Polyethylene fiber-reinforced composite resin used as a short post in severely decayed primary anterior teeth: a case report

Esthetic Rehabilitation of Severely Mutilated Anterior Primary Teeth Using Fiber Post - Case Reports

Premature loss of primary teeth due to early childhood caries could be treated with different options. Presented cases discuss the clinical sequence of rehabilitation of maxillary anterior primary teeth. Endodontic treatment was followed by composite resin restoration reinforced with fiberglass post. Two case reports present a treatment option for severely mutilated primary maxillary incisors due to early childhood caries.

Evaluation of the Effects of Different Types of Resin Cement Systems on the Push-Out Bond Strength of the Fiber Post to Intracanal Dentin in Anterior Primary Teeth

Background

This study aimed to evaluate the effects of using three different resin cements on push-out bond strength (PBS) of fiber posts to root canal dentin of primary teeth.

Methods

Fifty primary canines were randomly divided into five experimental groups according to the type of the luting agent used for fiber post cementation after endodontic treatment and post space preparation as the following: Group 1: glass ionomer cement (GIC), Group 2: flowable resin composite, Group 3: etch and rinse (E&R) resin cement, Group 4: self-etch (SE) resin cement, Group 5: self-adhesive (SA) resin cement. The PBS values of the cemented fiber posts to root canals were measured. The data were statistically analyzed using a one-way analysis of variance, followed by Tukey's post hoc test.

Results

The highest mean PBS value was observed in Group 4 (SE resin cement), followed by Group 3 (E&R resin cement), and the lowest PBS value belonged to Group 1 (GIC), followed by Group 5 (p-values < 0.05). The mean PBS of Group 3 (E&R resin cement) was significantly higher than those of Groups 1 (GIC), 2 (flowable resin composite), and 5 (SA resin cement) (p-values < 0.05). However, no significant difference was found between the mean PBS of GIC and SA resin cement (p-value >0/05).

Conclusion

Using SE resin cement for fiber post cementation in primary anterior teeth showed the best results, followed by E&R resin cement. The lowest PBS was observed for GIC, followed by SA resin cement.

Clinical Performance of Composite Resin Restorations of Primary Incisors with Extensive Carious Lesions Retained by Glass Fiber Post or Biological Post

AIM

Intracanal posts enhance the resistance of the restoration to mechanical loads and masticatory forces in primary teeth with extensive carious breakdown. This study was done to investigate the clinical performance of composite resin restoration retained by either glass fiber post or biological post in the restoration of primary anterior teeth with extensive carious lesions.

MATERIALS AND METHODS

A total of 21 children (with 82 primary anterior teeth) who met the inclusion criteria were involved in the study. The 82 primary maxillary incisors were randomly allocated into two equal groups: groups I (glass fiber post) and II (biological post). All the teeth underwent pulpectomy, followed by glass fiber post or biological post, followed by celluloid strip crown restoration. Clinical analysis of all the teeth in the two groups was performed at 1, 3, 6, 9, and 12 months to assess the success of treatment procedures. Statistical Package for the Social Sciences (SPSS) software version "17" was used for statistical analysis. Pearson's Chi-squared test and Fisher's exact test were utilized to evaluate the success of both treatment procedures. The significance level was predetermined at p < 0.05.

RESULTS

At the end of the 12-month follow-up period, 89.4 and 84.2% of composite resin restorations of primary incisors with extensive carious lesions were retained by glass fiber and biological posts, respectively. The intergroup comparison revealed no statistically significant differences pertaining to retention loss, marginal discoloration, and marginal adaptation at all follow-up intervals (p > 0.05).

CONCLUSION AND CLINICAL SIGNIFICANCE

Since biological posts are inexpensive and economical, they may replace the commercial post systems available to pediatric dentists.

HOW TO CITE THIS ARTICLE

Jaiswal N, Garg N, Pathivada L, et al. Clinical Performance of Composite Resin Restorations of Primary Incisors with Extensive Carious Lesions Retained by Glass Fiber Post or Biological Post. Int J Clin Pediatr Dent 2023;16(6):850-857.

A Comparative Evaluation of Fracture Toughness of Composite Resin vs Protemp 4 for Use in Strip Crowns: An In Vitro Study

Aim

The aim of this study was to compare the fracture toughness of pedo shade packable composite resin (Z100, 3M ESPE, St. Paul, USA) vs Protemp 4 (3M ESPE, Seefeld, Germany) when used inside a strip crown to restore primary incisors.

Materials and methods

Thirty-six exfoliated noncarious human primary central and lateral incisors were randomly divided into two equal groups. The teeth were prepared to standardized dimensions to receive a strip crown. All the teeth were etched, rinsed, and dried following which bonding agent was applied and light cured. In group I, pedo shade packable composite resin (Z100, 3M ESPE, St. Paul, USA) was packed into strip crowns, placed on the prepared tooth, and light cured. In group II, the strip crowns were filled with Protemp 4 (3M ESPE, Seefeld, Germany), placed on the prepared tooth, and left to autopolymerize for 10 minutes. The strip crowns were removed, and the teeth were tested using the universal testing machine until fracture. Fracture toughness of the two groups was recorded and analyzed statistically using Student's “t” test.

Results

The mean force required to fracture strip crowns restored with Protemp 4 (416.89 ± 124.58 N) was higher when compared with pedo shade packable composite resin (338.27 ± 130.99 N). However, statistical analysis did not show a significant difference in the fracture toughness between the two groups (p = 0.074), based on Student's “t” test results.

Conclusion

The fracture toughness of teeth restored with Protemp 4 was comparable with pedo shade packable composite resin when used inside a strip crown.

Clinical significance

The use of Protemp 4 is a possible alternative to pedo shade packable composite resin in restoring the primary anterior teeth, when used inside the strip crowns. The data also showed that the fracture toughness of Protemp 4 was comparable with pedo shade packable composite resin.

How to cite this article

Vignesh KC, Kandaswamy E, Muthu MS. A Comparative Evaluation of Fracture Toughness of Composite Resin vs Protemp 4 for Use in Strip Crowns: An In Vitro Study. Int J Clin Pediatr Dent 2020;13(1):57–60.

Fracture Resistance of a Bulk-Fill and a Conventional Composite and the Combination of Both for Coronal Restoration of Severely Damaged Primary Anterior Teeth

Objectives:

This study aimed to compare the fracture resistance of a bulk-fill and a conventional composite and a combination of both for coronal restoration of severely damaged primary anterior teeth.

Materials and Methods:

In this in vitro experimental study, 45 primary anterior teeth were randomly divided into three groups. After root canal preparation, the canals were filled with Metapex paste such that after the application of 1 mm of light-cure liner, 3 mm of the coronal third of the canal remained empty for composite post fabrication. Filtek Z250 conventional composite was used in group 1, Sonic-Fill bulk-fill composite was used in group 2 and Sonic-Fill with one layer of Filtek Z250 as the veneering were used in group 3. Adper Single Bond 2 was used in all groups. The teeth were thermocycled, and fracture resistance was measured by a universal testing machine. The mode of fracture was categorized as repairable or irreparable. Data were analyzed using one-way ANOVA.

Results:

The mean fracture resistance was 307.00±74.72, 323.31±84.28 and 333.30±63.96 N in groups 1 to 3, respectively (P=0.55). The mean fracture strength was 14.53±2.98, 15.08±2.82 and 15.26±3.02 MPa in groups 1 to 3, respectively (P=0.77). The frequency of repairable mode of failure was 80% for the conventional, 73.6% for the bulk-fill and 80% for the bulk-fill plus conventional group, with no significant difference (P>0.05).

Conclusion:

Bulk-fill composites can be used for coronal reconstruction of severely damaged primary anterior teeth similar to conventional composites to decrease the treatment time in pediatric patients.

Evaluation of the effect of different post materials and adhesive systems on the bonding strength of short-post technique for primary teeth

BACKGROUND

The most important process in treating grossly decayed teeth, including decay in the pulp, is the ability to hold a retainer in for a short time.

AIM

The aim of this study was to investigate the bond strengths of different adhesive systems and post materials on primary teeth.

DESIGN

One hundred and twenty extracted maxillar primary central incisor teeth were randomly divided into two main groups (total-etch and self-etch adhesive systems) and five subgroups (1: control-nanohybrid composite resin, 2: pre-impregnated glass fiber, 3: unsaturated glass fiber, 4: polyethylene fiber, 5: short-fiber reinforced composite resin). The push-out test was performed using a universal testing machine with a crosshead speed of 0.5 mm/min.

RESULTS

No statistically significant difference was detected between the two different adhesive systems and five different materials in terms of the maximum values measured for fractures in the specimens when both the adhesive materials and the short-post materials were evaluated separately (P > 0.05). However, as a result of multiple comparisons made, it was found that statistical differences between the groups applying the total-etch adhesive system occurred in Groups 3 and 5. The highest push-out test values were measured in Group 5 and Group 1, and the lowest value in Group 3. Although the fracture type distribution in the total-etch adhesive system groups was not statistically different based on the material used (χ²  = 11,865; P = 0.309), the self-etch adhesive systems did show differences (χ²  = 28,463; P < 0.001). Both the total-etch and the self-etch adhesive system groups showed mostly adhesive failures.

CONCLUSION

The fiber-reinforced and nanohybrid composite resin had higher values in the short-post technique, and there was no significant difference between the different fiber posts.

Aesthetic preformed paediatric crowns: systematic review

BACKGROUND

Different aesthetic preformed crowns (APC) are proposed to restore decayed and damaged primary teeth because the stainless steel crowns (SSCs) do not satisfy parents concerned about aesthetic.

AIM

The objective was to evaluate the clinical effectiveness of all types of APC for restoring primary teeth compared with conventional filling materials or other types of crowns.

DESIGN

Relevant articles were searched in electronic databases of PubMed via MEDLINE and the Cochrane central register of controlled trials. Two review authors independently assessed the risk of bias in the included articles and extracted data.

RESULTS

From 555 potentially eligible articles, seven relevant articles were included. The overall risk of bias was high for all the studies. SCCs cannot be replaced by APC, such as the open-faced SSCs and the pre-veneered SCCs, for restoring badly decayed primary molars. Zircon crowns were assessed only in primary incisors and compared with pre-veneered SCCs and resin composite strip crowns. After a follow-up of only 6 months, Zircon crowns gave significantly better results than the others with regard to gingival health and crown fractures.

CONCLUSION

Due to the small number of RCTs on this topic and their risk of bias, future RCTs should be carried out in primary teeth.

Survival of Composite Resin Restorations of severely Decayed Primary Anterior Teeth retained by Glass Fiber Posts or Reversed-orientated Metal Posts

Aim: The aim of this study was to compare the survival of composite resin restorations retained by glass fiber posts or reversed-orientated (upside-down) metal posts in severely decayed primary anterior teeth after 6, 12, and 18 months.

Materials and methods: A total of forty-four 3- to 5-year-old children with bilateral severely decayed primary maxillary canines were included. Patients were treated under general anesthesia. After pulpectomy, an intracanal post was seated in the primary maxillary canine on each side: either a glass fiber post or a metallic post in reversed orientation and teeth restored with light-cured composite. Survival rate of each technique was evaluated at predetermined follow-ups and data were analyzed with McNemar’s test (α = 0.05).

Results: The difference in survival of restorations retained by two types of posts was not statistically significant in clinical and radiographical evaluations after 6, 12, and 18 months. The survival rate of reversed-orientated metal and glass fiber posts after 18 months was 81.1 and 67.6% respectively (p = 0.14).

Conclusion: Reversed-orientated metal post did not show lower clinical survival compared with glass fiber posts in 18-month follow-up. Hence, reversed-orientated metal post can be considered as a potential method to obtain retention for composite restorations in severely decayed primary anterior teeth.

How to cite this article: Vafaei A, Ranjkesh B, L0vschall H, Erfanparast L, Jafarabadi MA, Oskouei SG, Isidor F. Survival of Composite Resin Restorations of severely Decayed Primary Anterior Teeth retained by Glass Fiber Posts or Reversed-orientated Metal Posts. Int J Clin Pediatr Dent 2016;9(2):109-113.

Lining prefabricated dowel(s) with fibre reinforced resin composite

The study evaluated the adaptation and push-out bond force of two different lined fibre dowels in oval canals. Dowel spaces were prepared in 30 obturated mandibular premolars with oval roots. The samples were divided into three groups (n = 10). The first group received non-lined fibre dowels (NL). The fibre dowels in the second group were lined with a resin composite (PL). The fibre dowels in third group were lined with resin composite reinforced with polyethylene fibre ribbon (PFL). The proportion of surface area (PSA) occupied by the dowel and push-out bond force were analysed. The data were statistically analysed using two-way anova with post-hoc Holm-Sidak and Tukey tests. The PSA was higher in lined dowels. Highest push-out bond forces were recorded in PFL. Fibre reinforced composite lining improves the adaptation and push-out bond force of fibre dowel in oval canals.

Methods of Intracanal Reinforcement in Primary Anterior Teeth-Assessing the Outcomes through a Systematic Literature Review

AIM

To assess how the various methods of intracanal reinforcement (short root canal posts) performed in their clinical and radiographic outcomes for restoring grossly broken down primary anterior teeth after pulpectomy for 1 year or longer follow-up period.

MATERIALS AND METHODS

Literature search of electronic databases (Sept 2013) and various journals (1980-Sept 2013) using medical subject headings and free text terms was conducted. For inclusion in quality assessment, prespecified inclusion criteria were applied. Quality assessment was performed by using 'The Cochrane collaboration's tool for assessing risk of bias'.

RESULTS

Seven relevant papers were selected for full text evaluation. After applying the inclusion criteria, only two trials could be considered for quality assessment. Both of these were classified as having high risk of bias.

CONCLUSION

The evidence to support any method of intracanal reinforcement for restoring grossly broken down anterior teeth is presently lacking. Further trials with well-defined methodology are needed. How to cite this article: Mittal N, Bhatia HP, Haider K. Methods of Intracanal Reinforcement in Primary Anterior Teeth- Assessing the Outcomes through a Systematic Literature Review. Int J Clin Pediatr Dent 2015;8(1):48-54.

Fibre reinforced composite: post and core material in a pediatric patient - an alternative to usual

Fractured teeth are always a challenge to the dentist. The root canal therapy today can retain even very badly broken teeth. One of the most accepted techniques involve restoration of extensively carious or badly fractured teeth by the fabrication of a post and core while utilizing the root canal space for anchorage. So far, the only materials that are available to the dentist for this procedure have been a variety of metallic alloys. These materials are hard and need to be cast precisely so that they can fit the canals. Today materials are available which usually eliminates all the intermediate steps which are done in laboratories and the total control is rendered in the hands of the dentist, to fabricate on the chair, a resilient, aesthetic and bonded post and core. One such material is discussed here in a pediatric permanent anterior tooth.

Retentive strength of different intracanal posts in restorations of anterior primary teeth: an in vitro study

Objectives

To determine the retentive strength and failure mode of undercut composite post, glass fiber post and polyethylene fiber post luted with flowable composite resin and resin-cement.

Materials and Methods

Coronal parts of 120 primary canine teeth were sectioned and specimens were treated endodontically. The teeth were randomly divided into 6 groups (n = 20). Prepared root canals received intracanal retainers with a short composite post, undercut composite post, glass fiber post luted with flowable resin or resin-cement, and polyethylene fiber post luted with flowable resin or resin-cement. After crown reconstruction, samples were tested for retentive strength and failure mode. Statistical analysis was done with one-way ANOVA and Tukey tests (p < 0.05).

Results

There were statistically significant differences between groups (p = 0.001). Mean bond strength in the undercut group was significantly greater than in the short composite post (p = 0.030), and the glass fiber post (p = 0.001) and the polyethylene fiber post group luted with resin-cement (p = 0.008). However, the differences between the undercut group and the groups with flowable composite as the luting agent were not significant (p = 0.068, p = 0.557). Adhesive failure was more frequent in the fiber post groups.

Conclusions

Although the composite post with undercutting showed the greatest resistance to dislodgement, fiber posts cemented with flowable composite resin provided acceptable results in terms of retentive strength and fracture mode.

A simple method for reconstruction of severely damaged primary anterior teeth

Restoration of severely decayed primary anterior teeth is often considered as a special challenge by pedodontists. This case report presents a 5-year-old boy with severely damaged maxillary right canine. Subsequent to root canal treatment, a reversed (upside-down) metal post was put into the canal and composite build-up was performed. This new method offers a simple, practical and effective procedure for reconstruction of severely decayed primary anterior teeth, which re-establishes function and esthetics for time the tooth should be present and functional in the child's mouth.