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Patel SR, Jarad F, Moawad E, Boland A, Greenhalgh J, Liu M, Maden M. The tooth survival of non-surgical root-filled posterior teeth and the associated prognostic tooth-related factors: A systematic review and meta-analysis. Int Endod J 2024. [PMID: 38949036 DOI: 10.1111/iej.14116] [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: 11/17/2023] [Revised: 05/28/2024] [Accepted: 06/18/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Analysis of the survival of root-filled posterior teeth and the associated prognostic tooth-related factors will enable clinicians to predict the outcome of root canal treatment. OBJECTIVES To investigate (i) the survival of root-filled posterior teeth and (ii) the tooth-related factors that may affect their survival. METHODS Randomized controlled trials, comparative studies and observational studies assessing survival rates of root-filled posterior teeth with a minimum 4-year follow-up period were identified through an electronic search of the following databases up to January 2023: The Cochrane Central Register of Controlled Trials, Medline via PubMed, the Cochrane Database of Systematic Reviews, Embase, Web of Science and NIHR centre for reviews and dissemination. Two reviewers (SP and ML) independently selected the final studies based on pre-defined inclusion criteria. The Newcastle Ottawa Scale and the Cochrane Risk of Bias Tool for Randomized Trials were used to assess the risk of bias. Pooled weighted survival rates were analysed using a random effects meta-analysis model using DerSimonean and Laird methods. Descriptive analysis of studies describing any prognostic tooth-related factors was conducted. RESULTS Of the 72 studies identified, data from 20 studies were included in the survival meta-analysis, and data from 13 of these studies were included in the descriptive analysis of tooth-related factors; 12 studies were retrospective, 7 were prospective, and one was a randomized control trial. The pooled survival rates at 4-7 years and 8-20 years of root-filled posterior teeth regardless of tooth type was 91% (95% CI, 0.85; 0.95) and 87% (95% CI, 0.77; 0.93), respectively. The prognostic tooth-related factors mentioned in the included studies were (i) remaining coronal tooth structure, (ii) ferrule, (iii) crown-to-root ratio (iv) tooth type and location (v) periodontal disease (vi) proximal contacts and (vii) cracks. CONCLUSIONS The meta-analysis suggests that root canal treatment has a high medium to long term survival outcome. The narrative summary identified 7 factors that affect tooth survival. However, there is a paucity of evidence, and more research is needed in this area. REGISTRATION PROSPERO Registration: CRD42021227213.
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Affiliation(s)
- S R Patel
- Department of Endodontics, University of Liverpool School of Dentistry, Liverpool, UK
| | - F Jarad
- Department of Endodontics, University of Liverpool School of Dentistry, Liverpool, UK
| | - E Moawad
- Department of Endodontics, University of Liverpool School of Dentistry, Liverpool, UK
| | - A Boland
- Liverpool Reviews and Implementation Group (LRiG), University of Liverpool, Liverpool, UK
| | - J Greenhalgh
- Liverpool Reviews and Implementation Group (LRiG), University of Liverpool, Liverpool, UK
| | - Maria Liu
- Department of Endodontics, University of Liverpool School of Dentistry, Liverpool, UK
| | - Michelle Maden
- Liverpool Reviews and Implementation Group (LRiG), University of Liverpool, Liverpool, UK
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Dotto L, Girotto LPS, Correa Silva Sousa YT, Pereira GKR, Bacchi A, Sarkis-Onofre R. Factors influencing the clinical performance of the restoration of endodontically treated teeth: An assessment of systematic reviews of clinical studies. J Prosthet Dent 2024; 131:1043-1050. [PMID: 35527069 DOI: 10.1016/j.prosdent.2022.03.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 10/18/2022]
Abstract
STATEMENT OF PROBLEM How best to restore endodontically treated teeth is still unclear because many types of material and techniques are involved. PURPOSE The purpose of this overview of systematic reviews of clinical studies was to assess the available evidence-based literature on the influence of associated clinical factors on the clinical performance (survival, failure rate, or success) of restored endodontically treated teeth. MATERIAL AND METHODS PubMed, Scopus, and Web of Science were searched from inception until September 27, 2021, to identify systematic reviews. Two reviewers independently screened titles, abstracts, and full-text articles, and each reviewer extracted the data of half of the included studies. A single reviewer with an independent verifier completed the quality appraisal. A descriptive analysis of the collected data was made. RESULTS A total of 36 systematic reviews fulfilled the inclusion criteria. The factors most assessed were the type of coronal restorative technique (n=22) and type of post (n=22). The results indicated that metal and fiber posts seem to present similar clinical performance, 1-piece endodontic crowns could be a suitable restorative option, there is no evidence to confirm whether single crowns are better or worse than direct restoration, the maintenance of the coronal structure is a fundamental factor, and the ferrule effect is still a controversial topic. Most of the studies (n=30, 81%) presented a final Grading of Recommendations, Assessment, Development and Evaluations (GRADE) rating of "critically low." CONCLUSIONS The post type does not appear to influence the clinical performance of restored endodontically treated teeth. However, conclusive evidence to suggest how different materials or techniques for restoring coronal tooth structure affect the clinical performance of such restorations, as well as the impact of the ferrule effect, is still lacking.
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Affiliation(s)
- Lara Dotto
- PhD student, School of Dentistry, Regional Integrated University of Upper Uruguai and Missions (URI), Erechim, RS, Brazil; and Master Student, Graduate Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil
| | - Luiza Paloma S Girotto
- Master Student, Graduate Program in Dentistry, Meridional Faculty (IMED), Passo Fundo, RS, Brazil
| | | | - Gabriel Kalil Rocha Pereira
- Associate Professor, Post-Graduate Program in Oral Sciences, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil
| | - Ataís Bacchi
- Associate Professor, Post-Graduate Program in Dentistry, Paulo Picanço School of Dentistry, Fortaleza, CE, Brazil
| | - Rafael Sarkis-Onofre
- Associate Professor, Graduate Program in Dentistry, Meridional Faculty (IMED), Passo Fundo, RS, Brazil.
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3
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Eachempati P, Lambourn G, Harris A, McColl E. Top tips for treatment planning: tooth-by-tooth prognosis - Part 1: restorative prognosis. Br Dent J 2024; 236:738-741. [PMID: 38789738 DOI: 10.1038/s41415-024-7472-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2024]
Affiliation(s)
- Prashanti Eachempati
- Peninsula Dental School (University of Plymouth), Derriford Dental Education Facility, Plymouth Science Park, Research Way, Plymouth, PL6 8BT, UK.
| | - Guy Lambourn
- Peninsula Dental School (University of Plymouth), Derriford Dental Education Facility, Plymouth Science Park, Research Way, Plymouth, PL6 8BT, UK.
| | - Andrew Harris
- Peninsula Dental School (University of Plymouth), Derriford Dental Education Facility, Plymouth Science Park, Research Way, Plymouth, PL6 8BT, UK.
| | - Ewen McColl
- Director of Clinical Dentistry, Peninsula Dental School (University of Plymouth), Derriford Dental Education Facility, Plymouth Science Park, Research Way, Plymouth, PL6 8BT, UK.
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Al-Sanabani FA, Al-Makramani BM, Alaajam WH, Al-Ak'hali MS, Alhajj MN, Nassani MZ, Assad M, Al-Maweri SA. Effect of partial ferrule on fracture resistance of endodontically treated teeth: A meta-analysis of in-vitro studies. J Prosthodont Res 2023; 67:348-359. [PMID: 36642507 DOI: 10.2186/jpr.jpr_d_22_00170] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE The present meta-analysis aimed to answer the following research question: In endodontically treated teeth (ETT), what is the effect of partial ferrule (PF) on fracture resistance compared to complete ferrule (CF) and/or no ferrule (NF)? STUDY SELECTION PubMed, Scopus, Web of Science, and Google Scholar were searched for relevant studies published until May 20, 2022. In vitro studies that compared the effect of partial ferrule with that of complete ferrule and/or no ferrule on fracture resistance of ETT were included. The studies were assessed for risk of bias, and a meta-analysis was performed. RESULTS Seventeen in vitro studies comprising 807 teeth were included. Nine studies were at a high risk of bias and eight presented a moderate risk of bias. Overall, the results showed that CF was superior to PF in increasing fracture resistance (SMD= 0.93, CI95%= 0.57-1.29, P< 0.0001), with no change in the effect based on the type of teeth (P< 0.001). However, the subgroup analysis found that PF 2 mm buccal, lingual, and buccal and lingual ferrule were comparable to CF (P= 0.06). Additionally, the PF group showed significantly higher fracture resistance than the NF group (SMD= 2.02, CI95%= 1.54-2.49, P< 0.00001). CONCLUSIONS Although CF design provided the highest fracture resistance to restored ETT, PF can still be a viable option for restoring ETT in cases where CF is not feasible.
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Affiliation(s)
- Fuad Ateik Al-Sanabani
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
- Department of Restorative Dentistry, Faculty of Dentistry, Sana'a University, Sana'a, Yemen
| | - Bandar Mohammed Al-Makramani
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
- Department of Restorative Dentistry, Faculty of Dentistry, Sana'a University, Sana'a, Yemen
| | - Wafa Hassan Alaajam
- Department of Restorative Dental Science, College of Dentistry, King Khalid University, Abha, Saudi Arabia
- Department of Conservative Dentistry, Faculty of Dentistry, Sana'a University, Sana'a, Yemen
| | - Mohammed Sultan Al-Ak'hali
- Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
- Department of Periodontology, Faculty of Dentistry, Sana'a University, Sana'a, Yemen
| | | | - Mohammad Zakaria Nassani
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, Dar Al Uloom University, Riyadh, Saudi Arabia
| | - Mounzer Assad
- Department of Oral Surgery, Faculty of Dentistry, Tishreen University, Lattakia, Syria
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Mannocci F, Bitter K, Sauro S, Ferrari P, Austin R, Bhuva B. Present status and future directions: The restoration of root filled teeth. Int Endod J 2022; 55 Suppl 4:1059-1084. [PMID: 35808836 PMCID: PMC9796050 DOI: 10.1111/iej.13796] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/04/2022] [Accepted: 07/05/2022] [Indexed: 12/30/2022]
Abstract
This narrative review will focus on a number of contemporary considerations relating to the restoration of root filled teeth and future directions for research. Clinicians are now more than ever, aware of the interdependence of the endodontic and restorative aspects of managing root filled teeth, and how these aspects of treatment are fundamental to obtaining the best long-term survival. To obtain the optimal outcomes for patients, clinicians carrying out endodontic treatment should have a vested interest in the restorative phase of the treatment process, as well as an appreciation for the structural and biomechanical effects of endodontic-restorative procedures on restoration and tooth longevity. Furthermore, the currently available research, largely lacks appreciation of occlusal factors in the longevity of root filled teeth, despite surrogate outcomes demonstrating the considerable influence this variable has. Controversies regarding the clinical relevance of minimally invasive endodontic and restorative concepts are largely unanswered with respect to clinical data, and it is therefore, all too easy to dismiss these ideas due to the lack of scientific evidence. However, conceptually, minimally invasive endodontic-restorative philosophies appear to be valid, and therefore, in the pursuit of improved clinical outcomes, it is important that the efficacies of these treatment protocols are determined. Alongside an increased awareness of the preservation of tooth structure, developments in adhesive bonding, ceramic materials and the inevitable integration of digital dentistry, there is also a need to evaluate the efficacy of new treatment philosophies and techniques with well-designed prospective clinical studies.
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Affiliation(s)
- Francesco Mannocci
- Department of EndodonticsFaculty of Dentistry, Oral and Craniofacial SciencesKing's College LondonLondonUK
| | - Kerstin Bitter
- Department of Operative and Preventive DentistryCharité ‐ University Medicine BerlinBerlinGermany
| | - Salvatore Sauro
- Departamento de Odontología, Facultad de Ciencias de la SaludUniversidad CEU‐Cardenal Herrera ValenciaAlfara del PatriarcaSpain
| | - Paolo Ferrari
- Department of Operative DentistryUniversity of ParmaParmaItaly
| | - Rupert Austin
- Department of ProsthodonticsFaculty of Dentistry, Oral and Craniofacial SciencesKing's College LondonLondonUK
| | - Bhavin Bhuva
- Department of EndodonticsFaculty of Dentistry, Oral and Craniofacial SciencesKing's College LondonLondonUK
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Popescu AD, Popa DL, Nicola AG, Dascălu IT, Petcu C, Tircă T, Tuculina MJ, Mocanu H, Staicu AN, Gheorghiță LM. Post Placement and Restoration of Endodontically Treated Canines: A Finite Element Analysis Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19158928. [PMID: 35897304 PMCID: PMC9332447 DOI: 10.3390/ijerph19158928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/18/2022] [Accepted: 07/21/2022] [Indexed: 02/04/2023]
Abstract
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.
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Affiliation(s)
- Alexandru Dan Popescu
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.D.P.); (C.P.); (A.N.S.); (L.M.G.)
| | - Dragoș Laurențiu Popa
- Department of Automotive, Transportation and Industrial Engineering, Faculty of Mechanics, University of Craiova, 200478 Craiova, Romania
- Correspondence: (D.L.P.); (M.J.T.)
| | - Andreea Gabriela Nicola
- Department of Oro-Dental Prevention, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.G.N.); (T.T.)
| | - Ionela Teodora Dascălu
- Department of Orthodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Cristian Petcu
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.D.P.); (C.P.); (A.N.S.); (L.M.G.)
| | - Tiberiu Tircă
- Department of Oro-Dental Prevention, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.G.N.); (T.T.)
| | - Mihaela Jana Tuculina
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.D.P.); (C.P.); (A.N.S.); (L.M.G.)
- Correspondence: (D.L.P.); (M.J.T.)
| | - Horia Mocanu
- Faculty of Dental Medicine, University Titu Maiorescu of Bucharest, 031593 Bucharest, Romania;
| | - Adela Nicoleta Staicu
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.D.P.); (C.P.); (A.N.S.); (L.M.G.)
| | - Lelia Mihaela Gheorghiță
- Department of Endodontics, Faculty of Dental Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.D.P.); (C.P.); (A.N.S.); (L.M.G.)
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Aldesoki M, Bourauel C, Morsi T, El-Anwar MI, Aboelfadl AK, Elshazly TM. Biomechanical behavior of endodontically treated premolars restored with different endocrown designs: Finite element study. J Mech Behav Biomed Mater 2022; 133:105309. [DOI: 10.1016/j.jmbbm.2022.105309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/31/2022] [Accepted: 06/02/2022] [Indexed: 10/18/2022]
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Gupta R, Thakur S, Pandey NK, Roopa B, Fares KT. Endocrown - A Paradigm Shift in Rehabilitation: A Report of Two Cases. Contemp Clin Dent 2021; 12:195-198. [PMID: 34220164 PMCID: PMC8237820 DOI: 10.4103/ccd.ccd_557_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/01/2020] [Accepted: 09/26/2020] [Indexed: 11/12/2022] Open
Abstract
Along with the advent of dentistry, the ideal restoration of an endodontically treated tooth has been a widely discussed and controversial topic. Coronal rehabilitation of an endodontically treated tooth is quite a challenge for clinicians as considerations should be taken for its minimally invasive preparation and the retention and stability of the restoration. With the development of adhesive systems, the need for intraradicular anchorage and thus the post-core system is greatly reduced. Endocrown is a restorative option for an endodontically treated tooth, and it serves as a suitable alternative to the conventional post-core restoration and full-coverage restoration. This novel approach promotes the stability and retention of the indirect restoration without the need of a cast metal core or reconstruction with intracanal post, thereby reducing the treatment time. Thus, endocrown has become a promising alternative in the esthetic and functional rehabilitation of an endodontically treated tooth.
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Affiliation(s)
- Rahul Gupta
- Department of Conservative Dentistry and Endodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Sophia Thakur
- Department of Conservative Dentistry and Endodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Nitish Kumar Pandey
- Department of Conservative Dentistry and Endodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - B Roopa
- Department of Conservative Dentistry and Endodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - K T Fares
- Department of Conservative Dentistry and Endodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
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Pires A, Poletto-Neto V, Chisini LA, Schwendicke F, Pereira-Cenci T. Post-retained Restorations: A Cost-minimization Analysis Nested in a Randomized Clinical Trial. Oper Dent 2021; 46:255-262. [PMID: 34192327 DOI: 10.2341/20-056-c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The aim of this study was to assess four post-retained restorative strategies for endodontically treated teeth using cost-minimization analysis. METHODS AND MATERIALS The cost-minimization analysis was based on primary data from a randomized clinical trial and followed the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guidelines. Two hundred twenty-five teeth (141 patients) restored using four strategies-teeth with ferrules+ restored with either glass fiber posts or direct composite or crowns, and teeth without ferrules- restored with either glass fiber or cast metal posts with crowns-were evaluated annually between 2009 and 2018. Initial costs and incremental costs per year were calculated. Survival curves were created using the Kaplan-Meier method and log-rank test. Kruskal-Wallis analysis was followed by Dunn's test, which was used to compare restorative treatments, with a significance level of 5%. RESULTS Initial costs were greater for cast metal posts without crowns (US$153.14). Glass fiber posts with composite (US$27.11) were least costly; the most failures occurred in this group, but they were primarily repairable restoration fractures. The number of extractions, and thus cost, was greater for glass fiber posts with crowns. The mean annual cost was significantly lower for teeth restored with composite (p<0.001). Ferrule presence did not significantly impact annual costs. CONCLUSIONS The use of glass fiber posts and direct composite incurred significantly lower annual costs than did other alternatives involving crowns or metal posts.
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Bhuva B, Giovarruscio M, Rahim N, Bitter K, Mannocci F. The restoration of root filled teeth: a review of the clinical literature. Int Endod J 2021; 54:509-535. [PMID: 33128279 DOI: 10.1111/iej.13438] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 10/26/2020] [Accepted: 10/27/2020] [Indexed: 02/06/2023]
Abstract
Clinicians often face dilemmas regarding the most appropriate way to restore a tooth following root canal treatment. Whilst there is established consensus on the importance of the ferrule effect on the predictable restoration of root filled teeth, other factors, such as residual tooth volume, tooth location, number of proximal contacts, timing of the definitive restoration and the presence of cracks, have been reported to influence restoration and tooth survival. The continued evolution of dental materials and techniques, combined with a trend towards more conservative endodontic-restorative procedures, prompts re-evaluation of the scientific literature. The aim of this literature review was to provide an updated overview of the existing clinical literature relating to the restoration of root filled teeth. An electronic literature search of the PubMed, Ovid (via EMBASE) and MEDLINE (via EMBASE) databases up to July 2020 was performed to identify articles that related the survival of root filled teeth and/or restoration type. The following and other terms were searched: restoration, crown, onlay, root canal, root filled, post, clinical, survival, success. Wherever possible, only clinical studies were selected for the literature review. Full texts of the identified articles were independently screened by two reviewers according to pre-defined criteria. This review identifies the main clinical factors influencing the survival of teeth and restorations following root canal treatment in vivo and discusses the data related to specific restoration type on clinical survival.
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Affiliation(s)
- B Bhuva
- Department of Endodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - M Giovarruscio
- Department of Endodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.,Department of Therapeutic Dentistry, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - N Rahim
- Department of Endodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - K Bitter
- Department of Operative and Preventive Dentistry, Charité - University Medicine, Berlin, Germany
| | - F Mannocci
- Department of Endodontics, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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Jurema AB, Bresciani E, Caneppele TMF. Influence of glass fiber posts on the fracture susceptibility of endodontically treated maxillary anterior teeth with direct veneers: Preliminary results of a randomized clinical trial. J ESTHET RESTOR DENT 2020; 33:613-620. [PMID: 33006446 DOI: 10.1111/jerd.12669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/29/2020] [Accepted: 09/12/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The purpose of this randomized clinical trial was to evaluate the influence of glass fiber posts on fracture susceptibility of endodontically treated maxillary anterior teeth with direct veneers. MATERIALS AND METHODS Fifty participants had 1 maxillary anterior tooth restored with a direct veneer. They were divided into 2 groups (n = 25) according to the use of intraradicular glass fiber posts. Clinical evaluation was performed at baseline, 6 and 12 months. The treatment success was determined by the absence of tooth fracture. If there was fracture, it was classified according to its extent. Fischer exact test was performed to analyze the criteria among the groups at each evaluation time. Friedman repeated analysis of variance assessed the difference in the performance of each group at three recall times (α = 0.5). RESULTS For control group, at the 6-month follow-up, one tooth had suffered a catastrophic failure, which resulted in tooth extraction. Fisher statistical analysis showed no significant difference between the cumulative success rate of the groups for the 6 (P > .999) and the 12-month (P > .999) period. Friedman test showed no significant difference among the periods of evaluation (P > .999). CONCLUSIONS Both groups had a similar success rate for maxillary anterior endodontically treated teeth with direct veneers after 12 months. CLINICAL IMPLICATIONS Glass fiber post use does not influence the fracture susceptibility of maxillary anterior endodontically treated teeth with direct veneers in the short term.
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Affiliation(s)
- AnaLuiza Barbosa Jurema
- Department of Restorative Dentistry, São Paulo State University (UNESP), Institute Science and Technology, São Paulo, Brazil
| | - Eduardo Bresciani
- Department of Restorative Dentistry, São Paulo State University (UNESP), Institute Science and Technology, São Paulo, Brazil
| | - Taciana Marco Ferraz Caneppele
- Department of Restorative Dentistry, São Paulo State University (UNESP), Institute Science and Technology, São Paulo, Brazil
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Spicciarelli V, Marruganti C, Marzocco D, Martignoni M, Ounsi H, Grandini S. Influence of Endodontic Access Cavity Design on Fracture Strength of Maxillary Incisors and Premolars and on Fatigue Resistance of Reciprocating Instruments. FRONTIERS IN DENTAL MEDICINE 2020. [DOI: 10.3389/fdmed.2020.575010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Khabadze Z, Mordanov O, Taraki F, Magomedov O, Kuznetsova A, Solimanov S, Nazhmudinov S, Bokova R, Adzhieva A, Bakaev Y. Effects of the Ferrule Design on Fracture Resistance to Endodontically-Treated Teeth Restored with Fiber Posts: A Systematic Review. Open Dent J 2019. [DOI: 10.2174/1874210601913010493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The ferrule is considered to be a key element in teeth preparation when restoring using a fiber post. It helps to resist occlusal forces, maintain cement tightness and minimize stress concentration on restoration using posts.
Aim:
The aim of this review is to determine the influence of the ferrule design in endodontically-treated teeth using fiber posts on their fracture resistance.
Materials and Methods:
The electronic databases examined were Medline, Scopus, and PubMed from April 2019 to October 2019. The studies were selected using well-established inclusion criteria.
Results:
In total, 79 articles were identified, 16 of which were selected after considering the titles and abstracts. After reading the full-text articles, the total number of articles included in this review was 7 with a low risk of bias.
Conclusion:
A full ferrule with a maximum height is the best design for resistance to fractures in all groups of teeth, but if it is impossible to provide this condition, the ferrule height from the palatal/lingual wall of the tooth should be increased.
The PROSPERO ID: 153543.
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Fontana PE, Bohrer TC, Wandscher VF, Valandro LF, Limberger IF, Kaizer OB. Effect of Ferrule Thickness on Fracture Resistance of Teeth Restored With a Glass Fiber Post or Cast Post. Oper Dent 2019; 44:E299-E308. [DOI: 10.2341/18-241-l] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Purpose:
To investigate the influence of ferrule thickness on fracture resistance after mechanical cycling of teeth restored with different intracanal posts.
Methods and Materials:
One hundred twenty bovine incisor teeth were randomized into six study groups, based on the intracanal post used (fiber post or cast post and core) and the presence and thickness of a ferrule (without ferrule, presence of 0.5-mm or 1-mm-thick ferrule, retaining unaltered 2-mm ferrule height). The root posts and the metal crowns were cemented using an adhesive cement. The samples were subjected to mechanical cycling (at 37°C, 45°, 130 N, 2.2 Hz, and 2 × 106 pulses). Afterward, they were subjected to a fracture load test at a speed of 0.5 mm/min and on a 45° slope until failure occurred. The failures were classified as favorable or unfavorable. The fracture resistance data were analyzed with two-way analysis of variance and Tukey test. The chi-square test was used to analyze the pattern of failure.
Results:
When considering the cast post and core, the 1-mm ferrule thickness group presented a higher resistance to fracture than did the group in which a ferrule was not used (p=0.001). When using a glass fiber post, the groups showed no differences in fracture resistance. Overall, 96.7% of the specimens survived the mechanical cycling. Of the fractures, 58.6% of the fractures were unfavorable, while 41.6% were favorable.
Conclusions:
A thicker ferrule statistically increased the fracture resistance only for cast post and core when it was at least 1 mm thick, despite causing more unfavorable failures. Thus, ferrule thickness should be considered when choosing different intracanal posts, to reduce the occurrence of unfavorable failures. In the absence of a ferrule, the use of a cast post and core presents more favorable failures, and in the presence of a 1-mm-thick ferrule, the use of a glass fiber post seems to be the best clinical decision.
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Affiliation(s)
- PE Fontana
- Patrícia Eliana Fontana, MSD, DDS graduate student in Oral Sciences (Prosthodontics), Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Brazil
| | - TC Bohrer
- Thaís Camponogara Bohrer, MSD, DDS graduate student in Oral Sciences (Prosthodontics), MSD, Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Brazil
| | - VF Wandscher
- Vinícius Felipe Wandscher, MSD, PhD, adjunct professor, Faculty of Odontology, Franciscan University (Prosthodontics Unit), Santa Maria, Brazil
| | - LF Valandro
- Luiz Felipe Valandro, MSD, PhD, associate professor, MDS Graduate Program in Oral Science (Prosthodontics-Biomaterials Units), Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Brazil
| | - IF Limberger
- Inácio F Limberger, PhD, associate professor, Faculty of Mechanical Engineering, Federal University of Santa Maria, Santa Maria, Brazil
| | - OB Kaizer
- Osvaldo Bazzan Kaizer, MSD, PhD, adjunct professor, MDS Graduate Program in Oral Science (Prosthodontics Units), Faculty of Odontology, Federal University of Santa Maria, Santa Maria, Brazil
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15
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Richert R, Robinson P, Viguie G, Farges JC, Ducret M. Multi-Fiber-Reinforced Composites for the Coronoradicular Reconstruction of Premolar Teeth: A Finite Element Analysis. BIOMED RESEARCH INTERNATIONAL 2018; 2018:4302607. [PMID: 29984233 PMCID: PMC6011147 DOI: 10.1155/2018/4302607] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 05/08/2018] [Indexed: 11/17/2022]
Abstract
A coronoradicular reconstruction (CRR) has conventionally used a metallic inlay core (MIC) or a single-fiber-reinforced composite (sFRC) but extensive dentin removal can lead to root fracture. We propose herein a multi-fiber-reinforced composite (mFRC) based on a bundle of thin flexible fibers that can be adapted to the root anatomy without removing additional dentin. The aim of this study was to compare the mechanical behavior of the root reconstructed with mFRC, MIC, or sFRC using a finite element analysis (FEA). Models with or without a ferrule effect were created using Autodesk© software and divided into four parts: root, post, bonding composite or cement, and zirconia crown. For both models, extreme stress values (ESV), stress distribution, and risk of fracture were calculated for an oblique force (45°) of 100 N applied to the top of the buccal cusp. Results indicated that mFRC and mFRCG present a lower risk of fracture of the root and of the CRR without ferrule and thus could be valuable alternatives for premolar CRR. Further studies are necessary to evaluate the clinical success of these CRR.
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Affiliation(s)
- Raphaël Richert
- Université de Lyon, Université Lyon 1, Faculté d'Odontologie, Lyon, France
- Hospices Civils de Lyon, Service de Consultations et Traitements Dentaires, Lyon, France
| | | | - Gilbert Viguie
- Université de Lyon, Université Lyon 1, Faculté d'Odontologie, Lyon, France
- Hospices Civils de Lyon, Service de Consultations et Traitements Dentaires, Lyon, France
| | - Jean-Christophe Farges
- Université de Lyon, Université Lyon 1, Faculté d'Odontologie, Lyon, France
- Hospices Civils de Lyon, Service de Consultations et Traitements Dentaires, Lyon, France
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR5305 CNRS/Université Lyon 1, UMS3444 BioSciences Gerland-Lyon Sud, Lyon, France
| | - Maxime Ducret
- Université de Lyon, Université Lyon 1, Faculté d'Odontologie, Lyon, France
- Hospices Civils de Lyon, Service de Consultations et Traitements Dentaires, Lyon, France
- Laboratoire de Biologie Tissulaire et Ingénierie Thérapeutique, UMR5305 CNRS/Université Lyon 1, UMS3444 BioSciences Gerland-Lyon Sud, Lyon, France
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