Comparison of fatigue for three prefabricated threaded post systems

Comparison of the fracture strength of endodontically treated teeth restored with polyether ether ketone, zirconia and glass-fibre post-core systems

PURPOSE

This study aimed to compare the fracture resistance and fracture mode of maxillary central incisors restored with four different sizes and three different post-core systems.

MATERIALS AND METHODS

One hundred and twenty maxillary incisors were endodontically treated and randomly divided into three groups (12 subgroups). Post cavities for the narrow subgroups were prepared with 1.4-mm-diameter drills in lengths of 7.5 mm (SN) and 10 mm (LN). Post cavities for the wide subgroups were prepared with 1.6-mm-diameter drills in lengths of 7.5 mm (SW) and 10 mm (LW) (n = 10). Group F was restored with glass-fibre post and composite resin core, Group P was restored with custom PEEK post-core and Group Z was restored with custom zirconia post-core. All posts were cemented with a dual-cure resin cement. Zirconia copings were cemented. Specimens were loaded on the palatal surface with a universal testing machine, and the fracture strengths of the teeth were statistically analysed using ANOVA and post hoc Tukey tests.

RESULTS

Statistically significant differences existed between the fracture strengths of the post materials. The highest fracture strength was in Group F, and the lowest was in Group P. Evaluation of the fracture strengths of the post lengths and diameters demonstrated that the short-narrow group of Group Z had the lowest fracture strength (P < .05). The long-wide group of Group F showed the highest fracture resistance. In Group P, no statistically significant difference existed between the post-cores of different dimensions (P > .05). Irreparable fractures were observed mostly in Group Z, and decementation was more common in Group P.

CONCLUSIONS

PEEK post-cores showed sufficient fracture strength for the anterior region, similar to the other two post-core materials. PEEK post-cores showed more decementation and repairable fractures at lower forces, while restoration failure was mostly catastrophic for glass-fibre and zirconia posts.

Evaluation of the fracture resistance of root filled thin walled teeth restored with different post systems

Background

Restoration of the teeth with extensive root canals with different post systems is a challenge for clinicians. Evaluation of these systems is important for clinical success. The aim of this study was to compare the fracture resistance and fracture mode of endodontically treated thin-walled teeth which restored with different post systems.

Methods

Eighty extracted and endodontically treated maxillary canines were divided into 4 groups (n = 20) and the thickness of the radicular dentin walls was reduced by using diamond burs. Each root was embedded in an autopolymerizing resin with a 0.25 mm layer of vinyl polysiloxane material to simulate the periodontal ligament. The subgroups were restored with one of the following post systems: only composite resin (Group 1), cast post (Group 2), glass-fiber post (Group 3), and I-TFC post (Group 4). The samples were subjected to a gradually increasing force (0,5 mm/min). The force required to fracture was recorded, and the data were analyzed with ANOVA, Tukey test's and Chi–Square test (p < 0.05).

Results

The highest fracture resistance was recorded for Group 2, followed by the Group 3, Group 4, and Group 1. Differences in the fracture resistance of teeth were significant among the groups (p < 0.05). The fracture resistance of Group 4 was significantly different than the other tested post systems (p < 0.05).

Conclusions

The lowest fracture resistance was recorded for Group 1, but among all post systems, Group 4 had the lowest fracture resistance. The fracture mode of the fiber posts (Radix and I-TFC posts) would permit repair of the tooth.

Fracture Resistance of Endodontically Treated Roots Restored with Fiber Posts Using Different Resin Cements- An In-vitro Study

INTRODUCTION

The influence of the remaining coronal tooth structure along with intra-radicular esthetic posts increases fracture resistance of fractured teeth especially in the anterior region. The advent of resin based luting cements improves the adhesion of fiber posts.

AIM

To evaluate the fracture resistance of endodontically treated roots restored with fiber posts using different resin cements - Calibra (etch and rinse), PermaFlo® DC (self-etch primer) and SmartCem2 (self-adhesive).

MATERIALS AND METHODS

Extracted human maxillary central incisors having similar dimensions were decoronated at the Cemento-Enamel Junction (CEJ) to create 16mm long specimens and endodontically treated. A total of 45 teeth were divided into three groups with 15 teeth each for cementation of easy fiber posts (size1, 0.8mm diameter). Post spaces were prepared to a depth of 10mm. Group 1 - Caulk 34% phosphoric acid gel, dual cure adhesive Prime and Bond NT followed by luting of post with Calibra cement. Group 2 - Ultra - etch then Primer A and Primer B, and PermaFlo® DC was used to cement the post. Group 3 - SmartCem2 [1:1 ratio] was used to cement the post. The excess lengths of posts were seared and teeth were mounted on acrylic blocks and loaded under compressive force to the long axis of the tooth which increased in periodic pattern of 1mm/min. The value of the force at which each root section gets fractured was noted. The data were statistically analysed using ANOVA and Tukey's Test.

RESULTS

The mean fracture load (and SD) were as follows Group 1 - 762.400 (251.490); Group 2 - 662.933 (206.709); Group 3 - 657.800 (57.372). No statistically significant differences were seen among all three Groups, p-value (0.228).

CONCLUSION

Posts cemented using self -adhesive resin cement SmartCem2 have highest fracture resistance and bonding efficacy of self-adhesive technique showed reliably better results but was comparable to total-etch and self-etch techniques.

Titanium posts and bonded amalgam core longevity: A 22-year clinical survival retrospective study

BACKGROUND

The authors conducted a retrospective study to evaluate the long-term (18-22 years) clinic results of titanium post and bonded amalgam core restorations with metal-ceramic crowns placed in patients.

METHODS

From 1992 through 1996, the authors placed 88 restorations in 66 patients. They measured the ferrule effect in the minor dentin collar area. In 2014, the authors analyzed the following variables: ferrule length, length and thickness of the post, and tooth position.

RESULTS

The overall survival of the restorations decreased over time with survival rates of 89.6% after 5 years of follow-up appointments and 64.2% after 18 years of follow-up appointments. There were 42 failures, and the maxillary premolars had the most failures. The teeth with 2 or more millimeters ferrule length had a higher survival rate than those with a 0 to less than 2 mm ferrule length; these results were not statistically significant.

CONCLUSIONS

Statistically significant differences were detected according to the location of the tooth. The cores in the anterior teeth were 3.26 times more likely to fail than those in the molars, which presented higher survival rates; maxillary premolars had the most failures (28.5%). Both the metallic post length and its diameter did not influence restoration survival. The ferrule length was not statistically significant.

PRACTICAL IMPLICATIONS

The clinical technique to restore endodontically treated teeth that includes a titanium post and bonded amalgam restorations results in greater coronal destruction but shows good long-term results, ease of fabrication, and modest cost in comparison with other techniques.

Fracture resistance of weakened roots restored with a transilluminating post and adhesive restorative materials

STATEMENT OF PROBLEM

The increase in wall thickness of weakened roots using composite resins may increase the root resistance to fracture. However, little is known about the recently developed methods for intraradicular reinforcement of weakened roots.

PURPOSE

The purpose of this study was to determine the fracture resistance of experimentally weakened roots reinforced with composite resins, compared with conventional systems that use cast and prefabricated posts.

MATERIAL AND METHODS

Forty-eight maxillary incisors were divided into 6 groups (n = 8). The control group (C) used a conventionally prepared root canal filled with cast CuAl posts. Experimental groups had the root canals overprepared to weaken them and were restored as follows: CP, cast CuAl posts; LT, light-transmitting polymerization post (Luminex) + Tetric Ceram resin + prefabricated titanium post (PTP); LF, Luminex posts + Filtek Supreme resin + PTP; LZ, Luminex posts + Z100 resin + PTP; and LR, Luminex posts + Renew resin + PTP. All posts were cemented with a resin luting agent (C & B Cement). Specimens were subjected to compressive load (N) until fracture. Data were submitted to 1-way analysis of variance and the Dunnett test (alpha = .05).

RESULTS

There was significant difference (P < .01) between the conventionally prepared specimens and those filled with a cast post (C, 447.8 +/- 167.9) and the overprepared specimens and those filled with a cast post (CP, 212.8 +/- 62.4). No significant differences were found among the control specimens (447.8 +/- 167.9) and the weakened-roots filled with Luminex and composite resins LT (520.9 +/- 173.1), LF (479.9 +/- 214.9), LZ (391.6 +/- 173.6), and LR (333.0 +/- 112.2).

CONCLUSION

The use of composite resins in root canals reinforced the weakened roots during fracture resistance testing.

Fatigue resistance and structural characteristics of fiber posts: three-point bending test and SEM evaluation

OBJECTIVES

The aim of the present study was to assess the fatigue resistance of different types of fiber posts, and to observe their ultrastructure through scanning electron microscopy (SEM) before and after undergoing the fatigue test.

METHODS

Eight types of fiber posts were selected for this study. Easypost (Group 1), Para Post Fiber White (Group 2), FibreKor (Group 3), Ghimas White (Group 4), DT Light-Post radiopaque (Group 5), FRC Postec (Group 6), Luscent Anchors (Group 7), Snowpost (Group 8). Ten out of fifteen posts in each group were used for the fatigue test, and the other five were processed for SEM. A three-point bending machine, loading at an angle of 90 degrees and a frequency of 3 Hz was employed for fatigue testing. The test was carried out until two million cycles were completed or until fracturing of the post. SEM evaluation was performed using a three-step scale method to assess the fiber/resin ratio and fiber dimension.

RESULTS

The fatigue test showed statistically significant differences among the different posts. Groups 5 and 6 performed better than all the other groups, withstanding practically all the stipulated number of load cycles. All the other posts fractured before the end of the test. SEM observations of the surface integrity of the fiber posts showed that Groups 4-6 obtained better scores for both longitudinal sections and cross-sections.

SIGNIFICANCE

There was a large variation in the response of different kinds of fiber posts a fatigue resistance test. The absence of correlation between results of fatigue testing and parameters of structural integrity suggests that the latter mostly reflect random variations in the fiber post manufacturing process.

Corono-radicular reconstruction of pulpless teeth: a mechanical study using finite element analysis

STATEMENT OF PROBLEM

Following endodontic therapy, teeth need to be protected, particularly in the cervical region, where the majority of fractures occur. The likelihood of a fracture depends on the condition of the crown and the type of reconstruction performed.

PURPOSE

This simulation study was designed to compare the effect of different corono-radicular reconstruction methods on stress transmission to dental tissues.

MATERIAL AND METHODS

The study software performed stress analysis of complex structures by finite element analysis. Seven 3-dimensional models were created, each representing a tooth embedded in a bony medium. The following parameters affecting corono-radicular restoration were studied: 2 levels of coronal destruction, core materials, post materials when present, and absence of post. The 2 levels of coronal tissue loss were (1) total tissue loss of the coronal dentin and (2) partial tissue loss of the coronal dentin with 2-mm surviving dentin walls. Teeth with 2 different levels of tissue loss (first study parameter) were reconstructed by 4 different techniques: nickel chromium (NiCr) cast post and core, NiCr post and composite core combination, carbon fiber post and composite core combination, and composite restoration without post. A NiCr crown covered each of the models and received a 30 degrees oblique occlusal load at a constant intensity of 100 N. The software computed the stresses (local tensile stress inducing cracks and compressive stress) for each of the models, comparing maximum intensity observed, localization, and concentration.

RESULTS

Whatever the type of stress (tensile or compressive), the greatest stress was observed in the cervical region, regardless of the model. Only tensile stresses potentially responsible for fractures were compared. Cervical tensile stresses exceeded 230 Pa in the absence of a ferrule and were less than 140 Pa when a ferrule was present. In the absence of a ferrule, the NiCr composite/post combination generated greater cervical stress (254 Pa) than the cast post and core (235 Pa). Results with a ferrule showed 92 Pa for the NiCr composite/post combination and 90.5 Pa for the cast post and core. In the presence of a ferrule, the tensile stress intensities generated by the composite restoration with no root canal post (139 Pa) were 51% greater than those generated by the NiCr/composite combination and approximately 26% greater than those generated by the composite/carbon combination.

CONCLUSION

Within the limitations of this study, it was confirmed that all simulated reconstructed teeth were more subject to stress in the cervical region. The absence of a cervical ferrule was found to be a determining negative factor, giving rise to considerably higher stress levels. When no ferrule was present, the NiCr post/composite combination generated greater cervical stress than cast post and cores. Nevertheless, the peripheral ferrule seemed to cancel the mechanical effect of the reconstruction material on the intensity of the stresses. With a ferrule, the choice of reconstruction material had no impact on the level of cervical stress. The root canal post, the purpose of which is to protect the cervical region, was also shown to be beneficial even with sufficient residual coronal dentin. In the presence of a root canal post, cervical stress levels were lower than when no root canal post was present. Moreover, the higher the elasticity modulus, the lower the stress levels.

Effect of core stiffness on the in vitro fracture of crowned, endodontically treated teeth

STATEMENT OF PROBLEM

Dentin and core materials that substitute for missing dentin are dissimilar materials. A core material with a lower elastic modulus may deform more under applied stress and therefore result in reduced stress concentration at the core/dentin junction.

PURPOSE

This in vitro study examined the effect of core stiffness on the fracture resistance and failure characteristics of a crowned, endodontically treated tooth under simulated occlusal load.

MATERIAL AND METHODS

Forty extracted human mandibular premolars were divided equally into 4 groups and prepared for posts and cast crowns as follows: group 1 = cast post and core, cast crown; group 2 = preformed metal post, composite core, and cast crown; group 3 = preformed metal post, amalgam core, and cast crown; and group 4 (control) = preformed metal post, no core, and cast crown. All prepared teeth had 2 mm of sound dentin on which the cemented crown rested. A continuous load (kg) was applied to the buccal cusp at a 30-degree angle to the long axis of each tooth at a crosshead speed of 2 mm/min until failure. Collected data were subjected to 1-way analysis of variance with the Welch modification to compare groups (P<.05).

RESULTS

Failure loads for the 4 test groups were as follows: 98.1 +/- 34.6 kg (group 1), 94.4 +/- 41.8 kg (group 2), 105.5 +/- 18.6 kg (group 3), and 101.1 +/- 55.3 kg (group 4). No significant difference in failure load values was found among the 4 groups. The primary mode of failure (80%) in all groups was an oblique radicular fracture, either apical to the post or at the post level. Horizontal fracture of the root and post was found in groups 1, 2, and 3 (20%). Loosening of the crown, post, and core was found only in group 2(20%).

CONCLUSION

Within the limitations of this study, core stiffness did not affect the failure resistance of teeth restored with posts and cores and complete-coverage cast metal crowns. The dominant pattern of failure was unrepairable root fracture. Only the composite core exhibited repairable fractures.

Effect of prefabricated metal post-head design on the retention of various core materials

Retention of various post heads to core restorative materials is an important factor in the selection of prefabricated post systems and restorative materials for the restoration of endodontically treated teeth. This study examines the retention of a post-core prefabricated system in relation to core material and post-head design. A total of 60 samples were prepared using two different post systems (ParaPost Plus (PP) and ParaPost Unity (PU), with amalgam, composite or glass-ionomer as one of the core materials. The samples were tested using the Instron testing machine. The PP was superior to the PU prefabricated post with respect to the retention of various core materials. Retention values in descending order of magnitude were found to be: composite, amalgam and glass-ionomer (significantly lower). The rhomboid serrated design of PP was superior in retention to the rounded smooth UP system. Composite material proved to be superior in retention, closely followed by amalgam, with glass-ionomer significantly less retentive.

Comparison of the fracture resistances of pulpless teeth restored with a cast post and core or carbon-fiber post with a composite core

STATEMENT OF PROBLEM

The survival of pulpless teeth restored with a post and core system is a controversial issue.

PURPOSE

This study compared the fracture resistance of 2 types of restorations: teeth restored with prefabricated carbon-fiber posts and composite cores to cast dowel-core restored teeth.

MATERIAL AND METHODS

A total of 44 recently extracted sound premolars were randomly distributed into 2 equal groups: group I, restored with prefabricated carbon-fiber post and a composite core; and group II, with custom-cast type III gold alloy post and cores. The size and shape of the posts were identical in the 2 groups. All teeth were fully covered with a nonprecious cast crown. Fracture resistance was measured by applying a point force at 45 degrees to the long angle of the tooth.

RESULTS

Mean fracture threshold was 103.7 +/- 53.1 kg for group I versus 202.7 +/- 125.0 kg for group II (differences significant with P = .003). In group II, however, fracture nearly always affected the tooth itself, whereas in group I, the post-core nearly always failed first.

CONCLUSIONS

Significantly higher fracture thresholds were recorded for the cast post and core group. Teeth restored with cast posts typically showed fracture of the tooth, although at loads rarely occurring clinically.

Fracture resistance of endodontically treated roots after restoration

This study evaluated the shear strength resistance of endodontically treated roots that were restored by two different techniques. Twenty-seven recently extracted single-rooted teeth with similar anatomic characteristics were sectioned to obtain the same length for all specimens. Group I (GI) consisted of 14 roots restored with cast post-core (nickel-chromium alloy) and cemented using zinc phosphate cement; group II (GII) consisted of 13 roots restored with steel prefabricated posts (FKG) cemented with zinc phosphate cement and rotated with caution for anchorage. The crown portion of this group was made using a hybrid composite resin (Prisma APH). Results showed that on all specimens of GI the fracture occurred in the cervical root structure while in GII the composite resin fractured in all specimens. Statistical analysis showed a significantly higher resistance to fracture for GI than GII. The specimens were sectioned longitudinally for stereoscopic microscope analysis (63x) and did not show fracture lines in the dentin anchorage post area for any of the specimens.

Retention of three endodontic posts cemented with five dental cements

STATEMENT OF PROBLEM

The retention of a post is believed to be a major factor in restoration survival. Therefore the cement with the greatest in vitro retention property should give the best performance for a restoration.

PURPOSE

This study compared retentive values of three posts (Flexi-Post, AccessPost, and ParaPost) cemented with five cements (Flexi-Flow, zinc phosphate, Advance, Duet, and Ketac-Cem) plus a control group that consisted of a Flexi-Post No. 2 dowel without cement.

MATERIAL AND METHODS

A total of 160 recently extracted human single-rooted teeth with crowns removed at the cementoenamel junction were divided into 16 groups of 10 samples. Post holes were prepared according to manufacturers' instructions. Posts were then cemented with one of the five cements. Each sample was placed into a specialized jig and on a tensile testing machine with crosshead speed of 0.638 cm/minute, applied until failure. A two-way analysis of variance and Newman-Keuls multiple range comparison tests were performed for all cemented groups. A one-way analysis of variance and a Student-Newman-Keuls multiple range comparison test were performed only for the groups with the Flexi-Post dowel, this included the no cement condition, with significant results if p < 0.05.

RESULTS

Flexi-Post dowel with Flexi-Flow Natural cement obtained the highest retentive value (303.91 pounds). ParaPost dowel with Duet cement exhibited the lowest retention value (21.23 pounds). The Flexi-Post dowel demonstrated higher mean retention than AccessPost or ParaPost dowels, AccessPost dowel was higher than ParaPost dowel. Flexi-Flow cement had the highest overall mean retention followed, in decreasing order, by zinc phosphate, Advance, Ketac-Cem, and Duet cements.

CONCLUSIONS

Flexi-Post dowel was the most retentive post studied with values ranging from 303.91 pounds with Flexi-Flow Natural cements to 150.93 pounds without cement. Flexi-Flow cements had a higher overall mean retention than other cements studied.

Esthetic, biologic and restorative considerations in coronal segment reattachment for a fractured tooth: a clinical report

Reattachment of a fractured clinical crown involving minimal invasion of the biologic width can be accomplished without conventional ostectomy and crown lengthening so that satisfactory esthetics can be achieved. Adhesive techniques sometimes in conjunction with traditional mechanical retention, such as a post, can be used to reattach the fractured segment. An esthetic result can be obtained with a minimal number of procedures and cost to the patient.

Fracture strengths of three core restorative materials supported with or without a prefabricated split-shank post

PURPOSE

The aim of this study was to compare the fracture strengths of three restorative materials, a lanthanide reinforced composite (Ti-Core Natural), a silver amalgam (Tytin), and a hybrid glass ionomer (Advance), supported by either a multitiered, threaded split-shank post (Flexi-Flange) or with a dentin spur without a post.

MATERIAL AND METHODS

A total of 60 recently extracted single-rooted human teeth were divided into six groups of 10. All groups were stored at 100% humidity at room temperature for 1 week before testing. Each specimen was placed in a special jig at a 45-degree angle to the buccolingual axis and subjected to a load that was recorded in pounds and converted to Newtons on a universal testing machine, with a crosshead speed of 0.63 cm/minute until failure. Two-way analysis of variance followed by the Newman-Keuls pairwise multiple comparisons test were used to compare the results.

RESULTS

There was a statistically significant difference between core materials (p < 0.001), but not regarding post conditions. Ti-Core Natural material had a significantly larger mean failure threshold for fracture than either Tytin silver amalgam or Advance material and the letter two core materials (Tytin and Advance) do not differ from each other. There was no statistical difference between Ti-Core material supported by a post and Ti-Core material supported without a post.