1
|
Uzun İ, Timur AH, Şenel K. In-vitro comparison of fracture resistance of CAD/CAM porcelain restorations for endodontically treated molars. BMC Oral Health 2024; 24:1187. [PMID: 39369196 DOI: 10.1186/s12903-024-04983-3] [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: 05/24/2024] [Accepted: 09/30/2024] [Indexed: 10/07/2024] Open
Abstract
BACKGROUND This study evaluates the fracture strength and patterns of feldspathic porcelain restorations made using CAD/CAM technology for lower first molars with extensive crown destruction. The restorations include post-core and full-contour crown, composite resin core and full-contour crown, and endocrown. This research provides insights into effective restorative options to address tooth fracture risk, supporting minimally invasive procedures and CAD/CAM integration in dental practices. METHODS This study utilized 80 permanent mandibular first molars, which were divided into four groups: Group I (Post-Core-Full-contour crown), Group II (Core- Full-contour crown), Group III (Endocrown), and Group IV (Control). Root canal treatment was performed on all samples except for the control group. Following access cavity preparation, restorations for each tooth were fabricated using the CAD/CAM system and cemented with resin cement. The specimens were embedded in acrylic blocks. After undergoing thermomechanical aging, the samples were subjected to fracture resistance testing using a universal testing machine, which applied force until fracture occurred. The fracture patterns were subsequently analyzed, and the data were statistically evaluated using the Kruskal-Wallis and Chi-Square tests (p < 0.05). RESULTS A significant difference in fracture values under axial forces was observed (p < 0.05). The control group had the highest fracture strength (1830 ± 277 N), while the Core- full-contour crown group showed the lowest (1532 ± 371 N). Failure types varied significantly among the groups (χ2 = 26.886, df = 9, p = 0.001). The most common failure type was Type-2 (33.75%), characterized by restorable fractures, while Type-3 fractures, unrestorable, were the least common (12.5%). CONCLUSIONS The findings underscore the significance of technological advancements in CAD/CAM for effectively restoring endodontically treated teeth with extensive crown damage. This study contributes valuable insights, emphasizing the clinical relevance of selecting appropriate restorative options to mitigate the risk of tooth fracture associated with coronal restoration failures.
Collapse
Affiliation(s)
- İsmail Uzun
- Faculty of Dentistry, Department of Endodontics, Ondokuz Mayıs University, Samsun, Turkey.
| | | | - Kevser Şenel
- Endodontist, Ordu Central Dental Hospital, Ordu, Turkey
| |
Collapse
|
2
|
Özyürek T, Uslu G, Arıcan B, Gündoğar M, Nekoofar MH, Dummer PMH. Influence of endodontic access cavity design on mechanical properties of a first mandibular premolar tooth: a finite element analysis study. Clin Oral Investig 2024; 28:433. [PMID: 39026036 PMCID: PMC11258061 DOI: 10.1007/s00784-024-05808-x] [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: 03/12/2024] [Accepted: 06/27/2024] [Indexed: 07/20/2024]
Abstract
OBJECTIVES This study aimed to investigate the influence of access cavity designs on the mechanical properties of a single-rooted mandibular first premolar tooth under various static loads using a finite element analysis. MATERIALS AND METHODS 3-dimensional FEA designs were modeled according to the access cavity designs: an intact tooth (control), traditional access cavity (TEC-I), traditional access cavity with Class-II mesio-occlusal cavity design (TEC-II), conservative access cavity (CEC), ninja access cavity (NEC), caries-driven access cavity (Cd-EC), buccal access cavity (BEC) and bucco-occlusal access cavity (BOEC). After the simulated access cavity preparations, root canal treatment was simulated and three different static loads which mimicked oblique and vertical mastication forces were applied to the models. The stress distribution and maximum Von Misses stress values were recorded. The maximum stress values were obtained on both enamel and dentin under multi-point vertical loads. RESULTS The maximum stress values were obtained on both enamel and dentin under multi-point vertical loads. Under all load types, the minimum stress distribution was observed in the control group, followed by CEC, NEC and BEC designs. The highest stress concentration was detected in Cd-EC and TEC-II designs. Under single-point vertical loading, the stress was mostly concentrated in the lingual PCD area, while under multi-point vertical loading, the entire root surface was stress-loaded except for the lingual apical third of the root. CONCLUSION Preserving tooth tissue by simulating CEC, NEC and BEC access cavities increased the load capacity of a single-rooted mandibular first premolar following simulated endodontic treatment.
Collapse
Affiliation(s)
- Taha Özyürek
- Department of Endodontics, School of Dental Medicine, Bahçeşehir University, Istanbul, Turkey
| | - Gülşah Uslu
- Department of Endodontics, Faculty of Dentistry, Çanakkale Onsekiz Mart University, Istanbul, Turkey
| | - Burçin Arıcan
- Department of Endodontics, School of Dental Medicine, Bahçeşehir University, Istanbul, Turkey.
| | - Mustafa Gündoğar
- Department of Endodontics, Faculty of Dentistry, Medipol University, Istanbul, Turkey
| | - Mohammad Hossein Nekoofar
- Department of Endodontics, School of Dental Medicine, Bahçeşehir University, Istanbul, Turkey
- Department of Endodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
- Department of Tissue Engineering, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | |
Collapse
|
3
|
Samra N, Madina MM, El-Negoly SAER, Dawood L. The effect of restorative material selection and cementation procedures on the durability of endocrowns in the anterior teeth: an in-vitro study. BMC Oral Health 2024; 24:670. [PMID: 38851731 PMCID: PMC11161972 DOI: 10.1186/s12903-024-04381-9] [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: 07/30/2023] [Accepted: 05/17/2024] [Indexed: 06/10/2024] Open
Abstract
OBJECTIVE To investigate the fracture resistance and failure modalities of anterior endocrown restorations fabricated employing diverse ceramic materials, and bonded using various cementation methodologies. MATERIALS AND METHODS Forty maxillary central incisors were divided into two main groups based on the ceramic materials used; GroupI (Zir): zirconia endocrwons (Zolid HT+, Ceramill, Amanngirrbach) and GroupII (E-Max): e-max endocrowns (IPS e.max CAD, Ivoclar Vivadent). Both groups were further split into two subgroups depending on the cementation protocols; subgroup IA "ZirMDP": endocowns cemented with MDP primer + MDP resin cement, subgroup IB (ZirNon-MDP): cemented with MDP primer + non-MDP resin cement, subgroup IIA (E-maxMDP): cemented with MDP primer + MDP resin cement, subgroup IIB (E-maxNon-MDP): cemented with MDP primer + non-MDP resin cement. (n = 10/subgroup). Endocrowns were manufactured using CAD/ CAM. Teeth were subjected to 10,000 thermal cycles. The fracture test was performed at 45o with a palatal force direction until the fracture occurred. Test results were recorded in Newton. The failure mode was examined using a stereomicroscope. A One-way ANOVA test was utilized to compare different groups regarding fracture strength values. Tukey`s Post Hoc was utilized for multiple comparisons. RESULTS The comparative analysis of fracture strength across the diverse groups yielded non-significant differences, as indicated by a p-value exceeding 0.05. Nonetheless, an observable trend emerged regarding the mode of failure. Specifically, a statistically significant prevalence was noted in fractures localized within the endocrown/tooth complex below the cementoenamel junction (CEJ) across all groups, except for Group IIB, "E-max Non-MDP," where fractures within the endocrown/tooth complex occurred above the CEJ. CONCLUSIONS Combining an MDP-based primer with an MDP-based resin cement did not result in a significant effect on the anterior endocrown fracture strength. CLINICAL RELEVANCE Regardless of the presence of the MDP monomer in its composition, adhesive resin cement achieved highly successful fracture strength when used with MDP-based ceramic primers. Additionally, ceramic materials exhibiting elastic moduli surpassing those of dentin are discouraged due to their propensity to induce catastrophic fractures within the tooth structure.
Collapse
Affiliation(s)
- Nehal Samra
- Prosthodontic Department, Faculty of Dentistry, Kafr Elsheikh University, Kafr Elsheikh, Egypt.
| | - Manal M Madina
- Fixed Prosthodontic department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | | | - Lamia Dawood
- Fixed Prosthodontic department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| |
Collapse
|
4
|
Vervack V, Johansson C, Coster PD, Fokkinga W, Papia E, Vandeweghe S. The fracture strength and the failure mode of lithium disilicate or resin nano ceramics as a crown, overlay, or endocrown restoration on endodontically treated teeth. J ESTHET RESTOR DENT 2024; 36:796-803. [PMID: 38152852 DOI: 10.1111/jerd.13187] [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: 12/05/2022] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/29/2023]
Abstract
INTRODUCTION Different materials and restorative concepts have been proposed over the years to restore endodontically treated teeth (ETT). Monolithic ceramic and composite restoration can be lute to the tooh, without the use of a post. However, little is known how the material stiffness and presence of a composite core will affect the survival and failure mode. The objective of this in-vitro study was to evaluate the fracture strength and failure mode of endodontically treated molars, restored with ceramic or hybrid composite monolithic restoration, in the presence of absence of a composite core. MATERIALS AND METHODS Sixty depulped molars were restored with a lithium-disilicate (e.max CAD) or hybrid composite (Cerasmart) restoration. Both materials were used in a monolithic approach, but with 3 different designs: (a) monolithic endocrown, (b) crown with a separate composite core, and (c) overlay without core buildup or pulpal extension. Ten sound teeth were used as control group. All groups were thermocycled (10,000 cycles), subsequently loaded in a chewing simulator (100,000 cycles) and finally loaded until fracture. RESULTS Peak fracture loads and failure modes were registered. No significant differences were seen between the groups in terms of fracture load. Failure modes were statistically significantly different among groups with significant correlation between restoration type and material. (p < 0.001 and p = 0.033, respectively). No group presented significantly higher fracture resistance. Although ceramic crowns and overlays presented the highest repairability, all restored ETT were within the range of the intact tooth' fracture strength. CONCLUSION No restoration presented significant different fracture loads. However, the type of restoration and material choice were correlated to the fracture mode.
Collapse
Affiliation(s)
- Valentin Vervack
- Department of Oral Health Sciences, Reconstructive Dentistry, Faculty of medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Camilla Johansson
- Faculty of Odontology, Material Science and Technology, Dental Technology, Malmö University, Malmö, Sweden
| | - Peter De Coster
- Department of Oral Health Sciences, Reconstructive Dentistry, Faculty of medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Wietske Fokkinga
- Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Evaggelia Papia
- Faculty of Odontology, Material Science and Technology, Dental Technology, Malmö University, Malmö, Sweden
| | - Stefan Vandeweghe
- Department of Oral Health Sciences, Reconstructive Dentistry, Faculty of medicine and Health Sciences, Ghent University, Ghent, Belgium
| |
Collapse
|
5
|
Lenz U, Bacchi A, Della Bona A. Biomechanical performance of endocrown and core-crown restorations: A systematic review. J ESTHET RESTOR DENT 2024; 36:303-323. [PMID: 37571973 DOI: 10.1111/jerd.13119] [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: 06/12/2023] [Revised: 07/26/2023] [Accepted: 07/29/2023] [Indexed: 08/13/2023]
Abstract
OBJECTIVE To assess and compare, through a systematic review of the literature, the biomechanical performance of endocrowns and traditional core-crowns (with and without intracanal post) for the rehabilitation of endodontically treated teeth with severe coronal structure damage. MATERIALS AND METHODS A systematic search was performed in MEDLINE/PubMed, Scopus, and Web of Science databases. In-vitro studies comparing endocrowns with (post-)core-crown restorations were selected and screened by two independent reviewers. The included studies were submitted to the risk of bias analysis using the RoBDEMAT tool and the biomechanical outcomes were collected for qualitative analysis. The extracted data were presented based on comparative analyses among the included studies. RESULTS Thirty-one studies were included: 9 studies evaluated restorations of molars, 14 for premolars, and 8 studies evaluated anterior restorations. For the majority of the studies, endocrowns showed either similar or greater survival rates under fatigue and monotonic load than (post-)core-crown restorations, irrespectively of the tooth. The endocrowns showed more favorable failure patterns than (post-)core-crowns, irrespectively of the tooth. Endocrowns produced lower stresses in the restorative material for molars and premolars and in the luting material for premolars than (post-)core-crown restorations. The included studies presented adequate information for most items of the RoBDEMAT risk of bias tool. CONCLUSION Endocrowns showed similar or greater biomechanical performance than the traditional (post-)core-crown restorations in most of the evaluated studies. CLINICAL SIGNIFICANCE This systematic review showed that endocrowns present either similar or greater biomechanical performance than core-crown restorations for anterior and posterior endodontically treated teeth with severe structural damage.
Collapse
Affiliation(s)
- Ulysses Lenz
- Postgraduate Program in Dentistry, University of Passo Fundo, Passo Fundo, Brazil
| | - Atais Bacchi
- Postgraduate Program in Dentistry, Paulo Picanço School of Dentistry, Fortaleza, Brazil
| | - Alvaro Della Bona
- Postgraduate Program in Dentistry, University of Passo Fundo, Passo Fundo, Brazil
| |
Collapse
|
6
|
Yanapa Márquez J, Chávez-Méndez MA. [Compressive stress in three types of finishing lines with lithium disilicate crowns in permanent teeth: finite element analysis]. REVISTA CIENTÍFICA ODONTOLÓGICA 2024; 12:e182. [PMID: 39015314 PMCID: PMC11247469 DOI: 10.21142/2523-2754-1201-2024-182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/14/2023] [Indexed: 07/18/2024] Open
Abstract
Introduction In oral rehabilitation, the use of ceramic restorations is widely accepted due to its aesthetic capacity to mimic the naturalness of the dental tissue, provide longevity of the material, and present a greater marginal fit compared to crowns with a metal structure. Termination lines are biological preparations whose function is to minimize the cervical opening of the marginal seal. Consequently, analyzing the behavior of restorative materials under compressive forces decreases the risk of fracture and increases the success of the treatment. Objective To compare the compressive stresses of lithium disilicate crowns with three different finishing lines. Methodology In silico study of the simulation of a dental preparation on a lower right first molar with chamfer (0.6 mm), shoulder (0.5 mm) and deep chamfer (0.5 mm) finish lines. Using the SolidWorks®️ version 2017 software, the maximum stresses, minimum stresses, and location of the compressive force were collected on the Megapascal (Mpa) measurement scale. Results The chamfer type termination line (0.6mm) obtained a lower compressive stress compared to the other two shoulder type termination lines (0.5mm) and deep chamfer (0.5mm). Conclusions It was shown that the chamfer type finishing line (0.6mm) presented a better force distribution, determining greater reliability in the selection of this finishing line with the use of a lithium disilicate crown in a unitary manner.
Collapse
Affiliation(s)
- Joshua Yanapa Márquez
- Carrera de Estomatología, Universidad Científica del Sur. Lima, Perú. Universidad Científica del Sur Carrera de Estomatología Universidad Científica del Sur Lima Peru
| | - Martín Andrés Chávez-Méndez
- Facultad de Ciencias de la Salud, Carrera de Estomatología, Universidad Científica del Sur. Lima, Perú. Universidad Científica del Sur Facultad de Ciencias de la Salud Carrera de Estomatología Universidad Científica del Sur Lima Peru
| |
Collapse
|
7
|
Veselinova M, Diamantopoulou S, Paximada C, Papazoglou E. In-Vitro Comparison of Fracture Strength of Endocrowns and Overlays in Endodontically Treated Teeth Manufactured with Monolithic Lithium Disilicate and Zirconia. J Funct Biomater 2023; 14:422. [PMID: 37623666 PMCID: PMC10455451 DOI: 10.3390/jfb14080422] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/25/2023] [Accepted: 08/08/2023] [Indexed: 08/26/2023] Open
Abstract
To evaluate the fracture strength and the failure mode of endodontically treated molars restored with monolithic lithium disilicate and zirconia endocrowns and overlays. A total of 48 extracted mandibular molars were endodontically treated, decoronated 2 mm above the cementoenamel junction and divided into four 12-specimen groups. Group ELD: lithium disilicate endocrowns. Group EZ: monolithic zirconia endocrowns. Group OLD: lithium disilicate overlays. Group OZ: monolithic zirconia overlays. Overlays did not extend in the pulp chamber and endocrowns extended in the pulp chamber 2 mm. After adhesive bonding of the restorations, the specimens were subjected to thermocycling (×5000 cycles) and then to fracture resistance testing at lateral static loading (1 mm/min) at a universal testing machine. The failure mode of the specimens was qualitatively evaluated. Differences in means were compared using with t-tests for independent samples or Mann-Whitney test (p < 0.05). Weibull distribution analysis was also performed. Group ELD showed significantly higher fracture strength than all other groups (p = 0.001), and the highest Weibull modulus. Conclusions: Lithium disilicate endocrowns exhibit higher fracture strength and are more reliable compared to the other types of restorations examined. Endocrowns had more catastrophic failures compared to overlays.
Collapse
Affiliation(s)
| | | | | | - Efstratios Papazoglou
- Department of Operative Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.V.); (S.D.); (C.P.)
| |
Collapse
|
8
|
Zhong Q, Cao X, Shen Y, Song Y, Wu Y, Qu F, Wang S, Xu C. Finite element analysis of maxillary first molar with mesial-occlusal-distal-palatal defect restored with different post-and-core strategies. Heliyon 2023; 9:e18131. [PMID: 37496905 PMCID: PMC10366429 DOI: 10.1016/j.heliyon.2023.e18131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 06/06/2023] [Accepted: 07/07/2023] [Indexed: 07/28/2023] Open
Abstract
Purpose To explore which restoration strategy generates the most favorable stress distribution in an endodontically-treated maxillary first molar with mesial-occlusal-distal-palatal defect. Methods Models with one post in palatal canal (PP), each post in palatal and distobuccal canals (PDP), each post in palatal and mesiobuccal canals (PMP), and each post in all canals (PDMP) were established for an endodontically-treated maxillary first molar with mesial-occlusal-distal-palatal defect either with fiber-reinforced composite (FRC) post or gold alloy cast (GAC) post. A 400-N vertical force and a 225-N lateral force were respectively applied. The Mohr-Coulomb stress ratio (σMC ratio) in the residual tooth structure (RTS), the resin cement, and the crowns, the tensile stress (σt) and compressive stress (σc) in the FRC posts, the von-Mises stress ratio (σvM ratio) in the GAC post-and-cores, and the σt and shear stress (σs) at the adhesive interfaces were calculated using finite element analysis. Results FRC posts generated lower σMC ratio than GAC posts in the RTS (0.3274-0.3643 vs. 0.3399-0.4118). Among the FRC post groups, the PDMP group got the lowest σs at the dentin-post interface (14.92 MPa) and the abutment-crown interface (8.242 MPa) under vertical loading, as well as the lowest σMC ratio in the RTS (0.3381) and the lowest σs at the dentin-post interface (38.00 MPa) under lateral loading. Conclusions From the point of stress distribution, placing FRC posts in the palatal, distobuccal, and mesiobuccal canals is the optimal strategy in restoring a severely damaged maxillary first molar, provided that lateral occlusal force is reduced.
Collapse
Affiliation(s)
- Qi Zhong
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Ximeng Cao
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yingyi Shen
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yingshuang Song
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yaqin Wu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Fang Qu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Shaohai Wang
- Department of Stomatology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Chun Xu
- Department of Prosthodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| |
Collapse
|
9
|
Yoon Y, Lee MJ, Kang I, Oh S. Evaluation of Biomechanical Stability of Teeth Tissue According to Crown Materials: A Three-Dimensional Finite Element Analysis. MATERIALS (BASEL, SWITZERLAND) 2023; 16:4756. [PMID: 37445067 DOI: 10.3390/ma16134756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 06/18/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023]
Abstract
The biomechanical effects of dental tissue according to various dental crown materials were investigated using finite element analysis. Bone, prepared tooth, root canal, and periodontal ligament were modeled based on computed tomography. Depending on the characteristics of the crown material, it was classified into zirconia, hybrid ceramic, gold alloy, and acrylic resin. A loading force of 200 N was applied in the vertical direction to the occlusal surface of the crown, and analysis was performed under the condition that all interfaces were tied. The results demonstrate that the highest von Mises stress was shown in the prepared tooth of the acrylic resin model, which is a temporary prosthesis, and the pulpal pressure was also the highest. Additionally, among the final prosthesis, the highest stress was shown in the hybrid ceramic model prepared teeth. The properties of restoration materials can be a factor influencing the tooth structure. Thus, in order to make a correct decision when selecting a material for restorative treatment, it is necessary to understand, analyze, and evaluate the properties of these restoration materials.
Collapse
Affiliation(s)
- Youngjae Yoon
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Myung-Jin Lee
- Department of Dental Hygiene, Division of Health Science, Baekseok University, Cheonan 31065, Republic of Korea
| | - Inyeong Kang
- School of Mechanical Engineering, Korea University, Seoul 02841, Republic of Korea
| | - Sanghwan Oh
- Department of Dental Hygiene, Konyang University, Daejeon 35365, Republic of Korea
| |
Collapse
|
10
|
Demachkia AM, Velho HC, Valandro LF, Dimashkieh MR, Samran A, Tribst JPM, de Melo RM. Endocrown restorations in premolars: influence of remaining axial walls of tooth structure and restorative materials on fatigue resistance. Clin Oral Investig 2023:10.1007/s00784-023-04895-6. [PMID: 36781479 DOI: 10.1007/s00784-023-04895-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 02/01/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVES To evaluate the effect of the remaining tooth structure and different CAD/CAM materials on the fatigue performance and failure mode of endodontically treated premolars restored with endocrowns. MATERIALS AND METHODS Ninety maxillary premolars were endodontically treated and assigned into 6 groups (n = 15) according to the number of remaining axial walls (four, three, and two) and restorative materials (ultra-translucent zirconia 5Y-PSZ [KATANA UTML] and lithium disilicate [IPS e.max-CAD]). The specimens were subjected to cyclic fatigue loading test (initial load 200 N; 20 Hz). An incremental step load of 100 N per 10,000 cycles was applied until failure. The fatigue failure load (FFL) and number of failure cycles (CFFs) data were statistically analyzed with two-way ANOVA and Kaplan-Meier test (α = 0.05). Failed specimens were examined under a stereomicroscope 25 × and failure modes were determined. RESULTS FFL and CFF were significantly influenced by restorative material (p < 0.05). 5Y-PSZ endocrowns showed significantly higher FFL when compared with lithium disilicate. The number of remaining walls did not affect the fatigue behavior or failure mode of the specimens. Of the lithium disilicate restorations, 51% had repairable failures, while 95% 5Y-PSZ restorations had non-repairable failures. CONCLUSIONS Zirconia endocrowns showed better FFL than lithium disilicate endocrowns, regardless of the number of remaining axis walls. Lithium disilicate and 5Y-PSZ endocrowns showed FFL higher than the normal masticatory loads. CLINICAL RELEVANCE Restoring endodontically treated premolars with endocrown could be a promising treatment, regardless of the remaining axial walls. However, precaution should be taken in material selection since it affects the fatigue resistance and failure mode.
Collapse
Affiliation(s)
- Amir Mohidin Demachkia
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (UNESP), Av. Engenheiro Francisco José Longo,777. 12245000, São José Dos Campos, São Paulo, Brazil.
| | - Helder Callegaro Velho
- Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande Do Sul State, Brazil
| | - Luiz Felipe Valandro
- Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande Do Sul State, Brazil
| | - Mohiddin Rida Dimashkieh
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, Dar Al-Uloom University, Riyadh, Saudi Arabia
| | - Abdulaziz Samran
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, Dar Al-Uloom University, Riyadh, Saudi Arabia
| | - João Paulo Mendes Tribst
- Department of Oral Regenerative Medicine, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Renata Marques de Melo
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (UNESP), Av. Engenheiro Francisco José Longo,777. 12245000, São José Dos Campos, São Paulo, Brazil
| |
Collapse
|
11
|
Darwich MA, Aljareh A, Alhouri N, Szávai S, Nazha HM, Duvigneau F, Juhre D. Biomechanical Assessment of Endodontically Treated Molars Restored by Endocrowns Made from Different CAD/CAM Materials. MATERIALS (BASEL, SWITZERLAND) 2023; 16:764. [PMID: 36676500 PMCID: PMC9864025 DOI: 10.3390/ma16020764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/03/2023] [Accepted: 01/11/2023] [Indexed: 06/17/2023]
Abstract
The aim of this study was to evaluate the deflection and stress distribution in endodontically treated molars restored by endocrowns from different materials available for the computer-aided design/computer-aided manufacturing (CAD/CAM) technique using three-dimensional finite element analysis. The models represented extensively damaged molars restored by endocrowns from the following materials: translucent zirconia; zirconia-reinforced glass ceramic; lithium disilicate glass ceramic; polymer-infiltrated ceramic network (PICN) and resin nanoceramic. Axial and oblique loadings were applied and the resulting stress distribution and deflection were analyzed. The Mohr-Coulomb (MC) ratio was also calculated in all models. The translucent zirconia endocrown showed the highest stress concentration within it and the least stress in dental structures. The resin nanoceramic model was associated with the greatest stress concentration in dental tissues, followed by the PICN model. Stress was also concentrated in the distal region of the cement layer. The MC ratio in the cement was higher than 1 in the resin nanoceramic model. Oblique loading caused higher stresses in all components and greater displacement than axial loading, whatever the material of the endocrown was. The translucent zirconia model recorded deflections of enamel and dentin (38.4 µm and 35.7 µm, respectively), while resin nanoceramic showed the highest stress concentration and displacement in the tooth-endocrown complex.
Collapse
Affiliation(s)
- Mhd Ayham Darwich
- Faculty of Biomedical Engineering, Al-Andalus University for Medical Sciences, Tartous, Syria
- Faculty of Technical Engineering, University of Tartous, Tartous, Syria
| | - Abeer Aljareh
- Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Nabil Alhouri
- Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Szabolcs Szávai
- Faculty of Mechanical Engineering and Informatics, University of Miskolc, 3515 Miskolc, Hungary
| | - Hasan Mhd Nazha
- Faculty of Mechanical Engineering, Institute of Mechanics, Otto Von Guericke University Magdeburg, Universitätsplatz 2, 39106 Magdeburg, Germany
| | - Fabian Duvigneau
- Faculty of Mechanical Engineering, Institute of Mechanics, Otto Von Guericke University Magdeburg, Universitätsplatz 2, 39106 Magdeburg, Germany
| | - Daniel Juhre
- Faculty of Mechanical Engineering, Institute of Mechanics, Otto Von Guericke University Magdeburg, Universitätsplatz 2, 39106 Magdeburg, Germany
| |
Collapse
|
12
|
Zhang Y, Lai H, Meng Q, Gong Q, Tong Z. The synergetic effect of pulp chamber extension depth and occlusal thickness on stress distribution of molar endocrowns: a 3-dimensional finite element analysis. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2022; 33:56. [PMID: 35723747 PMCID: PMC9209353 DOI: 10.1007/s10856-022-06677-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 05/29/2022] [Indexed: 06/15/2023]
Abstract
The aim of this study was to evaluate the effects of butt margin, occlusal thickness and pulp chamber extension depth on stress distributions on mandibular molar endodontically treated teeth (ETT) with EMAX endocrown restoration using 3-dimensional finite element analysis (FEA). The FEA models of endocrown with flat surface or curve surface of butt margin were firstly evaluated stress distributions, and then 9 FEA models of endocrown with 1-, 2- or 3-mm pulp chamber extension depth and 1-, 2- or 3-mm occlusal thickness were generated using curve surface of butt margin. In all of FEA models, a 200 N of vertical load or horizontal load was applied, and the von Mises stress (VMS) were evaluated. The results showed that curve surface of butt margin offered more adhesive area of enamel, though VMS on the prepared teeth was similar in flat surface and curve surface models. In 9 endocrown models, 2-mm occlusal thickness showed the lowest VMS on restorations, teeth tissue and root furcations, and 2-mm extension depth displayed the lowest VMS on root furcations under vertical load. Also, 2-mm extension depth exhibited the lowest VMS on restorations and teeth tissue under horizontal load. Within the limitations of this FEA study, the results of this study could be used as an aid for dentists to better devise endocrown restorations. Graphical abstract.
Collapse
Affiliation(s)
- Yuejiao Zhang
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Hongbin Lai
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Qingzhen Meng
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Qimei Gong
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhongchun Tong
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China.
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China.
| |
Collapse
|
13
|
Comparison of stress distribution between zirconia/alloy endocrown and CAD/CAM multi-piece zirconia post-crown: three-dimensional finite element analysis. Clin Oral Investig 2022; 26:5007-5017. [PMID: 35352185 DOI: 10.1007/s00784-022-04470-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/17/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study aimed to evaluate a digital multi-piece zirconia post-crown to restore a mandibular second molar with extensive coronal loss and limited restoration space, and to compare the stress distribution between endocrowns made of zirconia or alloy and CAD/CAM multi-piece zirconia post-crowns. MATERIAL AND METHODS Four three-dimensional finite element analysis models of a mandibular second molar with extensive coronal loss and limited restoration space were created as follows: (A) intact molar; (B) zirconia endocrown restored molar; (C) multi-piece post-crown restored-molar with tapered nail; (D) multi-piece post-crown restored molar with T-shaped nail. Models C and D were divided into two subgroups according to the material type: C1/D1, zirconia; C2/D2, NiCr alloy. The maximum modified von Mises failure criterion (mvM) stresses were calculated, and the stress distribution was recorded to analyze the effects of the restoration and material types on the biomechanical properties of dentin and prosthesis. RESULTS The maximum mvM stress of dentin in model B (33.80 MPa) was lower compared with models C (C1, 37.81 MPa; C2, 36.36 MPa) and D (D1, 36.34 MPa; D2, 34.97 MPa) under vertical load, but the opposite was observed under oblique load. The highest mvM stress was concentrated in the nail region located in the root canal, and the T-shaped nail values were greater than the tapered nail, whereas model D with T-shaped nail showed a lower mvM stress level in dentin compared with Model C with tapered nail. CONCLUSIONS The digital multi-piece zirconia post-crown is a potential approach to restore mandibular second molars with extensive coronal loss and limited restoration space. CLINICAL RELEVANCE The digital multi-piece zirconia post-crown has potential to restore mandibular second molars with extensive coronal loss and limited restoration space using an innovative approach.
Collapse
|
14
|
Ordinola-Zapata R, Lin F, Nagarkar S, Perdigão J. A critical analysis of research methods and experimental models to study the load capacity and clinical behavior of the root filled teeth. Int Endod J 2022; 55 Suppl 2:471-494. [PMID: 35263455 PMCID: PMC9314814 DOI: 10.1111/iej.13722] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 03/04/2022] [Indexed: 12/04/2022]
Abstract
The prognosis of root‐filled teeth depends not only on a successful root canal treatment but also on the restorative prognosis. This critical review discusses the advantages and limitations of various methodologies used to assess the load capacity or clinical survivability of root‐filled teeth and restorations. These methods include static loading, cyclic loading, finite element analysis and randomized clinical trials. In vitro research is valuable for preclinical screening of new dental materials or restorative modalities. It also can assist investigators or industry to decide whether further clinical trials are justified. It is important that these models present high precision and accuracy, be reproducible, and present adequate outcomes. Although in vitro models can reduce confounding by controlling important variables, the lack of clinical validation (accuracy) is a downside that has not been properly addressed. Most importantly, many in vitro studies did not explore the mechanisms of failure and their results are limited to rank different materials or treatment modalities according to the maximum load capacity. An extensive number of randomized clinical trials have also been published in the last years. These trials have provided valuable insight on the survivability of the root‐filled tooth answering numerous clinical questions. However, trials can also be affected by the selected outcome and by intrinsic and extrinsic biases. For example, selection bias, loss to follow‐up and confounding. In the clinical scenario, hypothesis‐based studies are preferred over observational and retrospective studies. It is recommended that hypothesis‐based studies minimize error and bias during the design phase.
Collapse
Affiliation(s)
- Ronald Ordinola-Zapata
- Division of Endodontics, Department of Restorative Sciences, School of Dentistry, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Fei Lin
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, Beijing, 100081, China.,Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Sanket Nagarkar
- Park Dental Group, Minneapolis, Minnesota, and Clinical Research Assistant Professor (affiliated), Department of Restorative Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jorge Perdigão
- Division of Operative Dentistry, Department of Restorative Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| |
Collapse
|
15
|
Three-Dimensional Biomechanical Finite Element Analysis of Lumbar Disc Herniation in Middle Aged and Elderly. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:7107702. [PMID: 35075391 PMCID: PMC8783749 DOI: 10.1155/2022/7107702] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 12/06/2021] [Accepted: 12/22/2021] [Indexed: 12/16/2022]
Abstract
Lumbar intervertebral disc protrusion disease refers to the degeneration of intervertebral disc, rupture of fibrous ring, nucleus pulpous protrusion and stimulation or compression of nerve root. The import command in Mimics medical 3D reconstruction software was used to erase the irrelevant image data and obtain vertebral body images. The original 3D model of each vertebral body was built by 3D computing function. A three-dimensional finite element model was established to analyze the effect of different surgical methods on the mechanical distribution of the spine after disentomb. The stress distribution of the spine, intervertebral disc, and left and right articular cartilage at L4/L5 stage and the position shift of the fourth lumbar vertebra were analyzed under 7 working conditions of vertical, forward flexion, extension, left and right flexion, and left and right rotation. The results showed that the established model was effective, and the smaller the area of posterior laminar decompression was, the lesser the impact on spinal stability was. The PELD treatment of lumbar disc herniation had little impact on spinal biomechanics and could achieve good long-term biomechanical stability. Combining the clinical experiment method and finite element simulation, using the advantages of finite element software to optimize the design function can provide guidance for the design and improvement of medical devices and has important significance for the study of clinical mechanical properties and biomechanics.
Collapse
|
16
|
Abtahi S, Alikhasi M, Siadat H. Biomechanical behavior of endocrown restorations with different cavity design and CAD-CAM materials under a static and vertical load: A finite element analysis. J Prosthet Dent 2022; 127:600.e1-600.e8. [PMID: 35016795 DOI: 10.1016/j.prosdent.2021.11.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 11/29/2021] [Accepted: 11/29/2021] [Indexed: 11/29/2022]
Abstract
STATEMENT OF PROBLEM The influence of different restorative materials, the divergence angle, and the preparation design of the pulp chamber floor in endocrowns on stress distribution is unclear. PURPOSE The purpose of this finite element analysis study was to evaluate the stress distribution and maximum von Mises stress values in endocrown restorations and remaining teeth. MATERIAL AND METHODS An endodontically treated first mandibular molar was prepared with 2-mm occlusal reduction, a butt-joint margin, and a mesial box with a 4-mm buccolingual extension to receive an endocrown restoration. The model was then scanned, and the exported standard tessellation language file was designed according to the anatomic references by using a computer-aided design software program. The reference model was duplicated, and 27 variations were formed: restorations made of IPS e.max, Vitablocs MarkII, and Vita Enamic, as well as different divergence angles of 6, 12, and 16 degrees prepared with 3 variations of pulp chamber floor designs, keeping the natural form, adding a 1-mm glass ionomer pulp chamber base, and adding a 2-mm extension into the distal canal. Stress distribution under axial loading and maximum von Mises stress values were analyzed and calculated by using the Ansys software program. RESULTS Endocrown restoration presented the lowest von Mises stress values when a 6-degree divergence angle was used with Vitablocs MarkII. However, in other layers such as enamel, resin cement, and pulpal floor, the lowest von Mises stress values were observed in IPS e.max restorative material when the divergence angle was increased to 16 degrees. No difference was found in the stress distribution pattern and maximum von Mises stress values in the alveolar bone or periodontal ligament. CONCLUSIONS Endocrowns fabricated with lithium disilicate ceramics without intraradicular extension exhibited lower stresses on tooth structure. An increase in the divergence angle improved the stress distribution on tooth structure; however, sound dental tissue should not be removed to achieve better stress distribution.
Collapse
Affiliation(s)
- Sara Abtahi
- Graduate student, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzieh Alikhasi
- Professor, Department of Prosthodontics, Dental Research Center, Dentistry Research Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Hakimeh Siadat
- Professor, Department of Prosthodontics, Dental Research Center, Dentistry Research Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
17
|
Balaji L, Joshna B, Kuzhanchinathan M. Biomechanical stress analysis of ceramic and indirect hybrid composite endocrowns: A three-dimensional finite element analysis. ENDODONTOLOGY 2022. [DOI: 10.4103/endo.endo_156_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
18
|
Rehabilitation of severely-destructed endodontically treated premolar teeth with novel endocrown system: Biomechanical behavior assessment through 3D finite element and in vitro analyses. J Mech Behav Biomed Mater 2021; 126:105031. [PMID: 34922296 DOI: 10.1016/j.jmbbm.2021.105031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 11/30/2021] [Accepted: 12/06/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Rehabilitation of endodontically treated premolars with extensive coronal destruction through endocrown approach remains a controversial topic in reconstructive dentistry. There is no clear consensus in the literature which endocrown design with which material is the most effective restoration option for severely-destructed endodontically treated premolars. The aim of this study was to assess the biomechanical behavior of endodontically treated maxillary first premolars restored with a novel endocrown system compared to the conventional one varying the applied load type through finite element and in vitro analyses. MATERIALS AND METHODS For finite element analysis, two models representing two endocrown systems used for restoration of severely-destructed endodontically treated maxillary first premolar tooth were generated: Model C for the conventional monolithic IPS e.max CAD endocrown and Model P for the novel bi-layered endocrown (PEKKTON ivory coping veneered with cemented IPS e.max CAD). Modified von Mises stress values on the remaining tooth structure, cement lines and restorative materials were evaluated separately under axial and oblique loading of 450 N. For in vitro analysis, forty sound human bifurcated maxillary first premolars were collected, endodontically-treated, and divided into 2 main groups (n = 20) according to the system used for endocrown fabrication; Group C: the conventional monolithic endocrowns and Group P: the novel bi-layered endocrowns. All specimens were subjected to an artificial thermomechanical aging protocol. Each main group was subdivided into two subgroups (n = 10) according to the loading type (axial and oblique) applied during the fracture resistance test. Qualitative analysis using Stereomicroscopy and Scanning Electron Microscopy was performed. Data were statistically analyzed at p-value ≤ 0.05. RESULTS Regarding stress distribution pattern of remaining tooth structure (enamel and dentin), both endocrown systems and cement lines under both axial and oblique load application, Model P resulted in lower stresses than Model C. The oblique stress values of all analyzed structures were higher than corresponding values resulted axially. Considering failure load, a significantly higher load was recorded for Group P when axial or oblique loading was applied (p = 0.00). A significantly higher failure load was recorded with axial loading for both main groups. With regard to failure mode, a statistically significant difference was observed between main groups (p = 0.033), with more favorable failures detected for Group P axially. CONCLUSIONS Compared to the conventional endocrown system, the studied novel system improved the biomechanical behavior within tooth/restoration complex of the restored severely-destructed endodontically treated maxillary first premolar teeth, whatever the applied load type. CLINICAL SIGNIFICANCE The novel endocrown system using a PEKK coping veneered with cemented IPS e.max CAD can be considered a favorable promising option for restoration of severely-destructed endodontically treated premolar teeth, with more protection for residual tooth structure. It can be considered as a conservative alternative option to the conventional treatment modalities not only for normal clinical conditions, but also for parafunctional cases.
Collapse
|
19
|
Biomechanical behavior of endodontically treated premolar teeth restored with novel endocrown system: 3D Finite Element and Weibull analyses. J Mech Behav Biomed Mater 2021; 124:104853. [PMID: 34600429 DOI: 10.1016/j.jmbbm.2021.104853] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To date, there is no clear consensus in the literature which endocrown design with which material is the most effective treatment option to restore endodontically treated maxillary premolars with extensive loss of tooth structure. The aim of this study was to evaluate the stress distribution pattern and failure probability of maxillary first premolars restored with a novel endocrown system compared to the conventional one by means of Finite Element and Weibull analyses. MATERIALS AND METHODS Two finite element (FE) models representing two endocrown systems used for restoration of severely-destructed endodontically treated maxillary first premolar tooth were generated: model C for the conventional monolithic IPS e.max CAD endocrown and model P for the novel bi-layered endocrown (PEKKTON ivory coping veneered with cemented IPS e.max CAD). A static occlusal compressive load was axially and centrally-applied. Modified von Mises and maximum principal stress values on the remaining tooth structure, cement lines and restorative materials were evaluated separately. Weibull function was incorporated with FE analysis to calculate the long term failure probability. RESULTS Regarding stresses occurred in the remaining tooth structure (enamel and dentin), model P transmitted less stresses than model C. The individual enamel of model C showed about 5% and 40% risk of failure at normal and maximum occlusal load values, respectively, while for model P, it had no failure risk at both values. For dentin, model C showed about 13% failure risk at the normal masticatory force, while model P showed only 2%. At clenching value, model C dentin showed about 44% failure risk, while only 9% was resulted for model P. CONCLUSIONS Compared to the conventional endocrown system, the positive impact of the studied novel endocrown system on the stress distribution pattern and also on the survival/failure probability of the restored severely-destructed endodontically treated maxillary first premolar teeth was reflected (more tooth-friendly), not only at normal masticatory forces but also at the maximum functional loads. CLINICAL SIGNIFICANCE The novel endocrown system using a PEKK coping veneered with cemented IPS e.max CAD can be considered a favorable option for restoration of severely-destructed endodontically treated premolar teeth, with more protection for residual tooth structure. Despite the conventional endocrown system may benefit the durability of tooth bonding, it should not be selected for restoration of clenching cases because of the too high overall failure risk.
Collapse
|
20
|
Beji Vijayakumar J, Varadan P, Balaji L, Rajan M, Kalaiselvam R, Saeralaathan S, Ganesh A. Fracture resistance of resin based and lithium disilicate endocrowns. Which is better? - A systematic review of in-vitro studies. Biomater Investig Dent 2021; 8:104-111. [PMID: 34368777 PMCID: PMC8312589 DOI: 10.1080/26415275.2021.1932510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Objectives: The primary objective of this systematic review is to compare the fracture resistance of lithium disilicate (LDS)-based endocrowns and resin-based (RB) endocrowns of in-vitro studies, and the secondary objective is to compare their catastrophic failures. Materials and Methods: The review protocol was registered in the P ROSP ERO database (CRD42020166201). A comprehensive literature search was done in PubMed, Cochrane, EBSCOhost and Google Scholar using key terms. Only in-vitro studies that compared fracture resistance of LDS-based endocrowns and indirect RB endocrowns in molars were included. Data extraction, risk of bias assessment and qualitative analysis of the included studies were performed. Results: Five studies were included in this systematic review. The overall risk of bias for the included studies was moderate. Under axial loading, RB endocrowns showed similar fracture resistance when compared with LDS endocrowns. However, they showed better fracture resistance when compared with zirconia reinforced lithium silicate (ZLS) endocrowns. Furthermore, RB endocrowns showed fewer catastrophic failures than LDS-based endocrowns. Conclusions: RB endocrowns have similar or better fracture resistance and fewer catastrophic failures when compared to LDS-based endocrowns.
Collapse
Affiliation(s)
- Joshna Beji Vijayakumar
- Department of Conservative Dentistry & Endodontics, Sri Ramachandra Faculty of Dental Sciences, SRIHER (DU), Chennai, India
| | - Preethi Varadan
- Department of Conservative Dentistry & Endodontics, Sri Ramachandra Faculty of Dental Sciences, SRIHER (DU), Chennai, India
| | - Lakshmi Balaji
- Department of Conservative Dentistry & Endodontics, Sri Ramachandra Faculty of Dental Sciences, SRIHER (DU), Chennai, India
| | - Mathan Rajan
- Department of Conservative Dentistry & Endodontics, Sri Ramachandra Faculty of Dental Sciences, SRIHER (DU), Chennai, India
| | - Rajeswari Kalaiselvam
- Department of Conservative Dentistry & Endodontics, Sri Ramachandra Faculty of Dental Sciences, SRIHER (DU), Chennai, India
| | - Sindhu Saeralaathan
- Department of Conservative Dentistry & Endodontics, Sri Ramachandra Faculty of Dental Sciences, SRIHER (DU), Chennai, India
| | - Arathi Ganesh
- Department of Conservative Dentistry & Endodontics, Sri Ramachandra Faculty of Dental Sciences, SRIHER (DU), Chennai, India
| |
Collapse
|
21
|
Influence of Polymeric Restorative Materials on the Stress Distribution in Posterior Fixed Partial Dentures: 3D Finite Element Analysis. Polymers (Basel) 2021; 13:polym13050758. [PMID: 33670991 PMCID: PMC7957672 DOI: 10.3390/polym13050758] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 02/12/2021] [Accepted: 02/12/2021] [Indexed: 01/06/2023] Open
Abstract
Background: This study evaluated the effect of interim restorative materials (acrylic resin (AR), resin composite (RC) or polyetheretherketone (PEEK) for dental computer-aided design/computer-aided manufacturing (CAD/CAM)) on the stress distribution of a posterior three-unit fixed partial denture. Methods: The abutment teeth (first molar and first premolar) were modeled using the BioCAD protocol containing 1.5 mm of axial reduction and converging axial walls. A static structural analysis was performed in the computer-aided engineering software, and the Maximum Principal Stress criterion was used to analyze the prosthesis and the cement layers of both abutment teeth. The materials were considered isotropic, linearly elastic, homogeneous and with bonded contacts. An axial load (600 N) was applied to the occlusal surface of the second premolar. Results: Regardless of the restorative material, the region of the prosthetic connectors showed the highest tensile stress magnitude. The highest stress peak was observed with the use of RC (129 MPa) compared to PEEK and AR. For the cement layers, RC showed the lowest values in the occlusal region (7 MPa) and the highest values for the cervical margin (14 MPa) compared to PEEK (21 and 12 MPa) and AR (21 and 13 MPa). Conclusions: Different interim restorative materials for posterior fixed partial dentures present different biomechanical behavior. The use of resin composite can attenuate the stress magnitude on the cement layer, and the use of acrylic resin can attenuate the stress magnitude on the connector region.
Collapse
|
22
|
Tribst JPM, Borges ALS, Silva-Concílio LR, Bottino MA, Özcan M. Effect of Restorative Material on Mechanical Response of Provisional Endocrowns: A 3D-FEA Study. MATERIALS 2021; 14:ma14030649. [PMID: 33572533 PMCID: PMC7866804 DOI: 10.3390/ma14030649] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/22/2021] [Accepted: 01/26/2021] [Indexed: 12/14/2022]
Abstract
The goal of this study was to evaluate the stress distribution in an endocrown restoration according to different provisional restorative materials. An endodontically treated maxillary molar model was selected for conducting the finite element analysis (FEA), with a determined amount of dental remnant of 1.5 mm. The model was imported to the analysis software (ANSYS 19.2, ANSYS Inc., Houston, TX, USA) in STEP format. All contacts were considered perfectly bonded. The mechanical properties of each structure were considered isotropic, linear, elastic, and homogeneous. Three different provisional restorative materials were simulated (acrylic resin, bis-acrylic resin, and resin composite). An axial load (300 N) was applied at the occlusal surface in the center of the restoration. Results were determined by colorimetric stress maps of maximum principal stress, maximum shear stress, and total deformation. The different materials influenced the stress distribution for all structures; the higher the material’s elastic modulus, the lower the stress magnitude on the cement layer. In the present study, all provisional restorative materials showed similar stress patterns in the endocrown and on the cement layer however, with different magnitude. Based on this study limitation, the use of resin composite to manufacture provisional endocrowns is suggested as a promising material to reduce the stresses in the cement layer and in the dental tissue surfaces.
Collapse
Affiliation(s)
- João Paulo Mendes Tribst
- School of Dentistry, University of Taubaté, Taubaté, São Paulo 12020-340, Brazil; (J.P.M.T.); (L.R.S.-C.)
| | - Alexandre Luiz Souto Borges
- Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo 12220-690, Brazil; (A.L.S.B.); (M.A.B.)
| | | | - Marco Antonio Bottino
- Institute of Science and Technology, São Paulo State University (Unesp), São José dos Campos, São Paulo 12220-690, Brazil; (A.L.S.B.); (M.A.B.)
| | - Mutlu Özcan
- Division of Dental Biomaterials, Center for Dental and Oral Medicine, Clinic for Reconstructive Dentistry, University of Zurich, 8032 Zurich, Switzerland
- Correspondence:
| |
Collapse
|
23
|
Ozkurt-Kayahan Z, Turgut B, Akin H, Kayahan MB, Kazazoglu E. A 3D finite element analysis of stress distribution on different thicknesses of mineral trioxide aggregate applied on various sizes of pulp perforation. Clin Oral Investig 2020; 24:3477-3483. [PMID: 32333173 DOI: 10.1007/s00784-020-03218-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 01/20/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the stress distribution on different thicknesses of mineral trioxide aggregate (MTA) placed on various widths of pulp perforations during the condensation of the composite resin material. MATERIALS AND METHODS The mandibular molar tooth was modeled by COSMOSWorks program (SolidWorks, Waltham, MA). Three finite elemental analysis models representing 3 different dimensions of pulp perforations, 1, 2, and 3 mm in diameter, were created. The perforation area was assumed as filled with MTA with different thicknesses, 1, 2, and 3 mm for each pulp perforation width, creating a total of 9 different models. Then, a composite resin material was layered on MTA for each model. A 66.7 N load was applied and an engineering simulation program (ANSYS, Canonsburg, US) was used for the analysis. Results were presented considering von Mises stress criteria. RESULTS As MTA thickness increased, the stress values recorded within the area between pulp and MTA decreased. Strain was decreased when the thickness of MTA increased. CONCLUSIONS Stresses at MTA-pulp interface and strain on MTA decreased with the increase in MTA thickness. CLINICAL RELEVANCE In clinical practice, when MTA is required for pulp capping, using a thick layer of the material seems to be a better option in order to reduce the stress under forces of hand condensation of overlying restorative materials.
Collapse
Affiliation(s)
- Zeynep Ozkurt-Kayahan
- Department of Prosthodontics, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey.
| | - B Turgut
- Department of Mechanical Engineering, Faculty of Natural Sciences and Engineering, Gaziosmanpasa University, Tokat, Turkey
| | - H Akin
- Department of Prosthodontics, Faculty of Dentistry, Sakarya University, Sakarya, Turkey
| | - M B Kayahan
- Department of Endodontics, Faculty of Dentistry, Okan University, Istanbul, Turkey
| | - E Kazazoglu
- Department of Prosthodontics, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey
| |
Collapse
|
24
|
Tribst JPM, Dal Piva AMDO, de Jager N, Bottino MA, de Kok P, Kleverlaan CJ. Full-Crown Versus Endocrown Approach: A 3D-Analysis of Both Restorations and the Effect of Ferrule and Restoration Material. J Prosthodont 2020; 30:335-344. [PMID: 32856743 DOI: 10.1111/jopr.13244] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2020] [Indexed: 01/18/2023] Open
Abstract
PURPOSE To assess stress distribution in full-crowns with a composite buildup and endocrowns under axial or oblique loads, both with different ferrules (1 or 2 mm) and ceramic materials (glass ceramic or hybrid ceramic). MATERIALS AND METHODS Sixteen models were analyzed with finite element analysis. No-separation contacts were considered between restoration/resin cement and resin cement/tooth. The contact between the fixation cylinder and the root was considered perfectly bonded. The axial load was applied to the occlusal surface and the oblique load was applied to the buccal cusp. The resulting tensile stresses were shown for the crown, the cement layer and the tooth. RESULTS Almost all factors influenced the stress distribution significantly in the crown and the cement layer, as well as the tooth. The only exception was found under oblique loading by the restoration material and the type of crown that were of no significant influence on the stress distribution in the tooth. CONCLUSIONS Under axial load, the endocrown showed the least tensile stresses in the tooth, but under oblique loads, the full-crown showed less tensile stresses than the endocrown. With the hybrid ceramic material, lower stresses were found in the crown, but higher stresses were present in the cement layer. The 2 mm ferrule is beneficial for reducing the resulting tensile stresses in all modalities.
Collapse
Affiliation(s)
- João Paulo Mendes Tribst
- Department of Dental Materials and Prosthetics, São Paulo State University (UNESP), Institute of Science and Technology, São José dos Campos, Brazil
| | - Amanda Maria de Oliveira Dal Piva
- Department of Dental Materials and Prosthetics, São Paulo State University (UNESP), Institute of Science and Technology, São José dos Campos, Brazil
| | - Niek de Jager
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Marco Antonio Bottino
- Department of Dental Materials and Prosthetics, São Paulo State University (UNESP), Institute of Science and Technology, São José dos Campos, Brazil
| | - Paul de Kok
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Cornelis Johannes Kleverlaan
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| |
Collapse
|
25
|
Zhu J, Wang D, Rong Q, Qian J, Wang X. Effect of central retainer shape and abduction angle during preparation of teeth on dentin and cement layer stress distributions in endocrown-restored mandibular molars. Dent Mater J 2020; 39:464-470. [PMID: 32092721 DOI: 10.4012/dmj.2019-050] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
To study the effect of central retainer shape and abduction angle during tooth preparation on stress distribution in endocrown-restored molars via finite element (FE) analysis, we constructed five FE models with different central retainer shapes and abduction angles. Under an oblique load, the distributions of maximum tensile stress in cervical dentin around the endocrown and on the cement layer, as well as maximum shear stress on the cement layer, were more balanced in the FE model in which the central retainer shape was generated based on the anatomical form of the pulp chamber. Moreover, there were no differences in stress distributions among FE models with different abduction angles. Therefore, the shape of the central retainer should be designed on the basis of the anatomical form of the pulp chamber; abduction angle during tooth preparation does not influence the repair effect of endocrown-restored mandibular molars.
Collapse
Affiliation(s)
- Junxin Zhu
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology
| | - Dongmei Wang
- 2nd Dental Center, Peking University School and Hospital of Stomatology
| | - Qiguo Rong
- Department of Mechanics and Engineering Science, College of Engineering, Peking University
| | - Jun Qian
- 2nd Dental Center, Peking University School and Hospital of Stomatology
| | - Xiaoyan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology
| |
Collapse
|
26
|
Zhai XY, Zhang JY, Zhang SK, Jiang CJ, Qiu XX. [Finite-element analysis of mandibular first molar with two marginal designs of endocrown for the repair of different defects]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2019; 37:480-484. [PMID: 31721493 PMCID: PMC7030409 DOI: 10.7518/hxkq.2019.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 06/21/2019] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study aimed to evaluate the stress distribution of the mandibular first molar with different thicknesses and heights of the axial wall restored by the endocrown with two marginal designs and thus provide a theoretical basis for selecting clinical preparation through the finite-element method. METHODS Two marginal endocrowns of the mandibular first molar with different axial-wall thicknesses (t=1, 2, 3 mm) and heights (h=2, 3, 4 mm) were established. Group A was the butt-joint design, whereas group B was the shoulder-surrounded design. After applying vertical and oblique loads , the size and distribution of the maximum principal stress and equivalent stress of residual tooth tissue were recorded. RESULTS The maximum principal stress and equivalent stress distribution of residual tooth tissue were similar among different models. Group A showed a lower maximum principal stress and equivalent stress than group B at the same thickness and height under vertical load. Meanwhile, under oblique load, the maximum principal stress values of groups A and B decreased with increased thickness at constant height. Group A showed lower equivalent stress than group B at the same thickness and height of 2 and
3 mm. However, when the height was 4 mm, the trend was reversed. CONCLUSIONS In mastication, when bearing the vertical force, the retention of the butt-joint marginal endocrown preferred to the shoulder-surrounded one. Given the higher axial wall of the shoulder-surrounded marginal endocrown, it showed better ability to bear the oblique force than the butt-joint one.
Collapse
Affiliation(s)
- Xiao-Yang Zhai
- Dept. of Prosthodontics, The First Affiliated Hospital of Zhengzhou University, Stomatological College of Zhengzhou University, Zhengzhou 450052, China
| | - Jing-Ya Zhang
- Dept. of Prosthodontics, The First Affiliated Hospital of Zhengzhou University, Stomatological College of Zhengzhou University, Zhengzhou 450052, China
| | - San-Ke Zhang
- Dept. of Prosthodontics, The First Affiliated Hospital of Zhengzhou University, Stomatological College of Zhengzhou University, Zhengzhou 450052, China
| | - Chuan-Jing Jiang
- Dept. of Prosthodontics, The First Affiliated Hospital of Zhengzhou University, Stomatological College of Zhengzhou University, Zhengzhou 450052, China
| | - Xiao-Xia Qiu
- Dept. of Prosthodontics, The First Affiliated Hospital of Zhengzhou University, Stomatological College of Zhengzhou University, Zhengzhou 450052, China
| |
Collapse
|
27
|
El Ghoul W, Özcan M, Silwadi M, Salameh Z. Fracture resistance and failure modes of endocrowns manufactured with different CAD/CAM materials under axial and lateral loading. J ESTHET RESTOR DENT 2019; 31:378-387. [DOI: 10.1111/jerd.12486] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 01/28/2019] [Accepted: 04/09/2019] [Indexed: 01/10/2023]
Affiliation(s)
- Wiam El Ghoul
- Lebanese UniversityFaculty of Dental Medicine, Department of Prosthodontics Beirut Lebanon
| | - Mutlu Özcan
- University of ZurichCenter for Dental and Oral Medicine, Division of Dental Biomaterials Zurich Switzerland
| | - Munir Silwadi
- Lebanese UniversityFaculty of Dental Medicine, Department of Prosthodontics Beirut Lebanon
| | - Ziad Salameh
- Lebanese UniversityFaculty of Dental Medicine, Department of Prosthodontics Beirut Lebanon
| |
Collapse
|
28
|
Abdelaziz KM, Keshk CK, Alshadidi A, Mafraq S, Murchison DF. Fracture Resistance of Ceramic Crowns Supported with Indirect Chair-side Composite Cores. J Int Soc Prev Community Dent 2018; 8:34-40. [PMID: 29629327 PMCID: PMC5853040 DOI: 10.4103/jispcd.jispcd_381_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 11/22/2017] [Indexed: 11/04/2022] Open
Abstract
Aims and Objectives To evaluate the influence of indirect chair-side polymerization of resin composite cores on the fracture resistance of overlaying IPS e.max Press crowns. Materials and Methods Root canals of 60 extracted premolars were prepared to receive #2 fiber posts after the crowns were sectioned 2 mm above the cervical line. In Groups 1-3 (n = 10 each), posts were luted to the prepared dowel spaces using self-adhesive resin cement. Resin composite cores were then bonded and incrementally built-up using Filtek Z250 XT, Filtek P60, and Filtek P90 resin composites. In Groups 4-6 (n = 10 each), the fabricated post-core systems were subjected to post-curing heat and pressure treatment before cementation to their respective teeth using self-adhesive resin cement. Another 10 sound premolars served as control. All teeth in the test and control groups were then subjected to standardized preparation to receive IPS e.max Press crowns before testing their fracture resistance and the mode of restorations' failure. The collected results were statistically analyzed using ANOVA, Kruskal-Wallis, and Tukey's tests on the past software used at α = 0.05 to stand on the significance of the detected differences. Results Significant differences were detected between the fracture resistance of teeth in different groups (ANOVA, P = 2.857E-35). Crowns in Groups 4-6 provided higher fracture resistance than those in Groups 1-3 (Tukey's test, P < 0.05). Crowns in Groups 4 and 6 provided higher fracture resistance than the control, while those in Groups 2 and 3 provided lower fracture resistance than the control (Tukey's test, P < 0.05). Conclusion Indirect composite cores improved the fracture resistance of IPS e.max Press crowns when compared to directly fabricated post and cores. The directly and indirectly polymerized nanohybrid, methacrylate-based composite (Filtek Z250 XT) cores yielded the highest fracture resistance for the utilized all-ceramic crowns.
Collapse
Affiliation(s)
- Khalid M Abdelaziz
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, KSA
| | - Cinderella K Keshk
- BDS Program, Faculty of Oral and Dental Medicine, Al-Ahram Canadian University, 6 October City, Giza, Egypt
| | - Abdulkhaliq Alshadidi
- Department of Dental Technology, College of Allied Health Sciences, King Khalid University, Abha, KSA
| | | | - David F Murchison
- Department of Diagnostic Sciences, Texas A and M University College of Dentistry, Dallas, Texas, USA
| |
Collapse
|
29
|
Abdelaziz KM, Khalil AA, Alsalhi IY, Almufarrij AJ, Mojathel AY. Fracture Resistance of Tilted Premolars Restored with Different Post-Core Systems. J Int Soc Prev Community Dent 2018; 7:344-350. [PMID: 29387618 PMCID: PMC5774055 DOI: 10.4103/jispcd.jispcd_382_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 11/14/2017] [Indexed: 11/06/2022] Open
Abstract
Aims and Objective: To assess the effect of root tilt on the fracture resistance and failure pattern of endodontically-treated premolars restored with different post-core systems. Materials and Methods: Ninety endodontically-treated premolars were mounted in acrylic blocks with 0°, 12°, and 24° axial root tilt. Teeth in each group were restored in three subgroups with cast post-core, readymade metal posts and composite cores, and fiber post and composite cores. Crowns of all teeth were prepared coinciding with the long axis of the acrylic blocks to receive all-ceramic crowns. All restored teeth were stressed to record the maximum load at failure and the associated failure pattern. The collected data were statistically analyzed using two-way ANOVA, Tukey's, and Kruskal–Wallis tests at α = 0.05 on past software to detect any differences between subgroups. Results: Analysis of the collected data indicated significant differences between the tested subgroups (ANOVA, P = 3.86). Further analysis showed significant difference between all test subgroups and the control (Tukey's, P < 0.05). In general, teeth with 0° tilt seemed more resistant to fracture than the tilted ones. For all groups, teeth restored with fiber post and composite cores (SG3) were more resistant to fracture compared to other post-core systems (SG1 and SG2) (Tukey's, P < 0.05). The root fracture was the most commonly seen mode of failure. Conclusions: Root tilting usually affects the fracture resistance of teeth restored with post-core systems. The fiber post and composite cores seemed to be the best choice to restore teeth with different root tilting possibilities.
Collapse
Affiliation(s)
- Khalid M Abdelaziz
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Ashraf A Khalil
- Department of Restorative Dental Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia.,Department of Crown and Bridge, Faculty of Dentistry, Tanta University, Tanta, Egypt
| | - Ibrahim Y Alsalhi
- Internship Program, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Ali J Almufarrij
- Internship Program, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Ahmed Y Mojathel
- Internship Program, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| |
Collapse
|