Fatigue behavior of direct post-and-core-restored premolars

Evaluation of stress distribution on an endodontically treated maxillary central tooth with lesion restored with different crown materials: A finite element analysis

Objectives

The biomechanical response of teeth with periapical lesions that have been restored using various substructure materials, as well as the stress mapping in the alveolar bone, has not been thoroughly described. In this context, the objective of this study is to investigate the structural stress distributions on root canal-treated maxillary right central incisors with lesions restored using different crown materials under linear static loading conditions through finite element analysis (FEA).

Methods

In the study, five FEA models were utilised to represent healthy teeth and teeth restored with different substructure materials: (A) a healthy tooth, (B) a lesioned, root canal-treated, composite-filled tooth, (C) a lesioned, fiber-posted, zirconia-based crown, (D) a tooth with lesions, a fiber post, and Ni-Cr infrastructure crown, (E) a tooth with a lesion, a fiber post, and an IPS E-max infrastructure crown. A force of 100 N was applied at an angle of 45° to the long axis of the tooth from 2 mm cervical to the incisal line on the palatal surface. Deformation behaviour and maximum equivalent stress distributions on the tooth sub-components, including the bony structure for each model, were simulated.

Results

Differences were observed in the stress distributions of the models. The maximum stress values of the models representing the restorations with different infrastructures varied, and the highest value was obtained in the model of the E-max crown (Model E: 136.050 MPa). The minimum stress magnitudes were obtained from Model B the composite-filled tooth (80.39 MPa); however, it was observed that the equivalent stresses in all the models showed a similar distribution for all components with varying magnitudes. In periapical lesion areas, low stresses were observed. In all models, the cervicobuccal collar region of the teeth had dense equivalent stresses.

Conclusion

Different restorative treatment methods applied to root canal-treated teeth with periapical lesions can impact the stress in the alveolar bone and the biomechanical response of the tooth. Relatively high stress values in the cortical bone at the cervical line of the tooth have been observed to decrease towards the apical region. This observation may suggest a potential healing effect by reducing pressure in the periapical lesion area.

Clinical significance

Composite resin restorations can be considered the first-choice treatment option for the restoration of root canal-treated teeth with lesions. In crown restorations, it would be advantageous to prefer zirconia or metal-supported prostheses in terms of biomechanics.

Cyclic fatigue tests on non-anatomic specimens of dental ceramic materials: A scoping review

The aim of the present scoping review was to identify and discuss the methods, testing parameters, and characteristics used to induce cyclic fatigue on non-anatomic dental ceramic specimens. In vitro studies written in English which evaluated commercially-available non-anatomic dental ceramic specimens subjected to mechanical cyclic fatigue were selected. The search was performed in the PubMed, Scopus and Web of Science databases. The initial search yielded 1,636 articles, of which 81 were included. Based on the collected data, most of the included studies evaluated dental ceramic specimens cemented to supporting substrate (n= 42; 51.9%); used step-stress (n= 35; 42.2%) accelerated fatigue test, loading frequencies above 10 Hz (n= 31, 35.6%), stainless steel (n = 28, 32.6%) load applicator with spherical shaped tip 40 mm diameter (n= 25, 30.9%); applied only axial loads (n= 77, 95.1%); and considered a wet testing environment (n= 65, 78.3%). The definition of test geometry, method, and testing parameters must be cautiously considered according to the study objective and the scenario that is simulated. Accelerated fatigue tests, load frequencies up to 20 Hz, a 40 mm stainless steel spherical load applicator and a wet testing environment are the major common defined parameters presented in the existing literature. More studies exploring the influence of such factors on fatigue mechanism are necessary.

Comparative study of mechanical properties of direct core build-up materials

Background and Objectives:

The strength greatly influences the selection of core material because core must withstand forces due to mastication and para-function for many years. This study was conducted to evaluate certain mechanical properties of commonly used materials for direct core build-up, including visible light cured composite, polyacid modified composite, resin modified glass ionomer, high copper amalgam, and silver cermet cement.

Materials and Methods:

All the materials were manipulated according to the manufacturer's recommendations and standard test specimens were prepared. A universal testing machine at different cross-head speed was used to determine all the four mechanical properties. Mean compressive strength, diametral tensile strength, flexural strength, and elastic modulus with standard deviations were calculated. Multiple comparisons of the materials were also done.

Results:

Considerable differences in compressive strength, diametral tensile strength, and flexural strength were observed. Visible light cured composite showed relatively high compressive strength, diametral tensile strength, and flexural strength compared with the other tested materials. Amalgam showed the highest value for elastic modulus. Silver cermet showed less value for all the properties except for elastic modulus.

Conclusions:

Strength is one of the most important criteria for selection of a core material. Stronger materials better resist deformation and fracture provide more equitable stress distribution, greater stability, and greater probability of clinical success.

Vertical fracture of root filled teeth restored with posts: the effects of patient age and dentine thickness

AIM

To determine whether patient age contributed to the fracture resistance of teeth subjected to root canal treatment and post placement.

METHODOLOGY

Forty-five single-rooted, single-canal human teeth were mounted, instrumented, obturated and prepared for a post. The teeth were divided into young (18 < or = age < or = 35) and old (60 < or = age) groups and subjected to cyclic loading until fracture; those reaching 200,000 cycles without undergoing failure were then subjected to static loading to fracture. Statistical differences between groups were examined using one-way anovas, and correlations were identified using Pearson's r; significance was established at P < or = 0.05.

RESULTS

There was no significant difference between the two age groups in terms of the number of cycles to fracture (P > 0.05) or the load to fracture (P > 0.05). However, there was a significant correlation (P < or = 0.05) between the root fracture resistance and individual age, indicating that the susceptibility to root fracture increases significantly with increasing patient age. Also, the dentine thickness of roots that fractured was significantly less than those that did not (P = 0.04).

CONCLUSION

Vertical root fracture of teeth receiving root canal treatment with posts is more likely to occur in the teeth of older patients (60+) and particularly in those with low dentine thickness.

Fracture loads of all-ceramic crowns under wet and dry fatigue conditions

PURPOSE

The aim of this study was to test the hypothesis that fracture loads of fatigued dental ceramic crowns are affected by testing environment and luting cement.

MATERIALS AND METHODS

One hundred and eighty crowns were prepared from bovine teeth using a lathe. Ceramic crowns were prepared from three types of ceramic systems: an alumina-infiltrated ceramic, a lithia-disilicate-based glass ceramic, and a leucite-reinforced ceramic. For each ceramic system, 30 crowns were cemented with a composite resin cement, and the remaining 30 with a resin-modified glass ionomer cement. For each ceramic system and cement, ten specimens were loaded to fracture without fatiguing. A second group (n = 10) was subjected to cyclic fatigue and fracture tested in a dry environment, and a third group (n = 10) was fatigued and fractured in distilled water. The results were statistically analyzed using one-way ANOVA and Tukey HSD test.

RESULTS

The fracture loads of ceramic crowns decreased significantly after cyclic fatigue loading (p<or= 0.05); furthermore, fracture loads of crowns fatigued in a wet environment were statistically lower than those in a dry environment (p < 0.05). Crowns luted with a composite resin cement showed statistically greater fracture loads than those luted with a resin-modified glass ionomer cement (p<or= 0.05).

CONCLUSIONS

Fracture load of the three ceramic systems was found to be influenced by ceramic composition. Moreover, cement and fatigue condition influenced the fracture loads of the crown specimens evaluated in this study.

Contact versus flexure fatigue of a fiber-filled composite

OBJECTIVE

The intent of this project was to examine the effect of two different modes of fatigue loading, contact and flexure, on the flexure strength of a dental composite.

METHODS

The composite was Restolux (a fiber-filled composite) formed as bars 3 mm x 3 mm x 25 mm in size. The cyclic loading ranges were 30-50, 60-80, and 90-110 N for contact loading and 20-40 and 40-60 N for the flexure loading. Number of cycles completed was 1, 1000 or 100,000 in four different media: air, water, artificial saliva, and a 50/50 mixture of water and ethanol. Specimens were aged in sealed polyethylene containers in their respective media for 4 months at 37 degrees C.

RESULTS

Statistical analysis indicated a significantly lower flexure strength for the specimens flexure loaded versus contact loaded. For the flexure loaded specimens, the number of cycles had no significant effect, but the aging, load, and the media were all significant. For the contact loaded specimens, a significant effect was observed for the media, aging, and cycles completed, but no effect for the different cycling loads.

SIGNIFICANCE

In summary, the decrease in flexure strength from flexure loading was mainly affected by the aging media, whereas, the decrease from contact loading was attributed mainly to the number of cycles.

Rotational fatigue-resistance of seven post types anchored on natural teeth

PURPOSE

To develop a laboratory model aimed at duplicating the failure process of post and core restorations. The load pattern applied was to be repetitive (fatigue) and multivectorial. To determine and compare the resistance under fatigue loading of seven endodontic post/natural root combinations: stainless steel-, titanium-, ceramic-, composite-fiber/epoxy-, two glass-fiber/epoxy- and glass-fiber/acrylic posts.

MATERIALS AND METHODS

The repetitive, alternating and multivectorial intraoral force pattern was reproduced by subjecting the specimens to the rotating cantilever beam test. To this end, the samples were designed as rotation-symmetric structures comprising a root, a post, periodontal ligament- and bone analogs and a restoration analog. The following posts were tested: Unimetric-Ti, Unimetric-SS, Biopost, Composipost, Easypost, DT Lightpost, Everstickpost. The samples were spun around their long axes while being clamped into a revolving collet on one end and loaded normal to their long axis on the other end. The aim was to determine the load level at which 50% of the specimens survived- and 50% fractured before 10E6 cycles. The 50% means were determined using the staircase procedure.

RESULTS

In increasing order of magnitude, the resistances to fatigue loading were as follows: Biopost, Unimetric-Ti, Unimetric-SS, Composipost, Easypost, Everstickpost, DT Lightpost.

SIGNIFICANCE

The fatigue resistance of the two fibrous posts with the highest fatigue resistance was twice that of any of the ceramic or metal posts.

Evaluation of the biomechanical behavior of maxillary central incisors restored by means of endocrowns compared to a natural tooth: A 3D static linear finite elements analysis

OBJECTIVE

The present study aimed at evaluating different restoring configurations of a crownless maxillary central incisor, in order to compare the biomechanical behavior of the restored tooth with that of a sound tooth.

MATERIALS AND METHODS

A 3D FE model of a maxillary central incisor is presented. An arbitrary static force of 10 N was applied with an angulation of 125 degrees to the tooth longitudinal axis at level of the palatal surface of the crown. Different material configurations were tested: composite, syntered alumina, feldspathic ceramic endocrowns and glass post resorations with syntered alumina and feldspathic ceramic crown.

RESULTS

High modulus materials used for the restoration strongly alter the natural biomechanical behavior of the tooth. Critical areas of high stress concentration are the restoration-cement-dentin interface both in the root canal and on the buccal and lingual aspects of the tooth-restoration interface. Materials with mechanical properties underposable to that of dentin or enamel improve the biomechanical behavior of the restored tooth reducing the areas of high stress concentration.

SIGNIFICANCE

The use of endocrown restorations present the advantage of reducing the interfaces of the restorative system. The choice of the restorative materials should be carefully evaluated. Materials with mechanical properties similar to those of sound teeth improve the reliability of the restoartive system.

Engineering Properties and Performance of Dental Crowns

Dental crowns are used to replace damaged natural crowns of teeth and are fixed to prepared teeth with luting cements, which should provide an adhesive bond to the tooth structure giving reliable retention and minimal microleakage. Mechanical testing of crowns in vitro gives failure load distributions that are well described by Weibull models, comparing probabilities of survival and reliability. Fatigue testing of crowns is time consuming, but regression analysis to interpolate functions through data points quoting probability limits or applying Weibull analysis is achievable. A complementary approach is to conduct materials tests with appropriate interfacial geometries. Luting cements are used in thin layers of 40–150 um. Contraction during polymerization is restrained by adhesion to substrates, allowing little relaxation of stresses. Conventional and resin-modified glass ionomer cements create thin zones of interaction with dentine and fail cohesively. The chevron notch short rod technique has been used to measure fracture toughness and rank cements. A development of this method, using chevron notch short bar specimens, permitted fracture toughness to be determined for luting cement-dentine substrate interfaces. Representative fracture experiments need to be developed to apply mixed mode conditions. The basic challenge to predict long-term performance from short-term laboratory tests remains.

3D FEA of cemented steel, glass and carbon posts in a maxillary incisor

OBJECTIVES

A comparative study on the stress distribution in the dentine and cement layer of an endodontically treated maxillary incisor has been carried out by using Finite Element Analysis (FEA). The role of post and cement rigidity on reliability of endodontic restorations is discussed.

METHODS

A 3D FEM model (13,272 elements and 15,152 nodes) of a central maxillary incisor is presented. A chewing static force of 10 N was applied at 125 degree angle with the tooth longitudinal axis at the palatal surface of the crown. Steel, carbon and glass fiber posts have been considered. The differences in occlusal load transfer ability when steel, carbon and glass posts, fixed to root canal using luting cements of different elastic moduli (7.0 and 18.7 GPa) are discussed.

RESULTS AND SIGNIFICANCE

The more stiff systems (steel and carbon posts) have been evaluated to work against the natural function of the tooth. Maximum Von Mises equivalent stress values ranging from 7.5 (steel) to 5.4 and 3.6 MPa (respectively, for carbon posts fixed with high and low cement moduli) and to 2.2 MPa (either for glass posts fixed with high and low cement moduli) have been observed under a static masticatory load of 10 N. A very stiff post works against the natural function of the tooth creating zones of tension and shear both in the dentine and at the interfaces of the luting cement and the post. Stresses in static loading do not reach material (dentine and cement) failure limits, however, they significantly differ leading to different abilities of the restored systems to sustain fatigue loading. The influence of the cement layer elasticity in redistributing the stresses has been observed to be less relevant as the post flexibility is increased.

Flexural fatigue behavior of machinable and light-activated hybrid composites for esthetic restorations

The purpose of this study was to determine the flexural strength and flexural fatigue strength of a machinable composite (GN-I) and three hybrid composites (Artglass, Estenia, and Gradia). Specimens (2 x 2 x 25 mm) were polymerized in a laboratory photo-curing unit and then immersed in water at 37 degrees C for 24 h, 6 months, and 1 year. After each immersion period, flexural strengths (4-PFS) were measured at a cross-head speed of 1 mm/min in 4-point bending (span = 20 mm; distance between inside loading points = 10 mm). The cyclic fatigue test was performed at 2.0 Hz on a fatigue tester. The staircase method was employed for flexural fatigue strength (FFS) using a 5000 cyclic load limitation, 5-MPa stress increment, and 20 specimens for each material. Both 4-PFS and FFS of the machinable composite after all immersion periods were significantly greater than those of the three hybrid composites. The FFS results followed the same pattern as those of the 4-PFS. The Estenia material exhibited the highest 4-PFS and FFS after 24 h of immersion among three hybrid composites, whereas after 1 year of immersion, all three composites showed almost identical 4-PFS and FFS statistically. A strong correlation was observed between 4-PFS and FFS of the machinable composite and three hybrid resin composites.

Resistance of core materials against torsional forces on differently conditioned titanium posts

STATEMENT OF THE PROBLEM

The separation of core materials from titanium posts, which have a low modulus of elasticity, has been identified as a problem in restorative dentistry.

PURPOSE

This study evaluated the resistance to torsional forces of various core materials adapted to differently conditioned titanium posts.

MATERIAL AND METHODS

Seven hundred and twenty specimens were tested consisting of: 6 core materials and 5 surface conditioning techniques for 2 kinds of opaquers with 10 specimens in each group (6 x 5 x 2 x 10=600) plus 6 core materials and 2 opaquers were tested and considered as control groups on nonconditioned titanium posts, each group containing 10 specimens (6 x 2 x 10=120). The custom-made pure titanium posts were conditioned with the following products: Silicoater Classical, Silicoater MD, Rocatec, Kevloc, and Siloc surface-conditioning systems. Subsequently, 6 core materials with different compositions (Durafill, Adaptic, Coradent, Ti-Core, Hytac Aplitip, and Photac-Fil Aplitip) were applied to titanium posts that were previously coated with 2 types of light-polymerized opaquers, either Artglass or Dentacolor. Sixty air-abraded titanium posts (250 microm, 30 seconds) were used as controls for each core material. Following thermocycling (5 degrees -55 degrees C, 30 seconds, 5,000 cycles), maximum torsional forces were determined with an electronic torque movement key. Data were statistically analyzed by 1-way analysis of variance followed by 2-way analysis of variance (P<.05).

RESULTS

Significantly higher mean torsional forces were observed with respect to Siloc (20.4 Newton decimeter [dNm]), Silicoater Classical (18.6 dNm), Silicoater MD (18.2 dNm), and Rocatec (17.0 dNm) systems compared with the mean for the untreated control group (14.6 dNm) (P<.001). The Kevloc system (10.4 dNm) demonstrated no significant difference compared with the control group (P>.001). The Kevloc system in combination with the Artglass opaquer and Photac-Fil Aplitip (0.00 dNm) core material showed no resistance against torsional forces. Significant differences were observed between hybrid core materials and microfilled composite, compomer, or resin-modified glass ionomer core materials (P<.001).

CONCLUSION

Within the limitations of this study, the resistance to torsional forces for the core materials on titanium posts increased with the use of chemical surface-conditioning techniques and varied in accordance with the opaquer type. Type of core material also significantly influenced the resistance after thermocycling.

Restoration of the endodontically treated tooth

It has been the purpose of this article to provide a rationale for the restoration of endodontically treated teeth. Treatment recommendations have been made in the areas of post design, placement technique, cements, core materials, and definitive restorations, based on a review of the clinical and laboratory data.

Survival rate and fracture strength of incisors restored with different post and core systems after exposure in the artificial mouth

The survival rate and fracture resistance of 40 decapitated endodontically treated maxillary central incisors using four different post and core systems covered with all-ceramic copings was evaluated after exposure in the artificial mouth. Ten samples of the following post and core systems were investigated: high precious metal post (Permador) and core (Olympia) (A), zirconia post (Cerapost) with a pre-fabricated bonded ceramic core (Ceracap) (B), resin-ceramic post (experimental) with a pre-fabricated bonded ceramic core (Ceracap(R)) (C) and a zirconia post (Cerapost) with a custom made ceramic core (Cosmo Ingots) (D). The all-ceramic copings (Procera) were cemented using Panavia TC. The survival rates after 1 200 000 cycles in the artificial mouth are as follows: 90% (A), 80% (B), 60% (C) and 100% (D). The results of the means and standard deviations (s.d.) of the fracture resistance during static loading are: 1270 +/- 312.5 (A), 1494.5 +/- 333.5 (B), 1146.7 +/- 182.6 (C) and 463.3 +/- 46.2 (D). There are statistically significant differences between all groups with the exception of A and B, and A and C (Wilcoxon test). None of the zirconia posts with custom made ceramic cores covered with all-ceramic copings fractured during dynamic loading in the artificial mouth. The mean fracture strength during static loading was less favourable than that of groups A, B and C but above the clinical necessary level.

Whisker-reinforced dental core buildup composites: effect of filler level on mechanical properties

The strength and toughness of dental core buildup composites in large stress-bearing restorations need to be improved to reduce the incidence of fracture due to stresses from chewing and clenching. The aims of the present study were to develop novel core buildup composites reinforced with ceramic whiskers, to examine the effect of filler level, and to investigate the reinforcement mechanisms. Silica particles were fused onto the whiskers to facilitate silanization and to roughen the whisker surface for improved retention in the matrix. Filler level was varied from 0 to 70%. Flexural strength, compressive strength, and fracture toughness of the composites were measured. A nano-indentation system was used to measure elastic modulus and hardness. Scanning electron microscopy (SEM) was used to examine the fracture surfaces of specimens. Whisker filler level had significant effects on composite properties. The flexural strength in MPa (mean +/- SD; n = 6) increased from (95+/-15) for the unfilled resin to (193+/- 8) for the composite with 50% filler level, then slightly decreased to (176+/-12) at 70% filler level. The compressive strength increased from (149+/-33) for the unfilled resin to (282+/-48) at 10% filler level, and remained equivalent from 10 to 70% filler level. Both the modulus and hardness increased monotonically with filler level. In conclusion, silica particle-fused ceramic single-crystalline whiskers significantly reinforced dental core buildup composites. The reinforcement mechanisms appeared to be crack deflection and bridging by the whiskers. Whisker filler level had significant effects on the flexural strength, compressive strength, elastic modulus, and hardness of composites.

Surface contact fatigue and flexural fatigue of dental restorative materials

Antagonistic contact on a dental restoration may produce surface and subsurface stresses leading to fatigue wear as well as to bulk stressing, eventually causing catastrophic failure. It was the aim of the present work to study the outcome of two different approaches to fatigue testing of materials involving either surface contact fatigue or flexural fatigue mechanisms. A range of materials was tested, including conventional glass-ionomers, resin-modified glass-ionomers, poly-acid modified composites, and composites. Materials were prepared and tested using both surface contact and flexural fatigue. The results show that conventional glass-ionomers have the least resistance to fatigue under both regimes while composites have the longest fatigue lives and the highest values of flexural fatigue limit. However, the results also support the fact that catastrophic failure should be investigated separately from surface contact fatigue. Within the group of composite products tested, a hybrid composite material had a significantly greater flexural fatigue limit than a microfilled one, but the latter material had a significantly greater surface contact fatigue life, indicating that wear behavior cannot be predicted from bulk fracture characteristics and vice versa. The process of wear occurs by a combination of a number of fundamental processes, and the contribution fatigue makes will vary according to the environment and nature of the material.

Diametral and compressive strength of dental core materials

STATEMENT OF PROBLEM

Strength greatly influences the selection of core materials. Many disparate material types are now recommended for use as cores. Cores must withstand forces due to mastication and parafunction for many years.

PURPOSE

This study compared the compressive and diametral tensile strengths of 8 core materials of various material classes and formulations (light-cured hybrid composite, autocured titanium containing composite, amalgam, glass ionomer, glass ionomer cermet, resin-modified glass ionomer, and polyurethane).

MATERIAL AND METHODS

Materials were manipulated according to manufacturers' instructions for use as cores. Mean compressive and diametral strengths with associated standard errors were calculated for each material (n = 10). Analyses of variance were computed (P <.0001) and multiple comparisons tests discerned many differences among materials.

RESULTS

Compressive strengths varied widely from 61.1 MPa for a polyurethane to 250 MPa for a resin composite. Diametral tensile strengths ranged widely from 18.3 MPa for a glass ionomer cermet to 55.1 MPa for a resin composite. Some resin composites had compressive and tensile strengths equal to those of amalgam.

CONCLUSION

Light-cured hybrid resin composites were stronger than autocured titanium containing composites. The strengths of glass ionomer-based materials and of a polyurethane material were considerably lower than for resin composites or amalgam.

Leakage associated with load fatigue-induced preliminary failure of full crowns placed over three different post and core systems

Thirty-six maxillary central incisors were endodontically treated and restored with a post and core and cast crown. Three different post and core systems were evaluated. Restored teeth were fatigue-loaded until preliminary failure of the casting occurred as detected by a strain gauge bonded across the lingual margin of the cast crown. After preliminary failure, fatigue loading was continued for 100,000 load cycles with the crown margin exposed to basic fuschin dye. Teeth were then immersed in dye for 24 h, sectioned, and evaluated for leakage. There was no significant difference in the number of load cycles required to cause preliminary failure among the three post and core systems. Leakage occurred in all three groups, with no significant difference between groups. The occurrence of preliminary failure is clinically undetectable, yet it allows leakage between the restoration and tooth that may extend down the prepared post space.

The behaviour of post-retained core materials supported by coronal tooth structure in vitro

This study was designed to investigate the effect of retaining coronal tooth substance on the performance of post-retained core materials, and to compare the fracture resistance of the system with an intact tooth prepared to similar dimensions. Ten teeth restored with post-retained silver amalgam, and 10 teeth restored with silver-glass cermet, all with a retained single wall of coronal tooth substance, were compared with 10 unrestored teeth prepared to similar dimensions when subjected to a shearing load. The results showed no statistically significant difference between the unrestored teeth and those restored with a silver-glass cermet. Whilst the teeth restored with silver amalgam had a significantly higher fracture resistance (P > 0.01) there was greater tendency to root fracture.

The evaluation of post-retained crowns using a custom-designed fatigue machine

There are many published reports of static tests on dental materials that are required to perform clinically under a range of load amplitudes and cyclic frequencies. There are fewer reports in the dental literature of fatigue tests on dental structures and materials, and these are reviewed in this paper along with a description of the design, manufacture and commissioning of a machine which can apply chosen cyclic load/time characteristics up to a maximum amplitude of 700 N and frequency of 5 Hz. The machine design is not specific to particular test specimens but is widely applicable within dental materials testing. The machine is being used for a continuing study of post-retained crowns, cemented with glass-ionomer cement. The planning of fatigue tests and the interpretation of results is discussed with reference to the experience of previous authors, and it is concluded that a survival analysis approach offers a means of understanding materials' performances. The initial results from a random, blocked comparison of three glass-ionomer luting cements indicated that cyclic loads can be identified to give a 50% survival probability for specimens. It is expected that loads experienced in vivo have lower amplitude than those applied in this study, however, such loading cycles have been chosen to facilitate material comparisons. It is concluded that gaining significant results under laboratory fatigue conditions is difficult, but that they may usefully complement clinical trials.

The influence of simulated clinical handling on the flexural and compressive strength of posterior composite restorative materials

OBJECTIVES

The aim of this study was to investigate the influence of clinical handling on the flexural and compressive strengths of two commercially available posterior composites.

METHODS

Since the manufacturing of test specimens in a truly clinical situation presents many problems, an in vitro model was developed, consisting of a phantom-head set-up in a clinical operatory. Two composite materials, recommended for use in posterior teeth, were used: P50 APC (3M Dental Products) and Herculite XRV (Kerr, Dental Manufacturing). Beam specimens for 3-point bending tests of both materials and cylindrical specimens for compression test of P50 were made both under ideal laboratory circumstances and under simulated clinical circumstances.

RESULTS

The difference in mean flexural strength between laboratory prepared and the quasi-clinically prepared specimens was highly significant for both the specimens handled in a clinical manner was 15% of the flexural strength of the P50 specimens made under laboratory conditions, and the difference for Herculite XRV was 29%. No difference in compressive strength could be shown between the laboratory-fabricated and the quasi-clinically made specimens of P50.

SIGNIFICANCE

The relative flexural strength of composite materials in a clinical situation may differ significantly from that predicted from mechanical properties measured in vitro.

Comparison of fatigue for three prefabricated threaded post systems

Post designs may have a direct effect on fracture resistance of endodontically treated teeth. This in vitro study compared the resistance of three prefabricated threaded post systems with lateral shearing forces. After endodontics were completed, prefabricated posts were inserted according to the manufacturer's instructions. A silver amalgam core was placed, and extracted human teeth were prepared to a standard size with a 1 mm gingival chamfer finished on sound dentino A cast was fabricated and cemented, and the specimens were thermocycled. The test samples were secured to an Instron testing machine and loaded until failure. Fracture patterns were recorded, fractured surface areas were measured, and compressive stresses were calculated. However, there were no statistically significant differences among threaded posts in each test group.

Mechanical longevity estimation model for post-and-core restorations

OBJECTIVES

The aim of this study was to integrate existing knowledge of in vitro strength of post-and-cores and masticatory loading to arrive at longevity estimates for post-and-core restorations when subjected to clinically relevant loads.

METHODS

A biomechanical model was developed to predict the in vivo longevity. This method was applied to direct post-and-core restorations with amalgam or composite cores. Both experimental laboratory strength values and theoretical clinical strength values were used in the model. The restorations made in the laboratory were assumed to be of a higher quality than clinically made restorations, due to factors such as ease of manipulation, absence of saliva, etc. Both a high and low level of average masticatory loading were considered. The model was used to estimate the probability of mechanical failure before 5 X 10(6) load cycles (5 to 15 years) for all combinations of load range and manufacturing quality.

RESULTS

The calculated failure probability was effectively zero for most combinations except for a clinical quality core subjected to loads in the high range. There the probability of mechanical failure before 5 X 10(6) cycles was estimated to be 2 X 10(-5) for amalgam and 5 X 10(-5) for composite cores. These results agree with the overall observed clinical failure rate of about 1% per year for post-and-core restorations.

SIGNIFICANCE

The mechanical properties of the post-and-core restorations were adequate for clinically relevant loading conditions.

Marginal and internal fit of four different types of ceramic inlays after luting. An in vitro study

The marginal and internal fit of four different types of ceramic inlays--Cerec, Celay, Empress, and Vita In-Ceram Spinell--was determined after they had been luted on extracted premolars. For the Cerec inlays sharp and U-shaped proximal box shapings were also compared. There was no statistically significant difference either in the proximal fit or in the gingivoproximal fit between the four inlay systems studied, with the exception of the Cerec inlays made for preparations with sharp proximal boxes, which had wider marginal gaps. At the occlusal margins a significant-principle order of the gap width was established. The best internal fit was recorded for the Celay inlays, whereas there was no significant difference in the internal fit between the other systems. For the Cerec inlays the U-shaped proximal box shaping improved the marginal accuracy all around the restoration.

In vitro flexural fatigue limits of dental composites

The flexural fatigue test equipment developed was used to study the fatigue behavior of dental restorative composites, using a "staircase" approach. Three commercial composites were tested after dry and wet storage conditions. The findings indicate that the method is accurate and reliable, and that changes due to water sorption are clearly reflected: The flexural fatigue limit decreases after water sorption. From the present results it seems that under environmentally controlled conditions, the fatigue behavior is characterized by a well-defined fatigue stress level above which the composites tested fail rapidly, and below which they survive.

Almost two centuries with amalgam: where are we today?

Amalgam has provided valuable and comparatively inexpensive service to patients for a longer time than any other restorative material. Despite the excitement surrounding the use of each new restorative material, each has a shortcoming that amalgam hasn't.

Failure behaviour of fatigue-tested post and cores

Evaluation of the long-term behaviour of restorations in clinical trials can be time-consuming. A partial alternative to the clinical trial can be found in mechanical fatigue testing. The aim of this study was to evaluate the failure behaviour of post and core restored teeth when subjected to cyclic mechanical loading and to compare it with quasistatic failure. Eighty seven premolar teeth were restored with a titanium alloy post and an amalgam or composite core. Five to 21 days after restoration, the specimens were subjected to cyclic loading (frequency 5 Hz), at an angle of 45 degrees to the long axis of the tooth. The load levels were 50, 60, 65 and 70% of mean quasistatic failure loads. The specimens were divided into three groups according to their survival time: short (S) (< 10(4) cycles), intermediate (I) (10(4) < or = life < 10(5) cycles) and long (L) (> or = 10(5) cycles). For both core materials failure behaviour changed after approximately 10(5) cycles, and the change was most marked for the composite group. Catastrophic fatigue failure consisted of core fracture in the amalgam group (three times) and of post fracture in the composite L group (four times). Three post fractures occurred at a site theoretically predisposed to fatigue failure. It was concluded that fatigue failure characteristics of post and core restorations may be very different from those of quasistatic failure. Therefore, in addition to quasistatic tests, fatigue tests are necessary, covering at least 10(5) load cycles.

Mechanical performance of a dental composite: probabilistic failure prediction

In clinical situations, the mechanical performances of dental structures--for example, composite restorations--depend on many factors. Most of them have a probabilistic character. Because composites are brittle materials, their strength should also be considered as a probabilistic quantity. For successful prediction of mechanical failure of structures consisting of these materials, a probabilistic approach is indispensable, and a suitable definition of equivalent stress must be introduced. An equivalent stress facilitates the transfer of strength data of laboratory specimens to situations where the stress state is much more complicated. The tensile and compressive strengths of composites differ considerably. Of two equivalent stress definitions that potentially describe this experimental fact (the Drücker-Prager and the Modified von Mises equivalent stress), the predictive capacity was investigated for a microfine composite. In a probabilistic approach to failure, use of the Drücker-Prager equivalent stress appeared to be superior, because the average failure load of notched beams was predicted with an error smaller than 8%.

Finite element analysis of quasistatic and fatigue failure of post and cores

Finite element (FE) analysis of the mechanical behaviour of materials and structures facilitates the investigation of their internal stress distributions. However, the validity of the model is not always ascertained. In this study a three-dimensional (3D) FE model was developed, representing a laboratory set-up of direct post and core restored upper premolars. These restorations, using either composite or amalgam for core material, have been the subject of study in previous quasistatic and fatigue strength tests. The aim of this study was to validate the FE model for prefailure and failure modelling, by comparing the computational results with the laboratory observations and failure results. Two failure criteria were selected for investigation: Modified Von Mises and Drücker-Prager equivalent stress. Four model variations were carried out, representing different conditions at the core-tooth interface. Prefailure modelling was found to be adequate. The calculated failure results could only partly be fitted to the quasistatic tests. The best fit was effected with a model using partial bonding of the core, for the composite core. Fatigue failure was reproduced somewhat better by a model using no bonding at all, again to a higher degree for the composite core. Calculations of post stress using a model simulating increased core mobility supported an observation made previously (M. C. D. N. J. M. Huysmans et al., in press; Int. Endodont. J. XX, XXX-XXX), implying that a composite core raises the demands made on the post. The conclusion is made that validation of FE calculations is essential. A 3D model as presented here shows a satisfactory fit to fatigue data but not to quasistatic results.(ABSTRACT TRUNCATED AT 250 WORDS)