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Borges KT, Servín MPM, França FMG, Turssi CP, Basting RT, Hirata R, Vieira-Junior WF. Influence of viscosity and fiber reinforcement of resin composite on fracture strength and failure mode of restored molars. J ESTHET RESTOR DENT 2024. [PMID: 39095320 DOI: 10.1111/jerd.13293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 07/15/2024] [Accepted: 07/23/2024] [Indexed: 08/04/2024]
Abstract
OBJECTIVE To evaluate the fracture behavior of human molars with extensive MOD restorations using short-fiber-reinforced resin composite of varying viscosities. MATERIALS AND METHODS Human molars were randomly divided into seven groups (n = 12): intact teeth (control); restoration using conventional high-viscosity resin composite without (Filtek Z350XT, 3M) or with fibers (everX Posterior, GC); conventional low-viscosity resin composite without (Filtek Supreme Flowable, 3M) or with fibers (everX Flow Dentin Shade, GC); bulk-fill low-viscosity resin composite (Filtek Bulk Fill Flow, 3M) or with fibers (everX Flow Bulk Shade, GC). Restorations were performed on extensive MOD preparations, following the manufacturers' recommendations for each material. Specimens underwent fracture strength testing (N) and fracture pattern (%) categorized as repairable, possibly repairable, or non-repairable. Results were analyzed using a generalized linear model (N) and Fisher's exact test (%), with α = 0.05. RESULTS Restorations performed with high-viscosity materials showed fracture strength values similar to the control and higher than those of restorations using low-viscosity resin composites (p < 0.0001), except for the bulk-fill low-viscosity resin composite with fibers (p > 0.05). Teeth restored using low-viscosity resin composite with fibers showed a higher % of repairable and possibly repairable fractures than the control (p = 0.0091). CONCLUSIONS The viscosity of materials mediated the fracture strength, with restorations using high-viscosity resin composites promoting values similar to the intact tooth; however, the presence of fibers influenced the fracture pattern. CLINICAL SIGNIFICANCE Teeth with MOD cavities restored with high-viscosity resin composites showed similar fracture strength to intact teeth. Fiber-reinforced low-viscosity resin composite for the base of restoration resulted in a more repairable/possibly repairable fracture pattern.
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Affiliation(s)
- Karin Tyeme Borges
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, São Paulo, Brazil
| | - María Paz Méndez Servín
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, São Paulo, Brazil
| | | | - Cecilia Pedroso Turssi
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, São Paulo, Brazil
| | - Roberta Tarkany Basting
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Campinas, São Paulo, Brazil
| | - Ronaldo Hirata
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York City, New York, USA
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de Carvalho MA, Lazari-Carvalho PC, Del Bel Cury AA, Magne P. Fatigue and failure analysis of restored endodontically treated maxillary incisors without a dowel or ferrule. J Prosthet Dent 2024; 131:241-250. [PMID: 35705432 DOI: 10.1016/j.prosdent.2021.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 07/11/2021] [Accepted: 07/12/2021] [Indexed: 11/17/2022]
Abstract
STATEMENT OF PROBLEM Information on the survival and mode of failure of endodontically treated incisors without a ferrule and restored without dowels is lacking. PURPOSE The purpose of this in vitro study was to compare the survival and failure mode of endodontically treated incisors without a ferrule and restored with bonded ceramic crowns and various composite resin foundation restorations without dowels with a control group with fiber dowels. MATERIAL AND METHODS Forty-five decoronated endodontically treated bovine incisors without ferrule were divided into 3 experimental groups and restored with different adhesive foundation restorations without dowel: nanohybrid composite resin (Nd), bulk-fill composite resin foundation restoration (NdB), and fiber-reinforced bulk-fill composite resin (NdFR). A control group with conventional foundation restorations (glass-fiber dowel with nanohybrid composite resin foundation restoration without ferrule) (D) was included for comparison. All teeth were prepared to receive bonded lithium disilicate ceramic crowns luted with dual-polymerizing composite resin cement and were subjected to accelerated fatigue testing. Cyclic isometric loading was applied to the incisal edge at an angle of 30 degrees and a frequency of 5 Hz, beginning with a load of 100 N (5000 cycles). A 100-N load increase was applied each 15 000 cycles. Specimens were loaded until failure or to a maximum for cycles endured of 1000 N (140 000 cycles). Groups were compared by using the Kaplan-Meier survival analysis (log rank test at α=.05 and pairwise post hoc comparisons) and life table analysis for load-at-failure (followed by Wilcoxon pairwise comparison α=.05). RESULTS All the specimens failed before 140 000 load cycles. Even though no statistically significant differences were found between the experimental groups without dowel (P>.127), the fiber-reinforced foundation restoration yielded the highest mean ±standard deviation cycles to failure (46 023 ±4326) compared with Nd (38 899 ±2975) and NdB (39 751 ±2998). NdFR, however, outperformed the foundation restoration with glass-fiber dowel (35 026 ±2687) (P<.05). Most failure in groups without dowel were restorable, while 100% of catastrophic failure (unrestorable) were found in the group with dowels. CONCLUSIONS Based on the present in vitro study, dowels did not improve the performance of the adhesive restoration of endodontically treated incisors without a ferrule. The use of a short fiber-reinforced composite resin foundation restoration without a dowel was able to not only improve the resistance of the restorations compared with adhesive foundation restorations with dowels but also minimize catastrophic failures.
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Affiliation(s)
- Marco Aurelio de Carvalho
- Professor, Department of Oral Rehabilitation, School of Dentistry, Evangelic University of Goias (UniEVANGÉLICA), Anápolis, GO, Brazil
| | - Priscilla Cardoso Lazari-Carvalho
- Professor, Department of Oral Rehabilitation, School of Dentistry, Evangelic University of Goias (UniEVANGÉLICA), Anápolis, GO, Brazil.
| | - Altair Antoninha Del Bel Cury
- Full Professor, Department of Prosthodontics and Periodontology, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Pascal Magne
- Tenured Associate Professor, Don & Sybil Harrington Foundation Professor of Esthetic Dentistry, Department of Restorative Sciences, The Herman Ostrow School of Dentistry, University of Southern California (USC), Los Angeles, Calif
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Garoushi S, Akbaşak-Sungur AÖ, Erkut S, Vallittu PK, Uctasli S, Lassila L. Evaluation of fracture behavior in short fiber-reinforced direct and indirect overlay restorations. Clin Oral Investig 2023; 27:5449-5458. [PMID: 37477724 PMCID: PMC10492695 DOI: 10.1007/s00784-023-05164-2] [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: 05/29/2023] [Accepted: 07/13/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVES The aim was to assess how incorporating a short-fiber composite (SFC) core would affect the fracture behavior of direct and indirect overlays. Furthermore, to examine the relationship between the thickness ratio of SFC core to particulate-filled composite (PFC) veneering and the fracture-behavior of bilayered-structured restorations. MATERIALS AND METHODS A total of 120 molars were used to create MOD cavities, with palatal cusps removed. Four different groups of direct overlays were then made (n = 15/group), all of which featured a SFC core (everX Flow) with varying thicknesses (0, 1, 4, and 5 mm), as well as a surface layer of PFC (G-aenial Posterior), with the overall thickness of the bilayered-structured restoration set at 5 mm. Additionally, four groups of CAD/CAM restorations were created (Cerasmart 270 and Initial LiSi Block), with or without 2 mm of SFC core reinforcement. Following the fabrication of these restorations, cyclic fatigue aging was carried out for a total of 500,000 cycles, with an applied maximum load (Fmax) of 150 N. Subsequently, each restoration underwent quasi-static loading until fracture. The fracture mode was subsequently evaluated using optical microscopy and SEM. RESULTS There were no statistically significant differences (p > 0.05) observed in the fracture resistance of indirect overlays reinforced with a 2-mm SFC core compared to those made solely from restorative materials. Direct overlays constructed using plain SFC or with a 4-mm layer thickness of SFC core exhibited significantly higher fracture resistance values (2674 ± 465 and 2537 ± 561 N) (p < 0.05) when compared to all other groups tested, according to the statistical analysis ANOVA. CONCLUSIONS The most effective method for restoring large MOD cavities was found to be direct restoration using SFC either alone or as a bulk core in combination with PFC composite. CLINICAL RELEVANCE The use of SFC as bulk reinforcing base will significantly improve the loading performance of directly layered restorations.
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Affiliation(s)
- S Garoushi
- Department of Biomaterials Science and Turku Clinical Biomaterial Center -TCBC, Institute of Dentistry, University of Turku, Turku, Finland.
| | - A Ö Akbaşak-Sungur
- Department of Prosthetic Dentistry, Faculty of Dentistry, Baskent University, Ankara, Turkey
| | - S Erkut
- Department of Prosthetic Dentistry, Faculty of Dentistry, Baskent University, Ankara, Turkey
| | - P K Vallittu
- Department of Biomaterials Science and Turku Clinical Biomaterial Center -TCBC, Institute of Dentistry, University of Turku, Turku, Finland
- Wellbeing Services County of Southwest Finland, Turku, Finland
| | - S Uctasli
- Department of Prosthodontics, Faculty of Dentistry, University of Ankara, Ankara, Turkey
| | - L Lassila
- Department of Biomaterials Science and Turku Clinical Biomaterial Center -TCBC, Institute of Dentistry, University of Turku, Turku, Finland
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Selvaraj H, Krithikadatta J, Shrivastava D, Onazi MAA, Algarni HA, Munaga S, Hamza MO, Saad Al-Fridy T, Teja KV, Janani K, Alam MK, Srivastava KC. Systematic review fracture resistance of endodontically treated posterior teeth restored with fiber reinforced composites- a systematic review. BMC Oral Health 2023; 23:566. [PMID: 37574536 PMCID: PMC10423428 DOI: 10.1186/s12903-023-03217-2] [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: 03/31/2023] [Accepted: 07/10/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND Large cavity designs and access cavities impair endodontically treated tooth fracture resistance. As the tooth's strength is known to reduce significantly after the root canal treatment, occlusal loading as a result of functions such as chewing, biting and certain parafunctional tendencies makes the endodontically treated tooth vulnerable to fracture. Hence, after endodontic treatment, it is vital to give adequate and appropriate restorative material to avoid tooth fractures. Accordingly, the choice of such restorative material should be dictated by the property of fracture resistance. OBJECTIVE The goal of this study was to conduct a systematic review and critical analysis of available data from in vitro studies examining the fracture resistance of endodontically treated posterior teeth restored with fiber-reinforced composites. METHODOLOGY The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRIS-MA) Statement was used to guide the reporting of this systematic review A comprehensive literature search was performed using MEDLINE (via PubMed), Scopus, ScienceDirect, Google Scholar, and LILACS. A manual search of the reference lists of the articles was also performed. The databases provided a total of 796 studies from the electronic systematic search. The databases provided a total of 796 studies from the electronic systematic search. Two reviewers scrutinized the papers for eligibility based on inclusion/exclusion criteria and extracted data. The studies were assessed for their potential risk of bias. Based on modified JBI & CRIS (checklist for reporting in vitro studies) guidelines, along with the methodology and treatment objective, we have formulated 13 parameters specifically to assess the risk of bias. A total of 18 studies met the inclusion criteria and were included for qualitative analysis. Considering the high heterogeneity of the studies included, a meta-analysis could not be performed. RESULTS The majority of the included studies had a moderate or high risk of bias. When compared to traditional hybrid composites, fiber-reinforced composites showed increased fracture resistance of endodontically treated teeth in the majority of investigations. On the other hand, limited evidence was found for the bulk fill composites. Moreover, moderate evidence was found for the fracture resistance of inlays and fiber posts with fiber-reinforced composites for core build-up in endodontically treated teeth. No evidence could be found comparing the fracture resistance of endo crowns and fiber-reinforced composites in endodontically treated teeth. CONCLUSION According to the research, using fiber-reinforced composites instead of conventional hybrid composites improves the fracture resistance of endodontically treated teeth. However, there was a high risk of bias in the research considered. No judgments could be reached about the superiority of one material over another based-on comparisons between other core restorations.
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Affiliation(s)
- Harish Selvaraj
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, 152006005, India
| | | | - Deepti Shrivastava
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
| | - Meshal Aber Al Onazi
- Department of Operative Dentistry and Endodontics, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Hmoud Ali Algarni
- Department of Operative Dentistry and Endodontics, College of Dentistry, Jouf University, Sakaka, 72345, Saudi Arabia
| | - Swapna Munaga
- Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud Bin, Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - May Osman Hamza
- Department of Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
| | | | - Kavalipurapu Venkata Teja
- Department of Conservative Dentistry and Endodontics, Mamata Institute of Dental Sciences, Mamata Educational Society, Bachupally, Hyderabad, 500 090, India
| | - Krishnamachari Janani
- Department of Conservative Dentistry and Endodontics, SRM Dental College, SRM Institute of Science & Technology, Chennai, India
| | - Mohammad Khursheed Alam
- Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Saudi Arabia
- Department of Dental Research Cell, Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College and Hospitals, Chennai, 600077, India
- Department of Public Health, Faculty of Allied Health Sciences, Daffodil International University, Dhaka, 1207, Bangladesh
| | - Kumar Chandan Srivastava
- Department of Oral & Maxillofacial Surgery & Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka, Saudi Arabia.
- Department of Oral Medicine and Radiology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, 602105, India.
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Singer L, Fouda A, Bourauel C. Biomimetic approaches and materials in restorative and regenerative dentistry: review article. BMC Oral Health 2023; 23:105. [PMID: 36797710 PMCID: PMC9936671 DOI: 10.1186/s12903-023-02808-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 02/10/2023] [Indexed: 02/18/2023] Open
Abstract
Biomimetics is a branch of science that explores the technical beauty of nature. The concept of biomimetics has been brilliantly applied in famous applications such as the design of the Eiffel Tower that has been inspired from the trabecular structure of bone. In dentistry, the purpose of using biomimetic concepts and protocols is to conserve tooth structure and vitality, increase the longevity of restorative dental treatments, and eliminate future retreatment cycles. Biomimetic dental materials are inherently biocompatible with excellent physico-chemical properties. They have been successfully applied in different dental fields with the advantages of enhanced strength, sealing, regenerative and antibacterial abilities. Moreover, many biomimetic materials were proven to overcome significant limitations of earlier available generation counterpart. Therefore, this review aims to spot the light on some recent developments in the emerging field of biomimetics especially in restorative and regenerative dentistry. Different approaches of restoration, remineralisation and regeneration of teeth are also discussed in this review. In addition, various biomimetic dental restorative materials and tissue engineering materials are discussed.
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Affiliation(s)
- Lamia Singer
- Oral Technology, University Hospital Bonn, 53111, Bonn, North Rhine-Westphalia, Germany. .,Department of Orthodontics, University Hospital Bonn, 53111, Bonn, North Rhine-Westphalia, Germany.
| | - Ahmed Fouda
- grid.15090.3d0000 0000 8786 803XOral Technology, University Hospital Bonn, 53111 Bonn, North Rhine-Westphalia Germany ,grid.33003.330000 0000 9889 5690Department of Fixed Prosthodontics, Suez Canal University, Ismailia, Egypt
| | - Christoph Bourauel
- grid.15090.3d0000 0000 8786 803XOral Technology, University Hospital Bonn, 53111 Bonn, North Rhine-Westphalia Germany
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Oliveira AA, Ribeiro MLP, Costa PVM, Pereira RD, Versluis A, Veríssimo C. The effect of filling technique on the cuspal strain, polymerization shrinkage stress, enamel crack formation and depth of cure of restored molars. Dent Mater 2022; 38:1404-1418. [PMID: 35787894 DOI: 10.1016/j.dental.2022.06.033] [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: 02/21/2022] [Revised: 06/10/2022] [Accepted: 06/22/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Evaluate the effect of different restorative filling techniques on the residual shrinkage stress (ShrS), cuspal strain (CS), depth of cure (DC), and enamel crack formation (Ec) in molars with MOD restorations. METHODS Post-gel shrinkage, elastic modulus, compressive and diametral tensile strength of the Filtek One Bulk Fill composite were calculated. Sixty molars with MOD preparations were restored using four filling techniques: Bulk; Horizontal; Oblique; Natural enamel and dentin substitution (NEDS) technique. CS was measured using a strain gauge (n = 10). The DC (n = 5) was measured using Knoop hardness. Shrinkage stress/strain was analyzed using 3D finite element analysis. The Ec analysis was carried out by transillumination. Two-way ANOVA with repeated measures and Tukey's HSD test (α = 0.05) was performed for the CS data. Two-Way ANOVA and Tukey's HSD test was performed for the DC data (α = 0.05). RESULTS CS was higher at the lingual cusp for the horizontal and NEDS technique. No statistical difference was found between the buccal and lingual CS values for the Bulk (p = 0.367) or Oblique techniques (p = 0.192). CS values were lower for the Bulk. More enamel cracks were found for the Bulk. DC was lower at 4 mm regardless the filling technique. The Horizontal showed the highest ShrS values. The Bulk generated the lower ShrS values. SIGNIFICANCE A Bulk technique caused the lowest shrinkage stress/strain. An Oblique technique yielded the best balance between stress, strain and crack formation. NEDS technique is a good alternative to decrease the number of increments while maintaining the stress levels nearby the Oblique technique.
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Affiliation(s)
- A A Oliveira
- School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - M L P Ribeiro
- School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - P V M Costa
- School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - R D Pereira
- School of Dentistry, Faculdades de Ciências Odontológicas, FCO, Montes Claros, MG, Brazil
| | - A Versluis
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center - UTHSC, Memphis, TN, USA
| | - C Veríssimo
- School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil.
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Bijelic-Donova J, Garoushi S, Lassila LV, Rocca GT, Vallittu PK. Crack propagation and toughening mechanism of bilayered short-fiber reinforced resin composite structure -Evaluation up to six months storage in water. Dent Mater J 2022; 41:580-588. [PMID: 35584936 DOI: 10.4012/dmj.2021-321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Clinically relevant parameters, such as stress intensity factor of bilayered resin composite structure with short fiber base and its stability over time, has yet to be investigated. This study investigated the stress intensity factor of pre-cracked bilayered specimens composed of short fiber resin composite base (SFC) and particulate filler resin composite (PFC) as veneering layer, with a crack located in the PFC layer, 0.5 mm away from the PFC-SFC interface. Monolayered specimens served as controls. All specimens were stored in water at 37°C either for 1 week, 1 month or 6 months before testing. Two-way ANOVA (p=0.05) was used to determine the differences among the groups. Results indicated that SFC base improve the brittleness of the PFC. The type of short fibers affected the crack propagation; fiber bridging in millimeter-scale SFC was the main crack arresting mechanism, whereas fiber pulling observed in micrometer-scale SFC mainly deviated the crack path.
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Affiliation(s)
- Jasmina Bijelic-Donova
- Department of Prosthetic Dentistry and Stomatognathic Physiology, Institute of Dentistry, University of Turku
| | - Sufyan Garoushi
- Department of Biomaterials Science, Institute of Dentistry, University of Turku
| | - Lippo Vj Lassila
- Department of Biomaterials Science, Institute of Dentistry, University of Turku
| | | | - Pekka K Vallittu
- Department of Biomaterials Science, Institute of Dentistry, University of Turku.,City of Turku Welfare Division, Oral Health Care
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Feng X, Kou W, Liu H, Gong B, Tang C. Study on fracture behavior of molars based on three-dimensional high-precision computerized tomography scanning and numerical simulation. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2022; 38:e3561. [PMID: 34865323 DOI: 10.1002/cnm.3561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 12/02/2021] [Indexed: 06/13/2023]
Abstract
A series of three-dimensional (3D) numerical simulations are conducted to investigate the gradual failure process of molars in this study. The real morphology and internal mesoscopic structure of a whole tooth are implemented into the numerical simulations through computerized tomography scanning, digital image processing, and 3D matrix mapping. The failure process of the whole tooth subject to compressions including crack initiation, crack propagation, and final failure pattern is reproduced using 3D realistic failure process analysis (RFPA3D) method. It is concluded that a series of microcracks are gradually initiated, nucleated, and subsequently interconnect to form macroscopic cracks when the teeth are under over-compressions. The propagation of the macroscopic cracks results in the formation of fracture surfaces and penetrating cracks, which are essential signs and manifestations of the tooth failure. Moreover, the simulations reveal that, the material heterogeneity is a critical factor that affects the mechanical properties and fracture modes of the teeth, which vary from crown fractures to crown-root fractures and root fractures depending on different homogeneity indices.
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Affiliation(s)
- Xianhui Feng
- Faculty of Infrastructure Engineering, Dalian University of Technology, Dalian, China
| | - Wen Kou
- Dental Materials Science, Umeå University, Umeå, Sweden
| | - Hongyuan Liu
- College of Science and Engineering, University of Tasmania, Hobart, Australia
| | - Bin Gong
- Faculty of Infrastructure Engineering, Dalian University of Technology, Dalian, China
- Department of Civil and Environmental Engineering, Brunel University London, London, UK
| | - Chun'an Tang
- Faculty of Infrastructure Engineering, Dalian University of Technology, Dalian, China
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9
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Lima VP, Machado JB, Zhang Y, Loomans BAC, Moraes RR. Laboratory methods to simulate the mechanical degradation of resin composite restorations. Dent Mater 2022; 38:214-229. [PMID: 34949477 PMCID: PMC9903973 DOI: 10.1016/j.dental.2021.12.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 01/21/2023]
Abstract
OBJECTIVES This study reviewed the literature to identify in vitro approaches that have been used to simulate the mechanical degradation and fatigue of resin composite restorations. METHODS A search for articles was carried out in 4 databases and included studies in which composite restorations were bonded to teeth and subject to cyclic loading. Articles were assessed for eligibility, and the following items were the extracted from the included studies: authors, country, year, materials tested, simulation device and details including load magnitude and frequency, number of cycles, type of antagonist, test medium, and temperature. Data were analyzed descriptively. RESULTS The 49 studies included showed a high level of heterogeneity in methods, devices, and test parameters. Nineteen different simulation devices were used, applying loads varying between 30 and 2900 N, and frequencies varying between 0.4 and 12 Hz. The load and frequency used most often were ~ 50 N (63.3%) and 1.5-1.7 Hz (32.7%). The number of cycles varied between 10 K and 2.4 M, 1.2 M was the most prevalent (40.8%). The majority of studies combined cyclic loading with at least one additional aging method: static liquid storage, thermo-mechanical cycling applied simultaneously, and thermal cycling as a discrete aging step were the three most frequent methods. The overall evidence indicated reporting problems, and suggested a lack of clinical validation of the research methods used. SIGNIFICANCE Validation studies, underlying clinical supporting data, and better reporting practices are needed for further improving research on the topic. Specific suggestions for future studies are provided.
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Affiliation(s)
- Veronica P Lima
- Universidade Federal de Pelotas, Pelotas, RS, Brazil; Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Nijmegen, The Netherlands
| | | | - Yu Zhang
- Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, USA
| | - Bas A C Loomans
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Dentistry, Nijmegen, The Netherlands
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Samartzi TK, Papalexopoulos D, Sarafianou A, Kourtis S. Immediate Dentin Sealing: A Literature Review. Clin Cosmet Investig Dent 2021; 13:233-256. [PMID: 34188553 PMCID: PMC8232880 DOI: 10.2147/ccide.s307939] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/20/2021] [Indexed: 02/04/2023] Open
Abstract
Purpose The immediate application of a dentin-bonding agent after tooth preparation and before impression-taking (immediate dentin sealing [IDS]) has been suggested to provide several advantages concerning bacterial microleakage, hypersensitivity, and bonding quality. We reviewed the literature and clarified certain aspects related to each step of IDS application. Materials and Methods The search strategy comprised an electronic research in MEDLINE, Cochrane, Ovid and Scopus for studies published from January 1990 to December 2020 regarding the IDS technique and including both in vitro and clinical studies. Results After exclusion of irrelevant or duplicate articles, 88 articles focusing on aspects of the IDS technique were assessed. IDS seems to be advantageous with regard to bond strength, gap formation, bacterial microleakage, and dentin hypersensitivity. However, issues arising from interaction with impression materials, the provisional phase, and conditioning methods before cementation require further investigation. Conclusion There are no documented reasons preventing clinicians applying IDS in their everyday practice. On the contrary, the presented technique seems to be beneficial in certain aspects regarding indirect restorations.
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Affiliation(s)
| | | | - Aspasia Sarafianou
- Department of Prosthodontics, National and Kapodistrian University of Athens, Athens, Greece
| | - Stefanos Kourtis
- Department of Prosthodontics, National and Kapodistrian University of Athens, Athens, Greece
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11
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The influence of FRC base and bonded CAD/CAM resin composite endocrowns on fatigue behavior of cracked endodontically-treated molars. J Mech Behav Biomed Mater 2021; 121:104647. [PMID: 34171717 DOI: 10.1016/j.jmbbm.2021.104647] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 05/07/2021] [Accepted: 06/09/2021] [Indexed: 02/06/2023]
Abstract
Cracked endodontically treated molars (ETMs) are commonly treated with full crowns. Less invasive techniques could include fiber-reinforced composite (FRC) base and adhesively bonded endocrowns. The purpose of this study was to assess the fatigue resistance of ETMs restored with CAD/CAM resin composite endocrowns and reinforced with different FRC bases. Cracks were simulated in fifty mandibular molars by cutting the teeth longitudinally and reassembling the two parts. After performing endodontic treatments and preparing cavities, teeth were restored in one of the following methods (n = 10). In Group 1, cavity floors were lined with 0.5 mm of flowable composite (Universal Injectable; GUI, shade A2). In Groups 2 and 3, the cavity floors were covered with one and three layers of FRC-net (ES Net) respectively, whereas in Groups 4 and 5 with 1 mm and 2 mm of flowable FRC-resin (EverX Flow Dentin; EXFD) respectively. Endocrowns (Cerasmart 270; CE, A2 HT) with 5 mm thickness were adhesively luted with preheated composite and all specimens were subjected to cyclic loading in water at 5 Hz, starting with a load of 600 N (5000 cycles), followed by stages of 1000, 1300, 1600, 1900, 2200 and 2500 at a maximum of 20 000 cycles each. Results were analyzed using Kaplan-Meier survival analysis and the Log-Rank test (p = 0.05). The fatigue failure load of ES Net applied in three layers (1617 N ± 371) or in one layer (1499 N ± 306), as well as EXFD applied in 2 mm (1496 N ± 264) or in 1 mm (1434 N ± 372) did not differ significantly (p > 0.05). Control teeth fractured at 1255 N ± 350 (p > 0.05). In the fiber-reinforced groups, restorable fractures were observed in 50%-80%, with only 30% deemed restorable in the control group. The fractures originated mainly at the occlusal contact points and the main crack propagated in the corono-apical direction. No crack origin (primary or secondary) starting from the artificial pre-existing crack was observed in fractured specimens. FRC bases did not improve the fatigue resistance of cracked ETMs, but favorably influenced the failure mode.
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Garoushi S, Sungur S, Boz Y, Ozkan P, Vallittu PK, Uctasli S, Lassila L. Influence of short-fiber composite base on fracture behavior of direct and indirect restorations. Clin Oral Investig 2021; 25:4543-4552. [PMID: 33417063 PMCID: PMC8310497 DOI: 10.1007/s00784-020-03768-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 12/28/2020] [Indexed: 11/29/2022]
Abstract
Objectives The aim was to examine the influence of short-fiber composite (SFC) core on the fracture-behavior of different types of indirect posterior restorations. In addition, the effect of thickness ratio of SFC-core to the thickness of the veneering conventional composite (PFC) on fracture-behavior of bi-structured composite restorations was evaluated. Materials and methods MOD cavities with removed palatal cusps were prepared on 90 intact molars. Five groups of direct overlay restorations (n = 10/group) were fabricated having a SFC-core (everX Flow) with various thicknesses (0, 1, 2, 3, 4 mm) and layer of surface PFC (G-aenial Anterior), remaining the thickness of the bi-structure restoration to be 5 mm. Four groups of CAD/CAM-made restorations (Cerasmart 270 and e-max CAD) were fabricated either with 2-mm layer of SFC-core or without fiber reinforcement. Intact teeth (n = 10) were used as control group. Restorations were statically loaded until fracture. Fracture patterns were evaluated visually. Data were analyzed using ANOVA (p = 0.05). Results With indirect overlay restorations, no statistically significant differences (p > 0.05) were observed in the load-bearing capacities between restorations reinforced by 2-mm SFC-core (bi-structured) and those fabricated from plain restorative materials. ANOVA displayed that direct overlay restorations made from 4-mm layer thickness of SFC-core had significantly higher load-bearing capacities (3050 ± 574 N) (p < 0.05) among all the groups tested. Conclusions Restorations (direct/indirect) combining SFC-core and a surface layer of conventional material demonstrated encouraging achievement in reference to fracture behavior. Clinical relevance The use of flowable short-fiber composite as reinforcing base with large direct and indirect restorations may result in more repairable failure.
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Affiliation(s)
- S Garoushi
- Department of Biomaterials Science and Turku Clinical Biomaterial Center-TCBC, Institute of Dentistry, University of Turku, Turku, Finland.
| | - S Sungur
- Department of Prosthodontics, Faculty of Dentistry, University of Ankara, Ankara, Turkey
| | - Y Boz
- Department of Prosthodontics, Faculty of Dentistry, University of Ankara, Ankara, Turkey
| | - P Ozkan
- Department of Prosthodontics, Faculty of Dentistry, University of Ankara, Ankara, Turkey
| | - P K Vallittu
- Department of Biomaterials Science and Turku Clinical Biomaterial Center-TCBC, Institute of Dentistry, University of Turku, Turku, Finland.,City of Turku Welfare Division, Oral Health Care, Turku, Finland
| | - S Uctasli
- Department of Prosthodontics, Faculty of Dentistry, University of Ankara, Ankara, Turkey
| | - L Lassila
- Department of Biomaterials Science and Turku Clinical Biomaterial Center-TCBC, Institute of Dentistry, University of Turku, Turku, Finland
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