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Patel SR, Jarad F, Moawad E, Boland A, Greenhalgh J, Liu M, Maden M. The tooth survival of non-surgical root-filled posterior teeth and the associated prognostic tooth-related factors: A systematic review and meta-analysis. Int Endod J 2024. [PMID: 38949036 DOI: 10.1111/iej.14116] [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: 11/17/2023] [Revised: 05/28/2024] [Accepted: 06/18/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Analysis of the survival of root-filled posterior teeth and the associated prognostic tooth-related factors will enable clinicians to predict the outcome of root canal treatment. OBJECTIVES To investigate (i) the survival of root-filled posterior teeth and (ii) the tooth-related factors that may affect their survival. METHODS Randomized controlled trials, comparative studies and observational studies assessing survival rates of root-filled posterior teeth with a minimum 4-year follow-up period were identified through an electronic search of the following databases up to January 2023: The Cochrane Central Register of Controlled Trials, Medline via PubMed, the Cochrane Database of Systematic Reviews, Embase, Web of Science and NIHR centre for reviews and dissemination. Two reviewers (SP and ML) independently selected the final studies based on pre-defined inclusion criteria. The Newcastle Ottawa Scale and the Cochrane Risk of Bias Tool for Randomized Trials were used to assess the risk of bias. Pooled weighted survival rates were analysed using a random effects meta-analysis model using DerSimonean and Laird methods. Descriptive analysis of studies describing any prognostic tooth-related factors was conducted. RESULTS Of the 72 studies identified, data from 20 studies were included in the survival meta-analysis, and data from 13 of these studies were included in the descriptive analysis of tooth-related factors; 12 studies were retrospective, 7 were prospective, and one was a randomized control trial. The pooled survival rates at 4-7 years and 8-20 years of root-filled posterior teeth regardless of tooth type was 91% (95% CI, 0.85; 0.95) and 87% (95% CI, 0.77; 0.93), respectively. The prognostic tooth-related factors mentioned in the included studies were (i) remaining coronal tooth structure, (ii) ferrule, (iii) crown-to-root ratio (iv) tooth type and location (v) periodontal disease (vi) proximal contacts and (vii) cracks. CONCLUSIONS The meta-analysis suggests that root canal treatment has a high medium to long term survival outcome. The narrative summary identified 7 factors that affect tooth survival. However, there is a paucity of evidence, and more research is needed in this area. REGISTRATION PROSPERO Registration: CRD42021227213.
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Affiliation(s)
- S R Patel
- Department of Endodontics, University of Liverpool School of Dentistry, Liverpool, UK
| | - F Jarad
- Department of Endodontics, University of Liverpool School of Dentistry, Liverpool, UK
| | - E Moawad
- Department of Endodontics, University of Liverpool School of Dentistry, Liverpool, UK
| | - A Boland
- Liverpool Reviews and Implementation Group (LRiG), University of Liverpool, Liverpool, UK
| | - J Greenhalgh
- Liverpool Reviews and Implementation Group (LRiG), University of Liverpool, Liverpool, UK
| | - Maria Liu
- Department of Endodontics, University of Liverpool School of Dentistry, Liverpool, UK
| | - Michelle Maden
- Liverpool Reviews and Implementation Group (LRiG), University of Liverpool, Liverpool, UK
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Sadeghnezhad P, Sarraf Shirazi A, Borouziniat A, Majidinia S, Soltaninezhad P, Nejat AH. Enhancing subgingival margin restoration: a comprehensive review and meta-analysis of deep margin elevation's impact on microleakage. Evid Based Dent 2024:10.1038/s41432-024-01028-0. [PMID: 38907025 DOI: 10.1038/s41432-024-01028-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 06/03/2024] [Indexed: 06/23/2024]
Abstract
INTRODUCTION Restorative dentistry faces complex challenges with deep proximal surface destruction, requiring novel approaches like DME (Deep Margin Elevation). In order to achieve the best results while treating severe tooth damage, this study examines the advantages, disadvantages, and possible collaborations of different treatments. AIMS This systematic review investigates the efficacy of DME as an adjunctive procedure in restorative dentistry, specifically focusing on its impact on microleakage. METHODS The study adheres to PRISMA guidelines and employs the PICOS framework for eligibility criteria. 394 potentially qualifying studies were discovered and thorough literature search was carried out via databases. After applying inclusion criteria, 7 studies were included in the analysis. Articles were selected based on criteria that included indirect restoration and performing DME and were compared with indirect restorations without DME. Composite resin was used for DME. Other materials for DME performing, including GI and composite flow, were systematically reviewed. Data analysis was done by biostat software (α = 0.05). RESULTS The meta-analysis of selected studies reveals a statistically significant positive effect of DME on reduction of microleakage (p = 0.001). CONCLUSION The results of this study underscore the potential of DME in addressing subgingival margin challenges and provide valuable insights for restorative dentistry practices.
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Affiliation(s)
- Pegah Sadeghnezhad
- Dentist, School of Dentistry, Mashhad University of Medical Science, Mashhad, Iran
| | | | - Alireza Borouziniat
- Dental Research Center, Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sara Majidinia
- Dental Materials Research Center, Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Pouria Soltaninezhad
- Dentist, School of Dentistry, Mashhad University of Medical Science, Mashhad, Iran
| | - Amir Hossein Nejat
- Department of Prosthodontics, School of Dentistry, Louisiana State University Health Science Center, New Orleans, LA, USA
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Oh SL, Hu J, Kwak KH, Chung MK. Survival analysis of teeth following clinical crown lengthening and crown insertion procedures up to 14 years: A retrospective cohort study. J Periodontol 2024. [PMID: 38874285 DOI: 10.1002/jper.24-0118] [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: 02/16/2024] [Revised: 04/21/2024] [Accepted: 04/28/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND The purpose of this study was to conduct survival analysis of teeth following clinical crown lengthening procedures (CLPs) and crown insertions via a retrospective cohort study. METHODS Patient- and tooth-related data were collected from 268 participants who received CLPs from 2009 to 2015. The Kaplan-Meier curve and the log-rank tests were used to estimate the probability of survival and compare the survival probabilities among different variables. A Cox multivariate proportional hazard regression model was used to investigate the collective effects of root canal treatment (RCT) and the types of opposing dentition. RESULTS The rate of tooth loss was 21.6% during the observation period from 1 to 14 years, with 58 teeth extracted. The most attributable reason for tooth extraction was coronal tooth fracture, followed by endodontic failure such as root fracture. The survival probability was 0.87 at 5 years and 0.7 at 10 years. No significant differences in the survival probabilities were found among different providers and locations, the presence of a post, and the types of crowns. The hazard ratio for tooth loss was 6.3, 95% confidence interval (CI) [2.6 to 20.9] in the teeth with RCT (p < 0.001) and 2.4, 95% CI [1.1 to 4.8] in the teeth occluding implant-retained prostheses (p = 0.016). CONCLUSIONS Tooth loss following CLPs and crown insertions appeared least among the teeth without RCT when occluding natural teeth, while tooth loss was most among the teeth with RCT when occluding implants.
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Affiliation(s)
- Se-Lim Oh
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Jiaxin Hu
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Kee Hyun Kwak
- School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - Man-Kyo Chung
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
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Bruhnke M, Voß I, Sterzenbach G, Beuer F, Naumann M. Evaluating the prospective crown-root ratio after extrusion and crown lengthening procedures in vitro. Sci Rep 2023; 13:18899. [PMID: 37919362 PMCID: PMC10622524 DOI: 10.1038/s41598-023-46354-y] [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: 06/16/2023] [Accepted: 10/31/2023] [Indexed: 11/04/2023] Open
Abstract
For restoration of extensively damaged teeth preprosthetic treatment measures are necessary. Crown lengthening and extrusion affect the prospective crown-root ratio (CRR). The subject of this in vitro study was to compute CRRs for both treatment approaches. 120 human maxillary central extracted incisors were measured. Measurements were calculated for five treatment groups: C (control), E-2 mm (extrusion of 2 mm), E-4 mm (extrusion of 4 mm), CL-2 mm (crown lengthening of 2 mm), and CL-4 mm (crown lengthening of 4 mm). Tooth (TL), root (RL), and crown lengths (CL) were measured from mesial (m) and facial (f) cemento-enamel junction (CEJ), and respective anatomic (CRR) and effective crown-root ratios (eCRR) were calculated. Following CRR values were computed for C: CRR-m = 0.4 ± 0.1, CRR-f = 0.7 ± 0.1. All crown-root ratios were lower (more favourable) for extrusion compared to crown lengthening (p < 0.001). ECRRs were higher than anatomic CRRs. CRR at mesial CEJ was significantly lower than CRR with facial CEJ as reference (p < 0.001). Mesial measurement-based calculations of CRR typically based on radiographic images should be interpreted with caution as they underestimate the eCRR. CRR can be expected as lower, i.e. more favourable, when teeth are extruded than crown lengthened.
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Affiliation(s)
- Maria Bruhnke
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin and Berlin Institute of Health, Aßmannshauser Straße 4-6, 14197, Berlin, Germany.
| | - Isabelle Voß
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin and Berlin Institute of Health, Aßmannshauser Straße 4-6, 14197, Berlin, Germany
| | - Guido Sterzenbach
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin and Berlin Institute of Health, Aßmannshauser Straße 4-6, 14197, Berlin, Germany
| | - Florian Beuer
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin and Berlin Institute of Health, Aßmannshauser Straße 4-6, 14197, Berlin, Germany
| | - Michael Naumann
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt - Universität zu Berlin and Berlin Institute of Health, Aßmannshauser Straße 4-6, 14197, Berlin, Germany
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Li F, Shao Y, Han T, Li J, Yan X. Finite element analysis of endodontically treated premolars without ferrule restored with one-piece glass fiber post and core in combination with different inner shoulder retention form systems. J Mech Behav Biomed Mater 2023; 143:105912. [PMID: 37270902 DOI: 10.1016/j.jmbbm.2023.105912] [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] [Revised: 05/12/2023] [Accepted: 05/14/2023] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The current study was performed to explore the impact of post materials as well as the inner shoulder retention form (ISRF) design on the biomechanical behavior of endodontically treated premolars without ferrule restoration using a method of mathematical three-dimensional (3D) finite element analysis (FEA). METHODS Based on the tooth anatomy and our previous research, eight mandibular second premolar FEA models representing different restorative situations were built: teeth with (a) 2.0 mm height ferrule (DF), (b) no ferrule (NF), (c) 0.5 mm width and 0.5 mm depth ISRF (ISRFW0.5D0.5), (d) 0.5 mm width and 1.0 mm depth ISRF (ISRFW0.5D1.0), (e) 0.5 mm width and 1.5 mm depth ISRF (ISRFW0.5D1.5), (f) 1.0 mm width and 0.5 mm depth ISRF (ISRFW1.0D0.5), (g) 1.0 mm width and 1.0 mm depth ISRF (ISRFW1.0D1.0), (h) 1.0 mm width and 1.5 mm depth ISRF (ISRFW1.0D1.5). All groups were restored with prefabricated glass fiber post and resin composite core (PGF), one-piece glass fiber post-and-core (OGF) and cast Co-Cr alloy (Co-Cr) respectively, and the zirconia crown was restored. Load (180N) was subjected to the buccal cusp at 45° to the tooth's long axis. Stress pattern, maximum principal stress values (MPS), and maximum displacement values on root, post and core, cement layer were calculated for each model. RESULTS Stress distributions were similar while the values were different among groups. Regardless of restorative approaches, roots restored with PGF showed the highest MPS values, followed by OGF and Co-Cr groups. Regardless of post materials, NF groups resulted in the highest MPS values and maximum displacement values, while ISRF and DF groups exhibited similar results. Compared with PGF groups in association with ISRF, except for OGF with ISRFW0.5D0.5, the remaining OGF groups with ISRF and all Co-Cr groups in association with ISRF presented lower values than that of DF groups. And among different ISRF systems, roots restored with ISRFW1.0D1.0 presented the lowest stress (PGF: 32.96 MPa, OGF: 31.69 MPa, Co-Cr: 29.66 MPa). CONCLUSIONS For endodontically treated premolars without ferrule, restored with OGF in combination with ISRF preparation could effectively enhanced its load-bearing capacity. Furthermore, the ISRF with a depth and width of 1.0 mm is recommended.
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Affiliation(s)
- Feiming Li
- The VIP Department, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, No. 117 North Street Nanjing Road, Shenyang, 110002, Liaoning, China
| | - Ying Shao
- The VIP Department, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, No. 117 North Street Nanjing Road, Shenyang, 110002, Liaoning, China
| | - Tongtong Han
- The VIP Department, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, No. 117 North Street Nanjing Road, Shenyang, 110002, Liaoning, China
| | - Jian Li
- The VIP Department, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, No. 117 North Street Nanjing Road, Shenyang, 110002, Liaoning, China
| | - Xu Yan
- The VIP Department, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, No. 117 North Street Nanjing Road, Shenyang, 110002, Liaoning, China.
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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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Deep Margin Elevation: Current Concepts and Clinical Considerations: A Review. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58101482. [PMID: 36295642 PMCID: PMC9610387 DOI: 10.3390/medicina58101482] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/05/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022]
Abstract
Dietschi and Spreafico first proposed deep margin elevation (DME) in 1998 to address the multiple clinical problems associated with sub-gingival margins, where sub-gingival margins will be repositioned coronally using composite resin restorations. Given that dentistry is directing towards conservatism, its use is currently trending. Materials and Methods: a search was performed through PubMed, Scopus, and Google Scholar search engines to obtain relevant articles with no time restriction. Results: With biological width taken into consideration, well-defined and polished sub-gingival restorations are compatible with periodontal health. Marginal integrity in the DME technique seems to be affected by the type of adhesive, restoration, and incremental layering of the restoration. Regarding fracture resistance, DME has no significant effects. Conclusion: The DME technique seems to be a minimally invasive alternative to surgical crown lengthening (SCL) and orthodontic extrusion (OE) with respect to biological width. Well-controlled clinical trials are limited in this field; further long-term follow-up studies emphasizing the periodontal outcomes and prevention of complications are needed.
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Ferrari M, Pontoriero DIK, Ferrari Cagidiaco E, Carboncini F. Restorative difficulty evaluation system of endodontically treated teeth. J ESTHET RESTOR DENT 2022; 34:65-80. [PMID: 35133074 DOI: 10.1111/jerd.12880] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/11/2022] [Accepted: 01/17/2022] [Indexed: 01/22/2023]
Abstract
OBJECTIVE This article provides an updated overview of restorative procedures of endodontically treated teeth. CLINICAL CONSIDERATIONS The different techniques and procedures to restore an endodontic treated tooth were considered in the last decades. While they are generally performed using bonding procedures in combination with or without the placement of a post into the root to build up the abutment, there has been a lack of interest in restorative difficulties that can be faced. Failures are represented such as debonding of the post, fracture of the root, decementation, and/or fracture of the restoration, microleakage of the margins. Essentially, the presence of a sufficient failure is considered a key point of a long prognosis. Different clinical factors can directly influence the type of restoration and the longevity of the treatment. The restorative difficulty evaluation system (RDES) is proposed in this article. This new system is composed of eight different clinical factors that are divided into six levels of difficulties. The RDES is composed of 1. Endodontic complexity and outcome, 2. Vertical amount of coronal residual structure and dimension of the pulp chamber, 3. Horizontal amount of coronal residual structure, 4. Restoration marginal seal, 5. Local interdisciplinary conditions, 6. the complexity of the treatment planning, 7. Functional need, 8. Dental wear and esthetic need. CONCLUSION This article reviews the RDES and outlines critical steps and tips for clinical success. CLINICAL SIGNIFICANCE The RDES allows to any clinician to evaluate restorative difficulties when an endodontic treated tooth must be restored, combines clinical aspects that can involve from the single tooth to a full mouth rehabilitation.
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Affiliation(s)
- Marco Ferrari
- Department of Prosthodontics and Dental Materials, School of Dentistry, University of Siena, Siena, Italy
| | - Denise I K Pontoriero
- Department of Prosthodontics and Dental Materials, School of Dentistry, University of Siena, Siena, Italy
| | | | - Fabio Carboncini
- Department of Prosthodontics and Dental Materials, School of Dentistry, University of Siena, Siena, Italy
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Bruhnke M, Wierichs RJ, von Stein-Lausnitz M, Meyer-Lückel H, Beuer F, Naumann M, Sterzenbach G. Long-term survival of adhesively post-endodontically restored teeth. J Endod 2022; 48:606-613. [DOI: 10.1016/j.joen.2022.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/25/2022] [Accepted: 02/08/2022] [Indexed: 01/04/2023]
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10
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Pre-endodontic restoration of structurally compromised teeth: current concepts. Br Dent J 2021; 231:343-349. [PMID: 34561585 PMCID: PMC8463293 DOI: 10.1038/s41415-021-3467-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 02/21/2021] [Indexed: 11/29/2022]
Abstract
Teeth that require endodontic treatment are often structurally compromised and this considerably complicates endodontic procedures. Therefore, pre-endodontic restoration is a key approach that dentists should consider for such teeth. This article discusses current concepts of pre-endodontic restoration, with a focus on adhesive restorative methods and surgical/orthodontic techniques, and provides a relevant decision-making flowchart. Highlights the importance of pre-endodontic restoration for the predictability of endodontic treatment. Discusses restorability aspects for structurally compromised teeth. Reviews current restorative and surgical/orthodontic techniques for pre-endodontic restoration and provides a decision-making flowchart.
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Roberts H, Fuentealba R, Brewster J. Microtomographic Analysis of Resin Composite Core Material Porosity. J Prosthodont 2020; 29:623-630. [PMID: 32180298 DOI: 10.1111/jopr.13167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2020] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To nondestructively evaluate the porosity of ten contemporary resin composite core materials using microtomographic (microCT) analysis. MATERIAL AND METHODS Resin composite core material samples (n = 12) including dual-cure, visible light cure only, and a self-cure material were fabricated using a standardized mold following manufacturer's recommendations. After storage in phosphate buffered saline for one week, specimens were analyzed using a microCT unit at 5.3-µm resolution over a rotational range of 360°. Image 3D recombination and analysis was accomplished using microCT software. Evaluated parameters included material volume investigated, closed pore number and volume, as well as closed pore percentage. Parameter mean values were evaluated with Kruskal-Wallis/Dunn at a 95% confidence level (α = 0.05). RESULTS Mean percent total porosity with standard deviation identified significant differences in decreasing order as Ti-Core: 2.2 (0.4) > Ti-Core Auto E: 1.3 (0.3) = Ti-Core Flow Plus: 1.1 (0.02) > Clearfil Photo Core: 0.94 (0.5) = Clearfil DC Core Plus: 0.6 (0.18) = MultiCore Flow: 0.58 (0.1) > Fluorocore 2+: 0.14 (0.2) = Build-It FR: 0.068 (0.02) = Gradia Core: 0.03 (0.02) = Rebilda DC: 0.02 (0.01). A pilot microCT evaluation evaluating a mixing tip revealed incomplete mixture between the two resins with porosity introduced from turbulence as the materials are forced through the tip during preparation. CONCLUSIONS A wide range of porosity was identified between the ten materials evaluated. These preliminary results warrant more investigation evaluating additional resin composite core materials, the preparation capabilities of automix tips, and porosity presence in the unmixed materials.
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Affiliation(s)
- Howard Roberts
- Division of Restorative Dentistry, University of Kentucky College of Dentistry, Lexington, KY.,Postgraduate Dental College, Uniformed Services University of the Health Sciences, Biloxi, MS
| | - Rodrigo Fuentealba
- Division of Prosthodontics, University of Kentucky College of Dentistry, Lexington, KY
| | - John Brewster
- Postgraduate Dental College, Uniformed Services University of the Health Sciences, Biloxi, MS
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