Flexural strength of fiber reinforced posts after mechanical aging by simulated chewing forces

Effect of Laser Treatment of Root Dentine on Retention of Dental Fiber Post in Endodontically Treated Teeth: An In Vitro Study

Introduction: The most common causes of fiber post-failure are inadequate restorations and dislodgement. This study aimed to evaluate fiber post-bond strength to dentin following Er,Cr:YSGG laser irradiation. Methods: A total of 65 human mandibular premolars with single roots were included. The 14 mm root length was instrumented with the rotary system using the crown-down technique. Gutta-percha was used for obturation, followed by conventional post space preparation. The samples were divided into two major groups: control (A) and Er,Cr:YSGG (2780 nm) laser group (B). The laser group was subdivided into (B1) 1.25 W, (B2) 1.5 W, and (B3) 1.75 W. All laser groups were set at 20 Hz, 10% and 30% water/air ratio. Fiber posts were cemented with selfadhesive cement. Each sample was divided horizontally into two slices, coronal and apical. The universal testing equipment was used to conduct a push-out test. All groups were examined by SEM and temperature changes. The statistical analysis was performed by using one-way ANOVA and Tukey HSD tests. Results: SEM images of all laser groups revealed the elimination of the smear layer and opened dentinal tubules, which was particularly noticeable in the apical region with no thermal risk to the periodontal tissue. In the push-out test, all laser groups had highly significant (P<0.001) increases in the bond strength of fiber post to dentin. The failure mode of the control group was a predominantly adhesive failure, whereas the laser groups were a predominantly mixed type. Conclusion: The three laser protocols can be used safely in the surface treatment of the fiber post space of endodontically treated teeth. Laser help to increase the bond strength of fiber post to dentin, especially in the apical area.

Clinical performance of custom-milled polyetherketoneketone (PEKK) posts and cores: A 12-month follow-up randomized controlled pilot study

OBJECTIVES

Comparing the survival rate and the cumulative success rates of custom-milled polyetherketone ketone posts and cores (MPP) with prefabricated fiber posts (PFP) in restoring compromised endodontically treated premolars.

MATERIAL AND METHODS

This was a randomized, double-blind, parallel, two-arm controlled pilot study. A total of 24 patients (12 males, 12 females), each had a compromised lower premolar, needed a root canal treatment and to be restored with post and core. Patients were randomly allocated into two groups, MPP-group: restored with MPP, and PFP-group: restored with PFP and composite cores. After that, premolars were restored with single porcelain fused to metal (PFM) crowns. Clinical and radiographic follow-ups were conducted after 3, 6, and 12 months. The Kaplan-Meier, log-Rank, and χ2 tests were used to investigate differences between the two groups at the 0.05 significance level.

RESULTS

The survival rate after 12 months in the MPP and PFP groups was 66.7% and 100%, respectively. Meanwhile, the cumulative success rates were 63.6% and 100% in the same order. The log-rank test showed a significant difference between the two groups (p = .031). The difference in cumulative success rates was also significant, as the χ2 test revealed (p = .011).

CONCLUSION

The PFP group showed a higher success rate than the MPP group and according to the failure types, PEKK posts seem to be inferior to PFP in terms of the mechanical properties and bonding to resin mechanism.

TRIAL REGISTRATION

ISRCTN, ISRCTN13456471. October, 14, 2019. (https://doi.org/10.1186/ISRCTN13456471ISRCTN13456471).

Bond strength of various post-core restorations with different lengths and diameters following cycle loading

PURPOSE

This in vitro study aims to evaluate the bonding strengths of Polyether ether ketone (PEEK), Polyether ketone (PEKK), Fiber, and Zirconia (ZrO₂) post-core restorations with posts in different diameter and length following chewing simulator.

MATERIALS AND METHODS

Endodontic treatment was performed on 256 intact maxillary central teeth. The test specimens were prepared in four groups according to the types of materials: Glass fiber post-composite core (FB-n:64), Zirconia post-core (Zr-n:64), PEEK post-core (PE-n:64), and PEKK post-core (PK-n:64). The groups were divided into four subgroups according to diameter and length (n:16): Group 1: 10 mm length 1.75 mm diameter, Group 2: 10 mm length 1.5 mm diameter, Group 3: 7 mm length 1.75 mm diameter, Group 4: 7 mm length 1.5 mm diameter. Custom PEKK, PEEK, Zirconia post-cores, and Zirconia crowns were milled on the CAD/CAM. The post-cores and crowns were cemented to the teeth with dual-cure resin cement. After that, all subgroups were divided into control and cyclic loading groups. During the cycling, the control test group was kept in distilled water at 37±1^oC before the push-out test. Half of the specimens were loaded with 250,000 cycles and 50 N with a chewing simulator. All test specimens had 1.5 mm sections taken from their roots. Then, the push-out test was applied to these sections for bond strength. Data were analyzed by Mann-Whitney U test, Shapiro-Wilk, Kruskal-Wallis's test, and Chi-Square. The statistical significance level was determined as 0.05.

RESULTS

The bond strength of all test groups decreased after the cycling loading. The bond strength values of zirconia posts showed a statistically significant difference (p < 0.05). The 10 mm length 1.75 mm diameter posts made of Zirconium had the highest bond strength observed in all control and cyclic loading groups of test specimens (9.74 MPa-6.25 MPa). The PEEK test specimens with a 7 mm length and 1.75 mm diameter showed the weakest bond strength in all control and cyclic loading groups (5.44 MPa-3.37 MPa). The average of the cervical region's bond strength values was statistically significantly higher than the apical region (p < 0.05).

CONCLUSION

Within the limitations of this study, one-piece custom-milled Zirconia post-cores appear promising, as they perform well under functional forces, especially in the anterior region. In addition, custom-milled PEKK post-cores might be considered a suitable alternative to prefabricated fiber-reinforced posts.

Fracture strength, pull-out bond strength, and volume of luting agent of tooth-colored CAD-CAM post-and-cores

STATEMENT OF PROBLEM

Little is known about the fracture strength, retention, and adaptation of post-and-cores fabricated with novel tooth-colored materials by computer-aided design and computer-aided manufacturing (CAD-CAM).

PURPOSE

The purpose of this in vitro study was to investigate the fracture strength, pull-out bond strength (POBS), and volume of luting agent of endodontically treated premolars restored with post-and-cores milled from different CAD-CAM materials.

MATERIAL AND METHODS

Post spaces were prepared in 80 human premolars in which post-and-cores fabricated with polyetheretherketone (PK; Ceramill PEEK), nanohybrid composite resin (BB; Brava Block), polymer-infiltrated ceramic (EN; VITA Enamic), and fiber-reinforced epoxy resin (GF; Fiber Cad Post & Core) CAD-CAM materials were luted (n=20). All specimens were subjected to thermal aging (3000 cycles at 5 °C and 55 °C with a 20-second dwell time). Half of the specimens were subjected to mechanical fatigue (250 000 cycles at 5 Hz) before fracture strength testing, while the other half was submitted to POBS testing and volume of luting agent measurement. Fracture strength data were analyzed by 1-way ANOVA, while POBS and volume of luting agent data were submitted to Kruskal-Wallis followed by the Bonferroni-Dunn multiple comparison tests. The correlation between POBS and the volume of luting agent was determined by the Spearman test (α=.05).

RESULTS

POBS of GF was significantly higher than that for PK (P<.001); however, failure load (P=.160) and volume of luting agent (P=.390) values did not differ. EN showed the highest percentage of catastrophic failures (20%), while PK exhibited only core deformations. POBS and cement film volume were not significantly correlated (P>.05).

CONCLUSIONS

Different CAD-CAM materials did not influence the fracture strength and volume of luting agent of post-and-cores. Post-and-cores made with PEEK blocks showed lower bond strength to intracanal dentin than those made with fiber-reinforced epoxy resin blocks. No significant correlation was found between bond strength and the volume of luting agent.

Mechanical properties of glass-fibre-reinforced composite posts after laser irradiation with different energy densities

The aim of the present study was to evaluate the effect of the surface treatments on flexural strengths and flexural modulus of glass-fibre-reinforced composite (GFRC) posts. Sixty-three posts were randomly divided into 9 groups (n = 7), and various surface treatments were performed. The control group was left untreated. Other groups were treated with 9% hydrofluoric acid, sandblasting with 120 µm Al₂ O₃ particles and Er,Cr:YSGG laser irradiation with different powers (1 W, 2 W, 3 W, 4 W, 5 W and 6 W). The samples were subjected to 3-point bending test, and data were calculated. Statistical analysis was performed. The flexural strengths of fibre posts treated with sandblasting, hydrofluoric acid, 1 W and 2 W laser were statistically similar with control group (P > 0.01). However, the flexural strength of fibre posts treated with 3 W, 4 W, 5 W and 6 W laser was statistically lower than control group (P < 0.01). High laser irradiations cause melting on the post surface and breaks in fibrils.

The Effect of Diode and Er,Cr:YSGG Lasers on the Bond Strength of Fiber Posts

Background: Laser irradiation modifies the topography and composition of dentin surface aiming to increase the retention of bonded posts. Objective: To assess the effect of dentin irradiation with Er,Cr:YSGG or diode lasers on the bond strength of fiber posts using self-adhesive resin cement. Materials and methods: Sixty bovine root canals were root-canal treated, post spaces were prepared, and subsequently fiber posts were cemented. The samples were distributed according to the surface treatment: distilled water (control), Er,Cr:YSGG (1.5 W, 20 sec), or diode (1.5 W, 20 sec) lasers. Bond strengths were assessed by pull-out (n = 10) or push-out testing (n = 10). Pearson's correlation was calculated. Failure mode after testing and the depth of tags in the dentinal tubules were analyzed by confocal laser microscopy. Data were submitted to analysis of variance and Tukey's test. A p < 0.05 was considered significant. Results: In the push-out test, Er,Cr:YSGG laser had significantly different higher values (5.43 ± 0.10 MPa) compared to the control (4.79 ± 0.05 MPa). Diode laser values were not significantly different from the other groups (5.12 ± 0.27 MPa). In the pull-out test, there were no significant differences between Er,Cr:YSGG (6.86 ± 2.16 MPa) and diode (8.43 ± 1.77 MPa) lasers, and both had significant differences compared to the control (4.18 ± 1.29 MPa). No correlation was found. Adhesive failures were predominant in all groups, and no significant differences in tag penetration among the groups were found. Conclusions: The Er,Cr:YSGG laser increases the bond strength of resin cement and fiber post to dentin in both tests, compared to control group without laser treatment. Diode laser only enhanced bonding for pull-out test.

Microtensile bond strength of root canal dentin treated with adhesive and fiber-reinforced post systems

Nowadays, demand for esthetic restorations has risen considerably; thus, nonmetal esthetic posts made of either high-strength ceramics or reinforced resins, such as fiber-reinforced resin posts, have become more and more popular. Important characteristics of fiber-reinforced posts involve a modulus of elasticity similar to dentin and their ability to be cemented by an adhesive technique. A total of 36 maxillary incisors were divided into four groups. In this study, four adhesively luted fiber-reinforced (glass fiber, quartz glass fiber, zirconia glass fiber and woven polyethylene fiber ribbon) post systems were used. Post spaces were prepared by employing drills according to the protocol established for each group, and each post was adhesively luted with one of three adhesive systems. Three segments per root apical to the cementoenamel junction (CEJ) were obtained by sectioning the root under distilled water with a carbon spare saw. The samples (total of 108 sections) were 2.0±0.1 mm in thickness and they were stored individually in black film canisters with sterile distilled water. In order to determine the bond strength, the bonding area of each specimen was measured, and specimens were attached to a device to test microtensile strength at a speed of 1 mm/min. The analyses revealed no statistically significant differences between the adhesive systems and fiber-reinforced posts. (P> 0.05). However, the coronal portion of the root dentin had the highest bond strength. Adhesive systems used along with fiber-reinforced resin posts demonstrated reliable bonding.

Flexural Properties and Elastic Modulus of Different Esthetic Restorative Materials: Evaluation after Exposure to Acidic Drink

Background

Acidic beverages, such as soft drinks, can produce erosion of resin composites. The purpose of the present study was to investigate mechanical properties of different esthetic restorative materials after exposure to acidic drink.

Methods

Nine different composites were tested: nanofilled (Filtek Supreme XTE, 3M ESPE), microfilled hybrid (G-ænial, GC Corporation), nanohybrid Ormocer (Admira Fusion, Voco), microfilled (Gradia Direct, GC Corporation), microfilled hybrid (Essentia, GC Corporation), nanoceramic (Ceram.X Universal, Dentsply De Trey), supranano spherical hybrid (Estelite Asteria, Tokuyama Dental Corporation), flowable microfilled hybrid (Gradia Direct Flo, GC Corporation), and bulk fill flowable (SureFil SDR flow, Dentsply De Trey). Thirty specimens of each esthetic restorative material were divided into 3 subgroups (n=10): specimens of subgroup 1 were used as control, specimens of subgroup 2 were immersed in 50 ml of Coca Cola for 1 week, and specimens of subgroup 3 were immersed in 50 ml of Coca Cola for 1 month. Flexural strength and elastic modulus were measured for each material with an Instron Universal Testing Machine. Data were submitted to statistical analysis.

Results

After distilled water immersion, nanofilled composite showed the highest value of both flexural strength and elastic modulus, but its flexural values decreased after acidic drink immersion. No significant differences were reported between distilled water and acidic drink immersion for all other materials tested both for flexural and for elastic modulus values.

Conclusions

Even if nanofilled composite showed highest results, acidic drink immersion significantly reduced flexural values.

Bonding durability of titanium tetrafluoride treated glass fiber post with resin cement

This study evaluated the effect of titanium tetrafluoride (TiF₄) solution on the bond strength of glass fiber post to resin cement. The specimens were divided into eight groups according to the method of surface treatment performed. Flexural properties and microtensile bond strength (µTBS) were determined. Data were analyzed using two-way ANOVA and Tukey's post hoc tests. The highest µTBS achieved with the TiF₄ (4 wt/v%-4 min) group compared with the other groups (p<0.05). This finding could be attributed to the effectiveness of TiF₄ (4 wt/v%-4 min) on removing the surface layer of the resin matrix of fiber posts that provides more uncovered surface areas of posts which improved the micromechanical retention of the resin cement. Surface treatments did not affect the flexural properties of fiber posts (p>0.05). Surface treatment of fiber post with TiF₄ (4 wt/v%-4 min) solution exhibited higher bond strength to resin cement compared with other surface treatments.

Travel beyond Clinical Uses of Fiber Reinforced Composites (FRCs) in Dentistry: A Review of Past Employments, Present Applications, and Future Perspectives

The reinforcement of resins with short or long fibers has multiple applications in various engineering and biomedical fields. The use of fiber reinforced composites (FRCs) in dentistry has been described in the literature from more than 40 years. In vitro studies evaluated mechanical properties such as flexural strength, fatigue resistance, fracture strength, layer thickness, bacterial adhesion, bonding characteristics with long fibers, woven fibers, and FRC posts. Also, multiple clinical applications such as replacement of missing teeth by resin-bonded adhesive fixed dental prostheses of various kinds, reinforcement elements of dentures or pontics, and direct construction of posts and cores have been investigated. In orthodontics, FRCs have been used also for active and passive orthodontic applications, such as anchorage units, en-masse movement units, and postorthodontic tooth retention. FRCs have been extensively tested in the literature, but today the advances in new technologies involving the introduction of nanofillers or new fibers along with understanding the design principles of FRC devices open new fields of research for these materials both in vitro and in vivo. The present review describes past and present applications of FRCs and introduces some future perspectives on the use of these materials.