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Ghanem N, Ali H, Bahrli N, Hassan H. Clinical performance of custom-milled polyetherketoneketone (PEKK) posts and cores: A 12-month follow-up randomized controlled pilot study. Clin Exp Dent Res 2024; 10:e854. [PMID: 38433309 PMCID: PMC10909799 DOI: 10.1002/cre2.854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/12/2023] [Accepted: 01/26/2024] [Indexed: 03/05/2024] Open
Abstract
OBJECTIVES Comparing the survival rate and the cumulative success rates of custom-milled polyetherketone ketone posts and cores (MPP) with prefabricated fiber posts (PFP) in restoring compromised endodontically treated premolars. MATERIAL AND METHODS This was a randomized, double-blind, parallel, two-arm controlled pilot study. A total of 24 patients (12 males, 12 females), each had a compromised lower premolar, needed a root canal treatment and to be restored with post and core. Patients were randomly allocated into two groups, MPP-group: restored with MPP, and PFP-group: restored with PFP and composite cores. After that, premolars were restored with single porcelain fused to metal (PFM) crowns. Clinical and radiographic follow-ups were conducted after 3, 6, and 12 months. The Kaplan-Meier, log-Rank, and χ2 tests were used to investigate differences between the two groups at the 0.05 significance level. RESULTS The survival rate after 12 months in the MPP and PFP groups was 66.7% and 100%, respectively. Meanwhile, the cumulative success rates were 63.6% and 100% in the same order. The log-rank test showed a significant difference between the two groups (p = .031). The difference in cumulative success rates was also significant, as the χ2 test revealed (p = .011). CONCLUSION The PFP group showed a higher success rate than the MPP group and according to the failure types, PEKK posts seem to be inferior to PFP in terms of the mechanical properties and bonding to resin mechanism. TRIAL REGISTRATION ISRCTN, ISRCTN13456471. October, 14, 2019. (https://doi.org/10.1186/ISRCTN13456471ISRCTN13456471).
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Affiliation(s)
- Naif Ghanem
- Department of Fixed Prosthodontics, Faculty of DentistryTishreen UniversityLatakiaSyria
| | - Hasan Ali
- Department of Pediatric Dentistry, Faculty of DentistryTishreen UniversityLatakiaSyria
| | - Nasser Bahrli
- Department of Fixed Prosthodontics, Faculty of DentistryTishreen UniversityLatakiaSyria
| | - Hazem Hassan
- Department of Orthodontics, Faculty of DentistryTishreen UniversityLatakiaSyria
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Hawthan M, Larsson C, Chrcanovic BR. Survival of fixed prosthetic restorations on vital and nonvital teeth: A systematic review. J Prosthodont 2024; 33:110-122. [PMID: 37455556 DOI: 10.1111/jopr.13735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 07/06/2023] [Indexed: 07/18/2023] Open
Abstract
PURPOSE To evaluate the survival rate of full-coverage tooth-supported fixed prosthetic restorations, single crowns (SCs), and fixed dental prostheses (FDPs), taking into consideration the potential influence of tooth-vitality, presence and type of post, and type of prosthetic restoration material. MATERIALS AND METHODS In October 2022, two authors independently conducted a search in PubMed, Web of Science, and Scopus electronic databases as well as a hand search to identify clinical human studies on full-coverage SCs and FDPs supported by vital and/or non-vital abutments and/or a combination of both, with a minimum observation period of 24 months. RESULTS Out of 4198 studies identified through the database search and 22 through hand searching, 26 studies fulfilled the inclusion criteria and were included in the analysis of the present systematic review. Included studies scored six points and more according to Newcastle-Ottawa Scale (NOS). The highest estimated 5-year survival rate was observed for (metal-ceramic and all-ceramic) SCs on vital teeth (98.3%; 95% CI [98.1, 98.6%]) and all ceramic SCs on non-vital teeth with fiber post (95.0%; 95% CI [94.5-95.4%]). Metal-ceramic SCs on vital teeth (97.1%; 95% CI [95.6-98.7%]) showed a statistically significant higher estimated 5-year survival rate compared to metal-ceramic SCs with cast metal post (90.7%; 95% CI [87.4-94.0%], P < 0.001), fiber post (91.3%; 95% CI [90.9-91.6%], P < 0.001) and without post (85.7%; 95% CI [80.7, 90.6%], P < 0.032). All-ceramic SCs with fiber post had a statistically significant higher estimated 5-year survival rate (95.0%; 95% CI [94.5-95.4%]) compared to metal-ceramic SCs on non-vital teeth with fiber post (91.3%; 95% CI [90.9-91.6%], P < 0.001). SCs (all-ceramic and metal-ceramic) with fiber post had a statistically significantly higher estimated 5-year survival rate of (92.7%; 95% CI [92.4-92.9%]) than SCs made of metal-ceramic and retained by cast metal post (90.7%; 95% CI [87.4-94.0%], P < 0.001). For FDPs, the 5-year survival rate was significantly higher for FDPs on vital abutments (84.9%; 95% CI [75.9, 93.9%]) compared to FDPs retained by non-vital abutment/s (81.3%; 95% CI [80.3, 82.2%], P = 0.049) irrespective to presence, type of post, and FDPs material. The results are limited by the limited number of studies and the presence of uncontrolled confounding clinical variables. CONCLUSIONS Within the limitations of the study, tooth vitality is suggested to contribute positively to the survival of SCs and FDPs.
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Affiliation(s)
- Mohammed Hawthan
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Christel Larsson
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Bruno R Chrcanovic
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Al-Dabbagh RA, Sindi MA, Sanari MA, Manna AI, Al-Dabbagh MA. Effect of a circumferential ferrule on the survival and success of endodontically treated teeth restored with fiber posts: A systematic review and meta-analysis. J Prosthet Dent 2024:S0022-3913(23)00809-0. [PMID: 38216376 DOI: 10.1016/j.prosdent.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/29/2023] [Accepted: 12/01/2023] [Indexed: 01/14/2024]
Abstract
STATEMENT OF PROBLEM The success of endodontically treated teeth (ETT) is influenced by factors that include the use of prefabricated glass fiber posts. A consideration for success is the presence of a circumferential ferrule, but systematic reviews and meta-analyses are lacking. PURPOSE The purpose of this systematic review and meta-analysis was to assess the impact of the presence or absence of a circumferential ferrule on the survival and success rates of ETT restored with prefabricated fiber posts. MATERIAL AND METHODS Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search of the major scientific literature databases was conducted. Eligible studies included randomized clinical trials and prospective cohort studies with a minimum 6-month follow-up, focusing on ETT restored with fiber posts either with or without a uniform circumferential ferrule. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated to compare outcomes. The degree of variability among studies was assessed using the chi-squared test (α=.05). RESULTS Of 3731 identified records, 8 were eligible for inclusion. Direct analysis of success rates (2 studies, 123 teeth) showed a significant increase in success when a uniform circumferential ferrule was present (RR=1.28, 95% CI: 1.06, 1.54, P<.05). However, indirect analysis of survival and success rates (8 studies, 407 teeth) indicated no significant differences in outcomes between the ferrule and no ferrule groups (P>.05). CONCLUSIONS The results of this systematic review and meta-analysis determined that a uniform circumferential ferrule had a positive effect on the success rates of ETT restored with prefabricated fiber posts. However, further high-quality studies are required to provide more robust evidence and to allow potential confounding factors to be considered.
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Affiliation(s)
- Raghad A Al-Dabbagh
- Associate Professor and Prosthodontics Consultant, Oral and Maxillofacial Rehabilitation Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Mohammed A Sindi
- Graduate student, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed A Sanari
- Graduate student, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Alaa I Manna
- Assistant Professor and Restorative Dentistry Consultant, Department of Restorative Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mona A Al-Dabbagh
- Pediatric Infectious Diseases and Transplant Infectious Diseases Consultant, King Abdulaziz Medical City, Jeddah, Saudi Arabia; and Clinical Assistant Professor in Pediatric Infectious Diseases, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
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de Morais DC, Butler S, Santos MJMC. Current Insights on Fiber Posts: A Narrative Review of Laboratory and Clinical Studies. Dent J (Basel) 2023; 11:236. [PMID: 37886921 PMCID: PMC10605739 DOI: 10.3390/dj11100236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/21/2023] [Accepted: 10/07/2023] [Indexed: 10/28/2023] Open
Abstract
PURPOSE The aim of this study was to review the literature related to the clinical performance and laboratory findings regarding fiber posts, as well as the cementation technique employed with their use. MATERIALS AND METHODS A literature search was performed using an electronic database, PubMed/Medline, between 2010 and 2023. The terms used were "intra coronal post, fiber post, post cementation, and post length". Titles and abstracts were initially screened, and a full-text assessment was conducted for those that fulfilled the inclusion criteria. The reference list of the collected papers was also screened for further relevant citations. RESULTS In this work, 135 potentially eligible studies were analyzed. Titles and abstracts of 90 studies followed the inclusion criteria and were selected for a full-text assessment, resulting in 50 studies selected. Moreover, additional studies from relevant citations were included, totaling 57 studies. CONCLUSION According to the laboratory and clinical studies revised, the survival rate between fiber and prefabricated and cast metal posts was similar, and failures were mainly related to the loss of retention. The intra-canal post length of less than two-thirds of the root length presented successful results when ferrule was present. Furthermore, the ferrule increased the longevity of teeth restored with fiber posts. Additionally, the use of a surface treatment protocol for fiber posts and the adhesive cementation technique both contributed to the clinical success and longevity of the intra-canal post.
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Giok KC, Veettil SK, Menon RK. Comparative effectiveness of fiber and metal posts in the restoration of endodontically treated teeth: A systematic review with network meta-analysis. J Prosthet Dent 2023:S0022-3913(23)00569-3. [PMID: 37827970 DOI: 10.1016/j.prosdent.2023.08.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 10/14/2023]
Abstract
STATEMENT OF PROBLEM Different varieties of fiber and metal intraradicular posts have been used for the restoration of endodontically treated teeth with insufficient sound tooth structure. Evidence on the comparative efficacy of posts in a clinical setting is insufficient to provide clear clinical guidelines and recommendations. PURPOSE The purpose of this systematic review with network meta-analysis was to assess the comparative efficacy of fiber and metal posts used for the restoration of endodontically treated teeth. MATERIAL AND METHODS A search was conducted for trials published in Medline, Scopus, PubMed, and Cochrane Central Register of Controlled Trials from inception until November 2022. The study was registered with the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42022384340). A network meta-analysis was performed on data from randomized controlled trials that assessed the comparative efficacy of fiber posts and metal posts for the restoration of endodontically treated teeth. Subgroup analyses were performed to compare all the varieties of fiber and metal posts. The types of posts were ranked according to their efficacy using the Surface Under the Cumulative Ranking (SUCRA) system. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach was used to assess the level of certainty of evidence. RESULTS Twenty-five articles were included in the quantitative analysis. Fiber posts (RR=0.15 [95% CI: 0.06, 0.33]) significantly prevented tooth fracture as compared with no posts. Prefabricated carbon fiber posts (RR=0.06 [95% CI: 0, 0.54]) ranked highest followed by custom glass fiber posts (RR=0.15 [95% CI: 0.04, 0.52]) and prefabricated glass fiber posts (RR=0.22 [95% CI: 0.07, 0.62]) in the outcome of tooth fracture. Metal posts (RR=0.24 [95% CI: 0.12, 0.46]) ranked higher than fiber posts (RR=0.39 [95% CI: 0.27, 0.56]) in the outcome of debonding. Custom gold alloy posts (RR=0.12 [95% CI: 0.03, 0.48]), prefabricated gold alloy posts (RR=0.04 [95% CI: 0.00, 0.87]), and prefabricated titanium posts (RR=0.21 [95% CI: 0.10, 0.45]) had higher rankings in the outcome of debonding or loss of retention of a post followed by custom glass fiber posts (RR=0.37 [95% CI: 0.21, 0.63]) and prefabricated glass fiber posts (RR=0.38 [95%CI: 0.25, 0.58]). Prefabricated glass fiber posts (RR=0.40 [95% CI: 0.20, 0.81]) had statistically significant differences in the outcome of secondary caries. The GRADE approach determined a moderate level of certainty of evidence. CONCLUSIONS The use of a fiber post when indicated results in reduced risk of tooth fracture as compared with no post. Prefabricated carbon fiber posts, prefabricated glass fiber posts, and custom glass fiber posts reveal a lower risk of tooth fracture. Overall, the use of prefabricated glass fiber posts had a lower risk of tooth fracture, debonding, and secondary caries. However, more trials with longer follow-up periods are recommended to enhance the certainty of evidence.
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Affiliation(s)
- Koay Chun Giok
- Predoctoral student, School of Dentistry, International Medical University, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Sajesh K Veettil
- Research Associate, Department of Pharmacotherapy, College of pharmacy, University of Utah, Salt Lake City, Utah
| | - Rohit Kunnath Menon
- Assistant Professor of Prosthodontics, College of Dentistry, Ajman University, Ajman, United Arab Emirates..
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Rakotoaridina K, Delrieu J, Pages P, Vergé T, Nasr K, Canceill T. Evaluation of Poly(etheretherketone) Post's Mechanical Strength in Comparison with Three Metal-Free Biomaterials: An In Vitro Study. Polymers (Basel) 2023; 15:3583. [PMID: 37688208 PMCID: PMC10489626 DOI: 10.3390/polym15173583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/26/2023] [Accepted: 08/27/2023] [Indexed: 09/10/2023] Open
Abstract
The thinking about metallic replacement has begun in a global context of reducing metallic alloys' use in odontology. Among the materials proposed for their replacement, poly(etheretherketone) may present interesting properties, especially in removable dentures' frames. The purpose of this study is to evaluate fracture resistance of PEEK posts-and-cores compared to non-metallic CAD/CAM materials and fiber glass posts. Forty extracted maxillary central incisors were prepared to receive posts. Samples were divided into four groups depending on whether they had been reconstructed with LuxaCam® PEEK, Enamic®, Numerys GF® or LuxaPost®. Samples were submitted to an oblique compressive test and results were statistically analyzed with ANOVA and Student's tests (or non-parametric tests depending on the conditions). Glass fiber posts and Numerys GF® reveal a significantly higher fracture resistance than LuxaCam® PEEK and Enamic®. No exclusively dental fracture has been noted for the Enamic group, which significantly distinguishes these samples from the three other groups. In our study, it appears that the conception of posts and cores with hybrid ceramic never conducts to a unique tooth fracture. By weighting the results according to the materials used, our data, obtained for the first time on this type of PEEK block, cannot confirm the possibility of using PEEK for inlay-core conception, excepted for specific cases when the material is considered in a patient presenting allergies or systemic disease contraindicating resin or metal.
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Affiliation(s)
- Kévin Rakotoaridina
- Département Odontologie, Faculté de Santé, Hôpitaux de Toulouse, Université Paul Sabatier, 3 Chemin des Maraichers, 31062 Toulouse Cedex 9, France
| | - Julien Delrieu
- Département Odontologie, Faculté de Santé, Hôpitaux de Toulouse, Université Paul Sabatier, 3 Chemin des Maraichers, 31062 Toulouse Cedex 9, France
| | - Paul Pages
- Département Odontologie, Faculté de Santé, Hôpitaux de Toulouse, Université Paul Sabatier, 3 Chemin des Maraichers, 31062 Toulouse Cedex 9, France
| | - Thierry Vergé
- Département Odontologie, Faculté de Santé, Hôpitaux de Toulouse, Université Paul Sabatier, 3 Chemin des Maraichers, 31062 Toulouse Cedex 9, France
| | - Karim Nasr
- Département Odontologie, Faculté de Santé, Hôpitaux de Toulouse, Université Paul Sabatier, 3 Chemin des Maraichers, 31062 Toulouse Cedex 9, France
| | - Thibault Canceill
- Département Odontologie, Faculté de Santé, Hôpitaux de Toulouse, Université Paul Sabatier, 3 Chemin des Maraichers, 31062 Toulouse Cedex 9, France
- CNRS UMR 5085, INPT, Faculté de Pharmacie, CIRIMAT, Université Toulouse III Paul Sabatier, 35 Chemin des Maraichers, 31062 Toulouse Cedex 9, France
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Alshabib A, Abid Althaqafi K, AlMoharib HS, Mirah M, AlFawaz YF, Algamaiah H. Dental Fiber-Post Systems: An In-Depth Review of Their Evolution, Current Practice and Future Directions. Bioengineering (Basel) 2023; 10:bioengineering10050551. [PMID: 37237621 DOI: 10.3390/bioengineering10050551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/27/2023] [Accepted: 05/02/2023] [Indexed: 05/28/2023] Open
Abstract
The field of dental medicine is constantly evolving and advancing toward minimally invasive techniques. Several studies have demonstrated that bonding to the tooth structure, particularly enamel, yields the most predictable results. In some instances, however, significant tooth loss, pulpal necrosis, or irreversible pulpitis may limit the options available to the restorative dentist. In these cases, placement of a post and core followed by a crown is the preferred treatment option, provided all requirements are met. This literature review provides an overview of the historical development of dental FRC post systems as well as a comprehensive examination of the currently available posts and their bonding requirements. In addition, it offers valuable insights for dental professionals seeking to understand the current state of the field and the prospects of dental FRC post systems.
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Affiliation(s)
- Abdulrahman Alshabib
- Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Khaled Abid Althaqafi
- Department of Restorative Dental Department, College of Dentistry, University of Umm Al Qura, Makkah 24211, Saudi Arabia
| | - Hani S AlMoharib
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Mahir Mirah
- Department of Restorative Dental Science, Dental College, and Hospital, Taibah University, Madinah 42353, Saudi Arabia
| | - Yasser F AlFawaz
- Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Hamad Algamaiah
- Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
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Survival rate and treatment success of glass fiber posts cemented with two adhesive cementation strategies after up to 106 months: a randomized clinical trial. Clin Oral Investig 2023; 27:2197-2206. [PMID: 36894666 DOI: 10.1007/s00784-023-04939-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 03/01/2023] [Indexed: 03/11/2023]
Abstract
OBJECTIVES The objective of this study is to evaluate the longevity of two fiber post cementation strategies in a prospective, multicenter, non-inferiority, double-blind randomized controlled trial. METHODS A total of 152 teeth, with adequate endodontic treatment and loss of coronal structure and bilateral simultaneous posterior occlusal contacts, were randomly allocated to receive glass fiber posts cemented with a conventional cementation strategy (CRC group: adhesive system + resin cement) (Adper Single Bond + RelyX ARC; 3 M-ESPE) or a self-adhesive cementation strategy (SRC group: self-adhesive resin cement; RelyX U100/U200; 3 M-ESPE). The patients were recalled annually for clinical and radiographical evaluation with a 93% recall rate (142 teeth, with 74 at CR groups and 68 at SRC group). The primary outcome was survival rate, considering the fiber post debonding (loss of retention). The secondary outcome included the success rate of the prosthetic treatment with crown debonding, post fracture, and tooth loss (not related to post failure). Both outcomes were evaluated annually. The Kaplan-Meier method and Cox regression with 95% confidence interval were used for the statistical analysis. RESULTS For the primary outcome (failures directly related to fiber posts cementation strategy), there were 4 fiber post debondings (2 per group), 8 root fractures (3 for SRC group and 5 for CRC group), and one mixed failure (debonding combined with root fracture for CRC), with both strategies presenting similar survival rates (p = 0.331), with 88.9% for the CRC group and 90.9% for the SRC group. For the secondary outcome (failures not related to fiber post cementation strategies), there were 8 crown debondings, 3 post fractures, and 3 tooth losses, with no statistically difference between groups (p = 0.701), with 77% for SRC and 82% for CRC. CONCLUSION Fiber post cementation strategies with conventional or self-adhesive resin cement presents similar tooth survival and success rates. TRIAL REGISTRATION NCT01461239 CLINICAL RELEVANCE: Both adhesive cementation strategies led to high survival and success rates and are indicated for fiber post cementation, even after a long follow-up period (up to 106 months).
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Comparing the Long-Term Success Rates of Tooth Preservation and Dental Implants: A Critical Review. J Funct Biomater 2023; 14:jfb14030142. [PMID: 36976066 PMCID: PMC10055991 DOI: 10.3390/jfb14030142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 02/23/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
Implant therapy is considered a predictable, safe, and reliable rehabilitation method for edentulous patients in most clinical scenarios. Thus, there is a growing trend in the indications for implants, which seems attributable not only to their clinical success but also to arguments such as a more “simplified approach” based on convenience or the belief that dental implants are as good as natural teeth. Therefore, the objective of this critical literature review of observational studies was to discuss the evidence concerning the long-term survival rates and treatment outcomes, comparing endodontically or periodontally treated teeth with dental implants. Altogether, the evidence suggests that the decision between keeping a tooth or replacing it with an implant should carefully consider the condition of the tooth (e.g., amount of remaining tooth and degree of attachment loss and mobility), systemic disorders, and patient preference. Although observational studies revealed high success rates and long-term survival of dental implants, failures and complications are common. For this reason, attempts should be made to first save maintainable teeth over the long-term, instead of immediately replacing teeth with dental implants.
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Nagarkar S, Loguercio AD, Perdigão J. Evidence-based fact checking for selective procedures in restorative dentistry. Clin Oral Investig 2023; 27:475-488. [PMID: 36607490 DOI: 10.1007/s00784-022-04832-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 12/18/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Similar to other dental specialties, there are many clinical procedures in restorative dentistry that may or may not be supported by good evidence. Thus, the effectiveness of these procedures is uncertain. The aim of this paper is to reduce this knowledge gap by critically inspecting selective procedures in restorative dentistry and exploring if these well-established or widely advocated treatment modalities are necessary for improving treatment outcomes based on the best available evidence. MATERIALS AND METHODS A MEDLINE search was conducted to identify research on selective procedures while focusing on clinical trials and systematic reviews. Due to their practical relevance in the decision-making process, cost-effectiveness analyses were also included. RESULTS Mixed results were identified regarding the included interventions. Some procedures had adequate evidence supporting them while others were mostly based on beliefs. CONCLUSIONS A critical review of the available literature indicates that some common restorative procedures lack adequate support from high-quality research evidence. CLINICAL RELEVANCE This paper attempts to highlight the need to critically examine the scientific validity of traditional knowledge and techniques through the context of current research evidence. This will not only help generate consensus between educators, clinicians, and researchers regarding restorative procedures but will also lead to improved patient care and outcomes.
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Affiliation(s)
- Sanket Nagarkar
- Park Dental Group, Minneapolis, MN, USA.,Department of Restorative Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Alessandro D Loguercio
- School of Dentistry, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - Jorge Perdigão
- Division of Operative Dentistry, Department of Restorative Sciences, University of Minnesota, 515 SE Delaware St, 8-450 Moos Tower, Minneapolis, MN, 55455, USA.
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The Influence on Fracture Resistance of Different Composite Resins and Prefabricated Posts to Restore Endodontically Treated Teeth. Polymers (Basel) 2023; 15:polym15010236. [PMID: 36616585 PMCID: PMC9823756 DOI: 10.3390/polym15010236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 12/23/2022] [Indexed: 01/05/2023] Open
Abstract
Recent formulations of resin-based composites have incorporated different combinations of materials. However, the mechanical and bonding behavior of these materials with intraradicular posts are unclear. This study aimed to evaluate the effect of light-cure and dual-cure resin composite posts on the fracture resistance of endodontically-treated teeth. Materials and Methods: Ninety extracted human upper canines were selected and randomly divided into nine groups (n=10): (G1) endodontically treated teeth without endodontic posts; (G2) glass-fiber post cemented with glass-ionomer cement; (G3) endodontic post by dual-cure composite resin (Rebilda DC); (G4) endodontic post by dual-cure composite resin (Cosmecore); (G5) endodontic post by dual-cure composite resin (Bis-Core); (G6) endodontic post by light-cure composite resin; (G7) glass-fiber post customized with flowable composite resin; (G8) glass-fiber post cemented with light-cure composite resin; (G9) glass-fiber post cemented with self-adhesive resin cement. After the post insertion, all specimens were subjected to mechanical (250,000 cycles) and thermocycling (6000 cycles, 5 °C/55 °C) and immediate loading at 45 degrees in a universal testing machine until fracture. The data were analyzed by one-way ANOVA and multiple comparisons using the Fisher LSD Method (p < 0 05). Results: The mean failure loads (±SD) for the groups ranged from 100.7 ± 22.6 N to 221.9 ± 48.9 N. The G1 group (without endodontic posts) had a higher fracture strength than all experimental groups (p < 0.001). Conclusions: Within the limitations, the light- and dual-cure post technique did not present lower fracture resistance values as compared to the conventional glass-fiber post.
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Bergamo ETP, Lopes ACO, Campos TMB, Amorim PH, Costa F, Benalcázar Jalkh EB, Carvalho LFD, Zahoui A, Piza MMT, Gutierres E, Witek L, Bonfante EA. Probability of survival and failure mode of endodontically treated incisors without ferrule restored with CAD/CAM fiber-reinforced composite (FRC) post-cores. J Mech Behav Biomed Mater 2022; 136:105519. [PMID: 36279744 DOI: 10.1016/j.jmbbm.2022.105519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE This study evaluated the probability of survival and failure mode of endodontically treated incisors without ferrule restored with CAD/CAM FRC post-cores. METHODS Root canals of bovine incisors were treated, leaving post preparations of ∼10 mm. Teeth were allocated into three groups: (i) cast metal post-core, (ii) FRC prefabricated post with a direct resin core build-up, and (iii) CAD/CAM FRC post-core. Posts and zirconia crowns were cemented using resin cement. Specimens were subjected to step-stress accelerated-life fatigue testing in water. Use level probability Weibull curves, probability of survival for a mission of 100,000 cycles at 25, 50, and 100 N, Weibull modulus, and characteristic strength were calculated and plotted. Failure mode was examined under a stereomicroscope. RESULTS Restored incisors demonstrated high probability of survival (93-100%) for missions estimated at 25 and 50 N, irrespective of post-core foundation. At 100 N, incisors restored with metal posts presented significantly higher probability of survival (99%) relative to CAD/CAM posts (79%), whereas FRC groups demonstrated no significant difference. Weibull analysis indicated no significant difference on the Weibull modulus (m = 3.38-5.92). Incisors reconstructed with metal post-cores (431 N) presented significantly higher characteristic strength relative to prefabricated (200 N) and CAD/CAM (202 N) FRC post-cores. While post fracture was the chief failure mode for prefabricated and CAD/CAM FRC post-cores, post and/or root fracture were the main event for metal post-cores. CONCLUSION Endodontically treated incisors without ferrule restored with CAD/CAM FRC post-cores presented promising probability of survival for loads compatible with anterior masticatory forces and favorable failure modes.
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Affiliation(s)
- Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, 9-75 Octavio Pinheiro Brizolla, Bauru, SP, Brazil, 17012-901
| | - Adolfo C O Lopes
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, 9-75 Octavio Pinheiro Brizolla, Bauru, SP, Brazil, 17012-901
| | - Tiago M B Campos
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, 9-75 Octavio Pinheiro Brizolla, Bauru, SP, Brazil, 17012-901
| | - Pedro Henrique Amorim
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, 9-75 Octavio Pinheiro Brizolla, Bauru, SP, Brazil, 17012-901
| | - Fábio Costa
- dOne 3D, 2625 José Adolfo Bianco Molina, Ribeirão Preto, SP, 14024-210, Brazil
| | - Ernesto B Benalcázar Jalkh
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, 9-75 Octavio Pinheiro Brizolla, Bauru, SP, Brazil, 17012-901
| | - Laura F de Carvalho
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, 9-75 Octavio Pinheiro Brizolla, Bauru, SP, Brazil, 17012-901.
| | - Abbas Zahoui
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, 9-75 Octavio Pinheiro Brizolla, Bauru, SP, Brazil, 17012-901
| | - Mariana M T Piza
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, 9-75 Octavio Pinheiro Brizolla, Bauru, SP, Brazil, 17012-901
| | - Eliezer Gutierres
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, 9-75 Octavio Pinheiro Brizolla, Bauru, SP, Brazil, 17012-901
| | - Lukasz Witek
- Department of Biomaterials, New York University College of Dentistry, NY, 10012, New York, USA; Department of Biomedical Engineering, New York University Tandon Scholl of Engineering, Brooklyn, USA
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, 9-75 Octavio Pinheiro Brizolla, Bauru, SP, Brazil, 17012-901
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Prakash J, Golgeri MS, Haleem S, Kausher H, Gupta P, Singh P, C. SG. A Comparative Study of Success Rates of Post and Core Treated Anterior and Posterior Teeth Using Cast Metal Posts. Cureus 2022; 14:e30735. [DOI: 10.7759/cureus.30735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022] Open
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Costa TS, Brandão RMR, Farias Vajgel BC, SoutoMaior JR. CAD-CAM glass fiber compared with conventional prefabricated glass fiber posts: A systematic review. J Prosthet Dent 2022:S0022-3913(22)00053-1. [PMID: 35933174 DOI: 10.1016/j.prosdent.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 11/17/2022]
Abstract
STATEMENT OF PROBLEM A prefabricated glass fiber post provides esthetic and biomechanical benefits for severely damaged endodontically treated teeth; however, failures in post retention remain a challenge. PURPOSE The purpose of this systematic review was to compare the fracture resistance and bond strength of prefabricated glass fiber posts to those made with computer-aided design and computer-aided manufacturing (CAD-CAM). MATERIAL AND METHODS This review was entered into PROSPERO (CRD42020213668) and was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Electronic systematic searches of PubMed/MEDLINE, Embase, and the Cochrane Library were conducted for published articles until October 2020. Studies that compared prefabricated glass fiber posts with CAD-CAM-fabricated glass fiber posts were selected, and studies that had not been published in English or in the previous 10 years were excluded. The fracture resistance (N) and bond strength (MPa) were the primary outcomes. RESULTS After reviewing the title, abstract, and the entire text of 227 articles, 8 studies were selected. Four studies were omitted. Four of the 8 studies were retained for qualitative analyses, with 1 having a high risk of bias and 3 having a medium risk of bias. Only 1 study found significantly higher fracture resistance in the CAD-CAM group than in the prefabricated group. The bond strength study reported a significant difference, with the CAD-CAM group having greater bond strength than the prefabricated group. CONCLUSIONS Despite the high heterogeneity and the few included articles, a tendency was found for the CAD-CAM-fabricated glass fiber post to improve fracture resistance and bond strength. However, the available literature is insufficient to draw definitive conclusions.
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Affiliation(s)
- Tiago S Costa
- Undergraduate student, School of Dentistry, Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Ruana M R Brandão
- Master's Degree student, Department of Prosthesis and Oral-Facial Surgery, Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Bruna C Farias Vajgel
- Adjunct Professor, Department of Prosthesis and Oral-Facial Surgery, Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil
| | - Juliana R SoutoMaior
- Adjunct Professor, Department of Prosthesis and Oral-Facial Surgery, Federal University of Pernambuco (UFPE), Recife, Pernambuco, Brazil.
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Popescu AD, Popa DL, Nicola AG, Dascălu IT, Petcu C, Tircă T, Tuculina MJ, Mocanu H, Staicu AN, Gheorghiță LM. Post Placement and Restoration of Endodontically Treated Canines: A Finite Element Analysis Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158928. [PMID: 35897304 PMCID: PMC9332447 DOI: 10.3390/ijerph19158928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/18/2022] [Accepted: 07/21/2022] [Indexed: 02/04/2023]
Abstract
The purpose of this study was to show the improved outcomes of restoring endodontically treated teeth with fiberglass posts compared to restorations using metal posts. In our study, we used the Finite Element Method (FEM), which is based on the principle that a physical model that supports a given load distributes the stress throughout its volume. We sought to assess what stress results in a tooth when it is restored using a fiberglass post compared to restoration using a metal post. The finite element analysis showed that a system consisting of a tooth with a fiberglass post is more stable in terms of the maximum stress than a system consisting of a tooth with a metal post. The maximum displacements and deformations were obtained in the case of a canine restored with a fiberglass post, which showed that this system had a high elasticity, therefore, higher strength than a canine restored with a metal post, which had high rigidity.
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Affiliation(s)
- Alexandru Dan Popescu
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.D.P.); (C.P.); (A.N.S.); (L.M.G.)
| | - Dragoș Laurențiu Popa
- Department of Automotive, Transportation and Industrial Engineering, Faculty of Mechanics, University of Craiova, 200478 Craiova, Romania
- Correspondence: (D.L.P.); (M.J.T.)
| | - Andreea Gabriela Nicola
- Department of Oro-Dental Prevention, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.G.N.); (T.T.)
| | - Ionela Teodora Dascălu
- Department of Orthodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Cristian Petcu
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.D.P.); (C.P.); (A.N.S.); (L.M.G.)
| | - Tiberiu Tircă
- Department of Oro-Dental Prevention, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.G.N.); (T.T.)
| | - Mihaela Jana Tuculina
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.D.P.); (C.P.); (A.N.S.); (L.M.G.)
- Correspondence: (D.L.P.); (M.J.T.)
| | - Horia Mocanu
- Faculty of Dental Medicine, University Titu Maiorescu of Bucharest, 031593 Bucharest, Romania;
| | - Adela Nicoleta Staicu
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.D.P.); (C.P.); (A.N.S.); (L.M.G.)
| | - Lelia Mihaela Gheorghiță
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.D.P.); (C.P.); (A.N.S.); (L.M.G.)
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Ordinola-Zapata R, Lin F, Nagarkar S, Perdigão J. A critical analysis of research methods and experimental models to study the load capacity and clinical behavior of the root filled teeth. Int Endod J 2022; 55 Suppl 2:471-494. [PMID: 35263455 PMCID: PMC9314814 DOI: 10.1111/iej.13722] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 03/04/2022] [Indexed: 12/04/2022]
Abstract
The prognosis of root‐filled teeth depends not only on a successful root canal treatment but also on the restorative prognosis. This critical review discusses the advantages and limitations of various methodologies used to assess the load capacity or clinical survivability of root‐filled teeth and restorations. These methods include static loading, cyclic loading, finite element analysis and randomized clinical trials. In vitro research is valuable for preclinical screening of new dental materials or restorative modalities. It also can assist investigators or industry to decide whether further clinical trials are justified. It is important that these models present high precision and accuracy, be reproducible, and present adequate outcomes. Although in vitro models can reduce confounding by controlling important variables, the lack of clinical validation (accuracy) is a downside that has not been properly addressed. Most importantly, many in vitro studies did not explore the mechanisms of failure and their results are limited to rank different materials or treatment modalities according to the maximum load capacity. An extensive number of randomized clinical trials have also been published in the last years. These trials have provided valuable insight on the survivability of the root‐filled tooth answering numerous clinical questions. However, trials can also be affected by the selected outcome and by intrinsic and extrinsic biases. For example, selection bias, loss to follow‐up and confounding. In the clinical scenario, hypothesis‐based studies are preferred over observational and retrospective studies. It is recommended that hypothesis‐based studies minimize error and bias during the design phase.
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Affiliation(s)
- Ronald Ordinola-Zapata
- Division of Endodontics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Fei Lin
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, 100081, China.,Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Sanket Nagarkar
- Park Dental Group, Minneapolis, Minnesota, and Clinical Research Assistant Professor (affiliated), Department of Restorative Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jorge Perdigão
- Division of Operative Dentistry, Department of Restorative Sciences, University of Minnesota, Minneapolis, Minnesota, USA
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17
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Gallicchio V, Lodato V, De Santis R, Rengo S. Fracture Strength and Failure Modes of Endodontically Treated Premolars Restored with Compact and Hollow Composite Posts Subjected to Cyclic Fatigue. MATERIALS 2022; 15:ma15031141. [PMID: 35161083 PMCID: PMC8840014 DOI: 10.3390/ma15031141] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 01/22/2022] [Accepted: 01/29/2022] [Indexed: 11/26/2022]
Abstract
Physical and mechanical properties of continuous carbon or glass fiber reinforced endodontic posts are relevant to increase the retention and resistance of the tooth-restoration system. Hollow posts have been recently designed for delivering the luting cement through the post hole, thus enhancing the post-dentin interface by reducing the risk of air bubbles formation. Methods: Three type of endodontic posts, a carbon fiber hollow post, a glass fiber hollow post and a compact glass fiber post were investigated. Mechanical properties of these posts were assessed through bending tests. Teeth were subjected to fatigue cycling and the strength of restored teeth was detected through static tests. Failure modes were investigated through optical and scanning electron microscopy. Results show that composite posts increase the mechanical stability by more than 100% compared to premolars restored with particulate composite. Carbon fiber posts retain the highest strength (1467 N ± 304 N) among the investigated post and core restoration, but an unfavorable type of fracture has been observed, preventing the tooth re-treatment. Instead, more compliant posts (i.e., glass fiber reinforced composite, providing a strength of 1336 N ± 221 N), show a favorable mode of fracture that allows the re-treatment of teeth in the case that failure occurs. Glass fiber hollow posts show a good trade-off between strength and a favorable type of fracture.
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Affiliation(s)
- Vito Gallicchio
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University “Federico II” of Naples, Via S. Pansini 5, 80131 Naples, Italy; (V.G.); (V.L.); (S.R.)
| | - Vincenzo Lodato
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University “Federico II” of Naples, Via S. Pansini 5, 80131 Naples, Italy; (V.G.); (V.L.); (S.R.)
| | - Roberto De Santis
- Institute of Polymers, Composites and Biomaterials—National Research Council of Italy, V.le J.F. Kennedy 54—Mostra d’Oltremare Pad. 20, 80125 Naples, Italy
- Correspondence:
| | - Sandro Rengo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University “Federico II” of Naples, Via S. Pansini 5, 80131 Naples, Italy; (V.G.); (V.L.); (S.R.)
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18
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Efficacy of CAD/CAM Glass Fiber Posts for the Restoration of Endodontically Treated Teeth. Int J Biomater 2022; 2022:8621835. [PMID: 35096068 PMCID: PMC8799365 DOI: 10.1155/2022/8621835] [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: 11/07/2021] [Accepted: 01/07/2022] [Indexed: 12/03/2022] Open
Abstract
Objective The aim of this systematic review was to provide an overview of available scientific evidence regarding the comparative efficacy of computer-aided design (CAD) and computer-aided manufacturing (CAM) glass fiber posts with prefabricated and metal cast posts for the restoration of endodontically treated teeth (ETT). Methods This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Electronic and manual searches were performed using the PubMed, SciELO, Cochrane, ScienceDirect, Web of Science, and EBSCO databases. The reference lists of the selected papers were reviewed to identify relevant papers. There were no year restrictions, and eligible studies were those in English publications and describing in vitro studies evaluating intraradicular retainers (IRs) for (i) fracture resistance, (ii) bond strength, (iii) adaptation, and (iv) cement layer thickness. Literature reviews, systematic reviews, meta-analyses, case reports, in vitro studies with <8 specimens, and noncomparative trials involving prefabricated or metal cast posts were excluded. The authors of this review independently screened the search results, extracted data, and assessed the risk of bias. Results No significant differences were found in fracture resistance between prefabricated and CAD/CAM glass fiber posts or between CAD/CAM glass fiber and metal cast posts, although the latter demonstrated higher fracture resistance than the prefabricated glass fiber posts. Restoration with a full crown was not necessary to increase the fracture resistance in the presence of the ferrule effect. CAD/CAM glass fiber and metal cast posts had higher bond strength, lower nanoleakage, and better adaptation to the root canal. Conclusions Despite the heterogeneity of methodologies and results reported, the results of these studies indicated that the CAD/CAM glass fiber and metal cast posts showed greater efficacy in terms of fracture resistance, retention, and adaptation, compared to prefabricated glass fiber posts.
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19
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Malekipour M, Hoseini M, Shirani F. The Effect of Application of Sonic Vibration on the Bond Strength of Glass Fiber Post to Root Dentin using Duo-link and Theracem cements: An In Vitro Study. DENTAL HYPOTHESES 2022. [DOI: 10.4103/denthyp.denthyp_122_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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AlSaleh E, Dutta A, Dummer PMH, Farnell DJJ, Vianna ME. Influence of remaining axial walls on of root filled teeth restored with a single crown and adhesively bonded fibre post: A systematic review and meta-analysis. J Dent 2021; 114:103813. [PMID: 34530058 DOI: 10.1016/j.jdent.2021.103813] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/31/2021] [Accepted: 09/04/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To synthesise evidence on structural failures and prevalence of post-treatment endodontic disease (PTD) in anterior and posterior root filled teeth with a single crown and adhesively bonded fibre post with regards to the number of axial walls. DATA An electronic search was performed, no language constraints or restriction on the year of publication were applied. SOURCES PubMed, Medline, Cochrane and Scopus on 13th of July 2021. STUDY SELECTION Clinical studies that reported the remaining number of axial walls for permanent anterior and posterior root filled teeth (RFT) restored with single crowns and adhesively bonded fibre posts with a minimum of 1 year follow-up were included. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines [1] were used. The number of axial walls and the success/failures were analysed as follows: fibre post and/or core decementation, post and/or core fracture and post treatment endodontic disease, and root fracture. CONCLUSIONS A total of 811 studies were identified with 5 meeting the inclusion criteria. The two randomized controlled trials included had 'some concerns' as determined by the Cochrane risk-of-bias 2 tool while the Newcastle-Ottawa scale found low risk of bias for the remaining three studies. The random effects model for subgroup meta-analysis revealed failures for posterior RFT increased with decreasing numbers of remaining walls. Failures for 0 remaining walls were 23% (95% CI = 10% - 36%) and for one remaining wall 15% (CI: 3% -26%), irrespective of follow-up times. Fibre post debonding and PTD increased with decreasing numbers of walls. Relative & catastrophic failure of posterior teeth restored with a fibre post and single crown after root canal treatment increased with decreasing numbers of remaining axial walls. CLINICAL SIGNIFICANCE This synthesis is unique as it minimizes the presence of confounding factors by reviewing evidence of failures and post-treatment endodontic disease associated with teeth restored with single crowns. Therefore, it provides valuable predictive evidence of potential coronal restoration catastrophes and post-treatment endodontic disease associated with root filled teeth.
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Affiliation(s)
- E AlSaleh
- School of Dentistry, College of Biomedical and Lifesciences, Cardiff University, Cardiff CF14 4XY, United Kingdom
| | - A Dutta
- School of Dentistry, College of Biomedical and Lifesciences, Cardiff University, Cardiff CF14 4XY, United Kingdom
| | - P M H Dummer
- School of Dentistry, College of Biomedical and Lifesciences, Cardiff University, Cardiff CF14 4XY, United Kingdom
| | - D J J Farnell
- School of Dentistry, College of Biomedical and Lifesciences, Cardiff University, Cardiff CF14 4XY, United Kingdom
| | - M E Vianna
- School of Dentistry, College of Biomedical and Lifesciences, Cardiff University, Cardiff CF14 4XY, United Kingdom.
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21
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Alshahrani A, Albaqami M, Naji Z, Al-Khunein Y, Alsubaie K, Alqahtani A, Al-Thobity AM. Impact of different surface treatment methods on bond strength between fiber post and composite core material. Saudi Dent J 2021; 33:334-341. [PMID: 34434036 PMCID: PMC8376674 DOI: 10.1016/j.sdentj.2020.03.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/11/2020] [Accepted: 03/11/2020] [Indexed: 12/03/2022] Open
Abstract
PURPOSE To assess the impact of different surface treatments on the push-out bond strength between fiber post and a composite resin core material. MATERIAL AND METHODS Seventy-two glass-fiber posts were randomly assigned into six groups according to the method of surface treatment: Control (no treatment), silane, sandblasting, hydrofluoric acid, hydrogen peroxide, and hydrogen peroxide with sandblasting. Two posts from each group were inspected under a scanning electron microscope to assess the surface modifications and 10 posts were employed for the push-out test. Each post was placed vertically in the middle of a cylindrical putty matrix and a dual-cure composite resin material was applied for core build-up. Two discs of each specimen were cut using a low-speed diamond saw (total 120 discs). The push-out test was executed using a universal testing machine at a crosshead speed of 0.5 mm/min. Statistical analysis was performed using one-way ANOVA and Tukey's test (p ≤ 0.05). The mode of failure of each disc was evaluated under SEM. RESULTS The sandblasting and hydrofluoric acid groups presented significantly higher bond strength than control and hydrogen peroxide groups. The hydrogen peroxide groups exhibited significantly the lowest bond strength of all groups. There was no significant difference between the control and silane groups. All groups showed predominantly adhesive failure except the hydrogen peroxide with sandblasting, where the cohesive failure of the post was predominant. CONCLUSIONS Sandblasting and hydrofluoric acid surface treatments demonstrated superior results to silane and hydrogen peroxide. The combined method of hydrogen peroxide and sandblasting could weaken the fiber post and lead to clinical fractures.
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Affiliation(s)
- Abdullah Alshahrani
- Prosthetic Dental Sciences Department, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Muthyib Albaqami
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Zeyad Naji
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | - Khalid Alsubaie
- King Abdulaziz Dental Center, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Abdulaziz Alqahtani
- Prosthetic Dental Sciences Department, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Ahmad M. Al-Thobity
- Substitutive Dental Sciences Department, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Mannocci F, Bhuva B, Roig M, Zarow M, Bitter K. European Society of Endodontology position statement: The restoration of root filled teeth. Int Endod J 2021; 54:1974-1981. [PMID: 34378217 DOI: 10.1111/iej.13607] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
This position statement on the restoration of root filled teeth represents the consensus of an expert committee, convened by the European Society of Endodontology (ESE). Current clinical and scientific evidence, as well as the expertise of the committee, have been used to develop this statement. The aim is to provide clinicians with evidence-based principles for decision-making on the choice of restoration following the completion of root canal treatment. By discussing the evidence in relation to key topics regarding post-endodontic restoration, a series of clinical recommendations are made. The scientific basis of the recommendations made in this paper can be found in a recently published review article (Bhuva et al. 2021, International Endodontic Journal, https://doi.org/10.1111/iej.13438). It is the intention of the committee to update this statement as further evidence emerges.
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Affiliation(s)
| | - Francesco Mannocci
- Faculty of Dentistry, Oral & Craniofacial Sciences, Department of Endodontics, King's College London, Guy's Hospital, London, UK
| | - Bhavin Bhuva
- Faculty of Dentistry, Oral & Craniofacial Sciences, Department of Endodontics, King's College London, Guy's Hospital, London, UK
| | - Miguel Roig
- Section for Endodontology, Department of Restorative Dentistry, Universitat Internacional de Catalunya, Barcelona, Spain
| | | | - Kerstin Bitter
- Department of Operative and Preventive Dentistry, Charité - University Medicine, Berlin, Germany
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Martins MD, Junqueira RB, de Carvalho RF, Lacerda MFLS, Faé DS, Lemos CAA. Is a fiber post better than a metal post for the restoration of endodontically treated teeth? A systematic review and meta-analysis. J Dent 2021; 112:103750. [PMID: 34274439 DOI: 10.1016/j.jdent.2021.103750] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 05/04/2021] [Accepted: 07/11/2021] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To evaluate systematically the evidence about the failure rates of endodontically treated teeth (ETT) restored with intraradicular metal posts (MPs) or fiber posts (FPs). DATA The review protocol was registered on PROSPERO (CRD42020189792). Eligibility criteria included randomized clinical trials (RCT) and prospective clinical trials (PCT) that compared the failures between FP and MP restorations for ETT. Meta-analyses were conducted for failure rates using fixed- and random-effects models. Subgroup and funnel plot analyses were performed. SOURCES Four electronic databases (MEDLINE/PubMed, Web of Science, Scopus, and Cochrane Library), manual, and grey literature were screened by two researchers independently for articles published until November 2020 without language or time restrictions. For the analysis of the risk of bias, the Cochrane collaboration tool and ROBINS-I were used. The certainty of the evidence was evaluated using GRADE. STUDY SELECTION Ten studies were included. A total of 704 participants with a mean age of 42.7 years with a total of 844 ETT were restored using 453 FPs and 391 MPs. The FPs presented similar failures to that with MPs (P=0.39; risk ratio [RR]:0.82; 95% confidence interval [CI]: 0.52 to 1.29). Subgroup analysis showed no significant differences between the FPs and MPs for the anterior region (P=0.60; RR:0.88; [CI]: 0.54 to 1.42), posterior region (P=0.52; RR:1.18; [CI]: 0.71 to 1.98), root fracture (P=0.44; RR:0.78; [CI]: 0.41 to 1.49), and debonding (P=0.56; RR:1.27; [CI]: 0.57 to 2.80). Additionally, FP showed similar failures compared with those of cast (P=0.36; RR:0.63; [CI]: 0.23 to 1.72) and prefabricated MPs (P=0.68; RR:0.90; [CI]: 0.54 to 1.50). The RCT and PCT studies revealed a low risk of bias for most of the domains. However, the certainty of evidence was considered low. CONCLUSION No evidence of difference was observed for failure rates between FPs, and MPs, independent of region and different MPs used in ETT. However, further well-conducted clinical studies with high-quality evidence are encouraged. CLINICAL SIGNIFICANCE Our results indicate that both retainer posts can be considered an adequate alternative in restoring ETT. Therefore, the choice of post (fiber or metal) could be based on dentist preference or individual characteristics of the patient as the failure rates for different posts are similar.
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Affiliation(s)
- Marielle Dias Martins
- Department of Dentistry, Federal University of Juiz de Fora (UFJF), Campus Avançado Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | - Rafael Binato Junqueira
- Department of Dentistry, Federal University of Juiz de Fora (UFJF), Campus Avançado Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | - Rodrigo Furtado de Carvalho
- Department of Dentistry, Federal University of Juiz de Fora (UFJF), Campus Avançado Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | - Mariane Floriano Lopes Santos Lacerda
- Department of Dentistry, Federal University of Juiz de Fora (UFJF), Campus Avançado Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | - Daniele Sorgatto Faé
- Postgraduate Program in Applied Health Sciences (PPGCAS), Federal University of Juiz de Fora (UFJF), Campus Avançado Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | - Cleidiel Aparecido Araujo Lemos
- Department of Dentistry, Federal University of Juiz de Fora (UFJF), Campus Avançado Governador Valadares, Governador Valadares, Minas Gerais, Brazil.
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Influence of post type on periapical status: a prospective study in a Brazilian population. Clin Oral Investig 2021; 26:781-787. [PMID: 34231058 DOI: 10.1007/s00784-021-04057-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 06/26/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This prospective study assessed the effect of post type used to restore endodontically treated teeth in the onset, progression, and remission of periapical lesions. MATERIALS AND METHODS One hundred and forty teeth (92 patients) were endodontically treated and received a glass fiber post or a cast metal post and a final restoration at a University Clinic by undergraduate students. All patients were followed up for a mean period of 5.1 ± 2.2 years. Periapical Index (PAI) was used for endodontic assessment. Two calibrated and blind examiners assessed the radiographs. The longevity of the endodontic treatment was analyzed using Kaplan-Meier statistics. RESULTS Of the included teeth, 67.1% received glass fiber posts while 32.9% received cast metal posts. There were 4 endodontic failures, two glass fiber posts with a PAI = 3 in the baseline and PAI = 4 in the last follow-up, and one PAI = 4 in baseline and last follow-up. One cast metal post-failure was PAI = 4 in the baseline and the last follow-up. After 9.4 years, the overall success rate of the endodontic treatment was 97.1% (p = 0.7). CONCLUSIONS The tested posts presented similar endodontic healing. Precautions taken during endodontic therapy, post cementation, and final restoration are more likely to be responsible for the success of endodontic treatment rather than a specific type of post. Clinical relevance The type of post is not related to the success of the endodontic treatment.
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Pires A, Poletto-Neto V, Chisini LA, Schwendicke F, Pereira-Cenci T. Post-retained Restorations: A Cost-minimization Analysis Nested in a Randomized Clinical Trial. Oper Dent 2021; 46:255-262. [PMID: 34192327 DOI: 10.2341/20-056-c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The aim of this study was to assess four post-retained restorative strategies for endodontically treated teeth using cost-minimization analysis. METHODS AND MATERIALS The cost-minimization analysis was based on primary data from a randomized clinical trial and followed the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guidelines. Two hundred twenty-five teeth (141 patients) restored using four strategies-teeth with ferrules+ restored with either glass fiber posts or direct composite or crowns, and teeth without ferrules- restored with either glass fiber or cast metal posts with crowns-were evaluated annually between 2009 and 2018. Initial costs and incremental costs per year were calculated. Survival curves were created using the Kaplan-Meier method and log-rank test. Kruskal-Wallis analysis was followed by Dunn's test, which was used to compare restorative treatments, with a significance level of 5%. RESULTS Initial costs were greater for cast metal posts without crowns (US$153.14). Glass fiber posts with composite (US$27.11) were least costly; the most failures occurred in this group, but they were primarily repairable restoration fractures. The number of extractions, and thus cost, was greater for glass fiber posts with crowns. The mean annual cost was significantly lower for teeth restored with composite (p<0.001). Ferrule presence did not significantly impact annual costs. CONCLUSIONS The use of glass fiber posts and direct composite incurred significantly lower annual costs than did other alternatives involving crowns or metal posts.
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Iaculli F, Rengo C, Lodato V, Patini R, Spagnuolo G, Rengo S. Fracture resistance of endodontically-treated maxillary premolars restored with different type of posts and direct composite reconstructions: A systematic review and meta-analysis of in vitro studies. Dent Mater 2021; 37:e455-e484. [PMID: 34148785 DOI: 10.1016/j.dental.2021.06.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To conduct a systematic review and meta-analysis to assess if the presence of an endodontic post may increase the fracture resistance of endodontically-treated maxillary premolars directly restored with composite. METHODS A comprehensive systematic literature search according to the PRISMA statement was conducted to assess in vitro studies including endodontically-treated maxillary premolars, restored with different type of posts supporting direct composite reconstructions. Two groups of meta-analyses were performed using fixed effects model and additional Trial Sequential Analysis (TSA) was carried out. Moreover, risk of bias was conducted and quality of evidence for any performed meta-analysis was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS Twenty-four articles met the inclusion criteria and 13 studies also underwent quantitative evaluation. Fracture resistance of endodontically-treated premolars restored with fiber posts was significantly less than sound teeth (p value: < 0.00001), however endodontically-treated premolars with a fiber post provided an increase in fracture resistance when compared to equivalent teeth restored without post (p value: 0.003). TSA revealed high power of both meta-analyses. Moderate risk of bias was reported in 23/24 studies; only 1 study showed high risk of bias. GRADE system showed moderate strength of evidence due to the presence of a study with high risk of bias and to wide confidence intervals. SIGNIFICANCE Within the limitation of the present systematic review and meta-analysis, it can be concluded that endodontically-treated maxillary premolars restored with a fiber post and direct composite restoration demonstrated increased fracture resistance when compared to equivalent teeth without post.
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Affiliation(s)
- Flavia Iaculli
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
| | - Carlo Rengo
- Department of Prosthodontics and Dental Materials, School of Dental Medicine, University of Siena, Siena, Italy
| | - Vincenzo Lodato
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
| | - Romeo Patini
- Department of Head, Neck and Sense Organs "Fondazione Policlinico Universitario A. Gemelli- IRCCS", School of Dentistry, Rome, Italy
| | - Gianrico Spagnuolo
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy.
| | - Sandro Rengo
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
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Ahmed MAA, Kern M, Mourshed B, Wille S, Chaar MS. Fracture resistance of maxillary premolars restored with different endocrown designs and materials after artificial ageing. J Prosthodont Res 2021; 66:141-150. [PMID: 34108294 DOI: 10.2186/jpr.jpr_d_20_00082] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To evaluate the effect of three different designs and two monolithic ceramic materials on the durability and fracture resistance of endocrowns on maxillary first premolars, in comparison to post-and-core crowns. METHODS Fifty-six maxillary premolars were endodontically treated and shortened to a level of 2 mm from the cervical line, and randomly categorized into six endocrown groups and post-and-core crown control group (n=8); E1; endocrowns with flat occlusal table (without ferrule), E2; endocrowns with 1.5 mm circumferential ferrule, E3; endocrowns with 1.5 mm buccal ferrule preparation. Two materials were used for endocrowns: zirconia (4YSZ; Z), and lithium disilicate (L). The control group was restored with zirconia posts, and lithium disilicate crowns. All restorations were bonded using Panavia V5 and its respective primers and underwent thermo-mechanical fatigue with a 10 kg dynamic load for 1,200,000 cycles and thermocycling between 5 and 55 °C. Thereafter all survived specimens were loaded to fracture. The results were statistically analyzed using ANOVA and T-Test. RESULTS None of the specimens showed any signs of debonding or fracture caused by the fatigue test. The PC control group showed no statistically significant difference in comparison to groups ZE1, ZE2 and LE2 ( p > 0.05 ). However, it was significantly different from groups LE1, LE3, and ZE3 ( p ≤ 0.05 ). CONCLUSIONS Preparation designs and materials affected the fracture resistance of endocrowns. The results showed a superiority of the post-and-core crowns,zirconia/lithium disilicate endocrowns with 1.5 mm circumferential ferrule, and zirconia endocrowns with the flat occlusal table.
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Affiliation(s)
- Mohamed A A Ahmed
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel.,Department of Prosthodontics, College of Dentistry, Ibb University, Ibb
| | - Matthias Kern
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel
| | - Bilal Mourshed
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel
| | - Sebastian Wille
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel
| | - Mohamed Sad Chaar
- Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel
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Mastrogianni A, Lioliou EA, Tortopidis D, Gogos C, Kontonasaki E, Koidis P. Fracture strength of endodontically treated premolars restored with different post systems and metal-ceramic or monolithic zirconia crowns. Dent Mater J 2021; 40:606-614. [PMID: 33456031 DOI: 10.4012/dmj.2020-223] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The purpose of this study was to investigate the fracture strength of endodontically treated human maxillary premolars (ETP) restored with posts and metal ceramic (MC) or monolithic zirconia (MZ) crowns. Sixty ETP were randomly divided into 3 groups. Teeth in control group (C) received a resin filling. ETP in the MC group were restored with prefabricated metal posts, composite cores and MC crowns while in the MZ group with glass-fiber posts, composite cores and MZ crowns. Half of the specimens were loaded at a 135° angle and half under axial loading until fracture. The fracture modes were divided in repairable and irreparable using optical microscopy. Mean fracture strength was significantly higher for MC than for MZ crowns and control group only under axial loading. The distribution of repairable and irreparable failures presented no significant differences. Crown placement significantly improved the fracture strength of ETP irrespectively of post and crown type.
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Affiliation(s)
- Anna Mastrogianni
- Department of Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki
| | - Evdokia-Anna Lioliou
- Department of Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki
| | - Dimitrios Tortopidis
- Department of Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki
| | - Christos Gogos
- Department of Endodontology, School of Dentistry, Aristotle University of Thessaloniki
| | - Eleana Kontonasaki
- Department of Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki
| | - Petros Koidis
- Department of Prosthodontics, School of Dentistry, Aristotle University of Thessaloniki
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Verdum I, Abreu de Bem I, Marks Duarte PH, Machado LS, Pereira JR, Reis Só MV, Abreu da Rosa R. Effect of ultrasonic activation of the adhesive system on dentin tubule penetration and the pushout bond strength of fiber posts. J Prosthet Dent 2020; 127:295-301. [PMID: 33243473 DOI: 10.1016/j.prosdent.2020.07.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/27/2020] [Accepted: 07/27/2020] [Indexed: 11/18/2022]
Abstract
STATEMENT OF PROBLEM Whether ultrasonic activation of the adhesive system improves dentin tubule penetration and the bond strength of fiber posts to root dentin is unclear. PURPOSE The purpose of this in vitro study was to evaluate the effect of ultrasonic activation of 2 adhesive systems (etch-and-rinse and self-etch) and 1 glass ionomer cement on the dentin tubule penetration and pushout bond strength of fiber posts to root dentin. MATERIAL AND METHODS Sixty maxillary central incisors were endodontically treated and divided into 6 groups (n=10) as per the post cementation strategy: etch-and-rinse, etch-and-rinse and ultrasonic, self-etch, self-etch and ultrasonic, glass ionomer cement, and glass ionomer cement and ultrasonic. The primers, the adhesives, and the glass ionomer cement were activated for 20 seconds each, and the fiber posts were cemented with a resin cement. Dentin tubule penetration was evaluated by confocal laser scanning microscopy and the pushout bond strength measured at 3 post locations: cervical, middle, and apical. The failure patterns were also described after pushout testing. RESULTS Self-etch and ultrasonic showed higher dentin tubule penetration than the other cementation strategies (P<.05) and improved the bond strength values (P<.05), which were higher than etch-and-rinse and ultrasonic and glass ionomer cement and ultrasonic (P<.05). Adhesive failures at the cement and dentin interface were predominant in the etch-and-rinse, self-etch, and self-etch and ultrasonic groups. CONCLUSIONS Ultrasonic activation improved the dentin tubule penetration of a self-etch adhesive system. The bond strength of fiber posts cemented with a self-etch adhesive system and a resin cement was improved after ultrasonic activation.
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Affiliation(s)
- Isabel Verdum
- Graduate student, Department of Conservative Dentistry, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
| | - Igor Abreu de Bem
- Master student, Department of Conservative Dentistry, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
| | - Pedro Henrique Marks Duarte
- Doctoral student, Department of Conservative Dentistry, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
| | - Lucas Silveira Machado
- Assistant Professor, Department of Conservative Dentistry, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
| | - Jefferson Ricardo Pereira
- Associate Professor, Department of Prosthodontics, School of Dentistry, University of Southern Santa Catarina (UNISUL), Tubarão, Brazil.
| | - Marcus Vinícius Reis Só
- Associate Professor, Department of Conservative Dentistry, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
| | - Ricardo Abreu da Rosa
- Assistant Professor, Department of Conservative Dentistry, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
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Nahar R, Mishra SK, Chowdhary R. Evaluation of stress distribution in an endodontically treated tooth restored with four different post systems and two different crowns- A finite element analysis. J Oral Biol Craniofac Res 2020; 10:719-726. [PMID: 33088703 DOI: 10.1016/j.jobcr.2020.10.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 10/05/2020] [Indexed: 11/17/2022] Open
Abstract
Aim and objectives The study evaluated the stress distribution in an endodontically treated tooth with four different post systems and restored with two different prosthetic crown materials using finite element analysis (FEA). Material and methods A total of eight 3D FEA models of maxillary central incisor were created and divided into two groups; group porcelain fused to metal (PFM) crown (n = 4) and group PEEK crown (n = 4). The endodontically treated tooth was restored using four different post materials such as fiber-reinforced composite (FRC), carbon fiber-reinforced polyetheretherketone (CFR-PEEK), glass fiber reinforced polyetheretherketone (GFR-PEEK) and polyetherketoneketone (PEKK) and composite resin core. A static load of 100 N was applied and von Mises stress was calculated. The stress ratio in dentin was analyzed by using the Mohr-Coulomb failure theory. Results In dentin, under the applied forces for both, PFM group and PEEK group, it was observed that CFR-PEEK post exhibited minimum von Mises stress while PEKK post exhibited maximum von Mises stress values. The result obtained showed that low stresses were detected using CFR-PEEK post than FRC, GFR-PEEK, and PEKK posts. Conclusion Stress observed in dentin, when CFR-PEEK post was used was lesser in comparison to the FRC post. It was noted that PEEK crown and the PFM crown showed similar effect in dentin in stress generation. Hence, PEEK crown can be used as an alternative to the PFM crown.
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Affiliation(s)
- Rajvi Nahar
- Department of Prosthodontics, People's College of Dental Sciences & Research Centre, Bhopal, 462037, India
| | - Sunil Kumar Mishra
- Department of Prosthodontics, People's College of Dental Sciences & Research Centre, Bhopal, 462037, India
| | - Ramesh Chowdhary
- Department of Prosthodontics, Rajarajeswari Dental College and Hospital, Bengaluru, Karnataka, India
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Jurema AB, Bresciani E, Caneppele TMF. Influence of glass fiber posts on the fracture susceptibility of endodontically treated maxillary anterior teeth with direct veneers: Preliminary results of a randomized clinical trial. J ESTHET RESTOR DENT 2020; 33:613-620. [PMID: 33006446 DOI: 10.1111/jerd.12669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/29/2020] [Accepted: 09/12/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The purpose of this randomized clinical trial was to evaluate the influence of glass fiber posts on fracture susceptibility of endodontically treated maxillary anterior teeth with direct veneers. MATERIALS AND METHODS Fifty participants had 1 maxillary anterior tooth restored with a direct veneer. They were divided into 2 groups (n = 25) according to the use of intraradicular glass fiber posts. Clinical evaluation was performed at baseline, 6 and 12 months. The treatment success was determined by the absence of tooth fracture. If there was fracture, it was classified according to its extent. Fischer exact test was performed to analyze the criteria among the groups at each evaluation time. Friedman repeated analysis of variance assessed the difference in the performance of each group at three recall times (α = 0.5). RESULTS For control group, at the 6-month follow-up, one tooth had suffered a catastrophic failure, which resulted in tooth extraction. Fisher statistical analysis showed no significant difference between the cumulative success rate of the groups for the 6 (P > .999) and the 12-month (P > .999) period. Friedman test showed no significant difference among the periods of evaluation (P > .999). CONCLUSIONS Both groups had a similar success rate for maxillary anterior endodontically treated teeth with direct veneers after 12 months. CLINICAL IMPLICATIONS Glass fiber post use does not influence the fracture susceptibility of maxillary anterior endodontically treated teeth with direct veneers in the short term.
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Affiliation(s)
- AnaLuiza Barbosa Jurema
- Department of Restorative Dentistry, São Paulo State University (UNESP), Institute Science and Technology, São Paulo, Brazil
| | - Eduardo Bresciani
- Department of Restorative Dentistry, São Paulo State University (UNESP), Institute Science and Technology, São Paulo, Brazil
| | - Taciana Marco Ferraz Caneppele
- Department of Restorative Dentistry, São Paulo State University (UNESP), Institute Science and Technology, São Paulo, Brazil
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Girotto LPS, Dotto L, Pereira GKR, Bacchi A, Sarkis-Onofre R. Restorative preferences and choices of dentists and students for restoring endodontically treated teeth: A systematic review of survey studies. J Prosthet Dent 2020; 126:489-489.e5. [PMID: 32981715 DOI: 10.1016/j.prosdent.2020.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/22/2020] [Accepted: 07/22/2020] [Indexed: 12/17/2022]
Abstract
STATEMENT OF PROBLEM The best protocol to restore endodontically treated teeth is still unclear, with many factors to be considered, including the selection and necessity of a post, the type of coronal restoration, the amount of remaining coronal structure, and the type of luting agent. PURPOSE The purpose of this systematic review was to assess the restorative preferences for endodontically treated teeth between dentists and dental students. MATERIAL AND METHODS Survey studies, written in English, of dentists and dental students, which evaluated the use of intracanal posts and other restorative options for endodontically treated teeth, were selected. Searches were performed in the PubMed and SCOPUS databases without time restriction. Screening and data extraction were performed by 2 researchers independently. A standardized outline was used to extract the data (questions related to the theme and the response rate of each question on the survey), and the risk of bias was assessed. Descriptive analysis was performed of the collected information. RESULTS Twenty-five articles were included. Most dentists who answered the surveys reported the time since graduation as 1 to 20 years (40%), and 44% were specialists. The most reported choices concerning the type of posts used were prefabricated posts (45.8%), cast metal posts (16.7%), and both posts (16.7%). The cast metal posts were cited more frequently in surveys published between 1994 and 2010, whereas prefabricated posts, both metal and glass fiber ones, were cited between 2006 and 2019. The preferred luting agent for intracanal posts was resin-based (47%). These choices seem to have been influenced by time and by the level of postgraduate training. CONCLUSIONS Restorative preferences related to posts have changed over time, from the use of cast posts to prefabricated ones or the use of both posts and seem to be influenced by experience and postgraduate training.
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Affiliation(s)
- Luiza Paloma S Girotto
- Master student, Graduate Program in Dentistry, Meridional Faculty, IMED, Passo Fundo, Rio Grande do Sul, Brazil
| | - Lara Dotto
- Master student, Graduate Program in Dentistry, Meridional Faculty, IMED, Passo Fundo, Rio Grande do Sul, Brazil
| | - Gabriel K Rocha Pereira
- Associate Professor, Post-Graduate Program in Oral Sciences, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Ataís Bacchi
- Associate Professor, Graduate Program in Dentistry, Meridional Faculty, IMED, Passo Fundo, Rio Grande do Sul, Brazil
| | - Rafael Sarkis-Onofre
- Associate Professor, Graduate Program in Dentistry, Meridional Faculty, IMED, Passo Fundo, Rio Grande do Sul, Brazil.
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Ghoul WE, Özcan M, Tribst JPM, Salameh Z. Fracture resistance, failure mode and stress concentration in a modified endocrown design. Biomater Investig Dent 2020; 7:110-119. [PMID: 32939455 PMCID: PMC7470158 DOI: 10.1080/26415275.2020.1801348] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose The purpose of this study was to assess fracture resistance, failure mode and stress concentration of a modified endocrown preparation design, under axial and lateral forces. Materials and Methods Forty lower molars were divided into two groups (n = 20) and were restored with lithium disilicate glass-ceramic endocrowns following 2 preparation designs: Conventional, with circumferential butt margin 2 mm above the cemento–enamel junction; and Modified, by adding 2 grooves on the mesial side of the vestibular dentinal wall and on the distal side of the lingual dentinal wall. After cementation and thermomechanical cycling loading, half of the samples (n = 10) from each group were loaded axially and the other half (n = 10) was loaded laterally. Fracture resistance and failure modes were observed and the finite element analysis (FEA) was used to identify the stress concentration. Two-way ANOVA and Chi-square tests (α = 0.05) were used for in vitro data analyzes. Results Fracture resistance showed a statistically significant difference between conventional and modified preparations (p < .001), and between axial and lateral loadings (p < .001). Conventional preparation recorded 2914 N under axial loading and 1516 N under lateral loading, while modified preparation recorded 3329 N under axial loading and 1871 N under lateral loading. FEA showed that retention grooves have reduced the stress concentration under both loads for the tooth and the restoration. Conclusion Modified endocrown design showed higher fracture resistance than conventional endocrown. Lateral loading displayed a high percentage of severe fracture but under higher load to failure than the values reported for normal masticatory forces.
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Affiliation(s)
- Wiam El Ghoul
- Department of Prosthodontics, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
| | - Mutlu Özcan
- Division of Dental Biomaterials, Centre of Dental Medicine, Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Joao Paulo Mendes Tribst
- Department of Dental Materials and Prosthodontics, São Paulo State University, Institute of Science and Technology, São José dos Campos, Brazil
| | - Ziad Salameh
- Department of Prosthodontics, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon
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Randomized controlled trial comparing glass fiber posts and cast metal posts. J Dent 2020; 96:103334. [DOI: 10.1016/j.jdent.2020.103334] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 03/30/2020] [Accepted: 04/08/2020] [Indexed: 02/06/2023] Open
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Wan S, Tan Y, Xie J, Huang X, Guo L. The effect of a root-dentin pretreatment technique combining PIPS with MTAD aiming to improve the bond strength of glass fiber post. Microsc Res Tech 2020; 83:824-833. [PMID: 32187772 DOI: 10.1002/jemt.23474] [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: 01/02/2020] [Revised: 02/16/2020] [Accepted: 03/08/2020] [Indexed: 11/07/2022]
Abstract
The aim of this study was to evaluate the combined effect of MTAD and photon-induced photoacoustic streaming (PIPS) technique on the smear layer removal and the bond strength of glass fiber post. Fifty-five human mandibular premolars were chosen. After root canal therapy and post space preparation, the teeth were equally divided to five groups according to the methods of root-dentin pretreatment: G1: distilled water (control); G2: 2.5% NaOCl+17% EDTA; G3: MTAD; G4: PIPS; G5: MTAD+PIPS. One sample was randomly selected from each group, and scanning electron microscope (SEM) was used to observe the microscopic morphology of the coronal, middle and apical level of the root-dentin. The remaining ten samples from each group were glued to glass fiber posts, and the bond strength was assessed by push-out test. SEM evaluation showed that the most complete smear layer removal was found in MTAD + PIPS group, especially in coronal third. Push-out test results exhibited that there was a statistically significant interaction between the experimental groups and root canal third (p < .0005). Significant differences could be found among five groups (p < .05): G5 > G4 > G3 > G2 > G1. G5 had the highest bond strength. In conclusion, post space pretreatments with MTAD or PIPS technique can significantly remove smear layer and improve the bond strength of glass fiber post, and combination of them works best.
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Affiliation(s)
- Shu Wan
- Department of prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, LuZhou, China
| | - Yujie Tan
- Department of prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, LuZhou, China
| | - Jing Xie
- Department of prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, LuZhou, China
| | - Xiaoyu Huang
- Department of prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, LuZhou, China
| | - Ling Guo
- Department of prosthodontics, Hospital of Stomatology Affiliated to Southwest Medical University, LuZhou, China
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Fouad H, Mourad AHI, ALshammari BA, Hassan MK, Abdallah MY, Hashem M. Fracture toughness, vibration modal analysis and viscoelastic behavior of Kevlar, glass, and carbon fiber/epoxy composites for dental-post applications. J Mech Behav Biomed Mater 2020; 101:103456. [DOI: 10.1016/j.jmbbm.2019.103456] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 09/26/2019] [Accepted: 09/28/2019] [Indexed: 10/25/2022]
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Pomini MC, Machado MM, Quadros GDP, Pinheiro LOB, Samra APB. In vitro fracture strength and modes of cast post and cores luted with self-adhesive resin-based cement. BRAZILIAN JOURNAL OF ORAL SCIENCES 2019. [DOI: 10.20396/bjos.v18i0.8657261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Aim: Cast post and core (CPC) is the main used post type; however, the biomechanical behavior of CPCs adhesively luted to the dentin is still unclear. Therefore, we aimed to evaluate the fracture resistance (FR) and fracture modes of teeth restored with CPCs luted with zinc-phosphate (ZP) or resin-based self-adhesive (SA) cements, as well as the influence of the coronal remnant. Methods: For that, 24 human premolars were divided into four groups according to the cement (ZP or SA) and coronal remnant (with or without 2mm). FR was tested in a universal machine and data analyzed by two-way ANOVA and Tukey HSD (α=.05). Fracture modes were classified according to the degree of dental destruction. Results: The results showed that there was no difference in FR (p=.352); however, teeth without ferrule presented more irreparable fractures, specially in the ZP group. Conclusion: All in all, self-adhesion of CPCs does not enhance fracture resistance, however it reduces the number of irreparable fractures, compared to ZP cement.
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Pereira JR, Pamato S, Santini MF, Porto VC, Ricci WA, Só MVR. Push-out bond strength of fiberglass posts cemented with adhesive and self-adhesive resin cements according to the root canal surface. Saudi Dent J 2019; 33:22-26. [PMID: 33473238 PMCID: PMC7801235 DOI: 10.1016/j.sdentj.2019.11.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 11/18/2019] [Accepted: 11/21/2019] [Indexed: 11/18/2022] Open
Abstract
Evaluating the bond strength of fiberglass posts cemented with different resin cements. MATERIALS AND METHODS Seventy freshly extracted roots of healthy human canines were endodontically treated and prepared to receive fiberglass posts. The roots were randomly divided into seven groups: (G1) RelyX ARC, (G2) Enforce, (G3) BisCem, (G4) Duo-Link, (G5) Cement Post, (G6) Variolink II, and (G7) RelyX U200. After post cementation, the specimens were sectioned perpendicularly to the root axis using a high-speed diamond disc, totaling 340 specimens. The strength values obtained in the push-out test were submitted to two-factor ANOVA and Tukey test (p = 0.05). RESULTS The root thirds (p = 0.001) and the type of cement (p = 0.001) influenced the bond strength values. The relation between these two factors was also significant (p = 0.011). CONCLUSIONS The bond strength of self-adhesive resin cements was significantly higher as compared to other cements. Besides the cervical third in roots cemented with conventional cements types presented the highest bond strength values (p < 0.05).
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Affiliation(s)
- Jefferson Ricardo Pereira
- Postgraduate Program of Health Sciences, University of Southern Santa Catarina, Tubarão, Brazil
- Corresponding author at: Rua Recife 200 - Apto 601 - Bairro: Recife, Tubarão/SC CEP 88701-420, Brazil.
| | - Saulo Pamato
- Postgraduate Program of Health Sciences, University of Southern Santa Catarina, Tubarão, Brazil
| | - Manuela Favarin Santini
- Department of Conservative Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Weber Adad Ricci
- Department of Prosthodontics, Paulista State University at Araraquara, Araraquara, Brazil
| | - Marcus Vinícius Reis Só
- Department of Conservative Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Zhai XY, Zhang JY, Zhang SK, Jiang CJ, Qiu XX. [Finite-element analysis of mandibular first molar with two marginal designs of endocrown for the repair of different defects]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2019; 37:480-484. [PMID: 31721493 DOI: 10.7518/hxkq.2019.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study aimed to evaluate the stress distribution of the mandibular first molar with different thicknesses and heights of the axial wall restored by the endocrown with two marginal designs and thus provide a theoretical basis for selecting clinical preparation through the finite-element method. METHODS Two marginal endocrowns of the mandibular first molar with different axial-wall thicknesses (t=1, 2, 3 mm) and heights (h=2, 3, 4 mm) were established. Group A was the butt-joint design, whereas group B was the shoulder-surrounded design. After applying vertical and oblique loads , the size and distribution of the maximum principal stress and equivalent stress of residual tooth tissue were recorded. RESULTS The maximum principal stress and equivalent stress distribution of residual tooth tissue were similar among different models. Group A showed a lower maximum principal stress and equivalent stress than group B at the same thickness and height under vertical load. Meanwhile, under oblique load, the maximum principal stress values of groups A and B decreased with increased thickness at constant height. Group A showed lower equivalent stress than group B at the same thickness and height of 2 and
3 mm. However, when the height was 4 mm, the trend was reversed. CONCLUSIONS In mastication, when bearing the vertical force, the retention of the butt-joint marginal endocrown preferred to the shoulder-surrounded one. Given the higher axial wall of the shoulder-surrounded marginal endocrown, it showed better ability to bear the oblique force than the butt-joint one.
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Affiliation(s)
- Xiao-Yang Zhai
- Dept. of Prosthodontics, The First Affiliated Hospital of Zhengzhou University, Stomatological College of Zhengzhou University, Zhengzhou 450052, China
| | - Jing-Ya Zhang
- Dept. of Prosthodontics, The First Affiliated Hospital of Zhengzhou University, Stomatological College of Zhengzhou University, Zhengzhou 450052, China
| | - San-Ke Zhang
- Dept. of Prosthodontics, The First Affiliated Hospital of Zhengzhou University, Stomatological College of Zhengzhou University, Zhengzhou 450052, China
| | - Chuan-Jing Jiang
- Dept. of Prosthodontics, The First Affiliated Hospital of Zhengzhou University, Stomatological College of Zhengzhou University, Zhengzhou 450052, China
| | - Xiao-Xia Qiu
- Dept. of Prosthodontics, The First Affiliated Hospital of Zhengzhou University, Stomatological College of Zhengzhou University, Zhengzhou 450052, China
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Lins RBE, Cordeiro JM, Rangel CP, Antunes TBM, Martins LRM. The effect of individualization of fiberglass posts using bulk-fill resin-based composites on cementation: an in vitro study. Restor Dent Endod 2019; 44:e37. [PMID: 31799165 PMCID: PMC6875538 DOI: 10.5395/rde.2019.44.e37] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 09/15/2019] [Accepted: 09/15/2019] [Indexed: 11/29/2022] Open
Abstract
Objectives This study evaluated the bond strength of various fiberglass post cementation techniques using different resin-based composites. Materials and Methods The roots from a total of 100 bovine incisors were randomly assigned to 5 treatment groups: G1, post + Scotchbond Multi-Purpose (SBMP) + RelyX ARC luting agent; G2, relined post (Filtek Z250) + SBMP + RelyX ARC; G3, individualized post (Filtek Z250) + SBMP; G4, individualized post (Filtek Bulk-Fill) + SBMP; G5, individualized post (Filtek Bulk-Fill Flow) + SBMP. The samples were subjected to the push-out (n = 10) and pull-out (n = 10) bond strength tests. Data from the push-out bond strength test were analyzed using 2-way analysis of variance (ANOVA) with the Bonferroni post hoc test, and data from the pull-out bond strength test were analyzed using 1-way ANOVA. Results The data for push-out bond strength presented higher values for G2 and G5, mainly in the cervical and middle thirds, and the data from the apical third showed a lower mean push-out bond strength in all groups. No significant difference was noted for pull-out bond strength among all groups. The most frequent failure modes observed were adhesive failure between dentine and resin and mixed failure. Conclusions Fiberglass post cementation using restorative and flowable bulk-fill composites with the individualization technique may be a promising alternative to existing methods of post cementation.
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Affiliation(s)
- Rodrigo Barros Esteves Lins
- Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
| | - Jairo Matozinho Cordeiro
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Carolina Perez Rangel
- Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
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Martino N, Truong C, Clark AE, O'Neill E, Hsu SM, Neal D, Esquivel-Upshaw JF. Retrospective analysis of survival rates of post-and-cores in a dental school setting. J Prosthet Dent 2019; 123:434-441. [PMID: 31353108 DOI: 10.1016/j.prosdent.2019.05.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 04/16/2019] [Accepted: 05/02/2019] [Indexed: 11/16/2022]
Abstract
STATEMENT OF PROBLEM The clinical survival of different types of post-and-core systems requires assessment. PURPOSE The purpose of this retrospective clinical study was to evaluate the clinical survival rate (CSR) of custom-fabricated cast metal and prefabricated (both metal- and fiber-reinforced composite resin post) post-and-cores as a function of patient- and restoration-related variables. MATERIAL AND METHODS A retrospective analysis was conducted on electronic charts indicating that these patients had received some type of post-and-core between January 2003 and January 2018. A total of 754 records were included in the analysis based on the inclusion criteria. Data were analyzed by using the Kaplan-Meier and Cox proportional hazards analysis. RESULTS Kaplan-Meier analysis demonstrated the mean survival time for each group to be 12.0 years for fiber-reinforced composite resin posts, 11.8 years for cast metal post-and-cores, and 10.2 years for prefabricated metal posts. Although the mean survival time differed by 1.8 years among groups, with prefabricated metal posts having a slightly higher risk of failure, this effect was not statistically significant (P=.067). The effect of post type also failed to reach significance when controlling for patient demographics and post position in a Cox proportional hazards analysis (P=.106). However, the Cox model did show that survival was associated with tooth position (P=.003), cement (P=.021), and type of restoration (P<.001). CONCLUSIONS Analysis showed no evidence that post-and-core survival was significantly associated with 3 types of post-and-cores (custom-fabricated metal, prefabricated metal, and prefabricated fiber-reinforced composite resin). The percentage of root in the bone, tooth position, cement, and type of restoration, however, were significantly associated with survival.
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Affiliation(s)
- Nicole Martino
- Graduate Prosthodontic resident, Graduate Prosthodontics Program, Restorative Dental Sciences, University of Florida College of Dentistry, Gainesville, Fla
| | - Caroline Truong
- Graduate Prosthodontic resident, Graduate Prosthodontics Program, Restorative Dental Sciences, University of Florida College of Dentistry, Gainesville, Fla
| | - Arthur E Clark
- Professor, Restorative Dental Sciences, Division of Prosthodontics, University of Florida College of Dentistry, Gainesville, Fla
| | - Edgar O'Neill
- Clinical Associate Professor, Restorative Dental Sciences, Graduate Prosthodontics Program, University of Florida College of Dentistry, Gainesville, Fla
| | - Shu-Min Hsu
- Research Associate, Restorative Dental Sciences, Division of Prosthodontics, University of Florida College of Dentistry, Gainesville, Fla
| | - Dan Neal
- Senior Statistician, Department of Neurosurgery, University of Florida College of Medicine, Gainesville, Fla
| | - Josephine F Esquivel-Upshaw
- Associate Professor, Restorative Dental Sciences, University of Florida College of Dentistry, Division of Prosthodontics, Gainesville, Fla.
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Lo Giudice G, Ferrari Cagidiaco E, Lo Giudice R, Puleio F, Nicita F, Calapaj M. Evaluation of Mechanical Properties of a Hollow Endodontic Post by Three Point Test and SEM Analysis: A Pilot Study. MATERIALS 2019; 12:ma12121983. [PMID: 31226763 PMCID: PMC6630250 DOI: 10.3390/ma12121983] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 06/14/2019] [Accepted: 06/17/2019] [Indexed: 11/25/2022]
Abstract
The aim of this study was to investigate the mechanical properties of a fiber hollow endodontic post characterized by the presence of an empty central cylindrical channel extended along the whole length. This particular shape allows clinicians to use the post also as a cementation resin carrier. Ten hollow posts were divided in two groups: the control group (unfilled hollow posts) (Group 0) and hollow posts filled with dual resin cement (Group 1). The samples of both groups were subjected to mechanical and micromorphological analysis by performing a three-point test and SEM observations. In the three-point test, the Group 1 samples exhibited a fracture load of 57.09 ± 5.06 N, a flexural strength of 1323.53 ± 110.09 MPa, and a Young’s modulus of 42.87 ± 0.86 GPa. The samples of Group 2 exhibited a fracture load of 38.17 ± 1.7 N, a flexural strength of 908.87 ± 30.98 MPa, and a Young’s modulus of 40.33 ± 1.9 GPa. The difference between fracture load, flexural strength, and deflection between the two groups was statistically highly significant (p < 0.01). Further, the difference between the Young’s modulus of the two groups was statistically significant (p < 0.05). The values obtained are similar to those of other posts available on the market.
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Affiliation(s)
- Giuseppe Lo Giudice
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98122 Messina, Italy.
| | | | - Roberto Lo Giudice
- Department of Clinical and Experimental Medicine; Messina University, 98122 Messina, Italy.
| | - Francesco Puleio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98122 Messina, Italy.
| | - Fabiana Nicita
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98122 Messina, Italy.
| | - Massimo Calapaj
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98122 Messina, Italy.
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Garcia PP, Wambier LM, de Geus JL, da Cunha LF, Correr GM, Gonzaga CC. Do anterior and posterior teeth treated with post-and-core restorations have similar failure rates? A systematic review and meta-analysis. J Prosthet Dent 2019; 121:887-894.e4. [DOI: 10.1016/j.prosdent.2018.08.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 08/10/2018] [Accepted: 08/13/2018] [Indexed: 01/11/2023]
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El Ghoul W, Özcan M, Silwadi M, Salameh Z. Fracture resistance and failure modes of endocrowns manufactured with different CAD/CAM materials under axial and lateral loading. J ESTHET RESTOR DENT 2019; 31:378-387. [DOI: 10.1111/jerd.12486] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 01/28/2019] [Accepted: 04/09/2019] [Indexed: 01/10/2023]
Affiliation(s)
- Wiam El Ghoul
- Lebanese UniversityFaculty of Dental Medicine, Department of Prosthodontics Beirut Lebanon
| | - Mutlu Özcan
- University of ZurichCenter for Dental and Oral Medicine, Division of Dental Biomaterials Zurich Switzerland
| | - Munir Silwadi
- Lebanese UniversityFaculty of Dental Medicine, Department of Prosthodontics Beirut Lebanon
| | - Ziad Salameh
- Lebanese UniversityFaculty of Dental Medicine, Department of Prosthodontics Beirut Lebanon
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Fracture Strength and Stress Distribution in Premolars Restored with Cast Post-and-Cores or Glass-Fiber Posts Considering the Influence of Ferule. BIOMED RESEARCH INTERNATIONAL 2019; 2019:2196519. [PMID: 30719440 PMCID: PMC6335778 DOI: 10.1155/2019/2196519] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 11/22/2018] [Accepted: 12/11/2018] [Indexed: 12/25/2022]
Abstract
Objectives The aim of this study was to evaluate the influence of ferule and the post type on the fracture strength and stress distribution in premolars. Materials and Methods Forty human mandibular premolars were decoronated, allocated in four groups, and restored as follows: CPC-NF: cast post-and-core and absence of ferule; CPC-F: cast post-and-core and presence of ferule; FPC-NF: glass-fiber posts and absence of ferule; FPC-F: glass-fiber posts and presence of ferule. The fracture strength (FS) and failure patterns were evaluated. Finite element analysis (FEA) evaluated the stress distribution. Results FS did not differ between CPCs and FPC either in presence or in absence of ferule. The presence of ferule increased FS with both post types. Mean values of FS for ferule groups were higher than functional or parafunctional loads reported in literature, which was not the case for FPC-NF when compared to parafunctional loads. FEA with a functional load showed slightly higher compressive stresses in dentin in the group CPC-NF, which was much lower than the compressive strength of dentin. Lower percentage of catastrophic failures was observed in nonferule groups irrespective of post type, which was explained by the stress concentration in the cervical root region when FEA with the FS load was simulated. Conclusion Ferule effect was shown to be more important than post type in the analysis. Both posts showed potential to withstand functional loads irrespective of presence of ferule. However, the mean FS was lower than parafunctional loads for FPC in the absence of ferule.
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Hendi AR, Moharrami M, Siadat H, Hajmiragha H, Alikhasi M. The effect of conventional, half-digital, and full-digital fabrication techniques on the retention and apical gap of post and core restorations. J Prosthet Dent 2019; 121:364.e1-364.e6. [PMID: 30598306 DOI: 10.1016/j.prosdent.2018.09.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 09/18/2018] [Accepted: 09/19/2018] [Indexed: 11/24/2022]
Abstract
STATEMENT OF PROBLEM Conventional cast metal posts and cores are fabricated using direct and indirect techniques, both of which need impression materials and considerable laboratory work. Digital techniques have the capacity to substitute for conventional methods in fabricating the posts and cores. However, the accuracy of restorations resulting from a digital workflow is unknown. PURPOSE The purpose of this in vitro study was to compare the retention of posts and cores fabricated using full-digital, half-digital, and conventional techniques and to define the accuracy of each technique in terms of the apical gap. METHOD AND MATERIALS Thirty newly extracted mandibular first and second premolar teeth were selected for this in vitro study. Impressions were made using direct acrylic resin patterns (conventional), indirect silicone impressions of the intracanal which scanned with a 3Shape laboratory scanner (half digital), and intracanal scan posts captured with an intraoral 3Shape scanner (full digital). Casting and milling were conducted for the conventional impression and digital scans. The obtained posts were cemented using zinc phosphate cement. A universal pullout test was used to measure retention at a crosshead speed of 0.5 mm/min. The apical gap of each post in the canals was defined with parallel digital radiography. The data were analyzed using the Kruskal-Wallis test (α=.05) and Mann-Whitney test at the adjusted α=.016. RESULTS Significant differences were found among the conventional, full-digital, and half-digital techniques in terms of the apical gap (0.11, 0.29, and 0.66 mm; P<.001) and retention (171.6 ±1.9, 107.1 ±5.6 and 91.8 ±6.6 N; P<.001). The correlation between gap and retention in conventional (P=.43), full-digital (P=.09), and half-digital techniques (P=.06) was not statistically significantly different. CONCLUSIONS The conventional technique was more accurate and resulted in higher retention than both the full- and half-digital techniques. However, the retention and gap of all the posts fell within clinical guidelines.
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Affiliation(s)
- Amir Reza Hendi
- Assistant Professor, Dental Sciences Research Center, Department of Prosthodontics, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Moharrami
- Dentist, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hakimeh Siadat
- Professor, Dental Research Center, Dentistry Research Institute, Department of Prosthodontics, Tehran University of Medical Sciences, Tehran, Iran
| | - Habib Hajmiragha
- Assistant Professor, Department of Prosthodontics, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzieh Alikhasi
- Associate Professor, Dental Research Center, Dentistry Research Institute, Department of Prosthodontics, Tehran University of Medical Sciences, Tehran, Iran.
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Impact of endodontic post material on longitudinal changes in interproximal bone level: a randomized controlled pilot trial. Clin Oral Investig 2018; 23:2303-2311. [PMID: 30293188 DOI: 10.1007/s00784-018-2698-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 10/02/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Aim was to evaluate the impact of glass fiber versus titanium endodontic posts on the interproximal bone level around severely damaged endodontically treated teeth. MATERIALS AND METHODS Thirty-eight participants of a randomized controlled trial on glass fiber (n = 18) and titanium post-endodontic restorations (n = 20) received radiographs at two different times after post placement (T0 = <12 months and T1 = 36-72 months after post placement). A total of 76 radiographs were analyzed with an image-editing software. Medians of changes in mesial and distal interproximal bone level (∆MBL, ∆DBL) were calculated and tested for statistical significance with respect to post material using Mann-Whitney U test (p < 0.05). Impact of post material on bone level changes was assessed in multilevel mixed-effect linear regression models. RESULTS The mean observation period was 54 months for glass fiber and 50 months for titanium posts. Interproximal bone loss was small in both groups during the study period with no significant differences between groups (glass-fiber group, ∆MBL = - 0.03 mm and ∆DBL = - 0.06 mm; titanium group, ∆MBL = - 0.07 mm and ∆DBL = - 0.17 mm; both p > 0.05). Overall, impact of post material on bone loss was almost negligible with a nonsignificant difference between materials of 0.10 mm during the entire study period. CONCLUSION The rigidity of endodontic post material has no impact on the level of alveolar bone support of severely damaged endodontically treated teeth. CLINICAL RELEVANCE Post-endodontic restorations of severely damaged teeth can achieve steady levels of periodontal bone support as a parameter of periodontal health, irrespective of post material.
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Richert R, Robinson P, Viguie G, Farges JC, Ducret M. Multi-Fiber-Reinforced Composites for the Coronoradicular Reconstruction of Premolar Teeth: A Finite Element Analysis. BIOMED RESEARCH INTERNATIONAL 2018; 2018:4302607. [PMID: 29984233 PMCID: PMC6011147 DOI: 10.1155/2018/4302607] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 05/08/2018] [Indexed: 11/17/2022]
Abstract
A coronoradicular reconstruction (CRR) has conventionally used a metallic inlay core (MIC) or a single-fiber-reinforced composite (sFRC) but extensive dentin removal can lead to root fracture. We propose herein a multi-fiber-reinforced composite (mFRC) based on a bundle of thin flexible fibers that can be adapted to the root anatomy without removing additional dentin. The aim of this study was to compare the mechanical behavior of the root reconstructed with mFRC, MIC, or sFRC using a finite element analysis (FEA). Models with or without a ferrule effect were created using Autodesk© software and divided into four parts: root, post, bonding composite or cement, and zirconia crown. For both models, extreme stress values (ESV), stress distribution, and risk of fracture were calculated for an oblique force (45°) of 100 N applied to the top of the buccal cusp. Results indicated that mFRC and mFRCG present a lower risk of fracture of the root and of the CRR without ferrule and thus could be valuable alternatives for premolar CRR. Further studies are necessary to evaluate the clinical success of these CRR.
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Affiliation(s)
- Raphaël Richert
- Université de Lyon, Université Lyon 1, Faculté d'Odontologie, Lyon, France
- Hospices Civils de Lyon, Service de Consultations et Traitements Dentaires, Lyon, France
| | | | - Gilbert Viguie
- Université de Lyon, Université Lyon 1, Faculté d'Odontologie, Lyon, France
- Hospices Civils de Lyon, Service de Consultations et Traitements Dentaires, Lyon, France
| | - Jean-Christophe Farges
- Université de Lyon, Université Lyon 1, Faculté d'Odontologie, Lyon, France
- Hospices Civils de Lyon, Service de Consultations et Traitements Dentaires, Lyon, France
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR5305 CNRS/Université Lyon 1, UMS3444 BioSciences Gerland-Lyon Sud, Lyon, France
| | - Maxime Ducret
- Université de Lyon, Université Lyon 1, Faculté d'Odontologie, Lyon, France
- Hospices Civils de Lyon, Service de Consultations et Traitements Dentaires, Lyon, France
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR5305 CNRS/Université Lyon 1, UMS3444 BioSciences Gerland-Lyon Sud, Lyon, France
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49
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Corrêa G, Brondani LP, Wandscher VF, Pereira GKR, Valandro LF, Bergoli CD. Influence of remaining coronal thickness and height on biomechanical behavior of endodontically treated teeth: survival rates, load to fracture and finite element analysis. J Appl Oral Sci 2018; 26:e20170313. [PMID: 29742252 PMCID: PMC5933830 DOI: 10.1590/1678-7757-2017-0313] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 09/26/2017] [Indexed: 11/22/2022] Open
Abstract
Objective To evaluate the effect of restorative strategy (fiber post vs cast post and core), coronal height (0 mm vs 2 mm) and thickness (higher than 1 mm vs lower than 1 mm) on survival rate, fracture resistance and stress distribution. Material and Methods Seventy-two bovine teeth were cleaned and allocated in six groups (n = 12). Twenty-four teeth were sectioned at 13 mm length (no remaining coronal structure) and forty-eight were sectioned at 15 mm (2 mm remaining coronal structure). Half of the forty-eight had remaining coronal thickness lower than 1 mm and the other half had thickness higher than 1 mm. All root canals were prepared at 10 mm (luting length), fiber posts were cemented in thirty-six specimens and cast post and core in other thirty-six. All teeth were restored with metallic crowns. Specimens were submitted to 1.5 million cycles (100 N, 45°, 10 Hz at 2 mm below incisal edge) and evaluated at each 500,000 cycles to detect failures. Specimens that survived were submitted to load to fracture test. Bidimensional (Rhinoceros® 4.0) models were obteined survival data submitted to Kaplan-Meier (α=0.05) analysis and load to fracture values submitted to ANOVA and Tukey tests (α=0.05). Results Groups without remaining coronal structure showed survival rates lower than other groups (p=0.001). ANOVA showed higher values of load to fracture for groups with coronal thickness higher than 1 mm (p=0.0043). Finite element analysis showed better stress distribution in groups with remaining coronal structure and restored with fiber post. Conclusion Specimens without remaining coronal structure have lower survival rates. Specimens with remaining structure lower than 1 mm and without coronal structure support the same load to fracture value independently of the restorative strategy.
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Affiliation(s)
- Gislene Corrêa
- Programa de Pós-Graduação em Odontologia, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brasil
| | - Lucas P Brondani
- Programa de Pós-Graduação em Odontologia, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brasil
| | - Vinícius F Wandscher
- Programa de Pós-Graduação em Odontologia, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brasil
| | - Gabriel K R Pereira
- Programa de Pós-Graduação em Odontologia, Faculdade Meridional - IMED, Passo Fundo, Rio Grande do Sul, Brasil
| | - Luiz F Valandro
- Faculdade de Odontologia, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brasil
| | - César D Bergoli
- Programa de Pós-Graduação em Odontologia, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brasil
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50
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Direct or indirect post crowns to restore compromised teeth: a review of the literature. Br Dent J 2018; 224:413-418. [PMID: 29569608 DOI: 10.1038/sj.bdj.2018.218] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2017] [Indexed: 11/08/2022]
Abstract
Post crowns are restorations which utilise the root canal space to improve the retention and resistance form of teeth which lack coronal tooth structure. In recent years there have been significant developments in the materials, systems and evidence-base surrounding the provision of post crowns. This review aims to refresh the general dental practitioner's (GDPs) knowledge of the different factors that must be considered when placing a post crown, and how these factors can help guide the dentist in their decision to provide either a direct or indirect post and core.
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