1
|
Pilecco RO, da Rosa LS, Baldi A, Machry RV, Tribst JPM, Valandro LF, Kleverlaan CJ, Scotti N, Pereira GKR. How do different intraoral scanners and milling machines affect the fit and fatigue behavior of lithium disilicate and resin composite endocrowns? J Mech Behav Biomed Mater 2024; 155:106557. [PMID: 38657286 DOI: 10.1016/j.jmbbm.2024.106557] [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: 02/27/2024] [Revised: 04/03/2024] [Accepted: 04/17/2024] [Indexed: 04/26/2024]
Abstract
The aim of this in vitro study was to evaluate the effect of the combinations of two different intraoral scanners (IOS), two milling machines, and two restorative materials on the marginal/internal fit and fatigue behavior of endocrowns produced by CAD-CAM. Eight groups (n= 10) were considered through the combination of TRIOS 3 (TR) or Primescan (PS) IOS; 4-axes (CR; CEREC MC XL) or 5-axes (PM; PrograMill PM7) milling machines; and lithium disilicate (LD; IPS e.max CAD) or resin composite (RC; Tetric CAD) restorative materials. Specific surface treatments were applied to each material, and the bonding to its corresponding Endocrown-shaped fiberglass-reinforced epoxy resin preparations was performed (Variolink Esthetic DC). Computed microtomography (μCT) was performed to assess the marginal/internal fit, as well as a mechanical fatigue test (20 Hz, initial load = 100 N/5000 cycles; step-size = 50 N/10,000 cycles until a threshold of 1500 N, then, the step-size was increased if needed to 100 N/10,000 cycles until failure or a threshold of 2800 N) to evaluate the restorations long-term behavior. Complementary analysis of the fracture features and surface topography in scanning electron microscopy was performed. Three-way ANOVA and Kaplan-Meier test (α = 0.05) were performed for marginal/internal fit, and fatigue behavior data, respectively. PS scanner, CR milling machine, and RC endocrowns resulted in a better marginal fit compared to their counterparts. Still, the PM machine resulted in a better pulpal space fit compared to the CR milling machine. Regardless of the scanner and milling machine, RC endocrowns exhibited superior fatigue behavior than LD ones. LD endocrowns presented margin chipping regardless of the milling machine used. Despite minor differences in terms of fit, the 'IOS' and 'milling machine' factors did not impair the fatigue behavior of endocrowns. Resin-composite restorations resulted in a higher survival rate compared to glass-ceramic ones, independently of the digital devices used in the workflow.
Collapse
Affiliation(s)
- Rafaela Oliveira Pilecco
- Post-Graduate Program in Oral Sciences (Prosthodontics Units), Faculty of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - Lucas Saldanha da Rosa
- Post-Graduate Program in Oral Sciences (Prosthodontics Units), Faculty of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - Andrea Baldi
- Department of Surgical Sciences, Dental School, University of Turin (UNITO), Turin, Piedmont, Italy.
| | - Renan Vaz Machry
- Post-Graduate Program in Oral Sciences (Prosthodontics Units), Faculty of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - João Paulo Mendes Tribst
- Department of Reconstructive Oral Care, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, the Netherlands.
| | - Luiz Felipe Valandro
- Post-Graduate Program in Oral Sciences (Prosthodontics Units), Faculty of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| | - Cornelis Johannes Kleverlaan
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, North Holland, the Netherlands.
| | - Nicola Scotti
- Department of Surgical Sciences, Dental School, University of Turin (UNITO), Turin, Piedmont, Italy.
| | - Gabriel Kalil Rocha Pereira
- Post-Graduate Program in Oral Sciences (Prosthodontics Units), Faculty of Dentistry, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul State, Brazil.
| |
Collapse
|
2
|
Xiao P, Zheng Z, Zhang Y, Zeng Y, Yan W. Accuracy and adaptation of one-piece endodontic crowns fabricated through 3D printing and milling. J Prosthet Dent 2024:S0022-3913(24)00363-9. [PMID: 38880678 DOI: 10.1016/j.prosdent.2024.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 05/17/2024] [Accepted: 05/17/2024] [Indexed: 06/18/2024]
Abstract
STATEMENT OF PROBLEM High-level evidence regarding the accuracy and adaptation of 1-piece endodontic crowns fabricated by using 3-dimensional (3D) printing technology is lacking. PURPOSE The purpose of this in vitro study was to compare the accuracy and adaptation of 1-piece endodontic crowns produced through 3D printing and computer-numerical-control milling technology and to explore the influence of trueness on 1-piece endodontic crown adaptation. MATERIAL AND METHODS One-piece endodontic crowns were prepared for a typodont right mandibular first molar, scanned with a 3Shape E3 scanner, and designed with a computer-aided design software program. Two types of 1-piece endodontic crowns were fabricated: 3D printed by using resin and zirconia slurry and milled from Grandio and zirconia blocks. A reverse engineering software program was used to superimpose 4 groups of crowns with the reference crowns used for accuracy analysis. Microcomputed tomography was used to measure 1-piece endodontic crown adaptation. The correlation between trueness and adaptation was evaluated through the Spearman correlation test (α=.05). RESULTS Milled resin-based 1-piece endodontic crowns demonstrated better trueness on marginal and occlusal surfaces compared with 3D printed ones (P<.001). However, no significant difference was observed in the trueness of intaglio surfaces between the 2 groups (P>.05). The milled group exhibited better adaptations than the printed one (P<.05). For zirconia 1-piece endodontic crowns, no significant differences were found in trueness or adaptation between the milled and printed groups (P>.05). Notably, the trueness of the axial wall had the greatest impact on overall crown adaptation, with its adaptation closely linked to the trueness of each area, particularly the axial wall. CONCLUSIONS Milled resin-based 1-piece endodontic crowns exhibited higher levels of trueness and adaptation compared with 3D printed ones, while 3D printed zirconia 1-piece endodontic crowns were comparable with milled ones.
Collapse
Affiliation(s)
- Ping Xiao
- Graduate student, Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Ziting Zheng
- Graduate student, Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Yanli Zhang
- Doctoral student, Stomatological Hospital, Southern Medical University, Guangzhou, PR China
| | - Yuting Zeng
- Graduate student, Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China
| | - Wenjuan Yan
- Professor, Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, PR China.
| |
Collapse
|
3
|
Zeng B, Luo B, Hu J, Meng D, Zhang J, Cao X, Jiang Q. Effect of margin designs and loading conditions on the stress distribution of endocrowns: a finite element analysis. BMC Oral Health 2024; 24:657. [PMID: 38840138 PMCID: PMC11151608 DOI: 10.1186/s12903-024-04422-3] [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: 04/13/2024] [Accepted: 05/30/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Margin designs and loading conditions can impact the mechanical characteristics and survival of endocrowns. Analyzing the stress distribution of endocrowns with various margin designs and loading conditions can provide evidence for their clinical application. METHODS Three finite element analysis models were established based on the margin designs: endocrown with a butt-joint type margin (E0), endocrown with a 90° shoulder (E90), and endocrown with a 135° shoulder (E135). The E0 group involved lowering the occlusal surface and preparing the pulp chamber. The E90 group created a 90° shoulder on the margin of model E0, measuring 1.5 mm high and 1 mm wide. The E135 group featured a 135° shoulder. The solids of the models were in fixed contact with each other, and the materials of tooth tissue and restoration were uniform, continuous, isotropic linear elasticity. Nine static loads were applied, with a total load of 225 N, and the maximum von Mises stresses and stress distribution were calculated for teeth and endocrowns with different margin designs. RESULTS Compared the stresses of different models under the same loading condition. In endocrowns, when the loading points were concentrated on the buccal side, the maximum von Mises stresses were E0 = E90 = E135, and when there was a lingual loading, they were E0 < E90 = E135. In enamel, the maximum von Mises stresses under all loading conditions were E0 > E90 > E135. In dentin, the maximum von Mises stresses of the three models were basically similar except for load2, load5 and load9. Compare the stresses of the same model under different loading conditions. In endocrowns, stresses were higher when lingual loading was present. In enamel and dentin, stresses were higher when loaded obliquely or unevenly. The stresses in the endocrowns were concentrated in the loading area. In enamel, stress concentration occurred at the cementoenamel junction. In particular, E90 and E135 also experienced stress concentration at the shoulder. In dentin, the stresses were mainly concentrated in the upper section of the tooth root. CONCLUSION Stress distribution is similar among the three margin designs of endocrowns, but the shoulder-type designs, especially the 135° shoulder, exhibit reduced stress concentration.
Collapse
Affiliation(s)
- Baijin Zeng
- Department of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, No. 4 Tiantanxili, Dongcheng District, Beijing, 100050, China
| | - Bin Luo
- Department of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, No. 4 Tiantanxili, Dongcheng District, Beijing, 100050, China
| | - Jiangqi Hu
- Department of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, No. 4 Tiantanxili, Dongcheng District, Beijing, 100050, China
| | - Dan Meng
- Department of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, No. 4 Tiantanxili, Dongcheng District, Beijing, 100050, China
| | - Jiebing Zhang
- Department of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, No. 4 Tiantanxili, Dongcheng District, Beijing, 100050, China
| | - Xu Cao
- Department of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, No. 4 Tiantanxili, Dongcheng District, Beijing, 100050, China.
| | - Qingsong Jiang
- Department of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, No. 4 Tiantanxili, Dongcheng District, Beijing, 100050, China.
| |
Collapse
|
4
|
Neri H, Aripin D, Muryani A, Dharsono HDA, Yolanda Y, Mahyuddin AI. Stress Analysis on Mesiolingual Cavity of Endodontically Treated Molar Restored Using Bidirectional Fiber-Reinforced Composite (Wallpapering Technique). Clin Cosmet Investig Dent 2024; 16:75-89. [PMID: 38632981 PMCID: PMC11022878 DOI: 10.2147/ccide.s450325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/27/2024] [Indexed: 04/19/2024] Open
Abstract
Introduction Endodontically treated teeth (ETT) undergo extensive structure change and experience high stress during biomechanical function. Stress distribution is influenced by the restoration material and the type of bond between material and tooth structure. The selection of materials that can distribute stress will affect the resistance and retention of ETT to mastication forces, thus biomechanical functions were achieved. Composite has mechanical properties similar to dentin, it can transmit and distribute stresses throughout the tooth surface. The disadvantage of composites in large cavities is their lack of toughness. The addition of fiber to composites can increase their toughness. Purpose This research is to determine the stress distribution of a fiber-reinforced composite made of polyethylene and e-glass on the mesiolingual cavity of ETT. Materials and Methods A three-dimensional model of the mandibular molar was prepared for cavity preparation and the formation of restorations using SolidWorks 2021. The models were analyzed with Abaqus 2020 to determine stress concentrations after given vertical and oblique loading. Results The maximum and minimum principal stress data were obtained to assess material resistance and interfacial damage criterion. Polyethylene fiber shows a more homogeneous stress distribution because the modulus of elasticity is close to the dentin and has a thickness that can reduce the volume of the composite. The E-glass shows the stress concentration on the circumferential fiber and cavity floor. Conclusion The stress distribution of fiber-reinforced composite on the buccolingual cavity of ETT using the finite element method did not show structural failure in the polyethylene group because the maximum and minimum principal stresses were lower than the strength of the material. Interfacial bond failure occurs at the enamel portion. The maximum and minimum principal values of e-glass indicate structural failure in the circumferential fiber and the base fiber because the stress exceeds the strength of the material. Interfacial bond failure occurred on the circumferential and the cavity floor.
Collapse
Affiliation(s)
- Harnia Neri
- Department of Conservative Dentistry, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
| | - Dudi Aripin
- Department of Conservative Dentistry, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
| | - Anna Muryani
- Department of Conservative Dentistry, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
| | | | - Yolanda Yolanda
- Department of Conservative Dentistry, Faculty of Dentistry, Universitas Padjadjaran, Bandung, Indonesia
| | - Andi Isra Mahyuddin
- Faculty of Mechanical and Aerospace Engineering, Bandung Institute of Technology, Bandung, Indonesia
| |
Collapse
|
5
|
M. S. Alqahtani W, A. Yousief S, Tammam R, M. Galal R, Brakat A, Mohamed El Sayed H, Kamal A, Noushad M, Nassani MZ. Biomechanics of Central Incisor Endocrowns with Different Lengths and Milled Materials after Static and Vertical Loading: A Finite Element Study. Int J Dent 2024; 2024:4670728. [PMID: 38585251 PMCID: PMC10999285 DOI: 10.1155/2024/4670728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 03/02/2024] [Accepted: 03/14/2024] [Indexed: 04/09/2024] Open
Abstract
Purpose The aim of this study was to compare and assess the stress distribution and failure possibility of endodontically treated central incisor protected with endocrowns with different heights, with various CAD-CAM blocks such as IPS e.max CAD, Katana Zirconia, and Zolid Fx Zirconia. Materials and Methods A root canal-treated central incisor (plastic model) restored with an endocrown was scanned with a laser scanner to prepare a control model with a CAD software and then transferred to an FEA software. Proposed crown heights were 2, 4, and 6 mm. The model that was duplicated and restored with CAD-CAM blocks, IPS e.max CAD, Katana Zirconia, and Zolid Fx Zirconia were tested as endocrown materials. Bone geometry was simplified to be two coaxial cylinders in all models. Stress distributions under 50 N axial and oblique (with 135° angle from the vertical plane) loading were analyzed. Each model was then subjected to two occlusal loading conditions-the lingual slope of the incisal edge and the junction between incisal and middle thirds. Eighteen runs and calculations were performed to determine the endocrown height and material effect. Results The results showed a minor or negligible effect of changing the endocrown material. Increasing endocrown height was shown to reduce stresses and deformations on most of the model components (bone, gutta-percha, periodontal ligament, and endocrown), except root and cement. Differences in deformations and stresses between the two models of 4 and 6 mm were relatively smaller (ranged between 1% and 30%) compared to those between the 2 and 4 mm models (ranged between 10% and 400%). Conclusions The material used to fabricate endocrowns did not show considerable effect on the underlying structures. However, the endocrown design (2, 4, and 6 mm height) was shown to affect all components of the studied systems. Increasing endocrown height is recommended for bone, periodontal ligaments, and endocrown body, as it reduces stresses and deformations. On the other hand, it dramatically increases stresses on the root and cement layer. Smaller endocrown sizes represent an acceptable treatment option when there is a healthy periodontal state, while using larger sizes will be more suitable when there is a periodontal compromise with bone loss.
Collapse
Affiliation(s)
- Waleed M. S. Alqahtani
- Department of Prosthetic Dentistry, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Salah A. Yousief
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, Dar Al Uloom University, Riyadh 13313, Saudi Arabia
- Department of Crown and Bridge, Faculty of Oral and Dental Medicine, Al Azhar University, Assuit Branch, Cairo 71524, Egypt
| | - Raafat Tammam
- Department of Prosthodontics, Faculty of Dentistry, Assiut University, Assiut 71515, Egypt
| | - Rami M. Galal
- Department of Fixed and Removable Prosthodontics, National Research Centre, Cairo, Egypt
| | - Ali Brakat
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, Dar Al Uloom University, Riyadh 13313, Saudi Arabia
| | - Hend Mohamed El Sayed
- Restorative Dentistry Conservative Dentistry Department, Faculty of Dentistry, Cairo University, 11 EL-Saraya Street Manial, Cairo 11553, Egypt
| | - Ala'a Kamal
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, Dar Al Uloom University, Riyadh 13313, Saudi Arabia
| | - Mohammed Noushad
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, Dar Al Uloom University, Riyadh 13313, Saudi Arabia
| | - Mohammad Zakaria Nassani
- Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, Dar Al Uloom University, Riyadh 13313, Saudi Arabia
| |
Collapse
|
6
|
Cruzado-Oliva FH, Alarco-La Rosa LF, Vega-Anticona A, Arbildo-Vega HI. Biomechanics of anterior endocrowns with different designs and depths: Study of finite elements. J Clin Exp Dent 2023; 15:e1016-e1021. [PMID: 38186913 PMCID: PMC10767734 DOI: 10.4317/jced.60889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/04/2023] [Indexed: 01/09/2024] Open
Abstract
Background To date, there is no clear consensus in the literature on which endocrown design and depth is the most effective treatment option for restoring endodontically treated maxillary central incisors. Aim: To determine the stress distribution of the anterior endocrowns by means of finite element analysis. Material and Methods Nine 3D finite element models (groups A - I) were made, each one representing a restoration system of endodontically treated upper central incisors. The models were endocrowns with and without ferrules at 0, 1, 3, and 5 mm depth and a post-core stump control group. A static load of 100N of force was applied to the palatal face at 45º from the long axis of the tooth. The Von Mise values and the maximum stress in the crown, dentin and resin cementum were evaluated separately. Results The maximum stress distribution was C < B < A < D < H < F < E < G < I and the Von Mises stresses were in the upper 1/3 of the retainer of endocrowns A, B, C and D. ; in the vestibular neck in endocrowns E and F; in the final 1/3 of the retainer in the endocrown G; in the middle 1/3 of the retainer in the H endocrown; and at the level of the vestibular neck of the crown in model I. Conclusions The smallest distribution of maximum and Von Mises stresses was observed in model C. Key words:Finite element analysis, Biomechanics, upper central incisor, endodontically treated teeth, dental restoration.
Collapse
Affiliation(s)
- Fredy-Hugo Cruzado-Oliva
- Escuela de Estomatología, Facultad de Estomatología, Universidad Nacional de Trujillo. Trujillo - Perú
| | | | - Alexander Vega-Anticona
- Escuela de Ingeniería de Materiales, Facultad de Ingeniería, Universidad Nacional de Trujillo. Trujillo - Perú
| | - Heber-Isac Arbildo-Vega
- Escuela de Estomatología, Facultad de Estomatología, Universidad Nacional de Trujillo. Trujillo - Perú
| |
Collapse
|
7
|
Dimitrova M, Vlahova A, Kalachev Y, Zlatev S, Kazakova R, Capodiferro S. Recent Advances in 3D Printing of Polymers for Application in Prosthodontics. Polymers (Basel) 2023; 15:4525. [PMID: 38231950 PMCID: PMC10708542 DOI: 10.3390/polym15234525] [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: 10/27/2023] [Revised: 11/15/2023] [Accepted: 11/22/2023] [Indexed: 01/19/2024] Open
Abstract
Contemporary mass media frequently depict 3D printing as a technology with widespread utilization in the creation of dental prosthetics. This paper endeavors to provide an evidence-based assessment of the current scope of 3D printing's integration within dental laboratories and practices. Its primary objective is to offer a systematic evaluation of the existing applications of 3D-printing technology within the realm of dental prosthetic restorations. Furthermore, this article delves into potential prospects, while also critically examining the sustained relevance of conventional dental laboratory services and manufacturing procedures. The central focus of this article is to expound upon the extent to which 3D printing is presently harnessed for crafting dental prosthetic appliances. By presenting verifiable data and factual insights, this article aspires to elucidate the actual implementation of 3D printing in prosthetic dentistry and its seamless integration into dental practices. The aim of this narrative review is twofold: firstly, to provide an informed and unbiased evaluation of the role that 3D printing currently plays within dental laboratories and practices; and secondly, to instigate contemplation on the transformative potential of this technology, both in terms of its contemporary impact and its future implications, while maintaining a balanced consideration of traditional dental approaches.
Collapse
Affiliation(s)
- Mariya Dimitrova
- Department of Prosthetic Dentistry, Faculty of Dental Medicine, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria; (A.V.); (Y.K.); (S.Z.); (R.K.)
| | - Angelina Vlahova
- Department of Prosthetic Dentistry, Faculty of Dental Medicine, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria; (A.V.); (Y.K.); (S.Z.); (R.K.)
- CAD/CAM Center of Dental Medicine, Research Institute, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria
| | - Yavor Kalachev
- Department of Prosthetic Dentistry, Faculty of Dental Medicine, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria; (A.V.); (Y.K.); (S.Z.); (R.K.)
| | - Stefan Zlatev
- Department of Prosthetic Dentistry, Faculty of Dental Medicine, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria; (A.V.); (Y.K.); (S.Z.); (R.K.)
- CAD/CAM Center of Dental Medicine, Research Institute, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria
| | - Rada Kazakova
- Department of Prosthetic Dentistry, Faculty of Dental Medicine, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria; (A.V.); (Y.K.); (S.Z.); (R.K.)
- CAD/CAM Center of Dental Medicine, Research Institute, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria
| | - Saverio Capodiferro
- Department of Interdisciplinary Medicine, Aldo Moro, University of Bari, 70100 Bari, Italy;
| |
Collapse
|
8
|
Al Qahtani WM. Comparative Finite Element Analysis of Endocrowns and Traditional Restorations for Endodontically Treated Mandibular First Molars. Med Sci Monit 2023; 29:e941314. [PMID: 37941316 PMCID: PMC10644702 DOI: 10.12659/msm.941314] [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: 06/01/2023] [Accepted: 08/24/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND This study evaluated 2 endocrown designs and traditional restoration with a conventional crown using post and core to find the best restoration design for endodontically treated mandibular first molars. MATERIAL AND METHODS Three 3D finite element models were constructed: (1) post and core restoration, (2) endocrown butt joint margin design, and (3) endocrown with shoulder finish line. The intact tooth geometry was extracted with computed tomography, then modified to the selected restoration designs. Bone and mucosa geometry was simplified and represented as 3 cylinders. Two loading cases were examined on E-max crowns as 400N and 200N vertically and 45º oblique, respectively, that were located at buccal cusp tips and central fossa by nodal force distributed on circular areas with 0.5-mm diameter in each location. RESULTS Traditional restoration kept crown deformation and stresses at lower levels than did endocrowns. Results of the butt joint margin design were comparable to that of shoulder finish line design. Cement had the lowest stress values under shoulder finish line design, while the remaining tooth indicated the superiority of butt joint margin design, with less stresses by 20% and 24%, compared with traditional and shoulder finish line restorations, respectively. CONCLUSIONS The 3 tested restoration designs worked well. Although the differences were small, according to stress analysis results, conventional restoration by post and core achieved the best performance, followed by butt joint margin, which ensures lowest level of stresses on dentine. Finally, the shoulder finish line endocrown can replace the other designs but with higher stress levels.
Collapse
|
9
|
Munoz-Sanchez ML, Gravier A, Francois O, Nicolas E, Hennequin M, Decerle N. In Vitro Resistance of Natural Molars vs. Additive-Manufactured Simulators Treated with Pulpotomy and Endocrown. J Funct Biomater 2023; 14:444. [PMID: 37754858 PMCID: PMC10531589 DOI: 10.3390/jfb14090444] [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: 07/10/2023] [Revised: 08/23/2023] [Accepted: 08/27/2023] [Indexed: 09/28/2023] Open
Abstract
Endocrowns are designed to restore endodontically treated teeth with root canal treatment (Rct). Recently, endocrowns were proposed for teeth treated with full pulpotomy (FP). No data exist on in vitro evaluations for this combination. This study aimed to evaluate the mechanical behavior of pulpotomy-treated teeth with endocrowns according to different protocols for preparation design and materials and to assess whether 3D-printed resin simulators could be a reliable alternative for human teeth during in vitro strength tests. One hundred and ten extracted natural molars were randomized into 11 groups according to the type of endodontic treatment, the material used, and the design of peripheric preparation. One hundred and ten resin simulators were separated similarly. The samples were embedded in epoxy resin blocks before being subjected to oblique compressive load until failure. For natural teeth, the variance analysis separated two homogeneous groups, one regrouping the endodontically treated or pulpotomy-treated teeth without coronal restoration and the other one regrouping all the other samples, i.e., the untreated teeth (positive controls) and the treated and restored teeth. The strength resistance was lower for the resin simulators than for natural teeth in all groups. Within the limit of this study, strength resistance is not the most important criterion for choosing the type of material, preparation, or endodontic treatment for endocrowns. Resin simulators are not efficient for in vitro strength studies.
Collapse
Affiliation(s)
- Marie-Laure Munoz-Sanchez
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (M.-L.M.-S.); (O.F.); (M.H.); (N.D.)
- CHU Clermont-Ferrand, Service d’Odontologie, F-63003 Clermont-Ferrand, France
| | - Alexis Gravier
- Institut Pascal UMR CNRS 6602, Université Clermont Auvergne, F-63000 Clermont-Ferrand, France;
| | - Olivier Francois
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (M.-L.M.-S.); (O.F.); (M.H.); (N.D.)
| | - Emmanuel Nicolas
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (M.-L.M.-S.); (O.F.); (M.H.); (N.D.)
- CHU Clermont-Ferrand, Service d’Odontologie, F-63003 Clermont-Ferrand, France
| | - Martine Hennequin
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (M.-L.M.-S.); (O.F.); (M.H.); (N.D.)
- CHU Clermont-Ferrand, Service d’Odontologie, F-63003 Clermont-Ferrand, France
| | - Nicolas Decerle
- Centre de Recherche en Odontologie Clinique (CROC), Université Clermont Auvergne, F-63000 Clermont-Ferrand, France; (M.-L.M.-S.); (O.F.); (M.H.); (N.D.)
- CHU Clermont-Ferrand, Service d’Odontologie, F-63003 Clermont-Ferrand, France
| |
Collapse
|
10
|
Thangarasu N, Venkatesh KV. Effect of various preparation designs on pull-out bond strength of endocrown. Indian J Dent Res 2023; 34:304-307. [PMID: 38197352 DOI: 10.4103/ijdr.ijdr_517_23] [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] [Indexed: 01/11/2024] Open
Abstract
Background The endocrown is described as monobloc ceramic component. The pull-out bond strength acts as a real-life scenario of failure that occurs in endocrown. The different preparation designs have been included to assess the type of preparation that resists the least failure. Aim To evaluate the effect of three different types of preparation designs on the pull-out bond strength (PBS) of computer-aided design/computer-aided manufacturing (CAD/CAM) monolithic endocrowns. Methods and Materials Thirty extracted mandibular first molars were used for this study. Root canal treatment was done. Samples were divided into three groups of 10 samples each. Group A consists of traditional endocrown preparation with a butt joint preparation. The group B consists of a modified preparation with 50-60 degree inward slope. The group C consists of preparation with a 50-60 degree outward slope. Endocrowns were fabricated using CAD/CAM lithium disilicate glass-ceramics. The endocrowns were adhesively bonded to the respective preparations. Pull-out bond strength was calculated using the universal testing machine at a crosshead speed of 1 mm/min. Statistical Analysis The results were statistically evaluated by one-way ANOVA and Tukey's post hoc analysis. Results Group B had higher pull-out bond strength compared to the other two types of preparation designs and showed a statistically significant value with a mean significant difference at 0.05 level (P < 0.05). Conclusion The 50-60 degree inward bevel in endocrown preparation increased the pull-out bond strength in lithium disilicate endocrowns.
Collapse
Affiliation(s)
- Naveen Thangarasu
- Department of Conservative Dentistry and Endodontics, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology, Chengalpattu, Tamil Nadu, India
| | - K Vijay Venkatesh
- Department of Conservative Dentistry and Endodontics, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology, Chengalpattu, Tamil Nadu, India
| |
Collapse
|
11
|
Capobianco V, Baroudi K, Santos MJMC, Rubo JH, Rizkalla AS, Dal Piva AMDO, Vitti RP, Tribst JPM, Santos GC. Post-fatigue fracture load, stress concentration and mechanical properties of feldspathic, leucite- and lithium disilicate-reinforced glass ceramics. Heliyon 2023; 9:e17787. [PMID: 37449193 PMCID: PMC10336509 DOI: 10.1016/j.heliyon.2023.e17787] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/09/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023] Open
Abstract
Objective To evaluate the mechanical properties of different CAD/CAM ceramic systems and the post-fatigue fracture and stress distribution when used as cemented crowns. Materials and methods Sixty (60) CAD/CAM monolithic crowns were milled using three different ceramic materials (FD - Feldspathic [Vita Mark II]), LE - Leucite-based ceramic [IPS Empress CAD] and LD - Lithium Disilicate [IPS e.max CAD]) and adhesively cemented on resin composite dyes. Specimens were stored in distillated water (37 °C) for 7 days. After, half of the crowns were submitted to immediate fracture load test while the other half was submitted to fatigue cycling. The average cement layer of approximately 80 μm was assessed using scanning electron microscopy (SEM). The average thickness was used in the three-dimensional (3D) Finite Element Analysis (FEA). For each ceramic material, the density, Poisson ratio, shear modulus, Young modulus, fracture toughness, and true hardness were assessed (n = 3). The data was used to assess the Maximum Principal Stress throughout 3D-FEA according to each material during load to fail and post-fatigue. Data were submitted to two-way ANOVA and Tukey test (α = 0.05). Results LD showed the highest compression load, density, shear modulus, Young modulus, fracture toughness and true hardness values. While LE presented the lowest mechanical properties values. There is no difference in the Poisson ratio between the evaluated ceramics. Conclusion LD was susceptible to aging process but presented stronger physicomechanical properties, showing the highest post-fatigue fracture load and highest stress magnitude.
Collapse
Affiliation(s)
| | - Kusai Baroudi
- RAK College of Dental Sciences, RAK Medical & Health Sciences University, RAS Al Khaimah, United Arab Emirates
- School of Dentistry, University of Taubaté, Taubaté, SP, Brazil
| | | | | | - Amin S. Rizkalla
- Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada
| | - Amanda Maria de Oliveira Dal Piva
- Department of Dental Materials, Academic Centre for Dentistry Amsterdam (ACTA),Universiteit van Amsterdam en Vrije Universiteit, Amsterdam, the Netherlands
| | - Rafael Pino Vitti
- School of Dentistry, Herminio Ometto University Center, Araras, SP, Brazil
| | - João Paulo Mendes Tribst
- Department of Reconstructive Oral Care, Academic Centre for Dentistry Amsterdam (ACTA),Universiteit van Amsterdam en Vrije Universiteit, Amsterdam, the Netherlands
| | - Gildo Coelho Santos
- Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada
| |
Collapse
|
12
|
Alshabib A, Abid Althaqafi K, AlMoharib HS, Mirah M, AlFawaz YF, Algamaiah H. Dental Fiber-Post Systems: An In-Depth Review of Their Evolution, Current Practice and Future Directions. Bioengineering (Basel) 2023; 10:bioengineering10050551. [PMID: 37237621 DOI: 10.3390/bioengineering10050551] [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: 03/16/2023] [Revised: 04/27/2023] [Accepted: 05/02/2023] [Indexed: 05/28/2023] Open
Abstract
The field of dental medicine is constantly evolving and advancing toward minimally invasive techniques. Several studies have demonstrated that bonding to the tooth structure, particularly enamel, yields the most predictable results. In some instances, however, significant tooth loss, pulpal necrosis, or irreversible pulpitis may limit the options available to the restorative dentist. In these cases, placement of a post and core followed by a crown is the preferred treatment option, provided all requirements are met. This literature review provides an overview of the historical development of dental FRC post systems as well as a comprehensive examination of the currently available posts and their bonding requirements. In addition, it offers valuable insights for dental professionals seeking to understand the current state of the field and the prospects of dental FRC post systems.
Collapse
Affiliation(s)
- Abdulrahman Alshabib
- Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Khaled Abid Althaqafi
- Department of Restorative Dental Department, College of Dentistry, University of Umm Al Qura, Makkah 24211, Saudi Arabia
| | - Hani S AlMoharib
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Mahir Mirah
- Department of Restorative Dental Science, Dental College, and Hospital, Taibah University, Madinah 42353, Saudi Arabia
| | - Yasser F AlFawaz
- Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| | - Hamad Algamaiah
- Department of Restorative Dental Science, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia
| |
Collapse
|
13
|
The Use of Polyetheretherketone (PEEK) as an Alternative Post and Core Material: Five-Year Follow-Up Report. Dent J (Basel) 2022; 10:dj10120237. [PMID: 36547053 PMCID: PMC9776542 DOI: 10.3390/dj10120237] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/05/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
This clinical report demonstrated the use of polyetheretherketone (PEEK) for manufacturing of custom-made post and core in weakened endodontically treated central incisors. The PEEK structure was manufactured using computer-aided design/computer-aided manufacturing (CAD/CAM). The optimal fit of this custom-made endodontic post allowed a thinner cement layer; and removed the need to manufacture a core build-up. While supplementary clinical trials and in vitro studies are needed to totally elucidate the advantages and limitations of PEEK as an option for post and core manufacturing, this case report showed that it can be promising for a predictable and simplified treatment with five years of success.
Collapse
|
14
|
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.
Collapse
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
| |
Collapse
|