOI: 10.1590/0103-6440201701829] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 10/11/2017] [Indexed: 11/22/2022] Open
Abstract
This study evaluated the stress distribution in endodontically treated teeth, weakened (W) or not weakened (NW), restored with different materials of prosthetic crown using 3D-FEA. Models of a maxillary canine were constructed based on micro-CT images and divided into the groups: G1 (control) - sound tooth; G2 to G7 - endodontically treated teeth restored with glass fiber post (GFP); which G2 to G4 simulated NW root and G5 to G7 simulated W root. For crown material the teeth were restored with: G2 and G5: metallic coping and ceramic veneering, G3 and G6: zirconia coping and ceramic veneering, G4 and G7: alumina coping and ceramic veneering. Load of 180 N was applied at the incisal third of lingual surface at 45º. Models were supported by the periodontal ligament (x=y=z=0). The von Mises stress (VMS) values were calculated. The W teeth presented higher VMS at coping when compared to NW teeth and group G1 showed lower VMS value. For crown material, for both W or NW teeth, increasing VMS was found at metallic, zirconia and alumina coping, respectively. Metallic coping showed a better performance despite its unfavorable esthetics, suggesting as an appropriate material for prosthetic restoration of endodontically treated teeth.
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Affiliation(s)
- Izabela C M Moris
- Dental School, UNAERP - Universidade de Ribeirão Preto, Ribeirão Preto, SP, Brazil
| | | | | | | | - Erica Alves Gomes
- Dental School, UNAERP - Universidade de Ribeirão Preto, Ribeirão Preto, SP, Brazil
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Naumann M, Sterzenbach G, Dietrich T, Bitter K, Frankenberger R, von Stein-Lausnitz M. Dentin-like versus Rigid Endodontic Post: 11-year Randomized Controlled Pilot Trial on No-wall to 2-wall Defects. J Endod 2017; 43:1770-1775. [PMID: 28951033 DOI: 10.1016/j.joen.2017.06.030] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 06/14/2017] [Accepted: 06/26/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION This is the first long-term randomized controlled trial to evaluate dentin-like glass fiber posts (GFPs) compared with rather rigid titanium posts (TPs) for post-endodontic restoration of severely damaged endodontically treated teeth with 2 or fewer remaining cavity walls. METHODS Ninety-one subjects in need of post-endodontic restorations were randomly assigned to receive either a tapered GFP (n = 45) or TP (n = 46). Posts were adhesively luted by using self-adhesive resin cement, followed by composite core build-up and preparation of 2-mm ferrule design. Primary end point was loss of restoration for any reason. Kaplan-Meier curves were constructed, and log-rank test was calculated (P < .05). RESULTS After a follow-up of 132 months, 17 GFP and 20 TP restorations survived, and 19 failed (12 GFP, 7 TP). Failure modes for GFP were root fracture (n = 4), core fracture (n = 1), secondary caries (n = 1), endodontic failure (n = 2), extraction because of tooth mobility grade III associated with insufficient design of removable partial denture (n = 1), tooth fracture (n = 1), and changes in treatment plan (n = 2); failure modes for TP were endodontic failure (n = 5), root fracture (n = 1), and 1 extraction for other reasons. Cumulative survival probability was 58.7% for GFP and 74.2% for TP. CONCLUSIONS When using self-adhesively luted prefabricated posts, resin composite core build-up, and 2-mm ferrule to reconstruct severely damaged endodontically treated teeth, tooth survival is not influenced by post rigidity. Survival decreased rapidly after 8 years of observation in both groups.
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Affiliation(s)
- Michael Naumann
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany, and Department of Prosthodontics, Berlin Institute of Health, Geriatric Dentistry and Craniomandibular Disorders, Berlin, Germany
| | - Guido Sterzenbach
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany, and Department of Prosthodontics, Berlin Institute of Health, Geriatric Dentistry and Craniomandibular Disorders, Berlin, Germany
| | - Thomas Dietrich
- Department of Oral Surgery, School of Dentistry, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Kerstin Bitter
- Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Roland Frankenberger
- Department of Operative Dentistry and Endodontology, University of Marburg, Marburg, Germany
| | - Manja von Stein-Lausnitz
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany, and Department of Prosthodontics, Berlin Institute of Health, Geriatric Dentistry and Craniomandibular Disorders, Berlin, Germany.
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Ferrari M, Sorrentino R, Juloski J, Grandini S, Carrabba M, Discepoli N, Ferrari Cagidiaco E. Post-Retained Single Crowns versus Fixed Dental Prostheses: A 7-Year Prospective Clinical Study. J Dent Res 2017; 96:1490-1497. [DOI: 10.1177/0022034517724146] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- M. Ferrari
- Department of Medical Biotechnologies, Division of Fixed Prosthodontics, University of Siena, Siena, Italy
- Department of Restorative Dentistry, University of Leeds, Leeds, UK
| | - R. Sorrentino
- Department of Medical Biotechnologies, Division of Fixed Prosthodontics, University of Siena, Siena, Italy
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Naples, Italy
| | - J. Juloski
- Department of Medical Biotechnologies, Division of Fixed Prosthodontics, University of Siena, Siena, Italy
- Clinic for Paediatric and Preventive Dentistry, Faculty of Dental Medicine, University of Belgrade, Serbia
| | - S. Grandini
- Department of Medical Biotechnologies, Division of Restorative Dentistry and Endodontics, University of Siena, Siena, Italy
| | - M. Carrabba
- Department of Medical Biotechnologies, Division of Fixed Prosthodontics, University of Siena, Siena, Italy
| | - N. Discepoli
- Department of Medical Biotechnologies, Division of Periodontics, University of Siena, Siena, Italy
| | - E. Ferrari Cagidiaco
- Department of Medical Biotechnologies, Division of Periodontics, Complutense University, Madrid, Spain
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