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Dotto L, Girotto LPS, Correa Silva Sousa YT, Pereira GKR, Bacchi A, Sarkis-Onofre R. Factors influencing the clinical performance of the restoration of endodontically treated teeth: An assessment of systematic reviews of clinical studies. J Prosthet Dent 2024; 131:1043-1050. [PMID: 35527069 DOI: 10.1016/j.prosdent.2022.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 10/18/2022]
Abstract
STATEMENT OF PROBLEM How best to restore endodontically treated teeth is still unclear because many types of material and techniques are involved. PURPOSE The purpose of this overview of systematic reviews of clinical studies was to assess the available evidence-based literature on the influence of associated clinical factors on the clinical performance (survival, failure rate, or success) of restored endodontically treated teeth. MATERIAL AND METHODS PubMed, Scopus, and Web of Science were searched from inception until September 27, 2021, to identify systematic reviews. Two reviewers independently screened titles, abstracts, and full-text articles, and each reviewer extracted the data of half of the included studies. A single reviewer with an independent verifier completed the quality appraisal. A descriptive analysis of the collected data was made. RESULTS A total of 36 systematic reviews fulfilled the inclusion criteria. The factors most assessed were the type of coronal restorative technique (n=22) and type of post (n=22). The results indicated that metal and fiber posts seem to present similar clinical performance, 1-piece endodontic crowns could be a suitable restorative option, there is no evidence to confirm whether single crowns are better or worse than direct restoration, the maintenance of the coronal structure is a fundamental factor, and the ferrule effect is still a controversial topic. Most of the studies (n=30, 81%) presented a final Grading of Recommendations, Assessment, Development and Evaluations (GRADE) rating of "critically low." CONCLUSIONS The post type does not appear to influence the clinical performance of restored endodontically treated teeth. However, conclusive evidence to suggest how different materials or techniques for restoring coronal tooth structure affect the clinical performance of such restorations, as well as the impact of the ferrule effect, is still lacking.
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Affiliation(s)
- Lara Dotto
- PhD student, School of Dentistry, Regional Integrated University of Upper Uruguai and Missions (URI), Erechim, RS, Brazil; and Master Student, Graduate Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Luiza Paloma S Girotto
- Master Student, Graduate Program in Dentistry, Meridional Faculty (IMED), Passo Fundo, RS, Brazil
| | | | - Gabriel Kalil Rocha Pereira
- Associate Professor, Post-Graduate Program in Oral Sciences, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Ataís Bacchi
- Associate Professor, Post-Graduate Program in Dentistry, Paulo Picanço School of Dentistry, Fortaleza, CE, Brazil
| | - Rafael Sarkis-Onofre
- Associate Professor, Graduate Program in Dentistry, Meridional Faculty (IMED), Passo Fundo, RS, Brazil.
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Jardim JS, Lemos CAA. The role of intraoral scanning in the fully digital workflow for post and core restorations: A scoping review. J Dent 2024; 147:105100. [PMID: 38797488 DOI: 10.1016/j.jdent.2024.105100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 05/19/2024] [Accepted: 05/24/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVE This scoping review aimed to map the literature on the utilization of intraoral scanners (IOS) in fabricating post and core restorations. DATA The study protocol is available at https://osf.io/ja9xh/. This scoping review followed Joanna Briggs Institute guidelines, and reporting was based on the checklist proposed by PRISMA-ScR. SOURCES Searches were conducted in PubMed/MEDLINE, Web of Science, Scopus, and grey literature up to August 2023. RESULTS A total of 455 studies were identified. After screening, 16 studies were deemed suitable for scoping review. Of these, 13 were in vitro studies, two were case reports, and one was a clinical study. Different IOS systems for scanning post spaces were evaluated, with Trios being most prevalent, followed by Prismescan. While most studies did not use any intraoral scanning devices, five studies reported the use of scan posts. Results regarding retention favored fully digital workflows. However, results about the adaptation and accuracy varied between included studies, highlighting the importance of standardized approaches. Future clinical studies should encompass variations in IOS systems, post space depths, scanner depth of field, light conditions, scan post utilization, operator experience, scanning time and strategy, and direct comparison with conventional techniques. CONCLUSION IOS is increasingly important in capturing digital impressions for post spaces and provides valuable insights for clinicians and researchers. Although included studies, primarily in vitro, demonstrated promising results for the utilization of IOS systems in fully digital workflows for post and core restorations, further well-conducted studies, particularly clinical trials, are recommended due to data heterogeneity and limitations. CLINICAL SIGNIFICANCE This mapping highlights the potential of modern IOS in fully digital workflows for post and core restorations. Despite promising results, challenges related to different variables associated with IOS require careful consideration. Standardization and additional clinical validation are essential for optimize IOS benefits in post and core restorations.
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Affiliation(s)
- Jacqueline Salomão Jardim
- Postgraduate Program in Applied Health Sciences (PPGCAS), Federal University of Juiz de Fora (UFJF), Campus Avançado Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | - Cleidiel Aparecido Araujo Lemos
- Department of Dentistry, Federal University of Juiz de Fora (UFJF), Campus Avançado Governador Valadares, Governador Valadares, Minas Gerais, Brazil.
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Matos LMRD, Silva ML, Cordeiro TO, Cardoso SDAM, Campos DES, de Muniz IAF, Barros SADL, Seraidarian PI. Clinical and laboratorial performance of rehabilitation of endodontically treated teeth: A systematic review. J ESTHET RESTOR DENT 2024. [PMID: 38563466 DOI: 10.1111/jerd.13225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/28/2024] [Accepted: 03/11/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE This systematic review aimed to analyze the clinical (survival rate, failure risk, or fracture) and laboratory performance (fracture mode or failure) of rehabilitations of endodontically treated teeth, with and without posts. MATERIALS AND METHODS A systematic search was conducted in the Pubmed, Scopus, Web of Science, Embase, Cochrane Library, and OpenGrey databases up to March 2023, according to PRISMA guidelines. In vitro and clinical studies that compared the clinical and laboratory performance of endodontically treated teeth with and without intraradicular posts were included. Studies selection, data extraction, and risk of bias analysis were performed. RESULTS Thirty-one in vitro and 7 clinical studies were included. For in vitro studies, fiberglass post (n = 24) was the most mentioned. The follow-up time of the clinical studies ranged from 1 to 17 years, with the fiber-reinforced composite post (n = 3) being the most evaluated, and only failure risk proved to be more favorable for using intraradicular posts. CONCLUSION Rehabilitations of endodontically treated teeth with and without intraradicular retainers showed no difference in fracture resistance and failure mode, evaluated by in vitro studies. Clinical studies showed no difference in survival rate, but failure risk proved to be more favorable for the use of posts. CLINICAL SIGNIFICANCE This analysis revealed significant variability between results, however, most laboratory and clinical studies revealed no difference with using the post. Furthermore, it is important to emphasize the need to evaluate the coronary remnant and the general characteristics of the tooth in each situation.
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Affiliation(s)
| | - Marcelo Lopes Silva
- Departamento de Odontologia, Centro Universitário Santo Agostinho, Teresina, Brazil
- Departamento de Odontologia, Universidade Federal do Maranhão, São Luís, Brazil
| | - Thais Oliveira Cordeiro
- Departamento de Odontologia, Centro Universitário Santo Agostinho, Teresina, Brazil
- Departamento de Odontologia, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | | | - Débora E Silva Campos
- Departamento de Odontologia Restauradora, Universidade Federal da Paraíba, João Pessoa, Brazil
| | | | - Suelen Aline de Lima Barros
- Departamento de Odontologia, Centro Universitário Santo Agostinho, Teresina, Brazil
- Departamento de Prótese e Materiais dentärios, UNESP/FOAr, Araraquara, Brazil
| | - Paulo Isaias Seraidarian
- Departamento de Odontologia, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Brazil
- Departamento de Odontologia Preventiva e Restauradora, Universidade Estadual Paulista Júlio de Mesquita Filho, Aracatuba, Brazil
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Rajnics Z, Pammer D, Kőnig-Péter A, Turzó K, Marada G, Radnai M. Push-Out Bond Strength of Glass Fiber Endodontic Posts with Different Diameters. MATERIALS (BASEL, SWITZERLAND) 2024; 17:1492. [PMID: 38612007 PMCID: PMC11013009 DOI: 10.3390/ma17071492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/09/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024]
Abstract
(1) Background: The retention of intraradicular posts is an important factor for the prognosis of endodontically treated teeth. The purpose of this study was to evaluate the push-out bond strength (PBS) of the posts relating to their diameter and region of the root. (2) Methods: A total of 40 premolar teeth (decoronated and root canal-filled) were divided into four groups (n = 10). After post-space preparation, different sizes (1.0, 1.2, 1.5, and 2.0 mm) of glass fiber posts were luted with resin cement into the root canals. After placement, 2 mm thick slices were cut from the roots according to their apical, middle, and coronal regions (n = 116). Push-out tests were carried out in a universal testing machine on each slice. A statistical evaluation of the data was applied. (3) Results: When comparing the diameter, the 2.0 mm posts had the highest PBS (111.99 ± 10.40 N), while the 1.0 mm posts had the lowest PBS (99.98 ± 8.05 N). Divided by the surface of the bonded area, the average PBS value was the highest for the 1.0 mm posts (18.20 ± 1.67 MPa) and the lowest for the 2.0 mm posts (12.08 ± 1.05 MPa). (4) Conclusions: Within the limitations of the study, when comparing the regions of the roots, no significant differences were found among the PBS values of the three regions (p = 0.219). When comparing the diameters, significant differences were shown between the PBS values of the four groups (p = 0.023 and p = 0.003, respectively).
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Affiliation(s)
- Zsolt Rajnics
- Faculty of Medicine, Dental School, University of Pécs, 7623 Pécs, Hungary; (K.T.); (G.M.)
| | - Dávid Pammer
- Department of Materials Science and Engineering, Faculty of Mechanical Engineering, Budapest University of Technology and Economics, 1111 Budapest, Hungary;
| | - Anikó Kőnig-Péter
- Institute of Bioanalysis, Medical School, University of Pécs, 7624 Pécs, Hungary;
| | - Kinga Turzó
- Faculty of Medicine, Dental School, University of Pécs, 7623 Pécs, Hungary; (K.T.); (G.M.)
| | - Gyula Marada
- Faculty of Medicine, Dental School, University of Pécs, 7623 Pécs, Hungary; (K.T.); (G.M.)
| | - Márta Radnai
- Department of Prosthodontics, Faculty of Dentistry, University of Szeged, 6720 Szeged, Hungary;
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Ben Suleiman A, Desai S, Tepperman A, Chvartszaid D, Malkhassian G, Habsha E, Barzilay I, Azarpazhooh A. The Outcomes of Endodontically Treated Teeth Restored with Custom-Made Cast Post-and-Core Restorations: A Retrospective Cohort Study. J Endod 2024; 50:316-328. [PMID: 38158119 DOI: 10.1016/j.joen.2023.12.006] [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: 06/20/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION Custom-made cast post-and-core (CMCPC) restorations have long been used to restore structurally deficient endodontically treated teeth (ETT). However, the evidence regarding their impact on the outcomes of ETT is largely inconclusive. This study evaluated the long-term treatment outcome of ETT restored with CMCPC. METHODS This retrospective cohort study examined the dental records of patients that received CMCPC at a specialty private practice in Toronto, Canada between 1999 and 2021. The proportion of ETT with complete periapical healing and those that survived were estimated, and prognostic factors were investigated using multiple logistic and Cox regression analyses respectively (P < .05). RESULTS A total of 500 and 1000 teeth met periapical healing and survival criteria, respectively. The periapical healing rate was 88.8% and was associated with the presence of baseline periapical radiolucency [odds ratio = 0.1; 95% confidence interval (CI), 0.05-0.2; P < .001]. The survival after a median follow-up time of 52.9 months (interquartile range: 26.5-99.4) was 90.1% and was associated with <75% of root length in bone [hazard ratio (HR) = 2.6; 95% CI, 1.0-6.6; P = .033], type and quality of final restoration (HR = 2.09; 95% CI, 1.1-3.9; P = .020; HR = 2.3; 95% CI, 1.2-4.5; P = .008, respectively), and the presence of periapical radiolucency at the latest recall (HR = 3.2; 95% CI, 1.7-6.3; P < .001). CONCLUSIONS The outcome of ETT restored with CMCPC was favorable. CMCPC may be regarded as a viable restorative option for structurally deficient ETT.
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Affiliation(s)
| | - Shivani Desai
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Adam Tepperman
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - David Chvartszaid
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, Ontario, Canada; The Alpha Omega Dental Centre, Baycrest Hospital, Toronto, Ontario, Canada
| | - Gevik Malkhassian
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Effrat Habsha
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, Ontario, Canada; Prosthodontic Associates Centre for Excellence, Toronto, Ontario, Canada
| | - Izchak Barzilay
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, Ontario, Canada; Prosthodontic Associates Centre for Excellence, Toronto, Ontario, Canada
| | - Amir Azarpazhooh
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada; Centre for Advanced Dental Research and Care, Mount Sinai Hospital, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
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Samran A, Hashem AW, Ali S, Al-Akhali M, Wille S, Kern M. Influence of post material and ferrule thickness on the fracture resistance of endodontically treated premolars: A laboratory study. J Prosthet Dent 2024:S0022-3913(24)00055-6. [PMID: 38402134 DOI: 10.1016/j.prosdent.2024.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/26/2024]
Abstract
STATEMENT OF PROBLEM The influence of the ferrule thickness and post materials on the fracture resistance of endodontically treated teeth remains unclear. PURPOSE The purpose of this laboratory study was to evaluate the influence of post material and ferrule thickness on the fracture resistance of endodontically treated mandibular premolars. MATERIAL AND METHODS Sixty-four extracted and endodontically treated mandibular first premolars were used and divided into 4 test groups (n=16) depending on the ferrule thickness: F-0: without a ferrule, F-0.5: with a 0.5-mm ferrule thickness, F-1: with a 1-mm ferrule thickness, and F-1.5: with a 1.5-mm ferrule thickness. In groups with ferrules, the height ranged from 2 mm buccally/lingually to 1 mm proximally. Teeth in subgroups (n=8) were restored with either prefabricated glass fiber (FF) or titanium posts (FT) (ISO size 70 and length of 7.5 mm) and then adhesively restored with composite resin foundation materials. After foundation procedures, each specimen was restored with a cobalt chromium crown which was cemented with glass-ionomer cement. All specimens were subjected to dynamic loading in a masticatory simulator for 1 200 000 loading cycles with a nominal load of 5 Kg at 1.2 Hz and simultaneous thermocycling (5 to 55 °C). Specimens were then quasistatically loaded at 30 degrees in a universal testing machine until fracture. Fracture loads were analyzed by using 2-way ANOVA followed by the Tukey honestly significant difference test (α=.05). RESULTS Fracture loads ranged from 610 ±45 N (no ferrule - glass fiber post) to 1216 ±169 N (1.5 mm ferrule thickness - glass fiber post). A statistically significant increase in fracture resistance was observed with increasing ferrule thickness (P<.001). However, post materials did not show a statistically significant influence (P=.977). CONCLUSIONS Under the conditions of this laboratory study, increasing the ferrule thickness had a significant effect on the fracture resistance of endodontically treated teeth after thermomechanical fatigue, irrespective of post materials.
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Affiliation(s)
- Abdulaziz Samran
- Visiting Associate Professor, Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel, Germany; Associate Professor, Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, Dar Al Uloom University, Riyadh, Saudi Arabia; and Associate Professor, Department of Prosthodontics, College of Dentistry, Ibb University, Ibb, Yemen.
| | - Ahmed Wagdy Hashem
- Visiting Assistant Professor, Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel, Germany; and Lecturer, Faculty of Dentistry, October University for Modern Sciences and Arts, Cairo, Egypt
| | - Shurouk Ali
- Assistant Professor, Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel, Germany
| | - Majed Al-Akhali
- Visiting Assistant Professor, Department of Prosthodontics, Propaedeutics and Dental Materials, Dental School, Christian-Albrechts University, Kiel, Germany; and Assistant Professor, Department of Prosthodontics, College of Dentistry, Ibb University, Ibb, Yemen
| | - Sebastian Wille
- Research Associate, Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel, Germany
| | - Matthias Kern
- Professor and Chairman, Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts University, Kiel, Germany
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Ming X, Zhang Z, Xie W, Zhang Y, Li Y, Zhang W. Internal adaptation and mechanical properties of CAD/CAM glass fiber post-cores in molars: An in vitro study. J Dent 2023; 138:104685. [PMID: 37659715 DOI: 10.1016/j.jdent.2023.104685] [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: 11/20/2022] [Revised: 08/16/2023] [Accepted: 08/30/2023] [Indexed: 09/04/2023] Open
Abstract
OBJECTIVE The purpose of this in vitro study was to evaluate the internal adaptation, fracture resistance, and fracture pattern of the residual roots and crowns of molars restored with computer-aided design/computer-aided manufacturing (CAD/CAM) glass fiber post-cores, and compare them with three other post-core restorations. MATERIALS AND METHODS We selected 32 extracted maxillary first molars and divided them into four groups according to the post-core system: traditional casting titanium (Ti) post-cores (TC group); Ti post-cores fabricated with selective laser melting (SLM group); CAD/CAM glass fiber post-cores of the split type (CCS group); and prefabricated glass fiber posts and composite resin cores (PF group). The internal adaptation was analyzed with microcomputed tomography. Teeth were restored with monolithic zirconia crowns and subjected to thermocycling and cyclic loading. A load was applied consistently along the long axis of the tooth until fracture to record the fracture resistance and pattern. For the statistical analysis, one- and two-way analyses of variance, Tukey's post hoc and chi-square tests were performed to compare the differences among the groups. RESULTS The CCS, TC, and SLM groups exhibited similar internal adaptations across all sections (P < 0.05). The FP group showed good fit with the root canals in the apical and middle sections but a poor fit with those in the cervical section. The fracture resistance was higher in the CCS, TC, and SLM groups compared to the PF group (P < 0.05). The proportions of restorable fractures in the CCS and PF groups were 62.5% and 50%, respectively. Unrestorable fractures were more frequent in the TC and SLM groups at frequencies of 100% and 87.5%, respectively. CONCLUSION The internal adaptation and fracture resistance of the CCS group were similar to those of the TC and SLM groups, and the fracture pattern was mostly restorable, thus meeting the clinical requirements for molar post-core restorations. CLINICAL SIGNIFICANCE CCS can be used to restore residual roots and crowns of molars and exhibit high efficacy in terms of adaptability and mechanical properties. More studies are required to evaluate the effectiveness of CCS.
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Affiliation(s)
- Xianqing Ming
- Department of Oral Special Consultation, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, PR China; Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, PR China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, PR China
| | - Ziwei Zhang
- Department of Oral Special Consultation, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, PR China; Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, PR China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, PR China
| | - Wenjing Xie
- Department of Stomatology, Jinling Hospital, Clinical School, Medical College, Nanjing University, Nanjing, PR China
| | - Yuhang Zhang
- Digital Center, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, PR China
| | - Yanyan Li
- Department of Stomatology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Wei Zhang
- Department of Oral Special Consultation, The Affiliated Stomatological Hospital of Nanjing Medical University, Nanjing, PR China; Jiangsu Province Key Laboratory of Oral Diseases, Nanjing, PR China; Jiangsu Province Engineering Research Center of Stomatological Translational Medicine, Nanjing, PR China.
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Hassouneh L, Matoug-Elwerfelli M, Al-Omari T, Setzer FC, Nagendrababu V. Assessment of biomechanical behavior of immature non-vital incisors with various treatment modalities by means of three-dimensional quasi-static finite element analysis. Sci Rep 2023; 13:17491. [PMID: 37840093 PMCID: PMC10577137 DOI: 10.1038/s41598-023-44609-2] [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: 03/29/2023] [Accepted: 10/10/2023] [Indexed: 10/17/2023] Open
Abstract
The objectives of this study were to evaluate the stress distribution and risk of fracture of a non-vital immature maxillary central incisor subjected to various clinical procedures using finite element analysis (FEA). A three-dimensional model of an immature central incisor was developed, from which six main models were designed: untreated immature tooth (C), standard apical plug (AP), resin composite (RC), glass-fibre post (GFP), regeneration procedure (RET), and regeneration with induced root maturation (RRM). Mineral trioxide aggregate (MTA) or Biodentine® were used as an apical or coronal plug. All models simulated masticatory forces in a quasi-static approach with an oblique force of 240 Newton at a 120° to the longitudinal tooth axis. The maximum principal stress, maximum shear stress, risk of fracture, and the strengthening percentage were evaluated. The mean maximum principal stress values were highest in model C [90.3 MPa (SD = 4.4)] and lowest in the GFP models treated with either MTA and Biodentine®; 64.1 (SD = 1.7) and 64.0 (SD = 1.6) MPa, respectively. Regarding the shear stress values, the dentine tooth structure in model C [14.4 MPa (SD = 0.8)] and GFP models [15.4 MPa (SD = 1.1)] reported significantly higher maximum shear stress values compared to other tested models (p < 0.001), while no significant differences were reported between the other models (p > 0.05). No significant differences between MTA and Biodentine® regarding maximum principal stress and maximum shear stress values for each tested model (p > 0.05). A maximum strain value of 4.07E-03 and maximum displacement magnitude of 0.128 mm was recorded in model C. In terms of strengthening percentage, the GFP models were associated with the highest increase (22%). The use of a GFP improved the biomechanical performance and resulted in a lower risk of fracture of a non-vital immature maxillary central incisor in a FEA model.
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Affiliation(s)
- Layla Hassouneh
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Taher Al-Omari
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Frank C Setzer
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Venkateshbabu Nagendrababu
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
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Vogler JAH, Billen L, Walther KA, Wöstmann B. Conventional cast vs. CAD/CAM post and core in a fully digital chairside workflow - An in vivo comparative study of accuracy of fit and feasibility of impression taking. J Dent 2023; 136:104638. [PMID: 37506812 DOI: 10.1016/j.jdent.2023.104638] [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: 04/14/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 07/30/2023] Open
Abstract
OBJECTIVES Clinical data for CAD/CAM post and cores (PC) is still scarce, even though developments in digital dentistry have improved dental treatment in many aspects. Therefore, the purpose of this in vivo study was to compare CAD/CAM PC fabricated in a fully digital chairside workflow to conventional cast PC (CPC) according to the accuracy of fit and the impression taking. The null hypothesis was that there is no significant difference between CAD/CAM PC and CPC. METHODS The study was conducted on 30 teeth in 25 patients receiving a CPC during their prosthetic treatment plan. On each tooth a conventional and a digital post impression were taken. Subsequently, one CPC following a conventional and one CAD/CAM PC following a digital workflow were fabricated. Both PC were tried-in intraorally and assessed according to a standardised evaluation sheet. The deviation between the two impression methods was evaluated by superimposing the datasets in a 3D analysis software. Statistical analysis for pairwise comparison was conducted according to Wilcoxon and median test with a significance level of p = 0.05. RESULTS CAD/CAM PC performed significantly better compared to CPC according to accuracy of fit (p = 0.022) and feasibility of impression taking (p < 0.001). The deviation between post impression methods increased from "coronal" to "apical". Between "coronal"/"middle" no significant difference (p = 0.158) was detected, whereas the pairwise comparison between the other measurement categories showed significant differences (p = 0.002, p < 0.001). CONCLUSIONS The null hypothesis was rejected since CAD/CAM PC performed significantly better and the deviation between the post impression methods showed significant differences. CLINICAL SIGNIFICANCE By using intraoral scanners (IOS) teeth can be restored with customised CAD/CAM PC in a single session. Within the limitations of this study the fully digital chairside workflow led to superior accuracy of fit of PC and higher feasibility of impression taking than the conventional workflow for CPC.
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Affiliation(s)
- Jonas Adrian Helmut Vogler
- Dental Clinic - Department of Prosthodontics, Justus Liebig University, Schlangenzahl 14, Giessen 35392, Germany.
| | - Louise Billen
- Dental Clinic - Department of Prosthodontics, Justus Liebig University, Schlangenzahl 14, Giessen 35392, Germany
| | - Kay-Arne Walther
- Dental Clinic - Department of Prosthodontics, Justus Liebig University, Schlangenzahl 14, Giessen 35392, Germany
| | - Bernd Wöstmann
- Dental Clinic - Department of Prosthodontics, Justus Liebig University, Schlangenzahl 14, Giessen 35392, Germany
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Rakotoaridina K, Delrieu J, Pages P, Vergé T, Nasr K, Canceill T. Evaluation of Poly(etheretherketone) Post's Mechanical Strength in Comparison with Three Metal-Free Biomaterials: An In Vitro Study. Polymers (Basel) 2023; 15:3583. [PMID: 37688208 PMCID: PMC10489626 DOI: 10.3390/polym15173583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 08/26/2023] [Accepted: 08/27/2023] [Indexed: 09/10/2023] Open
Abstract
The thinking about metallic replacement has begun in a global context of reducing metallic alloys' use in odontology. Among the materials proposed for their replacement, poly(etheretherketone) may present interesting properties, especially in removable dentures' frames. The purpose of this study is to evaluate fracture resistance of PEEK posts-and-cores compared to non-metallic CAD/CAM materials and fiber glass posts. Forty extracted maxillary central incisors were prepared to receive posts. Samples were divided into four groups depending on whether they had been reconstructed with LuxaCam® PEEK, Enamic®, Numerys GF® or LuxaPost®. Samples were submitted to an oblique compressive test and results were statistically analyzed with ANOVA and Student's tests (or non-parametric tests depending on the conditions). Glass fiber posts and Numerys GF® reveal a significantly higher fracture resistance than LuxaCam® PEEK and Enamic®. No exclusively dental fracture has been noted for the Enamic group, which significantly distinguishes these samples from the three other groups. In our study, it appears that the conception of posts and cores with hybrid ceramic never conducts to a unique tooth fracture. By weighting the results according to the materials used, our data, obtained for the first time on this type of PEEK block, cannot confirm the possibility of using PEEK for inlay-core conception, excepted for specific cases when the material is considered in a patient presenting allergies or systemic disease contraindicating resin or metal.
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Affiliation(s)
- Kévin Rakotoaridina
- Département Odontologie, Faculté de Santé, Hôpitaux de Toulouse, Université Paul Sabatier, 3 Chemin des Maraichers, 31062 Toulouse Cedex 9, France
| | - Julien Delrieu
- Département Odontologie, Faculté de Santé, Hôpitaux de Toulouse, Université Paul Sabatier, 3 Chemin des Maraichers, 31062 Toulouse Cedex 9, France
| | - Paul Pages
- Département Odontologie, Faculté de Santé, Hôpitaux de Toulouse, Université Paul Sabatier, 3 Chemin des Maraichers, 31062 Toulouse Cedex 9, France
| | - Thierry Vergé
- Département Odontologie, Faculté de Santé, Hôpitaux de Toulouse, Université Paul Sabatier, 3 Chemin des Maraichers, 31062 Toulouse Cedex 9, France
| | - Karim Nasr
- Département Odontologie, Faculté de Santé, Hôpitaux de Toulouse, Université Paul Sabatier, 3 Chemin des Maraichers, 31062 Toulouse Cedex 9, France
| | - Thibault Canceill
- Département Odontologie, Faculté de Santé, Hôpitaux de Toulouse, Université Paul Sabatier, 3 Chemin des Maraichers, 31062 Toulouse Cedex 9, France
- CNRS UMR 5085, INPT, Faculté de Pharmacie, CIRIMAT, Université Toulouse III Paul Sabatier, 35 Chemin des Maraichers, 31062 Toulouse Cedex 9, France
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Hinz S, Bömicke W, Bensel T. Cumulative 10-year performance of endodontically treated teeth with prosthetic restorations of base metal alloy double crowns with friction pins-a retrospective study. Clin Oral Investig 2023; 27:4411-4423. [PMID: 37212841 PMCID: PMC10415510 DOI: 10.1007/s00784-023-05060-9] [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: 03/12/2023] [Accepted: 05/02/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVES This 120-month follow-up study aimed to investigate the complication rate of abutment teeth after endodontic pretreatment with base metal alloy double crowns with friction pins. MATERIALS AND METHODS A total of 158 participants (n = 71, 44.9% women) aged 62.5 ± 12.7 years with 182 prostheses on 520 abutment teeth (n = 459, 88.3% vital) were retrospectively analyzed between 2006 and 2022. Of the endodontically treated abutment teeth, 6.9% (n = 36) were additionally treated with post and core reconstructions. Cumulative complication rates were calculated using the Kaplan-Meier estimator and log-rank test. In addition, Cox regression analysis was performed. RESULTS The cumulative complication rate at 120 months for the entire set of abutment teeth was 39.6% (confidence interval [CI]: 33.0-46.2). Endodontically treated abutment teeth (33.8%; CI: 19.6-48.0) were found to have a significantly higher cumulative fracture rate than vital teeth (19.9%; CI: 13.9-25.9, p < 0.001). Endodontically treated teeth restored with post and core reconstructions (30.4%; CI: 13.2-47.6) showed a nonsignificant lower cumulative fracture rate than that of teeth with root fillings only (41.6%; CI: 16.4-66.8, p = 0.463). CONCLUSIONS Higher 120-month cumulative fracture rates were observed in endodontically treated teeth. Comparable performance was observed in teeth with post and core reconstructions compared to teeth with root fillings only. CLINICAL RELEVANCE If endodontically treated teeth are used as abutments for double crowns, the risk of complications from these teeth should be considered when planning treatment and communicating with the patient.
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Affiliation(s)
- Sebastian Hinz
- Department of Prosthetic Dentistry, University School of Dental Medicine, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 16, 06112, Halle, Germany.
| | - Wolfgang Bömicke
- Department of Prosthetic Dentistry, University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Tobias Bensel
- Institute for Research in International Assistance, Akkon University for Human Sciences, Colditzstraße 34-36, 12099, Berlin, Germany
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Meng Q, Chen Y, Ni K, Li Y, Li X, Meng J, Chen L, Mei ML. The effect of different ferrule heights and crown-to-root ratios on fracture resistance of endodontically-treated mandibular premolars restored with fiber post or cast metal post system: an in vitro study. BMC Oral Health 2023; 23:360. [PMID: 37270602 PMCID: PMC10239114 DOI: 10.1186/s12903-023-03053-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 05/16/2023] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND This study aimed to investigate the effects of different ferrule heights and crown-to-root ratios on the fracture resistance of endodontically-treated premolars restored with fiber post or cast metal post system. METHODS Eighty extracted human mandibular first premolars with single root canal were treated endodontically and cut from 2.0 mm above the buccal cemento-enamel junction, to create horizontal residual roots. The roots were randomly divided into two groups. The roots in group FP were restored with a fiber post-and-core system, while the roots in group MP were restored with a cast metal post-and-core system. Each group was divided into five subgroups with different ferrule heights (0: no ferrule; 1: 1.0 mm ferrule; 2: 2.0 mm ferrule; 3: 3.0 mm ferrule; 4: 4.0 mm ferrule). All specimens were subsequently restored with metal crowns and embedded in acrylic resin blocks. The crown-to-root ratios of the specimens were controlled at approximately 0.6, 0.8, 0.9, 1.1, and 1.3 of the five subgroups, respectively. Fracture strengths and fracture patterns of the specimens were tested and recorded by a universal mechanical machine. RESULTS Mean fracture strengths (mean ± standard deviation (kN)) of FP/0 to FP/4 and MP/0 to MP/4 were: 0.54 ± 0.09, 1.03 ± 0.11, 1.06 ± 0.17, 0.85 ± 0.11; 0.57 ± 0.10, 0.55 ± 0.09, 0.88 ± 0.13, 1.08 ± 0.17, 1.05 ± 0.18 and 0.49 ± 0.09, respectively. Two-way ANOVA revealed significant effects of different ferrule heights and crown-to-root ratios on the fracture resistance (P < 0.001), but no difference in fracture resistance between two post-and-core systems (P = 0.973). The highest fracture strengths of the specimen were found with the ferrule length of 1.92 mm in group FP and 2.07 mm in group MP, the crown-to-root ratio of which in 0.90 and 0.92 respectively., there is a significant difference in fracture patterns among the groups(P < 0.05). CONCLUSIONS When a certain height of ferrule is prepared and a cast metal or fiber post-and-core system is restored for the residual root, the clinical crown-to-root ratio of the tooth after restoration should be kept within 0.90 to 0.92, so as to improve the fracture resistance of endodontically-treated mandibular first premolars.
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Affiliation(s)
- Qingfei Meng
- Department of Stomatology, Xuzhou Central Hospital, Xuzhou, China
- Department of Stomatology, Xuzhou Clinical School of Xuzhou Medical University, South Jiefang Road No. 199, 221000, Xuzhou, China
| | - Yuxin Chen
- Department of Stomatology, Xuzhou Central Hospital, Xuzhou, China
- Department of Stomatology, Xuzhou Clinical School of Xuzhou Medical University, South Jiefang Road No. 199, 221000, Xuzhou, China
| | - Ke Ni
- Department of Stomatology, Xuzhou Central Hospital, Xuzhou, China
- Department of Stomatology, Xuzhou Clinical School of Xuzhou Medical University, South Jiefang Road No. 199, 221000, Xuzhou, China
| | - Yingmei Li
- College of Stomatology, Bengbu Medical College, Bengbu, China
| | - Xinran Li
- Department of Stomatology, Xuzhou Central Hospital, Xuzhou, China
- Department of Stomatology, Xuzhou Clinical School of Xuzhou Medical University, South Jiefang Road No. 199, 221000, Xuzhou, China
| | - Jian Meng
- Department of Stomatology, Xuzhou Central Hospital, Xuzhou, China.
- Department of Stomatology, Xuzhou Clinical School of Xuzhou Medical University, South Jiefang Road No. 199, 221000, Xuzhou, China.
| | - Lijuan Chen
- Department of Stomatology, Xuzhou first People's Hospital, Daxue Road No. 269, 221000, Xuzhou, China.
| | - May Lei Mei
- Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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Alshabib A, Abid Althaqafi K, AlMoharib HS, Mirah M, AlFawaz YF, Algamaiah H. Dental Fiber-Post Systems: An In-Depth Review of Their Evolution, Current Practice and Future Directions. Bioengineering (Basel) 2023; 10:bioengineering10050551. [PMID: 37237621 DOI: 10.3390/bioengineering10050551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/27/2023] [Accepted: 05/02/2023] [Indexed: 05/28/2023] Open
Abstract
The field of dental medicine is constantly evolving and advancing toward minimally invasive techniques. Several studies have demonstrated that bonding to the tooth structure, particularly enamel, yields the most predictable results. In some instances, however, significant tooth loss, pulpal necrosis, or irreversible pulpitis may limit the options available to the restorative dentist. In these cases, placement of a post and core followed by a crown is the preferred treatment option, provided all requirements are met. This literature review provides an overview of the historical development of dental FRC post systems as well as a comprehensive examination of the currently available posts and their bonding requirements. In addition, it offers valuable insights for dental professionals seeking to understand the current state of the field and the prospects of dental FRC post systems.
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Affiliation(s)
- Abdulrahman Alshabib
- Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Khaled Abid Althaqafi
- Department of Restorative Dental Department, College of Dentistry, University of Umm Al Qura, Makkah 24211, Saudi Arabia
| | - Hani S AlMoharib
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Mahir Mirah
- Department of Restorative Dental Science, Dental College, and Hospital, Taibah University, Madinah 42353, Saudi Arabia
| | - Yasser F AlFawaz
- Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Hamad Algamaiah
- Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
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Survival rate and treatment success of glass fiber posts cemented with two adhesive cementation strategies after up to 106 months: a randomized clinical trial. Clin Oral Investig 2023; 27:2197-2206. [PMID: 36894666 DOI: 10.1007/s00784-023-04939-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 03/01/2023] [Indexed: 03/11/2023]
Abstract
OBJECTIVES The objective of this study is to evaluate the longevity of two fiber post cementation strategies in a prospective, multicenter, non-inferiority, double-blind randomized controlled trial. METHODS A total of 152 teeth, with adequate endodontic treatment and loss of coronal structure and bilateral simultaneous posterior occlusal contacts, were randomly allocated to receive glass fiber posts cemented with a conventional cementation strategy (CRC group: adhesive system + resin cement) (Adper Single Bond + RelyX ARC; 3 M-ESPE) or a self-adhesive cementation strategy (SRC group: self-adhesive resin cement; RelyX U100/U200; 3 M-ESPE). The patients were recalled annually for clinical and radiographical evaluation with a 93% recall rate (142 teeth, with 74 at CR groups and 68 at SRC group). The primary outcome was survival rate, considering the fiber post debonding (loss of retention). The secondary outcome included the success rate of the prosthetic treatment with crown debonding, post fracture, and tooth loss (not related to post failure). Both outcomes were evaluated annually. The Kaplan-Meier method and Cox regression with 95% confidence interval were used for the statistical analysis. RESULTS For the primary outcome (failures directly related to fiber posts cementation strategy), there were 4 fiber post debondings (2 per group), 8 root fractures (3 for SRC group and 5 for CRC group), and one mixed failure (debonding combined with root fracture for CRC), with both strategies presenting similar survival rates (p = 0.331), with 88.9% for the CRC group and 90.9% for the SRC group. For the secondary outcome (failures not related to fiber post cementation strategies), there were 8 crown debondings, 3 post fractures, and 3 tooth losses, with no statistically difference between groups (p = 0.701), with 77% for SRC and 82% for CRC. CONCLUSION Fiber post cementation strategies with conventional or self-adhesive resin cement presents similar tooth survival and success rates. TRIAL REGISTRATION NCT01461239 CLINICAL RELEVANCE: Both adhesive cementation strategies led to high survival and success rates and are indicated for fiber post cementation, even after a long follow-up period (up to 106 months).
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15
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Machry RV, Bergoli CD, Schwantz JK, Brondani LP, Pereira-Cenci T, Pereira GKR, Valandro LF. Longevity of metal-ceramic single crowns cemented onto resin composite prosthetic cores with self-adhesive resin cement: an update of a prospective analysis with up to 106 months of follow-up. Clin Oral Investig 2023; 27:1071-1078. [PMID: 36030454 DOI: 10.1007/s00784-022-04693-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/18/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To evaluate the longevity of metal-ceramic single crowns cemented onto resin composite prosthetic cores using a self-adhesive resin cement in a prospective clinical descriptive study. METHODS A total of 152 teeth were endodontically treated and received resin composite prosthetic cores and metal-ceramic crowns cemented with a self-adhesive resin cement. The patients included in the sample were recalled for clinical and radiography evaluation in an up-to-106-month period after the final cementation procedures, with an average of 62 months of follow-up. 91.5% of the sample (142 teeth) were evaluated regarding the treatment survival rate, analyzed considering the loss of crown retention (crown debonding) and tooth loss as the primary outcome. In addition, post debonding, and root fracture occurrences were also recorded as secondary outcomes to evaluate the success rate of the prosthetic treatment. The aesthetic parameters were also evaluated according to the FDI criteria. The Kaplan-Meier method and Cox regression with 95% confidence interval were applied for the statistical analysis. RESULTS Regarding the primary outcome, the metal-ceramic crowns cemented with self-adhesive resin cement presented a high survival rate (91.5%), with 8 crown debondings and 3 tooth losses (1 due to caries and 2 due to periodontal disease) occurring after the evaluation period. For secondary outcomes, 9 root fractures and 4 post debondings occurred, generating a success rate of 72%. All crowns had a score 1 on the FDI criteria, indicating that they were clinically excellent or very good regarding the aesthetic parameters. CONCLUSION The metal-ceramic crowns luted with a self-adhesive resin cement presented a survival rate of 91.5% after an average of 62 months of follow-up. Furthermore, the restorations remained aesthetically satisfactory over time, without changes that would indicate prosthetic retreatment. A success rate of 72% was obtained considering the secondary outcome, mainly related to intraradicular retainer failures (root fractures or post debonding). CLINICAL SIGNIFICANCE The self-adhesive resin cement is clinically indicated for cementation of metal-ceramic crowns onto resin composite prosthetic cores.
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Affiliation(s)
- Renan Vaz Machry
- Post-Graduate Program in Oral Science, School of Dentistry, Federal University of Santa Maria, UFSM Campus, 1000 Roraima Av., T Street, Building 26F, Room 2386, Santa Maria, Rio Grande Do Sul State, 97105-900, Brazil
| | - César Dalmolin Bergoli
- Post-Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Gonçalves Chaves Street 457, Pelotas, Rio Grande Do Sul State, 96015-560, Brazil
| | - Julia Kaster Schwantz
- Post-Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Gonçalves Chaves Street 457, Pelotas, Rio Grande Do Sul State, 96015-560, Brazil
| | - Lucas Pradebon Brondani
- Post-Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Gonçalves Chaves Street 457, Pelotas, Rio Grande Do Sul State, 96015-560, Brazil
| | - Tatiana Pereira-Cenci
- Post-Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Gonçalves Chaves Street 457, Pelotas, Rio Grande Do Sul State, 96015-560, Brazil
| | - Gabriel Kalil Rocha Pereira
- Post-Graduate Program in Oral Science, School of Dentistry, Federal University of Santa Maria, UFSM Campus, 1000 Roraima Av., T Street, Building 26F, Room 2386, Santa Maria, Rio Grande Do Sul State, 97105-900, Brazil
| | - Luiz Felipe Valandro
- Post-Graduate Program in Oral Science, School of Dentistry, Federal University of Santa Maria, UFSM Campus, 1000 Roraima Av., T Street, Building 26F, Room 2386, Santa Maria, Rio Grande Do Sul State, 97105-900, Brazil.
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Mannocci F, Bitter K, Sauro S, Ferrari P, Austin R, Bhuva B. Present status and future directions: The restoration of root filled teeth. Int Endod J 2022; 55 Suppl 4:1059-1084. [PMID: 35808836 PMCID: PMC9796050 DOI: 10.1111/iej.13796] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 12/30/2022]
Abstract
This narrative review will focus on a number of contemporary considerations relating to the restoration of root filled teeth and future directions for research. Clinicians are now more than ever, aware of the interdependence of the endodontic and restorative aspects of managing root filled teeth, and how these aspects of treatment are fundamental to obtaining the best long-term survival. To obtain the optimal outcomes for patients, clinicians carrying out endodontic treatment should have a vested interest in the restorative phase of the treatment process, as well as an appreciation for the structural and biomechanical effects of endodontic-restorative procedures on restoration and tooth longevity. Furthermore, the currently available research, largely lacks appreciation of occlusal factors in the longevity of root filled teeth, despite surrogate outcomes demonstrating the considerable influence this variable has. Controversies regarding the clinical relevance of minimally invasive endodontic and restorative concepts are largely unanswered with respect to clinical data, and it is therefore, all too easy to dismiss these ideas due to the lack of scientific evidence. However, conceptually, minimally invasive endodontic-restorative philosophies appear to be valid, and therefore, in the pursuit of improved clinical outcomes, it is important that the efficacies of these treatment protocols are determined. Alongside an increased awareness of the preservation of tooth structure, developments in adhesive bonding, ceramic materials and the inevitable integration of digital dentistry, there is also a need to evaluate the efficacy of new treatment philosophies and techniques with well-designed prospective clinical studies.
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Affiliation(s)
- Francesco Mannocci
- Department of EndodonticsFaculty of Dentistry, Oral and Craniofacial SciencesKing's College LondonLondonUK
| | - Kerstin Bitter
- Department of Operative and Preventive DentistryCharité ‐ University Medicine BerlinBerlinGermany
| | - Salvatore Sauro
- Departamento de Odontología, Facultad de Ciencias de la SaludUniversidad CEU‐Cardenal Herrera ValenciaAlfara del PatriarcaSpain
| | - Paolo Ferrari
- Department of Operative DentistryUniversity of ParmaParmaItaly
| | - Rupert Austin
- Department of ProsthodonticsFaculty of Dentistry, Oral and Craniofacial SciencesKing's College LondonLondonUK
| | - Bhavin Bhuva
- Department of EndodonticsFaculty of Dentistry, Oral and Craniofacial SciencesKing's College LondonLondonUK
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Wang B, Huang M, Dang P, Xie J, Zhang X, Yan X. PEEK in Fixed Dental Prostheses: Application and Adhesion Improvement. Polymers (Basel) 2022; 14:polym14122323. [PMID: 35745900 PMCID: PMC9228596 DOI: 10.3390/polym14122323] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 01/27/2023] Open
Abstract
Polyetheretherketone (PEEK) has been widely applied in fixed dental prostheses, comprising crowns, fixed partial dentures, and post-and-core. PEEK’s excellent mechanical properties facilitate better stress distribution than conventional materials, protecting the abutment teeth. However, the stiffness of PEEK is not sufficient, which can be improved via fiber reinforcement. PEEK is biocompatible. It is nonmutagenic, noncytotoxic, and nonallergenic. However, the chemical stability of PEEK is a double-edged sword. On the one hand, PEEK is nondegradable and intraoral corrosion is minimized. On the other hand, the inert surface makes adhesive bonding difficult. Numerous strategies for improving the adhesive properties of PEEK have been explored, including acid etching, plasma treatment, airborne particle abrasion, laser treatment, and adhesive systems.
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Affiliation(s)
- Biyao Wang
- Liaoning Provincial Key Laboratory of Oral Diseases, The VIP Department, School and Hospital of Stomatology, China Medical University, No. 117 North Street Nanjing Road, Shenyang 110002, China; (B.W.); (P.D.); (J.X.)
| | - Minghao Huang
- Liaoning Provincial Key Laboratory of Oral Diseases, Center of Implant Dentistry, School and Hospital of Stomatology, China Medical University, No. 117 North Street Nanjing Road, Shenyang 110002, China;
| | - Pengrui Dang
- Liaoning Provincial Key Laboratory of Oral Diseases, The VIP Department, School and Hospital of Stomatology, China Medical University, No. 117 North Street Nanjing Road, Shenyang 110002, China; (B.W.); (P.D.); (J.X.)
| | - Jiahui Xie
- Liaoning Provincial Key Laboratory of Oral Diseases, The VIP Department, School and Hospital of Stomatology, China Medical University, No. 117 North Street Nanjing Road, Shenyang 110002, China; (B.W.); (P.D.); (J.X.)
| | - Xinwen Zhang
- Liaoning Provincial Key Laboratory of Oral Diseases, Center of Implant Dentistry, School and Hospital of Stomatology, China Medical University, No. 117 North Street Nanjing Road, Shenyang 110002, China;
- Correspondence: (X.Z.); (X.Y.); Tel.: +86-024-31927731 (X.Z.); +86-024-31927715 (X.Y.)
| | - Xu Yan
- Liaoning Provincial Key Laboratory of Oral Diseases, The VIP Department, School and Hospital of Stomatology, China Medical University, No. 117 North Street Nanjing Road, Shenyang 110002, China; (B.W.); (P.D.); (J.X.)
- Correspondence: (X.Z.); (X.Y.); Tel.: +86-024-31927731 (X.Z.); +86-024-31927715 (X.Y.)
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18
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Future Trends in Endodontics: How Could Materials Increase the Long-Term Outcome of Root Canal Therapies? MATERIALS 2022; 15:ma15103473. [PMID: 35629501 PMCID: PMC9146320 DOI: 10.3390/ma15103473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 02/04/2023]
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19
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Fracture Resistance and Stress Distribution Pattern of Different Posts-Core Systems in Immature Teeth: An In Vitro Study and 3D Finite Element Analysis. Int J Dent 2022; 2022:2610812. [PMID: 35186084 PMCID: PMC8849807 DOI: 10.1155/2022/2610812] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 12/30/2021] [Accepted: 01/13/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction Restoration of immature teeth with open apices and thin dentinal walls with conventional post systems remains a challenge. The purpose of this study was to evaluate the fracture resistance of simulated immature teeth restored with different intraradicular posts and assess their stress distribution pattern using 3D Finite Element Analysis (FEA). Methods Fracture strength testing using universal testing machine was carried out in simulated immature teeth restored with different intraradicular posts grouped as follows: Group A: teeth not restored with posts served as control group; Group B: Cast metal post (CMP); Group C: Customized Composite Post (CCP); Group D: Fiber post (FP). Four 3D FEA models of the above groups were created using CATIATM software and analyzed for stress distribution using ANSYSTM. The results of fracture strength testing and FEA were correlated. Multiple group comparisons were analyzed by one-way ANOVA followed by Tukey HSD post hoc test. Results The CMP exhibited highest fracture resistance (336.43 N) but resulted in root fractures. The CCP exhibited lower fracture resistance (240.90 N) and favorable stress distribution as compared to CMP. The FP and control group exhibited lower fracture resistance values of 182.69 N and 130.46 N, respectively. The results of 3D FEA demonstrated higher stress concentration in model comprising metallic post and core. Conclusions Teeth restored with cast metal posts and cores exhibited maximum fracture resistance followed by the customized composite posts, the fiber posts, and the control group. The cast metal posts indicated higher von Mises stresses concentrated in the radicular region; however, the customized composite posts, the fiber posts, and the control group demonstrated stress concentration in the coronal region.
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Cayo-Rojas C, Santander-Rengifo F, Castillo-Andamayo D, Tay L, López-Gurreonero C, Cornejo-Pinto A, Cervantes-Ganoza L. Bond strength and failure mode of glass fiber posts with different surface treatments prior to silanization: An in vitro comparative study. J Int Soc Prev Community Dent 2022; 13:42-53. [PMID: 37153932 PMCID: PMC10155880 DOI: 10.4103/jispcd.jispcd_292_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 02/03/2022] [Accepted: 03/15/2022] [Indexed: 11/11/2022] Open
Abstract
Aim The use of chemical agents in the surface treatment of glass fiber posts can improve their bond strength to the root canal. The aim of this study was to assess the bond strength and failure mode of glass fiber posts that received different surface treatments prior to silanization. Materials and Methods In this cross-sectional and in vitro experimental study, 50 human lower premolar roots were randomly divided into five groups and subsequently prepared to receive the cementation of a fiberglass post prior to silanization. They were distributed as group 1 (with 24% hydrogen peroxide), group 2 (with 37% phosphoric acid), group 3 (with 1.23% acidulated phosphate fluoride for 2 minutes), group 4 (with 1.23% acidulated phosphate fluoride for 6 minutes), and group 5 (without pretreatment). After cementation, the roots were sectioned into two discs for each cervical, middle, and apical region. Bond strength was assessed using the push out technique. Adhesive, mixed, and cohesive failure modes were also assessed. For data analysis, ANOVA and Tukey's post hoc tests were used, as well as Pearson's chi-square test. A significance of P < 0.05 was considered in all statistical analyses. Results When comparing the bond strength of root regions, significant differences were obtained in groups pretreated with phosphoric acid (P = 0.018) and acidulated phosphate fluoride for 2 and 6 minutes (P = 0.001 and P = 0.000, respectively). Furthermore, significant differences were obtained between posts treated only with silane and those that received phosphoric acid pretreatment (P = 0.006) and acidulated phosphate fluoride for 6 minutes (P = 0.001). Significant association of mixed failure mode was observed with hydrogen peroxide (P = 0.014) and phosphoric acid (P = 0.006) pretreatments. Cohesive failure was significantly associated with acidulated phosphate fluoride pretreatment for 2 minutes (P = 0.032) and with posts that did not receive treatment prior to silanization (P = 0.000). Conclusion Posts treated only with silane and pretreated with hydrogen peroxide and acidulated phosphate fluoride for 2 minutes presented significantly higher bond strength with respect to those pretreated with phosphoric acid and acidulated phosphate fluoride for 6 minutes. However, acidulated phosphate fluoride for 2 minutes and silane were associated with a better bonding type.
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