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Saitamon P, Pravalpruekskul S, Vongphan N, Harnirattisai C, Sattabanasuk V. Universal Adhesive Application Modes Differentially Affect the Fracture Resistance of Resin Composite Restored Teeth. Oper Dent 2024; 49:200-209. [PMID: 38196084 DOI: 10.2341/23-092-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2023] [Indexed: 01/11/2024]
Abstract
This study evaluated the fracture resistance of teeth with mesio-occluso-distal (MOD) resin composite restorations using universal adhesive (Single Bond Universal; SBU) in three different manipulation modes compared with those using two-step self-etch (Clearfil SE bond; CSE) and 3-step etch-and-rinse (Scotchbond Multi-Purpose; SBMP) adhesives at 24 hours and after thermocycling. One hundred and sixty maxillary premolars were assigned into eight groups of 20 each. Intact teeth and nonrestored cavity-prepared teeth served as controls. For the remaining specimens, cavities were restored with resin composite using different adhesives-SBU in self-etch, etch-and-rinse, or selective enamel etching modes; CSE in self-etch or selective enamel etching; and SBMP. Specimens from each group were either stored in 37°C water for 24 hours or further submitted to thermocycling for 30,000 cycles (n=10), then subjected to axial compression stress until fracture. Fracture patterns were observed microscopically. Data were statistically analyzed at a 95% confidence level. Among the restored teeth, mean failure load of the group using SBMP was the highest at both short-term and long-term evaluation periods (p<0.05). Fracture strengths of the SBU groups where enamel was etched with phosphoric acid prior to the adhesive application were similar and were greater than in those specimens without pre-etching (p<0.05). After thermal aging, a significant decrease in fracture resistance value was detected only for the group using SBU in etch-and-rinse application mode (p<0.05). For the self-etch strategy, SBU demonstrated lower load to fracture than CSE following thermocycling; all specimens failed at and beneath the crestal level (p<0.05). Application of SBU universal adhesive in selective enamel etching mode provided higher and more stable fracture resistance of teeth with MOD resin composite restorations than in self-etch mode.
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Affiliation(s)
- P Saitamon
- Piyathida Saitamon, DDS, resident, Residency Training Program in Operative Dentistry, Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - S Pravalpruekskul
- Sukhum Pravalpreukskul, DDS, MSc, private dentist, Phyathai 2 International Hospital, Bangkok, Thailand
| | - N Vongphan
- Nataya Vongphan, DDS, Grad Dip in Clin Sc, clinical professor, Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - C Harnirattisai
- *Choltacha Harnirattisai, DDS, PhD, associate professor, Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - V Sattabanasuk
- Vanthana Sattabanasuk, DDS, PhD, assistant professor, Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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Zhang S, Xu Y, Ma Y, Zhao W, Jin X, Fu B. The treatment outcomes of cracked teeth: A systematic review and meta-analysis. J Dent 2024; 142:104843. [PMID: 38272437 DOI: 10.1016/j.jdent.2024.104843] [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: 10/25/2023] [Revised: 12/28/2023] [Accepted: 01/15/2024] [Indexed: 01/27/2024] Open
Abstract
OBJECTIVES The aim of this review was to analyze the clinical treatment outcomes of cracked teeth (CT) retaining vital dental pulp (CT-VDP) or undergoing root canal treatment (CT-RCT). SOURCES A systematic search was conducted in Medline, Embase, PubMed, and Cochrane Library databases. STUDY SELECTION Studies evaluating tooth survival rate (TSR), pulp survival rate (PSR), and success rate (SR) with at least a one-year follow-up were included. The risk of bias was evaluated with the Newcastle-Ottawa scale. DATA Twenty-seven studies underwent qualitative analysis, 26 of which were included in the meta-analysis. SR of monitoring without restorative treatments was 80 % at three years. TSR of CT-VDP was 92.8-97.8 % at 1‒6 years, PSR of CT-VDP was 85.6‒90.4 % at 1‒3 years, and SR of CT-VDP was 80.6‒89.9 % at 1‒3 years; TSR of CT-RCT was 90.5‒91.1 % at 1‒2 years, and SR of CT-RCT was 83.0‒91.2 % at 1‒4 years. Direct restorations without cuspal coverage for CT-VDP increased the risk ratio (RR) of pulpal complications (RR=3.2, 95 % CI: 1.51-6.82, p = 0.002) and tooth extraction (RR=8.1, 95 % CI: 1.05-62.5, p = 0.045) compared with full-crown restorations. The CT-RCT without full-crown restorations had an 11.3-fold higher risk of tooth extraction than the CT-RCT with full-crown restorations (p < 0.001). CONCLUSIONS Monitoring without restorative treatments might be an option for the CT without any symptoms. Direct restorations without cuspal coverage for the CT-VDP could significantly increase the RR of pulpal complications and tooth extraction compared with full-crown restorations. Full-crown restorations are strongly recommended for the CT-RCT. CLINICAL SIGNIFICANCE Monitoring without restorative treatments could be a viable option for the CT without any symptoms. Full-crown restorations are strongly recommended for the CT with any symptoms and the CT-RCT.
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Affiliation(s)
- Sisi Zhang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Yingcai Xu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Yuhan Ma
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Weijia Zhao
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Xiaoting Jin
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Baiping Fu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China.
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Naik A, de Ataide IDN, Fernandes M. Fracture Resistance of Endodontically Treated Premolars Using Nanohybrid Composite, Fiber-Reinforced Composite, Horizontal Glass Fiber Posts, and Ceramic Inlays: An In Vitro Study. J Endod 2023; 49:1739-1746. [PMID: 37595683 DOI: 10.1016/j.joen.2023.08.004] [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: 05/23/2023] [Revised: 08/05/2023] [Accepted: 08/07/2023] [Indexed: 08/20/2023]
Abstract
INTRODUCTION This study evaluated the resistance to fracture of endodontically treated premolars (ETPs) with mesio-occluso-distal (MOD) cavities filled with nanohybrid composite (NHC), fiber-reinforced composite (FRC), horizontal glass fiber posts (HFP), and ceramic inlays (CI). METHODS Eighty-four intact maxillary premolars were taken, and endodontic treatment was performed followed by MOD cavity preparations (except in the control group). They were distributed into 7 groups based on type of restoration: intact teeth (control group), ETP + MOD (not restored), NHC, FRC + NHC, HFP + NHC, FRC + HFP + NHC, and CI groups. Samples were subjected to universal testing machine until the fracture occurred and failure mode was visually inspected. RESULTS Mean and standard deviation of fracture resistance of the 7 groups ranged from 265.6 ± 68.0 N to 1023.7 ± 76.5 N. The highest reading was noted for intact teeth followed by FRC + HFP + NHC group and then the CI group, with no significant difference among the 3 groups. The lowest reading was noted for the ETP + MOD group. Maximum unrepairable fractures were seen in the ETP + MOD and CI groups. CONCLUSION FRC + HFP + NHC combination and CIs increased the resistance to fracture of ETPs significantly.
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Affiliation(s)
- Asmita Naik
- Department of Conservative Dentistry and Endodontics, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Ida de Noronha de Ataide
- Department of Conservative Dentistry and Endodontics, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Marina Fernandes
- Department of Conservative Dentistry and Endodontics, Goa Dental College and Hospital, Bambolim, Goa, India.
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Kazemi-Yazdi H, Rezaei S, Seyedan K, Kazeminia M, Rezaei S. The effect of preparation design on fracture resistance of endodontically treated maxillary premolars restored with lithium disilicate computer-aided design/computer-aided manufacturing endocrowns: An in vitro study. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2023; 26:627-633. [PMID: 38292752 PMCID: PMC10823980 DOI: 10.4103/jcde.jcde_66_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/22/2023] [Accepted: 09/18/2023] [Indexed: 02/01/2024]
Abstract
Purpose This study aimed to assess the effect of preparation design on fracture resistance (FR) of endodontically treated maxillary premolars restored with lithium disilicate (LDS) endocrowns fabricated by the computer-aided design/computer-aided manufacturing (CAD/CAM) technology. Materials and Methods In this in vitro, experimental study, 30 sound maxillary premolars were randomly assigned to three groups (n = 10) of control (no preparation), endocrown preparation with butt-joint design without ferrule, and endocrown preparation with ferrule (shoulder design with 1 mm height). After restoration fabrication and cementation, the teeth underwent thermocycling, were mounted with 45° angle, and subjected to compressive load in a universal testing machine to measure their FR. The mode of failure was also determined under a stereomicroscope. Data were analyzed using one-way ANOVA and Tukey's test (α =0.05). Results The shoulder group showed the highest FR (1768.98 ± 386.1 N). The difference in FR was statistically significant among the three groups (P < 0.05). Pairwise comparisons revealed that the shoulder group had significantly higher FR than the butt-joint (P = 0.001) and control (P = 0.009) groups. However, the difference in FR between the butt-joint and control groups was not significant (P = 0.75). The mode of failure was not significantly different among the three groups (P > 0.05). Conclusions Preparation design had a significant effect on FR of endodontically treated maxillary premolars restored with LDS CAD/CAM Endocrowns, such that addition of a short axial wall in shoulder group significantly increased the FR of endocrowns.
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Affiliation(s)
- Haleh Kazemi-Yazdi
- Department of Operative Dentistry, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Sadaf Rezaei
- Department of Aesthetic and Restorative Dentistry, Faculty of Dentistry, Iran University of Medical Sciences, Tehran, Iran
| | - Kaveh Seyedan
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marjan Kazeminia
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Golestan University of Medical Sciences, Gorgan, Iran
| | - Sina Rezaei
- Department of Undergraduate Student of Dentistry, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Sharma S, Ramesh S, Rayapudi J. Biomechanical Performance of Mandibular Molars with Deep Mesio-Occlusal-Distal Cavities Rehabilitated with Horizontal Posts: A 3D Finite Element Analysis. Int J Dent 2023; 2023:3379373. [PMID: 37095899 PMCID: PMC10122578 DOI: 10.1155/2023/3379373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 02/04/2023] [Accepted: 02/27/2023] [Indexed: 04/26/2023] Open
Abstract
Aim To compare and contrast by three-dimensional finite element analysis the biomechanical performance of deep mesio-occlusal-distal cavities of mandibular molars reinforced by different sizes of horizontal fiber posts. Materials and Methods The finite element (FE) stress analysis was performed with the ANSYS, a commercial finite element method package. Based on the evidence-based scientific data and on the mechanical properties of materials, i.e., Young's modulus and Poisson ratio, the model of a mandible and mandibular first molar was replicated. The mandibular molar models replicating the clinical scenarios were simulated, designed, and built, assuming all materials to be homogenous, isotropic, and linearly elastic as follows: Model 1 control: the model of an intact first mandibular molar. Model 2: the prepared cavity mesio-occlusal-distal is replicated by the subtraction Boolean method. The remaining thickness of dentin is 1 mm. Model 3: these were rehabilitated by three different diameters of two horizontal fiber posts. Model 3A: fiber post diameter 1 mm, Model 3B: 1.5 mm and Model 3C: 2 mm. The dimensions of the cavity, the intercuspal distance between buccal walls and lingual walls, and the distance of placement of the post from occlusal reference points were all kept constant for all three subgroups of Model 3. The cavities of Model 3 were restored with Filtek bulk-fill posterior composite. After meshing the models, loads were defined on the buccal and lingual distal cusps with a constant value of 600 N and at an angle of 45°. Results The results of finite element analysis are expressed as stresses, i.e., tensile compressive, shear, or a combination known as von Mises stresses. The overall von Mises stresses were as follows: Model 1:154.83 Mpa; Model 2: 376.877 Mpa; Model 3A: 160.221 Mpa; Model 3B: 159.488 Mpa; Model 3C: 147.231 Mpa. Statistical analysis of the compiled data was carried out. It was seen that there was a significant difference in stress values from the intact tooth Model 1 and cavity Model 2 (p < 0.05) with means values of 53.1 and 139.22, respectively. The means of all subgroups were comparable but there was a statistically significant difference between Model 3, i.e., 3A (67.74), Model 3B (60.47), Model 3C (53.70), and Model 2. Model 1 and Model 3C had comparable mean values. Conclusion Rehabilitation of deep mesio-occlusal-distal cavities of molars with intact buccal and lingual walls with the aid of a horizontal post of any diameter has a similar stress distribution to an intact tooth. However, the biomechanical performance of a 2 mm horizontal post was exacting of the natural tooth. Horizontal posts can be included in expanding our restorative option for rehabilitating grossly mutilated teeth.
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Affiliation(s)
- Sonali Sharma
- Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, India
| | - Sindhu Ramesh
- Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, India
| | - Jasmine Rayapudi
- Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, India
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Arya A, Grewal MS, Arya V, Choudhary E, Duhan J. Stress distribution of endodontically treated mandibular molars with varying amounts of tooth structure restored with direct composite resin with or without cuspal coverage: A 3D finite element analysis. J Conserv Dent 2023; 26:20-25. [PMID: 36908730 PMCID: PMC10003291 DOI: 10.4103/jcd.jcd_333_22] [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: 06/06/2022] [Revised: 08/11/2022] [Accepted: 08/19/2022] [Indexed: 12/12/2022] Open
Abstract
Background Decision-making regarding whether cuspal coverage is required or not for the restoration of root canal-treated posterior teeth is still a matter of challenge for the dentist. Methodology Four models of endodontically treated mandibular molars with mesio-occlusal (MO) cavity were designed and simulated with direct composite resin restorations. Group 1A - cavity width <½ the intercuspal distance restored without cuspal coverage, Group 1B - same as Group 1A but with cuspal coverage, Group 2A - MO cavity width >½ but <2/3rd the intercuspal distance restored without cuspal coverage, and Group 2B - same as Group 2A but with cuspal coverage. The models received occlusal load to simulate a mastication load. Static finite element analysis (FEA) was adopted for predicting the stress distribution generated in the restored tooth by the loading condition. Results FEA of the models have shown that the variations in stress values were significant in bulk-fill material compared to enamel and other structures. Comparing the maximum and minimum principal stress values in the overall region demonstrated that 2A was safer, whereas 2B was found to be the worst case. Conclusions The results indicate that restoration of endodontically treated mandibular molar with loss of one marginal ridge with composite resin without cuspal coverage revealed minimal internal stress values and showed the best performance overall.
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Affiliation(s)
- Ashtha Arya
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, SGT University, Gurgaon, Haryana, India
| | - Mandeep S. Grewal
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, SGT University, Gurgaon, Haryana, India
| | - Vishal Arya
- Department of Preventive and Paediatric Dentistry, Faculty of Dental Sciences, SGT University, Gurgaon, Haryana, India
| | - Ekta Choudhary
- Department of Conservative Dentistry and Endodontics, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Jigyasa Duhan
- Department of Conservative Dentistry and Endodontics, PGIDS, Rohtak, Haryana, India
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McGrath CE, Bonsor SJ. Survival of direct resin composite onlays and indirect tooth-coloured adhesive onlays in posterior teeth: a systematic review. Br Dent J 2022:10.1038/s41415-022-4395-3. [PMID: 35725911 DOI: 10.1038/s41415-022-4395-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/06/2022] [Indexed: 11/08/2022]
Abstract
Objective To compare the survival of direct resin-composite used as onlays and indirect tooth-coloured adhesive onlays in posterior teeth, along with modes of failure, deterioration and variables affecting survival.Materials and methods PubMed, Embase, The Cochrane Library, Web of Science and Scopus were searched systematically up to 16 October 2020. In total, 3,768 studies were screened, with their results for survival, failure mode, deterioration and variables affecting survival.Results In total, 30 studies were selected. Survival rates in included studies greater than three years in length were 73.1-100%, with a median survival of 92.5% and median follow-up length of 5.1 years. The most prevalent failure mode was fracture, followed by pulpal episodes, debonding and caries. The most prevalent deterioration criteria were loss of marginal integrity and discolouration.Conclusions Survival of direct resin composite onlays and indirect tooth-coloured adhesive onlays in posterior teeth is acceptable (73.1-100%) in the medium-term. There is a need for more studies on direct cusp covering resin composite restorations, zirconia onlays and studies comparing material types. Fracture was the most prevalent failure mode. Restoration margins were the most prevalent area of deterioration.Clinical significance Direct and indirect tooth-coloured adhesive onlays can be a reliable and more conservative way to restore posterior teeth across a range of material options.
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Affiliation(s)
- Colin E McGrath
- Tier 2 Practitioner, DPHC Restorative Managed Clinical Network, Dental Centre Leconfield, HU17 7LX, UK.
| | - Stephen J Bonsor
- Dental Surgeon, The Dental Practice, 21 Rubislaw Terrace, Aberdeen, UK; Online Tutor and Clinical Lecturer, University of Edinburgh, UK; Senior Clinical Lecturer, Institute of Dentistry, University of Aberdeen, UK
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Jakab A, Volom A, Sáry T, Vincze-Bandi E, Braunitzer G, Alleman D, Garoushi S, Fráter M. Mechanical Performance of Direct Restorative Techniques Utilizing Long Fibers for “Horizontal Splinting” to Reinforce Deep MOD Cavities—An Updated Literature Review. Polymers (Basel) 2022; 14:polym14071438. [PMID: 35406311 PMCID: PMC9002665 DOI: 10.3390/polym14071438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/23/2022] [Accepted: 03/29/2022] [Indexed: 02/04/2023] Open
Abstract
Excessive cavity preparation and root canal treatment leads to a weakened tooth structure with a lower resistance to fracture. Fiber reinforcement is frequently used to reinforce such teeth, and multiple fiber types and possible applications exist. Various methods for utilizing long fibers to internally splint the remaining cavity walls in the case of large mesio-occluso-distal (MOD) cavities have been proposed; however, no summary of their performance has been written up to now. Our study aims to review the available literature to evaluate and compare the mechanical performance of the different materials and methods utilized for horizontal splinting in large MOD cavities. Three independent authors performed a thorough literature search using PubMed, ScienceDirect, and Google Scholar up until January 2022. The authors selected in vitro studies that used long fibers placed horizontally in posterior teeth with large MOD cavities to reinforce these teeth. From 1683 potentially relevant articles, 11 publications met our inclusion criteria. Seven out of eleven studies showed that horizontal splinting with long fibers improved the fracture resistance of the restored teeth. Three articles showed no significant difference between the fracture resistance of the restored groups. Only one article reported a lower fracture resistance to the horizontally splinted group, compared to conventional direct composite restoration. Within the limitations of this review, evidence suggests that long fiber reinforcement could be used to improve the fracture resistance of heavily restored teeth.
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Affiliation(s)
- András Jakab
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, H-6720 Szeged, Hungary; (A.J.); (T.S.); (E.V.-B.)
| | | | - Tekla Sáry
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, H-6720 Szeged, Hungary; (A.J.); (T.S.); (E.V.-B.)
| | - Eszter Vincze-Bandi
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, H-6720 Szeged, Hungary; (A.J.); (T.S.); (E.V.-B.)
| | | | - David Alleman
- The Alleman Center for Biomimetic Dentistry, South Jordan, UT 84095, USA;
| | - Sufyan Garoushi
- Department of Biomaterials Science and Turku Clinical Biomaterials Center-TCBC, Institute of Dentistry, University of Turku, FI-20520 Turku, Finland;
| | - Márk Fráter
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, H-6720 Szeged, Hungary; (A.J.); (T.S.); (E.V.-B.)
- Correspondence:
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Zhabuawala M, Alirajpurwala T, Nadig R. Corono-radicular reinforcement with minimal invasion: A novel case report. J Conserv Dent 2022; 25:101-104. [PMID: 35722063 PMCID: PMC9200174 DOI: 10.4103/jcd.jcd_463_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/30/2021] [Accepted: 12/21/2021] [Indexed: 11/23/2022] Open
Abstract
Maxillary premolar with an oval-shaped canal always poses a challenge while reconstruction using the post and core system. Fiber-post has many advantages over metallic-post and so fiber-post is becoming more popular and particularly widely used than metallic-post nowadays. Fiber-post has benefits of esthetic and strength, and its combination with flexible material, Ribbond has provided it with a high rise in the field of dentistry. The purpose of this case report was to show an innovative technique to place both glass fiber-post and Ribbond as a single assembly into the canal which gives a monoblock effect. This technique is feasible and may eradicate some of the problems associated with the cementation of ill-fitted fiber-post in an oval-shaped canal with widened canal space.
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Fatigue performance of endodontically treated premolars restored with direct and indirect cuspal coverage restorations utilizing fiber-reinforced cores. Clin Oral Investig 2021; 26:3501-3513. [PMID: 34846558 PMCID: PMC8979888 DOI: 10.1007/s00784-021-04319-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 11/23/2021] [Indexed: 01/11/2023]
Abstract
Objectives The aim of this in vitro study was to investigate the fatigue survival and fracture behavior of endodontically treated (ET) premolars restored with different types of post-core and cuspal coverage restorations. Materials and methods MOD cavities were prepared on 108 extracted maxillary premolars. During the endodontic treatment, all teeth were instrumented with rotary files (ProTaper Universal) to the same apical enlargement (F2) and were obturated with a matched single cone obturation. After the endodontic procedure, the cavities were restored with different post-core and overlay restorations (n = 12/group). Three groups (A1–A3) were restored with either conventional composite core (PFC; control) or flowable short-fiber-reinforced composite (SFRC) core with/without custom-made fiber posts and without overlays. Six groups had similar post-core foundations as described above but with either direct PFC (B1–B3) or indirect CAD/CAM (C1–C3) overlays. Fatigue survival was tested for all restorations using a cyclic loading machine until fracture occurred or 50,000 cycles were completed. Kaplan-Meyer survival analysis was conducted, followed by pairwise post hoc comparisons. Results None of the restored teeth survived all 50,000. Application of flowable SFRC as luting-core material with fiber post and CAD/CAD overlays (Group C3) showed superior performance regarding fatigue survival (p < 0.05) to all the other groups. Flowable SFRC with fiber post and direct overlay (Group B3) showed superior survival compared to all other direct techniques (p < 0.05), except for the same post-core foundation but without cuspal coverage (Group A3). Conclusions Custom-made fiber post and SFRC as post luting core material with or without cuspal coverage performed well in terms of fatigue resistance and survival when used for the restoration of ET premolars. Clinical relevance The fatigue survival of direct and indirect cuspal coverage restorations in ET MOD premolars is highly dependent on whether the core build-up is fiber-reinforced or not. The combination of short and long fibers in the form of individualized post-cores seems to offer a favorable solution in this situation.
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Pereira R, Soares P, Bicalho AA, Barcelos LM, Oliveira L, Soares CJ. Impact of the Porosity from Incremental and Bulk Resin Composite Filling Techniques on the Biomechanical Performance of Root-Treated Molars. Oper Dent 2021; 46:197-207. [PMID: 34192325 DOI: 10.2341/19-297-l] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To analyze the effect of the porosity caused by incremental and bulk resin composite filling techniques using low- and high-viscosity composite resins on the biomechanical performance of root-treated molars. METHODS Forty intact molars received standardized mesio-occlusal-distal (MOD) cavity preparation, were root treated, and randomly divided into four groups with different filling techniques (n=10). The first involved two incremental filling techniques using VIT/Z350XT, a nanofilled composite resin (Filtek Z350XT, 3M ESPE) associated with a resinmodified glass ionomer cement, and resin-modified glass ionomer cement (RMGIC; Vitremer, 3M ESPE) for filling the pulp chamber. The second involved TPH/VIT, a microhybrid composite resin TPH3 Spectrum associated with Vitremer. The third and fourth involved two bulk-fill composite resins: SDR/TPH, a low-viscosity resin composite (Surefill SDR flow, Dentsply) associated with TPH3 Spectrum, and POST, a high-viscosity bulkfill resin composite (Filtek Bulk Fill Posterior, 3M ESPE). The volume of the porosity inside the restoration was calculated by micro-CT. The cusp deformation caused by polymerization shrinkage was calculated using the strain-gauge and micro-CT methods. The cusp deformation was also calculated during 100 N occlusal loading and loading to fracture. The fracture resistance and fracture mode were recorded. Data were analyzed by one-way analysis of variance and Tukey test. The fracture mode was analyzed by the χ2 test. The volume of the porosity was correlated with the cusp deformation, fracture resistance, and fracture mode (α=0.05). RESULTS Incremental filling techniques associated with RMGIC resulted in a significantly higher porosity than that of both bulk-fill techniques. However, no significant difference was found among the groups for the fracture resistance, fracture mode, and cusp deformation, regardless of the measurement time and method used. No correlation was observed between the volume of the porosity and all tested parameters. CONCLUSIONS The porosity of the restorations had no influence on the cuspal deformation, fracture resistance, or fracture mode. The use of the RMGIC for filling the pulp chamber associated with incremental composite resins resulted in similar biomechanical performance to that of the flowable or regular paste bulk-fill composite resin restorations of root-treated molars.
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Iaculli F, Rengo C, Lodato V, Patini R, Spagnuolo G, Rengo S. Fracture resistance of endodontically-treated maxillary premolars restored with different type of posts and direct composite reconstructions: A systematic review and meta-analysis of in vitro studies. Dent Mater 2021; 37:e455-e484. [PMID: 34148785 DOI: 10.1016/j.dental.2021.06.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To conduct a systematic review and meta-analysis to assess if the presence of an endodontic post may increase the fracture resistance of endodontically-treated maxillary premolars directly restored with composite. METHODS A comprehensive systematic literature search according to the PRISMA statement was conducted to assess in vitro studies including endodontically-treated maxillary premolars, restored with different type of posts supporting direct composite reconstructions. Two groups of meta-analyses were performed using fixed effects model and additional Trial Sequential Analysis (TSA) was carried out. Moreover, risk of bias was conducted and quality of evidence for any performed meta-analysis was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS Twenty-four articles met the inclusion criteria and 13 studies also underwent quantitative evaluation. Fracture resistance of endodontically-treated premolars restored with fiber posts was significantly less than sound teeth (p value: < 0.00001), however endodontically-treated premolars with a fiber post provided an increase in fracture resistance when compared to equivalent teeth restored without post (p value: 0.003). TSA revealed high power of both meta-analyses. Moderate risk of bias was reported in 23/24 studies; only 1 study showed high risk of bias. GRADE system showed moderate strength of evidence due to the presence of a study with high risk of bias and to wide confidence intervals. SIGNIFICANCE Within the limitation of the present systematic review and meta-analysis, it can be concluded that endodontically-treated maxillary premolars restored with a fiber post and direct composite restoration demonstrated increased fracture resistance when compared to equivalent teeth without post.
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Affiliation(s)
- Flavia Iaculli
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
| | - Carlo Rengo
- Department of Prosthodontics and Dental Materials, School of Dental Medicine, University of Siena, Siena, Italy
| | - Vincenzo Lodato
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
| | - Romeo Patini
- Department of Head, Neck and Sense Organs "Fondazione Policlinico Universitario A. Gemelli- IRCCS", School of Dentistry, Rome, Italy
| | - Gianrico Spagnuolo
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy.
| | - Sandro Rengo
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
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Tangsripongkul P, Jearanaiphaisarn T. Resin Composite Core and Fiber Post Improved the Fracture Parameters of Endodontically Treated Maxillary Premolars with Wedge-shaped Cervical Lesions. J Endod 2020; 46:1733-1737. [DOI: 10.1016/j.joen.2020.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 07/08/2020] [Accepted: 07/13/2020] [Indexed: 10/23/2022]
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14
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Yu OY, Zaeneldin AM, Hamama HHH, Mei ML, Patel N, Chu CH. Conservative Composite Resin Restoration for Proximal Caries - Two Case Reports. Clin Cosmet Investig Dent 2020; 12:415-422. [PMID: 33116910 PMCID: PMC7549752 DOI: 10.2147/ccide.s270453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 09/05/2020] [Indexed: 11/23/2022] Open
Abstract
The paradigms of contemporary caries management have shifted to minimal intervention dentistry. Conservative restorative procedures are recommended to replace the complete removal of all carious tissues in the management of dental caries. This article reports two clinical cases of conservative restorations of proximal caries. Different conservative cavity designs and restorative techniques were performed in the two cases. Proximal caries in posterior teeth were prepared using the box-only preparation technique or the proximal tunnel preparation technique. The cavities were restored directly with resin composites. The advantages of using the box-only preparation with fissure sealant included the maximum conservation of tooth hard tissues and the prevention of unnecessary tissue removal in the occlusal surface. The tunnel preparation preserved the marginal ridge and protected the restored tooth from fracture. The filling of composites into the tunnel demonstrated a better marginal adaptation than other restorative materials. These two techniques allowed for the preservation of more healthy dental hard tissue compared with traditional techniques. Potential problems in the restoration included the high incidence of the inappropriate removal of dental hard tissue, damage of the vital pulp and the microleakage due to the polymerization shrinkage. The solutions to minimize the risk of these problems in the operative procedures were discussed.
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Affiliation(s)
- Ollie Yiru Yu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Ahmed Mohamed Zaeneldin
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | | | - May Lei Mei
- Faculty of Dentistry, University of Otago, Dunedin, Otago, New Zealand
| | - Neil Patel
- Division of Dentistry, University of Manchester, Manchester, UK
| | - Chun-Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, People's Republic of China
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15
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Fracture strength of non-invasively reinforced MOD cavities on endodontically treated teeth. Odontology 2020; 109:368-375. [PMID: 32886263 PMCID: PMC7954736 DOI: 10.1007/s10266-020-00552-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 08/23/2020] [Indexed: 11/24/2022]
Abstract
The purpose of this in-vitro study was to evaluate the fracture resistance and failure mode of non-invasively reinforced endodontically treated mandibular molars. Sixty freshly extracted defect-free mandibular molars were divided into four experimental groups with extensive MOD cavities on endodontically treated teeth with different restoration types and one control group with intact teeth (n = 12). The groups were as follows: “Normal”: direct resin composite; “Ring”: glass fiber-reinforced strip (Dentapreg) wrapped around buccal and lingual walls followed by direct resin composite; “Inlay”: indirect CAD/CAM resin composite inlay; “Onlay”: indirect CAD/CAM resin composite onlay; “Intact”: Intact teeth (Control). Tetric EvoCeram and Adhese Universal (Ivoclar Vivadent) were used for direct restorations and Tetric CAD (Ivoclar Vivadent) adhesively luted with Adhese Universal and Variolink Esthetic LC (Ivoclar Vivadent) were used for indirect restorations. All teeth were submitted to thermo-mechanical cyclic loading. All samples were then submitted to a compressive load until fracture. Fracture load was noted and teeth were analyzed to classify the failure mode as either catastrophic (C) or non-catastrophic (NC). No statistically significant difference was found between fracture strength of the five groups when all specimens were considered (p = 0.1461). Intact group showed the lowest percentage of catastrophic failures (41.67%). Ring group presents less catastrophic failures (75%) than Normal group (83.34%), and failures of indirect restorations—Inlay and Onlay—were almost all catastrophic (91.67% and 100%, respectively).
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16
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Stenhagen S, Skeie H, Bårdsen A, Laegreid T. Influence of the coronal restoration on the outcome of endodontically treated teeth. Acta Odontol Scand 2020; 78:81-86. [PMID: 31322454 DOI: 10.1080/00016357.2019.1640390] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: The tooth weakens due to removal of hard tissue during an endodontic procedure. Many dentists find it difficult to choose between different coronal restorations after root canal treatment (RCT). Studies show that the coronal restoration may affect the endodontic prognosis. This student-based study had three aims. (1) Examine the choice of coronal restoration of endodontically treated teeth at a Scandinavian dental school, (2) examine the survival of these restorations and (3) evaluate the influence of the coronal restoration on the outcome of the RCT. Material and methods: Radiographic and clinical examination was performed on 127 posterior teeth. The quality of the root canal treatment and the periapical status (PAI-index) were evaluated. Results: 43.8% of the teeth were restored with an indirect coronal restoration and 47.2% with a direct coronal restoration. The period from finished root canal treatment until placement of a permanent coronal restoration was significantly longer for an indirect restoration than a direct restoration. The teeth treated with a PAI score of 1 and 2 following pulpectomy, necrotic pulp treatment and endodontic retreatment was 93.8%, 82.6% and 69.4%, respectively.Conclusion: There was no significant association between choice of coronal restoration and PAI-score.
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Affiliation(s)
- Sebastian Stenhagen
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Haakon Skeie
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Asgeir Bårdsen
- Department of Clinical Dentistry – Endodontics, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Torgils Laegreid
- Department of Clinical Dentistry – Cariology, Faculty of Medicine, University of Bergen, Bergen, Norway
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17
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Silva AA, Belladonna FG, Rover G, Lopes RT, Moreira EJL, De‐Deus G, Silva EJNL. Does ultraconservative access affect the efficacy of root canal treatment and the fracture resistance of two‐rooted maxillary premolars? Int Endod J 2019; 53:265-275. [DOI: 10.1111/iej.13219] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 09/09/2019] [Indexed: 12/24/2022]
Affiliation(s)
- A. A. Silva
- Department of Endodontics Grande Rio University Duque de Caxias Rio de JaneiroBrazil
| | - F. G. Belladonna
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
| | - G. Rover
- Department of Dentistry Federal University of Santa Catarina Florianópolis Santa CatarinaBrazil
| | - R. T. Lopes
- Nuclear Engineering Program Federal University of Rio de Janeiro Rio de Janeiro Rio de Janeiro Brazil
| | - E. J. L. Moreira
- Department of Endodontics Grande Rio University Duque de Caxias Rio de JaneiroBrazil
| | - G. De‐Deus
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
| | - E. J. N. L. Silva
- Department of Endodontics Grande Rio University Duque de Caxias Rio de JaneiroBrazil
- Department of Endodontics Fluminense Federal University Niterói Rio de JaneiroBrazil
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18
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Lempel E, Lovász BV, Bihari E, Krajczár K, Jeges S, Tóth Á, Szalma J. Long-term clinical evaluation of direct resin composite restorations in vital vs. endodontically treated posterior teeth — Retrospective study up to 13 years. Dent Mater 2019; 35:1308-1318. [DOI: 10.1016/j.dental.2019.06.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/17/2019] [Accepted: 06/17/2019] [Indexed: 01/11/2023]
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19
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Luciano M, Francesca Z, Michela S, Tommaso M, Massimo A. Lithium disilicate posterior overlays: clinical and biomechanical features. Clin Oral Investig 2019; 24:841-848. [DOI: 10.1007/s00784-019-02972-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 06/06/2019] [Indexed: 10/26/2022]
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20
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Kantardžić I, Vasiljević D, Lužanin O, Maravić T, Blažić L. Influence of the restorative procedure factors on stress values in premolar with MOD cavity: a finite element study. Med Biol Eng Comput 2018; 56:1875-1886. [DOI: 10.1007/s11517-018-1824-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 03/26/2018] [Indexed: 11/24/2022]
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21
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Suksaphar W, Banomyong D, Jirathanyanatt T, Ngoenwiwatkul Y. Survival Rates from Fracture of Endodontically Treated Premolars Restored with Full-coverage Crowns or Direct Resin Composite Restorations: A Retrospective Study. J Endod 2018; 44:233-238. [DOI: 10.1016/j.joen.2017.09.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 09/15/2017] [Accepted: 09/20/2017] [Indexed: 11/29/2022]
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22
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Moosavi H, Afshari S, Manari F. Fracture resistance of endodontically treated teeth with different direct corono-radicular restoration methods. J Clin Exp Dent 2017; 9:e454-e459. [PMID: 28298991 PMCID: PMC5347298 DOI: 10.4317/jced.53160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 07/18/2016] [Indexed: 11/24/2022] Open
Abstract
Background Endodontically treated teeth are widely considered to be more susceptible to fracture than vital teeth. Obturation procedures and post placement have been a main cause of vertical root fracture. Material and Methods Forty-eight human premolars with standardized weakened roots were endodontically treated and allocated to four experimental groups (n=12). After root canal treatment, in group 1, fiber posts #1 were cemented in root canals using Estelite Core Quick, and the crowns were restored with resin composite. For group 2 and 3, the roots and crowns were restored using a light-cured and self-cured adhesive and resin composites respectively. In group 4, it was used the Panavia F 2.0 resin cement and resin composite for corono-radicular reconstruction. In group 5, the teeth remained untouched. After 24 hours storage and 1000 thermocycles, samples were loaded at a cross head speed of 1 mm per minute. Results A significant difference was observed in fracture resistance among groups 4 and 5 compared to other groups. Conclusions Root reconstruction with fiber post and Panavia resin cement, and crown building using light-cured resin composite resulted in increased fracture resistance equal to that of intact teeth. Key words:Fracture resistance, fiber post, resin cement, resin composite.
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Affiliation(s)
- Horieh Moosavi
- Associate Professor of Dental Materials Research Center and Department of Operative Dentistry, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Safora Afshari
- Assistant Professor of Dental Materials Research Center and Department of Operative Dentistry, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Manari
- DDS, Dentist, Mashhad University of Medical Sciences, Mashhad, Iran
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23
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Eliyas S, Jalili J, Martin N. Restoration of the root canal treated tooth. Br Dent J 2016; 218:53-62. [PMID: 25613259 DOI: 10.1038/sj.bdj.2015.27] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2014] [Indexed: 11/09/2022]
Abstract
When considering endodontically treated teeth, the quality of the restoration is important from the outset. It sheds light into possible causes of pulp necrosis or failure of endodontic treatment and influences the outcome of future endodontic treatment. A tooth undergoing endodontic treatment requires an effective coronal seal during and following completion of endodontic treatment. This paper discusses, using the available literature, the maintenance of optimal coronal seal and coronal integrity during and after root canal treatment.
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Affiliation(s)
- S Eliyas
- Glenfield Hospital, University Hospitals of Leicester NHS Trust, Groby Road, Leicester, LE3 9QP
| | - J Jalili
- Charles Clifford Dental Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Wellesley Road, Sheffield, S10 2SZ
| | - N Martin
- Academic Unit of Restorative Dentistry, School of Clinical Dentistry, University of Sheffield
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Fracture Resistance of Endodontically Treated Maxillary Premolars Restored by Various Direct Filling Materials: An In Vitro Study. Int J Biomater 2016; 2016:9138945. [PMID: 27656212 PMCID: PMC5021482 DOI: 10.1155/2016/9138945] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 08/01/2016] [Accepted: 08/15/2016] [Indexed: 11/18/2022] Open
Abstract
The aim of this study is to compare the effect of various restorative materials on fracture resistance in maxillary premolars. Premolars (n = 64) with no restorations or cracks were selected. MOD cavities were prepared considering the buccolingual width to be equal to half of the intercuspal distance. The specimens were randomly divided into 8 groups, 8 specimens each: group A intact teeth, group B unfilled cavity, group C composite made by oblique layering technique, group D composite with 2 mm cusp coverage, group E bulk-filled posterior composite, group F glass-ionomer, group G amalgam, and group H composite with proximal boxes. The specimens were subjected to an axial compression load with the mean values of fracture resistance in group A: 1289 N, group B: 181.75 N, group C: 445.38 N, group D: 645.88 N, group E: 355.13 N, group F: 352.00 N, group G: 191.38 N, and group H: 572.00 N. There was no significant difference between groups B and G, between C and D, E, and F, and between group D and H. All other measurements were statistically significant. We conclude that composite restoration with cusp coverage is the most ideal nonprosthetic solution for endodontically treated teeth. Cusp coverage increases the fracture resistance compared to the conventional cavity design.
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25
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Serin Kalay T, Yildirim T, Ulker M. Effects of different cusp coverage restorations on the fracture resistance of endodontically treated maxillary premolars. J Prosthet Dent 2016; 116:404-10. [PMID: 27086106 DOI: 10.1016/j.prosdent.2016.02.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 01/27/2016] [Accepted: 02/10/2016] [Indexed: 11/26/2022]
Abstract
STATEMENT OF PROBLEM Cusp coverage restorations for the restoration of endodontically treated teeth represent a conservative approach in terms of function and esthetics. However, limited scientific data are available regarding the optimum reduction design and thicknesses. PURPOSE The purpose of this in vitro study was to evaluate the fracture resistance and fracture patterns of cusp coverage restorations with different cusp reduction designs and reduction thicknesses on endodontically treated maxillary premolars (ETMPs) with mesio-occluso-distal (MOD) cavities. MATERIAL AND METHODS One hundred sixty-five extracted intact human maxillary premolars were divided into 11 groups: G1-10 (test groups) and G11 (intact group). In the test groups, all of the teeth were restored with composite resin after canal treatments with MOD cavities. However, the cusps of the G1-9 teeth were reduced with combinations of different thicknesses (1.5, 2.5, and 3.5 mm) and designs (beveled, horizontal, and anatomic). The specimens were subjected to 10(5) cycles of 50 N mechanical loading. Next, the specimens were subjected to a compressive load at a crosshead speed of 0.5 mm/min until fracture. The fractured specimens were analyzed to determine the fracture pattern. Two-way ANOVA followed by the Fisher least significant difference (LSD) test was used to analyze the interaction between groups. RESULTS The fracture resistance values increased with increases in the cusp reductions. The fracture resistance values of the G6 (2.5 mm, anatomic) and G9 (3.5 mm, anatomic) groups were significantly greater than that of the MOD group. However, the G6, G8 (3.5 mm, horizontal), and G9 groups were comparable with G11. The highest restorable fracture rates were observed in G6 and G9. CONCLUSIONS Cusp reduction design and thickness influenced the fracture resistance and fracture patterns of cusp coverage restorations of ETMPs with MOD cavities. The teeth restored with anatomic cusp reduction designs with reduction thicknesses of at least 2.5 mm exhibited greater fracture resistance and more frequent restorable fractures.
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Affiliation(s)
- Tugba Serin Kalay
- Research Assistant, Department of Restorative Dentistry, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey.
| | - Tahsin Yildirim
- Professor, Department of Restorative Dentistry, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey
| | - Mustafa Ulker
- Associate Professor, Department of Restorative Dentistry, Faculty of Dentistry, Selcuk University, Konya, Turkey
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26
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Di Iorio E. Il restauro adesivo in disilicato di litio nella riabilitazione dei denti singoli posteriori trattati endodonticamente. DENTAL CADMOS 2016. [DOI: 10.1016/s0011-8524(16)30021-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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27
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Mei ML, Chen YM, Li H, Chu CH. Influence of the indirect restoration design on the fracture resistance: a finite element study. Biomed Eng Online 2016; 15:3. [PMID: 26758615 PMCID: PMC5002181 DOI: 10.1186/s12938-015-0115-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 12/11/2015] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES To establish a three-dimensional (3D) finite element (FE) model of a maxillary first premolar and to evaluate the stress generated on the tooth (dentine) and on the indirect composite resin restorations by occlusal forces. METHODS An embedded intact maxillary first premolar tooth was sliced serially and scanned digitally parallel to the occlusal surface. The 64 images were assembled in a 3D FE mesh and exported to generate a 3D solid tooth model. Simulated, adhesively cemented indirect mesial-occlusal-distal (MOD) inlays of 2 mm (I1), 3 mm (I2) and 4 mm (I3) in width, and MOD onlays with occlusal cusp coverage of 2 mm (O1) and 3 mm (O2) in depth were created. The peak von Mises stress values in the five tooth models resulting from static vertical and oblique occlusal forces (300 N) were evaluated using Patran FE software. RESULTS The peak stress values generated by vertical occlusal force generated in dentine of I1, I2, I3, O1 and O2 restoration were 67, 32, 29, 38 and 27 MPa, respectively, and those generated by oblique occlusal force were 52, 114, 168, 54 and 55 MPa, respectively. The peak von Mises stress values in I1, I2, I3, O1 and O2 restoration subjected to oblique occlusal loading were 79, 120, 1740, 1400 and 1170 MPa, respectively. CONCLUSION A 3D FE model of a maxillary first premolar was established. Simulated cemented composite resin onlay markedly reduces occlusal stress in the underlying dentine of large MOD preparation. Oblique occlusal force imparts substantially higher stress to large composite resin inlay than to the adjacent dentine.
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Affiliation(s)
- May Lei Mei
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Hong Kong SAR, China.
| | - Ya Ming Chen
- Institute of Stomatology, Nanjing Medical University, Nanjing, China.
| | - Hao Li
- School of Civil and Hydraulic Engineering, Hefei University of Technology, Hefei, China.
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Hong Kong SAR, China.
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28
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Karataş E, Arslan H, Topçuoğlu HS, Yılmaz CB, Yeter KY, Ayrancı LB. The Effect of Diode Laser With Different Parameters on Root Fracture During Irrigation Procedure. Artif Organs 2015; 40:604-9. [DOI: 10.1111/aor.12608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Ertuğrul Karataş
- Faculty of Dentistry, Department of Endodontics; Ataturk University; Erzurum Turkey
| | - Hakan Arslan
- Faculty of Dentistry, Department of Endodontics; Ataturk University; Erzurum Turkey
| | | | - Cenk Burak Yılmaz
- Faculty of Dentistry, Department of Endodontics; Ataturk University; Erzurum Turkey
| | - Kübra Yesildal Yeter
- Faculty of Dentistry, Department of Endodontics; Ataturk University; Erzurum Turkey
| | - Leyla Benan Ayrancı
- Faculty of Dentistry, Department of Endodontics; Ataturk University; Erzurum Turkey
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29
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Shafiei F, Tavangar MS, Ghahramani Y, Fattah Z. Fracture resistance of endodontically treated maxillary premolars restored by silorane-based composite with or without fiber or nano-ionomer. J Adv Prosthodont 2014; 6:200-6. [PMID: 25006384 PMCID: PMC4085244 DOI: 10.4047/jap.2014.6.3.200] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 03/11/2014] [Accepted: 03/17/2014] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This in vitro study investigated the fracture resistance of endodontically treated premolars restored using silorane- or methacrylate-based composite along with or without fiber or nano-ionomer base. MATERIALS AND METHODS Ninety-six intact maxillary premolars were randomly divided into eight groups (n = 12). G1 (negative control) was the intact teeth. In Groups 2-8, root canal treatment with mesio-occlusodistal preparation was performed. G2 (positive control) was kept unrestored. The other groups were restored using composite resin as follows: G3, methacrylate-based composite (Z250); G4, methacrylate composite (Z250) with polyethylene fiber; G5 and G6, silorane-based composite (Filtek P90) without and with the fiber, respectively; G7 and G8, methacrylate- and silorane-based composite with nano-ionomer base, respectively. After aging period and thermocycling for 1000 cycles, fracture strength was tested and fracture patterns were inspected. The results were analyzed using ANOVA and Tukey HSD tests (α=0.05). RESULTS Mean fracture resistance for the eight groups (in Newton) were G1: 1200 ± 169a, G2: 360 ± 93b, G3: 632 ± 196c, G4: 692 ± 195c, G5: 917 ± 159d, G6: 1013 ± 125ad, G7: 959 ± 148d, G8: 947 ± 105d (different superscript letters revealed significant difference among groups). Most of the fractures in all the groups were restorable, except Group 3. CONCLUSION Silorane-based composite revealed significantly higher strength of the restored premolars compared to that of methacrylate one. Fiber insertion demonstrated no additional effect on the strength of both composite restorations; however, it increased the prevalence of restorable fracture of methacrylate-based composite restored teeth. Using nano-ionomer base under methacrylate-based composite had a positive effect on fracture resistance and pattern. Only fiber-reinforced silorane composite restoration resulted in a strength similar to that of the intact teeth.
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Affiliation(s)
- Fereshteh Shafiei
- Department of Operative Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Sadat Tavangar
- Department of Operative Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran. ; Biomaterial Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Yasamin Ghahramani
- Department of Endodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Fattah
- Department of Operative Dentistry, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Chu CH, Mei ML, Cheung C, Nalliah RP. Restoring proximal caries lesions conservatively with tunnel restorations. Clin Cosmet Investig Dent 2013; 5:43-50. [PMID: 24019754 PMCID: PMC3760193 DOI: 10.2147/ccide.s48567] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The tunnel restoration has been suggested as a conservative alternative to the conventional box
preparation for treating proximal caries. The main advantage of tunnel restoration over the
conventional box or slot preparation includes being more conservative and increasing tooth integrity
and strength by preserving the marginal ridge. However, tunnel restoration is technique-sensitive
and can be particularly challenging for inexperienced restorative dentists. Recent advances in
technology, such as the contemporary design of dental handpieces with advanced light-emitting diode
(LED) and handheld comfort, offer operative dentists better vision, illumination, and
maneuverability. The use of magnifying loupes also enhances the visibility of the preparation. The
advent of digital radiographic imaging has improved dental imaging and reduced radiation. The new
generation of restorative materials has improved mechanical properties. Tunnel restoration can be an
option to restore proximal caries if the dentist performs proper case selection and pays attention
to the details of the restorative procedures. This paper describes the clinical technique of tunnel
restoration and reviews the studies of tunnel restorations.
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Affiliation(s)
- Chun-Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, People's Republic of China
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31
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Gli intarsi adesivi per il restauro dei denti posteriori trattati endodonticamente. GIORNALE ITALIANO DI ENDODONZIA 2012. [DOI: 10.1016/j.gien.2012.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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