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Fathey IT, Azer AS, Abdelraheem IM. Fracture resistance and failure mode of three esthetic CAD-CAM post and core restorations. BMC Oral Health 2024; 24:523. [PMID: 38702708 DOI: 10.1186/s12903-024-04273-y] [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: 02/14/2024] [Accepted: 04/18/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND The rising demand for improved aesthetics has driven the utilization of recently introduced aesthetic materials for creating custom post and core restorations. However, information regarding the fracture resistance of these materials remains unclear, which limits their practical use as custom post and core restorations in clinical applications. AIM OF THE STUDY: This study aimed to evaluate the fracture resistance of three non-metallic esthetic post and core restorations and their modes of failure. MATERIALS AND METHODS Thirty-nine single-rooted human maxillary central incisors were endodontically treated. A standardized post space preparation of 9mm length was performed to all teeth to receive custom-made post and core restorations. The prepared teeth were randomly allocated to receive a post and core restoration made of one of the following materials (n=13): glass fiber-reinforced composite (FRC), polyetheretherketone (PEEK) and polymer-infiltrated ceramic-network (PICN). An intraoral scanner was used to scan all teeth including the post spaces. Computer-aided design and computer-aided manufacturing (CAD-CAM) was used to fabricate post and core restorations. Post and core restorations were cemented using self-adhesive resin cement. All specimens were subjected to fracture resistance testing using a universal testing machine. Failure mode analysis was assessed using a stereomicroscope and SEM. The data was statistically analyzed using One-Way ANOVA test followed by multiple pairwise comparisons using Bonferroni adjusted significance level. RESULTS Custom PEEK post and core restorations displayed the least fracture load values at 286.16 ± 67.09 N. In contrast, FRC exhibited the highest average fracture load at 452.60 ± 105.90 N, closely followed by PICN at 426.76 ± 77.99 N. In terms of failure modes, 46.2% of specimens with PICN were deemed non-restorable, while for PEEK and FRC, these percentages were 58.8% and 61.5%, respectively. CONCLUSIONS Within the limitation of this study, both FRC and PICN demonstrated good performance regarding fracture resistance, surpassing that of PEEK.
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Affiliation(s)
- Islam T Fathey
- Division of Fixed Prosthodontics, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, P. O. Box: 21527, Champollion St., Azarita, Alexandria, Egypt.
| | - Amir Shoukry Azer
- Division of Fixed Prosthodontics, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, P. O. Box: 21527, Champollion St., Azarita, Alexandria, Egypt
| | - Islam M Abdelraheem
- Division of Fixed Prosthodontics, Conservative Dentistry Department, Faculty of Dentistry, Alexandria University, P. O. Box: 21527, Champollion St., Azarita, Alexandria, Egypt
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Alghazzawi TF. Relation of Crown Failure Load to Flexural Strength for Three Contemporary Dental Polymers. Polymers (Basel) 2023; 15:4312. [PMID: 37959992 PMCID: PMC10649243 DOI: 10.3390/polym15214312] [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: 09/27/2023] [Revised: 10/30/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023] Open
Abstract
Polymeric materials show great promise for use in a variety of dental applications. Manufacturers generally provide flexural strength information based on standardized (ISO and ASTM) specimen dimensions and loading conditions. It is not clear, however, if flexural strength data are predictive of the clinical performance of dental crowns. The objectives of this study were, therefore, to determine whether flexural strengths, as measured via three-point bending (3PB), would be predictive of failure loads assessed via crunch-the-crown (CTC) tests. Three brands of polymers (Trilor, Juvora, and Pekkton) were fabricated into rectangular bars and fully contoured crowns (10 specimens of each polymer brand, 30 specimens of each shape). Differential scanning calorimetry (DSC), Fourier transform infrared spectroscopy (FTIR), and burn off tests were used to characterize/confirm the materials. Bars were tested blindly in 3PB to determine flexural strength, and crowns were CTC-tested to determine failure load after luting to resin abutments. The statistical significance of the test results was evaluated via one-way ANOVA (α = 0.05) and Pearson's correlation coefficient, while regression analysis was used to test for a correlation between 3PB and CTC results. The fracture mechanisms and failure surface characteristics were characterized using scanning electron microscopy (SEM). There were significant differences (p < 0.05) in the mean crown failure loads (Trilor (7033 N) > Juvora (5217 N) > Pekkton (3023 N)) and mean flexural strengths of the bars (Trilor (468 MPa) > Juvora (197 MPa) = Pekkton (192 MPa)). The mode of crown fracture was different between the materials and included deformation (Juvora), ductile-to-brittle fracture (Pekkton), and a combination of cracks and deformation (Trilor). Flexural strengths did not correlate with the corresponding crown failure loads for any of the materials tested. These results suggest that dental practitioners should not rely on the flexural strengths reported from three-point bending tests, as advertised by the manufacturer, to predict the performance of polymeric crowns.
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Affiliation(s)
- Tariq F. Alghazzawi
- Department of Substitutive Dental Sciences, Taibah University, Madinah 42353, Saudi Arabia;
- Department of Mechanical and Materials Engineering, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
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Chen T, Jinno Y, Atsuta I, Tsuchiya A, Stocchero M, Bressan E, Ayukawa Y. Current surface modification strategies to improve the binding efficiency of emerging biomaterial polyetheretherketone (PEEK) with bone and soft tissue: A literature review. J Prosthodont Res 2023; 67:337-347. [PMID: 36372438 DOI: 10.2186/jpr.jpr_d_22_00138] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
PURPOSE The aim of this study was to review the literature on current surface modification strategies used to improve the binding efficiency of an emerging biological material, polyetheretherketone (PEEK), with bone and soft tissues. STUDY SELECTION This review was based on articles retrieved from PubMed, Google Scholar, Web of Science, and ScienceDirect databases. The main keywords used during the search were "polyetheretherketone (PEEK)," "implant," "surface modification," "biomaterials," "bone," "osseointegration," and "soft tissue." RESULTS The suitability of PEEK surface modification strategies has been critically analyzed and summarized here. Many cell and in vivo experiments in small animals have shown that the use of advanced modification technologies with appropriate surface modification strategies can effectively improve the surface inertness of PEEK, thereby improving its binding efficiency with bone and soft tissues. CONCLUSIONS Surface modifications of PEEK have revealed new possibilities for implant treatment; however, most results are based on in vitro or short-term in vivo evaluations in small animals. To achieve a broad application of PEEK in the field of oral implantology, more in vivo experiments and long-term clinical evaluations are needed to investigate the effects of various surface modifications on the tissue integration ability of PEEK to develop an ideal implant material.
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Affiliation(s)
- Tianjie Chen
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Yohei Jinno
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Ikiru Atsuta
- Division of Advanced Dental Devices and Therapeutics, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Akira Tsuchiya
- Department of Biomaterials, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Michele Stocchero
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Eriberto Bressan
- Department of Neurosciences, Section of Dentistry, University of Padova, Padova, Italy
| | - Yasunori Ayukawa
- Section of Implant and Rehabilitative Dentistry, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
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Shi Y, Liu J, Du M, Zhang S, Liu Y, Yang H, Shi R, Guo Y, Song F, Zhao Y, Lan J. Customized Barrier Membrane (Titanium Alloy, Poly Ether-Ether Ketone and Unsintered Hydroxyapatite/Poly-l-Lactide) for Guided Bone Regeneration. Front Bioeng Biotechnol 2022; 10:916967. [PMID: 35837554 PMCID: PMC9273899 DOI: 10.3389/fbioe.2022.916967] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 05/09/2022] [Indexed: 12/15/2022] Open
Abstract
Sufficient bone volume is indispensable to achieve functional and aesthetic results in the fields of oral oncology, trauma, and implantology. Currently, guided bone regeneration (GBR) is widely used in reconstructing the alveolar ridge and repairing bone defects owing to its low technical sensitivity and considerable osteogenic effect. However, traditional barrier membranes such as collagen membranes or commercial titanium mesh cannot meet clinical requirements, such as lack of space-preserving ability, or may lead to more complications. With the development of digitalization and three-dimensional printing technology, the above problems can be addressed by employing customized barrier membranes to achieve space maintenance, precise predictability of bone graft, and optimization of patient-specific strategies. The article reviews the processes and advantages of three-dimensional computer-assisted surgery with GBR in maxillofacial reconstruction and alveolar bone augmentation; the properties of materials used in fabricating customized bone regeneration sheets; the promising bone regeneration potency of customized barrier membranes in clinical applications; and up-to-date achievements. This review aims to present a reference on the clinical aspects and future applications of customized barrier membranes.
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Affiliation(s)
- Yilin Shi
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Key Laboratory of Oral Tissue Regeneration, Jinan, China
- Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - Jin Liu
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Key Laboratory of Oral Tissue Regeneration, Jinan, China
- Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - Mi Du
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Key Laboratory of Oral Tissue Regeneration, Jinan, China
- Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - Shengben Zhang
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Key Laboratory of Oral Tissue Regeneration, Jinan, China
- Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - Yue Liu
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Key Laboratory of Oral Tissue Regeneration, Jinan, China
- Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - Hu Yang
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Key Laboratory of Oral Tissue Regeneration, Jinan, China
- Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - Ruiwen Shi
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Key Laboratory of Oral Tissue Regeneration, Jinan, China
- Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - Yuanyuan Guo
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Key Laboratory of Oral Tissue Regeneration, Jinan, China
- Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - Feng Song
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Key Laboratory of Oral Tissue Regeneration, Jinan, China
- Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - Yajun Zhao
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Key Laboratory of Oral Tissue Regeneration, Jinan, China
- Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
- *Correspondence: Jing Lan, ; Yajun Zhao,
| | - Jing Lan
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan, China
- Shandong Key Laboratory of Oral Tissue Regeneration, Jinan, China
- Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
- *Correspondence: Jing Lan, ; Yajun Zhao,
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Barrier Membrane in Regenerative Therapy: A Narrative Review. MEMBRANES 2022; 12:membranes12050444. [PMID: 35629770 PMCID: PMC9143924 DOI: 10.3390/membranes12050444] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/08/2022] [Accepted: 04/10/2022] [Indexed: 02/01/2023]
Abstract
Guided bone and tissue regeneration remains an integral treatment modality to regenerate bone surrounding teeth and dental implants. Barrier membranes have been developed and produced commercially to allow space for bone regeneration and prevent the migration of unwanted cells. Ideal membrane properties, including biocompatibility, sufficient structural integrity and suitable shelf life with easy clinical application, are important to ensure good clinical regenerative outcomes. Membranes have various types, and their clinical application depends on the origin, material, structure and properties. This narrative review aims to describe the currently available barrier membranes in terms of history, main features, types, indication and clinical application and classify them into various groups. Various membranes, including those which are resorbable and non-resorbable, synthetic, added with growth factors and composed of modern materials, such as high-grade polymer (Polyetheretherketone), are explored in this review.
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