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Falahchai M, Musapoor N, Mokhtari S, Babaee Hemmati Y, Neshandar Asli H. Fracture resistance and failure mode of endodontically treated premolars reconstructed by different preparation approaches: Cervical margin relocation and crown lengthening with complete and partial ferrule with three different post and core systems. J Prosthodont 2024; 33:774-782. [PMID: 37505114 DOI: 10.1111/jopr.13741] [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: 06/15/2023] [Revised: 07/14/2023] [Accepted: 07/23/2023] [Indexed: 07/29/2023] Open
Abstract
PURPOSE To assess the fracture resistance and failure mode of endodontically treated premolars reconstructed by different preparation approaches: cervical margin relocation (CMR) and crown lengthening (CL) with complete ferrule (CLF) and partial ferrule (CLPF) with three different post and core systems. MATERIALS AND METHODS In this in vitro study, 100 maxillary premolars were assigned to the following 10 groups according to their preparation approach and type of post and core system (n = 10): (I) control (intact teeth), (II) prefabricated fiber post (PFP) and composite core with CMR (PFP-CMR), (III) polyethylene fiber-reinforced composite (PEFRC) with CMR (PEFRC-CMR), (IV) casting post (CP) and core with CMR (CP-CMR), (V) PFP-CLPF, (VI) PEFRC-CLPF, (VII) CP-CLPF, (VIII) PFP-CLF, (IX) PEFRC-CLF, and (X) CP-CLF. After thermomechanical loading, the fracture resistance and failure mode were assessed. Data were analyzed statistically (α = 0.05). RESULTS In all post and core systems, the CLPF approach had lower fracture resistance than CMR (p < 0.05); CLF showed higher fracture resistance than CLPF only in the PFP system (p = 0.038). In PEFRC and CP systems, the difference between CLF and CLPF was not significant (p > 0.05). No significant difference was found in fracture resistance of different post and core systems with the same preparation approach (p > 0.05). CLPF showed the highest frequency of favorable, and CLF showed the highest frequency of unfavorable fractures. CONCLUSION CLPF yielded lower fracture resistance than CMR. The difference in fracture resistance was not significant between CLF and CMR but the frequency of unfavorable fractures was higher in CLF than in other groups.
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Affiliation(s)
- Mehran Falahchai
- Department of Prosthodontics, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Naghmeh Musapoor
- Department of Prosthodontics, School of Dentistry, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Soroosh Mokhtari
- Department of Prosthodontics, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Yasamin Babaee Hemmati
- Department of Orthodontics, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
| | - Hamid Neshandar Asli
- Department of Prosthodontics, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
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Vazzoler LO, Rosa LSD, Velho HC, Dotto L, Valandro LF, Bacchi A, Sarkis-Onofre R, Spazzin AO, Alessandretti R, Pereira GKR. Exploring fiberglass post numbers for enhanced fatigue resistance in molars without coronary remnants. Braz Dent J 2024; 35:e245946. [PMID: 39320004 PMCID: PMC11405009 DOI: 10.1590/0103-6440202405946] [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: 02/16/2024] [Accepted: 06/03/2024] [Indexed: 09/26/2024] Open
Abstract
This study aimed to assess the fatigue resistance of molars lacking a coronary remnant, using zero, one, two, or three fiberglass posts. Forty caries/crack-free human molars with coronal portions removed at the pulp chamber floor were randomly allocated into four groups (n=10). Following endodontic treatment, posts (Whitepost DC/DC.E 0.5, 1.0, FGM) were silanized (silane agent, Angelus) and cemented with a resin cement (RelyX U200, 3M ESPE). Resin composite cores (Z350, 3M ESPE) were built, and metal crowns were fabricated and cemented using the same luting system. Samples underwent cyclic fatigue testing at 45°, applying load in the occlusal surface at 10 Hz and 100 N initial load for 10,000 cycles, with 50 N increments every 10,000 cycles until failure. Fatigue failure load and cycles for failure data were recorded and subjected to survival analysis through Kaplan-Meier and Mantel-Cox post hoc tests, and Weibull analysis. Fractography patterns of failed crowns were qualitatively analyzed. The group without posts exhibited the lowest fatigue performance (p < 0.05) for both fatigue failure load and cycles to failure. Superior fatigue performance was observed in the three-post group, followed by groups with one or two posts, corroborated by the Weibull characteristic strength parameter. Weibull moduli were similar among conditions. All specimens exhibited failure involving detachment of the restorative set (posts/core/crown) with a portion of the dental remnant, without tooth fracture. Thus, when restoring mandibular molars without crown remnants, the use of fiberglass posts promotes greater fatigue resistance to oblique loads.
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Affiliation(s)
| | - Lucas Saldanha da Rosa
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria(UFSM), Santa Maria, RS, Brazil
| | - Helder Callegaro Velho
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria(UFSM), Santa Maria, RS, Brazil
| | - Lara Dotto
- Post-Graduate Program in Dentistry, Paulo Picanço School of Dentistry, Fortaleza, Ceará, CE, Brazil
| | | | - Atais Bacchi
- Post-Graduate Program in Dentistry, Paulo Picanço School of Dentistry, Fortaleza, Ceará, CE, Brazil
| | | | | | | | - Gabriel Kalil Rocha Pereira
- Post-Graduate Program in Oral Sciences, Center for Development of Advanced Materials, Division of Prosthodontics-Biomaterials, Federal University of Santa Maria(UFSM), Santa Maria, RS, Brazil
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Sunlakawit C, Chaimanakarn C, Srimaneekarn N, Osiri S. Effect of Calcium Hydroxide as an Intracanal Medication on Dentine Fracture Resistance: A Systematic Review and Network Meta-Analysis. J Endod 2024:S0099-2399(24)00443-6. [PMID: 39168239 DOI: 10.1016/j.joen.2024.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 08/06/2024] [Accepted: 08/07/2024] [Indexed: 08/23/2024]
Abstract
INTRODUCTION Bacterial infections necessitate effective root canal disinfection during endodontic therapy. Calcium hydroxide (CH), a widely used intracanal medication, shows conflicting effects on dentine fracture resistance in different studies. This study aimed to perform a comprehensive systematic review and network meta-analysis to evaluate the effects of CH on the fracture resistance of dentine in human teeth across different periods. METHODS PubMed, EMBASE, MEDLINE (EBSCO), Cochrane Library, Scopus, Google Scholar, and ProQuest databases were exhaustively searched to identify studies published until February 29, 2024, with no language restrictions. Laboratory studies that investigated dentine fracture resistance in human permanent teeth following intracanal CH exposure were included. The risk of bias was evaluated using modified criteria derived from previous studies. Network meta-analysis was performed using the frequentist method. Prespecified subgroup analyses focused on simulating immature teeth. RESULTS The search yielded 2,265 studies from all databases, and 27 met the inclusion criteria, involving 3,879 teeth or roots. The overall results from network meta-analysis indicated that CH affected the fracture resistance of human dentine. Subgroup analysis revealed that the duration influencing fracture resistance was ≥4 weeks for mature teeth, but no specific time limitation for immature teeth. The overall quality of the evidence showed a moderate to high risk of bias. CONCLUSIONS Short-term use of CH does not compromise human root dentine strength, supporting its routine application in clinical practice. CH remains a viable treatment strategy for over 4 weeks of medication needs but requires carefully considering the associated risks and benefits emphasizing on preservation and disease resolution. REGISTRATION PROSPERO database (CRD 42024513199).
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Affiliation(s)
- Chayanit Sunlakawit
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Chitpol Chaimanakarn
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | | | - Sittichoke Osiri
- Department of Operative Dentistry and Endodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.
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Caussin E, Izart M, Ceinos R, Attal JP, Beres F, François P. Advanced Material Strategy for Restoring Damaged Endodontically Treated Teeth: A Comprehensive Review. MATERIALS (BASEL, SWITZERLAND) 2024; 17:3736. [PMID: 39124400 PMCID: PMC11313123 DOI: 10.3390/ma17153736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 07/22/2024] [Accepted: 07/25/2024] [Indexed: 08/12/2024]
Abstract
The restoration of endodontically treated teeth (ETT) remains a significant challenge in modern dentistry. These teeth often suffer from substantial structural damage due to both the original pathology and the invasive nature of endodontic procedures. Consequently, ETT are more susceptible to fractures compared to vital teeth, necessitating restorative strategies that can effectively restore both function and aesthetics while minimizing the risk of failure. In recent years, advances in adhesive dentistry and the development of high-strength ceramics have further expanded the restorative options for ETT. Bonded restorations have gained popularity as they preserve more tooth structure and enhance the overall strenght of the tooth-restoration complex. The choice of restorative material and technique is influenced by numerous factors, including the amount of remaining tooth structure, the functional requirements of the tooth, and the aesthetic demands of the patient. Despite the plethora of available materials and techniques, the optimal approach to restoring ETT remains a topic of ongoing research and debate. In this comprehensive review, the current state of and recent advances in restoring damaged endodontically treated teeth are explored. Numerous therapeutic options exist, involving a wide range of materials. This article aims to present the biomaterial advancements of the past decade and their applications, offering alternative approaches to treating damaged ETT with the goal of prolonging their retention on the dental arch and serving as a valuable resource for dental practitioners who face this issue daily.
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Affiliation(s)
- Elisa Caussin
- Faculty of Dental Surgery, University of Paris Cité, 75006 Paris, France
- Bretonneau Hospital, Assistance Publique des Hôpitaux de Paris, 75018 Paris, France
- URB2i, Université of Paris Cité, 92100 Montrouge, France
| | - Mathieu Izart
- Faculty of Dental Surgery, University of Paris Cité, 75006 Paris, France
- Bretonneau Hospital, Assistance Publique des Hôpitaux de Paris, 75018 Paris, France
| | - Romain Ceinos
- URB2i, Université of Paris Cité, 92100 Montrouge, France
- Faculty of Dental Surgery, Côte d’Azur University, 06000 Nice, France
| | - Jean-Pierre Attal
- Faculty of Dental Surgery, University of Paris Cité, 75006 Paris, France
- URB2i, Université of Paris Cité, 92100 Montrouge, France
- Charles Foix Hospital, Assistance Publique des Hôpitaux de Paris, 94200 Ivry-Sur-Seine, France
| | - Fleur Beres
- Faculty of Dental Surgery, University of Paris Cité, 75006 Paris, France
- Bretonneau Hospital, Assistance Publique des Hôpitaux de Paris, 75018 Paris, France
| | - Philippe François
- Faculty of Dental Surgery, University of Paris Cité, 75006 Paris, France
- Bretonneau Hospital, Assistance Publique des Hôpitaux de Paris, 75018 Paris, France
- URB2i, Université of Paris Cité, 92100 Montrouge, France
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Hassouneh L, Matoug-Elwerfelli M, Al-Omari T, Setzer FC, Nagendrababu V. Assessment of biomechanical behavior of immature non-vital incisors with various treatment modalities by means of three-dimensional quasi-static finite element analysis. Sci Rep 2023; 13:17491. [PMID: 37840093 PMCID: PMC10577137 DOI: 10.1038/s41598-023-44609-2] [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: 03/29/2023] [Accepted: 10/10/2023] [Indexed: 10/17/2023] Open
Abstract
The objectives of this study were to evaluate the stress distribution and risk of fracture of a non-vital immature maxillary central incisor subjected to various clinical procedures using finite element analysis (FEA). A three-dimensional model of an immature central incisor was developed, from which six main models were designed: untreated immature tooth (C), standard apical plug (AP), resin composite (RC), glass-fibre post (GFP), regeneration procedure (RET), and regeneration with induced root maturation (RRM). Mineral trioxide aggregate (MTA) or Biodentine® were used as an apical or coronal plug. All models simulated masticatory forces in a quasi-static approach with an oblique force of 240 Newton at a 120° to the longitudinal tooth axis. The maximum principal stress, maximum shear stress, risk of fracture, and the strengthening percentage were evaluated. The mean maximum principal stress values were highest in model C [90.3 MPa (SD = 4.4)] and lowest in the GFP models treated with either MTA and Biodentine®; 64.1 (SD = 1.7) and 64.0 (SD = 1.6) MPa, respectively. Regarding the shear stress values, the dentine tooth structure in model C [14.4 MPa (SD = 0.8)] and GFP models [15.4 MPa (SD = 1.1)] reported significantly higher maximum shear stress values compared to other tested models (p < 0.001), while no significant differences were reported between the other models (p > 0.05). No significant differences between MTA and Biodentine® regarding maximum principal stress and maximum shear stress values for each tested model (p > 0.05). A maximum strain value of 4.07E-03 and maximum displacement magnitude of 0.128 mm was recorded in model C. In terms of strengthening percentage, the GFP models were associated with the highest increase (22%). The use of a GFP improved the biomechanical performance and resulted in a lower risk of fracture of a non-vital immature maxillary central incisor in a FEA model.
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Affiliation(s)
- Layla Hassouneh
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Taher Al-Omari
- Department of Conservative Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Frank C Setzer
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Venkateshbabu Nagendrababu
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, UAE
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Marinescu AG, Abuabboud O, Zimbru ȘD, Cîrligeriu LE, Piț BA, Borcean IA, Paven M, Nica LM, Stoia DI. Influence of the Fiber Post Length on the Fracture Strength of Endodontically Treated Teeth. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1797. [PMID: 37893515 PMCID: PMC10608114 DOI: 10.3390/medicina59101797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/08/2023] [Accepted: 10/08/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Although fiber posts are widely used in the restoration of endodontically treated teeth (ETT), their ideal cementation depth into the root canal is still debated in literature. The aim of the present study was to evaluate whether the different intra-radicular insertion lengths of the fiber posts influence the fracture strength of ETT. Materials and Methods: A total of 10 permanent human lower incisors with straight roots of similar length and volume extracted for periodontal reason were sectioned 2 mm above the cement-enamel junction (CEJ) to a total length of 18 mm and endodontically treated in the same manner, then randomly divided into two groups of five each (Groups 1 and 2, n = 5). Two sound incisors, with no endodontic treatment, were used as the control group (Group 3, n = 2). After one week of storage in a humid environment, spaces for fiber post no. 1 (Reforpost, Angelus, Londrina, PR, Brazil) were prepared in the first two groups at a depth of 5 mm (Group 1) and 7 mm (Group 2), and the fiber posts were adhesively cemented using self-adhesive resin cement (Maxcem Elite, Kerr GmbH, Herzogenrath, Germany). After 7 days, the samples were vertically positioned and fixed in a self-curing transparent acrylic resin, up to 2 mm below the CEJ level, and mechanically tested in compression after another week of storage using a displacement-controlled testing machine up to each sample's fracture. The force-displacement curves were recorded for each sample, the means were calculated for each group and a statistical comparative analysis between groups was conducted. Results: Although no statistically significant differences between groups were observed, the highest mean fracture force (N) was recorded in Group 2 (1099.41 ± 481.89) in comparison to Group 1 (985.09 ± 330.28), even when compared to the sound, non-treated teeth (1045.69 ± 146.19). Conclusions: Within the limitations of this in vitro study, teeth where fiber posts were placed deeper into the root canal (7 mm) recorded slightly higher fracture forces in comparison with shorter lengths (5 mm). However, similar biomechanical performances obtained in the mechanical tests showed no statistical differences between the 7 mm and the 5 mm inserted posts.
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Affiliation(s)
- Adrian-George Marinescu
- Department of Restorative Dentistry and Endodontics, Research Center TADERP, Faculty of Dentistry, “Victor Babeș” U.M.Ph.–Timisoara, 300041 Timisoara, Romania; (A.-G.M.); (L.-E.C.); (M.P.)
| | - Osama Abuabboud
- Faculty of Dentistry, “Victor Babeș” U.M.Ph.–Timisoara, 300041 Timisoara, Romania; (O.A.); (Ș.-D.Z.); (B.-A.P.); (I.-A.B.)
| | - Ștefana-Denisa Zimbru
- Faculty of Dentistry, “Victor Babeș” U.M.Ph.–Timisoara, 300041 Timisoara, Romania; (O.A.); (Ș.-D.Z.); (B.-A.P.); (I.-A.B.)
| | - Laura-Elena Cîrligeriu
- Department of Restorative Dentistry and Endodontics, Research Center TADERP, Faculty of Dentistry, “Victor Babeș” U.M.Ph.–Timisoara, 300041 Timisoara, Romania; (A.-G.M.); (L.-E.C.); (M.P.)
| | - Bianca-Adina Piț
- Faculty of Dentistry, “Victor Babeș” U.M.Ph.–Timisoara, 300041 Timisoara, Romania; (O.A.); (Ș.-D.Z.); (B.-A.P.); (I.-A.B.)
| | - Ioana-Amalia Borcean
- Faculty of Dentistry, “Victor Babeș” U.M.Ph.–Timisoara, 300041 Timisoara, Romania; (O.A.); (Ș.-D.Z.); (B.-A.P.); (I.-A.B.)
| | - Mihai Paven
- Department of Restorative Dentistry and Endodontics, Research Center TADERP, Faculty of Dentistry, “Victor Babeș” U.M.Ph.–Timisoara, 300041 Timisoara, Romania; (A.-G.M.); (L.-E.C.); (M.P.)
| | - Luminița-Maria Nica
- Department of Restorative Dentistry and Endodontics, Research Center TADERP, Faculty of Dentistry, “Victor Babeș” U.M.Ph.–Timisoara, 300041 Timisoara, Romania; (A.-G.M.); (L.-E.C.); (M.P.)
| | - Dan Ioan Stoia
- Department of Mechanics and Strength of Materials, Polytechnica University Timisoara, 300006 Timișoara, Romania;
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Nadler AMO, da Silva EJ, Lins-Filho PC, Dias MF, Guimarães RP, da Silva CHV, Silva SDS, Gomes ASL. Influence of different adhesion strategies on glass fiber post retention. J Clin Exp Dent 2023; 15:e649-e657. [PMID: 37674597 PMCID: PMC10478191 DOI: 10.4317/jced.60452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 05/22/2023] [Indexed: 09/08/2023] Open
Abstract
Background Failures in glass fiber post (GFP) retention may be associated with low adhesion achieved in root dentin. Material and Methods 55 single-rooted premolars were endodontically treated and distributed according to different adhesion strategies (n=11): G1: RelyX ARC (3M ESPE; etch-rinse strategy); G2: Relyx Ultimate (3M ESPE; etch-rinse strategy); G3: AllCem (FGM; etch-rinse strategy); G4: Relyx Ultimate (3M ESPE; self-etching strategy); G5: RelyX U200 (3M ESPE; self-adhesive strategy). For Bonding Strength (BS) analysis, the roots were sectioned in slices (1.0mm thickness) corresponding to each root third and submitted to push-out test. The type of failure was assessed by scanning electron microscopy (SEM). Results The highest BS averages were found in G2 and G3. However, in the middle and apical root thirds, G3 showed statistically similar results to G4 and G5. In the cervical and middle third, G1 was statistically similar to G4 and G5. The mixed type of failure was the most common in all groups. Conclusions Self-etching (G4) and self-adhesive resin (G5) cements, showed similar BS results of immediate bonding in the cementation of GFP compared to conventional resin cements (G1, G2, G3). Key words:Dental Cements, Dentin-Bonding Agents, Post and Core Technique, Dental Bonding.
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Affiliation(s)
| | - Evair-Josino da Silva
- PhD Student of the Dentistry Post-Graduate Program, Universidade Federal de Pernambuco, Recife, Brazil
| | - Paulo-Cardoso Lins-Filho
- PhD Student of the Dentistry Post-Graduate Program, Universidade Federal de Pernambuco, Recife, Brazil
| | - Marlon-Ferreira Dias
- PhD Student of the Post-Graduate Program in Oral Rehabilitation, Universidade Estadual de São Paulo - UNESP, Araraquara, Brazil
| | | | | | - Sérgio-Dos Santos Silva
- Head of the Laboratory technicians of the Department of Physics, Universidade Federal de Pernambuco, Recife, Brazil
| | - Anderson-Stevens-Leonidas Gomes
- Professor of the Dentistry Post-Graduate Program, Universidade Federal de Pernambuco, Recife, Brazil
- Professor of the Department of Physics, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
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Santos TDSA, Abu Hasna A, Abreu RT, Tribst JPM, de Andrade GS, Borges ALS, Torres CRG, Carvalho CAT. Fracture resistance and stress distribution of weakened teeth reinforced with a bundled glass fiber-reinforced resin post. Clin Oral Investig 2022; 26:1725-1735. [PMID: 34435252 DOI: 10.1007/s00784-021-04148-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 08/14/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To make an in vitro assessment of fracture resistance of weakened and non-weakened teeth receiving intraradicular reinforcement using Rebilda bundled glass fiber-reinforced composite posts (GT), Rebilda conventional glass fiber posts (RP), or both systems combined (GT + RP). MATERIALS AND METHODS Eighty sound bovine incisors were prepared and divided randomly into eight groups as follows: (a) nWnR: without simulating weakness, and without intraradicular reinforcement; (b) WnR: simulating weakness, but without intraradicular reinforcement; (c) nWGT: without simulating weakness, but with GT; (d) WGT: simulating weakness, and with GT; (e) nWRP: without simulating weakness, but with RP; (f) WRP: simulating weakness, and with RP; (g) nWGTRP: without simulating weakness, but with GT + RP; (h) WGTRP: simulating weakness, and with GT + RP. The specimens were subjected to the load-to-fracture test using the DL-2000MF universal testing machine. The finite element method assessed the mechanical behavior and stress distribution in endodontically treated teeth. RESULTS The groups nWGTRP and WGTRP presented the best results in the load-to-fracture test, with the former being better than the latter, but with no statistically significant difference (P > 0.05). However, there was a significant difference between these and the other groups (P < 0.05), except for nWRP. Stress distribution inside the canal wall was different among the groups, with promising mechanical behavior for nWGTRP and nWRP. CONCLUSIONS The Rebilda conventional fiber post (RP), combined with the Rebilda bundled glass fiber-reinforced composite post (GT) improves the resistance and stress distribution of immature teeth. CLINICAL RELEVANCE Longitudinal fracture is less frequent in teeth restored with GT and RP posts.
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Affiliation(s)
- Thaís da Silva Alves Santos
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University (UNESP), Av. Francisco José Longo 777, São Dimas, São José dos Campos, SP, 12245-000, Brazil
| | - Amjad Abu Hasna
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University (UNESP), Av. Francisco José Longo 777, São Dimas, São José dos Campos, SP, 12245-000, Brazil.
| | - Ricardo Toledo Abreu
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University (UNESP), Av. Francisco José Longo 777, São Dimas, São José dos Campos, SP, 12245-000, Brazil
| | - João Paulo Mendes Tribst
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, Brazil
| | - Guilherme Schmitt de Andrade
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, Brazil
| | - Alexandre Luiz Souto Borges
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, Brazil
| | - Carlos Rocha Gomes Torres
- Department of Restorative Dentistry, Operative Dentistry Division, Institute of Science and Technology, São Paulo State University (UNESP), São José dos Campos, Brazil
| | - Cláudio Antonio Talge Carvalho
- Department of Restorative Dentistry, Endodontics Division, Institute of Science and Technology, São Paulo State University (UNESP), Av. Francisco José Longo 777, São Dimas, São José dos Campos, SP, 12245-000, Brazil
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Duarte Santos Lopes L, da Silva Pedrosa M, Beatriz Melo Oliveira L, Maria da Silva Costa S, Aguiar Santos Nogueira Lima L, Lucisano Botelho do Amaral F. Push-out bond strength and failure mode of single adjustable and customized glass fiber posts. Saudi Dent J 2021; 33:917-922. [PMID: 34916764 PMCID: PMC8665234 DOI: 10.1016/j.sdentj.2021.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 05/14/2021] [Accepted: 09/06/2021] [Indexed: 11/28/2022] Open
Abstract
Purpose To evaluate the push-out bond strength (PBS) and failure mode of single adjustable (SAP) and customized (CP) posts cemented to root canal dentin using conventional (RelyX Ultimate) or self-adhesive (RelyX U200) dual-cure resin cements. Methods Herein, 40 bovine mandibular incisors were divided into four groups (n = 10): SAP cemented with RelyX Ultimate (SAP-UT), SAP cemented with RelyX U200 (SAP-U2), CP cemented with RelyX Ultimate (CP-UT), and CP cemented with RelyX U200 (CP-U2). PBS and failure modes were analyzed. Three-way repeated measures ANOVA test followed by Tukey’s test and Fisher–Freeman–Halton exact test were used for data analysis (α = 5%). Results The PBS values for SAP (p < .05) were higher than those for CP and were not influenced by the root third and resin cement (p > .05). When conventional resin cement was used, the SAP showed significant differences compared to CP (p < .05). When cemented with RelyX Ultimate, a higher prevalence of mixed and adhesive failures for SAP and CP, respectively, was observed (p < .05). For the self-adhesive resin cement, the failures were mostly adhesive (p < .05). Conclusion SAP showed better performance than CP. The root third and resin cements did not influence the PBS. The most prevalent failures were adhesive and mixed.
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Affiliation(s)
- Lívia Duarte Santos Lopes
- São Leopoldo Mandic Institute and Research Center, Campinas, São Paulo, Brazil.,Course of Dentistry, Centro Universitário UniFacid
- Wyden, Teresina, Piauí, Brazil
| | - Marlus da Silva Pedrosa
- Department of Biomaterials and Oral Biology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Iaculli F, Rengo C, Lodato V, Patini R, Spagnuolo G, Rengo S. Fracture resistance of endodontically-treated maxillary premolars restored with different type of posts and direct composite reconstructions: A systematic review and meta-analysis of in vitro studies. Dent Mater 2021; 37:e455-e484. [PMID: 34148785 DOI: 10.1016/j.dental.2021.06.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To conduct a systematic review and meta-analysis to assess if the presence of an endodontic post may increase the fracture resistance of endodontically-treated maxillary premolars directly restored with composite. METHODS A comprehensive systematic literature search according to the PRISMA statement was conducted to assess in vitro studies including endodontically-treated maxillary premolars, restored with different type of posts supporting direct composite reconstructions. Two groups of meta-analyses were performed using fixed effects model and additional Trial Sequential Analysis (TSA) was carried out. Moreover, risk of bias was conducted and quality of evidence for any performed meta-analysis was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). RESULTS Twenty-four articles met the inclusion criteria and 13 studies also underwent quantitative evaluation. Fracture resistance of endodontically-treated premolars restored with fiber posts was significantly less than sound teeth (p value: < 0.00001), however endodontically-treated premolars with a fiber post provided an increase in fracture resistance when compared to equivalent teeth restored without post (p value: 0.003). TSA revealed high power of both meta-analyses. Moderate risk of bias was reported in 23/24 studies; only 1 study showed high risk of bias. GRADE system showed moderate strength of evidence due to the presence of a study with high risk of bias and to wide confidence intervals. SIGNIFICANCE Within the limitation of the present systematic review and meta-analysis, it can be concluded that endodontically-treated maxillary premolars restored with a fiber post and direct composite restoration demonstrated increased fracture resistance when compared to equivalent teeth without post.
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Affiliation(s)
- Flavia Iaculli
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
| | - Carlo Rengo
- Department of Prosthodontics and Dental Materials, School of Dental Medicine, University of Siena, Siena, Italy
| | - Vincenzo Lodato
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
| | - Romeo Patini
- Department of Head, Neck and Sense Organs "Fondazione Policlinico Universitario A. Gemelli- IRCCS", School of Dentistry, Rome, Italy
| | - Gianrico Spagnuolo
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy.
| | - Sandro Rengo
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, University of Naples "Federico II", Naples, Italy
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Silva CF, Cabral LC, Navarro de Oliveira M, da Mota Martins V, Machado AC, Blumenberg C, Paranhos LR, Santos-Filho PCF. The influence of customization of glass fiber posts on fracture strength and failure pattern: A systematic review and meta-analysis of preclinical ex-vivo studies. J Mech Behav Biomed Mater 2021; 118:104433. [PMID: 33684707 DOI: 10.1016/j.jmbbm.2021.104433] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 02/22/2021] [Accepted: 02/26/2021] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To perform a systematic review of the literature focused to evaluate in vitro function of prefabricated fiber posts with and without customization by additional auxillary fiber posts and composite resin on the fracture strength of wide or enlarged canals and the failure pattern. METHODS Six databases were used as primary search sources (PubMed, Scopus, LILACS, SciELO, Science Direct, and Web of Science) and three databases (Open Grey, Open Thesis, and OATD) were used to partially capture the "grey literature". The research included laboratory studies that used human upper anterior teeth aiming to assess the fracture strength and failure pattern of different glass fiber post customizations by additional auxiliary fiber posts or composite resin. The search had no restriction of year, language, and publication status. The risk of bias of the studies was assessed from the criteria established in systematic reviews of laboratory studies. Standardized mean differences were calculated by comparing the mean fracture strengths of customized and non-customized posts. Pooled estimates were calculated by Glass' delta method using the random-effects model. Subtotal estimates were presented according to each type of relining procedure and an overall estimate was described considering all studies combined. RESULTS The search provided 2291 results, from which six met the eligibility criteria and were included in the qualitative assessment of the review. Only three studies presented a moderate risk of bias. The meta-analysis results showed that the use of auxiliary posts produced higher mean fracture strengths than non-customized posts (SMD = 2.21; 95%CI: 0.74; 3.68), and it was more effective than the use of composite resin to reline the posts. CONCLUSION Based on laboratories studies, even though has not been observed any difference to a statistically significant level on fracture strength and failure pattern of the customized and non-customized post, future studies should follow a standardized approach to implementation and reporting of data.
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Affiliation(s)
- Camila Ferreira Silva
- Post-graduate Program in Dentistry, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil
| | - Luana Cardoso Cabral
- Post-graduate Program in Dentistry, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil
| | - Murilo Navarro de Oliveira
- Post-graduate Program in Dentistry, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil
| | - Victor da Mota Martins
- Post-graduate Program in Dentistry, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil
| | - Alexandre Coelho Machado
- Department of Oral Health, Technical Health School, Federal University of Uberlândia, Uberlândia, Brazil
| | - Cauane Blumenberg
- Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Luiz Renato Paranhos
- Department of Preventive and Community Dentistry, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil.
| | - Paulo César Freitas Santos-Filho
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Uberlândia, Brazil
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12
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De Matos LMR, Oliveira LP, Silva AM, Silva JKDA, Silva ML. Resistance to fracture of endodontically treated teeth: Influence of the post systems and cements. Dent Res J (Isfahan) 2020; 17:417-423. [PMID: 33889346 PMCID: PMC8045523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Endodontically treated teeth with extensive structural damage present higher fragility due to the low amount and worse quality of the reminiscent tissues of the crown. MATERIALS AND METHODS The present in vitro study evaluated the effect of different intraradicular retainers and cementation agents on the fracture resistance of devitalized teeth. Incisive teeth (n = 40) of bovine mandibles were used. After preparation of the root canals, they were immersed in polyether, in a polyvinyl chloride cylinder containing acrylic resin, to simulate the periodontal ligament. The specimens were randomly divided into four groups (n = 10), according to the type of retainer (anatomical or main with accessory posts) and resin cement used (conventional resin cement - RelyX ARC or self-adhesive resin cement - RelyX U200). The specimens were stored in distilled water at 37°C and submitted to fracture resistance testing. ANOVA and Tukey's test were applied for data analysis, with significance level set at 5%. RESULTS There was no interaction between cement type and intraradicular retainers (P = 0.56) or even between the types of cement used (P = 0.65). However, in the variation of the types of retainers, the group using main with accessory posts presented greater resistance to the fracture than the anatomical post (P = 0.04). CONCLUSION Different cementing agents have no effect on the fracture strength of devitalized teeth, unlike the use of posts, in which the use of accessory post proved more resistant when compared to the anatomical post.
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Affiliation(s)
| | - Lucas Portela Oliveira
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (Unesp), Araraquara, Brazil,Address for correspondence: Dr. Lucas Portela Oliveira, 1680 Humaitá Street, Centro, 14801903 Araraquara, São Paulo, Brazil. E-mail:
| | - Aryvelto Miranda Silva
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araraquara, Brazil
| | | | - Marcelo Lopes Silva
- Department of Dentistry, School of Dentistry, Wyden Educational Group – FACID WYDEN, Teresina, Piauí, Brazil
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13
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Mayya A, Naik R, Mayya SS, Paul MP. Fracture Resistance of Endodontically Treated Maxillary Premolars with a Longer Single Post and Shorter Double Posts of Different Sizes: An In Vitro Study. J Int Soc Prev Community Dent 2020; 10:183-184. [PMID: 32670907 PMCID: PMC7339994 DOI: 10.4103/jispcd.jispcd_472_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 01/20/2020] [Indexed: 01/24/2023] Open
Abstract
Aim: The aim of this study was to determine if there is any difference in fracture resistance between different post sizes and lengths when more than one post is involved. Materials and Methods: Thirty extracted maxillary first premolars were endodontically treated and divided into three groups: In Group 1 (control group), no post space preparation was conducted and access cavities were restored with composite; in Group 2 (single post), post space preparation of 10 mm was carried out only in one of the canals; and in Group 3 (double post), post space preparation of 5 mm was conducted in both the canals. Appropriately sized glass fiber posts were cemented in Groups 2 and 3 followed by core buildup. The fracture resistance of the specimen was measured using a universal testing machine and the data analyzed. The mean fracture resistance values of the three groups were compared applying one-way analysis of variance (ANOVA) followed by post hoc Tukey’s test. The data were analyzed using Statistical Package for the Social Sciences software program, version 15.0. South Asia, Bangalore. Results: The control group had a significantly lower fracture resistance value as compared to Groups 2 and 3. No statistically significant difference was observed in the fracture resistance between Groups 2 and 3. Conclusions: No significant difference was observed between the fracture resistance of endodontically treated maxillary first premolars restored with size 3 single post of longer length and size 1 double posts of shorter lengths.
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Affiliation(s)
- Arun Mayya
- Department of Conservative Dentistry and Endodontics, A.J. Institute of Dental Sciences, Mangalore, India
| | - Rajaram Naik
- Department of Conservative Dentistry and Endodontics, A.J. Institute of Dental Sciences, Mangalore, India
| | - Shreemathi S Mayya
- Department of Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Maria P Paul
- Department of Conservative Dentistry and Endodontics, A.J. Institute of Dental Sciences, Mangalore, India
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Surface characterization and bonding properties of milled polyetheretherketone dental posts. Odontology 2020; 108:596-606. [PMID: 31965408 DOI: 10.1007/s10266-020-00484-1] [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] [Received: 09/28/2019] [Accepted: 01/05/2020] [Indexed: 10/25/2022]
Abstract
PEEK has been used in many dental applications except intra-radicular post. The aim of this study is to test polyetheretherketone (PEEK) as a dental post material through tensile bond strength (TBS) and surface roughness (SR), and to compare it with glass-fiber and cast-metal posts. Thus, 60 human maxillary central incisors with a single root were endodontically treated and divided into three groups (n = 20) according to the type of post (Group P: PEEK, Group F: Glass-fiber, Group M: Cast-metal). Appropriate surface treatment was employed for each group and SR was determined by a three-dimensional non-contact profilometer before cementation. All posts were luted to the canal dentin using self-etch resin cement (Panavia F2.0). Pull-out test was performed on a universal testing machine at a speed of 0.5 mm/min crosshead speed until failure, and TBS were calculated. One-way ANOVA, Tukey's HSD, and Pearson chi-squared tests were performed for statistical analyses (α = 0.05). According to the results, group F demonstrated the highest SR (2.93 ± 0.18 µm) and lowest TBS values (10.05 ± 0.53 MPa), while group P exhibited lowest SR (1.37 ± 0.11 µm) and highest TBS values (14.33 ± 0.58 MPa) (p < 0.001). No significant differences in failure modes were identified among groups, mostly adhesive (p = 0.243). As conclusion, PEEK may be a reliable and contemporary option for dental post systems when used with appropriate surface treatment and luting agent. This high-performance polymer may be a novel candidate as a contemporary dental post system due to its superior mechanical, chemical, thermal, and esthetical properties with low risk of fracture.
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Chauhan NS, Saraswat N, Parashar A, Sandu KS, Jhajharia K, Rabadiya N. Comparison of the Effect for Fracture Resistance of Different Coronally Extended Post Length with Two Different Post Materials. J Int Soc Prev Community Dent 2019; 9:144-151. [PMID: 31058064 PMCID: PMC6489518 DOI: 10.4103/jispcd.jispcd_334_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 12/03/2018] [Indexed: 11/20/2022] Open
Abstract
Aims and Objectives: To compare the effect for fracture resistance of different coronally extended post length with two different post materials. Materials and Methods: One hundred and sixty endodontically treated maxillary central incisors embedded in acrylic resin with decoronated root portion were taken for the study. The postspaces were prepared according to standard protocol. The samples were divided into two groups according to the post material: glass-fiber post and Quartz fiber post. These groups were further subdivided on the basis of coronal extension of 4 and 6 mm for glass fiber and Quartz fiber posts, respectively. The posts were then luted with dual-polymerizing resin cement followed by core buildup. Samples were subjected to increasing compressive oblique load until fracture occurred in a universal testing machine. Data were analyzed with one-way ANOVA and independent Student's t-test. Analysis was done using SPSS version 15 (SPSS Inc., Chicago, IL, USA) Windows software program. Results: Glass fiber post with coronal extension of 4 mm (182.8 N) showed better results than with 6-mm length (124.1 N). Similarly, in quartz fiber posts group, 4-mm postlength (314 N) was better when compared with 6 mm (160 N). The 4-mm coronal extension of quartz fiber post displayed superior fracture resistance. Conclusions: Glass fiber posts showed better fracture resistance than Quartz fiber posts. 4-mm coronal length showed more fracture resistance than 6 mm.
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Affiliation(s)
- Niharika Singh Chauhan
- Department of Prosthodontics, MA Rangoonwala Dental College and Research Center, Pune, Maharashtra, India
| | - Nidhi Saraswat
- Department of Dentistry, Ingham Institute Applied Medical Research, Western Sydney University, South Western Sydney Local Health District, Sydney, Australia
| | - Ankita Parashar
- Index Institute of Dental Science, Indore, Madhya Pradesh, India
| | - Kuldeep Singh Sandu
- Department of Conservative and Endodontics, R R Dental College, Udaipur, Rajasthan, India
| | - Kapil Jhajharia
- Department of Endodontics, Faculty of Dentistry, Melaka Manipal Medical College, Melaka, Malaysia
| | - Nirav Rabadiya
- BDS, MPH, Grand Valley State University, Allendale, Michigan, USA
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