Space maintainer using fiber-reinforced composite and natural tooth - a non-invasive technique

Fiber-reinforced composites in dentistry - An insight into adhesion aspects of the material and the restored tooth construct

OBJECTIVE

This review aimed to highlight the insight into adhesion aspects within the components of the glass FRC (i.e., fiber and matrix) and between resin luting material and the glass FRC construction.

METHODS

The fundamentals of semi-interpenetrating polymer network (semi-IPN) based FRCs and their advantages in forming a solid adhesive interface with indirect FRC restoration, dental adhesive, and luting cement are elaborated. The important resin matrix systems and glass fibers used in FRCs are discussed. This is principally based on a survey of the literature over Medline/PubMed, Web of Science, and Scopus databases and a review of the relevant studies and publications in scientific papers in international peer-reviewed journals for the specific topic of biomaterials science. The keywords used for the search approach were: adhesion, fiber-reinforced composite, glass fiber, and semi-interpenetrating polymer network.

RESULTS

The polymer matrix systems of semi-IPN-based FRCs and formation of secondary-IPN layer are pivotal for bonding of multiphasic indirect dental constructs and repair. Additionally, describing areas of indication for FRCs in dentistry, explaining the adhesion aspects of FRC for the cohesion of the material itself, and for obtaining durable adhesion when the FRC construct is luted to tooth and remaining dentition. Current progress in the field of FRC research and future directions are summarized and presented.

SIGNIFICANCE

By understanding the isotropic-anisotropic nature of fibers and the interfacial adhesion within the components of the FRC; between resin cement and the FRC construction, the clinically successful FRC-based multiphasic indirect tooth construct can be achieved. The interfacial adhesion within the components of the FRC and between resin luting material and the FRC construction play a key role in adhesion-based unibody dental restorations.

Reinsertion of a fractured clinical crown as a biological restoration after dental trauma

This clinical report describes the rehabilitation procedure of an upper central tooth with a coronal fracture without compromising the root. The treatment plan consisted of the reinsertion of the fractured fragment as a definitive cemented biological restoration. Due to the deficient remnant, a fiber-reinforced composite post was used. The objective of this clinical case was to report the biological behavior of the enamel and dentin of a biological restoration after dental trauma. Patient satisfaction with the treatment was achieved by continuing with the same tooth and biomimetizing the fracture line with conventional composites. Controls were conducted, and 1 year after dental trauma, no color changes in dental tissues and no inflammation in periodontal and soft tissues were observed.

Travel beyond Clinical Uses of Fiber Reinforced Composites (FRCs) in Dentistry: A Review of Past Employments, Present Applications, and Future Perspectives

The reinforcement of resins with short or long fibers has multiple applications in various engineering and biomedical fields. The use of fiber reinforced composites (FRCs) in dentistry has been described in the literature from more than 40 years. In vitro studies evaluated mechanical properties such as flexural strength, fatigue resistance, fracture strength, layer thickness, bacterial adhesion, bonding characteristics with long fibers, woven fibers, and FRC posts. Also, multiple clinical applications such as replacement of missing teeth by resin-bonded adhesive fixed dental prostheses of various kinds, reinforcement elements of dentures or pontics, and direct construction of posts and cores have been investigated. In orthodontics, FRCs have been used also for active and passive orthodontic applications, such as anchorage units, en-masse movement units, and postorthodontic tooth retention. FRCs have been extensively tested in the literature, but today the advances in new technologies involving the introduction of nanofillers or new fibers along with understanding the design principles of FRC devices open new fields of research for these materials both in vitro and in vivo. The present review describes past and present applications of FRCs and introduces some future perspectives on the use of these materials.

Longevity of fiber-reinforced composite fixed partial dentures (FRC FPD)-Systematic review

OBJECTIVES

to assess FRC FPDs longevity through systematically reviewing contemporary clinical evidence. Population investigated comprised patients requiring replacement of a single missing anterior/posterior tooth. Intervention was FRC FPDs. No control/comparison selected. Outcome was longevity of FRC FPDs. The focus question was: 'What is the longevity of FRC FPDs used to replace one anterior or posterior tooth in patients?'

DATA

Randomised, non-randomised, controlled, prospective and retrospective clinical studies were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses were applied. The Overall Strength of Clinical Recommendation (OSCR) was assessed using the Strength of Recommendation Taxonomy system. Survival of FPDs was assessed using the Kaplan-Meier method. Analysis of FPD-survival according to location and occurrence of different failures was performed using Logrank and Chi-square testing.

SOURCES

PubMed, MEDLINE, and Web of Science databases were searched between January 2007 and December 2015.

STUDY SELECTION

Nine studies were included, involving placement of 592 FRC FPDs in 463 patients. Follow-up periods ranged between 2 months and 8 years. Kaplan-Meier overall survival probability was 94.5% (95%C.I: 92.5%-96.5%) at 4.8 years. There was no significant difference in survival probability of anterior versus posterior FRC FPDs (P=0.278). Veneering material fracture/delamination occurred significantly more than other types of failures (Ps<0.05). A meta-analysis could not be performed. OSCR was moderate.

CONCLUSIONS

FRC FPDs demonstrated high overall survival with predictable performance outcomes. However, long-term performance remains unclear.

CLINICAL SIGNIFICANCE

FRC FPDs are viable medium-term management alternatives for replacing single anterior or posterior teeth in patients.

Effects of nanofillers on mechanical properties of fiber-reinforced composites polymerized with light-curing and additional postcuring

BACKGROUND

The purpose of the present study was to evaluate the effect of nanofillers on the mechanical properties of 2 sizes (diameters 0.6 and 0.9 mm) of conventional and nanofilled fiber-reinforced composites (FRCs) polymerized with conventional light-curing and additional postcuring.

METHODS

The FRCs samples were divided into 8 groups (10 specimens each). Conventional FRCs with glass fibers preimpregnated with polymethyl methacrylate (groups 1, 2, 3 and 4) and FRCs with impregnating solution containing 32% nanofilled resin (groups 5, 6, 7 and 8) were tested in 2 different sections (0.6 and 0.9 mm in diameter). Two different polymerizations were analyzed: hand light-curing for 40 seconds with an halogen light, and additional postcuring for 25 minutes in a light-curing oven. Each sample was evaluated with a 3-point bending test on a universal testing machine, after 48 hours of dry storage. All of the data were statistically analyzed.

RESULTS

After oven postcuring, nanofilled FRCs exhibited significantly higher load values than conventional FRCs. No significant differences were found when comparing conventional and nanofilled FRCs after hand light-curing. Moreover, 0.6-mm FRCs showed significantly lower load values than 0.9-mm FRCs, both for conventional and nanofilled FRCs.

CONCLUSIONS

Nanofilled FRCs showed higher load values after additional oven postcuring.

Clinical evaluation of bond failures and survival between mandibular canine-to-canine retainers made of flexible spiral wire and fiber-reinforced composite

OBJECTIVES

The purpose of this longitudinal prospective randomized study was to evaluate the clinical reliability of two different types of postorthodontic treatment retainers: a silanised-treated glass fibers-reinforced resin composite (FRC) and a directly bonded multistranded stainless steel wire. The hypothesis of the study was to assess if significant differences are present between failure rates of the two retainers.

STUDY DESIGN

This prospective study was based on an assessment of 87 patients (35 men and 52 women),with an average age of 24 years who required a lower arch fixed retainer after orthodontic treatment. Patients were divided in two groups. Assignment was carried out with random tables. A follow-up examination was carried out once a month. The number, cause, and date of single bond adhesive failures were recorded for both retainers over 12 months. Teeth that were rebonded after failure were not included in the success analysis. Statistical analysis was performed by means of a Fisher's exact test, Kaplan-Meier survival estimates, and log rank test.

RESULTS

Bond failure rate was significantly higher (P=0.0392) for multistranded metallic wire than for FRC.

CONCLUSIONS

Glass fiber-reinforced resin composite retainers and multistranded metallic wires showed no significant difference in single bond failure rates over a one-year follow up. Key words:Fiber reinforced composite, fixed retention, multistranded wire, orthodontics, retainer, splint.

Flexural strengths of conventional and nanofilled fiber-reinforced composites: a three-point bending test

OBJECTIVES

The purpose of this study was to evaluate the effect of the introduction of nanofillers on the mechanical properties of fiber-reinforced composites (FRCs) for stabilization and conservative treatment of multiple traumatized anterior teeth. In particular, the aim of the research was to point out the force levels of two sizes (diameters 0.6 and 0.9 mm) of both conventional and nanofilled FRCs.

METHODS

Eighty FRCs samples were divided into eight groups, each consisting of 10 specimens. Conventional (groups 1, 2, 3, and 4) and nanofilled (groups 5, 6, 7, and 8) FRC samples were evaluated. Each FRC was tested in two diameters (0.6 and 0.9 mm) and under two deflections (1 and 2 mm). Each sample was polymerized with the same halogen curing unit and then evaluated with a 3-point bending test on a universal testing machine after 48 h of dry storage.

RESULTS

Nanofilled FRCs showed significantly higher load values than conventional FRCs. Moreover, 0.9-mm-diameter FRCs showed significantly higher load value than 0.6-mm-diameter FRCs. Specimens tested at 2-mm deflection showed significantly higher load values than those tested at 1-mm deflection.

CONCLUSIONS

Nanofilled FRCs showed significantly higher load values than conventional FRCs. Higher flexural strength values were recorded with 1-mm deflection for both FRC tested.