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Abdellatif D, Iandolo A, Pisano M, Fornara R, Sangiovanni G, Amato M. The incidence of dental fractures in the Italian population during the COVID-19 pandemic: An observational study. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:146-153. [PMID: 38463480 PMCID: PMC10923222 DOI: 10.4103/jcde.jcde_241_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/10/2023] [Accepted: 12/05/2023] [Indexed: 03/12/2024]
Abstract
Background The COVID-19 infection has become a pandemic after breaking out in China in the past months of 2019 and spreading rapidly worldwide. To counter this pandemic, several governments worldwide have taken several drastic measures to try to stop the spread of the virus, including a very strict lockdown that has caused a sudden and, in many cases, negative change in people's daily lives. In the literature, several studies have shown how the pandemic has significantly impaired many people's mental health, causing short- and long-term stress, anxiety, and sleep disturbances. Introduction This study aims to analyze the correlation between the stress caused by the COVID-19 pandemic and the parafunctions of the temporomandibular joint and masticatory muscles, which in turn, have led to an increase in the incidence of fractures and dental injuries. The ultimate goal is to understand the best choice the dentist must make in the preventive and therapeutic fields. Materials and Methods A questionnaire called "Incidence of tooth fractures during the COVID-19 pandemic" was prepared using the Google® Forms platform. This questionnaire consists of 13 questions. This electronic questionnaire was addressed to all dentists in the Campania Region (ITA) and disseminated through social networks such as WhatsApp® or Facebook® or E-mail. Results A total of 730 dentists completed the survey. Of these, 450 (61.7%) stated that the number of patients reporting muscle and joint pain in the morning had increased during the COVID-19 pandemic. 414 (56.7%) dentists noted an increase in parafunction and 392 (53.6%) an increase in dental fractures during the pandemic period. Discussion and Conclusions As can be seen from the study results, an important correlation was found between the stress resulting from the COVID-19 pandemic and dental fractures. The dental elements treated endodontically, depending on the extent of the damage, require restoration, which is also the best preventive strategy in the case of dental fractures.
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Affiliation(s)
- Dina Abdellatif
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Alfredo Iandolo
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Massimo Pisano
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Roberto Fornara
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | | | - Massimo Amato
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
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Lai H, Lin X, Zhang Y, Gong Q, Tong Z. Effect of different endodontic access preparations on the biomechanical behavior of lithium disilicate and resin nanoceramic onlay restorations: An in vitro and 3D finite element analysis study. J Prosthet Dent 2024; 131:64-74. [PMID: 35216818 DOI: 10.1016/j.prosdent.2021.12.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 12/21/2021] [Accepted: 12/21/2021] [Indexed: 02/06/2023]
Abstract
STATEMENT OF PROBLEM The effect of different sizes of endodontic access preparations on the performance of lithium disilicate glass-ceramic and resin nanoceramic onlay restorations is unclear. PURPOSE The purpose of this in vitro and 3D finite element analysis study was to assess the effect of a conservative endodontic access cavity and a traditional endodontic access cavity on the fracture resistance and stress distribution of lithium disilicate glass-ceramic and resin nanoceramic onlays. MATERIAL AND METHODS Sixty caries-free human mandibular molars were anatomically prepared for onlays and divided into 6 groups. After restoration with a lithium disilicate glass-ceramic (N=30) or resin nanoceramic (N=30), each material was further divided into traditional or conservative endodontic access cavity or intact tooth groups. After endodontic therapy and thermocycling, all specimens were submitted to a cycle fatigue test and then loaded until fracture. Failure type and location after debonding or fracture were classified and recorded. Furthermore, stress distribution in the 6 models was analyzed by using a finite element analysis software program. The data were compared by using a 2-way ANOVA test and the Tukey post hoc test (α=.05). The Weibull modulus and Weibull failure probabilities were also estimated for each group. RESULTS The lithium disilicate glass-ceramic onlays had lower fracture resistance values than the resin nanoceramic onlays in both the traditional and conservative endodontic access cavity groups (P<.05). The fracture resistance of the 2 materials for onlays with endodontic access was significantly lower than that for the intact restorations (P<.05). No significant difference was found between the fracture resistance of Lava Ultimate restorations with traditional endodontic access and conservative endodontic access, while the fracture resistance of EMAX restorations with traditional endodontic access was significantly lower than that of restorations with conservative endodontic access (P<.05). A higher percentage of irreparable fractures was found in the 3 resin nanoceramic restoration groups. The von Mises stresses were higher in the lithium disilicate glass-ceramic restorations than in the resin nanoceramic restorations with the same access cavities. The von Mises stresses in the tooth structure were higher with the resin nanoceramic restorations than with the lithium disilicate glass-ceramic restorations with the same access cavities. CONCLUSIONS An endodontic access cavity had more influence on the lithium disilicate glass-ceramic onlays than on the resin nanoceramic onlays, and a traditional endodontic access cavity significantly decreased the fracture resistance of lithium disilicate glass-ceramic onlays.
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Affiliation(s)
- Hongbin Lai
- Graduate student, Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, PR China; Graduate student, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Xinwei Lin
- Graduate student, Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, PR China; Graduate student, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Yuejiao Zhang
- Lecturer, Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, PR China; Lecturer, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Qimei Gong
- Professor, Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, PR China; Professor, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Zhongchun Tong
- Professor, Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, PR China; Professor, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, PR China.
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Al Fodeh RS, Al-Johi OS, Alibrahim AN, Al-Dwairi ZN, Al-Haj Husain N, Özcan M. Fracture strength of endocrown maxillary restorations using different preparation designs and materials. J Mech Behav Biomed Mater 2023; 148:106184. [PMID: 37839334 DOI: 10.1016/j.jmbbm.2023.106184] [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: 08/15/2023] [Revised: 10/07/2023] [Accepted: 10/10/2023] [Indexed: 10/17/2023]
Abstract
PURPOSE This study investigated the impact of preparation design and material types on fracture strength in maxillary premolars endocrowns after thermodynamic aging. MATERIALS AND METHODS Eighty two-rooted maxillary premolar crowns underwent endodontic treatment (N = 80, n = 10). The teeth were categorized into ten groups (4-mm deep with no intracanal extension lithium disilicate glass ceramic & multilayer zirconia endocrowns (LE0 & ZE0); 4-mm deep with 4-mm intracanal extension in one canal (LE1 & ZE1); 4-mm deep with 2-mm intracanal extensions in both canals (LE2 & ZE2); flat overlays with no endocore (LO & ZO); glass fiber reinforced post & core and crown (LC & ZC)). After cementation, all specimens were subjected to 1500 thermocycles and 1,200,000 chewing cycles with an axial occlusal load of 49 N. A static loading test was performed at a non-axial 45° loading using a universal testing machine and failure modes (Type I: restoration debonding; Type II: restoration fracture; Type III: restoration/tooth complex fracture above bone level; Type IV: restoration/tooth complex fracture below bone level) were evaluated using a stereoscope. Data were ananalzed using 2-way ANOVA and Tukey's tests (alpha = 0.05). RESULTS The endocrowns manufactured from multilayered zirconia and pressed lithium disilicate glass ceramic exhibited a fracture load ranging between 1334 ± 332 N and 756 ± 150 N, with ZC presenting the highest and LE2 the lowest values. The differences were not statistically significant (p > 0.05). CONCLUSION All endocrowns tested in this study performed similar considering the different designs and materials tested. The distribution of fracture modes did not differ significantly depending on the design of the restoration and the type of material used.
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Affiliation(s)
- Rami S Al Fodeh
- Department of Prosthodontics, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Omer S Al-Johi
- Department of Prosthodontics, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Anas N Alibrahim
- Department of Prosthodontics, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Ziad N Al-Dwairi
- Department of Prosthodontics, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Nadin Al-Haj Husain
- Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland; Clinic of Masticatory Disorders and Dental Biomaterials, Center of Dental Medicine, University of Zurich, Zurich, Switzerland; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Mutlu Özcan
- Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland; Clinic of Masticatory Disorders and Dental Biomaterials, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
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Madfa AA, Almansour MI, Alshammari AF, Alenezi NM, Alrashidi EF, Aldhaban AA, Aljohani T, Alshammari FA. Knowledge and Awareness of Dental Practitioners About the Utilization of Endocrown in Post-endodontic Management. Cureus 2023; 15:e49838. [PMID: 38164301 PMCID: PMC10758257 DOI: 10.7759/cureus.49838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND The objective of this study was to evaluate the knowledge, and awareness of dentists in Ha'il, Kingdom of Saudi Arabia, regarding the use of endocrown as post-endodontic restorations, utilizing an online questionnaire. METHODS A cross-sectional study was carried out among dental practitioners working in Ha'il, Kingdom of Saudi Arabia. Dentists who practice in the Ha'il were included in the current study. The survey study involved a sample size of 245 participants. The researchers employed the snowball sampling technique in this investigation. The validated, closed-ended questionnaires were disseminated to the entire sample of selected dental practitioners using electronic mail. The initial section of the survey encompassed inquiries pertaining to the demographic characteristics of the participants, encompassing variables such as gender, years of professional experience, and workplace. The subsequent section of the survey focused on assessing the participants' knowledge and opinions regarding the endocrown technique. The Chi-square test was employed to assess the associations between categorical variables. RESULTS The most of participants 228 (93.1%) had knowledge about endocrown and 94 (38.4%) of them received information from their educational institutions. Among the responses of the participants, 232 (94.7%) expressed their preference for utilizing endocrown restorations specifically for molar teeth. Moreover, 183 (74.7%) of respondents indicated that the endocrown is preferred when there is a restricted amount of inter-arch space available. A majority of respondents 152 (62.0%) indicated that the ferrule does not exert any influence on the endocrown. A majority of participants 135 (55.1%) expressed a preference for utilizing lithium disilicate ceramic in the fabrication of endocrown. The most of participants 209 (85.3%) opted to use resin cement for the purpose of cementation. The characteristics of gender, experience, and working place were found to have a significant relationship with the knowledge of the participants about endocrown (p <0.05). CONCLUSIONS The study participants need to enhance their knowledge and awareness pertaining to the utilization of endocrowns as a post-endodontic treatment.
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Affiliation(s)
- Ahmed A Madfa
- Department of Restorative Dental Science, College of Dentistry, University of Ha'il, Ha'il, SAU
| | - Moazzy I Almansour
- Department of Restorative Dental Science, College of Dentistry, University of Ha'il, Ha'il, SAU
| | - Asma F Alshammari
- Department of Restorative Dental Science, College of Dentistry, University of Ha'il, Ha'il, SAU
| | | | | | - Adel A Aldhaban
- Department of Restorative Dental Science, College of Dentistry, University of Ha'il, Ha'il, SAU
| | - Thoraya Aljohani
- Department of Restorative Dental Science, College of Dentistry, University of Ha'il, Ha'il, SAU
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Kazemi-Yazdi H, Rezaei S, Seyedan K, Kazeminia M, Rezaei S. The effect of preparation design on fracture resistance of endodontically treated maxillary premolars restored with lithium disilicate computer-aided design/computer-aided manufacturing endocrowns: An in vitro study. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2023; 26:627-633. [PMID: 38292752 PMCID: PMC10823980 DOI: 10.4103/jcde.jcde_66_23] [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: 07/03/2023] [Revised: 08/22/2023] [Accepted: 09/18/2023] [Indexed: 02/01/2024]
Abstract
Purpose This study aimed to assess the effect of preparation design on fracture resistance (FR) of endodontically treated maxillary premolars restored with lithium disilicate (LDS) endocrowns fabricated by the computer-aided design/computer-aided manufacturing (CAD/CAM) technology. Materials and Methods In this in vitro, experimental study, 30 sound maxillary premolars were randomly assigned to three groups (n = 10) of control (no preparation), endocrown preparation with butt-joint design without ferrule, and endocrown preparation with ferrule (shoulder design with 1 mm height). After restoration fabrication and cementation, the teeth underwent thermocycling, were mounted with 45° angle, and subjected to compressive load in a universal testing machine to measure their FR. The mode of failure was also determined under a stereomicroscope. Data were analyzed using one-way ANOVA and Tukey's test (α =0.05). Results The shoulder group showed the highest FR (1768.98 ± 386.1 N). The difference in FR was statistically significant among the three groups (P < 0.05). Pairwise comparisons revealed that the shoulder group had significantly higher FR than the butt-joint (P = 0.001) and control (P = 0.009) groups. However, the difference in FR between the butt-joint and control groups was not significant (P = 0.75). The mode of failure was not significantly different among the three groups (P > 0.05). Conclusions Preparation design had a significant effect on FR of endodontically treated maxillary premolars restored with LDS CAD/CAM Endocrowns, such that addition of a short axial wall in shoulder group significantly increased the FR of endocrowns.
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Affiliation(s)
- Haleh Kazemi-Yazdi
- Department of Operative Dentistry, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Sadaf Rezaei
- Department of Aesthetic and Restorative Dentistry, Faculty of Dentistry, Iran University of Medical Sciences, Tehran, Iran
| | - Kaveh Seyedan
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marjan Kazeminia
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Golestan University of Medical Sciences, Gorgan, Iran
| | - Sina Rezaei
- Department of Undergraduate Student of Dentistry, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Veselinova M, Diamantopoulou S, Paximada C, Papazoglou E. In-Vitro Comparison of Fracture Strength of Endocrowns and Overlays in Endodontically Treated Teeth Manufactured with Monolithic Lithium Disilicate and Zirconia. J Funct Biomater 2023; 14:422. [PMID: 37623666 PMCID: PMC10455451 DOI: 10.3390/jfb14080422] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/25/2023] [Accepted: 08/08/2023] [Indexed: 08/26/2023] Open
Abstract
To evaluate the fracture strength and the failure mode of endodontically treated molars restored with monolithic lithium disilicate and zirconia endocrowns and overlays. A total of 48 extracted mandibular molars were endodontically treated, decoronated 2 mm above the cementoenamel junction and divided into four 12-specimen groups. Group ELD: lithium disilicate endocrowns. Group EZ: monolithic zirconia endocrowns. Group OLD: lithium disilicate overlays. Group OZ: monolithic zirconia overlays. Overlays did not extend in the pulp chamber and endocrowns extended in the pulp chamber 2 mm. After adhesive bonding of the restorations, the specimens were subjected to thermocycling (×5000 cycles) and then to fracture resistance testing at lateral static loading (1 mm/min) at a universal testing machine. The failure mode of the specimens was qualitatively evaluated. Differences in means were compared using with t-tests for independent samples or Mann-Whitney test (p < 0.05). Weibull distribution analysis was also performed. Group ELD showed significantly higher fracture strength than all other groups (p = 0.001), and the highest Weibull modulus. Conclusions: Lithium disilicate endocrowns exhibit higher fracture strength and are more reliable compared to the other types of restorations examined. Endocrowns had more catastrophic failures compared to overlays.
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Affiliation(s)
| | | | | | - Efstratios Papazoglou
- Department of Operative Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.V.); (S.D.); (C.P.)
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Luo B, Sun X, He L, Zhao L, Liu X, Jiang Q. Impact of different axial wall designs on the fracture strength and stress distribution of ceramic restorations in mandibular first molar. BMC Oral Health 2022; 22:549. [PMID: 36456942 PMCID: PMC9714140 DOI: 10.1186/s12903-022-02577-5] [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: 10/11/2022] [Accepted: 11/08/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The purpose of this study was to investigate the fracture strength and stress distribution of four ceramic restorations. METHODS Forty human mandibular first molars were collected and randomized into four groups after establishing the distal defect: full crown group with 4 mm axial wall height (AWH) (FC4); short AWH crown group with 2 mm AWH (SC2); occlusal veneer group with 0 mm AWH (OV0); occlusal distal veneer group with only the distal surface prepared, and 4 mm AWH (OD4). The teeth were prepared according to the groups and the ceramic restorations were completed using celtra duo ceramic blocks. The ceramic thickness of the occlusal surface is about 1.5 mm and the edge is about 1 mm. The failure load values and fracture modes of each group were detected by mechanical test in vitro. According to the groups to establish three-dimensional finite element analysis (FEA) models, a 600 N loading force was applied vertically using a hemispherical indenter with a diameter of 6 mm. and compare the stress distribution under the condition of different restorations. RESULTS In vitro mechanical tests showed that the failure load values were SC2 (3232.80 ± 708.12 N) > OD4 (2886.90 ± 338.72 N) > VO0 (2133.20 ± 376.15 N) > FC4(1635.40 ± 413.05 N). The failure load values of the short AWH crown and occlusal distal veneer were significantly higher than that of occlusal veneer and full crown (P<0.05). The fracture modes of the full crown and occlusal veneer groups were mainly ceramic fractures and some were restorable tooth fractures. The short AWH crown and occlusal distal veneer groups presented with three fracture modes, the proportion of non-restorable tooth fracture was higher. The results of FEA show that under the spherical loading condition, the stress of ceramic was concentrated in the contact area of the loading head, the maximum von Mises stress values were FC4 (356.2 MPa) > VO0 (214.3 MPa) > OD4 (197.9 MPa) > SC2 (163.1 MPa). The stress of enamel was concentrated in the area where the remaining enamel was thinner, the maximum von Mises stress values was OD4 (246.2 MPa) ≈ FC4 (212.4 MPa) > VO0 (61.8 MPa) ≈ SC2 (45.81 MPa). The stress of dentin is concentrated in the root furcation and the upper third region of the root. However, stress concentration was observed at the tooth cervix in the full crown. CONCLUSION Under certain conditions, the occlusal distal veneer shows better performance than the full crown.
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Affiliation(s)
- Bin Luo
- grid.24696.3f0000 0004 0369 153XDepartment of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 100050 Beijing, China
| | - Xiaolu Sun
- grid.479671.a0000 0004 9154 7430Shunyi Hospital, Beijing Traditional Chinese Medicine Hospital, 100010 Beijing, China
| | - Lin He
- grid.24696.3f0000 0004 0369 153XDepartment of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 100050 Beijing, China
| | - Lidan Zhao
- grid.410737.60000 0000 8653 1072Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, 510013 Guangzhou, China
| | - Xinggang Liu
- grid.24696.3f0000 0004 0369 153XDepartment of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 100050 Beijing, China
| | - Qingsong Jiang
- grid.24696.3f0000 0004 0369 153XDepartment of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 100050 Beijing, China
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Channarong W, Lohawiboonkij N, Jaleyasuthumkul P, Ketpan K, Duangrattanaprathip N, Wayakanon K. Fracture resistance of bonded ceramic overlay restorations prepared in various designs. Sci Rep 2022; 12:16599. [PMID: 36198863 PMCID: PMC9534891 DOI: 10.1038/s41598-022-21167-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 09/23/2022] [Indexed: 11/26/2022] Open
Abstract
This study investigates fracture resistance of adhesive ceramic overlays of various designs. Forty-eight upper premolar teeth were divided into eight groups. The variations were: shoulder margins on the buccal and lingual surfaces with axial wall heights of 1, 2, or 3 mm; one shoulder margin with axial wall height of 1, 2, or 3 mm on the lingual surface and one contrabevel margin on the buccal surface; contrabevel margins on the buccal and lingual surfaces; and a control of sound teeth. Overlays were designed and fabricated with CAD/CAM using zirconia-reinforced lithium disilicate ceramic and bonded with resin cement. Samples underwent thermocycling and dynamic fatigue equivalent to 6 months of use. Compressive loading was applied until fracture, and fracture mode was analyzed. Results showed no statistical difference in fracture resistance between designs, and the fracture pattern of most was involvement of pulp tissue and below the CEJ. Fracture resistance of the restored teeth was also not statistically different from the control. All control fractures were within the dentin and above the CEJ. Overlay restorations were therefore effective in strengthening damaged teeth and imparting fracture resistance equal to sound teeth, and axial wall heights and margin types did not influence this result.
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Affiliation(s)
| | | | | | - Kittipong Ketpan
- Department of Restorative Dentistry, Naresuan University, Phitsanulok, Thailand
| | | | - Kornchanok Wayakanon
- Department of Restorative Dentistry, Naresuan University, Phitsanulok, Thailand.
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Finite element and in vitro study on biomechanical behavior of endodontically treated premolars restored with direct or indirect composite restorations. Sci Rep 2022; 12:12671. [PMID: 35879388 PMCID: PMC9314407 DOI: 10.1038/s41598-022-16480-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 07/11/2022] [Indexed: 11/08/2022] Open
Abstract
Objectives of the study were to investigate biomechanical properties of severely compromised premolars restored with composite restorations using finite element analysis (FEA), and in vitro fracture resistance test. A 3-D model of an endodontically treated premolar was created in Solidworks. Different composite restorations were modelled (direct restoration-DR; endo-crown-EC; post, core, and crown-C) with two different supporting tissues: periodontal ligament/alveolar bone (B), and polymethyl methacrylate (PMMA). Models were two-point axially loaded occlusally (850 N). Von Mises stresses and strains were calculated. The same groups were further tested for static fracture resistance in vitro (n = 5, 6.0 mm-diameter ball indenter, vertical load). Fracture resistance data were statistically analyzed (p < 0.050). The highest stresses and strains in all FEA models were observed on occlusal and vestibular cervical surfaces, corresponding to fracture propagation demonstrated in vitro. C showed the lowest stress in dentin, while EC showed lower stresses and strains in crown cement. B models demonstrated larger high stress areas in the root than PMMA models. No significant differences in fracture resistance (N) were observed between groups (DR: 747.7 ± 164.0, EC: 867.3 ± 108.1, C: 866.9 ± 126.3; p = 0.307). More conservative restorations seem a feasible alternative for endodontically treated premolars to conventional post-core-crown.
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Aldesoki M, Bourauel C, Morsi T, El-Anwar MI, Aboelfadl AK, Elshazly TM. Biomechanical behavior of endodontically treated premolars restored with different endocrown designs: Finite element study. J Mech Behav Biomed Mater 2022; 133:105309. [DOI: 10.1016/j.jmbbm.2022.105309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/31/2022] [Accepted: 06/02/2022] [Indexed: 10/18/2022]
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Comparison of stress distribution between zirconia/alloy endocrown and CAD/CAM multi-piece zirconia post-crown: three-dimensional finite element analysis. Clin Oral Investig 2022; 26:5007-5017. [PMID: 35352185 DOI: 10.1007/s00784-022-04470-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/17/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study aimed to evaluate a digital multi-piece zirconia post-crown to restore a mandibular second molar with extensive coronal loss and limited restoration space, and to compare the stress distribution between endocrowns made of zirconia or alloy and CAD/CAM multi-piece zirconia post-crowns. MATERIAL AND METHODS Four three-dimensional finite element analysis models of a mandibular second molar with extensive coronal loss and limited restoration space were created as follows: (A) intact molar; (B) zirconia endocrown restored molar; (C) multi-piece post-crown restored-molar with tapered nail; (D) multi-piece post-crown restored molar with T-shaped nail. Models C and D were divided into two subgroups according to the material type: C1/D1, zirconia; C2/D2, NiCr alloy. The maximum modified von Mises failure criterion (mvM) stresses were calculated, and the stress distribution was recorded to analyze the effects of the restoration and material types on the biomechanical properties of dentin and prosthesis. RESULTS The maximum mvM stress of dentin in model B (33.80 MPa) was lower compared with models C (C1, 37.81 MPa; C2, 36.36 MPa) and D (D1, 36.34 MPa; D2, 34.97 MPa) under vertical load, but the opposite was observed under oblique load. The highest mvM stress was concentrated in the nail region located in the root canal, and the T-shaped nail values were greater than the tapered nail, whereas model D with T-shaped nail showed a lower mvM stress level in dentin compared with Model C with tapered nail. CONCLUSIONS The digital multi-piece zirconia post-crown is a potential approach to restore mandibular second molars with extensive coronal loss and limited restoration space. CLINICAL RELEVANCE The digital multi-piece zirconia post-crown has potential to restore mandibular second molars with extensive coronal loss and limited restoration space using an innovative approach.
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Radwan W, AlTuwaijri DS, Alwoseamer AT, AlMajed AI. Endodontically Treated Teeth Restoration Assessment, Decision Making and Treatment Option Among Dental Practitioners in Saudi Arabia. ANNALS OF DENTAL SPECIALTY 2022. [DOI: 10.51847/j9kotfltnz] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Yildirim G, Demir C, Güven MÇ, Koç O, Dalkiliç EE. Influence of fiber insertion and different material type on stress distribution in endocrown restorations: a 3D-FEA study. Comput Methods Biomech Biomed Engin 2021; 25:1509-1519. [PMID: 34964689 DOI: 10.1080/10255842.2021.2019228] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The study aimed to evaluate the effects of fibers insertion and restorative material type on the stress distribution in endocrowns with finite element analysis. Five 3D models of first mandibular molars were created and restored as follows: (1) IN: intact tooth, (2) IPS-E: tooth restored with lithium disilicat ceramic endocrowns, (3) C-E: tooth restored with composite endocrowns, (4) IPS-E + F: lithium disilicate ceramic endocrowns + fiber, (5) C-E + F: composite endocrowns + fiber. Vertical masticatory load was imitated with finite element analysis. The equivalent stress of von Mises failure criterion (mvM) was calculated. The maximum mvM stress, enamel/crown, dentin and cement were compared among models and strength of the materials. Endocrowns presented a lower mvM stress level than intact tooth. In IPS-E, the mvM stress values in the crown and dentin were higher than C-E, while the mvM stress values in cement were higher in C-E group. Fibers insertion did not affect the stress level of IPS-E and C-E groups. In IPS model, fiber showed more stress absorption than C-E. The restorative material type changed the stress distribution of endocrown restorations. The fiber application did not affect the stress distribution in either endocrown group. But, more stress absorption was observed in fiber under IPS-E than C-E.
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Affiliation(s)
- Gulhan Yildirim
- Department of Prosthodontics, Beykent University, Istanbul, Turkey
| | - Cihan Demir
- Faculty of Mechanical Engineering, Yildiz Technical University, Istanbul, Turkey
| | | | - Osman Koç
- Faculty of Mechanical Engineering, Yildiz Technical University, Istanbul, Turkey
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The fracture strength of endocrowns manufactured from different hybrid blocks under axial and lateral forces. Clin Oral Investig 2020; 25:1889-1897. [PMID: 32813076 DOI: 10.1007/s00784-020-03495-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/03/2020] [Indexed: 02/06/2023]
Abstract
AIM This in vitro study was conducted to compare the fracture strength of endocrowns manufactured from different hybrid blocks under axial and lateral forces. MATERIAL AND METHODS Following root-canal treatment, 100 permanent mandibular first molars were randomly distributed among 5 groups according to restoration material. Endocrown restorations were produced from IPS e.max CAD (IPS), Vita Enamic (VE), GC Cerasmart (GC), Shofu (SH), and Brilliant Crios (BC) using CAD/CAM technology. Specimens were cemented, subjected to artificial aging, and further divided into 2 subgroups (n = 10) per group for fracture testing. Each specimen was placed on a universal testing machine and subjected to axial or lateral forces applied at a crosshead speed of 1 mm/min. Fracture data were analyzed using one-way ANOVA, Tukey, Tamhane T2, and Weibull tests. RESULTS Statistically significant differences in fracture-strength (FS) values under axial and lateral forces were observed among the groups (P < 0.05). Group BC had the highest FS value under axial forces, whereas group IPS had the highest FS value under lateral forces. According to Weibull analysis, VE exhibited the highest reliability under axial forces (7.62), whereas IPS exhibited the highest reliability under lateral forces (4.68). No statistically significant differences were detected in the distribution of failure types under either axial or lateral forces among the groups (P > 0.05). CONCLUSION All of the hybrid blocks tested showed sufficient fracture strength for use as CAD/CAM-fabricated endocrowns. CLINICAL RELEVANCE Hybrid blocks can be used as an alternative to lithium disilicate blocks in endocrown restorations.
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Wang Q, Liu Y, Wang Z, Yang T, Liang Y, Gao Z, Fang C, Zhang Y. Effect of Access Cavities and Canal Enlargement on Biomechanics of Endodontically Treated Teeth: A Finite Element Analysis. J Endod 2020; 46:1501-1507. [PMID: 32615176 DOI: 10.1016/j.joen.2020.06.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/18/2020] [Accepted: 06/19/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION The purpose of this study was to investigate the influence of access cavities and tapers of canal preparations on fracture resistance of endodontically treated first molars by finite element method and Weibull analysis. METHODS On the basis of the micro-computed tomography data of maxillary first molar, the models of endodontically treated teeth with conservative endodontic cavity, traditional endodontic cavity, and 4 tapers of canal preparations (0.02, 0.04, 0.06, and 0.08) were created. Four static loads (800 N in total) were applied vertically to the contact points. The stress distributions of maximum principal stress were recorded and analyzed. Weibull analysis was performed to analyze the failure risk in enamel and dentin. RESULTS The stress distributions of maximum principal stress on occlusal surfaces were similar. In cervical region, the tensile stress was mainly concentrated on mesiobuccal root and root furcation. The finite element analysis and Weibull analysis showed that conservative endodontic cavity significantly reduced the maximum principal stress in cervical region and the failure probability, compared with traditional endodontic cavity. No significant difference was detected among tapers of prepared canals. CONCLUSIONS Preserving coronal dentin by using conservative endodontic cavity significantly reduced the concentration of tensile stress and the failure probability of dentin, although the maximum principal stress and failure probability were less affected by taper of canal preparation.
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Affiliation(s)
- Qian Wang
- Department of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yuxuan Liu
- Department of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhihui Wang
- Department of Prosthodontics, Changsha Stomatological Hospital, Changsha, Hunan, China
| | - Tianru Yang
- Department of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ye Liang
- Department of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhengrong Gao
- Department of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Changyun Fang
- Department of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yiyi Zhang
- Department of Stomatology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
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Skalskyi V, Makeev V, Stankevych O, Dubytskyi O. Acoustic properties of fracture of dental restorative materials and endocrown restorations under quasi-static loading. Dent Mater 2020; 36:617-625. [DOI: 10.1016/j.dental.2020.03.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 02/17/2020] [Accepted: 03/12/2020] [Indexed: 11/17/2022]
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Al-Dabbagh RA. Survival and success of endocrowns: A systematic review and meta-analysis. J Prosthet Dent 2020; 125:415.e1-415.e9. [PMID: 32197821 DOI: 10.1016/j.prosdent.2020.01.011] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 01/10/2020] [Accepted: 01/10/2020] [Indexed: 10/24/2022]
Abstract
STATEMENT OF PROBLEM Endocrowns are a monoblock type of restoration that use the pulp chamber and remaining coronal tooth structure as a means of retention. However, data on their long-term survival and success rates as compared with conventional crowns are lacking. PURPOSE The purpose of this systematic review and meta-analysis was to collate published work on endocrowns to assist clinicians in making decisions on when and whether they are an appropriate restorative option with a predictable outcome for extensively damaged endodontically treated teeth. MATERIAL AND METHODS Databases such as PubMed (MEDLINE), Scopus, EMBASE, Cochrane library, and Google Scholar were searched up to June 2019 for clinical and in vitro studies on endocrown survival and success rates. For the meta-analysis, endocrown and conventional crown survival and success rates were compared, and the pooled effects were presented as relative risks and 95% confidence intervals using a random effects model. RESULTS Ten studies fulfilled the inclusion criteria (3 clinical and 7 in vitro) and were included in the systematic review. The meta-analysis of the clinical studies showed an estimated overall 5-year survival rate of 91.4% for endocrowns and 98.3% for conventional crowns. The estimated overall 5-year success rates were 77.7% for endocrowns and 94% for conventional crowns. There were no significant differences in overall survival or success estimates between the assessed restorations (P>.05). CONCLUSIONS Additional well-designed clinical studies with long-term assessment are needed; however, endocrowns appear to be a promising conservative restorative option with acceptable long-term survival for endodontically treated posterior teeth in selected patients.
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Affiliation(s)
- Raghad A Al-Dabbagh
- Assistant Professor and Consultant in Prosthodontics, Oral and Maxillofacial Rehabilitation Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
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Endocrowns: A systematic review. J Prosthet Dent 2020; 123:411-418.e9. [DOI: 10.1016/j.prosdent.2019.04.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 04/14/2019] [Accepted: 04/15/2019] [Indexed: 11/18/2022]
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Taha D, Spintzyk S, Sabet A, Wahsh M, Salah T. Assessment of marginal adaptation and fracture resistance of endocrown restorations utilizing different machinable blocks subjected to thermomechanical aging. J ESTHET RESTOR DENT 2018; 30:319-328. [PMID: 30113129 DOI: 10.1111/jerd.12396] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 04/22/2018] [Accepted: 05/13/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This in vitro study was conducted to assess the marginal adaptation and fracture resistance of computer aided design/computer aided manufacturer (CAD-CAM) fabricated endocrowns restoring endodontically treated molars using different machinable blocks with thermomechanical loading protocols. MATERIALS AND METHODS Devitalized mandibular molars were prepared in a standardized way and divided into 4 groups (n = 10) to receive CAD/CAM fabricated endocrowns using four materials (Lithium disilicate ceramics, polymer infiltrated ceramics, zirconia-reinforced lithium silicate ceramics and resin nanoceramics. Marginal gaps (µm) were measured using stereomicroscope before cementation and after cementation. After thermomechanical aging, marginal gap measurements were repeated, and then fracture resistance test was performed. Two-way analysis of variance (ANOVA) and Tukey HSD multiple comparisons were used to assess the effect of material on the marginal gap before, after cementation, and after thermomechanical aging. One Way ANOVA was used to assess the effect of material on the fracture resistance. RESULTS The difference between marginal gaps values of the tested materials was statistically insignificant but with significant increase after cementation and after thermomechanical aging. Cerasmart endocrowns showed the highest mean fracture load value (1508.5 ± 421.7N) with statistically significant difference than Vita Enamic endocrowns and Celtra Duo. CONCLUSION The tested materials showed marginal vertical gap readings within the limits of clinically acceptable standards. Resin nanoceramics and lithium disilicate showed the highest values of fracture resistance followed by polymer infiltrated ceramics favoring their use for endocrown restorations. CLINICAL SIGNIFICANCE The mechanical behavior of ceramic materials varies with the variation of their structure and mechanical properties. Accordingly, further investigation is always needed to explore the biomechanical behavior of recent materials when used as endocrowns before clinical trials.
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Affiliation(s)
- Doaa Taha
- Section Medical Materials science & technology, University Hospital Tübingen, Tübingen, Germany.,Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Sebastian Spintzyk
- Section Medical Materials Science & Technology, University Hospital Tübingen, Germany
| | - Ahmed Sabet
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Marwa Wahsh
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Tarek Salah
- Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
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Vagropoulou GI, Klifopoulou GL, Vlahou SG, Hirayama H, Michalakis K. Complications and survival rates of inlays and onlays vs complete coverage restorations: A systematic review and analysis of studies. J Oral Rehabil 2018; 45:903-920. [PMID: 30019391 DOI: 10.1111/joor.12695] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 07/07/2018] [Accepted: 07/16/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The aim of this study was to identify if different types of indirect restorations used for single teeth had different biological and technical complications, as well as survival rates. METHOD An electronic search was performed in various electronic databases to identify articles, published between 1980 and 2017. The search terms were categorised into 4 groups: inlay, onlay, inlay/onlay and crown. Manual searches of published full-text articles and related reviews were also performed. RESULTS A total number of 2849 papers were retrieved initially. After a detailed assessment for eligibility, 9 studies were selected for inclusion. The heterogeneity of the studies did allow neither a meta-analysis nor any meaningful comparison between types of restorations or materials. Only some pooling was performed for representative reasons. The mean survival rate of inlays was 90.89%, while for onlays and crowns it was 93.50% and 95.38%, respectively. For the fourth study group, consisting of both inlays and onlays, the survival rate was found to be 99.43%. Statistical analysis demonstrated caries to be the main biological complication for all types of restorations, followed by a root and/or tooth fracture incidence (11.34%) and endodontic incidence. Ceramic fractures represented the most common technical complication, followed by loss of retention and porcelain chipping. CONCLUSION The 5-year survival rate for crowns and inlays/onlays is very high, exceeding 90%. An association between the kind of complications and different types of restorations could not be established. Nevertheless, a relatively high failure rate due to caries and ceramic fractures was noted.
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Affiliation(s)
- Georgia I Vagropoulou
- Department of Prosthodontics, Division of Graduate Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Stefania G Vlahou
- School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Hiroshi Hirayama
- Department of Restorative Sciences and Biomaterials, Division of Graduate Prosthodontics, Henry M Goldman School of Dental Medicine, Boston University, Boston, Massachusetts
| | - Konstantinos Michalakis
- Department of Prosthodontics, Division of Graduate Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Department of Prosthodontics, Division of Graduate and Postgraduate Prosthodontics, School of Dental Medicine, Tufts University, Boston, Massachusetts
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Fracture resistance and failure modes of polymer infiltrated ceramic endocrown restorations with variations in margin design and occlusal thickness. J Prosthodont Res 2018; 62:293-297. [DOI: 10.1016/j.jpor.2017.11.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 11/14/2017] [Accepted: 11/23/2017] [Indexed: 11/17/2022]
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Skalskyi V, Makeev V, Stankevych O, Pavlychko R. Features of fracture of prosthetic tooth-endocrown constructions by means of acoustic emission analysis. Dent Mater 2018; 34:e46-e55. [DOI: 10.1016/j.dental.2018.01.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 12/07/2017] [Accepted: 01/16/2018] [Indexed: 11/30/2022]
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Helal MA, Wang Z. Biomechanical Assessment of Restored Mandibular Molar by Endocrown in Comparison to a Glass Fiber Post‐Retained Conventional Crown: 3D Finite Element Analysis. J Prosthodont 2017; 28:988-996. [PMID: 29067737 DOI: 10.1111/jopr.12690] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2017] [Indexed: 11/27/2022] Open
Affiliation(s)
- Mohammed Abu Helal
- Prosthodontic Department, Henan Provincial People's HospitalPeople's Hospital of Zhengzhou University Zhengzhou China
| | - Zhigang Wang
- Prosthodontic Department, Henan Provincial People's HospitalPeople's Hospital of Zhengzhou University Zhengzhou China
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Atash R, Arab M, Duterme H, Cetik S. Comparison of resistance to fracture between three types of permanent restorations subjected to shear force: An in vitro study. J Indian Prosthodont Soc 2017; 17:239-249. [PMID: 28936037 PMCID: PMC5601495 DOI: 10.4103/jips.jips_24_17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 05/19/2017] [Indexed: 11/04/2022] Open
Abstract
Introduction: Our study's objective was to compare resistance to fracture between endocrown and conventional post and core restorations when subjected to shear force. Materials and Methods: Thirty human mandibular premolars were extracted for orthodontic reasons, endodontically treated, and restored using three different methods: endocrown, glass fiber post and composite resin core, and metal post. All the crowns were made from IPS e.max ceramic. Shear forces were applied to these restorations using a test machine until breakage. Load and displacement were recorded every 0.1 s. Results: No significant difference was observed in resistance to fracture between glass fiber post and metal post. No relationship between the displacement of prosthetic dental system and type of material used was uncovered and by comparing the type of fracture with the restoration material used. However, a greater number of favorable fractures were observed in the glass fiber group whereas most of the fractures in the endocrown and metal post groups were unfavorable. Conclusion: Endocrown displays better resistance to fracture compared to conventional post and core restorations. In addition, endocrown did not show more displacement or cause more unfavorable fractures than the conventional restorations. This restoration may represent a reliable alternative for restoring a damaged, endodontically treated tooth.
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Affiliation(s)
- Ramin Atash
- Department of Stomatology and Dentistry, Erasmus Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Maiyas Arab
- Department of Stomatology and Dentistry, Erasmus Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Hadrien Duterme
- Department of Stomatology and Dentistry, Erasmus Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Sibel Cetik
- Department of Stomatology and Dentistry, Erasmus Hospital, Laboratory of Physiology and Pharmaceutics, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
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No post-no core approach to restore severely damaged posterior teeth: An up to 10-year retrospective study of documented endocrown cases. J Dent 2017; 63:1-7. [DOI: 10.1016/j.jdent.2017.04.009] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Revised: 04/19/2017] [Accepted: 04/25/2017] [Indexed: 11/21/2022] Open
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Biomechanical behavior of endodontically treated premolars using different preparation designs and CAD/CAM materials. J Dent 2017; 59:54-61. [PMID: 28214537 DOI: 10.1016/j.jdent.2017.02.007] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 02/07/2017] [Accepted: 02/13/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To evaluate the effect of restoration design ('2.5-mm deep endocrown', '5-mm deep endocrown' or '5-mm deep post&crown') and CAD/CAM material type (composite or lithium disilicate glass-ceramic) on the load-to-failure of endodontically treated premolars in absence of any ferrule. METHODS The crowns of 48 single-rooted premolars were cut and the roots were endodontically treated. Teeth were randomly divided into six groups (n=8); teeth in each group were restored using one of the two tested materials with standardized CAD/CAM fabricated endocrowns (with either 2.5-mm or 5-mm deep intra-radicular extension) or conventional crowns (5-mm deep post&crown). After cementation using luting composite, the specimens were immersed in distilled water and subjected to 1,200,000 chewing cycles with a load of 50N applied parallel to the long axis of the tooth (0°). After cyclic loading, a compressive load was applied at 45° to the tooth's long axis using a universal testing machine until failure. Load-to-failure was recorded (N) and the specimens were examined under a stereomicroscope with 3.5x magnification to determine the mode of failure. RESULTS All specimens survived the 1,200,000 chewing cycles. A significant interaction between restoration design and CAD/CAM material was found using two-way ANOVA. In the '2.5-mm deep endocrown' groups, the composite achieved a significantly higher load-to-failure than the lithium disilicate glass-ceramic, while no differences between materials were found in the '5-mm deep endocrown' and '5-mm deep post&crown' groups. More unfavorable failures (root fractures) were observed for higher load-to-failure values. CONCLUSIONS Only following a '2.5-mm deep endocrown' design, composite appeared more favorable than lithium disilicate glass-ceramic as crown material; this may be explained by their difference in elastic modulus. CLINICAL SIGNIFICANCE Shallow endocrown preparations on premolars present less surface for adhesive luting and a difference in crown material becomes apparent in terms of load-to-failure. The use of a more flexible composite crown material appeared then a better option.
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Endocrown restorations: A systematic review and meta-analysis. J Dent 2016; 52:8-14. [DOI: 10.1016/j.jdent.2016.07.005] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 07/07/2016] [Accepted: 07/11/2016] [Indexed: 11/21/2022] Open
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A novel anatomical short glass fiber reinforced post in an endodontically treated premolar mechanical resistance evaluation using acoustic emission under fatigue testing. J Mech Behav Biomed Mater 2016; 65:151-159. [PMID: 27572232 DOI: 10.1016/j.jmbbm.2016.08.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Revised: 08/05/2016] [Accepted: 08/08/2016] [Indexed: 11/20/2022]
Abstract
This study evaluates the fracture resistance in an endodontically treated tooth using circular fiber-reinforced composite (FRC) and innovated anatomical short glass fiber reinforced (SGFR) posts under fatigue testing, monitored using the acoustic emission (AE) technique. An anatomical SGFR fiber post with an oval shape and slot/notch design was manufactured using an injection-molding machine. Crown/core maxillary second premolar restorations were executed using the anatomical SGFR and commercial cylindrical fiber posts under fatigue test to understand the mechanical resistances. The load versus AE signals in the fracture and fatigue tests were recorded to evaluate the restored tooth failure resistance. The static fracture resistance results showed that teeth restored using the anatomical SGFR post presented higher resistance than teeth restored using the commercial FRC post. The fatigue test endurance limitation (1.2×106 cycles) was 207.1N for the anatomical SGFR fiber post, higher than the 185.3N found with the commercial FRC post. The average accumulated number of AE signals and corresponding micro cracks for the anatomical SGFR fiber post (153.0 hits and 2.44 cracks) were significantly lower than those for the commercial FRC post (194.7 hits and 4.78 cracks) under 40% of the static maximum resistance fatigue test load (pass 1.2×106 cycles). This study concluded that the anatomical SGFR fiber post with surface slot/notch design made using precise injection molding presented superior static fracture resistance and fatigue endurance limitation than those for the commercial FRC post in an endodontically treated premolar.
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Aktas G, Yerlikaya H, Akca K. Mechanical Failure of Endocrowns Manufactured with Different Ceramic Materials: An In Vitro Biomechanical Study. J Prosthodont 2016; 27:340-346. [PMID: 27465810 DOI: 10.1111/jopr.12499] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2016] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To evaluate the effect of different silica-based ceramic materials on the mechanical failure behavior of endocrowns used in the restoration of endodontically treated mandibular molar teeth. MATERIALS AND METHODS Thirty-six intact mandibular molar teeth extracted because of a loss of periodontal support received root canal treatment. The teeth were prepared with a central cavity to support the endocrowns, replacing the occlusal surface with mesial-lingual-distal walls. Data acquisition of the prepared tooth surfaces was carried out digitally with a powder-free intraoral scanner. Restoration designs were completed on manufactured restorations from three silicate ceramics: alumina-silicate (control), zirconia-reinforced (Zr-R), and polymer-infiltrated (P-I). Following adhesive cementation, endocrowns were subjected to thermal aging, and then, each specimen was obliquely loaded to record the fracture strength and define the mechanical failure. For the failure definition, the fracture type characteristics were identified, and further analytic measurements were made on the fractured tooth and ceramic structure. RESULTS Load-to-fracture failure did not differ significantly, and the calculated mean values were 1035.08 N, 1058.33 N, and 1025.00 N for control, Zr-R, and P-I groups, respectively; however, the stiffness of the restoration-tooth complex was significantly higher than that in both test groups. No statistically significant correlation was established in paired comparisons of the failure strength, restorative stiffness, and fractured tooth distance parameters. The failure mode for teeth restored with zirconia-reinforced glass ceramics was identified as non-restorable. The resin interface in the control and P-I groups presented similar adhesive failure behavior. CONCLUSION Mechanical failure of endocrown restorations does not significantly differ for silica-based ceramics modified either with zirconia or polymer.
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Affiliation(s)
- Guliz Aktas
- Department of Prosthodontics, Hacettepe University, Ankara, Turkey
| | - Hatice Yerlikaya
- Department of Prosthodontics, Hacettepe University, Ankara, Turkey
| | - Kivanc Akca
- Department of Prosthodontics, Hacettepe University, Ankara, Turkey
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Spreafico R, Brenna F, Nuvina M, Robello C, Grassi M, Gagliani M. La ricostruzione parziale negli elementi posteriori con metodiche di impronta digitale. DENTAL CADMOS 2016. [DOI: 10.1016/s0011-8524(16)30034-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Huang SF, Chen WR, Lin CL. Biomechanical interactions of endodontically treated tooth implant-supported prosthesis under fatigue test with acoustic emission monitoring. Biomed Eng Online 2016; 15:23. [PMID: 26912169 PMCID: PMC4765056 DOI: 10.1186/s12938-016-0140-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 02/14/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study investigated the biomechanical interactions in endodontically treated tooth implant-supported prosthesis (TISP) with implant system variations under dynamic cyclic loads monitored using the acoustic emission (AE) technique. METHODS Macrostructure implants using a taper integrated screw-in (TIS; 2-piece implant) and a retaining-screw (RS; 3-piece implant) connected to an abutment were used for this investigation and their corresponding mechanical resistances in conformity with the ISO 14801 standard were evaluated. The endodontically treated TISP samples were constructed containing TIS and RS implants splinted to the second premolar with fatigue tests performed by applying occlusal force onto the premolar simulating the bending moment effect. The numbers of accumulated AE signals in the fatigue tests and failure modes for the sample were recorded to evaluate the mechanical resistance. RESULT The maximum load in the static test for RS (3-piece) implant (797N) was significantly higher than that for the TIS (2-piece) implant (559N). Large deformations were found at abutment screws in both RS and TIS implants. Although the numbers of accumulated AE signals for the TIS implant (72511) were higher than those for the RS implant (437), statistical non-significant differences were found between TIS and RS implants. No obvious damage was noted in endodontically treated TISP samples using RS implants but two of the corresponding TIS implants fractured in the abutment screws. CONCLUSIONS Splints with RS (3-piece) implant prosthesis produce better mechanical responses than the TIS (2-piece) implant when connected to an endodontically treated tooth restored with a post core and crown.
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Affiliation(s)
- Shao-Fu Huang
- Department of Biomedical Engineering, National Yang-Ming University, 2 No.155, Sec.2, Linong Street, 112, Taipei, Taiwan.
| | - Wan-Rung Chen
- Department of Biomedical Engineering, National Yang-Ming University, 2 No.155, Sec.2, Linong Street, 112, Taipei, Taiwan.
| | - Chun-Li Lin
- Department of Biomedical Engineering, National Yang-Ming University, 2 No.155, Sec.2, Linong Street, 112, Taipei, Taiwan.
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Carvalho AO, Bruzi G, Anderson RE, Maia HP, Giannini M, Magne P. Influence of Adhesive Core Buildup Designs on the Resistance of Endodontically Treated Molars Restored With Lithium Disilicate CAD/CAM Crowns. Oper Dent 2015; 41:76-82. [PMID: 26266647 DOI: 10.2341/14-277-l] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To assess the influence of adhesive core buildup designs (4-mm buildup, 2-mm buildup, and no buildup/endocrown) on the fatigue resistance and failure mode of endodontically treated molar teeth restored with lithium disilicate computer-aided design/computer-aided manufacturing (CAD/CAM) complete crowns placed with self-adhesive cement. METHODS AND MATERIALS Forty-five extracted molars were decoronated at the level of the cementoenamel junction and endodontically treated. Specimens received different Filtek Z100 adhesive core buildups (4-mm buildup; 2-mm buildup; and no buildup endocrown preparation) and were restored with Cerec 3 CAD/CAM lithium disilicate crowns (IPS e.max CAD). The intaglio surfaces of restorations (n=15) were conditioned by hydrofluoric acid etching and silane, and prepared teeth were treated with airborne-particle abrasion, followed by cementation with RelyX Unicem 2 Automix. Specimens were then subjected to cyclic isometric loading at 10 Hz, beginning with a load of 200 N (×5000 cycles), followed by stages of 400, 600, 800, 1000, 1200, and 1400 N at a maximum of 30,000 cycles each. Specimens were loaded until failure or to a maximum of 185,000 cycles. The chewing cycle was simulated by an isometric contraction (load control) applied through a 10-mm in diameter composite resin sphere (Filtek Z100). Surviving specimens were axially loaded until failure or to a maximum load of 4500 N (crosshead speed 0.5 mm/min). The failure mode was assessed, and fractures were designated as catastrophic (tooth/root fracture that would require tooth extraction) or reparable (cohesive or cohesive/adhesive fracture of restoration only). Groups were compared using the life table survival analysis (log-rank test at p=0.05). Surviving specimens were loaded to failure and compared with one-way analysis of variance. RESULTS The survival rates after the fatigue test were 100%, 93%, and 100% for 4-mm, 2-mm, and no buildup (endocrown), respectively and were not statistically different (only one specimen failed with a 2-mm buildup under a crown that cohesively fractured at 1,400 N). Postfatigue load to failure averaged 3181 N for 4-mm buildups (15 specimens), 3759 N for 2-mm buildups (12 specimens), and 3265 N for endocrowns (14 specimens). The 2-mm buildups were associated with higher loads to failure than endocrowns and 4-mm buildups, but no differences were found between 4-mm buildups and endocrowns (p<0.05.) One endocrown and 2 restorations with a 2-mm buildup survived the load-to-failure test (at 4500 N). Only catastrophic fractures occurred after the load-to-failure test. CONCLUSIONS The buildup design influenced the performance of endodontically treated molars restored with lithium disilicate CAD/CAM complete crowns placed with self-adhesive resin cement. The 2-mm buildups were associated with higher loads to failure than the endocrown and the 4-mm buildup, but all restoration designs survived far beyond the normal range of masticatory forces.
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Souza ACO, Xavier TA, Platt JA, Borges ALS. Effect of Base and Inlay Restorative Material on the Stress Distribution and Fracture Resistance of Weakened Premolars. Oper Dent 2015; 40:E158-66. [DOI: 10.2341/14-229-l] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
The purpose of this study was to evaluate the influence of direct base and indirect inlay materials on stress distribution and fracture resistance of endodontically treated premolars with weakened cusps. Forty healthy human premolars were selected; five were left intact as controls (group C+), and the others were subjected to endodontic treatment and removal of buccal and lingual cusp dentin. Five teeth were left as negative controls (group C−). The remaining 30 teeth were divided into two groups according to the direct base material (glass ionomer [GIC] or composite resin [CR]). After base placement, each group was subjected to extensive inlay preparation, and then three subgroups were created (n=5): no inlay restoration (GIC and CR), restored with an indirect composite resin inlay (GIC+IR and CR+IR), and restored with a ceramic inlay (GIC+C and CR+C). Each specimen was loaded until fracture in a universal testing machine. For finite element analysis, the results showed that the removal of tooth structure significantly affected fracture resistance. The lowest values were presented by the negative control group, followed by the restored and based groups (not statistically different from each other) and all lower than the positive control group. In finite element analysis, the stress concentration was lower in the restored tooth compared to the tooth without restoration, whereas in the restored teeth, the stress concentration was similar, regardless of the material used for the base or restoration. It can be concluded that the inlay materials combined with a base showed similar behavior and were not able to regain the strength of intact tooth structure.
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Affiliation(s)
- ACO Souza
- Ana Carolina de Oliveira Souza, DDS, MS, Department of Dental Materials and Prosthodontics, Institute of Science and Technology, Universidade Estadual Paulista, São José dos Campos, SP, Brazil
| | - TA Xavier
- Tathy Aparecida Xavier, PhD, Department of Dental Materials, School of Dentistry, Universidade de of São Paulo, São Paulo, SP, Brazil
| | - JA Platt
- Jeffrey A Platt, DDS, MS, Department of Restorative Dentistry, Indiana University School of Dentistry, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA
| | - ALS Borges
- Alexandre Luiz Souto Borges, DDS, MS, PhD, Department of Dental Materials and Prosthodontics, Institute of Science and Technology, Universidade Estadual Paulista, São José dos Campos, SP, Brazil
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Modeling of damage driven fracture failure of fiber post-restored teeth. J Mech Behav Biomed Mater 2015; 49:277-89. [PMID: 26056997 DOI: 10.1016/j.jmbbm.2015.05.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 04/25/2015] [Accepted: 05/07/2015] [Indexed: 11/23/2022]
Abstract
Mechanical failure of biomaterials, which can be initiated by either violent force, or progressive stress fatigue, is a serious issue. Great efforts have been made to improve the mechanical performances of dental restorations. Virtual simulation is a promising approach for biomechanical investigations, which presents significant advantages in improving efficiency than traditional in vivo/in vitro studies. Over the past few decades, a number of virtual studies have been conducted to investigate the biomechanical issues concerning dental biomaterials, but only with limited incorporation of brittle failure phenomena. Motivated by the contradictory findings between several finite element analyses and common clinical observations on the fracture resistance of post-restored teeth, this study aimed to provide an approach using numerical simulations for investigating the fracture failure process through a non-linear fracture mechanics model. The ability of this approach to predict fracture initiation and propagation in a complex biomechanical status based on the intrinsic material properties was investigated. Results of the virtual simulations matched the findings of experimental tests, in terms of the ultimate fracture failure strengths and predictive areas under risk of clinical failure. This study revealed that the failure of dental post-restored restorations is a typical damage-driven continuum-to-discrete process. This approach is anticipated to have ramifications not only for modeling fracture events, but also for the design and optimization of the mechanical properties of biomaterials for specific clinically determined requirements.
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Sevimli G, Cengiz S, Oruc MS. Endocrowns: review. J Istanb Univ Fac Dent 2015; 49:57-63. [PMID: 28955538 PMCID: PMC5573486 DOI: 10.17096/jiufd.71363] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 12/02/2014] [Indexed: 11/22/2022] Open
Abstract
The ideal restoration of endodontically treated
teeth (ETT) has been widely and controversially
discussed in the literature. Prevention of healthy
dental structure is essential to help mechanical
stabilization of tooth-restoration integrity, increase
the amount of suitable surfaces for adhesion and
thus positively affect the long-term success. ETT are
affected by a higher risk of biomechanical failure than
vital teeth. With the development of adhesive systems,
the need for post-core restorations is also reduced.
Especially for restoration of excessively damaged
ETT, endocrowns have been used as an alternative to
the conventional post-core and fixed partial dentures.
Compared to conventional methods, good aesthetics,
better mechanical performance, and less cost and
clinic time are the advantages of endocrowns.
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Affiliation(s)
- Gaye Sevimli
- Department of Prosthodontics, Faculty of Dentistry, Bulent Ecevit University, Turkey
| | - Seda Cengiz
- Department of Prosthodontics, Faculty of Dentistry, Bulent Ecevit University, Turkey
| | - M Selcuk Oruc
- Department of Prosthodontics, Faculty of Dentistry, Bulent Ecevit University, Turkey
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Rocca GT, Saratti CM, Poncet A, Feilzer AJ, Krejci I. The influence of FRCs reinforcement on marginal adaptation of CAD/CAM composite resin endocrowns after simulated fatigue loading. Odontology 2015; 104:220-32. [DOI: 10.1007/s10266-015-0202-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 02/17/2015] [Indexed: 11/29/2022]
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Homsy F, Eid R, El Ghoul W, Chidiac JJ. Considerations for Altering Preparation Designs of Porcelain Inlay/Onlay Restorations for Nonvital Teeth. J Prosthodont 2015; 24:457-62. [PMID: 25754648 DOI: 10.1111/jopr.12279] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2014] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The aim of this study was to compare all ceramic inlay/onlay survival rates in vital and nonvital teeth having the same cavity design. Filling the pulp chamber with ceramic materials or not was also discussed. MATERIALS AND METHODS Ceramic class II inlays/onlays were made on 11 premolars and 30 molars: 14 vital, 27 endodontically treated. The same tooth preparation design was performed on vital and nonvital teeth: In nonvital teeth the pulp chambers were covered by a glass ionomer cement until the pulpal floor depths were between 2 and 2.5 mm, more likely similar to the vital teeth preparations. In vital teeth, glass ionomer was used as a liner to achieve pulpal floor depths between 2 and 2.5 mm when needed. The restorations were assessed (at baseline, 6 months, 1 and 2 years) according to three criteria: marginal discoloration, marginal integrity, and fracture of teeth/restorations, consistent with United States Public Health Service (USPHS) criteria. RESULTS Eight teeth (19%) showed minor marginal discolorations, while three molars (7%) had loss of marginal integrity. These margins were adjusted using rubber polishing cups and were then judged clinically acceptable. From these three molars, one was vital and two were endodontically treated. No fracture of teeth or restorations was observed. Chi square and exact probability tests were used. There was no statistical difference between vital and nonvital teeth (p = 0.719 chi-squared and Fisher) or between premolars and molars (p = 0.564 chi-squared; 1.000, Fisher). CONCLUSION Within the limitations of this study there was no difference for the same inlay/onlay cavity design between vital and nonvital teeth. In nonvital teeth, it seems that filling the pulp chamber with a ceramic core material is not important. Long-term observation periods are needed to reinforce the clinical behavior outcome.
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Affiliation(s)
- Foudda Homsy
- Department of Prosthodontics, Lebanese University, Baabda, Lebanon
| | - Rita Eid
- Department of Prosthodontics, Lebanese University, Baabda, Lebanon
| | - Wiam El Ghoul
- Department of Prosthodontics, Lebanese University, Baabda, Lebanon
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El-Damanhoury HM, Haj-Ali RN, Platt JA. Fracture resistance and microleakage of endocrowns utilizing three CAD-CAM blocks. Oper Dent 2015; 40:201-10. [PMID: 25268039 DOI: 10.2341/13-143-l] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study assessed marginal leakage and fracture resistance of computer-aided design/computer-aided manufacturing (CAD/CAM) fabricated ceramic crowns with intracoronal extensions into the pulp chambers of endodontically treated teeth (endocrowns) using either feldspathic porcelain (CEREC Blocks [CB], Sirona Dental Systems GmbH, Bensheim, Germany), lithium disilicate (e.max [EX], Ivoclar Vivadent, Schaan, Liechtenstein), or resin nanoceramic (Lava Ultimate [LU], 3M ESPE, St Paul, MN, USA).). Thirty extracted human permanent maxillary molars were endodontically treated. Standardized preparations were done with 2-mm intracoronal extensions of the endocrowns into the pulp chamber. Teeth were divided into three groups (n=10); each group was restored with standardized CAD/CAM fabricated endocrowns using one of the three tested materials. After cementation with resin cement, specimens were stored in distilled water at 37°C for one week, subjected to thermocycling, and immersed in a 5% methylene-blue dye solution for 24 hours. A compressive load was applied at 35 degrees to long axis of the teeth using a universal testing machine until failure. Failure load was recorded, and specimens were examined under a stereomicroscope for modes of failure and microleakage. Results were analyzed using one-way analysis of variance and Bonferroni post hoc multiple comparison tests (α=0.05). LU showed significantly (p<0.05) higher fracture resistance and more favorable fracture mode (ie, fracture of the endocrown without fracture of tooth) as well as higher dye penetration than CB and EX. In conclusion, although using resin nanoceramic blocks for fabrication of endocrowns may result in better fracture resistance and a more favorable fracture mode than other investigated ceramic blocks, more microleakage may be expected with this material.
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Maccari D. La preparazione tipo “endo-crown” per la ricostruzione degli elementi anteriori. DENTAL CADMOS 2015. [DOI: 10.1016/s0011-8524(15)30013-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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EREIFEJ NS, OWEIS YG, ALTARAWNEH SK. Fracture of fiber-reinforced composites analyzed via acoustic emission. Dent Mater J 2015; 34:417-24. [DOI: 10.4012/dmj.2014-325] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Nadia S EREIFEJ
- Department of Prosthodontics, Faculty of Dentistry, University of Jordan
| | - Yara G OWEIS
- Department of Conservative Dentistry, Faculty of Dentistry, University of Jordan
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Chang YH, Yu JJ, Lin CL. Examination of ceramic restoration adhesive coverage in cusp-replacement premolar using acoustic emission under fatigue testing. Biomed Eng Online 2014; 13:165. [PMID: 25495010 PMCID: PMC4273487 DOI: 10.1186/1475-925x-13-165] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 11/19/2014] [Indexed: 11/10/2022] Open
Abstract
Background This study investigates CAD/CAM ceramic cusp-replacing restoration resistance with and without buccal cusp replacement under static and dynamic cyclic loads, monitored using the acoustic emission (AE) technique. Method The cavity was designed in a typical MODP (mesial-occlusal-distal-palatal) restoration failure shape when the palatal cusp has been lost. Two ceramic restorations [without coverage (WOC) and with (WC) buccal cuspal coverage with 2.0 mm reduction in cuspal height] were prepared to perform the fracture and fatigue tests with normal (200 N) and high (600 N) occlusal forces. The load versus AE signals in the fracture and fatigue tests were recorded to evaluate the restored tooth failure resistance. Results The results showed that non-significant differences in load value in the fracture test and the accumulated number of AE signals under normal occlusal force (200 N) in the fatigue test were found between with and without buccal cuspal coverage restorations. The first AE activity occurring for the WOC restoration was lower than that for the WC restoration in the fracture test. The number of AE signals increased with the cyclic load number. The accumulated number of AE signals for the WOC restoration was 187, higher than that (85) for the WC restoration under 600 N in the fatigue test. Conclusion The AE technique and fatigue tests employed in this study were used as an assessment tool to evaluate the resistances in large CAD/CAM ceramic restorations. Non-significant differences in the tested fracture loads and accumulated number of AE signals under normal occlusal force (200 N) between different restorations indicated that aggressive treatment (with coverage preparation) in palatal cusp-replacing ceramic premolars require more attention for preserving and protecting the remaining tooth.
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Affiliation(s)
| | | | - Chun-Li Lin
- Department of Biomedical Engineering, National Yang-Ming University, No,155, Sec,2, Linong Street, Taipei 112, Taiwan.
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Lin CL, Kuo WC, Chang YH, Yu JJ, Lin YC. Examination of ceramic/enamel interfacial debonding using acoustic emission and optical coherence tomography. Dent Mater 2014; 30:910-6. [PMID: 24958691 DOI: 10.1016/j.dental.2014.05.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2013] [Revised: 04/04/2014] [Accepted: 05/21/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE This study investigates monitored micro-crack growth and damage in the ceramic/enamel adhesive interface using the acoustic emission (AE) technique with optical coherence tomography (OCT) under fatigue shear testing. METHODS Shear bond strength (SBS) was measured first with eight prepared ceramic/enamel adhesive specimens under static loads. The fatigue shear testing was performed with three specimens at each cyclic load according to a modified ISO14801 method, applying at 80%, 75%, 70%, and 65% of the SBS to monitor interface debonding. The number of cycles at each load was recorded until ceramic/enamel adhesive interface debonding occurred. The AE technique was used to detect micro-crack signals in static and fatigue shear bond tests. RESULTS The results showed that the average SBS value in the static tests was 18.07 ± 1.72 MPa (mean ± standard deviation), expressed in Newton's at 56.77 ± 5.40N. The average number of fatigue cycles in which ceramic/enamel interface damage was detected in 80%, 75%, 70% and 65% of the SBS were 41, 410, 8141 and 76,541, respectively. The acoustic behavior varied according to the applied load level. Events were emitted during 65% and 70% fatigue tests. A good correlation was observed between the crack location in OCT images and the number of AE signal hits. SIGNIFICANCE The AE technique combined with OCT images as a pre-clinical assessment tool to determine the integrity of cemented load bearing restored ceramic material. Sustainable cyclic load stresses in ceramic/enamel bonded specimens were substantially lower than the measured SBS. Predicted S-N curve showed that the maximum endured load was 10.98 MPa (about 34.48 N) passing 10(6) fatigue cyclic.
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Affiliation(s)
- Chun-Li Lin
- Department of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan.
| | - Wen-Chuan Kuo
- Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan.
| | - Yen-Hsiang Chang
- Department of General Dentistry, Chang Gung Memorial Hospital, Tao-yuan, Taiwan.
| | - Jin-Jie Yu
- Department of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan.
| | - Yun-Chu Lin
- Department of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan.
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Restoration of endodontically treated molars using all ceramic endocrowns. Case Rep Dent 2014; 2013:210763. [PMID: 24455318 PMCID: PMC3881385 DOI: 10.1155/2013/210763] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 11/17/2013] [Indexed: 11/17/2022] Open
Abstract
Clinical success of endodontically treated posterior teeth is determined by the postendodontic restoration. Several options have been proposed to restore endodontically treated teeth. Endocrowns represent a conservative and esthetic restorative alternative to full coverage crowns. The preparation consists of a circular equigingival butt-joint margin and central retention cavity into the entire pulp chamber constructing both the crown and the core as a single unit. The case reports discussed here are moderately damaged endodontically treated molars restored using all ceramic endocrowns fabricated using two different systems, namely, CAD/CAM and pressed ceramic.
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3D-Finite element analysis of molars restored with endocrowns and posts during masticatory simulation. Dent Mater 2013; 29:e309-17. [DOI: 10.1016/j.dental.2013.09.014] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Revised: 07/03/2013] [Accepted: 09/25/2013] [Indexed: 11/18/2022]
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Lin CL, Kuo WC, Yu JJ, Huang SF. Examination of ceramic restorative material interfacial debonding using acoustic emission and optical coherence tomography. Dent Mater 2013; 29:382-8. [DOI: 10.1016/j.dental.2012.12.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2012] [Revised: 10/23/2012] [Accepted: 12/14/2012] [Indexed: 10/27/2022]
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Rocca GT, Rizcalla N, Krejci I. Fiber-reinforced resin coating for endocrown preparations: a technical report. Oper Dent 2012; 38:242-8. [PMID: 22917439 DOI: 10.2341/12-139-tr] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Coronal rehabilitation of endodontically treated posterior teeth is still a controversial issue. Although the use of classical crowns supported by radicular metal posts remains widespread in dentistry, their invasiveness has been largely criticized. New materials and therapeutic options based entirely on adhesion are available nowadays, from direct composite resins to indirect endocrowns. They allow for a more conservative, faster, and less expensive dental treatment. However, the absence of a metal or high-strength ceramic substructure as in full-crown restorations can expose this kind of restoration to a higher risk of irreversible fracture in case of crack propagation. The aim of this case report is to present a technique to reinforce the cavity of an endodontically treated tooth by incorporating a fiber-reinforced composite (FRC) layer into the resin coating of the tooth preparation, before the final impressions of the cavity. This technique allows the use of FRCs in combination with any kind of restorative material for an adhesive overlay/endocrown.
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Affiliation(s)
- G T Rocca
- Geneva School of Dentistry, Department of Cariology and Endodontology, Geneva, Switzerland.
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