Load-bearing capacity of indirect inlay-retained fixed dental prostheses made of particulate filler composite alone or reinforced with E-glass fibers impregnated with various monomers

Fatigue Resistance of Dissected Lower First Molars Restored with Direct Fiber-Reinforced Bridges—An In Vitro Pilot Study

The aim of this research was to evaluate the mechanical impact of utilizing different fiber-reinforced composite (FRC) systems to reinforce inlay-retained bridges in dissected lower molars with different levels of periodontal support. A total of 24 lower first molars and 24 lower second premolars were included in this study. The distal canal of all molars received endodontic treatment. After root canal treatment, the teeth were dissected, and only the distal halves were kept. Standardized class II occluso-distal (OD) (premolars) and mesio-occlusal (MO) (dissected molars) cavities were prepared in all teeth, and premolar–molar units were created. The units were randomly distributed among four groups (n = six/group). With the aid of a transparent silicone index, direct inlay-retained composite bridges were fabricated. In Groups 1 and 2, both discontinuous (everX Flow) and continuous (everStick C&B) fibers were used for reinforcement, while in Groups 3 and 4, only discontinuous fibers (everX Flow) were used. The restored units were embedded in methacrylate resin, simulating either physiological periodontal conditions or furcation involvement. Subsequently, all units underwent fatigue survival testing in a cyclic loading machine until fracture, or a total of 40,000 cycles. Kaplan–Meyer survival analyses were conducted, followed by pairwise log-rank post hoc comparisons. Fracture patterns were evaluated visually and with scanning electron microscopy. In terms of survival, Group 2 performed significantly better than Groups 3 and 4 (p < 0.05), while there was no significant difference between the other groups. In the case of impaired periodontal support, a combination of both continuous and discontinuous short FRC systems increased the fatigue resistance of direct inlay-retained composite bridges compared to bridges that only contained short fibers. Such a difference was not found in the case of sound periodontal support between the two different bridges.

Load bearing capacity and Weibull characteristics of inlay-retained resin-bonded fixed dental prosthesis made of all-ceramic, fiber-reinforced composite and metal-ceramic after cyclic loading

PURPOSE

The objectives of this study were to evaluate the load bearing capacity of RBFDPs made of different materials after cyclic loading, and classify the failure types after loading.

MATERIALS AND METHODS

Sound human mandibular first premolars and first molar pairs (N = 60 per tooth type, n = 10 per group) were randomly divided into six experimental groups to receive one of the following inlay-retained RBFDP types: RC: Resin composite only, DFRC: Direct E-glass fiber-reinforced composite (FRC), IFRC: Indirect E-glass FRC, LS: Lithium disilicate glass-ceramic, ZR: Yttria-stabilized tetragonal zirconia, MC: Metal-ceramic. Box preparations were made in abutment teeth using diamond burs followed by standardized ultrasonic burs. The teeth were conditioned employing an etch-and-rinse adhesive system and the indirect RBFDPs were cemented adhesively. The specimens were subjected to cyclic loading for x1.200.000 in distilled water alternating between 5 and 55 °C (Zurich Chewing Simulator). They were then loaded to failure from the occlusal surface in the Universal Testing Machine (cross-head speed: 1 mm/min). Failure types were classified as repairable or irreparable depending on the location and size. Data were analyzed using Welch and Tamhane's T2 post-hoc tests (α = 0.05). Weibull modulus for each group was calculated based on parametric distribution analysis of censored data for maximum fracture load.

RESULTS

Mean load bearing capacity (N) of Groups LS (1274 ± 270), ZR (1567 ± 363) and MC (1544 ± 787) were significantly higher than those of other groups (p < 0.05). RC, DFRC, IFRC (601 ± 130 - 819 ± 270) and MC did not show significant difference (p > 0.05). Weibull modulus (m) was the highest in Group LS (m = 5.3) followed by Group RC (m = 5.1). Other groups presented Weibull moduli ranging between 1.4 and 3.3. Only in Group ZR, 2 early debonding occurred during cyclic loading. While in this group predominantly irreparable failures (debonding with without tooth fracture) were observed (8 out of 10), all other groups presented mainly single or a combination of repairable failures (chipping in the veneering material). DFRC, IDRC and MC did not show any debonding from the abutment teeth.

CONCLUSION

Considering load bearing capacity, repairable failure types and Weibull moduli, lithium disilicate seem to be more durable than those of other material options for posterior inlay-retained RBFDPs. Due to early debondings and catastrophic irreparable failure types, zirconia RBFDPs should be indicated with caution in the posterior region.

Effects of biocompatible Nanofillers on mixed-mode I and II fracture toughness of PMMA base dentures

A modified single edge cracked bend beam specimen called "inclined edge crack asymmetric bend" (IE-CAB) specimen was designed and proposed for investigating mixed mode I/II fracture toughness behavior of brittle materials. Using a large number of finite element analyses performed for different geometry and loading conditions, it was demonstrated that unlike the conventional single edge notch beam specimen, the IE-CAB configuration can provide full combinations of mode mixities from pure mode I to pure mode II. Then the IE-CAB specimen was employed for mixed mode I/II fracture toughness testing of two PMMA based denture materials (i.e. neat PMMA and toughened PMMA with Nano-hydroxyapatite (HAP)and Nano-alumina (Al₂O₃) particles). The obtained experimental results showed that adding bio-compatible (HAP and Al₂O₃) Nano-particles can increase both modes I and II fracture resistance (K_Ic and K_IIc) values of base PMMA denture. However, the influence of such particles was more pronounced on enhancing mode I fracture toughness (K_Ic) value. Pure mode II fracture toughness value was obtained less than the pure mode I fracture toughness in the tested specimen showing the higher crack growth risk of such PMMA base dentures against dominantly shear loads. The well-known maximum tangential stress theory was also used for estimating the obtained experimental data both for mixed mode fracture toughness and fracture initiation direction in the tested PMMA base denture materials.

Influence of preheating and post-curing on a novel fiber-reinforced composite post material

The aim of this study was to investigate the influence of preheating and post-curing methods on diametral tensile strength (DTS), flexural strength (FS), knoop microhardness (KHN), and degree of conversion (DC) of an experimental fiber-reinforced composite (FRC). Specimens (30 wt% of 3-mm-short E-glass fiber, 22.5 wt% of methacrylated-based resin and 47.5 wt% of filler particles) were subjected to: P - photocuring at 1500 mW/cm2 for 40 s (control); P/M - photocuring and microwave post-curing (540W/5 minutes); P/A - photocuring and autoclave post-curing (120°C/15 minutes); PH-P - preheating (60°C) and photocuring; PH-P/M - preheating, photocuring and microwave post-curing; and PH-P/A - preheating, photocuring and autoclave post-curing. Specimens for DTS (Ø 3 x 6 mm) and FS (25 x 2 x 2 mm) were tested at Instron 5965. KHN employed a 50g load for 30s. DC was measured using FTIR spectroscopy. Statistical analysis employed: factorial analysis, normality test, one-way ANOVA and Tukey's HSD test, independent T-test and the Dunnett test. Interaction between factors was not significant (P>0.05). Preheating promoted significantly higher values of FS and KHN (p = 0.0001). Post-curing promoted significantly higher values for KHN (p = 0.0001). For DTS (p = 0.066) and DC (p= 0.724) no statistical difference was found between groups. SEM images showed that preheating promoted better interaction between glass fibers and resin matrix. Preheating increased FS, KHN and DTS, and post-curing increased KHN. DC was not affected by both methods. Preheating and post-curing methods can be used to improve some mechanical properties of FRCs' but degree of conversion remains unaffected.

Direct Fiber-Reinforced Interim Fixed Partial Dentures: Six-Year Survival Study

PURPOSE

Mechanical and optical studies of glass fiber composites have revealed great resistance and satisfactory bonds between the glass fibers and composite resins. This study aimed to evaluate the long-term survival of anterior and posterior direct glass fiber-reinforced composite (FRC) fixed partial dentures (FPD).

MATERIALS AND METHODS

Twenty-three patients (9 men, 14 women) aged 18 to 67 received 23 d-FRC-FPDs. The frameworks of the FPDs were unidirectional pre-impregnated glass fibers (ever Stick C&B). The retainers were inlay composite resin retainers (n1 = 19) and composite resin wings (n2 = 4). The FPD that used inlay retainers and composite resin wing retainers was called the hybrid design. The mean follow-up period was 4.91 years with 12-month check-ups performed by two independent operators. The survival rates of the glass fiber FPDs were determined.

RESULTS

Six-year survival rates for the two types of FPDs were 94.7% for the inlay retainer type versus 25% for the hybrid type, with a statistically significant difference (log-rank test χ² (1) = 11.422, p = 0.001). The inlay retainers were functional, with only one patient with a fracture line in the connector held by the glass fibers. Kaplan-Meier survival curves were drawn to show the difference between the two types of retainers.

CONCLUSION

According to the results of this study, these long-term interim FRC-FPD were resistant enough to allow mastication, minimally invasive and also esthetic, with inlay composite retainers as the better solution.

Load-bearing capacity of novel resin-based fixed dental prosthesis materials

To evaluate the influence of different materials on the load-bearing-capacity of inlay-retained fixed-dental-prosthesis (FDP). Ten types of FDPs were evaluated (n=7/group): Group PEEK: CAD-CAM polyetheretherketone (PEEK-TechnoMed), Group RC, made of discontinuous-fiber-composite (EverX Posterior); Group FRC1, made of discontinuous-fiber-composite (EverX Posterior) with two-bundles of continuous-unidirectional fiber-reinforced-composite (FRC) (Everstick C&B); Group FRC2, made of discontinuous-fiber-composite (EverX Posterior) with two-bundles of continuous-unidirectional-FRC (Everstick C&B) covered by two-pieces of short-unidirectional-FRC (Everstick C&B) placed perpendicular to the main-framework; Group FB, CAD-CAM fiber-block (Fibra-Composite Bio-C); Group PMMA, CAD-CAM polymethyl methacrylate block (Temp basic); Group RP, resin-paste; Group FRP1, made of resin-paste (G-Fix) with two-bundles of continuous-unidirectional-FRC (Everstick C&B); Group FRP2, made of resin-paste (G-Fix) two-bundles of continuous-unidirectional-FRC covered by two-pieces of short unidirectional-FRC placed perpendicular to the main-framework and Group exp-FRC, experimental CAD-CAM FRC. The bridges were statically-loaded until fracture. Fracture modes were visually examined. ANOVA revealed that significant differences were observed between FDP-materials (p<0.05). In addition, fiber addition to the framework significantly affected load-bearing-capacity (p<0.05).

Inlay-retained fixed dental prosthesis: a clinical option using monolithic zirconia

DIFFERENT INDIRECT RESTORATIONS TO REPLACE A SINGLE MISSING TOOTH IN THE POSTERIOR REGION ARE AVAILABLE IN DENTISTRY: traditional full-coverage fixed dental prostheses (FDPs), implant-supported crowns (ISC), and inlay-retained FDPs (IRFDP). Resin bonded FDPs represent a minimally invasive procedure; preexisting fillings can minimize tooth structure removal and give retention to the IRFDP, transforming it into an ultraconservative option. New high strength zirconia ceramics, with their stiffness and high mechanical properties, could be considered a right choice for an IRFDP rehabilitation. The case report presented describes an IRFDP treatment using a CAD/CAM monolithic zirconia IRFDP; clinical and laboratory steps are illustrated, according to the most recent scientific protocols. Adhesive procedures are focused on the Y-TZP and tooth substrate conditioning methods. Nice esthetic and functional integration of indirect restoration at two-year follow-up confirmed the success of this conservative approach.