Corrigendum to "Biomechanical Evaluation of a Tooth Restored with High Performance Polymer PEKK Post-Core System: A 3D Finite Element Analysis"

Polyetheretherketone split post and core for restoration of multirooted molar with insufficient dental tissue remnants by digital techniques: a case report and 3-year follow up

BACKGROUND

Multi-rooted teeth with extensive dental defects often face challenges in stability and biomechanical failure. High-performance polymer PEEK materials, with properties closer to dentin, show promise in reducing stress concentration and preserving tooth structure. This report aimed to explore the use of a highly retentive polyetheretherketone (PEEK) for manufacturing custom-made split post and core for the restoration of grossly destroyed endodontically treated molars.

CLINICAL CONSIDERATIONS

A 40-year-old female patient presented with complaints of loss of tooth substance in the posterior mandibular tooth. This case involved the digital design and fabrication of PEEK split post and core to restore multirooted molar with insufficient dental tissue remnants. The restorations were evaluated over a 3-year follow-up using the World Federation criteria (FDI). The restoration was clinically evaluated through intraoral examination, radiographic assessment, and subjective patient satisfaction, and was deemed clinically good according to FDI criteria.

CONCLUSION

The outstanding mechanical properties of PEEK, coupled with the structure of the split post, provide an effective treatment option for weakened multirooted teeth. Simultaneously, the restoration configuration effectively addressed the challenge of varying postinsertion directions, and the interlocking mechanism between the primary and auxiliary posts enhanced the stability of the post and core.

Shock Absorption Capacity of High-Performance Polymers for Dental Implant-Supported Restorations: In Vitro Study

BACKGROUND

Restorative materials might significantly affect load transmission in peri-implant bone. The aim of the present study is to evaluate the shock absorption capacity of two different polymeric materials to be used for implant-supported prostheses.

METHODS

A masticatory robot was used to compare the shock absorption capacity of veneered and non-veneered polyetherketoneketone (PEKK), Pekkton®ivory (Cendres+Mètaux), and the glass fiber-reinforced composite (GFRC), TRINIATM (Bicon). Five identical sample crowns for each of the three groups were tested. Forces transmitted at the simulated peri-implant bone were recorded and statistically analyzed.

RESULTS

The statistical analysis of forces transmitted at the simulated dental implant revealed significant differences between the materials tested and between these materials and zirconia, glass ceramic, composite resin, and acrylic resin. Only differences between PEKK and veneered PEKK and between PEKK and one of the previously tested composite resins were not statistically significant. PEKK samples demonstrated significantly greater shock absorption capacity compared to GFRC.

CONCLUSIONS

PEKK revealed optimal shock absorption capacity. Further studies are needed to evaluate its efficacy in the case of long-span prostheses with reduced prosthetic volume.

Mechanical behavior of endodontically treated teeth: A three-dimensional finite element analysis using displacement vector

PURPOSE

This study aimed to analyze the effects of core materials, remaining tooth structures, and interfacial bonding on stress distribution in endodontically treated teeth using finite element analysis (FEA).

MATERIALS AND METHODS

Three-dimensional FEA was conducted using a reverse engineering technique based on maxillary premolars scanned by micro-computed tomography. Six models were generated with or without ferrules and with one of the following three abutment systems: metal core, resin core, or resin core with fiber posts. In each model, bonding and debonding were assumed in the dentin and surrounding structures: bonded and debonded models. The maximum principal stress values were recorded, and stress distribution of the entire restored teeth and dentin was generated. Furthermore, the distribution of the displacement vector of the debonded models was generated.

RESULTS

In comparing the bonded and debonded models, the debonded models showed larger values for tensile stresses than those in bonded models for all abutment models. The models without ferrules rotated around the center of the abutment, whereas those with ferrules did not show remarkable displacement in the analysis.

CONCLUSION

FEA assuming fracture of adhesive interface proved to be an effective method to clarify the significance of ferrules. It prevents stress concentration in dentin by reducing the rotation of the abutment, even when the adhesive fails.

Impact of different CAD/CAM materials on internal and marginal adaptations and fracture resistance of endocrown restorations with: 3D finite element analysis

PURPOSE

To assess and compare the impact of various computers aided design/manufacturing (CAD/CAM) materials on internal and marginal discrepancies, fracture resistance and failure probability of Endocrown restorations with 3D Finite Element analysis.

MATERIAL AND METHODS

Forty devitalized human maxillary first molars were collected. After endodontic treatment, they classified into 4 groups (n = 10) based on the materials used for endocrown fabrication. Group V (Vita-Enamic), Group N (Nacera Hybrid), Group T (Translucent Prettau Zirconia) and Group P (Pekkton ivory). All samples were exposed to artificial aging method simulating one year of clinical service. Silicone replica technique and stereomicroscope (25X) utilized to evaluate the marginal and internal gaps of endocrowns at different areas. Fracture resistance test used for cemented specimens followed by qualitative investigation utilizing Stereomicroscopy. Four models representing four endocrown systems used for restoration of severely-damaged endodontically treated upper first molar were generated for finite element analysis (FEA). Axially and centrally static occlusal compressive load was applied. Modified Von Mises and maximum principal stress values on the remaining tooth structure, cement lines and restorative materials were assessed independently. Resulted data were statistically analyzed at P-value ≤ 0.05.

RESULTS

In the current study, the highest mean values of internal and marginal discrepancies (μm) among studied groups were reported for Zirconia group (100.300 and 102.650) respectively, while the lowest mean value of internal discrepancy (μm) was observed for Nacera group (69.275) and the lowest mean value of marginal discrepancy (μm) was observed for PEKK group (78.4750). Regarding internal discrepancy, Vita-Enamic and PEKK groups did not exhibit any statistically significant differences (P = 0.293), however zirconia and the other tested groups exhibited statistically significant differences in the mean values of the marginal gap region (p 0.05).On the other hand, PEKK group showed the highest mean value of fracture resistance (1845.20 N) and the lowest value was observed for Vita-Enamic group (946.50 N). Regarding to stress distributions through 3D FEA, and according to modified von Mises (mvM) analysis, the greatest possible stress values were noticed in PEKK model in relation to tooth structure, cement line, and flowable composite as the following: (93.1, 64.5, 58.4 MPa) respectively, while Zirconia revealed lower maximum stress values (11.4, 13.6, 11.6 MPa) respectively.

CONCLUSIONS

Statistically excellent marginal and internal fit was observed for PEKK in relation to other used endocrown materials. Also, PEKK material explained fracture resistance comparable to zirconia value while the lowest value was detected for Vita Enamic material.

Description of Poly(aryl-ether-ketone) Materials (PAEKs), Polyetheretherketone (PEEK) and Polyetherketoneketone (PEKK) for Application as a Dental Material: A Materials Science Review

Poly(aryl-ether-ketone) materials (PAEKs), a class of high-performance polymers comprised of polyetheretherketone (PEEK) and polyetherketoneketone (PEKK), have attracted interest in standard dental procedures due to their inherent characteristics in terms of mechanical and biological properties. Polyetheretherketone (PEEK) is a restorative dental material widely used for prosthetic frameworks due to its superior physical, mechanical, aesthetic, and handling features. Meanwhile, polyetherketoneketone (PEKK) is a semi-crystalline thermoplastic embraced in the additive manufacturing market. In the present review study, a new way to fabricate high-performance polymers, particularly PEEK and PEKK, is demonstrated using additive manufacturing digital dental technology, or 3-dimensional (3D) printing. The focus in this literature review will encompass an investigation of the chemical, mechanical, and biological properties of HPPs, particularly PEEK and PEKK, along with their application particularly in dentistry. High-performance polymers have gained popularity in denture prosthesis in advance dentistry due to their flexibility in terms of manufacturing and the growing interest in utilizing additive manufacturing in denture fabrication. Further, this review also explores the literature regarding the properties of high-performance polymers (HPP) compared to previous reported polymers in terms of the dental material along with the current advancement of the digital designing and manufacturing.

The Effects of Different Molding Orientations, Highly Accelerated Aging, and Water Absorption on the Flexural Strength of Polyether Ether Ketone (PEEK) Fabricated by Fused Deposition Modeling

Rising prices are currently a problem in the world. In particular, the abnormal increases in the price of metals, which are often used in dental prosthetics, have increased the burden of dental costs on the public. There is therefore an urgent need to develop prosthetic devices made from materials that are not affected by the global situation and that have excellent biocompatibility and mechanical properties comparable to those of metals. Polyether ether ketone (PEEK) is a promising alternative to metal in dentistry. This study compared the effects of different molding orientations, highly accelerated aging, and water absorption on the flexural strength of PEEK fabricated by fused deposition modeling (FDM) and examined its potential for dental applications. The flexural strength of PEEK stacked at 0° to the molding stage (0° PF), with and without highly accelerated aging, was significantly greater than for the other molding orientations. As with PD, the maximum test load for 0° PF was measured without fracture. PEEK stacked at 45° (45° PF) and 90° (90° PF) to the molding stage easily fractured, as the applied load pulled the stacked layers. No statistically significant difference was found between the flexural strength of 45° PF and 90° PF. The flexural strength decreased under all conditions due to defects in the crystal structure of PEEK caused by highly accelerated aging.

The Use of Polyetheretherketone (PEEK) as an Alternative Post and Core Material: Five-Year Follow-Up Report

This clinical report demonstrated the use of polyetheretherketone (PEEK) for manufacturing of custom-made post and core in weakened endodontically treated central incisors. The PEEK structure was manufactured using computer-aided design/computer-aided manufacturing (CAD/CAM). The optimal fit of this custom-made endodontic post allowed a thinner cement layer; and removed the need to manufacture a core build-up. While supplementary clinical trials and in vitro studies are needed to totally elucidate the advantages and limitations of PEEK as an option for post and core manufacturing, this case report showed that it can be promising for a predictable and simplified treatment with five years of success.

Clinical assessment of different implant-supported esthetic crown systems fabricated with semi-digital workflow: Two-year prospective study

OBJECTIVE

To assess the clinical outcome of three esthetic implant-supported crown systems fabricated with semi-digital workflow and their influence on the clinical outcome of dental implants.

MATERIAL AND METHODS

A total of 30 participants had received dental implants restoring missing maxillary first/second premolars. After 6 weeks, customized zirconia abutments were early loaded. Two months later, the definitive crowns were fabricated using semi-digital workflow and cemented. According to the crown material, 3 groups were randomly allocated; group (Z): ultrahigh-translucent monolithic zirconia, group (C): resin-matrix ceramic and group (P): polyetherketoneketone veneered with light-cured composite resin. Clinical outcomes including the survival and success rates were evaluated at baseline, 6, 12, 18, and 24 months.

RESULTS

The survival rate for all studied groups was 100%, while their success rate was 100% for group (Z) and 90% for group (C) and group (P). Based on the functional implant prosthodontic score, a statistically significant difference was detected between group (Z) and group (P) (p < 0.001) as well as between group (C) and group (P) (p = 0.01).

CONCLUSIONS

The zirconia group had the most favorable clinical behavior, while the polyetherketoneketone had the least. All crown systems had comparable success rates with similar values of the peri-implant marginal bone loss.

CLINICAL SIGNIFICANCE

Using semi-digital workflow, ultrahigh-translucent monolithic zirconia, resin-matrix ceramic and polyetherketoneketone veneered with light-cured composite resin can be considered as favorable implant-supported crowns. The implant-supported crown system based on polyetherketoneketone veneered with light-cured composite resin is counted as a promising esthetic and restorative option.

Fracture strength, pull-out bond strength, and volume of luting agent of tooth-colored CAD-CAM post-and-cores

STATEMENT OF PROBLEM

Little is known about the fracture strength, retention, and adaptation of post-and-cores fabricated with novel tooth-colored materials by computer-aided design and computer-aided manufacturing (CAD-CAM).

PURPOSE

The purpose of this in vitro study was to investigate the fracture strength, pull-out bond strength (POBS), and volume of luting agent of endodontically treated premolars restored with post-and-cores milled from different CAD-CAM materials.

MATERIAL AND METHODS

Post spaces were prepared in 80 human premolars in which post-and-cores fabricated with polyetheretherketone (PK; Ceramill PEEK), nanohybrid composite resin (BB; Brava Block), polymer-infiltrated ceramic (EN; VITA Enamic), and fiber-reinforced epoxy resin (GF; Fiber Cad Post & Core) CAD-CAM materials were luted (n=20). All specimens were subjected to thermal aging (3000 cycles at 5 °C and 55 °C with a 20-second dwell time). Half of the specimens were subjected to mechanical fatigue (250 000 cycles at 5 Hz) before fracture strength testing, while the other half was submitted to POBS testing and volume of luting agent measurement. Fracture strength data were analyzed by 1-way ANOVA, while POBS and volume of luting agent data were submitted to Kruskal-Wallis followed by the Bonferroni-Dunn multiple comparison tests. The correlation between POBS and the volume of luting agent was determined by the Spearman test (α=.05).

RESULTS

POBS of GF was significantly higher than that for PK (P<.001); however, failure load (P=.160) and volume of luting agent (P=.390) values did not differ. EN showed the highest percentage of catastrophic failures (20%), while PK exhibited only core deformations. POBS and cement film volume were not significantly correlated (P>.05).

CONCLUSIONS

Different CAD-CAM materials did not influence the fracture strength and volume of luting agent of post-and-cores. Post-and-cores made with PEEK blocks showed lower bond strength to intracanal dentin than those made with fiber-reinforced epoxy resin blocks. No significant correlation was found between bond strength and the volume of luting agent.

Finite Element Study of PEEK Materials Applied in Post-Retained Restorations

Background: This study aimed to investigate the biomechanical behaviors of polyether ether ketone (PEEK) and traditional materials (titanium and fiber) when used to restore tooth defects in the form of prefabricated post or customized post via computational modelling. Methods: First, the prototype of natural tooth, and the prototypes of prefabricated post and customized post were established, respectively, whilst the residual root was restored with dentin ferrule using reverse engineering methods. Then, the stress and strain of CFR-PEEK (PEEK reinforced by 30% carbon fiber) and pure PEEK (PEEK without any reprocessing) post were compared with those made in traditional materials using the three-dimensional finite element method. Results: From the stress point of view, compared with metal and fiber posts, CFR-PEEK and pure PEEK prefabricated post both demonstrated reduced post-core interface stress, post stress, post-root cement stress and root cement stress; moreover, CFR-PEEK and pure PEEK customized post demonstrated reduced post stress, post-root cement stress and root cement stress, while the strain of CFR-PEEK post was the closest to that of dentin. Conclusions: Compared with the traditional posts, both the CFR-PEEK and pure PEEK posts could reduce the risk of debonding and vertical root fracture, whether they were used as prefabricated posts or customized posts, but the biomechanical behavior of carbon fiber-reinforced CFR-PEEK restorations was the closest to dentin, no matter if they were used as prefabricated post or customized post. Therefore, the CFR-PEEK post could be more suitable to restore massive tooth defects. Pure PEEK needs filler reinforcement to be used for post-retained restoration.

Post Placement and Restoration of Endodontically Treated Canines: A Finite Element Analysis Study

The purpose of this study was to show the improved outcomes of restoring endodontically treated teeth with fiberglass posts compared to restorations using metal posts. In our study, we used the Finite Element Method (FEM), which is based on the principle that a physical model that supports a given load distributes the stress throughout its volume. We sought to assess what stress results in a tooth when it is restored using a fiberglass post compared to restoration using a metal post. The finite element analysis showed that a system consisting of a tooth with a fiberglass post is more stable in terms of the maximum stress than a system consisting of a tooth with a metal post. The maximum displacements and deformations were obtained in the case of a canine restored with a fiberglass post, which showed that this system had a high elasticity, therefore, higher strength than a canine restored with a metal post, which had high rigidity.

The effects of root canal perforation repair materials on the bond strength of fiber posts

INTRODUCTION

This study aimed to evaluate the effect of calcium hydroxide and bioceramics used in perforation repair on the bonding strength of fiber posts via a push-out test.

METHODOLOGY

This study used 106 extracted single-rooted human mandibular premolar teeth. Root canal preparations were performed with a rotary file system and perforations were created in the middle third of each tooth. The samples were randomized into two main experimental groups, one with calcium hydroxide and one without. Each group had four subgroups in which different bioceramic cements were applied (n = 11) and a control group (n = 9). The root canals perforations were repaired using MTA, Biodentine, Bioaggregate, and Endosequence BC root repair material. A fiber post was applied to each tooth and a push-out test was performed. The samples were examined at 40× magnification with a digital microscope in order to identify fracture type.

RESULTS

Bonding strength was calculated in MPa. A statistical analysis showed that the calcium hydroxide had no effect on the bonding strength of the fiber posts. A comparison of the perforation repair materials revealed that Biodentine in the calcium hydroxide group and Bioaggregate in both groups decreased the bonding strength compared to the other materials (p < 0.05). The most common failure type was adhesive failure between the dentin and resin cement (38.16%).

CONCLUSIONS

The use of different perforation repair materials can affect the bonding strength of fiber posts. Therefore, the choice of perforation repair material should be made on an individual basis.

Effect of different surface treatments on the bond strength of milled polyetheretherketone posts

STATEMENT OF PROBLEM

Polyetheretherketone (PEEK) can be used as a framework material for removable and fixed dental prostheses. However, information about the use of PEEK as a post-and-core restoration is scarce.

PURPOSE

The purpose of this in vitro study was to evaluate the effect of different surface treatments on the push-out bond strength of milled polyetheretherketone posts to resin cement.

MATERIAL AND METHODS

Sixty intact human maxillary central incisors were selected and endodontically treated, and standardized post spaces were prepared. Sixty PEEK posts were milled from a prefabricated PEEK blank by using a computer-aided design and computer-aided manufacturing (CAD-CAM) system and divided into 3 groups (n=15) according to the surface treatment: acid etching by using 98% sulfuric acid (AE); airborne-particle abrasion by using 50-μm Al₂O₃ (AA); nonthermal plasma treatment (NTP); in addition, PEEK posts (n=15) received no treatment (NT) and served as a control. All posts were bonded by using a self-adhesive resin cement. Three sections (coronal, middle, and apical) were obtained for each specimen. Push-out bond strength measurements (MPa) for each section were recorded by using a universal testing machine at a crosshead speed of 0.5 mm/min until failure occurred. The post-cement interfaces and failure modes were evaluated by using scanning electron microscopy. The data obtained were statistically analyzed by using 1-way ANOVA and the pair-wise Tukey (HSD) test to study the difference between group mean values (α=.05).

RESULTS

The overall mean ±standard deviation of the push-out bond strength was 11 ±2 MPa for AE group, 6 ±1 MPa for AA group, 5 ±1 MPa for NTP group, and 3 ±1 MPa for NT group. A statistically significant difference was found among all groups subjected to different surface treatments as indicated by the ANOVA test (P<.001). The pair-wise Tukey honestly significant difference (HSD) test showed a significant difference among the AE group and all groups (P<.001); however, no significant difference was observed between the AA and NTP groups (P>.05). Moreover, a significant difference was observed among all root sections (P<.001).

CONCLUSIONS

Surface treatment of PEEK posts with 98% sulfuric acid for 60 seconds showed significantly higher bond strength values than those in other groups. The bond strength of PEEK posts to resin cement was significantly higher in the coronal section than that in other sections.

Mechanical performance of Anatomic-Functional-Geometry dental treatments: A computational study

In this paper the biomechanical response of a novel dental preparation technique, referred to as the Anatomic-Functional-Geometry treatment (AFG), is investigated through a 3D nonlinear finite-element modelling approach. A comparative investigation against a standard technique employed in dental clinical practice is carried out, by simulating typical experimental mechanical tests and physiological functional conditions. Failure mechanisms of treated tooth models are investigated through a progressive damage formulation implemented via a displacement-driven incremental approach. Computational results clearly show that AFG-treated teeth, as a consequence of a more conservative morphological preparation of the tooth, are characterized by more effective crown-dentin loading transfer mechanisms, higher fracture strength levels and more homogeneous stress patterns than the standard-treated ones, thereby opening towards widespread clinical application.

Mechanical and thermal stress evaluation of PEEK prefabricated post with different head design in endodontically treated tooth: 3D-finite element analysis

An endodontic post is required to retain and support the core restoration in case of insufficient remaining coronal dentin after root canal therapy. This study analyzed the biomechanical and thermal behavior of PEEK prefabricated post after choosing the head design that produces the least amount of stress on the core and remaining tooth structure. These results were compared with the most common commercially available prefabricated post, which is titanium and glass fiber post. Thus a CBCT scanning of a maxillary central incisor with its supporting structure was used to construct a 3D solid model of an endodontically treated teeth for finite element analysis (FEA). The restored tooth with the spherical head design of PEEK prefabricated post yielded a more benign stress distribution and repairable failure mode on the crown, luting cement, core, and dentin under both mechanical and thermal loads, followed by glass fiber post and titanium post respectively.

Fracture resistance of endodontically treated teeth restored with various esthetic posts

BACKGROUND

Dental esthetic materials are constantly introduced to meet the increasing esthetic demand in contemporary dental practice.

OBJECTIVE

To test the fracture resistance of endodontically treated teeth (ETT) restored with different esthetic post materials like fiber-reinforced composite post (FRC), polyether ether ketone (PEEK), and polymer infiltrated ceramic (PIC).

METHODS

Thirty-six human root canal treated single-rooted premolar teeth were decoronated 3 mm above the cemento-enamel junction and prepared to receive the post. They were randomly divided into three groups (n= 12) to be restored with FRC, PEEK, and PIC. After appropriate surface treatment, they were cemented with self-adhesive luting cement and restored with full veneer crowns. The samples were thermocycled, subjected to a compressive static load at 45∘ angulation until fracture. Obtained data were analyzed by one-way ANOVA and Tukey's HSD post hoc comparison test.

RESULTS

The results indicate that the ETT restored with PEEK post had the maximum fracture load (1929.94 N), followed by PIC endodontic post group (1810.65N), and FRC post (1715.68N). Meanwhile, ETT restored with FRC showed a predominantly favorable fracture, whereas PEEK restored teeth had a more unfavorable fracture.

CONCLUSION

Of all the esthetic post materials, the group for which PEEK endodontic post was used displayed higher fracture resistance.

Fracture Resistance and Failure Mode of Custom-made Post-and-cores of Polyetheretherketone and Nano-ceramic Composite

Clinical Relevance

Custom-made post-and-cores of polyetheretherketone (PEEK) and nano-ceramic composite showed good fracture resistance and failure mode. Clinicians should be aware that these materials might be an efficient alternative for post-and-cores, because they promote esthetics while reducing the risk of root fractures.

SUMMARY

Purpose: The purpose of this study was to evaluate the fracture resistance and failure mode of custom-made post-and-cores manufactured with different esthetic materials.

Methods and Materials: A total of 48 mandibular premolar extracted teeth were selected, endodontically treated, and prepared to receive the posts. Specimens were randomly divided into four groups (n=12/group): group 1, polyetheretherketone (PEEK, Degos; G1); group 2, nano-ceramic composite (Lava Ultimate, 3M ESPE; G2); group 3, cast metal post (NiCr alloy, control; G3); group 4, fiberglass post (Whitepost, FGM, control; G4) customized with a nano-hybrid resin composite (Z250, 3M ESPE). Experimental post-and-cores (G1 and G2) were manufactured with a computer-aided design/computer-aided manufacturing system. All posts were cemented with self-adhesive resin cement (Rely X U200, 3M ESPE), and specimens were stored in distilled water at 37°C for 60 days. A universal testing machine was used to measure the fracture resistance (0.5 mm/min at an angle of 45° to the long axis of the tooth). Fractures were classified as repairable or catastrophic. One-way analysis of variance with Tukey post hoc and χ2 tests for independence and Bonferroni adjustments were applied (α=0.05).

Results: The fracture resistance values (mean ± SD, in newtons) were 379.4 ± 119.8 (G1), 506.4 ± 138 (G2), 939.6 ± 146.5 (G3), and 449.6 ± 66.5 (G4). Only G3 exhibited a significant difference (p&lt;0.05). The χ2 test showed an association between failure mode and post-and-core material [χ2(3) = 23.65; p&lt;0.001]. After Bonferroni adjustment, only G3 presented a higher than expected incidence of catastrophic failures (p&lt;0.001). In the remaining groups, most failures were repairable and related to debonding.

Conclusions: Customized post-and-cores of PEEK and nano-ceramic composites exhibited good mechanical performance. Their fracture resistance was comparable to that observed for fiberglass customized posts, yet lower than that for cast metal posts. For PEEK post-and-cores, in particular, additional studies are needed to improve adhesiveness and reduce the risk of debonding.

Custom and prefabricated PolyEtherKetoneKetone (PEKK) post-core systems bond strength: Scanning electron microscopy evaluation

The present study evaluated the bond strengths of prefabricated PolyEtherKetoneKetone (PEKK) posts, PEKK posts custom-configured according to root-canal size, and conventional fiber posts. A total of 30 maxillary incisors were randomly divided into three groups, as follows: Group 1: fiber posts; Group 2: prefabricated PEKK posts; Group 3; custom-made PEKK posts. Following endodontic treatment, post spaces were prepared, and posts were cemented with resin cement. Push-out bond strength testing was performed using a universal testing machine, and fractures modes were examined under a scanning electron microscope. Data were analyzed using One-way ANOVA and Tukey's HSD tests, with the level of significance set at .05. The highest bond-strength values in the cervical section were observed with the custom-made PEKK post (17.3470 MPa), whereas the highest bond-strength values in the middle and apical sections were observed with the conventional fiber posts (11.5375 MPa and 6.8625 MPa, respectively). Bond-strength values for all posts systems decreased in a cervical to apical direction. PEKK posts are a suitable alternative to fiber posts. Although custom-made PEKK posts demonstrated better bond strength than prefabricated PEKK posts, further studies are needed to evaluate their clinical performance.

Assessment of artefacts produced by metal posts on CBCT images

AIM

To evaluate artefact intensity in cone beam computed tomography (CBCT) images of two alloys used in metal posts scanned using different exposure parameters.

METHODOLOGY

The sample consisted of 20 single-rooted teeth divided into two groups for use with either a NiCr post or AgPd post. All teeth were scanned with and without their corresponding metal posts and with and without the presence of an extra restored tooth in the arch. The samples were scanned using CS 9000 3D scanner with two exposure protocols: 85 kV 6.3 mA and 85 kV 10 mA. Voxel size and FOV were fixed at 0.100 mm and 5 cm × 3.75 cm. The presence of artefacts was assessed qualitatively by two calibrated observers using the CBCT volume and paired 2D images, and quantitatively by one trained observer, using ImageJ software. Wilcoxon's signed rank, Mann-Whitney, kappa and chi-square tests were used for qualitative analyses. Two-way anova and Tukey's tests were used for quantitative analyses. All analyses were conducted considering the 95% confidence level (α < 0.05).

RESULTS

For the CBCT volume qualitative analysis, significant differences were observed between the metal alloys in the presence of an extra restored tooth, with higher artefact intensity for AgPd when assessing hypodense halos and lines (P = 0.006). Images with two restored teeth had significantly more hypodense and hyperdense lines (P = 0.033). When evaluating exposure parameters and number of restored teeth, the paired image quality analysis revealed significant disagreement between observers for diagnostic image quality (P = 0.001). Quantitative artefact analysis revealed higher artefact intensity for the AgPd posts in the presence of two restored teeth.

CONCLUSION

Although the exposure parameters tested did not interfere with artefact intensity, post alloys with a higher atomic number and the presence of another metal structure in the arch increased artefact intensity and impaired the diagnostic quality of CBCT images.

Theoretical Design of Multilayer Dental Posts Using CAD-Based Approach and Sol-Gel Chemistry

A computer-aided design (CAD)-based approach and sol-gel chemistry were used to design a multilayer dental post with a compositional gradient and a Young’s modulus varying from 12.4 to 2.3 GPa in the coronal-apical direction. Specifically, we propose a theoretical multilayer post design, consisting of titanium dioxide (TiO₂) and TiO₂/poly(ε-caprolactone) (PCL) hybrid materials containing PCL up to 24% by weight obtained using the sol-gel method. The current study aimed to analyze the effect of the designed multilayer dental post in endodontically treated anterior teeth. Stress distribution was investigated along and between the post and the surrounding structures. In comparison to a metal post, the most uniform distributions with lower stress values and no significant stress concentration were found when using the multilayer post.

FE analysis of conceptual hybrid composite endodontic post designs in anterior teeth

OBJECTIVES

To assess conceptual designs of dental posts consisting of polyetherimide (PEI) reinforced with carbon (C) and glass (G) glass fibers in endodontically treated anterior teeth.

METHODS

3D tessellated CAD and geometric models of endodontically treated anterior teeth were generated from Micro-CT scan images. Model C-G/PEI composite posts with different Young's moduli were analyzed by Finite Element (FE) methods post A (57.7GPa), post B (31.6GPa), post C (from 57.7 to 9.0GPa in the coronal-apical direction). A load of 50N was applied at 45° to the longitudinal axis of the tooth, acting on the palatal surface of the crown. The maximum principal stress distribution was determined along the post and at the interface between the post and the surrounding structure.

RESULTS

Post C, with Young's modulus decreasing from 57.7 to 9.0GPa in the coronal-apical direction, reduced the maximum principal stress distribution in the restored tooth. Post C gave reduced stress and the most uniform stress distribution with no stress concentration, compared to the other C-G/PEI composite posts.

SIGNIFICANCE

The FE analysis confirmed the ability of the functionally graded post to dissipate stress from the coronal to the apical end. Hence actual (physical) C-G/PEI posts could permit optimization of stress distributions in endodontically treated anterior teeth.