1
|
Bahadır HS, Bulut AC, Yılmaz B. Effect of preparation design on the fracture resistance and fracture patterns of 3D printed one-piece endodontic crowns. J Prosthet Dent 2024:S0022-3913(24)00423-2. [PMID: 38960755 DOI: 10.1016/j.prosdent.2024.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 06/06/2024] [Accepted: 06/11/2024] [Indexed: 07/05/2024]
Abstract
STATEMENT OF PROBLEM The impact of various preparation designs on the fracture resistance and fracture type of mandibular premolars restored with 3 dimensionally (3D) printed, 1-piece endodontic crowns remains unclear. PURPOSE The purpose of this study was to investigate the effect of different preparation designs on the fracture resistance and fracture patterns of mandibular premolars restored with 3D printed 1-piece endodontic crowns after thermal aging. MATERIAL AND METHODS Forty-five freshly extracted mandibular premolars received 3 different preparation designs: with at least 2 intact cuspal walls (2CW), with only 1 intact cuspal wall (1CW), and no cuspal wall present (NoCW). One-piece endodontic crowns were designed by using a computer-aided design (CAD) software program, 3D printed, cemented to the prepared teeth with self-adhesive resin cement, and thermocycled between 5 °C and 55 °C in artificial saliva. Subsequently, all specimens were subjected to a fracture test. The results were statistically analyzed using 1-way ANOVA (α=.05), and fracture types of all specimens were examined using a light microscope. RESULTS The analysis of fracture resistance values across separate designs revealed no statistically significant differences (P>.05). Mean fracture resistance values were 724.5 N in 2CW, 713 N in 1CW, and 861 N in NoCW. In 2CW and 1CW, the 1-piece endodontic crowns mostly displayed Type III fractures, whereas those in NoCW exhibited a combination of Type II and Type III fractures. CONCLUSIONS The mandibular premolar 1-piece endodontic crowns tested in this study exhibited similar fracture resistance and type of fracture with different preparation designs.
Collapse
Affiliation(s)
- Hasibe Sevilay Bahadır
- Assistant Professor, Department of Restorative Dentistry, Faculty of Dentistry, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Ali Can Bulut
- Associate Professor, Department of Prosthodontic Dentistry, Faculty of Dentistry, Ankara Yıldırım Beyazıt University, Ankara, Turkey.
| | - Burak Yılmaz
- Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; and Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio
| |
Collapse
|
2
|
Tribst JPM, Dal Piva AMDO, Muris J, Kleverlaan CJ, Feilzer AJ. One-piece endodontic crown fixed partial denture: Is it possible? J Prosthet Dent 2024; 131:1118-1125. [PMID: 36801103 DOI: 10.1016/j.prosdent.2023.01.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/18/2023] [Accepted: 01/18/2023] [Indexed: 02/18/2023]
Abstract
STATEMENT OF PROBLEM Whether the replacement of a missing tooth with a fixed partial denture supported by an endodontically treated abutment could be improved with 1-piece endodontic crowns is unclear. PURPOSE The purpose of the study was to evaluate the mechanical behavior of a fixed partial denture (FPD) according to the preparation of the abutment teeth (1-piece endodontic crown or complete crown) in terms of stress magnitude in the prosthesis, cement layer, and tooth. MATERIAL AND METHODS A posterior model with 2 abutment teeth (first molar and first premolar) was modeled with a computer-aided design (CAD) software program for conducting a 3-dimensional finite element analysis (FEA). To replace the missing second premolar, the model was replicated in different possible FPDs according to the abutment preparation design (complete crown [Conventional], 2 1-piece endodontic crowns [EC]) or a 1-piece endodontic crown on one of the abutment teeth (first molar [ECM] and first premolar [ECP]) for a total of 4 designs. All FPDs were in lithium disilicate. The solids were imported to an analysis software program (ANSYS 19.2) in the standard for the exchange of product data (STEP) format. The mechanical properties were considered isotropic and the materials to show linear elastic and homogeneous behavior. An axial load (300 N) was applied at the occlusal surface of the pontic. The results were evaluated by colorimetric stress maps of von Mises and maximum principal stress in the prosthesis, maximum principal stress and shear stresses on the cement layer, and maximum principal stress in the abutment teeth. RESULTS The von Mises stresses revealed that all FPD designs behaved similarly and that, considering the maximum principal stress criteria, the pontic was the most stressed region. For the cement layer, the combined designs presented an intermediate behavior, with the ECM more suitable to reducing the stress peak. The conventional preparation allowed less stress concentration in both teeth, and higher stress concentration in the premolar was observed with a 1-piece endodontic crown. The 1-piece endodontic crown decreased the risk of fracture failure. Considering the risk of debonding failure for the prosthesis, the 1-piece endodontic crown preparation was only able to decrease the failure risk when the EC design was used and when only the shear stress was considered. CONCLUSIONS Performing 1-piece endodontic crown preparations to retain a 3-unit lithium disilicate FPD is an alternative to conventional complete crown preparations.
Collapse
Affiliation(s)
- João Paulo M Tribst
- Assistant Professor, Department of Oral Regenerative Medicine, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands
| | - Amanda Maria de O Dal Piva
- Assistant Professor, Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands.
| | - Joris Muris
- Assistant Professor, Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands
| | - Cornelis J Kleverlaan
- Professor, Department of Dental Materials Science, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam & Vrije Universiteit, Amsterdam, the Netherlands
| | - Albert J Feilzer
- Professor, Department of Oral Regenerative Medicine, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam & Vrije Universiteit, Amsterdam, the Netherlands
| |
Collapse
|
3
|
Stoilov M, Boehmer T, Stoilov L, Stark H, Marder M, Enkling N, Kraus D. Influence of Cementation Mode and Ferrule Design on the Fatigue Resistance of Monolithic Zirconia Endocrowns. J Clin Med 2024; 13:1165. [PMID: 38398475 PMCID: PMC10889707 DOI: 10.3390/jcm13041165] [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: 01/30/2024] [Revised: 02/13/2024] [Accepted: 02/17/2024] [Indexed: 02/25/2024] Open
Abstract
Background: Classic endocrowns made of dental ceramics are considered a promising alternative to traditional post-endodontic restorations. The use of circular ferrules in endocrowns is a topic of controversial discussion. Therefore, the present study aims to evaluate the effect of ferrule design and cementation mode on the fatigue resistance of zirconia endocrowns. Methods: Eighty human molars were divided into four groups (n = 20): NFC (no-ferrule, conventional cementation), NFA (no-ferrule, adhesive luting), FC (ferrule, conventional cementation) and FA (ferrule, adhesive luting). Both the classic and the modified endocrown preparation with a two-millimeter ferrule design were carried out. Endocrowns were fabricated from zirconia using the CEREC system. After thermocycling, specimens were loaded according to the step-stress test up to 1500 N. Results: Failure rate was low; 88.8% of total specimens passed the step-stress test. Fractures were distributed between all groups; no significant differences in fatigue resistance were detected for preparation design and cementation mode. Conclusions: Endocrowns appear to be a promising concept for endodontically treated molars. Ferrule and also cementation mode have only a minor influence on fatigue resistance of zirconia endocrowns. However, at very high forces, the marginal area of the ferrule represents a weak point.
Collapse
Affiliation(s)
- Milan Stoilov
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
| | - Tobias Boehmer
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
| | - Lea Stoilov
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
| | - Helmut Stark
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
| | - Michael Marder
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
| | - Norbert Enkling
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
- Department of Reconstructive Dentistry and Gerodontology, Bern University, 3012 Bern, Switzerland
| | - Dominik Kraus
- Department of Prosthodontics, Preclinical Education and Dental Materials Science, Bonn University, 53111 Bonn, Germany; (T.B.); (L.S.); (H.S.); (M.M.); (N.E.); (D.K.)
| |
Collapse
|
4
|
Lenz U, Bacchi A, Della Bona A. Biomechanical performance of endocrown and core-crown restorations: A systematic review. J ESTHET RESTOR DENT 2024; 36:303-323. [PMID: 37571973 DOI: 10.1111/jerd.13119] [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: 06/12/2023] [Revised: 07/26/2023] [Accepted: 07/29/2023] [Indexed: 08/13/2023]
Abstract
OBJECTIVE To assess and compare, through a systematic review of the literature, the biomechanical performance of endocrowns and traditional core-crowns (with and without intracanal post) for the rehabilitation of endodontically treated teeth with severe coronal structure damage. MATERIALS AND METHODS A systematic search was performed in MEDLINE/PubMed, Scopus, and Web of Science databases. In-vitro studies comparing endocrowns with (post-)core-crown restorations were selected and screened by two independent reviewers. The included studies were submitted to the risk of bias analysis using the RoBDEMAT tool and the biomechanical outcomes were collected for qualitative analysis. The extracted data were presented based on comparative analyses among the included studies. RESULTS Thirty-one studies were included: 9 studies evaluated restorations of molars, 14 for premolars, and 8 studies evaluated anterior restorations. For the majority of the studies, endocrowns showed either similar or greater survival rates under fatigue and monotonic load than (post-)core-crown restorations, irrespectively of the tooth. The endocrowns showed more favorable failure patterns than (post-)core-crowns, irrespectively of the tooth. Endocrowns produced lower stresses in the restorative material for molars and premolars and in the luting material for premolars than (post-)core-crown restorations. The included studies presented adequate information for most items of the RoBDEMAT risk of bias tool. CONCLUSION Endocrowns showed similar or greater biomechanical performance than the traditional (post-)core-crown restorations in most of the evaluated studies. CLINICAL SIGNIFICANCE This systematic review showed that endocrowns present either similar or greater biomechanical performance than core-crown restorations for anterior and posterior endodontically treated teeth with severe structural damage.
Collapse
Affiliation(s)
- Ulysses Lenz
- Postgraduate Program in Dentistry, University of Passo Fundo, Passo Fundo, Brazil
| | - Atais Bacchi
- Postgraduate Program in Dentistry, Paulo Picanço School of Dentistry, Fortaleza, Brazil
| | - Alvaro Della Bona
- Postgraduate Program in Dentistry, University of Passo Fundo, Passo Fundo, Brazil
| |
Collapse
|
5
|
Abbas MH, Elerian FA, Elsherbiny AA, Elgohary NMM, Atout A. Influence of occlusal reduction design on the fracture resistance and biomechanical behavior of endocrowns restoring maxillary premolars. BMC Oral Health 2024; 24:113. [PMID: 38243249 PMCID: PMC10799380 DOI: 10.1186/s12903-023-03688-3] [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: 08/22/2023] [Accepted: 11/21/2023] [Indexed: 01/21/2024] Open
Abstract
PURPOSE To investigate the effect of different occlusal reduction design on stress distribution and fracture resistance of different endocrown systems. MATERIAL AND METHODS Sixty-four maxillary human premolars with endodontic treatment, prepared for endocrowns were divided into 2 groups (n = 32) according to the occlusal design: Butt joint preparation (B group) and Anatomical preparation (A group). Each group were subdivided into four groups according to ceramic systems: IPS E max CAD (EM group), monolithic zirconia (ZR group), Nacera Hyprid (NH group) and PEKKTON (PE group). After manufacturing of endocrowns and adhesive bonding the specimens were thermomechanically loaded and subsequently they were tested in a universal testing machine for evaluating the fracture resistance. The specimens failure mode was qualitatively assessed. The stress distribution in each group was assessed using three-dimensional finite element analysis (FEA). 1-way ANOVA and the Post Hoc Tukey HSD test were used to evaluate the data (a = .05). RESULTS The fracture resistance values between the groups showed statistically significant variations. The B PE and A PE groups had a higher ratio of fracture resistance values. Regarding failure mode, ceramic endocrowns recorded mainly irreparable failures. FEA showed that anatomical occlusal preparation have reduced the stress concentration under all endocrown systems. CONCLUSION Endocrowns could be used to restore endodontically treated maxillary premolars. PEKKTON endocrowns with anatomical preparations revealed most appropriate restoration. The tested new endocrown systems enhanced the biomechanical performance of the tooth. CLINICAL SIGNIFICANCE The innovative endocrown systems (PEKK, Nacera Hyprid) can be seen as a promising choice for restoration of severely-destructed endodontic treated premolars, with less stress transmit to the residual tooth structure. Although the traditional endocrown technology might increase the longevity of tooth bonding, it shouldn't be used for clenching cases since the risk of failure is too great overall.
Collapse
Affiliation(s)
- Mahy Hassouna Abbas
- Fixed Prosthodontics Dept, Faculty of Dentistry, Mansoura University and Delta University for Science and Technology, Mansoura, Egypt.
| | - Fatma Abdallah Elerian
- Department of Mechanical Engineering, College of Engineering, University of Bisha, P.O. Box 001, Bisha, 67714, Saudi Arabia
- Mansoura University, Mansoura, Egypt
| | - Abdallah Ahmed Elsherbiny
- Production Engineering and Mechanical Design Department, Faculty of Engineering, Mansoura University, Mansoura, Egypt
| | | | - Abeer Atout
- Department of prosthetic dental sciences , College of Dentistry, Jazan University, KSA and Fixed Prosthodontics Dept, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| |
Collapse
|
6
|
AlHelal AA. Biomechanical behavior of all-ceramic endocrowns fabricated using CAD/CAM: A systematic review. J Prosthodont Res 2024; 68:50-62. [PMID: 37286503 DOI: 10.2186/jpr.jpr_d_22_00296] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE This study performed a systematic review to assess the biomechanical behavior of all-ceramic endowcrowns fabricated using computer-aided design and computer-aided manufacturing (CAD/CAM) for the restoration of endodontically treated teeth. STUDY SELECTION Three electronic databases (PubMed, Web of Science, and Scopus) were searched by operators specializing in health sciences databases searches to answer the following focused question based on the Population, Intervention, Comparison, Outcome (PICO) format: "Whether all-ceramic CAD/CAM endocrowns (Intervention) used to restore human endodontically treated teeth (Population) exhibit superior fracture resistance (Outcome) compared to non-CAD/CAM all-ceramic or non-ceramic endocrowns (Comparison)." The methodological quality assessment was performed using previously conducted systematic reviews of in vitro studies. The outcomes were expressed as the mean ± the standard deviation (SD). RESULTS Seventeen in vitro studies were included. The materials used in these studies were lithium disilicate glass-ceramic, polymer-infiltrated ceramic, zirconia-reinforced lithium silicate glass-ceramic, resin/hybrid nanoceramics, zirconia-reinforced lithium silicate ceramics, and feldspathic ceramic. The fracture resistance of endocrowns using different ceramics varied as follows: (i) IPS e.max CAD (2863.62 ± 51.47 N), (ii) Vita Enamic (1952 ± 378 N), (iii) Vita Suprinity (1859 ± 588 N), (iv) Cerasmart (1981 ± 169.5 N), (v) LAVA Ultimate (2484 ± 464 N), (vi) Celtra Duo (1618.30 ± 585.00 N), and (vii) Cerec Blocs (236.29 ± 32.12 N). CONCLUSIONS CAD/CAM all-ceramic endocrowns can withstand occlusal forces in the posterior region. All-ceramic endocrowns improve the fracture strength of endodontically treated teeth. Lithium disilicate crowns were commonly and successfully used in the included studies. More in vitro investigations that implement uniformity in material and measurement approaches are required to strengthen the evidence currently available in the literature regarding the durability of all-ceramic endocrowns.
Collapse
Affiliation(s)
- Abdulaziz A AlHelal
- Department of Prosthetic Dental Sciences, King Saud University, College of Dentistry, Riyadh, Saudi Arabia
| |
Collapse
|
7
|
Gibson T, Alsahafi T, Clark W, Duqum I, Culp L, Sulaiman TA. Fatigue resistance of 3D printed anatomic post-and-core after mastication simulation. J Prosthet Dent 2023; 130:858.e1-858.e6. [PMID: 37802733 DOI: 10.1016/j.prosdent.2023.09.010] [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: 07/03/2023] [Revised: 09/11/2023] [Accepted: 09/13/2023] [Indexed: 10/08/2023]
Abstract
STATEMENT OF PROBLEM Rigid post-and-core systems have traditionally been used in the restoration of endodontically treated teeth and are regarded by many as the standard treatment. Flexible materials, including nanoceramic resins, are being increasingly implemented as post-and-core systems, but data supporting their use are lacking. PURPOSE The purpose of this in vitro study was to compare the fatigue resistance of conventional cast metal and nanoceramic 3-dimensionally (3D) printed resin post-and-core systems with teeth without posts. MATERIAL AND METHODS Thirty freshly extracted human maxillary premolars were endodontically treated and divided into 3 subgroups (n=10) according to the restorative procedure: cast metal post-and-core (CM), nanoceramic 3D printed resin post-and-core (3DR), and without a post (0P). The CM post-and-core group was fabricated conventionally, while the 3DR group was printed using a 3D resin printing material. For the 0P group, the teeth were restored with a composite resin foundation after root canal obturation. Complete coverage 3-mol% monolithic zirconia restorations were cemented on all specimens. The specimens were exposed to simultaneous mastication simulation (1.2 million cycles) and thermocycling (10 000 cycles at 5 ºC to 55 ºC) and analyzed based on the failure of specimens. Data were analyzed using the Kruskal-Wallis survival analysis and the Wilcoxon rank sum test (α=.05). RESULTS The Kruskal-Wallis test indicated statistically significant differences among the cycles needed to reach failure for each of the 3 groups (P<.001). At 1.2 million cycles, there were no CM failures. The 3DR group failed at a median value of 950 000 cycles, while the 0P group failed at a median value of 222 500 cycles (P<.001). CONCLUSIONS All the endodontically treated teeth that received CM survived the 1 200 000 simulated mastication cycles. Both 3DR and 0P specimens fractured at the crown cervical third during mastication simulation.
Collapse
Affiliation(s)
- Timothy Gibson
- Resident, Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Tariq Alsahafi
- PhD student and Teaching Assistant, Oral and Craniofacial Biomedicine, Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC; and Lecturer, Department of Conservative Dentistry, College of Dentistry, Qassim University, Buraydah, Saudi Arabia
| | - Wendy Clark
- Associate Professor, Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Ibrahim Duqum
- Professor, Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Taiseer A Sulaiman
- Associate Professor, Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC..
| |
Collapse
|
8
|
Al Fodeh RS, Al-Johi OS, Alibrahim AN, Al-Dwairi ZN, Al-Haj Husain N, Özcan M. Fracture strength of endocrown maxillary restorations using different preparation designs and materials. J Mech Behav Biomed Mater 2023; 148:106184. [PMID: 37839334 DOI: 10.1016/j.jmbbm.2023.106184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 10/07/2023] [Accepted: 10/10/2023] [Indexed: 10/17/2023]
Abstract
PURPOSE This study investigated the impact of preparation design and material types on fracture strength in maxillary premolars endocrowns after thermodynamic aging. MATERIALS AND METHODS Eighty two-rooted maxillary premolar crowns underwent endodontic treatment (N = 80, n = 10). The teeth were categorized into ten groups (4-mm deep with no intracanal extension lithium disilicate glass ceramic & multilayer zirconia endocrowns (LE0 & ZE0); 4-mm deep with 4-mm intracanal extension in one canal (LE1 & ZE1); 4-mm deep with 2-mm intracanal extensions in both canals (LE2 & ZE2); flat overlays with no endocore (LO & ZO); glass fiber reinforced post & core and crown (LC & ZC)). After cementation, all specimens were subjected to 1500 thermocycles and 1,200,000 chewing cycles with an axial occlusal load of 49 N. A static loading test was performed at a non-axial 45° loading using a universal testing machine and failure modes (Type I: restoration debonding; Type II: restoration fracture; Type III: restoration/tooth complex fracture above bone level; Type IV: restoration/tooth complex fracture below bone level) were evaluated using a stereoscope. Data were ananalzed using 2-way ANOVA and Tukey's tests (alpha = 0.05). RESULTS The endocrowns manufactured from multilayered zirconia and pressed lithium disilicate glass ceramic exhibited a fracture load ranging between 1334 ± 332 N and 756 ± 150 N, with ZC presenting the highest and LE2 the lowest values. The differences were not statistically significant (p > 0.05). CONCLUSION All endocrowns tested in this study performed similar considering the different designs and materials tested. The distribution of fracture modes did not differ significantly depending on the design of the restoration and the type of material used.
Collapse
Affiliation(s)
- Rami S Al Fodeh
- Department of Prosthodontics, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Omer S Al-Johi
- Department of Prosthodontics, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Anas N Alibrahim
- Department of Prosthodontics, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Ziad N Al-Dwairi
- Department of Prosthodontics, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Nadin Al-Haj Husain
- Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland; Clinic of Masticatory Disorders and Dental Biomaterials, Center of Dental Medicine, University of Zurich, Zurich, Switzerland; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Mutlu Özcan
- Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland; Clinic of Masticatory Disorders and Dental Biomaterials, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
| |
Collapse
|
9
|
Kazemi-Yazdi H, Rezaei S, Seyedan K, Kazeminia M, Rezaei S. The effect of preparation design on fracture resistance of endodontically treated maxillary premolars restored with lithium disilicate computer-aided design/computer-aided manufacturing endocrowns: An in vitro study. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2023; 26:627-633. [PMID: 38292752 PMCID: PMC10823980 DOI: 10.4103/jcde.jcde_66_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/22/2023] [Accepted: 09/18/2023] [Indexed: 02/01/2024]
Abstract
Purpose This study aimed to assess the effect of preparation design on fracture resistance (FR) of endodontically treated maxillary premolars restored with lithium disilicate (LDS) endocrowns fabricated by the computer-aided design/computer-aided manufacturing (CAD/CAM) technology. Materials and Methods In this in vitro, experimental study, 30 sound maxillary premolars were randomly assigned to three groups (n = 10) of control (no preparation), endocrown preparation with butt-joint design without ferrule, and endocrown preparation with ferrule (shoulder design with 1 mm height). After restoration fabrication and cementation, the teeth underwent thermocycling, were mounted with 45° angle, and subjected to compressive load in a universal testing machine to measure their FR. The mode of failure was also determined under a stereomicroscope. Data were analyzed using one-way ANOVA and Tukey's test (α =0.05). Results The shoulder group showed the highest FR (1768.98 ± 386.1 N). The difference in FR was statistically significant among the three groups (P < 0.05). Pairwise comparisons revealed that the shoulder group had significantly higher FR than the butt-joint (P = 0.001) and control (P = 0.009) groups. However, the difference in FR between the butt-joint and control groups was not significant (P = 0.75). The mode of failure was not significantly different among the three groups (P > 0.05). Conclusions Preparation design had a significant effect on FR of endodontically treated maxillary premolars restored with LDS CAD/CAM Endocrowns, such that addition of a short axial wall in shoulder group significantly increased the FR of endocrowns.
Collapse
Affiliation(s)
- Haleh Kazemi-Yazdi
- Department of Operative Dentistry, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Sadaf Rezaei
- Department of Aesthetic and Restorative Dentistry, Faculty of Dentistry, Iran University of Medical Sciences, Tehran, Iran
| | - Kaveh Seyedan
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marjan Kazeminia
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Golestan University of Medical Sciences, Gorgan, Iran
| | - Sina Rezaei
- Department of Undergraduate Student of Dentistry, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
10
|
Munoz-Sanchez ML, Gravier A, Francois O, Nicolas E, Hennequin M, Decerle N. In Vitro Resistance of Natural Molars vs. Additive-Manufactured Simulators Treated with Pulpotomy and Endocrown. J Funct Biomater 2023; 14:444. [PMID: 37754858 PMCID: PMC10531589 DOI: 10.3390/jfb14090444] [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: 07/10/2023] [Revised: 08/23/2023] [Accepted: 08/27/2023] [Indexed: 09/28/2023] Open
Abstract
Endocrowns are designed to restore endodontically treated teeth with root canal treatment (Rct). Recently, endocrowns were proposed for teeth treated with full pulpotomy (FP). No data exist on in vitro evaluations for this combination. This study aimed to evaluate the mechanical behavior of pulpotomy-treated teeth with endocrowns according to different protocols for preparation design and materials and to assess whether 3D-printed resin simulators could be a reliable alternative for human teeth during in vitro strength tests. One hundred and ten extracted natural molars were randomized into 11 groups according to the type of endodontic treatment, the material used, and the design of peripheric preparation. One hundred and ten resin simulators were separated similarly. The samples were embedded in epoxy resin blocks before being subjected to oblique compressive load until failure. For natural teeth, the variance analysis separated two homogeneous groups, one regrouping the endodontically treated or pulpotomy-treated teeth without coronal restoration and the other one regrouping all the other samples, i.e., the untreated teeth (positive controls) and the treated and restored teeth. The strength resistance was lower for the resin simulators than for natural teeth in all groups. Within the limit of this study, strength resistance is not the most important criterion for choosing the type of material, preparation, or endodontic treatment for endocrowns. Resin simulators are not efficient for in vitro strength studies.
Collapse
Affiliation(s)
- Marie-Laure Munoz-Sanchez
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (M.-L.M.-S.); (O.F.); (M.H.); (N.D.)
- CHU Clermont-Ferrand, Service d’Odontologie, F-63003 Clermont-Ferrand, France
| | - Alexis Gravier
- Institut Pascal UMR CNRS 6602, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France;
| | - Olivier Francois
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (M.-L.M.-S.); (O.F.); (M.H.); (N.D.)
| | - Emmanuel Nicolas
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (M.-L.M.-S.); (O.F.); (M.H.); (N.D.)
- CHU Clermont-Ferrand, Service d’Odontologie, F-63003 Clermont-Ferrand, France
| | - Martine Hennequin
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (M.-L.M.-S.); (O.F.); (M.H.); (N.D.)
- CHU Clermont-Ferrand, Service d’Odontologie, F-63003 Clermont-Ferrand, France
| | - Nicolas Decerle
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (M.-L.M.-S.); (O.F.); (M.H.); (N.D.)
- CHU Clermont-Ferrand, Service d’Odontologie, F-63003 Clermont-Ferrand, France
| |
Collapse
|
11
|
Veselinova M, Diamantopoulou S, Paximada C, Papazoglou E. In-Vitro Comparison of Fracture Strength of Endocrowns and Overlays in Endodontically Treated Teeth Manufactured with Monolithic Lithium Disilicate and Zirconia. J Funct Biomater 2023; 14:422. [PMID: 37623666 PMCID: PMC10455451 DOI: 10.3390/jfb14080422] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/25/2023] [Accepted: 08/08/2023] [Indexed: 08/26/2023] Open
Abstract
To evaluate the fracture strength and the failure mode of endodontically treated molars restored with monolithic lithium disilicate and zirconia endocrowns and overlays. A total of 48 extracted mandibular molars were endodontically treated, decoronated 2 mm above the cementoenamel junction and divided into four 12-specimen groups. Group ELD: lithium disilicate endocrowns. Group EZ: monolithic zirconia endocrowns. Group OLD: lithium disilicate overlays. Group OZ: monolithic zirconia overlays. Overlays did not extend in the pulp chamber and endocrowns extended in the pulp chamber 2 mm. After adhesive bonding of the restorations, the specimens were subjected to thermocycling (×5000 cycles) and then to fracture resistance testing at lateral static loading (1 mm/min) at a universal testing machine. The failure mode of the specimens was qualitatively evaluated. Differences in means were compared using with t-tests for independent samples or Mann-Whitney test (p < 0.05). Weibull distribution analysis was also performed. Group ELD showed significantly higher fracture strength than all other groups (p = 0.001), and the highest Weibull modulus. Conclusions: Lithium disilicate endocrowns exhibit higher fracture strength and are more reliable compared to the other types of restorations examined. Endocrowns had more catastrophic failures compared to overlays.
Collapse
Affiliation(s)
| | | | | | - Efstratios Papazoglou
- Department of Operative Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.V.); (S.D.); (C.P.)
| |
Collapse
|
12
|
El-Farag SAA, Elerian FA, Elsherbiny AA, Abbas MH. Impact of different CAD/CAM materials on internal and marginal adaptations and fracture resistance of endocrown restorations with: 3D finite element analysis. BMC Oral Health 2023; 23:421. [PMID: 37357307 DOI: 10.1186/s12903-023-03114-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 06/06/2023] [Indexed: 06/27/2023] Open
Abstract
PURPOSE To assess and compare the impact of various computers aided design/manufacturing (CAD/CAM) materials on internal and marginal discrepancies, fracture resistance and failure probability of Endocrown restorations with 3D Finite Element analysis. MATERIAL AND METHODS Forty devitalized human maxillary first molars were collected. After endodontic treatment, they classified into 4 groups (n = 10) based on the materials used for endocrown fabrication. Group V (Vita-Enamic), Group N (Nacera Hybrid), Group T (Translucent Prettau Zirconia) and Group P (Pekkton ivory). All samples were exposed to artificial aging method simulating one year of clinical service. Silicone replica technique and stereomicroscope (25X) utilized to evaluate the marginal and internal gaps of endocrowns at different areas. Fracture resistance test used for cemented specimens followed by qualitative investigation utilizing Stereomicroscopy. Four models representing four endocrown systems used for restoration of severely-damaged endodontically treated upper first molar were generated for finite element analysis (FEA). Axially and centrally static occlusal compressive load was applied. Modified Von Mises and maximum principal stress values on the remaining tooth structure, cement lines and restorative materials were assessed independently. Resulted data were statistically analyzed at P-value ≤ 0.05. RESULTS In the current study, the highest mean values of internal and marginal discrepancies (μm) among studied groups were reported for Zirconia group (100.300 and 102.650) respectively, while the lowest mean value of internal discrepancy (μm) was observed for Nacera group (69.275) and the lowest mean value of marginal discrepancy (μm) was observed for PEKK group (78.4750). Regarding internal discrepancy, Vita-Enamic and PEKK groups did not exhibit any statistically significant differences (P = 0.293), however zirconia and the other tested groups exhibited statistically significant differences in the mean values of the marginal gap region (p 0.05).On the other hand, PEKK group showed the highest mean value of fracture resistance (1845.20 N) and the lowest value was observed for Vita-Enamic group (946.50 N). Regarding to stress distributions through 3D FEA, and according to modified von Mises (mvM) analysis, the greatest possible stress values were noticed in PEKK model in relation to tooth structure, cement line, and flowable composite as the following: (93.1, 64.5, 58.4 MPa) respectively, while Zirconia revealed lower maximum stress values (11.4, 13.6, 11.6 MPa) respectively. CONCLUSIONS Statistically excellent marginal and internal fit was observed for PEKK in relation to other used endocrown materials. Also, PEKK material explained fracture resistance comparable to zirconia value while the lowest value was detected for Vita Enamic material.
Collapse
Affiliation(s)
- Shaimaa Ahmed Abo El-Farag
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University and Horus University (HUE), Mansoura, Egypt
| | - Fatma Abdallah Elerian
- Production and Mechanical Design Department, Faculty of Engineering, Mansoura University, Mansoura, 35516, Egypt
| | - Abdallah Ahmed Elsherbiny
- Production and Mechanical Design Department, Faculty of Engineering, Mansoura University, Mansoura, 35516, Egypt
| | - Mahy Hassouna Abbas
- Fixed Prosthodontics Department, Faculty of Dentistry, Mansoura University and Delta University for Science and Technology, Mansoura, Egypt.
| |
Collapse
|
13
|
Qamar Z, Alghamdi AMS, Haydarah NKB, Balateef AA, Alamoudi AA, Abumismar MA, Mathur A, Minervini G. In Vitro Evaluation of Lithium Disilicate Endocrowns and Post and Core Crowns-A Systematic Review. J Funct Biomater 2023; 14:jfb14050276. [PMID: 37233386 DOI: 10.3390/jfb14050276] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/25/2023] [Accepted: 05/08/2023] [Indexed: 05/27/2023] Open
Abstract
The aim of this systematic review was to summarize the results of the studies that have compared the physical and mechanical properties of lithium disilicate (LDS) endocrowns constructed for posterior teeth to those retained by post-and-core retention systems. The review was conducted following the PRISMA guidelines. The electronic search process was conducted on PubMed-Medline, Scopus, Embase and ISI Web of Knowledge (WoS) from the earliest available date till 31 January 2023. Additionally, the studies were assessed for their overall quality and risk of bias using the Quality Assessment Tool For In Vitro Studies (the QUIN). The initial search resulted in 291 articles, out of which, only 10 studies met the eligibility criteria. In all studies LDS endocrowns were compared with various kinds of endodontic posts and crowns made from other materials. There were no definite pattern or trends observed in the fracture strengths of tested specimens. There was no predilection observed in failure patters among the experimental specimens. No predilection was observed in the fracture strengths of LDS endocrowns when compared to post-and-core crowns. Furthermore, no differences in failure patterns could be observed when both types of restorations were compared. The authors propose standardized testing of endocrowns against post-and-core crowns in future studies. In conclusion, long-term clinical trials are advocated to compare the survival, failure and complication rates of LDS endocrowns and post-and-core restorations.
Collapse
Affiliation(s)
- Zeeshan Qamar
- Department of O&MFS and Diagnostic Sciences, Faculty of Dentistry, Riyadh Elm University, Riyadh 13244, Saudi Arabia
| | | | | | | | | | | | - Ankita Mathur
- STAT SENSE, Srushti 10, Sector 1 D, Amba Township Pvt. Ltd., Trimandir, Adalaj 382421, Gujarat, India
- Department of Periodontology, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune 411018, Maharashtra, India
| | - Giuseppe Minervini
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
| |
Collapse
|
14
|
Biomechanical properties of different endocrown designs on endodontically treated teeth. J Mech Behav Biomed Mater 2023; 140:105691. [PMID: 36739827 DOI: 10.1016/j.jmbbm.2023.105691] [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: 11/21/2022] [Revised: 01/07/2023] [Accepted: 01/23/2023] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To compare the biomechanical properties of different endocrown designs on endodontically treated teeth with an extensive defect in the mesial wall using a three-dimensional finite element method (3D FEM). METHODS Four finite element analysis models were designed and built up based on different endocrown configurations in a mandibular molar. One model was designed as a butt joint preparation with 2 mm occlusal thickness(control), the other three models were butt joint designs with different distances between the bottom of the mesial wall preparation and the cemento-enamel junction (CEJ): 2 mm, 1 mm and 0 mm respectively. A vertical load parallel with the longitudinal axis of the tooth and an oblique load with a 45°angle to the longitudinal axis were applied to the occlusal surfaces. The maximum Von Misses (VM) stresses and stress distribution patterns were calculated and compared. Weibull risk-of-rupture analysis was used to analyze the survival probability of the restorations and tooth in the different models. RESULTS For the restoration, the model with a mesial wall destruction at the level of CEJ showed much higher risk of failure than other models. Overall, none of the four models showed failure. Under oblique loading, VM stress in the cement layer of the models with a mesial wall defect was higher than in the control model. In the dentin, the highest VM stresses were found in the peri-cervical dentin. Under the oblique loading, the model with the mesial wall destruction at the level of CEJ restored by endocrown showed the highest risk of failure. CONCLUSION Under the oblique loading, with the increase of the simulated defect in the mesial wall, the peak VM stress values in the cement layer increased accordingly. In the model with a mesial wall defect up to the level of CEJ risk of failure was highest in the cervical dentin.
Collapse
|
15
|
Mertsöz B, Ongun S, Ulusoy M. In-Vitro Investigation of Marginal Adaptation and Fracture Resistance of Resin Matrix Ceramic Endo-Crown Restorations. MATERIALS (BASEL, SWITZERLAND) 2023; 16:2059. [PMID: 36903174 PMCID: PMC10004208 DOI: 10.3390/ma16052059] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
The aim of this study was to evaluate the fracture resistance and marginal adaptation of endo-crown restorations produced from different resin-matrix ceramics (RMS) and the effects of these materials on marginal adaptation and fracture resistance. Three frasaco models were used by preparing (first) premolar teeth in three different margin preparations: butt-joint, heavy chamfer and shoulder. Each group was further divided into four subgroups according to the type of restorative material used: Ambarino High Class (AHC), Voco Grandio (VG), Brilliant Crios (BC) and Shofu (S) (n = 30). Master models were obtained using an extraoral scanner and fabricated with a milling machine. Marginal gap evaluation was performed with a silicon replica technique using a stereomicroscope. Replicas of the models (n = 120) were produced with epoxy resin. The fracture resistance of the restorations was recorded using a universal testing machine. The data were statistically analyzed using two-way ANOVA, and a t-test was applied for each group. Tukey's post-hoc test was performed to compare significant differences (p ≤ 0.05). The highest marginal gap was observed in VG, and the best marginal adaptation and the highest fracture resistance were found in BC. The lowest fracture resistance in Butt-joint preparation design was found in S. In addition, the lowest fracture resistance value in the heavy chamfer preparation design was found in AHC. The heavy shoulder preparation design displayed the highest fracture resistance values for all materials.
Collapse
Affiliation(s)
- Burak Mertsöz
- Department of Prosthodontics, Faculty of Dentistry, Near East University, Mersin 10, Lefkosa 99040, Turkey
| | - Salim Ongun
- Department of Prosthodontics, Faculty of Dentistry, Final International University, Nicosia 99010, Turkey
| | - Mutahhar Ulusoy
- Department of Prosthodontics, Faculty of Dentistry, Near East University, Mersin 10, Lefkosa 99040, Turkey
| |
Collapse
|
16
|
Demachkia AM, Velho HC, Valandro LF, Dimashkieh MR, Samran A, Tribst JPM, de Melo RM. Endocrown restorations in premolars: influence of remaining axial walls of tooth structure and restorative materials on fatigue resistance. Clin Oral Investig 2023:10.1007/s00784-023-04895-6. [PMID: 36781479 DOI: 10.1007/s00784-023-04895-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 02/01/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVES To evaluate the effect of the remaining tooth structure and different CAD/CAM materials on the fatigue performance and failure mode of endodontically treated premolars restored with endocrowns. MATERIALS AND METHODS Ninety maxillary premolars were endodontically treated and assigned into 6 groups (n = 15) according to the number of remaining axial walls (four, three, and two) and restorative materials (ultra-translucent zirconia 5Y-PSZ [KATANA UTML] and lithium disilicate [IPS e.max-CAD]). The specimens were subjected to cyclic fatigue loading test (initial load 200 N; 20 Hz). An incremental step load of 100 N per 10,000 cycles was applied until failure. The fatigue failure load (FFL) and number of failure cycles (CFFs) data were statistically analyzed with two-way ANOVA and Kaplan-Meier test (α = 0.05). Failed specimens were examined under a stereomicroscope 25 × and failure modes were determined. RESULTS FFL and CFF were significantly influenced by restorative material (p < 0.05). 5Y-PSZ endocrowns showed significantly higher FFL when compared with lithium disilicate. The number of remaining walls did not affect the fatigue behavior or failure mode of the specimens. Of the lithium disilicate restorations, 51% had repairable failures, while 95% 5Y-PSZ restorations had non-repairable failures. CONCLUSIONS Zirconia endocrowns showed better FFL than lithium disilicate endocrowns, regardless of the number of remaining axis walls. Lithium disilicate and 5Y-PSZ endocrowns showed FFL higher than the normal masticatory loads. CLINICAL RELEVANCE Restoring endodontically treated premolars with endocrown could be a promising treatment, regardless of the remaining axial walls. However, precaution should be taken in material selection since it affects the fatigue resistance and failure mode.
Collapse
Affiliation(s)
- Amir Mohidin Demachkia
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (UNESP), Av. Engenheiro Francisco José Longo,777. 12245000, São José Dos Campos, São Paulo, Brazil.
| | - Helder Callegaro Velho
- Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande Do Sul State, Brazil
| | - Luiz Felipe Valandro
- Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande Do Sul State, Brazil
| | - Mohiddin Rida Dimashkieh
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, Dar Al-Uloom University, Riyadh, Saudi Arabia
| | - Abdulaziz Samran
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, Dar Al-Uloom University, Riyadh, Saudi Arabia
| | - João Paulo Mendes Tribst
- Department of Oral Regenerative Medicine, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Renata Marques de Melo
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (UNESP), Av. Engenheiro Francisco José Longo,777. 12245000, São José Dos Campos, São Paulo, Brazil
| |
Collapse
|
17
|
Kaya Büyükbayram I, Güven ME, Ayman D, Şener Yamaner ID, Cakan EF. Fracture resistance of resin endocrowns with and without fiber reinforced composite base material: A preliminary study. J Appl Biomater Funct Mater 2023; 21:22808000231151832. [PMID: 36708253 DOI: 10.1177/22808000231151832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE The aim of this study was to investigate the effects of fiber-reinforced composite base material on fracture resistance and fracture pattern of endodontically treated maxillary premolars restored with endocrowns using two different resin nanoceramic computer-aided design and computer-aided manufacturing (CAD/CAM) restorative material. METHODS Forty extracted sound maxillary premolars with an occlusal reduction of 2 mm above the cementoenamel junction (CEJ) was performed following root canal treatment. Mesial interproximal box was prepared for each tooth at the margin of the CEJ and randomly distributed into four groups (n = 10) as follows: Group A, no resin build-up in the pulp chamber; Group B, 2 mm of fiber-reinforced composite (FRC) build-up (EverX Posterior, GC).; Group C, no resin build-up in pulp chamber; Group D, 2 mm of FRC build-up. Groups A and B were prepared with resin nanoceramic (RNC) consisting ceramic nanofillers (Lava Ultimate 3 M ESPE), while Group C and D were prepared with RNC consisting ceramic nanohybrid fillers (Cerasmart GC Corp). All samples were subjected to 1,200,000 chewing cycles (1.6 Hz, 50 N) and 5000 thermal cycles (5°C-55°C) for artificial aging on a chewing simulator with thermal cycles (CSTC). Samples that survived the CSTC test without being damaged were subjected to a load-to-fracture test. RESULTS The highest mean fracture strength was found in Group D (936.0 ± 354.7) and lowest in Group A (684.2 ± 466.9). Fracture strength was higher in groups where FRC was used as a base material than plain restorations. However, there were no significant differences between the Lava and Cerasmart groups with and without FRC (p > 0.05). Most of the samples were irreparably fractured under CEJ. CONCLUSION Using short FRCs as a resin base material did not significantly improve fracture resistance. Cerasmart and Lava blocks had similar fracture resistance and fracture pattern.
Collapse
Affiliation(s)
- Işıl Kaya Büyükbayram
- Department of Endodontics, School of Dentistry, İstanbul Aydın University, Küçükçekmece, İstanbul, Turkey
| | - Mehmet Esad Güven
- Department of Prosthodontics, School of Dentistry, Necmettin Erbakan University, Konya, İstanbul, Turkey
| | | | | | | |
Collapse
|
18
|
Altitinchi A, Hussein A, Saemundsson S, Clark W, Culp L, Sulaiman TA. Anatomic CAD-CAM post-and-core systems: A mastication simulation study. J Prosthet Dent 2022:S0022-3913(22)00513-3. [PMID: 36163200 DOI: 10.1016/j.prosdent.2022.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/21/2022] [Accepted: 08/22/2022] [Indexed: 11/30/2022]
Abstract
STATEMENT OF PROBLEM Few studies have investigated the differences among various post-and-core systems under mastication simulation. Comparing these systems while simulating the clinical environment should provide a more accurate assessment of their performance. PURPOSE The purpose of this in vitro study was to evaluate the fatigue resistance of conventional cast metal and prefabricated fiber post systems with computer-aided design and computer-aided manufacture (CAD-CAM) prefabricated nonmetal post-and-core systems. MATERIAL AND METHODS Forty freshly extracted human maxillary premolars were endodontically treated and divided into 4 subgroups (n=10) according to the material: cast metal, zirconia, fiber-reinforced composite resin, prefabricated fiber post. The post-and-core materials were manufactured either conventionally or milled with CAD-CAM technology. All specimens were exposed to simultaneous mastication simulation (1.2 million cycles) and thermocycling (10 000 cycles at 5 °C to 55 °C) and analyzed based on failure of specimens. Data were analyzed by using the Kaplan-Meier survival analysis and Cox-regression (α=.05). RESULTS Both cast metal and zirconia post-and-core groups had similar fatigue resistance (P>.05) but significantly higher fatigue resistance than the fiber-reinforced groups (P<.05). Fiber-reinforced composite resin and prefabricated fiber post did not survive the mastication simulation, fracturing between 504 000 and 752 000 cycles, with fractures occurring in the cervical portion of the tooth. CONCLUSIONS Cast metal and zirconia post-and-core systems had improved physical properties with high resistance to fatigue when compared with fiber-reinforced post-and-core systems.
Collapse
Affiliation(s)
- Ali Altitinchi
- Post-Doc, Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Alabbas Hussein
- Resident, Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Siggi Saemundsson
- Associate Professor and Program Director, Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Wendy Clark
- Assistant Professor, Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Taiseer A Sulaiman
- Associate Professor, Division of Comprehensive Oral Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC.
| |
Collapse
|
19
|
Finite element and in vitro study on biomechanical behavior of endodontically treated premolars restored with direct or indirect composite restorations. Sci Rep 2022; 12:12671. [PMID: 35879388 PMCID: PMC9314407 DOI: 10.1038/s41598-022-16480-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 07/11/2022] [Indexed: 11/08/2022] Open
Abstract
Objectives of the study were to investigate biomechanical properties of severely compromised premolars restored with composite restorations using finite element analysis (FEA), and in vitro fracture resistance test. A 3-D model of an endodontically treated premolar was created in Solidworks. Different composite restorations were modelled (direct restoration-DR; endo-crown-EC; post, core, and crown-C) with two different supporting tissues: periodontal ligament/alveolar bone (B), and polymethyl methacrylate (PMMA). Models were two-point axially loaded occlusally (850 N). Von Mises stresses and strains were calculated. The same groups were further tested for static fracture resistance in vitro (n = 5, 6.0 mm-diameter ball indenter, vertical load). Fracture resistance data were statistically analyzed (p < 0.050). The highest stresses and strains in all FEA models were observed on occlusal and vestibular cervical surfaces, corresponding to fracture propagation demonstrated in vitro. C showed the lowest stress in dentin, while EC showed lower stresses and strains in crown cement. B models demonstrated larger high stress areas in the root than PMMA models. No significant differences in fracture resistance (N) were observed between groups (DR: 747.7 ± 164.0, EC: 867.3 ± 108.1, C: 866.9 ± 126.3; p = 0.307). More conservative restorations seem a feasible alternative for endodontically treated premolars to conventional post-core-crown.
Collapse
|
20
|
Zheng Z, Sun J, Jiang L, Wu Y, He J, Ruan W, Yan W. Influence of margin design and restorative material on the stress distribution of endocrowns: a 3D finite element analysis. BMC Oral Health 2022; 22:30. [PMID: 35120525 PMCID: PMC8817586 DOI: 10.1186/s12903-022-02063-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background This study aimed to evaluate the stress distributions in endocrown restorations as applied to endodontically treated teeth (ETT), according to the factors of “margin design” (four levels) and “restorative material” (six levels). Methods Four 3D-finite elements models were constructed for endocrown restored molars considering different margin designs. Model A was prepared with a flat butt joint margin and received an endocrown with a 2.0-mm occlusal thickness. Model B was prepared with a 20° bevel margin and received an endocrown with a 2.0-mm occlusal thickness. Model C was prepared with an axial reduction and 1-mm shoulder margin and received an endocrown with a 2.0-mm occlusal thickness. Model D was prepared with an anatomic margin and received an endocrown with a 2.0-mm occlusal thickness. The following endocrown materials were used: In-Ceram Zirconia (Zr), Vita Suprinity (VS), IPS Empress (IE), Grandio blocs (GR), VisCalor bulk (VS), and CopraPeek Light (CP). The Load application (600 N) was performed at the food bolus and tooth surface during the closing phase of the chewing cycle. The results for the endocrown and tooth remnants were determined according to the von Mises stress. The failure risk of the cement layer was also calculated based on the normal stress criterion. Results Model D (with an anatomic margin) showed the greatest stress concentrations, especially in the irregular and sharp angles of the restoration and tooth remnants. The stress concentrated on the dentin was significantly lower in Model B with a 20° bevel margin (20.86 MPa), i.e., 1.3 times lower than the other three margin designs (27.80 MPa). Restorative materials with higher elastic moduli present higher stress concentrations inside the endocrown and transmit less stress to the cement layer, resulting in lower bonding failure risks. In contrast, materials with an elastic modulus similar to that of dentin presented with a more homogeneous stress distribution on the whole structure. Conclusions An endocrown with a 20° bevel margin design could be a favorable preparation option for ETT. Composite resins (GR and VC) exhibit a more even stress distribution, and seem to be more promising materials for endocrown molars.
Collapse
Affiliation(s)
- Ziting Zheng
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jieli Sun
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Department of Stomatology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Lifang Jiang
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yuan Wu
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jiahui He
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Wenhao Ruan
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Wenjuan Yan
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
| |
Collapse
|
21
|
Barallat L, Arregui M, Fernandez-Villar S, Paniagua B, Pascual-La Rocca A. Fracture Resistance in Non-Vital Teeth: Absence of Interproximal Ferrule and Influence of Preparation Depth in CAD/CAM Endocrown Overlays-An In Vitro Study. MATERIALS 2022; 15:ma15020436. [PMID: 35057154 PMCID: PMC8778771 DOI: 10.3390/ma15020436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 12/27/2021] [Accepted: 01/04/2022] [Indexed: 02/04/2023]
Abstract
There is ample evidence to support the use of endocrowns to restore endodontic teeth. However, the influence of the position of the interproximal margins on fracture strength has not yet been studied. The aim was to determine the relationship between the apicocoronal position of the interproximal restorative margins and fracture resistance in nonvital teeth restored with CAD/CAM endocrown overlays. Forty extracted human maxillary premolars were prepared for endocrown overlay restorations without ferrule on the interproximal aspects and classified according to the position of the interproximal restoration margins in relation to the alveolar crest: 2 mm (group A), 1 mm (group B), 0.5 mm (group C), and 0 mm (group D). Fracture strength was measured using a universal testing machine applying a compressive force to the longitudinal tooth axis. Group A had a mean fracture resistance of 859.61 (±267.951) N, group B 1053.9 (±333.985) N, group C 1124.6 (±291.172) N, and group D 780.67 (±183.269) N, with statistical differences between groups. Group C had the highest values for fracture strength compared to the other groups (p < 0.05). The location of the interproximal margins appears to influence the fracture resistance of CAD/CAM endocrown overlays. A distance of 0.5 mm between the interproximal margin and the alveolar crest was associated with increased fracture resistance.
Collapse
Affiliation(s)
- Lucía Barallat
- Department of Periodontics, Faculty of Dentistry, Universitat Internacional de Catalunya, 08195 Sant Cugat del Valles, Spain; (L.B.); (B.P.); (A.P.-L.R.)
| | - María Arregui
- Department of Dentistry, Faculty of Dentistry, Universitat Internacional de Catalunya, 08195 Sant Cugat del Valles, Spain
- Correspondence: ; Tel.: +34-93504200
| | - Sandra Fernandez-Villar
- Department of Restorative Dentistry, Faculty of Dentistry, Universitat Internacional de Catalunya, 08195 Sant Cugat del Valles, Spain;
| | - Blanca Paniagua
- Department of Periodontics, Faculty of Dentistry, Universitat Internacional de Catalunya, 08195 Sant Cugat del Valles, Spain; (L.B.); (B.P.); (A.P.-L.R.)
| | - Andrés Pascual-La Rocca
- Department of Periodontics, Faculty of Dentistry, Universitat Internacional de Catalunya, 08195 Sant Cugat del Valles, Spain; (L.B.); (B.P.); (A.P.-L.R.)
| |
Collapse
|
22
|
Yildirim G, Demir C, Güven MÇ, Koç O, Dalkiliç EE. Influence of fiber insertion and different material type on stress distribution in endocrown restorations: a 3D-FEA study. Comput Methods Biomech Biomed Engin 2021; 25:1509-1519. [PMID: 34964689 DOI: 10.1080/10255842.2021.2019228] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The study aimed to evaluate the effects of fibers insertion and restorative material type on the stress distribution in endocrowns with finite element analysis. Five 3D models of first mandibular molars were created and restored as follows: (1) IN: intact tooth, (2) IPS-E: tooth restored with lithium disilicat ceramic endocrowns, (3) C-E: tooth restored with composite endocrowns, (4) IPS-E + F: lithium disilicate ceramic endocrowns + fiber, (5) C-E + F: composite endocrowns + fiber. Vertical masticatory load was imitated with finite element analysis. The equivalent stress of von Mises failure criterion (mvM) was calculated. The maximum mvM stress, enamel/crown, dentin and cement were compared among models and strength of the materials. Endocrowns presented a lower mvM stress level than intact tooth. In IPS-E, the mvM stress values in the crown and dentin were higher than C-E, while the mvM stress values in cement were higher in C-E group. Fibers insertion did not affect the stress level of IPS-E and C-E groups. In IPS model, fiber showed more stress absorption than C-E. The restorative material type changed the stress distribution of endocrown restorations. The fiber application did not affect the stress distribution in either endocrown group. But, more stress absorption was observed in fiber under IPS-E than C-E.
Collapse
Affiliation(s)
- Gulhan Yildirim
- Department of Prosthodontics, Beykent University, Istanbul, Turkey
| | - Cihan Demir
- Faculty of Mechanical Engineering, Yildiz Technical University, Istanbul, Turkey
| | | | - Osman Koç
- Faculty of Mechanical Engineering, Yildiz Technical University, Istanbul, Turkey
| | | |
Collapse
|
23
|
Rehabilitation of severely-destructed endodontically treated premolar teeth with novel endocrown system: Biomechanical behavior assessment through 3D finite element and in vitro analyses. J Mech Behav Biomed Mater 2021; 126:105031. [PMID: 34922296 DOI: 10.1016/j.jmbbm.2021.105031] [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] [Received: 11/04/2021] [Revised: 11/30/2021] [Accepted: 12/06/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Rehabilitation of endodontically treated premolars with extensive coronal destruction through endocrown approach remains a controversial topic in reconstructive dentistry. There is no clear consensus in the literature which endocrown design with which material is the most effective restoration option for severely-destructed endodontically treated premolars. The aim of this study was to assess the biomechanical behavior of endodontically treated maxillary first premolars restored with a novel endocrown system compared to the conventional one varying the applied load type through finite element and in vitro analyses. MATERIALS AND METHODS For finite element analysis, two models representing two endocrown systems used for restoration of severely-destructed endodontically treated maxillary first premolar tooth were generated: Model C for the conventional monolithic IPS e.max CAD endocrown and Model P for the novel bi-layered endocrown (PEKKTON ivory coping veneered with cemented IPS e.max CAD). Modified von Mises stress values on the remaining tooth structure, cement lines and restorative materials were evaluated separately under axial and oblique loading of 450 N. For in vitro analysis, forty sound human bifurcated maxillary first premolars were collected, endodontically-treated, and divided into 2 main groups (n = 20) according to the system used for endocrown fabrication; Group C: the conventional monolithic endocrowns and Group P: the novel bi-layered endocrowns. All specimens were subjected to an artificial thermomechanical aging protocol. Each main group was subdivided into two subgroups (n = 10) according to the loading type (axial and oblique) applied during the fracture resistance test. Qualitative analysis using Stereomicroscopy and Scanning Electron Microscopy was performed. Data were statistically analyzed at p-value ≤ 0.05. RESULTS Regarding stress distribution pattern of remaining tooth structure (enamel and dentin), both endocrown systems and cement lines under both axial and oblique load application, Model P resulted in lower stresses than Model C. The oblique stress values of all analyzed structures were higher than corresponding values resulted axially. Considering failure load, a significantly higher load was recorded for Group P when axial or oblique loading was applied (p = 0.00). A significantly higher failure load was recorded with axial loading for both main groups. With regard to failure mode, a statistically significant difference was observed between main groups (p = 0.033), with more favorable failures detected for Group P axially. CONCLUSIONS Compared to the conventional endocrown system, the studied novel system improved the biomechanical behavior within tooth/restoration complex of the restored severely-destructed endodontically treated maxillary first premolar teeth, whatever the applied load type. CLINICAL SIGNIFICANCE The novel endocrown system using a PEKK coping veneered with cemented IPS e.max CAD can be considered a favorable promising option for restoration of severely-destructed endodontically treated premolar teeth, with more protection for residual tooth structure. It can be considered as a conservative alternative option to the conventional treatment modalities not only for normal clinical conditions, but also for parafunctional cases.
Collapse
|
24
|
Rocca GT, Canneto JJ, Scotti N, Daher R, Feilzer A, Saratti CM, Krejci I. Restoration of Severely Damaged Endodontically Treated Premolars: Influence of the Ferrule Effect on Marginal Integrity and Fracture Load of Resin Nano-ceramic CAD-CAM Endocrowns. Oper Dent 2021; 46:650-660. [PMID: 35507906 DOI: 10.2341/20-081-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To explore the ferrule effect on Resin Nano-Ceramic (RNC) premolar endocrown marginal integrity and fracture resistance. METHODS Thirty-six root-canal-treated premolars were cut 2 mm above the cemento-enamel junction (CEJ). They were restored with standardized RNC computer-aided design/computer-aided manufacturing (CAD/CAM) restorations (Lava Ultimate, 3M Oral Care, St. Paul, MN, USA) and divided into three groups (n=12): endocrowns with a 3-mm endo-core (Group 1), endocrowns with a 3-mm endo-core and a 2-mm ferrule (Group 2), and conventional post-and-core crowns with a 2-mm ferrule (Group 3). All specimens were submitted to thermo-mechanical cycling loading (TMCL) (1.7 Hz, 49 N, 600 000 cycles, 1500 thermocycles). Margins were analyzed before and after the TMCL. In the second part of the experiment, the surviving specimens were submitted to unidirectional monotonic loading until fracture. Fragments were then analyzed using scanning electron microscopy (SEM) and the fracture mode was established. RESULTS Endocrowns of Groups 1 and 2 performed better than conventional crowns (Group 3) in terms of marginal continuity. Differences in fracture load values within all groups were not statistically significant. Most of the specimens fractured in a non-repairable way. CONCLUSIONS The present test failed to provide evidence of any kind of difference between endocrowns with and without a ferrule in terms of load-bearing capacity and marginal integrity after fatigue. Further studies are needed to confirm the role of the ferrule in adhesive restorations of endodontically treated teeth.
Collapse
Affiliation(s)
- G T Rocca
- *Giovanni Tommaso Rocca, Department of Cariology and Endodontics, School of Dentistry, University of Geneva, Switzerland
| | - J J Canneto
- Jean Jacques Canneto, DMD, Department of Cariology and Endodontics, School of Dentistry, University of Geneva, Switzerland
| | - N Scotti
- Nicola Scotti, DMD, Department of Cariology and Operative Dentistry, School of Dentistry, University of Turin, Italy
| | - R Daher
- Rene Daher, DMD, Department of Cariology and Endodontics, School of Dentistry, University of Geneva, Switzerland
| | - A Feilzer
- Albert Feilzer, professor, Department of Dental Materials, Academisch Centrum Tandheelkunde Amsterdam, Amsterdam, The Netherlands
| | - C M Saratti
- Carlo Massimo Saratti, DMD, Department of Cariology and Endodontics, School of Dentistry, University of Geneva, Switzerland
| | - I Krejci
- Ivo Krejci, Professor, Department of Cariology and Endodontics, School of Dentistry, University of Geneva, Switzerland
| |
Collapse
|
25
|
Biomechanical behavior of endodontically treated premolar teeth restored with novel endocrown system: 3D Finite Element and Weibull analyses. J Mech Behav Biomed Mater 2021; 124:104853. [PMID: 34600429 DOI: 10.1016/j.jmbbm.2021.104853] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To date, there is no clear consensus in the literature which endocrown design with which material is the most effective treatment option to restore endodontically treated maxillary premolars with extensive loss of tooth structure. The aim of this study was to evaluate the stress distribution pattern and failure probability of maxillary first premolars restored with a novel endocrown system compared to the conventional one by means of Finite Element and Weibull analyses. MATERIALS AND METHODS Two finite element (FE) models representing two endocrown systems used for restoration of severely-destructed endodontically treated maxillary first premolar tooth were generated: model C for the conventional monolithic IPS e.max CAD endocrown and model P for the novel bi-layered endocrown (PEKKTON ivory coping veneered with cemented IPS e.max CAD). A static occlusal compressive load was axially and centrally-applied. Modified von Mises and maximum principal stress values on the remaining tooth structure, cement lines and restorative materials were evaluated separately. Weibull function was incorporated with FE analysis to calculate the long term failure probability. RESULTS Regarding stresses occurred in the remaining tooth structure (enamel and dentin), model P transmitted less stresses than model C. The individual enamel of model C showed about 5% and 40% risk of failure at normal and maximum occlusal load values, respectively, while for model P, it had no failure risk at both values. For dentin, model C showed about 13% failure risk at the normal masticatory force, while model P showed only 2%. At clenching value, model C dentin showed about 44% failure risk, while only 9% was resulted for model P. CONCLUSIONS Compared to the conventional endocrown system, the positive impact of the studied novel endocrown system on the stress distribution pattern and also on the survival/failure probability of the restored severely-destructed endodontically treated maxillary first premolar teeth was reflected (more tooth-friendly), not only at normal masticatory forces but also at the maximum functional loads. CLINICAL SIGNIFICANCE The novel endocrown system using a PEKK coping veneered with cemented IPS e.max CAD can be considered a favorable option for restoration of severely-destructed endodontically treated premolar teeth, with more protection for residual tooth structure. Despite the conventional endocrown system may benefit the durability of tooth bonding, it should not be selected for restoration of clenching cases because of the too high overall failure risk.
Collapse
|
26
|
El-Ma'aita A, A Al-Rabab'ah M, Abu-Awwad M, Hattar S, Devlin H. Endocrowns Clinical Performance and Patient Satisfaction: A Randomized Clinical Trial of Three Monolithic Ceramic Restorations. J Prosthodont 2021; 31:30-37. [PMID: 34378269 DOI: 10.1111/jopr.13414] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2021] [Indexed: 01/16/2023] Open
Abstract
PURPOSE The purpose of this randomized, double-blind, clinical trial was to assess the survival of endocrowns made from three different monolithic ceramic materials, and to evaluate patient satisfaction. MATERIALS AND METHODS Fifty-three patients (sixty root canal treated molar teeth) were enrolled. Teeth were prepared to a flat butt-joint margin and randomly divided between three material groups: lithium disilicate-reinforced glass-ceramic, monolithic zirconia and polymer infiltrated hybrid ceramic. Predefined cementation protocols were used. Clinical assessment using modified United States Public Health Service (USPHS) criteria was carried out after two years by two independent clinicians blinded to the material used. Radiographic examination was conducted to check for the presence of caries, excess cement, and periapical infection. Statistical analysis was performed using the Kruskal Wallis and Wilcoxon signed-rank tests as well as the Kaplan-Meier survival estimate. RESULTS Forty-eight patients were available for assessment after 2 years (recall rate 90.6%). The overall Kaplan-Meier survival estimate among all groups was 90.9% with no statistically significant difference between the groups (p = 0.17). Three zirconia endocrowns debonded after 9, 10 and 13 months (82.4% survival rate), while 2 hybrid ceramic endocrowns chipped/fractured (89.5% survival rate). Lithium disilicate endocrowns had a 100% survival rate. The Kruskal Wallis test revealed no statistically significant difference between the groups in the USPHS criteria ratings and the radiographic assessment (P>0.05). Patient satisfaction ranged from 82.3% in the zirconia group to 100% in both the lithium disilicate and hybrid ceramic groups. CONCLUSIONS Endocrowns provide a predictable option for the restoration of endodontically treated molar teeth in the short term. Lithium disilicate-reinforced ceramic had fewer complications and required less intervention compared with zirconia and hybrid ceramics. Long-term follow-up is required to substantiate these study results.
Collapse
Affiliation(s)
| | | | | | - Susan Hattar
- School of Dentistry, University of Jordan, Amman, Jordan
| | - Hugh Devlin
- Division of Dentistry, The University of Manchester, Manchester, UK
| |
Collapse
|
27
|
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.
Collapse
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
| |
Collapse
|
28
|
Zhang H, Li H, Cong Q, Zhang Z, Du A, Wang Y. Effect of proximal box elevation on fracture resistance and microleakage of premolars restored with ceramic endocrowns. PLoS One 2021; 16:e0252269. [PMID: 34038489 PMCID: PMC8153463 DOI: 10.1371/journal.pone.0252269] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 05/13/2021] [Indexed: 11/19/2022] Open
Abstract
Background Restoration of endodontically treated premolar is in high risk for biomechanical failure, and often presents with subgingival margins. Proximal box elevation (PBE) has been used to relocate subgingival cavity outlines. Objective To evaluate the influence of PBE on fracture resistance and gingival microleakage of premolars with endodontic access cavities following ceramic endocrown. Methods Eighty sound maxillary premolars with standardized Class II cavities on mesial surfaces were randomly assigned to four groups (n = 20 in each group). Groups E1, E2 and E3, with proximal margins located in dentin/cementum, 2 mm below the cemento-enamel junction (CEJ), simulated subgingival location. Group E4 (supragingival group), with proximal margins located in enamel, 1 mm above the CEJ, was used as the positive control. For margin elevation of the proximal cavities, bulk-fill Smart Dentin Replacement (SDR), a visible light cured resin composite, was applied in group E1, and conventional resin composite (3M Z350 XT, a light-activated composite) was placed in group E2. Group E3 was only treated with a ceramic crown and served as the negative control. In all groups, computer-aided design (CAD) ceramic endocrowns were adhesively inserted, and fracture resistance, failure mode and microleakage were evaluated. Results A higher fracture resistance value was observed in PBE groups E1 and E2, regardless of the materials used (P = 0.038, and 0.010, respectively, vs E3), and fracture resistance in group E1 was higher than that in group E2. In teeth without PBE, the percentage of catastrophic failures reached 70%. Compared to group E3, a lower frequency distribution of microleakage was detected in supragingival group E4 (P = 0.031). No increased percentage of microleakage was observed in groups treated with PBE. Conclusion For endodontically treated maxillary premolars restored with ceramic endocrowns, PBE increases fracture resistance but not microleakage.
Collapse
Affiliation(s)
- Hong Zhang
- Hospital of Stomatology, Jilin University, Changchun, P.R China
| | - He Li
- Hospital of Stomatology, Jilin University, Changchun, P.R China
| | - Qian Cong
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, P.R China
| | - Zhimin Zhang
- Hospital of Stomatology, Jilin University, Changchun, P.R China
- * E-mail:
| | - Aobo Du
- Hospital of Stomatology, Jilin University, Changchun, P.R China
| | - Ying Wang
- Hospital of Stomatology, Jilin University, Changchun, P.R China
| |
Collapse
|
29
|
de Oliveira JC, Sordi MB, da Cruz ACC, Zanetti RV, Betiol EAG, Vieira SR, Zanetti AL. Number of dental abutments influencing the biomechanical behavior of tooth‒implant-supported fixed partial dentures: A finite element analysis. J Dent Res Dent Clin Dent Prospects 2020; 14:228-234. [PMID: 33575012 PMCID: PMC7867679 DOI: 10.34172/joddd.2020.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 10/21/2020] [Indexed: 11/09/2022] Open
Abstract
Background. Local or systemic issues might prevent installing a sufficient number of dental implants for fixed prosthetic rehabilitation. Splinting dental implants and natural teeth in fixed dentures could overcome such limitations. Therefore, this study aimed to evaluate the influence of the number of dental abutments in the biomechanics of tooth‒implant-supported fixed partial dentures (FPDs). The null hypothesis was that increasing the number of abutment teeth would not decrease the stress over the abutments and surrounding bone. Methods. Left mandibular lateral incisor, canine, premolars, and molars were reconstructed through computed tomography and edited using image processing software to represent a cemented fixed metal‒ceramic partial denture. Three models were set to reduce the number of abutment teeth: 1) lateral incisor, canine, and first premolar; 2) canine and first premolar; 3) the first premolar. The second premolar and first molar were set as pontics, and the second molar was set as an implant abutment in all the models. Finite element analyses were performed under physiologic masticatory forces with axial and oblique loading vectors. Results. After simulation of axial loads, the stress peaks on the bone around the implant, the bone around the first premolar, and prosthetic structures did not exhibit significant changes when the number of abutment teeth decreased. However, under oblique loads, decreasing the number of abutment teeth increased stress peaks on the surrounding bone and denture. Conclusion. Increasing the number of dental abutments in tooth‒implant-supported cemented FPD models decreased stresses on its constituents, favoring the prosthetic biomechanics.
Collapse
Affiliation(s)
| | - Mariane Beatriz Sordi
- Postgraduate in Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | | | | | | | | | - Artêmio Luiz Zanetti
- Department of Prosthodontics, Faculty of Dentistry, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
30
|
Haralur SB, Alamrey AA, Alshehri SA, Alzahrani DS, Alfarsi M. Effect of different preparation designs and all ceramic materials on fracture strength of molar endocrowns. J Appl Biomater Funct Mater 2020; 18:2280800020947329. [DOI: 10.1177/2280800020947329] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: The aim was to compare the fracture strength of Molar endocrowns fabricated from different all-ceramic materials and various preparation designs. Materials and methods: Ninety extracted human molar teeth were root canal treated and randomly divided into three groups according to the all ceramic materials used for fabrication of the endocrowns ( n = 30): (1) Lithium disilicate (IPS e.max Press); (2) Polymer infiltrated ceramic (Vita Enamic); (3) High translucency zirconia (Ceramill Zolid HT). Each group was subdivided into 3 subgroups ( n = 10) according to the preparation design as 2 mm occlusal reduction, 4.5 mm occlusal reduction, and 4.5 mm occlusal reduction with 2 mm radicular extension. The endocrowns from each material were fabricated and surface treated according to the manufacturer’s recommendations. After cementation with self-adhesive resin luting cement, the specimens were stored in a humid environment for 72 hours and subsequently subjected to 5000 thermal cycles. After, a compressive, static-axial load was applied using a universal testing machine until failure. Load-to-failure was recorded (N) and the specimens were examined under a stereomicroscope to determine the failure type. The data was statistically analyzed using One-way ANOVA and Tukey HSD tests at p < 0.05. Results: The Lithium Disilicate endocrowns recorded the higher mean fracture strength for 4.5 mm occlusal thickness and 2 mm radicular extension at 3770.28 N and 3877.40 correspondingly. The High translucency zirconia endocrowns at conventional 2 mm thickness showed the highest mean fracture load (3533.34 N). Even though polymer infiltrated ceramic endocrowns displayed comparatively lesser fracture load; they recorded the predominantly favorable fractures. Conclusions: Increased occlusal thickness showed a significant improvement in fracture strength of lithium disilicate and polymer infiltrated ceramic molar endocrowns. Although the 2 mm radicular extension had the substantial enhancement of fracture strength in high translucency zirconia, it resulted in more unfavorable failure types.
Collapse
Affiliation(s)
- Satheesh B Haralur
- Department of Prosthodontics, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Alaa Ali Alamrey
- College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | | | | | - Mohammed Alfarsi
- Department of Prosthodontics, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| |
Collapse
|
31
|
Sağlam G, Cengiz S, Karacaer Ö. Marginal adaptation and fracture strength of endocrowns manufactured with different restorative materials: SEM and mechanical evaluation. Microsc Res Tech 2020; 84:284-290. [PMID: 32915479 DOI: 10.1002/jemt.23586] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/06/2020] [Accepted: 08/17/2020] [Indexed: 11/08/2022]
Abstract
Endocrowns were manufactured using different restorative materials to evaluate the marginal adaptation and fracture strength. Fifty endodontically treated mandibular first molar teeth were divided into five groups (n = 10). Endocrowns were obtained from lithium disilicate glass ceramic ingots by heat-press technique (Group e.max Press: GEP), and from feldspathic blocks (Group Cerec: GC), polymer infiltrated ceramic network blocks (Group Enamic: GE), lithium disilicate glass ceramic blocks (Group e.max CAD: GEC), and zirconia-reinforced glass ceramic blocks (Group Suprinity: GS) by CAD/CAM technique. After thermocycling, marginal adaptation was evaluated under scanning electron microscope at ×200 magnification. The specimens' fracture strengths were tested in universal test machine, and fracture types were evaluated. Statistical analyses were performed with Kruskal-Wallis test. The highest marginal gap value was found in GEP, but no significant differences were determined among the other four groups (p > .05). Significant differences were observed among the groups in terms of fracture strength (p = .019). The fracture strength values of GEC were significantly higher than GE, GC, and GS (p < .05). Values were not significantly different between the GEC and GEP groups (p > .05). CAD/CAM endocrowns showed better marginal adaptation than heat-pressed endocrowns. Clinically acceptable marginal gaps were seen in both endocrown types. Both CAD/CAM and heat-pressed lithium disilicate glass ceramic endocrowns showed higher fracture strength.
Collapse
Affiliation(s)
- Gaye Sağlam
- Department of Prosthodontics, Faculty of Dentistry, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Seda Cengiz
- Department of Prosthodontics, Faculty of Dentistry, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Özgül Karacaer
- Department of Prosthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| |
Collapse
|
32
|
Hassouneh L, Jum’ah AA, Ferrari M, Wood DJ. Post-fatigue fracture resistance of premolar teeth restored with endocrowns: An in vitro investigation. J Dent 2020; 100:103426. [DOI: 10.1016/j.jdent.2020.103426] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/30/2020] [Accepted: 07/02/2020] [Indexed: 11/16/2022] Open
|
33
|
Biomechanical behavior of endocrown restorations with different CAD-CAM materials: A 3D finite element and in vitro analysis. J Prosthet Dent 2020; 125:890-899. [PMID: 32471627 DOI: 10.1016/j.prosdent.2020.03.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 03/01/2020] [Accepted: 03/02/2020] [Indexed: 11/21/2022]
Abstract
STATEMENT OF PROBLEM The performance of endocrowns fabricated with different types of computer-aided design and computer-aided manufacturing (CAD-CAM) materials is unclear. PURPOSE The purpose of this finite element analysis (FEA) and in vitro study was to compare and evaluate the stress distribution, failure probability, and fracture resistance of endodontically treated teeth restored with endocrowns from CAD-CAM milling blocks including ceramic, polymer-infiltrated ceramic (PICN), and composite resin. MATERIAL AND METHODS An endodontically treated first mandibular molar restored with an endocrown was modeled by using a CAD software program and imported into an FEA software program. The model was duplicated and received restorations made from CAD-CAM blocks: Vita Suprinity (VS), IPS e.max CAD (EMX), Vita Enamic (VE), Lava Ultimate (LU), and Grandio blocs (GR). Stress distributions under axial and oblique loading were analyzed. The Weibull function was combined with the FEA results to predict long-term failure probability. The mechanical failure behavior of endocrowns manufactured with these materials was tested by using a universal testing machine. Load-to-failure was recorded, and fractured specimens were subjected to fractography. The data were analyzed by 1-way ANOVA and the post hoc Tukey test (α=.05). RESULTS The models of GR and LU exhibited a more even stress distribution. The Weibull analysis revealed that 5 models performed in a similar manner under normal occlusal forces, while LU and VE models achieved the highest probabilities during clenching. The fracture loads of GR (3808 ±607 N) were significantly higher than those of other materials (P<.05). More favorable failure modes were observed in the GR and VE groups. Fractography showed a greater probability of compression curls and arrest lines in the endocrowns of VE, LU, and GR groups. CONCLUSIONS When restoring endodontically treated teeth, endocrown fabricated with composite resin exhibited a more uniform stress distribution and higher fracture resistance. More evidence from long-term clinical studies is needed to verify this effect.
Collapse
|
34
|
Influence of Occlusal Thickness and Radicular Extension on the Fracture Resistance of Premolar Endocrowns from Different All-Ceramic Materials. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10082696] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Endocrowns are primarily recommended in a molar region with a standardized preparation design. The aim of the study was to evaluate the effect of different occlusal preparation depths, pulp chamber-radicular extension, and all-ceramic materials on the fracture resistance of premolar endocrowns. Ninety human premolar teeth were root canal treated, randomly divided into three main groups according to all-ceramic material used for fabrication as Lithium Disilicate (LD) ceramic, Polymer infiltrated ceramic (PIC) and High translucency zirconia (HTZ). They were further subdivided into three subgroups (n = 10) according to preparation design of 2 mm occlusal reduction, 4.5 mm occlusal reduction and 4.5 mm occlusal reduction with 2 mm radicular extension. The endocrowns from respective restorative materials were fabricated, surface conditioned, and cemented with self-adhesive resin cement. All samples were thermocycled for 5000 cycles and subjected to compressive static load at 45° angluation with the cross-head speed of 0.5 mm/minute until the fracture. The mean fracture resistance of LD ceramic at 2 mm, 4.5 mm thickness and radicular extension was 62.55 MPa, 45.80 MPa, 74.27 MPa respectively. The corresponding values for the PIC and HTZ ceramics were 26.30 MPa, 21.65 MPa, 25.66 Mpa and 23.47 MPa, 27.30 MPa, 37.29 MPa respectively. The LD ceramic and greater extension inside the pulp chamber had higher fracture resistance.
Collapse
|
35
|
Al-Dabbagh RA. Survival and success of endocrowns: A systematic review and meta-analysis. J Prosthet Dent 2020; 125:415.e1-415.e9. [PMID: 32197821 DOI: 10.1016/j.prosdent.2020.01.011] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 01/10/2020] [Accepted: 01/10/2020] [Indexed: 10/24/2022]
Abstract
STATEMENT OF PROBLEM Endocrowns are a monoblock type of restoration that use the pulp chamber and remaining coronal tooth structure as a means of retention. However, data on their long-term survival and success rates as compared with conventional crowns are lacking. PURPOSE The purpose of this systematic review and meta-analysis was to collate published work on endocrowns to assist clinicians in making decisions on when and whether they are an appropriate restorative option with a predictable outcome for extensively damaged endodontically treated teeth. MATERIAL AND METHODS Databases such as PubMed (MEDLINE), Scopus, EMBASE, Cochrane library, and Google Scholar were searched up to June 2019 for clinical and in vitro studies on endocrown survival and success rates. For the meta-analysis, endocrown and conventional crown survival and success rates were compared, and the pooled effects were presented as relative risks and 95% confidence intervals using a random effects model. RESULTS Ten studies fulfilled the inclusion criteria (3 clinical and 7 in vitro) and were included in the systematic review. The meta-analysis of the clinical studies showed an estimated overall 5-year survival rate of 91.4% for endocrowns and 98.3% for conventional crowns. The estimated overall 5-year success rates were 77.7% for endocrowns and 94% for conventional crowns. There were no significant differences in overall survival or success estimates between the assessed restorations (P>.05). CONCLUSIONS Additional well-designed clinical studies with long-term assessment are needed; however, endocrowns appear to be a promising conservative restorative option with acceptable long-term survival for endodontically treated posterior teeth in selected patients.
Collapse
Affiliation(s)
- Raghad A Al-Dabbagh
- Assistant Professor and Consultant in Prosthodontics, Oral and Maxillofacial Rehabilitation Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
| |
Collapse
|
36
|
Endocrowns: A systematic review. J Prosthet Dent 2020; 123:411-418.e9. [DOI: 10.1016/j.prosdent.2019.04.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 04/14/2019] [Accepted: 04/15/2019] [Indexed: 11/18/2022]
|
37
|
Zhu J, Wang D, Rong Q, Qian J, Wang X. Effect of central retainer shape and abduction angle during preparation of teeth on dentin and cement layer stress distributions in endocrown-restored mandibular molars. Dent Mater J 2020; 39:464-470. [PMID: 32092721 DOI: 10.4012/dmj.2019-050] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
To study the effect of central retainer shape and abduction angle during tooth preparation on stress distribution in endocrown-restored molars via finite element (FE) analysis, we constructed five FE models with different central retainer shapes and abduction angles. Under an oblique load, the distributions of maximum tensile stress in cervical dentin around the endocrown and on the cement layer, as well as maximum shear stress on the cement layer, were more balanced in the FE model in which the central retainer shape was generated based on the anatomical form of the pulp chamber. Moreover, there were no differences in stress distributions among FE models with different abduction angles. Therefore, the shape of the central retainer should be designed on the basis of the anatomical form of the pulp chamber; abduction angle during tooth preparation does not influence the repair effect of endocrown-restored mandibular molars.
Collapse
Affiliation(s)
- Junxin Zhu
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology
| | - Dongmei Wang
- 2nd Dental Center, Peking University School and Hospital of Stomatology
| | - Qiguo Rong
- Department of Mechanics and Engineering Science, College of Engineering, Peking University
| | - Jun Qian
- 2nd Dental Center, Peking University School and Hospital of Stomatology
| | - Xiaoyan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology
| |
Collapse
|
38
|
de Kuijper MCFM, Cune MS, Tromp Y, Gresnigt MMM. Cyclic loading and load to failure of lithium disilicate endocrowns: Influence of the restoration extension in the pulp chamber and the enamel outline. J Mech Behav Biomed Mater 2020; 105:103670. [PMID: 32090891 DOI: 10.1016/j.jmbbm.2020.103670] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 02/02/2020] [Accepted: 02/03/2020] [Indexed: 01/22/2023]
Affiliation(s)
- Maurits C F M de Kuijper
- The University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry and Biomaterials, Groningen, the Netherlands.
| | - Marco S Cune
- The University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry and Biomaterials, Groningen, the Netherlands; St. Antonius Hospital Nieuwegein, Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, Nieuwegein, the Netherlands; University Medical Center Utrecht, Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, Utrecht, the Netherlands
| | - Youp Tromp
- The University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry and Biomaterials, Groningen, the Netherlands
| | - Marco M M Gresnigt
- The University of Groningen, University Medical Center Groningen, Center for Dentistry and Oral Hygiene, Department of Restorative Dentistry and Biomaterials, Groningen, the Netherlands; Martini Hospital, Department of Special Dental Care, Groningen, the Netherlands
| |
Collapse
|
39
|
Dartora G, Rocha Pereira GK, Varella de Carvalho R, Zucuni CP, Valandro LF, Cesar PF, Caldas RA, Bacchi A. Comparison of endocrowns made of lithium disilicate glass-ceramic or polymer-infiltrated ceramic networks and direct composite resin restorations: fatigue performance and stress distribution. J Mech Behav Biomed Mater 2019; 100:103401. [PMID: 31445400 DOI: 10.1016/j.jmbbm.2019.103401] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/14/2019] [Accepted: 08/19/2019] [Indexed: 11/15/2022]
Abstract
This study compared the fatigue performance and the stress distribution of endodontically treated molars restored with endocrowns obtained with lithium disilicate glass-ceramic or a polymer-infiltrated ceramic network, both processed by CAD-CAM, and direct composite restorations. Forty-eight human mandibular molars were randomly assigned into 03 groups (n = 16) and restored with endocrowns (LD - lithium disilicate glass-ceramic or PICN - polymer-infiltrated ceramic network) or with direct composite restorations. Fatigue testing followed a step-stress approach (initial maximum load of 200 N and 5000 cycles, incremental step load of 200N and 10,000 cycles/step, being the specimens loaded until failure or to a maximum of 135,000 cycles at 2800 N). The fatigue failure load and number of cycles until failure were recorded and statistically analyzed. Fractographic and finite element (FEA) analyzes were conducted as well. There were no differences in fatigue failure load, number of cycles until fracture and mean survival probabilities among groups. However, indirect endocrowns had higher mechanical structural reliability, and LD restorations lasted more time before start to failing. FEA showed that the stress concentration in tooth tissues was higher for the resin composite, followed by PICN and LD in a decreasing order. Almost all fractures were restricted to the restorative material (without tooth involvement), and origins were identified at occlusal surface. The type of restoration did not influence the fatigue failure load, number of cycles until fracture and mean survival probabilities of the restorative strategies. Despite that, the mechanical structural reliability of endocrowns, especially those made of lithium disilicate, was higher and lasted more time before start to failing.
Collapse
Affiliation(s)
- Gustavo Dartora
- MSciD Post-Graduate Program in Dentistry, Meridional Faculty, IMED, Passo Fundo, Brazil.
| | | | | | - Camila Pauleski Zucuni
- MSciD and PhD Post-Graduate Program in Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil.
| | - Luiz Felipe Valandro
- MSciD and PhD Post-Graduate Program in Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil.
| | - Paulo Francisco Cesar
- Department of Biomaterials and Oral Biology, University of São Paulo, USP, São Paulo, Brazil.
| | | | - Atais Bacchi
- MSciD Post-Graduate Program in Dentistry, Meridional Faculty, IMED, Passo Fundo, Brazil.
| |
Collapse
|
40
|
Evaluation of Fracture Resistance and Microleakage of Endocrowns with Different Intracoronal Depths and Restorative Materials Luted with Various Resin Cements. MATERIALS 2019; 12:ma12162528. [PMID: 31398883 PMCID: PMC6720342 DOI: 10.3390/ma12162528] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 07/28/2019] [Accepted: 08/06/2019] [Indexed: 11/18/2022]
Abstract
The aim of this study was to determine the effect of restoration design on the fracture resistance of different computer-aided design/computer-aided manufacturing (CAD/CAM) ceramics and investigate the marginal leakage of endocrowns according to different types of cement. In total, 96 extracted mandibular first premolars were used for fabrication of endocrowns; 48 of the endocrowns were divided into 6 groups (n = 8) according to intracoronal cavity depth (2 and 3 mm) and CAD/CAM ceramics (lithium disilicate IPS e.max-CAD, zirconia-reinforced glass-ceramic Vita Suprinity, and poly-ether-ether-ketone (PEEK)). Teeth were subjected to a fracture resistance test with a universal test machine following thermo-cycling. Failure modes were determined by stereomicroscope after the load test. The rest of the endocrowns (n = 48) were produced by Vita Suprinity ceramic and divided into 6 groups (n = 8) according to the cement used (Panavia V5, Relyx Ultimate, and GC cement) with intracoronal cavity depths of 2 and 3 mm. Microleakage tests were performed using methylene blue with stereomicroscope after thermo-cycling. Numerical data for both fracture resistance and microleakage tests were obtained and evaluated by three-way ANOVA. PEEK endocrowns had higher fracture resistance compared to lithium disilicate and Vita Suprinity. Panavia V5 cement had the lowest degree of microleakage, while GC cement had the highest. Different intracoronal cavity depths had no correlation with fracture resistance and microleakage.
Collapse
|
41
|
Fracture Resistance of CAD/CAM Lithium Disilicate of Endodontically Treated Mandibular Damaged Molars Based on Different Preparation Designs. Int J Biomater 2019; 2019:2475297. [PMID: 31214263 PMCID: PMC6535888 DOI: 10.1155/2019/2475297] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 03/19/2019] [Accepted: 04/15/2019] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to evaluate the fracture resistance of 2 different types of all-ceramic crown using immediate dentin sealing (IDS), obtained using a CAD/CAM system on molars with different preparations. Forty extracted lower molars were endodontically treated and divided into four groups (n = 10) according to the dental preparation. Group 1 (SP0) was prepared without filling the pulp chamber and crown-root junction was located at the cementoenamel junction (CEJ). Group 2 (SP1) was prepared without filling the pulp chamber and crown-root junction was located 1-mm above the CEJ. Groups 3 and 4 contained a flat preparation surface with no axial wall height. Group 3 (CP0) was made IDS with complete filling of the pulp chamber with composite resin and crown-root junction was located at the CEJ. Group 4 (CP1) was prepared with complete filling of the pulp chamber and crown-root junction was located 1-mm above the CEJ. All groups were restored with CAD/CAM lithium disilicate ceramic crowns. Specimens were subjected to the fracture test and statistically analyzed using analysis of variance (ANOVA). Fracture mode was determined using a stereoscopic microscope, classified as repairable or nonrepairable, and analyzed using Fischer's exact test. Results indicated that there were no significant differences between the groups in terms of fracture resistance or fracture pattern (p >0.05). Fracture resistance was the lowest in the SP0 group, followed by the SP1 group (1634.38 N) of CP0 (1821.50 N), and it was the highest in the CP1 group. There was a predominance of nonrepairable fractures and there were no significant differences in the fracture resistance and fracture mode of CAD/CAM lithium disilicate molar all-ceramic crowns. Endodontically treated molars teeth might be restored with endocrowns or all-ceramic crowns on flat preparation; however tooth fracture failures that affect reliability of these types of restorations should be considered.
Collapse
|
42
|
SEDREZ-PORTO JA, MÜNCHOW EA, VALENTE LL, CENCI MS, PEREIRA-CENCI T. New material perspective for endocrown restorations: effects on mechanical performance and fracture behavior. Braz Oral Res 2019; 33:e012. [DOI: 10.1590/1807-3107bor-2019.vol33.0012] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 01/10/2019] [Indexed: 01/06/2023] Open
|
43
|
Skalskyi V, Makeev V, Stankevych O, Pavlychko R. Features of fracture of prosthetic tooth-endocrown constructions by means of acoustic emission analysis. Dent Mater 2018; 34:e46-e55. [DOI: 10.1016/j.dental.2018.01.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 12/07/2017] [Accepted: 01/16/2018] [Indexed: 11/30/2022]
|
44
|
Rocca G, Daher R, Saratti C, Sedlacek R, Suchy T, Feilzer A, Krejci I. Restoration of severely damaged endodontically treated premolars: The influence of the endo-core length on marginal integrity and fatigue resistance of lithium disilicate CAD-CAM ceramic endocrowns. J Dent 2018; 68:41-50. [DOI: 10.1016/j.jdent.2017.10.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 10/11/2017] [Accepted: 10/25/2017] [Indexed: 12/15/2022] Open
|
45
|
Zarow M, Ramírez-Sebastià A, Paolone G, de Ribot Porta J, Mora J, Espona J, Durán-Sindreu F, Roig M. A new classification system for the restoration of root filled teeth. Int Endod J 2017; 51:318-334. [DOI: 10.1111/iej.12847] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 08/23/2017] [Indexed: 12/28/2022]
Affiliation(s)
| | - A. Ramírez-Sebastià
- Department of Restorative Dentistry and Endodontics; School of Dentistry; Universitat Internacional de Catalunya; Barcelona Spain
| | - G. Paolone
- Dental School; Universitá Vita e Salute San Raffaele; Milan Italy
| | - J. de Ribot Porta
- Department of Restorative Dentistry and Endodontics; School of Dentistry; Universitat Internacional de Catalunya; Barcelona Spain
| | - J. Mora
- Department of Restorative Dentistry and Endodontics; School of Dentistry; Universitat Internacional de Catalunya; Barcelona Spain
| | - J. Espona
- Department of Restorative Dentistry and Endodontics; School of Dentistry; Universitat Internacional de Catalunya; Barcelona Spain
| | - F. Durán-Sindreu
- Department of Restorative Dentistry and Endodontics; School of Dentistry; Universitat Internacional de Catalunya; Barcelona Spain
| | - M. Roig
- Department of Restorative Dentistry and Endodontics; School of Dentistry; Universitat Internacional de Catalunya; Barcelona Spain
| |
Collapse
|