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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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Martinho FC, Bisi BG, Gavini G, Griffin IL, Tordik PA. Comparison of the Accuracy and Efficiency of Two Dynamic Navigation System Workflow for Fiber-Post Removal: Small versus Large Field-of-View Registration Workflows. J Endod 2024:S0099-2399(24)00363-7. [PMID: 38945199 DOI: 10.1016/j.joen.2024.06.011] [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: 04/09/2024] [Revised: 06/18/2024] [Accepted: 06/21/2024] [Indexed: 07/02/2024]
Abstract
INTRODUCTION This study investigates the feasibility of a dynamic navigation system (DNS) small field of view workflow (DNS-SFOVw) for fiber-post removal and compares its accuracy and efficiency to the conventional large field of view workflow (DNS-LFOVw). METHODS Fifty-six extracted human maxillary molars were divided into DNS-SFOVw (n=28) and DNS-LFOVw (n=28). The palatal canal was restored with an intra-radicular RelyX fiber post and luted with RelyX Unicem; a core buildup was used. Teeth were mounted in a 3D-printed surgical jaw. A preoperative cone-beam-computed tomography (CBCT) scan was taken with a 40 x 40 mm FOV for the DNS-SFOVw and a single arch CBCT scan for the DNS-LFOVw. The drilling entry point, trajectory, angle, and depth were planned in the X-guide software. The DNS registration method for the DNS-SFOVw was virtual-based registration on teeth, and the marker point-based method was used for the DNS-LFOVw. The fiber posts were drilled out under DNS guidance. A postoperative CBCT scan was taken. Three-dimensional (3D) deviations, angular deflection, number of mishaps, registration, and total operation time were calculated. RESULTS The DNS-SFOVw was as accurate as DNS-LFOVw (p>.05). The DNS-LFOVw registration time was less than DNS-SFOVw (p<.05). There was no difference in the number of mishaps (p>.05). Both DNS-SFOVw and DNS-LFOVw were time-efficient, with DNS-LFOVw taking less total operational time (p<.05). CONCLUSION Within the limitations of this in-vitro study, the DNS-SFOVw was as accurate as the DNS-LFOVw for fiber-post removal. Both DNS-LFOVw and DNS-SFOVw were time-efficient in removing fiber-posts.
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Affiliation(s)
- Frederico C Martinho
- Clinical Professor - Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry - Baltimore - Maryland.
| | - Bruno G Bisi
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil; and Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry - Baltimore - Maryland
| | - Giulio Gavini
- Clinical Professor - Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Ina L Griffin
- Clinical Assistant Professor - Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry - Baltimore - Maryland
| | - Patricia A Tordik
- Clinical Professor - Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry - Baltimore - Maryland
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Martinho FC, Qadir SJ, Griffin IL, Melo MAS, Fay GG. Augmented Reality Head-Mounted Device and Dynamic Navigation System for Postremoval in Maxillary Molars. J Endod 2024; 50:844-851. [PMID: 38369102 DOI: 10.1016/j.joen.2024.02.004] [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: 09/29/2023] [Revised: 01/20/2024] [Accepted: 02/07/2024] [Indexed: 02/20/2024]
Abstract
INTRODUCTION This study evaluates the feasibility of an augmented reality (AR) head-mounted device (HMD) displaying a dynamic navigation system (DNS) in the surgical site for fiber postremoval in maxillary molars and compares it to the DNS technique. METHODS Fifty maxillary first molars were divided into 2 groups: AR HMD + DNS (n = 25) and DNS (n = 25). The palatal canal was restored with RelyX fiber post (3M ESPE) luted with RelyX Unicem (3M ESPE). A core buildup was performed using Paracore (Coltene/Whaledent). Cone beam computed tomography (CBCT) scans were taken before and after postremoval. The drilling trajectory and depth were planned under X-guide software (X-Nav Technologies, Lansdale, PA). For the AR HMD + DNS group, the AR HMD (Microsoft HoloLens 2) displayed the DNS in the surgical site. The three dimensional (3D) deviations (Global coronal deviation [GCD] and global apical deviation [GAD]) and angular deflection (AD) were calculated. The number of mishaps and operating time were recorded. RESULTS Fiber post was removed from all samples (50/50). The AR HMD + DNS was more accurate than DNS, showing significantly lower GCD and GAD deviations and AD (P < .05). No mishap was detected. The AR HMD + DNS was as efficient in time as DNS (P > .05). CONCLUSIONS Within the limitations of this in vitro study, the AR HMD can safely display DNS in the surgical site for fiber post-removal in maxillary molars. AR HMD improved the DNS accuracy. Both AR HMD + DNS and DNS were time-efficient for fiber postremoval in maxillary molars.
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Affiliation(s)
- Frederico C Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland.
| | - Syed J Qadir
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Ina L Griffin
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Mary Anne S Melo
- Division of Operative Dentistry, Department of General Dentistry, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Guadalupe G Fay
- Division of Prosthodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
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Wang ZF, Fu BP. Minimum residual root dentin thickness of mandibular premolars restored with a post: A finite element analysis study. J Prosthet Dent 2024; 131:878-885. [PMID: 35489836 DOI: 10.1016/j.prosdent.2022.03.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 03/21/2022] [Accepted: 03/21/2022] [Indexed: 10/18/2022]
Abstract
STATEMENT OF PROBLEM Thin root dentin after post space preparation will increase the risk of root fracture. However, the minimum residual root dentin thickness to be preserved after post space preparation is unclear. PURPOSE The purpose of this finite element analysis (FEA) study was to measure the residual root dentin thicknesses and analyze the stress distributions of post-restored mandibular premolars. MATERIAL AND METHODS The cone beam computed tomography (CBCT) data of 90 first and second mandibular premolars from Chinese participants (44 men, 46 women; aged between 20 and 79 years) were analyzed. Cross-sections 5 to 9 mm from the radiologic apex were used to measure the buccolingual and mesiodistal root diameters. The probability that the residual thickness of the buccolingual and mesiodistal root walls would be no less than 0.5, 0.6, 0.7, 0.8, 0.9, and 1 mm after post space preparation with a #2 Peeso reamer was calculated. Six 3-dimensional finite element models of cast post-restored mandibular premolars with 0.5, 0.6, 0.7, 0.8, 0.9, and 1 mm mesial and distal root dentin thicknesses were established. A static force of 100 N was applied to the buccal cusp tip at 45, 60, 75, and 90 degrees to the long axis of the tooth, and the maximum tensile stress and von Mises stress were analyzed. The Bonferroni post hoc test (αcorrected=.003) was used for multiple comparisons. RESULTS The buccolingual root diameter of mandibular premolars was wider than the mesiodistal root diameter. The probabilities that the mesiodistal residual root dentin thickness of mandibular first and second premolars at 5 mm from the apex would be no less than 1 mm after post space preparation with a #2 Peeso reamer were only 10% and 28%, respectively. The maximum tensile stress was at a minimum when the mesial and distal residual root dentin thickness was 0.6 mm in the external cervical dentin adjacent to the crestal bone and 1 mm in the apical dentin corresponding to the apex of the post. The maximum tensile stress of the mandibular premolar model with 0.6-mm mesial and distal residual root dentin thicknesses was lower than that with 0.9 mm and 1.0 mm thicknesses (Pcorrected<.001). CONCLUSIONS Short posts or smaller instruments for post space preparation are recommended to obtain a 1-mm residual root dentin thickness in the mesiodistal direction of mandibular premolars. If a 1-mm thickness cannot be preserved, a minimum residual root dentin thickness of 0.6 to 0.9 mm in the mesiodistal direction should be retained.
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Affiliation(s)
- Ze-Feng Wang
- Dental Attending Physician, Department of Prosthodontic, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, PR China
| | - Bai-Ping Fu
- Professor, Department of Prosthodontic, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, PR China.
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Krug R, Schwarz F, Dullin C, Leontiev W, Connert T, Krastl G, Haupt F. Removal of fiber posts using conventional versus guided endodontics: a comparative study of dentin loss and complications. Clin Oral Investig 2024; 28:192. [PMID: 38438798 PMCID: PMC10912265 DOI: 10.1007/s00784-024-05577-7] [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: 01/04/2024] [Accepted: 02/24/2024] [Indexed: 03/06/2024]
Abstract
OBJECTIVES To compare the efficacy of fiber post removal using conventional (CONV) versus guided endodontics (GE) in terms of dentin loss, residual resin material, procedural errors, and working time in vitro. MATERIAL AND METHODS Ninety human central incisors were root-filled and scanned by micro-computed tomography (CT), then restored with fiber posts and composite. Twenty-four sets of teeth with up to four human maxillary central incisors were fabricated and divided into three groups: conventional post removal by a general dentist (CG) or endodontology specialist (CS) and guided endodontics (GE) by a general dentist, yielding 30 teeth per operator and group. After treatment, the prepared access cavities were volumetrically assessed by micro-CT. Statistical significance was evaluated by one-way analysis of variance followed by post hoc comparisons with Tukey's HSD test and Pearson's chi-squared test for independence. RESULTS Both CONV and GE resulted in dentin loss and residual resin material. CS resulted in more dentin loss and less residual resin material than CG and GE (p < .05). All groups had some deviations from the original root canal but no perforations. The shortest working time was observed in the GE group. CONCLUSIONS Compared to the conventional freehand technique, GE resulted in significantly less radicular dentin loss, a few deviations but no perforations. CLINICAL RELEVANCE Guided endodontics can improve the speed and safety of fiber post removal without root perforation.
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Affiliation(s)
- R Krug
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology, University Hospital of Würzburg, Pleicherwall 2, 97070, Würzburg, Germany.
| | - F Schwarz
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology, University Hospital of Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - C Dullin
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - W Leontiev
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - T Connert
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - G Krastl
- Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology, University Hospital of Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - F Haupt
- Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
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Reich SM, Walther KA, Wöstmann B, Rehmann P, Vogler JAH. How long must a post be? A retrospective survival analysis on a large cohort with long follow-ups. J Dent 2024; 142:104879. [PMID: 38311019 DOI: 10.1016/j.jdent.2024.104879] [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: 12/19/2023] [Revised: 01/15/2024] [Accepted: 02/01/2024] [Indexed: 02/06/2024] Open
Abstract
OBJECTIVES Post and core (PC) is frequently used, but clinical evidence concerning how long a post must be is scarce. Recommendations in dental literature range from half of the root which should be incorporated, to post space preparations conducted as deep as possible increasing the risk for root perforation thus tooth loss. Therefore, the aim of this retrospective survival analysis is to evaluate the post length as well as the post-clinical crown ratio on a large patient cohort with long follow-ups. MATERIALS AND METHODS Overall 1026 PC in 731 patients could be included in this study (2004-2023). The files were analysed due to the parameters post length and post-clinical crown ratio on X-Ray. Furthermore, the influence of the type of covering prosthetic restoration, location, type of tooth, luting material, PC material, bone attachment and therapist was evaluated. The statistical analysis was assessed using Kaplan-Meier (univariate influences) and Cox regression (multifactorial influences). RESULTS Survival until extraction as well as decementation was significantly influenced by bone attachment and covering prosthetic restoration. Posts reaching the middle third of the root showed highly significant (p < 0.001) better survival probabilities than those reaching the coronal or apical third. Regarding the post-clinical crown ratio, no significant difference was found for post = crown/post > crown, whereas post CONCLUSIONS The post space preparation should not be extended over the middle third of the root, but has to be deep enough to ensure that the post is at least as long as the clinical crown. CLINICAL SIGNIFICANCE Against the background of the large sample size and the long follow-ups, the results of this retrospective survival analysis are suitable to give general recommendations regarding how long a post has to be in order to ensure the best survival probability for PC treatment.
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Affiliation(s)
- Sarah Marie Reich
- Justus Liebig University, Dental Clinic - Department of Prosthodontics, Schlangenzahl 14, 35392 Giessen, Germany
| | - Kay-Arne Walther
- Justus Liebig University, Dental Clinic - Department of Prosthodontics, Schlangenzahl 14, 35392 Giessen, Germany
| | - Bernd Wöstmann
- Justus Liebig University, Dental Clinic - Department of Prosthodontics, Schlangenzahl 14, 35392 Giessen, Germany
| | - Peter Rehmann
- Justus Liebig University, Dental Clinic - Department of Prosthodontics, Schlangenzahl 14, 35392 Giessen, Germany
| | - Jonas Adrian Helmut Vogler
- Justus Liebig University, Dental Clinic - Department of Prosthodontics, Schlangenzahl 14, 35392 Giessen, Germany.
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Vogler JAH, Stummer AL, Walther KA, Wöstmann B, Rehmann P. Survival of teeth treated with post and core - A retrospective study of more than 1000 cases with observation periods up to 18 years. J Dent 2023; 138:104723. [PMID: 37742809 DOI: 10.1016/j.jdent.2023.104723] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/11/2023] [Accepted: 09/21/2023] [Indexed: 09/26/2023] Open
Abstract
OBJECTIVES Even if survival of post and core (PC) itself was frequently investigated in recent literature, clinical data concerning the risk for extraction of teeth restored with PC is still scarce. Since most authors found the loss of retention of refitable post and cores as the most common cause of failure, it is impossible to draw a conclusion on tooth survival on the results of those studies. Therefore, the aim of the present study was to improve the clinical evidence on the survival of teeth treated with post and cores on a large number of cases over a long observation period. MATERIALS AND METHODS 735 patients were treated with 1053 post and cores in the observation period (2004-2022) and could be included in the study. The patient files were analysed due to the parameters: Type of covering prosthetic restoration, location, type of tooth, luting material, post and core material, bone attachment and therapist. The survival probability was assessed using Kaplan-Meyer analysis. Cox regression was used to assess possible multifactorial influences. RESULTS The overall average survival time until necessary extraction of a tooth restored with a post and core was 11.74 years. A root fracture in primary crown retained removeable partial dentures (RPDs) during the first five years was the most common reason for extraction in this study. A significant influence on the survival time of teeth restored with post and cores was found for the type of covering restoration, bone attachment, age of the patient and post and core material. CONCLUSIONS Post and core restored teeth should be avoided as abutments for primary crown retained RPDs. CLINICAL SIGNIFICANCE If it is inevitable to utilise post and core restored teeth for primary crown retained RPDs, post and core materials with matching mechanical properties to that of dentine should be preferred.
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Affiliation(s)
- Jonas Adrian Helmut Vogler
- Dental Clinic - Department of Prosthodontics, Justus Liebig University, Schlangenzahl 14, Giessen 35392, Germany.
| | - Anna-Lena Stummer
- Dental Clinic - Department of Prosthodontics, Justus Liebig University, Schlangenzahl 14, Giessen 35392, Germany
| | - Kay-Arne Walther
- Dental Clinic - Department of Prosthodontics, Justus Liebig University, Schlangenzahl 14, Giessen 35392, Germany
| | - Bernd Wöstmann
- Dental Clinic - Department of Prosthodontics, Justus Liebig University, Schlangenzahl 14, Giessen 35392, Germany
| | - Peter Rehmann
- Dental Clinic - Department of Prosthodontics, Justus Liebig University, Schlangenzahl 14, Giessen 35392, Germany
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Nawar NN, Abdelfattah RA, Kataia M, Saber SM, Kataia EM, Kim HC. Effect of Proximal Caries-driven Access on the Biomechanical Behavior of Endodontically Treated Maxillary Premolars. J Endod 2023; 49:1337-1343. [PMID: 37517584 DOI: 10.1016/j.joen.2023.07.022] [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: 06/15/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 08/01/2023]
Abstract
INTRODUCTION This study investigated the effects from the carious cavity and access from it on the fracture resistance of endodontically treated maxillary premolars using finite element analysis (FEA). METHODS A maxillary premolar was used to compare 3 types of access cavity related to having a proximal carious defect: caries-driven access (CDA), conservative access that has a mesial component (MCA), as well as traditional access with the same mesial component (MTA). Cyclic loading was simulated on the occlusal surface, and number of cycles until failure (NCF) was compared with the intact tooth model (IT). Mathematical analysis was done to evaluate the stress distribution patterns and calculated maximum von Mises (vM) and maximum principal stresses (MPS), with emphasis on pericervical region as a specific area of interest. RESULTS Maximum vM registered on the IT was 6.14 MPa. CDA provided the highest NCF with 92.28% of the IT, followed by MCA (84.90%) and MTA (83.79%). The vM and MPS analysis showed that the stress values and patterns are affected more by the proximity of the occlusal load to the tooth/restoration interface. Concerning the pericervical region, maximum vM was registered for IT (4.11 MPa), followed by CDA (4.85 MPa) and then MCA (8.13 MPa) and MTA (8.61 MPa), whereas the MPS analysis revealed that CDA showed the highest magnitude of tensile stresses. CONCLUSIONS A proximal CDA benefits the mechanical properties of maxillary premolars; however, its impact on the biological aspect should be assessed to provide a ruling for/against it.
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Affiliation(s)
- Nawar Naguib Nawar
- Department of Endodontics, Faculty of Dentistry, British University in Egypt (BUE), El Sherouk City, Egypt
| | | | - Mohamed Kataia
- Department of Endodontics, Faculty of Dentistry, British University in Egypt (BUE), El Sherouk City, Egypt
| | - Shehabeldin Mohamed Saber
- Department of Endodontics, Faculty of Dentistry, British University in Egypt (BUE), El Sherouk City, Egypt; Center for Innovative Dental Sciences (CIDS), Faculty of Dentistry, British University in Egypt (BUE), El Sherouk City, Egypt; Department of Endodontics, Ain Shams University, Cairo, Egypt
| | - Engy Medhat Kataia
- Department of Endodontics, Faculty of Dentistry, British University in Egypt (BUE), El Sherouk City, Egypt; Restorative and Dental Materials Department, National Research Centre, Doki, Egypt.
| | - Hyeon-Cheol Kim
- Department of Conservative Dentistry, Pusan National University School of Dentistry, Dental Research Institute, Dental and Life Science Institute, Yangsan, Korea.
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Vogler JAH, Billen L, Walther KA, Wöstmann B. Conventional cast vs. CAD/CAM post and core in a fully digital chairside workflow - An in vivo comparative study of accuracy of fit and feasibility of impression taking. J Dent 2023; 136:104638. [PMID: 37506812 DOI: 10.1016/j.jdent.2023.104638] [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: 04/14/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 07/30/2023] Open
Abstract
OBJECTIVES Clinical data for CAD/CAM post and cores (PC) is still scarce, even though developments in digital dentistry have improved dental treatment in many aspects. Therefore, the purpose of this in vivo study was to compare CAD/CAM PC fabricated in a fully digital chairside workflow to conventional cast PC (CPC) according to the accuracy of fit and the impression taking. The null hypothesis was that there is no significant difference between CAD/CAM PC and CPC. METHODS The study was conducted on 30 teeth in 25 patients receiving a CPC during their prosthetic treatment plan. On each tooth a conventional and a digital post impression were taken. Subsequently, one CPC following a conventional and one CAD/CAM PC following a digital workflow were fabricated. Both PC were tried-in intraorally and assessed according to a standardised evaluation sheet. The deviation between the two impression methods was evaluated by superimposing the datasets in a 3D analysis software. Statistical analysis for pairwise comparison was conducted according to Wilcoxon and median test with a significance level of p = 0.05. RESULTS CAD/CAM PC performed significantly better compared to CPC according to accuracy of fit (p = 0.022) and feasibility of impression taking (p < 0.001). The deviation between post impression methods increased from "coronal" to "apical". Between "coronal"/"middle" no significant difference (p = 0.158) was detected, whereas the pairwise comparison between the other measurement categories showed significant differences (p = 0.002, p < 0.001). CONCLUSIONS The null hypothesis was rejected since CAD/CAM PC performed significantly better and the deviation between the post impression methods showed significant differences. CLINICAL SIGNIFICANCE By using intraoral scanners (IOS) teeth can be restored with customised CAD/CAM PC in a single session. Within the limitations of this study the fully digital chairside workflow led to superior accuracy of fit of PC and higher feasibility of impression taking than the conventional workflow for CPC.
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Affiliation(s)
- Jonas Adrian Helmut Vogler
- Dental Clinic - Department of Prosthodontics, Justus Liebig University, Schlangenzahl 14, Giessen 35392, Germany.
| | - Louise Billen
- Dental Clinic - Department of Prosthodontics, Justus Liebig University, Schlangenzahl 14, Giessen 35392, Germany
| | - Kay-Arne Walther
- Dental Clinic - Department of Prosthodontics, Justus Liebig University, Schlangenzahl 14, Giessen 35392, Germany
| | - Bernd Wöstmann
- Dental Clinic - Department of Prosthodontics, Justus Liebig University, Schlangenzahl 14, Giessen 35392, Germany
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Hinz S, Bömicke W, Bensel T. Cumulative 10-year performance of endodontically treated teeth with prosthetic restorations of base metal alloy double crowns with friction pins-a retrospective study. Clin Oral Investig 2023; 27:4411-4423. [PMID: 37212841 PMCID: PMC10415510 DOI: 10.1007/s00784-023-05060-9] [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: 03/12/2023] [Accepted: 05/02/2023] [Indexed: 05/23/2023]
Abstract
OBJECTIVES This 120-month follow-up study aimed to investigate the complication rate of abutment teeth after endodontic pretreatment with base metal alloy double crowns with friction pins. MATERIALS AND METHODS A total of 158 participants (n = 71, 44.9% women) aged 62.5 ± 12.7 years with 182 prostheses on 520 abutment teeth (n = 459, 88.3% vital) were retrospectively analyzed between 2006 and 2022. Of the endodontically treated abutment teeth, 6.9% (n = 36) were additionally treated with post and core reconstructions. Cumulative complication rates were calculated using the Kaplan-Meier estimator and log-rank test. In addition, Cox regression analysis was performed. RESULTS The cumulative complication rate at 120 months for the entire set of abutment teeth was 39.6% (confidence interval [CI]: 33.0-46.2). Endodontically treated abutment teeth (33.8%; CI: 19.6-48.0) were found to have a significantly higher cumulative fracture rate than vital teeth (19.9%; CI: 13.9-25.9, p < 0.001). Endodontically treated teeth restored with post and core reconstructions (30.4%; CI: 13.2-47.6) showed a nonsignificant lower cumulative fracture rate than that of teeth with root fillings only (41.6%; CI: 16.4-66.8, p = 0.463). CONCLUSIONS Higher 120-month cumulative fracture rates were observed in endodontically treated teeth. Comparable performance was observed in teeth with post and core reconstructions compared to teeth with root fillings only. CLINICAL RELEVANCE If endodontically treated teeth are used as abutments for double crowns, the risk of complications from these teeth should be considered when planning treatment and communicating with the patient.
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Affiliation(s)
- Sebastian Hinz
- Department of Prosthetic Dentistry, University School of Dental Medicine, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 16, 06112, Halle, Germany.
| | - Wolfgang Bömicke
- Department of Prosthetic Dentistry, University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Tobias Bensel
- Institute for Research in International Assistance, Akkon University for Human Sciences, Colditzstraße 34-36, 12099, Berlin, Germany
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Shirani F, saatchi M, Shirani M, Jafari N. Evaluation of the Fracture Resistance of Conservative and Ultraconservative Access Cavity Designs with Different Treatment Modalities: An In Vitro Study. BIOMED RESEARCH INTERNATIONAL 2023; 2023:7247375. [PMID: 37483655 PMCID: PMC10359140 DOI: 10.1155/2023/7247375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 10/27/2022] [Accepted: 06/09/2023] [Indexed: 07/25/2023]
Abstract
Introduction The aim of this study was to evaluate the fracture resistance of endodontically treated mandibular molars using traditional and conservative access cavity preparation. Materials and Methods In this in vitro study, 100 extracted healthy human mandibular molars were selected and divided into 10 groups (n = 10). Healthy teeth in one group were considered the control group. In three groups, traditional access cavity preparation was done (groups A) without two marginal ridges (A1), with one marginal ridge (A2), and with two marginal ridges (A3). In three groups (group B), two separate access cavities with a dentinoenamel roof without two marginal ridges (B1), with one marginal ridge (B2), and with two marginal ridges (B3) were prepared. In three other groups (groups C), two separate access cavities were prepared only with a dentinal roof without two marginal ridges (C1), with one marginal ridge (C2), and with two marginal ridges (C3), on which root canal treatment was performed afterward. Then, these teeth were subjected to force until fracture. The fracture force and fracture mode of each tooth were recorded and compared between groups by ANOVA, Tukey's post hoc, and chi-square tests using SPSS ver. 23 (IBM, Somers, NJ, USA). Results The control teeth had the highest mean fracture force (2804.5 ± 338.5 N), followed by a conservative access cavity with a dentinoenamel roof and two marginal ridges (2360.4 ± 181.72 N) and a conservative access cavity with a dentinoenamel roof and one marginal ridge (1812.8 ± 263.9 N), respectively. The lowest mean fracture force was found for the conventional access cavity group without two marginal ridges (399.4 ± 95.2 N). Conclusion In the condition of this study, with two separate access cavities in mandibular molars and maintenance of the marginal ridges, it is possible to provide teeth with higher fracture resistance against occlusal forces.
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Affiliation(s)
- Farzaneh Shirani
- Department of Restorative Dentistry, Dental Research Centre, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoud saatchi
- Dental Research Centre, Department of Endodontics, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehrangiz Shirani
- School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Niloufar Jafari
- Department of Restorative Dentistry, School of Dentistry, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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Mihit Mihit FZ, Zubizarreta-Macho Á, Montiel-Company JM, Albaladejo Martínez A. Systematic review and network meta-analysis of the accuracy of the orthodontic mini-implants placed in the inter-radicular space by image-guided-based techniques. BMC Oral Health 2023; 23:383. [PMID: 37308848 DOI: 10.1186/s12903-023-03079-8] [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: 02/21/2023] [Accepted: 05/25/2023] [Indexed: 06/14/2023] Open
Abstract
OBJECTIVE The aim of the present systematic review and network meta-analysis (NMA) is to analyze the accuracy of image-guided-based orthodontic mini-implants placement techniques in the inter-radicular space. METHODS The study was conducted under the PRISMA recommendations. Three databases were searched up to July 2022. In vitro randomized experimental trials (RETs) including static computer-aided implant surgery (s-CAIS), mixed reality (MR), soft tissue static computer-aided implant surgery (ST s-CAIS) and conventional free-hand technique (FHT) for the orthodontic mini-implants placement in the inter-radicular space were selected. The risk of bias was assessed using the Current Research Information System scale. A random effects model was used in the NMA. Direct comparisons were combined with a random effects model in a frequentist NMA to estimate indirect comparisons, and the estimated effect size of the comparisons between techniques were analyzed by difference of means. Inconsistency was assessed with the Q test, with a significance level of p < 0.05, and a net heat plot. RESULTS A total of 92 articles was identified, and 8 RETs (8 direct comparisons of 4 techniques) were included in the NMA, which examined 4 orthodontic mini-implants placement techniques: s-CAIS, MR, ST s-CAIS, and FHT. Taking FHT as reference, s-CAIS and ST s-CAIS showed statistically significant coronal and apical deviation. In addition, s-CAIS showed statistically significant angular deviation. However, MR did not show statistically significant differences with respect to FHT, which presented the highest p-score. At the coronal deviation, ST s-CAIS presented the highest P-score (0.862), followed by s-CAIS (0.721). At the apical deviation, s-CAIS presented the highest P-score (0.844), followed by ST s-CAIS (0.791). Finally, at the angular deviation s-CAIS presented again the highest P-score (0.851). CONCLUSIONS Within the limitations of this study, it was found that the image-guided-based orthodontic mini-implants placement techniques showed more accuracy than the free-hand conventional placement technique; specially the computer-aided static navigation techniques for the orthodontic mini-implants placed in the inter-radicular space.
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Affiliation(s)
- Fatima Zahrae Mihit Mihit
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008, Salamanca, Spain
| | - Álvaro Zubizarreta-Macho
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008, Salamanca, Spain.
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, 28691, Madrid, Spain.
| | - José María Montiel-Company
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010, Valencia, Spain
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Qiu S, Chen Y, Tsauo C, Wu W, Huang D, Zhou X, Peng L, Gao Y. Microcomputed tomography analysis of the radicular residual dentin thickness in mandibular second molars after virtual fiber post placement: Identification of danger zones. J Prosthet Dent 2023:S0022-3913(23)00262-7. [PMID: 37210223 DOI: 10.1016/j.prosdent.2023.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/12/2023] [Accepted: 04/12/2023] [Indexed: 05/22/2023]
Abstract
STATEMENT OF PROBLEM Mandibular second molars have variable root, pulp chamber floor, and radicular groove morphologies, potentially affecting residual dentin thickness and post placement suitability. However, an identification of the danger zones is lacking. PURPOSE The purpose of this in vitro study was to investigate the residual dentin thickness in the danger zone of mandibular second molars after virtual fiber post placement by using a simulation method based on microcomputed tomography (μCT). MATERIAL AND METHODS A total of 84 extracted mandibular second molars were scanned using μCT and classified according to root morphology (separate or fused) and pulp chamber floor morphologies (C-shaped, non-C-shaped, or no pulp chamber floor). Fused-root mandibular second molars were further classified based on the radicular groove type (V-, U-, or Ω-shaped). All specimens were accessed, instrumented, and rescanned with μCT. Two types of commercial fiber posts were also scanned. Clinical fiber post placement was simulated in all prepared canals by using a multifunctional software program. The minimum residual dentin thickness of each root canal was measured and analyzed by using nonparametric tests to identify the danger zone. Perforation rates were calculated and recorded. RESULTS Larger fiber posts decreased minimum residual dentin thickness (P<.05) and increased perforation rate. In regard to mandibular second molars with separate roots, the distal root canal exhibited a significantly higher minimum residual dentin thickness than the mesiobuccal and mesiolingual root canals (P<.05). However, no significant difference in minimum residual dentin thickness was found between the different canals in fused-root mandibular second molars with C-shaped pulp chamber floors (P<.05). Fused-root mandibular second molars with Ω-shaped radicular grooves had a lower minimum residual dentin thickness than those with V-shaped radicular grooves (P<.05) and demonstrated the highest perforation rate. CONCLUSIONS The morphologies of the root, pulp chamber floor, and radicular groove were correlated with residual dentin thickness distribution in mandibular second molars after fiber post placement. A comprehensive understanding of mandibular second molar morphology is essential for determining the suitability of post-and-core crown restorations after endodontic treatment.
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Affiliation(s)
- Shenghao Qiu
- Postgraduate student, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Yue Chen
- Undergraduate student, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Chialing Tsauo
- Postgraduate student, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Weiwei Wu
- Postgraduate student, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Dingming Huang
- Professor, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Xuedong Zhou
- Professor, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
| | - Lin Peng
- Associate Professor, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China.
| | - Yuan Gao
- Associate Professor, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, PR China
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Kaya Büyükbayram I, Güven ME, Ayman D, Şener Yamaner ID, Cakan EF. Fracture resistance of resin endocrowns with and without fiber reinforced composite base material: A preliminary study. J Appl Biomater Funct Mater 2023; 21:22808000231151832. [PMID: 36708253 DOI: 10.1177/22808000231151832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE The aim of this study was to investigate the effects of fiber-reinforced composite base material on fracture resistance and fracture pattern of endodontically treated maxillary premolars restored with endocrowns using two different resin nanoceramic computer-aided design and computer-aided manufacturing (CAD/CAM) restorative material. METHODS Forty extracted sound maxillary premolars with an occlusal reduction of 2 mm above the cementoenamel junction (CEJ) was performed following root canal treatment. Mesial interproximal box was prepared for each tooth at the margin of the CEJ and randomly distributed into four groups (n = 10) as follows: Group A, no resin build-up in the pulp chamber; Group B, 2 mm of fiber-reinforced composite (FRC) build-up (EverX Posterior, GC).; Group C, no resin build-up in pulp chamber; Group D, 2 mm of FRC build-up. Groups A and B were prepared with resin nanoceramic (RNC) consisting ceramic nanofillers (Lava Ultimate 3 M ESPE), while Group C and D were prepared with RNC consisting ceramic nanohybrid fillers (Cerasmart GC Corp). All samples were subjected to 1,200,000 chewing cycles (1.6 Hz, 50 N) and 5000 thermal cycles (5°C-55°C) for artificial aging on a chewing simulator with thermal cycles (CSTC). Samples that survived the CSTC test without being damaged were subjected to a load-to-fracture test. RESULTS The highest mean fracture strength was found in Group D (936.0 ± 354.7) and lowest in Group A (684.2 ± 466.9). Fracture strength was higher in groups where FRC was used as a base material than plain restorations. However, there were no significant differences between the Lava and Cerasmart groups with and without FRC (p > 0.05). Most of the samples were irreparably fractured under CEJ. CONCLUSION Using short FRCs as a resin base material did not significantly improve fracture resistance. Cerasmart and Lava blocks had similar fracture resistance and fracture pattern.
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Affiliation(s)
- Işıl Kaya Büyükbayram
- Department of Endodontics, School of Dentistry, İstanbul Aydın University, Küçükçekmece, İstanbul, Turkey
| | - Mehmet Esad Güven
- Department of Prosthodontics, School of Dentistry, Necmettin Erbakan University, Konya, İstanbul, Turkey
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Mannocci F, Bitter K, Sauro S, Ferrari P, Austin R, Bhuva B. Present status and future directions: The restoration of root filled teeth. Int Endod J 2022; 55 Suppl 4:1059-1084. [PMID: 35808836 PMCID: PMC9796050 DOI: 10.1111/iej.13796] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 12/30/2022]
Abstract
This narrative review will focus on a number of contemporary considerations relating to the restoration of root filled teeth and future directions for research. Clinicians are now more than ever, aware of the interdependence of the endodontic and restorative aspects of managing root filled teeth, and how these aspects of treatment are fundamental to obtaining the best long-term survival. To obtain the optimal outcomes for patients, clinicians carrying out endodontic treatment should have a vested interest in the restorative phase of the treatment process, as well as an appreciation for the structural and biomechanical effects of endodontic-restorative procedures on restoration and tooth longevity. Furthermore, the currently available research, largely lacks appreciation of occlusal factors in the longevity of root filled teeth, despite surrogate outcomes demonstrating the considerable influence this variable has. Controversies regarding the clinical relevance of minimally invasive endodontic and restorative concepts are largely unanswered with respect to clinical data, and it is therefore, all too easy to dismiss these ideas due to the lack of scientific evidence. However, conceptually, minimally invasive endodontic-restorative philosophies appear to be valid, and therefore, in the pursuit of improved clinical outcomes, it is important that the efficacies of these treatment protocols are determined. Alongside an increased awareness of the preservation of tooth structure, developments in adhesive bonding, ceramic materials and the inevitable integration of digital dentistry, there is also a need to evaluate the efficacy of new treatment philosophies and techniques with well-designed prospective clinical studies.
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Affiliation(s)
- Francesco Mannocci
- Department of EndodonticsFaculty of Dentistry, Oral and Craniofacial SciencesKing's College LondonLondonUK
| | - Kerstin Bitter
- Department of Operative and Preventive DentistryCharité ‐ University Medicine BerlinBerlinGermany
| | - Salvatore Sauro
- Departamento de Odontología, Facultad de Ciencias de la SaludUniversidad CEU‐Cardenal Herrera ValenciaAlfara del PatriarcaSpain
| | - Paolo Ferrari
- Department of Operative DentistryUniversity of ParmaParmaItaly
| | - Rupert Austin
- Department of ProsthodonticsFaculty of Dentistry, Oral and Craniofacial SciencesKing's College LondonLondonUK
| | - Bhavin Bhuva
- Department of EndodonticsFaculty of Dentistry, Oral and Craniofacial SciencesKing's College LondonLondonUK
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Divyasree V, Raghavendra Reddy JMV, Chandrasekhar V, Kasam S, Ramachandruni N, Penigalapati S, Aravelli S, Alam S. Influence of Access Cavity Design on the Fracture Strength of Endodontically Treated Teeth Restored Using Short Fiber-Reinforced Composite and High Strength Posterior Glass Ionomer Cement. Cureus 2022; 14:e28135. [PMID: 36134048 PMCID: PMC9482382 DOI: 10.7759/cureus.28135] [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] [Accepted: 08/17/2022] [Indexed: 11/05/2022] Open
Abstract
Aim: This in vitro study aimed to determine the influence of access cavity design and residual tooth structure and to compare the fracture resistance of the teeth post endodontically restored with short fiber-reinforced composite (GC everX Posterior; GC, India) and conventional posterior high-strength GIC (Glass Ionomer Cement) (GC Gold Label IX; GC, India). Methods: Ninety extracted human mandibular molars were classified into five groups, i.e., one control group (n = 10) and four test groups based on the access cavity design (n = 20): Traditional access cavity (TAC), Conservative access cavity (CAC), Ninja access cavity (NAC), and Truss access cavity (TRAC). Then 80 teeth in test groups were endodontically treated and further subdivided (n = 10) based on post-endodontic restorative materials, i.e., short fiber-reinforced composite (SFC) and Type 9 GIC. Samples were then subjected to fracture resistance under a universal testing machine and fracture loads were compared statistically. Results: The fracture resistance of various access cavity designs (TAC, CAC, NAC, and TRAC) varied significantly (P < .05). Regardless of access cavity design, teeth restored with SFC had higher fracture resistance than teeth restored with high strength posterior GIC (P = .001). Conclusion: Using newer access cavity designs like (CAC, NAC, and TRAC) and reinforcing the teeth with a post-endodontic restoration such as SFC, fracture resistance of endodontically treated teeth can be improved notably.
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Neelakantan P, Vishwanath V, Taschieri S, Corbella S. Present status and future directions ‐ Minimally invasive root canal preparation and periradicular surgery. Int Endod J 2022; 55 Suppl 4:845-871. [DOI: 10.1111/iej.13750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 04/06/2022] [Accepted: 04/11/2022] [Indexed: 11/30/2022]
Affiliation(s)
- P. Neelakantan
- Faculty of Dentistry The University of Hong Kong Hong Kong SAR
| | - V. Vishwanath
- Faculty of Dentistry The University of Hong Kong Hong Kong SAR
| | - S. Taschieri
- Department of Biomedical Surgical and Dental Sciences Università degli Studi di Milano Milan Italy
- IRCCS Istituto Ortopedico Galeazzi Milan Italy
- Department of Oral Surgery Institute of Dentistry I. M. Sechenov First Moscow State Medical University Moscow Russia
| | - S. Corbella
- Department of Biomedical Surgical and Dental Sciences Università degli Studi di Milano Milan Italy
- IRCCS Istituto Ortopedico Galeazzi Milan Italy
- Department of Oral Surgery Institute of Dentistry I. M. Sechenov First Moscow State Medical University Moscow Russia
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The Effect of Sealer Application Methods on Voids Volume after Aging of Three Calcium Silicate-Based Sealers: A Micro-Computed Tomography Study. Tomography 2022; 8:778-788. [PMID: 35314641 PMCID: PMC8938853 DOI: 10.3390/tomography8020064] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/12/2022] [Accepted: 03/09/2022] [Indexed: 11/28/2022] Open
Abstract
During obturation, air voids are undesirable as they may provide shelter for microorganisms or passage for fluids. This study aimed to compare the occurrence of voids between three calcium silicate-based sealers (CSBSs) (MTA-Fillapex, BioRoot-RCS, Bio-C) and the change in their volume after aging. In addition, we aimed to compare voids when using two sealer application methods: lentulo-spiral (LS) and gutta-percha (GP) cone. Thirty extracted mandibular premolars (n = 30) were endodontically prepared and obturated using single GP cone (SGPC) technique. Each sealer was applied to 10 teeth (n = 10) using LS or GP. Micro-computed tomography (micro-CT) was used to quantify the volume of root filling and voids before and after 8-week storage in a phosphate-rich medium. The percentage of root filling and voids were compared between the groups using a Mann–Whitney U test and Kruskal–Wallis test with a Bonferroni correction. Before aging, the percentages of root filling volume after obturation were comparable with no significant differences between sealers (p = 0.325) or application methods (p = 0.950). After aging, the voids’ volume increased significantly in all sealers (p ≤ 0.05). However, no significant differences were found between sealers (p = 0.302). In conclusion, voids in CSBSs may not reduce in size with aging; hence, SGPC should be carefully selected for suitable cases.
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Vishwaja U, Surakanti J, Vemisetty H, Guntakandla V, Bingi S, Vantari S. In Vitro study of the effect of conservative endodontic cavities on fracture strength in mandibular molars using CBCT analysis. JOURNAL OF INDIAN ACADEMY OF ORAL MEDICINE AND RADIOLOGY 2022. [DOI: 10.4103/jiaomr.jiaomr_127_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Ha WN, Chaves GS, Decurcio D, Estrela C, Peters OA, Rossi-Fedele G. Remaining dentinal thickness after simulated post space preparation and the fit of prefabricated posts to root canal preparation shapes. J Am Dent Assoc 2021; 152:1020-1032.e12. [PMID: 34656294 DOI: 10.1016/j.adaj.2021.06.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/30/2021] [Accepted: 06/22/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Post space preparation can increase the risk of experiencing perforation and root fracture. The authors assessed remaining dentin thickness after post space preparation and the fit of different prefabricated posts to root canal preparation systems in a theoretical model. METHODS Ten datasets per type of tooth from cone-beam computed tomography were analyzed to determine the minimum root diameter from 5 through 13 mm from the apical foramen. The preparation shapes of 10 root canal preparation systems were calculated and compared with the root dimensions to determine the remaining dentin thickness. Eight post brands were compared with root dimensions to determine the areas where there was less than 1 mm dentin thickness. RESULTS The average root canal preparation shape produced canal diameters of 0.57 mm at 5 mm from the canal terminus and 0.94 mm at 13 mm from the canal terminus. The mean post size tip diameter was 1.03 mm, which is larger than the dimensions of the average canal preparation. Post preparation would result in less than 1 mm of dentin thickness remaining in premolars, smaller roots of molars, and mandibular incisors. The area with less than 1 mm of dentin thickness was around the post tip. CONCLUSIONS Endosequence Fiber Post (Brasseler USA), RelyX Fiber Post 3D (3M), and Rebilda (VOCO) were the better fitting posts with the root canal preparation shapes. PRACTICAL IMPLICATIONS Many posts would result in less than 1 mm dentin thickness. Clinicians should use posts that fit their root canal preparations to minimize dentin removal.
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Martins MD, Junqueira RB, de Carvalho RF, Lacerda MFLS, Faé DS, Lemos CAA. Is a fiber post better than a metal post for the restoration of endodontically treated teeth? A systematic review and meta-analysis. J Dent 2021; 112:103750. [PMID: 34274439 DOI: 10.1016/j.jdent.2021.103750] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 05/04/2021] [Accepted: 07/11/2021] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To evaluate systematically the evidence about the failure rates of endodontically treated teeth (ETT) restored with intraradicular metal posts (MPs) or fiber posts (FPs). DATA The review protocol was registered on PROSPERO (CRD42020189792). Eligibility criteria included randomized clinical trials (RCT) and prospective clinical trials (PCT) that compared the failures between FP and MP restorations for ETT. Meta-analyses were conducted for failure rates using fixed- and random-effects models. Subgroup and funnel plot analyses were performed. SOURCES Four electronic databases (MEDLINE/PubMed, Web of Science, Scopus, and Cochrane Library), manual, and grey literature were screened by two researchers independently for articles published until November 2020 without language or time restrictions. For the analysis of the risk of bias, the Cochrane collaboration tool and ROBINS-I were used. The certainty of the evidence was evaluated using GRADE. STUDY SELECTION Ten studies were included. A total of 704 participants with a mean age of 42.7 years with a total of 844 ETT were restored using 453 FPs and 391 MPs. The FPs presented similar failures to that with MPs (P=0.39; risk ratio [RR]:0.82; 95% confidence interval [CI]: 0.52 to 1.29). Subgroup analysis showed no significant differences between the FPs and MPs for the anterior region (P=0.60; RR:0.88; [CI]: 0.54 to 1.42), posterior region (P=0.52; RR:1.18; [CI]: 0.71 to 1.98), root fracture (P=0.44; RR:0.78; [CI]: 0.41 to 1.49), and debonding (P=0.56; RR:1.27; [CI]: 0.57 to 2.80). Additionally, FP showed similar failures compared with those of cast (P=0.36; RR:0.63; [CI]: 0.23 to 1.72) and prefabricated MPs (P=0.68; RR:0.90; [CI]: 0.54 to 1.50). The RCT and PCT studies revealed a low risk of bias for most of the domains. However, the certainty of evidence was considered low. CONCLUSION No evidence of difference was observed for failure rates between FPs, and MPs, independent of region and different MPs used in ETT. However, further well-conducted clinical studies with high-quality evidence are encouraged. CLINICAL SIGNIFICANCE Our results indicate that both retainer posts can be considered an adequate alternative in restoring ETT. Therefore, the choice of post (fiber or metal) could be based on dentist preference or individual characteristics of the patient as the failure rates for different posts are similar.
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Affiliation(s)
- Marielle Dias Martins
- Department of Dentistry, Federal University of Juiz de Fora (UFJF), Campus Avançado Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | - Rafael Binato Junqueira
- Department of Dentistry, Federal University of Juiz de Fora (UFJF), Campus Avançado Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | - Rodrigo Furtado de Carvalho
- Department of Dentistry, Federal University of Juiz de Fora (UFJF), Campus Avançado Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | - Mariane Floriano Lopes Santos Lacerda
- Department of Dentistry, Federal University of Juiz de Fora (UFJF), Campus Avançado Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | - Daniele Sorgatto Faé
- Postgraduate Program in Applied Health Sciences (PPGCAS), Federal University of Juiz de Fora (UFJF), Campus Avançado Governador Valadares, Governador Valadares, Minas Gerais, Brazil
| | - Cleidiel Aparecido Araujo Lemos
- Department of Dentistry, Federal University of Juiz de Fora (UFJF), Campus Avançado Governador Valadares, Governador Valadares, Minas Gerais, Brazil.
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22
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Antony S, Venkatesh KV, Vahanaan DS. Evaluation of accuracy of fit in cast metal post fabricated with direct and indirect techniques using micro-CT - An in vitro study. Indian J Dent Res 2021; 32:323-329. [PMID: 35229771 DOI: 10.4103/ijdr.ijdr_399_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Context Accuracy of fit of cast metal posts fabricated with direct and indirect techniques. Aims To evaluate the accuracy of fit of cast metal posts fabricated with direct and indirect techniques using micro-CT. Materials and Methods Sixty extracted human maxillary central incisors were used. The teeth were decoronated leaving 2 mm at the cementoenamel junction. Four patterns for each tooth were made including one direct and indirect wax pattern and one direct and indirect resin pattern. In total, 240 patterns and castings were made. Each tooth was scanned using microcomputed tomography (μCT) system with a resolution of 14.5 μm. μCT analyzer Sky scanner software was used to calculate the volume of space between the post and the canals. Statistical analysis used: The student paired t-test and unpaired t-test were used to determine the significant differences between groups. Results The overall space between the canal walls and posts made with the direct wax and resin technique had an average mean value of 1.10 mm3, whereas with the indirect technique resin and wax pattern, the average mean was 1.30 mm3 which was significant. Conclusion Within the limitations of the study, it was found that the accuracy of fit is better in direct technique using wax pattern.
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Affiliation(s)
- Sujana Antony
- Department of Conservative Dentistry and Endodontics, SRM Kattankulathur Dental College and Hospital, Kattankulathur, Tamil Nadu, India
| | - Kondas Vijay Venkatesh
- Department of Conservative Dentistry and Endodontics, SRM Kattankulathur Dental College and Hospital, Kattankulathur, Tamil Nadu, India
| | - Dhanasekaran Sihi Vahanaan
- Department of Conservative Dentistry and Endodontics, SRM Kattankulathur Dental College and Hospital, Kattankulathur, Tamil Nadu, India
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23
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Cho J, Liu J, Bukhari EA, Zheng F, Kim DG, Lee DJ. Comparison of Post Space Volume Changes Following Fiber Post Removal Using Er,Cr:YSGG Laser Versus Ultrasonic Instrument. J Prosthodont 2021; 31:245-251. [PMID: 34021668 DOI: 10.1111/jopr.13391] [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: 05/14/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The purpose of this in vitro study was to compare the post space volume changes following removal of glass fiber posts in endodontically treated teeth by using erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser to the conventional ultrasonic method. MATERIALS AND METHODS Twelve single-root human extracted teeth were cut into 13 mm near cementoenamel junction (CEJ), and then underwent endodontic treatment. The post spaces were prepared to 8 mm in length. Glass fiber posts were inserted with self-curing resin cement. Specimens were randomly assigned to laser or ultrasonic methods for their post removal. Post space volumes were measured using microcomputed tomography (micro-CT) before post cementation and after post removal. Dentin thickness was measured after post removal at coronal, middle, and apical third of the root canal space. Paired t-test and t-test were used to compare space volumes between before post cementation and after post removal, and between laser and ultrasonic groups, respectively. RESULTS Six specimens were tested for each group. The average volume change was 6.499 mm3 in laser and 7.418 mm3 in ultrasonic method. There was not a significant difference between laser and ultrasonic group in respect of post space volume changes (p = 0.71). Both methods showed significant volume increase following post removal (p < 0.05). Significantly less dentin was lost when laser was used for post removal in the coronal portion of the post space (p = 0.002). CONCLUSIONS Er,Cr:YSGG laser can be used as effective option, comparable to the conventional ultrasonic method when removing posts in endodontically treated teeth. Laser has the potential to provide conservative post removal.
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Affiliation(s)
- Juyeon Cho
- Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, OH.,Department of Dentistry, Dongsan Hospital, Keimyung University School of Medicine, Daegu, South Korea
| | - Jie Liu
- Division of Restorative and Prosthetic Dentistry/Division of Orthodontics, The Ohio State University College of Dentistry, Columbus, OH
| | - Esraa A Bukhari
- Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, OH
| | - Fengyuan Zheng
- Advanced Prosthodontics Program, Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, OH
| | - Do-Gyoon Kim
- Division of Orthodontics, The Ohio State University College of Dentistry, Columbus, OH
| | - Damian J Lee
- Advanced Prosthodontics Program, Division of Restorative and Prosthetic Dentistry, The Ohio State University College of Dentistry, Columbus, OH
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24
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Bhuva B, Giovarruscio M, Rahim N, Bitter K, Mannocci F. The restoration of root filled teeth: a review of the clinical literature. Int Endod J 2021; 54:509-535. [PMID: 33128279 DOI: 10.1111/iej.13438] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 10/26/2020] [Accepted: 10/27/2020] [Indexed: 02/06/2023]
Abstract
Clinicians often face dilemmas regarding the most appropriate way to restore a tooth following root canal treatment. Whilst there is established consensus on the importance of the ferrule effect on the predictable restoration of root filled teeth, other factors, such as residual tooth volume, tooth location, number of proximal contacts, timing of the definitive restoration and the presence of cracks, have been reported to influence restoration and tooth survival. The continued evolution of dental materials and techniques, combined with a trend towards more conservative endodontic-restorative procedures, prompts re-evaluation of the scientific literature. The aim of this literature review was to provide an updated overview of the existing clinical literature relating to the restoration of root filled teeth. An electronic literature search of the PubMed, Ovid (via EMBASE) and MEDLINE (via EMBASE) databases up to July 2020 was performed to identify articles that related the survival of root filled teeth and/or restoration type. The following and other terms were searched: restoration, crown, onlay, root canal, root filled, post, clinical, survival, success. Wherever possible, only clinical studies were selected for the literature review. Full texts of the identified articles were independently screened by two reviewers according to pre-defined criteria. This review identifies the main clinical factors influencing the survival of teeth and restorations following root canal treatment in vivo and discusses the data related to specific restoration type on clinical survival.
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Affiliation(s)
- B Bhuva
- Department of Endodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - M Giovarruscio
- Department of Endodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.,Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - N Rahim
- Department of Endodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - K Bitter
- Department of Operative and Preventive Dentistry, Charité - University Medicine, Berlin, Germany
| | - F Mannocci
- Department of Endodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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25
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Maske A, Weschenfelder VM, Soares Grecca Vilella F, Burnett Junior LH, Melo TAF. Influence of access cavity design on fracture strength of endodontically treated lower molars. AUST ENDOD J 2020; 47:5-10. [DOI: 10.1111/aej.12446] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Aline Maske
- Dentistry College Universidade Federal do Rio Grande do Sul Porto Alegre Brazil
| | | | - Fabiana Soares Grecca Vilella
- Endodontic Division Department of Conservative Dentistry Universidade Federal do Rio Grande do Sul Porto Alegre Brazil
| | - Luiz Henrique Burnett Junior
- Clinical Department Post‐Graduate Program Dental School Pontifícia Universidade Católica do Rio Grande do Sul Porto Alegre Brazil
| | - Tiago André Fontoura Melo
- Endodontic Division Department of Conservative Dentistry Universidade Federal do Rio Grande do Sul Porto Alegre Brazil
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26
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Vantorre T, Bécavin T, Deveaux E, Marchandise P, Chai F, Robberecht L. Are the evaluation criteria used in preclinical endodontic training courses relevant? A preliminary study. AUST ENDOD J 2020; 46:374-380. [PMID: 32654290 DOI: 10.1111/aej.12417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 04/16/2020] [Accepted: 06/15/2020] [Indexed: 11/27/2022]
Abstract
This study aimed to evaluate the relevance of a conventional evaluation protocol (CEP) for preclinical endodontic training. Seven dental students performed root canal treatments on an extracted human molar which was then evaluated by CEP (clinical and radiographic observations, including preparing the access cavities, preparing and filling the root canal, and detecting iatrogenic errors). A reference evaluation protocol (REP) based on micro-computed tomographic images analysis was used as a control. The evaluation scores obtained by CEP and REP were compared using a non-parametric Wilcoxon's test. CEP was relevant for access cavity, irrigation, working length and ledge detection training but was no more effective than the REP for evaluating the apical diameter and taper of the root canals, the quality of the fillings, and the presence of perforations and fractured instruments using retro-alveolar radiographs. The conventional evaluation criteria used in preclinical endodontics should be used with care to detect 'unsafe' students.
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Affiliation(s)
- Trystan Vantorre
- Department of Restorative Dentistry and Endodontics, Faculty of Odontology, Université de Lille, Lille, France
| | - Thibault Bécavin
- Department of Restorative Dentistry and Endodontics, Faculty of Odontology, Université de Lille, Lille, France
| | - Etienne Deveaux
- Department of Restorative Dentistry and Endodontics, Faculty of Odontology, Université de Lille, Lille, France
| | | | - Feng Chai
- Faculty of Medicine, Université de Lille, INSERM U1008, Lille, France
| | - Lieven Robberecht
- Department of Restorative Dentistry and Endodontics, Faculty of Odontology, Université de Lille, Lille, France.,Faculty of Medicine, Université de Lille, INSERM U1008, Lille, France
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Bauer LJ, Mustafa HA, Zaslansky P, Mantouvalou I. Chemical mapping of teeth in 2D and 3D: X-ray fluorescence reveals hidden details in dentine surrounding fillings. Acta Biomater 2020; 109:142-152. [PMID: 32294552 DOI: 10.1016/j.actbio.2020.04.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/24/2020] [Accepted: 04/03/2020] [Indexed: 01/15/2023]
Abstract
X-rays are frequently used for characterizing both tooth tissues and dental materials. Whereas radiographs and tomography utilize absorption contrast for retrieving details, chemical mapping is usually achieved by energy dispersive X-ray (EDX) analysis that is stimulated under vacuum in electron microscopes. However, the relatively dense mineralized composition of teeth, and the frequent inclusion of a large range of elements in filling materials raise the possibility that other X-ray based techniques such as X-ray fluorescence (XRF) spectroscopy may strongly contribute to investigations of a large variety of dental structures. By exploiting the fluorescence excited by micron sized X-rays (µXRF) it is possible to map minute quantities of a large range of elements (from aluminum to uranium), where spectra containing signals from multiple different elements can be resolved non-destructively and concomitantly. The high penetration depth of X-rays makes XRF highly effective at detecting variable compositions with information emerging from tooth tissues situated well beneath the sample surface. The method supports minimal sample preparation and, different from electron microscopy, it facilitates investigation of hydrated dental materials. Direct comparison of µXRF and confocal µXRF (CµXRF) with SEM-EDX reveals micro zones of chemical heterogeneity in the complex 3D architecture of root canal fillings. These methods reproducibly clarify the mutual arrangement of biomaterials in both fresh fillings as well as in repeatedly treated old teeth of unknown history. The results showcase the complementarity of X-ray and electron based elemental mapping for dental materials research. STATEMENT OF SIGNIFICANCE: Chemical characterization of mineralized tissues such as tooth dentine is often performed using energy dispersive X-ray spectroscopy (EDS/EDX) analysis by scanning electron microscopy (SEM). The widespread use of electron microscopes and simplified detector designs have made this form of chemical and structural analysis extremely popular. However, excitation by electrons is limited to the upper microns of the tissue, and these may not well represent the chemical composition of the bulk. Especially when heavier elements are of interest and when dental filling materials exhibit diffusion into the tooth, little is known about the spatial distribution. Here we show how complementary X-ray fluorescence data originating by electron and X-ray excitation can help visualize the distribution and impregnation of heavy elements through teeth, e.g. for root canal treatment.
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Affiliation(s)
- Leona J Bauer
- Institute for Optics and Atomic Physics, Technical University of Berlin, Hardenbergstr. 36, Berlin 10623, Germany
| | - Hawshan A Mustafa
- Department for Restorative and Preventive Dentistry, Centrum für Zahn-, Mund- und Kieferheilkunde, Charité-Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, Berlin 14197, Germany
| | - Paul Zaslansky
- Department for Restorative and Preventive Dentistry, Centrum für Zahn-, Mund- und Kieferheilkunde, Charité-Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, Berlin 14197, Germany.
| | - Ioanna Mantouvalou
- Institute for Optics and Atomic Physics, Technical University of Berlin, Hardenbergstr. 36, Berlin 10623, Germany; Current affiliation: Helmholtz Zentrum Berlin, Albert-Einstein-Str. 15, 12489 Berlin, Germany
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28
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Marchiulynaite-Ustiliene R, Trisiniene J, Skucaite N, Auskalnis A, Veberiene R, Machiulskiene V. Microcomputed tomography evaluation of contamination with endodontic obturation material remnants in teeth with different root canal anatomy after post space preparation. J Prosthet Dent 2020; 125:900-904. [PMID: 32475620 DOI: 10.1016/j.prosdent.2020.01.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 01/17/2020] [Accepted: 01/21/2020] [Indexed: 11/29/2022]
Abstract
STATEMENT OF PROBLEM Whether the amount of the endodontic obturation material remnants in a root canal prepared for a post is related to variations in the anatomic shape of the canal or whether it varies in different parts of the post space is unclear. PURPOSE The purpose of this in vitro study was to estimate the extent of root canal contamination with remnants of the obturation material after post space preparation in relation to the anatomic shape of the root canals by means of microcomputed tomography. MATERIAL AND METHODS Fifty freshly extracted teeth were divided into 5 test groups with respect to the root anatomy of different tooth types. The root canals were shaped and obturated with gutta percha. The space for the glass fiber post was prepared with standardized drills, and all specimens were scanned by microcomputed tomography. The areas of residual obturation material on the root canal walls in the coronal and apical parts of the prepared post space were estimated by using a 3D visualization software program. Parametric and nonparametric dispersive analysis (analysis of variance and Kruskal-Wallis) and Wilcoxon tests were used for statistical data evaluation (α=.05). RESULTS The estimates of the root canal surface areas contaminated with residual obturation material after post space preparation were significantly larger in premolars (P≤.01), as compared with mandibular incisors and with the palatal roots of maxillary first molars. The contamination areas in different parts of the root canal (apical and coronal) reported significant differences within and between the test groups. CONCLUSIONS The extent of root canal contamination with remnants of endodontic obturation material after post space preparation was related to the anatomic shape of the roots and varied in the coronal and apical parts of the prepared post space.
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Affiliation(s)
- Raimonda Marchiulynaite-Ustiliene
- Graduate endodontics, Clinic of Dental on Oral Pathology, Faculty of Odontology, Medical Academy, Lithuanianan University of Health Sciences, Kaunas, Lithuania.
| | - Jurate Trisiniene
- Graduate endodontics, Clinic of Dental on Oral Pathology, Faculty of Odontology, Medical Academy, Lithuanianan University of Health Sciences, Kaunas, Lithuania
| | - Neringa Skucaite
- Lecturer, Clinic of Dental on Oral Pathology, Faculty of Odontology, Medical Academy, Lithuanianan University of Health Sciences, Kaunas, Lithuania
| | - Adomas Auskalnis
- Lecturer, Clinic of Dental on Oral Pathology, Faculty of Odontology, Medical Academy, Lithuanianan University of Health Sciences, Kaunas, Lithuania
| | - Rita Veberiene
- Lecturer, Clinic of Dental on Oral Pathology, Faculty of Odontology, Medical Academy, Lithuanianan University of Health Sciences, Kaunas, Lithuania
| | - Vita Machiulskiene
- Professor, Clinic of Dental on Oral Pathology, Faculty of Odontology, Medical Academy, Lithuanianan University of Health Sciences, Kaunas, Lithuania
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29
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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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30
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Relationship between Canal Enlargement and Fracture Load of Root Dentin Sections. Dent Mater 2019; 35:818-824. [PMID: 30885408 DOI: 10.1016/j.dental.2019.02.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 02/13/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To investigate the effect of endodontic instrumentation on fracture susceptibility of root dentin using experiments and stress analysis. METHODS Root canals of lower premolars were enlarged with different tapers. After, teeth were cut into 2-mm sections. A metal rod of the same taper was pushed through the center of the sections using a universal test system to fracture them. The fracture load was determined from the peak load on the load-displacement curve. To determine fracture-causing stress, an axisymmetric FE model was created. An analytical solution was developed to understand the relationship between fracture load, geometrical and material parameters. RESULTS For the same taper, increased root canal diameter did not lead to reduced fracture load. Both analytical and FE solutions showed positive linear relationship between fracture load and enlarged root canal diameter. The hoop stress was maximum at inner surface of enlarged root canal and reduced with increasing radial distance from the center. Bending of sections introduced further nonuniform stresses along the depth. Predictions for the fracture load based on the maximum hoop stress were closest to experimental values; however, account must be taken of the variation in fracture stress of dentin along the root length. Significance Our results rejected the hypothesis that fracture load of root dentin sections reduced with endodontic instrumentation size. However, the stress distributions in whole endodontically treated teeth are more complicated. Thus, caution is necessary when using thin root sections to investigate the effect of endodontic instruments on vertical root fracture.
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31
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Corsentino G, Pedullà E, Castelli L, Liguori M, Spicciarelli V, Martignoni M, Ferrari M, Grandini S. Influence of Access Cavity Preparation and Remaining Tooth Substance on Fracture Strength of Endodontically Treated Teeth. J Endod 2018; 44:1416-1421. [DOI: 10.1016/j.joen.2018.05.012] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 05/02/2018] [Accepted: 05/19/2018] [Indexed: 10/28/2022]
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Evaluation of early resin luting cement damage induced by voids around a circular fiber post in a root canal treated premolar by integrating micro-CT, finite element analysis and fatigue testing. Dent Mater 2018; 34:1082-1088. [PMID: 29747911 DOI: 10.1016/j.dental.2018.04.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 03/28/2018] [Accepted: 04/13/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study utilizes micro-CT image combined with finite element (FE) analysis and in vitro fatigue testing to investigate the mechanical behavior associating with early resin luting cement damage induced by voids around a circular fiber post in a root canal treated premolar. METHODS Six similar mandibular first premolars with root canal treatment were scanned with high resolution micro-CT before and after fatigue testing. Micro-CT images of all teeth were processed to identify various materials (dentin, luting cement and void) to evaluate the volume/position of the void in each reconstructed tooth root canal model. Six corresponding mesh models from CT images were generated to perform FE simulations under receiving oblique concentrated loads (200N) to evaluate the luting cement layer mechanical behavior. All teeth were subjected to the fatigue test with 240,000 load cycles simulating chewing for one year to compare results with those in FE simulations. RESULTS The result showed that most voids occurred adjacent to the apical third of the fiber post. Voids induced the fiber post to pull out, creating a stress concentration at the void boundary. Fatigue life in the experimental testing was found decreased with the stress value/micro-motion increasing in FE analysis. SIGNIFICANCE This study establishes that micro-CT, FE simulation and fatigue testing can be integrated to understand the early de-bonding mechanism at the luting cement layer in a root canal treated premolar, suggesting that attention must be paid to resin luting cement dissolving/debonding easier when voids occur in the apical and peri-apical areas of fiber posts.
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33
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Rusu D, Surlin P, Stratul SI, Boariu M, Calniceanu H, Kasaj A, Sinescu C, Didilescu A. Changes in anatomic position of root canal orifices in pluriradicular teeth following re-location during endodontic treatment. Ann Anat 2018; 217:29-33. [DOI: 10.1016/j.aanat.2018.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 01/19/2018] [Accepted: 01/28/2018] [Indexed: 10/18/2022]
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34
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Shaikh SY, Shaikh SS. Direct Linear Measurement of Root Dentin Thickness and Dentin Volume Changes with Post Space Preparation: A Cone-Beam Computed Tomography Study. Contemp Clin Dent 2018; 9:77-82. [PMID: 29599589 PMCID: PMC5863415 DOI: 10.4103/ccd.ccd_785_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aim: The purpose of the present study was direct linear measurement of dentin thickness and dentin volume changes for post space preparation with cone-beam computed tomography (CBCT). Materials and Methods: Ten maxillary central incisors were scanned, before and after root canal and post space preparation, with Orthophos XG three-dimensional hybrid unit. Thirteen axial section scans of each tooth from orifice to apex and dentin thickness for buccal, lingual, mesial, and distal were measured using proprietary measuring tool and thereafter subjected to statistical analysis. Furthermore, dentin volume was evaluated using ITK-SNAP software. Results: There was statistically significant difference between the dentin thickness in pre- and postinstrumentation (paired t-test) and also between different groups (one-way ANOVA). In the shortest post length of 4.5mm the post space preparation resulted in 2.17% loss of hard tissue volume, where as 11mm longest post length post space preparation resulted in >40% loss of hard tissue volume. Conclusion: CBCT axial section scan for direct measurements of root dentin thickness can be guideline before and after post space preparation for selection of drill length and diameter.
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Affiliation(s)
- Shoeb Yakub Shaikh
- Department of Conservative Dentistry and Endodontics, Rural Dental College, Pravara Institute of Medical Sciences, Loni, Maharashtra, India
| | - Safia Shoeb Shaikh
- Department of Oral Medicine and Radiology, Rural Dental College, Pravara Institute of Medical Sciences, Loni, Maharashtra, India
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35
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Ossareh A, Rosentritt M, Kishen A. Biomechanical studies on the effect of iatrogenic dentin removal on vertical root fractures. J Conserv Dent 2018; 21:290-296. [PMID: 29899632 PMCID: PMC5977778 DOI: 10.4103/jcd.jcd_126_18] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction The aim of this study was to understand the mechanism by which iatrogenic root dentin removal influences radicular stress distribution and subsequently affects the resistance to vertical root fractures (VRF) in endodontically treated teeth. Materials and Methods The experiments were conducted in two phases. Phase 1: freshly extracted premolar teeth maintained in phosphate-buffered saline were instrumented to simulate three different degrees of dentin removal, designated as low, medium, and extreme groups. Micro-Ct analyzes were performed to quantitatively determine: (a) the amount of dentin removed, (b) the remaining dentin volume, and (c) the moment of inertia of root dentin. The specimens were then subjected to thermomechanical cycling and continuous loading to determine (a) the mechanical load to fracture and (b) dentin microcracking (fractography) using scanning electron microscopy. Phase 2: Finite element analysis was used to evaluate the influence of dentin removal on the stress distribution pattern in root dentin. The data obtained were analyzed using one-way ANOVA and Tukey's post hoc test (P < 0.05). Results Phase 1: A significantly greater volume of dentin was removed from teeth in extreme group when compared to low group (P < 0.01). The mechanical analysis showed that the load to fracture was significantly lower in teeth from extreme group (P < 0.05). A linear relationship was observed between the moment of inertia and load to fracture in all experimental groups (R2 = 0.52). Fractography showed that most microcracks were initiated from the root canal walls in extreme group. Phase 2: The numerical analysis showed that the radicular stress distribution increased apically and buccolingually with greater degree of root canal dentin removal. Conclusions The combined experimental/numerical analyses highlighted the influence of remaining root dentin volume on the radicular bending resistance, stress distribution pattern, and subsequent propensity to VRF.
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Affiliation(s)
- A Ossareh
- Dental Research Institute, Faculty of Dentistry, University of Toronto, Ontario M5G 1G6, Canada
| | - M Rosentritt
- Department of Prosthetic Dentistry, University Hospital Regensburg UKR, Regensburg, Germany
| | - A Kishen
- Dental Research Institute, Faculty of Dentistry, University of Toronto, Ontario M5G 1G6, Canada
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Allen C, Meyer CA, Yoo E, Vargas JA, Liu Y, Jalali P. Stress distribution in a tooth treated through minimally invasive access compared to one treated through traditional access: A finite element analysis study. J Conserv Dent 2018; 21:505-509. [PMID: 30294111 PMCID: PMC6161525 DOI: 10.4103/jcd.jcd_260_18] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction The purpose of this study was to compare the stress distributions in the teeth treated through minimally invasive access (MIA) designs to those of the teeth treated through traditional straight-line access and their relationship to the final restoration using three-dimensional finite element analysis (FEA). Materials and Methods Four FEA models of an extracted mandibular first molar were constructed. An intact model served as the control, whereas the other three were prepared with either an MIA or traditional straight-line access. Simulated composite access fillings with or without a simulated gold crown were applied to the models, followed by application of an occlusal load of 100 N. Von Mises stresses in the teeth were then calculated and analyzed. Results Stress values within the dentin for baseline, MIA with composite filling, MIA with composite filling and crown, and traditional access with composite filling and crown were 10.14 MPa, 6.98 MPa, 11.79 MPa, and 16.81 MPa, respectively. Higher stress values indicate that the tooth is more prone to fracture. Conclusions A traditional endodontic access cavity may render a tooth more susceptible to fracture compared with an MIA design.
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Affiliation(s)
- Chad Allen
- Department of Endodontics, Texas A and M University College of Dentistry, Richardson, Texas, USA
| | - Clark A Meyer
- Department of Bioengineering, University of Texas at Dallas, Richardson, Texas, USA
| | - Eunguk Yoo
- Department of Bioengineering, University of Texas at Dallas, Richardson, Texas, USA
| | - Jose Aldair Vargas
- Department of Bioengineering, University of Texas at Dallas, Richardson, Texas, USA
| | - Ying Liu
- Department of Biomedical Sciences, Texas A and M University College of Dentistry, Richardson, Texas, USA
| | - Poorya Jalali
- Department of Endodontics, Texas A and M University College of Dentistry, Richardson, Texas, USA
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Plotino G, Grande NM, Isufi A, Ioppolo P, Pedullà E, Bedini R, Gambarini G, Testarelli L. Fracture Strength of Endodontically Treated Teeth with Different Access Cavity Designs. J Endod 2017; 43:995-1000. [DOI: 10.1016/j.joen.2017.01.022] [Citation(s) in RCA: 130] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 01/10/2017] [Accepted: 01/12/2017] [Indexed: 11/27/2022]
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Affiliation(s)
- Shanon Patel
- King's College London and 45 Wimpole Street, London W1G 8SB, UK
| | - Louise Vincer
- Postgraduate Endodontic Unit, King's College Dental Institute at Guy's King's and St Thomas' Hospital, London, UK
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Kim JJ, Alapati S, Knoernschild KL, Jeong YH, Kim DG, Lee DJ. Micro-Computed Tomography of Tooth Volume Changes Following Post Removal. J Prosthodont 2016; 26:522-528. [DOI: 10.1111/jopr.12442] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2015] [Indexed: 11/29/2022] Open
Affiliation(s)
- Jiyeon J. Kim
- Department of Restorative Dentistry; University of Illinois at Chicago College of Dentistry; Chicago IL
| | - Satish Alapati
- Department of Endodontics; University of Illinois at Chicago College of Dentistry; Chicago IL
| | - Kent L. Knoernschild
- Department of Restorative Dentistry; University of Illinois at Chicago College of Dentistry; Chicago IL
| | - Yong-Hoon Jeong
- Division of Orthodontics; The Ohio State University College of Dentistry; Columbus OH
| | - Do Gyoon Kim
- Division of Orthodontics; The Ohio State University College of Dentistry; Columbus OH
| | - Damian J. Lee
- Division of Restorative Sciences and Prosthodontics; The Ohio State University College of Dentistry; Columbus OH
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Uzun I, Keleş A, Arslan H, Güler B, Keskin C, Gündüz K. Influence of oval and circular post placement using different resin cements on push-out bond strength and void volume analysed by micro-CT. Int Endod J 2015; 49:1175-1182. [DOI: 10.1111/iej.12568] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Accepted: 10/19/2015] [Indexed: 11/30/2022]
Affiliation(s)
- I. Uzun
- Department of Endodontics; Faculty of Dentistry; Ondokuz Mayıs University; Samsun Turkey
| | - A. Keleş
- Department of Endodontics; Faculty of Dentistry; Ondokuz Mayıs University; Samsun Turkey
| | - H. Arslan
- Department of Endodontics; Faculty of Dentistry; Ataturk University; Erzurum Turkey
| | - B. Güler
- Department of Endodontics; Faculty of Dentistry; Ondokuz Mayıs University; Samsun Turkey
| | - C. Keskin
- Department of Endodontics; Faculty of Dentistry; Ondokuz Mayıs University; Samsun Turkey
| | - K. Gündüz
- Department of Dentomaxillofacial Radiology; Faculty of Dentistry; Ondokuz Mayıs University; Samsun Turkey
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Ribeiro TR, Costa FWG, Soares ECS, Williams JR, Fonteles CSR. Enamel and dentin mineralization in familial hypophosphatemic rickets: a micro-CT study. Dentomaxillofac Radiol 2015; 44:20140347. [PMID: 25651274 DOI: 10.1259/dmfr.20140347] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVES The aim of the present study was to analyse the mineralization pattern of enamel and dentin in patients affected by X-linked hypophosphatemic rickets (XLHR) using micro-CT (µCT), and to associate enamel and dentin mineralization in primary and permanent teeth with tooth position, gender and the presence/absence of this disease. METHODS 19 teeth were collected from 5 individuals from the same family, 1 non-affected by XLHR and 4 affected by XLHR. Gender, age, tooth position (anterior/posterior) and tooth type (deciduous/permanent) were recorded for each patient. Following collection, teeth were placed in 0.1% thymol solution until µCT scan. Projection images were reconstructed and analysed. A plot profile describing the greyscale distance relationship in µCT images was achieved through a line bisecting each tooth in a region with the presence of enamel and dentin. The enamel and dentin mineralization densities were measured and compared. Univariate ANOVA and post hoc Tukey tests were used for all comparisons. RESULTS Teeth of all affected patients presented dentin with a different mineralization pattern compared with the teeth of healthy patients with dentin defects observed next to the pulp chambers. Highly significant differences were found for gray values between anterior and posterior teeth (p < 0.05), affected and non-affected (p < 0.05), as well as when position and disease status were considered (p < 0.05). CONCLUSIONS In conclusion, the mineralization patterns of dentin differed when comparing teeth from patients with and without FHR, mainly next to pulp chambers where areas with porosity and consequently lower mineral density and dentin defects were found.
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Affiliation(s)
- T R Ribeiro
- 1 Clinical Dentistry Department, Federal University of Ceará, Fortaleza, Ceará, Brazil
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Busquim S, Cunha RS, Freire L, Gavini G, Machado ME, Santos M. A micro-computed tomography evaluation of long-oval canal preparation using reciprocating or rotary systems. Int Endod J 2014; 48:1001-6. [DOI: 10.1111/iej.12398] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 10/10/2014] [Indexed: 11/29/2022]
Affiliation(s)
- S. Busquim
- Postgraduate Program in Endodontics; School of Dentistry; University of Sao Paulo; Sao Paulo Brazil
| | - R. S. Cunha
- Department of Restorative Dentistry; College of Dentistry; University of Manitoba; Winnipeg MB Canada
| | - L. Freire
- Postgraduate Program in Endodontics; School of Dentistry; University of Sao Paulo; Sao Paulo Brazil
| | - G. Gavini
- Division of Endodontics; Department of Restorative Dentistry; School of Dentistry; University of Sao Paulo; Sao Paulo Brazil
| | - M. E. Machado
- Division of Endodontics; Department of Restorative Dentistry; School of Dentistry; University of Sao Paulo; Sao Paulo Brazil
| | - M. Santos
- Division of Endodontics; Department of Restorative Dentistry; School of Dentistry; University of Sao Paulo; Sao Paulo Brazil
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Pop I, Manoharan A, Zanini F, Tromba G, Patel S, Foschi F. Synchrotron light-based μCT to analyse the presence of dentinal microcracks post-rotary and reciprocating NiTi instrumentation. Clin Oral Investig 2014; 19:11-6. [PMID: 24532388 DOI: 10.1007/s00784-014-1206-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 02/02/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The purpose of this study was to determine in vitro using a synchrotron radiation-based μCT (SRCT) whether rotary and reciprocating nickel titanium (NiTi) instrumentations lead to the formation of dentine microcracks. MATERIAL AND METHODS Fourteen extracted human molars were obtained with ethical approval. Seven distobuccal roots of the maxillary molars and seven mesial roots of the mandibular molars were assigned to two experimental groups: (A) prepared with rotary Pro Taper instrumentation (n = 6) and (B) reciprocating WaveOne (n = 6). Irrigation with 1 % NaOCl and 17 % EDTA solutions was carried out. The remaining roots served as positive control with induced fractures (group C). SRCT was used to scan all samples pre and post-operatively. An imaging software was used to determine the number and length of microcracks. Statistical analyses weighed differences between pre and post-instrumentation and between shaping methods. RESULTS A significant increase in the number and length of microcracks was detected post-shaping. No significant difference between rotary and reciprocating instrumentation was observed. CONCLUSIONS Within the limitations of this in vitro study, an increased number and length of microcracks was induced by mechanical instrumentation. Reciprocating and rotary instrumentation are similar in terms of effect. CLINICAL SIGNIFICANCE Dentinal damage may occur following rotary and reciprocating instrumentation.
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Affiliation(s)
- Ioana Pop
- Department of Restorative Dentistry, King's College London Dental Institute at Guy's, King's and St Thomas' Hospital, Floor 17, Tower Wing, Guy's Hospital, St Thomas' St, London, SE1 9RT, UK
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Quality of canal obturation assessed by micro-computed tomography: Influence of filling technique and post placement in canals shaped with Reciproc. GIORNALE ITALIANO DI ENDODONZIA 2013. [DOI: 10.1016/j.gien.2013.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Alhashimi R, Mannocci F, Foxton R, Deb S. Fabrication and characterization of polymer composites for endodontic use. Int Endod J 2013; 47:574-82. [PMID: 24164059 DOI: 10.1111/iej.12192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 08/31/2013] [Indexed: 11/28/2022]
Abstract
AIM To develop a low-density polyethylene-hydroxyapatite (HA-PE) composite with properties tailored to function as a potential root canal filling material. METHODOLOGY Hydroxyapatite and polyethylene mixed with strontium oxide as a radiopacifier were extruded from a single screw extruder fitted with an appropriate die to form fibres. The composition of the composite was optimized with clinical handling and placement in the canal being the prime consideration. The fibres were characterized using infrared spectroscopy (FTIR), and their thermal properties determined using differential scanning calorimetry (DSC). The tensile strength and elastic modulus of the composite fibres and gutta-percha were compared, dry and after 1 month storage in simulated body fluid (SBF), using a universal testing machine. The radiopacity of the fibres was determined using digital radiography. The interaction of the composites with eugenol was evaluated and compared with gutta-percha. Data of the tensile test were submitted to two-way anova and Bonferroni tests (P < 0.05). RESULTS The endothermic peaks obtained from the DSC studies showed that the melting point of the HA/PE composites ranged between 110.5 and 111.2 °C, whereas gutta-percha exhibited a melting point at 52 °C. The tensile strength and elastic modulus of the silanated HA/PE composites were significantly higher than those of gutta-percha (P < 0.0001) under dry conditions and 1 month storage in SBF. The gutta-percha in eugenol showed a significant increase in the polymer molar mass, whereas the silanated HA/PE composites were unchanged. Radiological evaluations demonstrated that silanated HA/PE fibres were sufficiently radiopaque. CONCLUSION Promising materials for endodontic applications have been developed, offering relevant benefits over the traditional materials in terms of mechanical and chemical properties.
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Affiliation(s)
- R Alhashimi
- Department of Biomaterial, King's College London Dental Institute, London, UK; Department of Conservative Dentistry, King's College London Dental Institute, London, UK
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Chiuch A, De Biasi M, Sossi D, Pecci R, Bedini R, Somma F, Angerame D. Nuovi e vecchi concetti in Endodonzia: il sistema Reciproc. GIORNALE ITALIANO DI ENDODONZIA 2013. [DOI: 10.1016/j.gien.2013.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Rengo C, Spagnuolo G, Ametrano G, Juloski J, Rengo S, Ferrari M. Micro-computerized tomographic analysis of premolars restored with oval and circular posts. Clin Oral Investig 2013; 18:571-8. [DOI: 10.1007/s00784-013-0982-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Accepted: 04/08/2013] [Indexed: 10/26/2022]
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Abella F, Patel S, Durán-Sindreu F, Mercadé M, Roig M. Mandibular first molars with disto-lingual roots: review and clinical management. Int Endod J 2012; 45:963-78. [DOI: 10.1111/j.1365-2591.2012.02075.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Rödig T, Hausdörfer T, Konietschke F, Dullin C, Hahn W, Hülsmann M. Efficacy of D-RaCe and ProTaper Universal Retreatment NiTi instruments and hand files in removing gutta-percha from curved root canals - a micro-computed tomography study. Int Endod J 2012; 45:580-9. [PMID: 22264204 DOI: 10.1111/j.1365-2591.2012.02014.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
AIM To compare the efficacy of two rotary NiTi retreatment systems and Hedström files in removing filling material from curved root canals. METHODOLOGY Curved root canals of 57 extracted teeth were prepared using FlexMaster instruments and filled with gutta-percha and AH Plus. After determination of root canal curvatures and radii in two directions, the teeth were assigned to three identical groups (n = 19). The root fillings were removed with D-RaCe instruments, ProTaper Universal Retreatment instruments or Hedström files. Pre- and postoperative micro-CT imaging was used to assess the percentage of residual filling material as well as the amount of dentine removal. Working time and procedural errors were recorded. Data were analysed using analysis of covariance and analysis of variance procedures. RESULTS D-RaCe instruments were significantly more effective than ProTaper Universal Retreatment instruments and Hedström files (P < 0.05). Hedström files removed significantly less dentine than the rotary NiTi systems (P < 0.0001). D-RaCe instruments were significantly faster compared to both other groups (P < 0.05). No procedural errors such as instrument fracture, blockage, ledging or perforation were detected in the Hedström group. In the ProTaper group, four instrument fractures and one lateral perforation were observed. Five instrument fractures were recorded for D-RaCe. CONCLUSIONS D-RaCe instruments were associated with significantly less residual filling material than ProTaper Universal Retreatment instruments and hand files. Hedström files removed significantly less dentine than both rotary NiTi systems. Retreatment with rotary NiTi systems resulted in a high incidence of procedural errors.
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Affiliation(s)
- T Rödig
- Department of Preventive Dentistry, Periodontology and Cariology, University of Göttingen, Göttingen Centre for Statistics, University of Göttingen, Germany.
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