Carbon fiber post adhesion to resin luting cement in the restoration of endodontically treated teeth

Carbon nanomaterials: A growing tool for the diagnosis and treatment of diabetes mellitus

Diabetes mellitus is a growing disease that affects people of different ages due to deficiencies in insulin action and secretion. Diabetes causing long-term hyperglycemia damages, destroys, and fails essential organs, including kidneys, eyes, hearts, nerves, and blood vessels. The involvement of pathogenic factors makes diabetes mellitus a severe disease. The autoimmune process results in insulin deficiency by destroying the beta-cells in the pancreas. This leads to insulin resistance. As a result of defects and abnormalities in fat, carbohydrate, and protein synthesis, insulin does not work as it should on the target tissues. As diabetes mellitus becomes, more severe, long-term and effective treatment becomes necessary. A wide range of nanomaterials can be used to treat diabetes mellitus in patients. In addition to being potential imaging, diagnostic, and treatment agents for diabetes mellitus, carbon nanomaterials (CNMs) are another group of nanoparticles that exhibit potential interest. The CNMs acts as implantable nanosensor to track and detect blood glucose level in patients with diabetes. CNMS are possible drug carriers that can treat diabetes mellitus selectively, precisely, and effectively. Diabetes mellitus can be diagnosed and treated with CNMs due to their structural specificity and high drug-loading efficiency. The present review explores CNMs for their types, synthesis, and anti-diabetic properties. This review aims to provide a detailed view of the new technology that can be used to decipher the mechanism of CNMs in diabetes mellitus.

Fracture Strength and Failure Modes of Endodontically Treated Premolars Restored with Compact and Hollow Composite Posts Subjected to Cyclic Fatigue

Physical and mechanical properties of continuous carbon or glass fiber reinforced endodontic posts are relevant to increase the retention and resistance of the tooth-restoration system. Hollow posts have been recently designed for delivering the luting cement through the post hole, thus enhancing the post-dentin interface by reducing the risk of air bubbles formation. Methods: Three type of endodontic posts, a carbon fiber hollow post, a glass fiber hollow post and a compact glass fiber post were investigated. Mechanical properties of these posts were assessed through bending tests. Teeth were subjected to fatigue cycling and the strength of restored teeth was detected through static tests. Failure modes were investigated through optical and scanning electron microscopy. Results show that composite posts increase the mechanical stability by more than 100% compared to premolars restored with particulate composite. Carbon fiber posts retain the highest strength (1467 N ± 304 N) among the investigated post and core restoration, but an unfavorable type of fracture has been observed, preventing the tooth re-treatment. Instead, more compliant posts (i.e., glass fiber reinforced composite, providing a strength of 1336 N ± 221 N), show a favorable mode of fracture that allows the re-treatment of teeth in the case that failure occurs. Glass fiber hollow posts show a good trade-off between strength and a favorable type of fracture.

Investigation of the Match Relation between Steel Fiber and High-Strength Concrete Matrix in Reactive Powder Concrete

This study investigated the strength and toughness of reactive powder concrete (RPC) made with various steel fiber lengths and concrete strengths. The results indicated that among RPC samples with strength of 150 MPa, RPC reinforced with long steel fibers had the highest compressive strength, peak strength, and toughness. Among the RPC samples with strength of 270 MPa, RPC reinforced with short steel fibers had the highest compressive strength, and peak strength, while RPC reinforced with medium-length steel fibers had the highest toughness. As a result of the higher bond adhesion between fibers and ultra-high-strength RPC matrix, long steel fibers were more effective for the reinforcement of RPC with strength of 150 MPa, while short steel fibers were more effective for the reinforcement of RPC with strength of 270 MPa.

An analysis on the potential of diode-pumped solid-state lasers for dental materials

Material structure-property relationship is strongly related to the employed process technology. Over the past years, laser processing of engineering materials has been proposed in many fields and different uses for diode lasers have been found in dentistry. In this contest, the potential of GaN- and InGaN-based laser diodes to cure dental materials was analysed. Two wavelengths of 405 nm and 445 nm were used as heat or light sources for warm condensation of gutta-percha, light transmission in dental posts and brackets or light curing of dental composites. Additive manufacturing approach was considered to fabricate 3D root analogues, suitable supports, positioning systems and moulds for optical measurements. A three-axis CAD/CAM system was implemented for positioning and aligning the laser beam. The ability of diode-pumped solid-state lasers to cure dental materials or to transmit light was compared to that of a traditional instrument. Temperature profile at the apex of an additive manufactured root canal sealed with gutta-percha, light transmission through translucent quartz fiber post or through aesthetic ceramic bracket, bending properties and morphological features of light cured dental composites (Gradia Direct - GC Corporation and Venus Diamond - Heraeus Kulzer) were measured. Results showed a very high potential of diode-pumped solid-state lasers to be used in endodontics, orthodontics and restorative dentistry.

Temperature Profiles Along the Root with Gutta-percha Warmed through Different Heat Sources

OBJECTIVES

To evaluate temperature profiles developing in the root during warm compaction of gutta-percha with the heat sources System B and System MB Obtura (Analityc Technology, Redmond, WA, USA). Thirty extracted human incisor teeth were used. Root canals were cleaned and shaped by means of Protaper rotary files (Dentsply-Maillefer, Belgium), and imaging was performed by micro-CT (Skyscan 1072, Aartselaar, Belgium).

METHODS

Teeth were instrumented with K-type thermocouples, and the roots were filled with thermoplastic gutta-percha. Vertical compaction was achieved through the heat sources System B and System MB, and temperature profiles were detect-ed by means of NI Dac Interface controlled by the LabView System. With both heat sources, higher temperature levels were recorded in the region of the root far from the apex. When the warm plugger tip was positioned at a distance of 3 mm from the root apex, temperature levels of about 180°C were used to soften gutta-percha, and no statistically significant differences were observed between peak temperatures developed by the two heating sources at the root apex. However, a temperature level higher than 40°C was maintained for a longer time with System MB.

RESULTS

Statistically significant differences were observed in peak temperature levels recorded far from the root apex. Thus, with a temperature of about 180°C and the warm plugger positioned at 3 mm from the root apex, both heating sources led to a temperature slightly higher than 40°C at the apex of the root, suggesting that the gutta-percha was properly softened.

SIGNIFICANCE

A temperature level higher than 40°C was maintained for a longer time with System MB, thus providing an ad-equate time for warm compaction of the gutta-percha.

[Carbon/carbon implants in oral and maxillofacial surgery -- part 1]

Over the past 20-30 years various carbon implant materials have become more interesting, because they are well accepted by the biological environment. The traditional carbon-based polymers give rise to many complications. The polymer complication may be eliminated through carbon fibres bound by pyrocarbon (carbon/carbon).

AIM

The aim of this study is to present the long-term results of carbon/carbon implants.

METHODS

Mandibular reconstruction was performed with pure (99.99%) carbon implants in 16 patients. Predominantly tumorous cases were included (10 malignant tumors, 4 large cystic lesions and 2 augmentative processes).

RESULTS

Because the interventions had been performed 6-8 years before the last follow-up visit, the authors report long-term results. Of the 16 patients, the implants had to be removed earlier in 5 patients because of the defect that arose on the oral mucosa above the carbon plates. The most probable cause of this complication was the strain in the oral mucosa and disturbances in its blood supply (previous surgery, irradiated tissue, etc.). During the long-term follow-up, plate fracture, loosening of screws, infection or inflammation around the carbon/carbon implants were not observed. After 8 years one carbon implant was substituted with an autogenous bone.

CONCLUSIONS

The clinical conclusion is that if the soft part cover is appropriate, the carbon implants are cosmetically and functionally more suitable than titanium plates. The structural and chemical investigation of the removed implant will be published in the near future.

Stress analysis of endodontically treated teeth restored with post-retained crowns: A finite element analysis study

BACKGROUND

The authors conducted a study to analyze the stress concentration areas in a tooth restored with a post-retained crown under various conditions.

MATERIALS AND METHODS

The authors constructed a three-dimensional finite element model describing a maxillary second premolar restored with an all-ceramic crown supported by a titanium post and a resin-based composite core. They applied static vertical and horizontal loads of 100 newton to the cusp tip of the crown and recorded Von Mises and tensile stress values. The variables investigated were the presence of the post, coronal and apical post extensions, post diameter, post shape, and post and core material.

RESULTS

The study results showed that horizontal loading generated higher levels of stress than did vertical loading. The greatest stress levels were concentrated at the cervical region and at the post-dentin interface in all models. Under both loads, a higher modulus of elasticity of the post material and a wider post diameter were associated with increased stress values at the post-dentin interface. Reduction of the post extension above the level of bone was associated with increased dentinal stresses near the apex of the post.

CONCLUSIONS

Although endodontic posts provide retention for coronal restorations, they result in dentinal stress values higher than those of crowns without posts. Posts that had a similar modulus of elasticity to dentin and smaller diameters were associated with better stress distribution. Resting coronal restorations on sound dental tissues affected stress distribution more than did the core material or the length of the coronal post extension.

CLINICAL IMPLICATIONS

Many factors influence the distribution of stress within dentin and, consequently, the fracture resistance of teeth restored with post-retained crowns. Clinicians need to keep these factors in mind when performing endodontic procedures that involve placement of post-retained crowns to ensure optimal success.

Three-point bending testing of fibre posts: critical analysis by finite element analysis

AIM

To evaluate the effect of taper, specimen supports and the isotropic and orthotropic properties of the posts on flexure and stress response during three-point bending using finite element analysis.

METHODOLOGY

A three-dimensional finite element model of a fibre post was created. The occlusal portion was cylindrical whilst the apical portion was tapered. Five different support positions were evaluated during a simulated three-point bending test: M1 - support distance of 10 mm centralized and no tilt; M2 - 10 mm centralized with tilt; M3 - 10 mm not centralized and no tilt; M4 - 10 mm not centralized with tilt; M5 - 6 mm not centralized with no tilt. A sixth post model (M6) was a centralized post without tapered section. The applied properties were elastic and orthotropic.

RESULTS

Tilting the tapered posts to level them in the test setup had little effect on the outcome. Flexure increased when 50% of the bent portion involved taper (M1, M2). If only 20% of the bent post involved taper (M3, M4), the flexure values were close to M6 (no taper). The orthotropic properties also caused increased flexure compared to an isotropic post. Maximum stresses were only a little higher when 50% of the bend structure involved taper, whilst the orthotropic properties had little effect.

CONCLUSIONS

Regardless of levelling, the flexural stress determination with tapered fibre posts in the three-point bending test was valid as long as the tapered portion was limited in length.

Effect of a Ferrule and Increased Clinical Crown Length on the In Vitro Fracture Resistance of Premolars Restored Using Two Dowel-and-Core Systems

Crown lengthening with a 2.0 mm apical extended ferrule preparation may result in reduced root fracture strengths for endodontically-treated teeth. A carbon fiber-reinforced dowel-resin core system may reduce the severity of the root fractures.

Accelerated aging of adhesive-mediated fiber post-resin composite bonds: A modeling approach

OBJECTIVES

Although fiber posts luted in root canals are not directly exposed to oral fluids, water storage is considered as in vitro accelerated aging test for bonded interfaces. The aim of the study was to evaluate the influence of accelerated water aging on fiber post-resin composite adhesion.

METHODS

Forty fiber posts (DT Light Post, RTD) were randomly divided into two main groups, according to the surface treatment performed. Group I: XPBond adhesive (Dentsply Caulk); Group II: sandblasting (Rocatec-Pre, 3M ESPE) and XPBond. Dual-cured resin cement (Calibra, Dentsply Caulk) and flowable composite (X-Flow, Dentsply Caulk) were applied on the posts to produce cylindrical specimens. The bond strength at the interface between post and cement/composite was measured with the microtensile test according to the non-trimming technique. Half of the sticks were tested immediately for bond strength, while in the other half testing was performed after 1 month of water storage at 37 degrees C. Post-cement/composite interfaces were evaluated under SEM prior and after water aging. Statistical analysis was performed using the Kruskal-Wallis ANOVA followed by Dunn's multiple range test (p<0.05).

RESULTS

Immediate bond strength was higher on sandblasted posts. After water aging the two post surface treatments resulted comparable in bond strength. Resin cement achieved higher bond strength to fiber posts than flowable composite. Water aging significantly reduced bond strength.

CONCLUSIONS

Sandblasting followed by adhesive coating may improve immediate post-resin bond strength in comparison to adhesive alone. However, fiber post-resin bond strength mediated by hydrophilic adhesive tends to decrease after water aging.

Three-dimensional finite element analysis of strain and stress distributions in endodontically treated maxillary central incisors restored with diferent post, core and crown materials

OBJECTIVES

The present comparative analysis aimed at evaluating which combination of restorative materials resulted in the most homogeneous stress and strain distributions.

METHODS

A three-dimensional finite element analysis was performed. All the nodes on the external surface of the root were constrained in all directions. Eighteen experimental models with different material properties and configurations were simulated. An arbitrary load of 10N was applied at 60 degrees angle with tooth longitudinal axis on the palatal surface of the crown. Von Mises (equivalent stresses) energetic criterion was chosen.

RESULTS

In all the models the values of both strain and stress recorded at the middle third of the buccal aspect of the root surface were at their maxima. On the contrary, the minimum values were noticed at level of both the apical portion of the post and the root apex. The maximum stresses were evidenced at level of the cemento-enamel junction (CEJ) on both the buccal and palatal aspects of root cement and dentin. Stress progressively decreased from the outer to the inner part of the root and from the CEJ towards the incisal margin of the crown as well.

SIGNIFICANCE

The results of the present study would allow clinicians to make an informed choice from among available materials to restore endodontically treated teeth.

The effect of sandblasting on adhesion of a dual-cured resin composite to methacrylic fiber posts: Microtensile bond strength and SEM evaluation

OBJECTIVES

To evaluate the influence of different surface treatments on the microtensile bond strength of a dual-cured resin composite to fiber posts.

METHODS

Thirty-two glass methacrylate-based fiber posts (GC Corp.) were used in the study. Posts were divided into two groups, according to the surface pretreatment performed. Group 1: sandblasting (Rocatec-Pre, 3M ESPE). Group 2: no pretreatment. In each of the two groups posts received three types of additional "chair-side" treatments. (1) Silane application (Monobond S, Ivoclar Vivadent); (2) adhesive application (Unifil Core self-etching bond, GC); (3) no treatment was performed. A dual-cured resin composite (Unifil Core, GC) was applied on the posts to produce cylindrical specimens. Specimens were cut to obtain microtensile sticks that were loaded in tension at a cross-head speed of 0.5mm/min until failure. The morphology of the post/composite interface and the post surface morphology were evaluated under SEM. Statistical analysis was performed with two-way ANOVA and Tukey test for post hoc comparisons (p<0.05).

RESULTS

Post surface pretreatment did not prove to be a significant factor in post-composite bond strength (p=0.08), whereas "chair-side" treatment modalities and the interaction between pretreatment and treatment showed a significant influence on bond strength (p<0.001). When no "chair-side" treatment was performed, bond strength was significantly higher on sandblasted posts. Additional adhesive application resulted in significantly lower bond strength on sandblasted posts. When no pretreatment was performed, silane application resulted in higher bond strength than adhesive application.

CONCLUSIONS

Sandblasting may give an increase in microtensile strength to methacrylate-based glass fiber posts, eliminating the need for additional "chair-side" treatments. Reducing the number of clinical steps could contribute to simplify the clinical procedures.

Evaluation of the biomechanical behavior of maxillary central incisors restored by means of endocrowns compared to a natural tooth: A 3D static linear finite elements analysis

OBJECTIVE

The present study aimed at evaluating different restoring configurations of a crownless maxillary central incisor, in order to compare the biomechanical behavior of the restored tooth with that of a sound tooth.

MATERIALS AND METHODS

A 3D FE model of a maxillary central incisor is presented. An arbitrary static force of 10 N was applied with an angulation of 125 degrees to the tooth longitudinal axis at level of the palatal surface of the crown. Different material configurations were tested: composite, syntered alumina, feldspathic ceramic endocrowns and glass post resorations with syntered alumina and feldspathic ceramic crown.

RESULTS

High modulus materials used for the restoration strongly alter the natural biomechanical behavior of the tooth. Critical areas of high stress concentration are the restoration-cement-dentin interface both in the root canal and on the buccal and lingual aspects of the tooth-restoration interface. Materials with mechanical properties underposable to that of dentin or enamel improve the biomechanical behavior of the restored tooth reducing the areas of high stress concentration.

SIGNIFICANCE

The use of endocrown restorations present the advantage of reducing the interfaces of the restorative system. The choice of the restorative materials should be carefully evaluated. Materials with mechanical properties similar to those of sound teeth improve the reliability of the restoartive system.

Effectiveness and dentin bond strengths of two materials for reinforcing thin-walled roots

OBJECTIVES

To investigate the effectiveness of two restorative materials for reinforcing thin-walled roots and their microtensile bond strengths to root canal dentin.

METHODS

Twenty-one decoronated maxillary central incisor roots were root filled and the canals enlarged to leave approximately 1.0 mm thick dentin walls. The roots were distributed randomly to three equal groups. Group 1 (control): a large tapered cast post-core was fabricated. Group 2 (BIS-CORE): a thick layer of dual-cured composite was placed in the post-hole before fabrication of a small-diameter tapered cast post-core. Group 3 (ChemFil Superior): a thick layer of glass-ionomer was placed, as before. Metal-ceramic crowns were fabricated for all teeth. Microtensile bond strength tests and optical and atomic force microscope observations were employed to examine adhesion between the two restorative materials and the root canal dentin.

RESULTS

Mechanical loading (kN) demonstrated that composite 0.64 (S.D. 0.05), but not glass-ionomer 0.49 (0.05), significantly reinforced the fracture resistance of thin-walled roots, P<0.001. Microtensile bond strengths (MPa) were 21.7 (1.6) for composite and 12.9 (1.7) for glass-ionomer, P=002.

SIGNIFICANCE

A thick intermediate layer of resin-bonded composite, sandwiched between the root dentin and a small-diameter cast Ni-Cr post or dowel, increased significantly the fracture resistance of the roots.

3D FEA of cemented steel, glass and carbon posts in a maxillary incisor

OBJECTIVES

A comparative study on the stress distribution in the dentine and cement layer of an endodontically treated maxillary incisor has been carried out by using Finite Element Analysis (FEA). The role of post and cement rigidity on reliability of endodontic restorations is discussed.

METHODS

A 3D FEM model (13,272 elements and 15,152 nodes) of a central maxillary incisor is presented. A chewing static force of 10 N was applied at 125 degree angle with the tooth longitudinal axis at the palatal surface of the crown. Steel, carbon and glass fiber posts have been considered. The differences in occlusal load transfer ability when steel, carbon and glass posts, fixed to root canal using luting cements of different elastic moduli (7.0 and 18.7 GPa) are discussed.

RESULTS AND SIGNIFICANCE

The more stiff systems (steel and carbon posts) have been evaluated to work against the natural function of the tooth. Maximum Von Mises equivalent stress values ranging from 7.5 (steel) to 5.4 and 3.6 MPa (respectively, for carbon posts fixed with high and low cement moduli) and to 2.2 MPa (either for glass posts fixed with high and low cement moduli) have been observed under a static masticatory load of 10 N. A very stiff post works against the natural function of the tooth creating zones of tension and shear both in the dentine and at the interfaces of the luting cement and the post. Stresses in static loading do not reach material (dentine and cement) failure limits, however, they significantly differ leading to different abilities of the restored systems to sustain fatigue loading. The influence of the cement layer elasticity in redistributing the stresses has been observed to be less relevant as the post flexibility is increased.