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Matos LMRD, Silva ML, Cordeiro TO, Cardoso SDAM, Campos DES, de Muniz IAF, Barros SADL, Seraidarian PI. Clinical and laboratorial performance of rehabilitation of endodontically treated teeth: A systematic review. J ESTHET RESTOR DENT 2024; 36:1281-1300. [PMID: 38563466 DOI: 10.1111/jerd.13225] [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: 12/05/2023] [Revised: 02/28/2024] [Accepted: 03/11/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE This systematic review aimed to analyze the clinical (survival rate, failure risk, or fracture) and laboratory performance (fracture mode or failure) of rehabilitations of endodontically treated teeth, with and without posts. MATERIALS AND METHODS A systematic search was conducted in the Pubmed, Scopus, Web of Science, Embase, Cochrane Library, and OpenGrey databases up to March 2023, according to PRISMA guidelines. In vitro and clinical studies that compared the clinical and laboratory performance of endodontically treated teeth with and without intraradicular posts were included. Studies selection, data extraction, and risk of bias analysis were performed. RESULTS Thirty-one in vitro and 7 clinical studies were included. For in vitro studies, fiberglass post (n = 24) was the most mentioned. The follow-up time of the clinical studies ranged from 1 to 17 years, with the fiber-reinforced composite post (n = 3) being the most evaluated, and only failure risk proved to be more favorable for using intraradicular posts. CONCLUSION Rehabilitations of endodontically treated teeth with and without intraradicular retainers showed no difference in fracture resistance and failure mode, evaluated by in vitro studies. Clinical studies showed no difference in survival rate, but failure risk proved to be more favorable for the use of posts. CLINICAL SIGNIFICANCE This analysis revealed significant variability between results, however, most laboratory and clinical studies revealed no difference with using the post. Furthermore, it is important to emphasize the need to evaluate the coronary remnant and the general characteristics of the tooth in each situation.
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Affiliation(s)
| | - Marcelo Lopes Silva
- Departamento de Odontologia, Centro Universitário Santo Agostinho, Teresina, Brazil
- Departamento de Odontologia, Universidade Federal do Maranhão, São Luís, Brazil
| | - Thais Oliveira Cordeiro
- Departamento de Odontologia, Centro Universitário Santo Agostinho, Teresina, Brazil
- Departamento de Odontologia, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | | | - Débora E Silva Campos
- Departamento de Odontologia Restauradora, Universidade Federal da Paraíba, João Pessoa, Brazil
| | | | - Suelen Aline de Lima Barros
- Departamento de Odontologia, Centro Universitário Santo Agostinho, Teresina, Brazil
- Departamento de Prótese e Materiais dentärios, UNESP/FOAr, Araraquara, Brazil
| | - Paulo Isaias Seraidarian
- Departamento de Odontologia, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Brazil
- Departamento de Odontologia Preventiva e Restauradora, Universidade Estadual Paulista Júlio de Mesquita Filho, Aracatuba, Brazil
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Kondo D, Komada W, Oishi S, Fueki K. Surface strain at the cervical area and fracture strength of flared root canals reinforced using a zirconia tube and glass-fiber post. J Dent Sci 2024; 19:1571-1577. [PMID: 39035343 PMCID: PMC11259610 DOI: 10.1016/j.jds.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/19/2023] [Indexed: 07/23/2024] Open
Abstract
Background/purpose Recently, an effective core build-up system for teeth with flared root canals is needed. This research aimed to evaluate the effect of foundation restorations using a composite resin core with a fiber post reinforced with a zirconia tube for the surface strain at the cervical area and the fracture load of teeth with flared root canals. Materials and methods Bovine teeth were shaped to mimic human premolars with flared root canals and restored using three types of composite resin foundation restorations with each materials described below: a fiber post (FC), a zirconia tube (ZC), a fiber post and zirconia tube (ZFC). Each specimen was restored with a zirconia crown. The surface strains of the specimens at the cervical area and fracture loads were analyzed using a one-way analysis of variance (ANOVA), followed by Tukey's honest significant difference test. Results The surface strains of Groups ZFC and ZC were significantly lower than that of Group FC in the buccal root. The fracture strengths of Groups ZFC and ZC were significantly higher than that of Group FC. The strength of Group ZFC was significantly higher than that of Group ZC. Conclusion The use of a composite resin core with a zirconia tube for the simulated premolar with flared root canals reduced surface strain at the cervical area and provided higher fracture strength compared to using a composite resin core with a fiber post. And the zirconia tubes provided even higher fracture strength when used with a fiber post.
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Affiliation(s)
- Daiki Kondo
- Division of Masticatory Function and Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Wataru Komada
- Division of Masticatory Function and Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shinya Oishi
- Division of Masticatory Function and Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kenji Fueki
- Division of Masticatory Function and Health Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Rahmayanti ZA, Aripin D, Muryani A, Yolanda Y, Dharsono HDA, Mihradi S, Wicaksono S. Stress Distribution of Endodontically Treated Tooth MOD Cavity Restored with Ribbon Fiber-Reinforced Composite (Wallpapering Technique) Using Finite Element Method. Clin Cosmet Investig Dent 2024; 16:91-99. [PMID: 38650600 PMCID: PMC11034570 DOI: 10.2147/ccide.s450458] [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: 12/14/2023] [Accepted: 03/26/2024] [Indexed: 04/25/2024] Open
Abstract
Purpose This research aimed to describe the stress distribution of an endodontically treated tooth with a mesio-occluso-distal (MOD) cavity restored with direct composite reinforced with polyethylene and e-glass ribbon fiber. Methods This research was a descriptive study using the finite element method. A 3D model of the mandibular first molar solid after endodontic treatment with class II MOD preparation was prepared using Solidworks software. Finite element simulation was carried out using Abaqus software. In the first simulation, 180 N force was applied (vertically 90° perpendicular to the occlusal surface) at four points of loading: the tip of the mesiobuccal and distobuccal cusp, central fossa, and distal marginal ridge. For the second simulation, a 100 N force was applied at a 45° lateral angle to the occlusal surface at two loading points: the lingual slope of the mesiobuccal and distobuccal cusp. Results This study showed that the stress concentration was located in the occlusal pit and fissure, CEJ distal area, bifurcation in dentin, and the 1/3 cervical area of root dentin. The stress value generated after vertical and lateral force did not exceed the tooth and restoration's compressive and tensile strength value. The failure occurred at the interface of enamel and composite near the loading point area due to vertical load, both on polyethylene and e-glass fiber ribbon-reinforced composite restoration. Stress distribution of an endodontically treated tooth with a MOD cavity restored with ribbon fiber-reinforced composite using the finite element method showed that the highest stress concentration occurred on the surface close to the loading point, in narrow, concave, and sharp areas, and more apically for endodontically treated teeth. Conclusion Neither the tooth nor restoration failed after vertical and horizontal loads. The interface between enamel and composite on the occlusal surface failed.
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Affiliation(s)
- Zenita Aisah Rahmayanti
- 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
| | | | - Sandro Mihradi
- Faculty of Mechanical and Aerospace Engineering, Bandung Institute of Technology, Bandung, Indonesia
| | - Satrio Wicaksono
- Faculty of Mechanical and Aerospace Engineering, Bandung Institute of Technology, Bandung, Indonesia
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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.
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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
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Cheniski DA, Freire A, Camargo ES, da Costa RG, de Souza EM, Rached RN. Bond strength of prefabricated and CAD-CAM milled glass fiber post-and-cores luted with conventional, universal, and self-adhesive composite resin cement. J Prosthet Dent 2024; 131:251.e1-251.e7. [PMID: 38368000 DOI: 10.1016/j.prosdent.2023.11.024] [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: 06/01/2023] [Revised: 11/18/2023] [Accepted: 11/20/2023] [Indexed: 02/19/2024]
Abstract
STATEMENT OF PROBLEM Little is known about the effect of different composite resin cements on the bond strength of prefabricated and milled glass fiber post-and-cores. PURPOSE The purpose of this in vitro study was to compare the push-out bond strengths of root dentin and standard, relined, or computer-aided design and computer-aided manufacturing (CAD-CAM) glass fiber post-and-cores luted with conventional, universal, or self-adhesive composite resin cement. MATERIAL AND METHODS Post spaces were prepared in 90 premolars. Standard and relined prefabricated and CAD-CAM-milled glass fiber post-and-cores were luted with conventional (RelyX ARC; 3M ESPE), universal (RelyX Ultimate; 3M ESPE), and self-adhesive (RelyX U200; 3M ESPE) composite resin cement (n=10). All specimens were thermally aged (5000 cycles at 5°C and 55°C with a 20-second dwell time) and mechanical fatigue (1 000 000 cycles at 2 Hz, 50-N load). The specimens were sectioned perpendicularly to the root long axis into 1-mm-thick sections (apical, middle, and cervical root thirds), the push-out bond strength was determined, and the mode of failure recorded. Data were submitted to the Kruskal-Wallis test followed by the Bonferroni-Dunn multiple comparison test (α=.05). RESULTS Push-out bond strength values did not differ (P>.05) among posts at the same root thirds. Standard posts showed higher bond strength than CAD-CAM at the apical third for data grouped by composite resin cements (P<.001). The cervical root thirds had higher bond strength than the apical thirds (P<.05). The cervical, middle, and apical root thirds showed decreasing bond strength values for each type of post for data grouped by composite resin cement (P<.001). Adhesive failures at the dentin-cement interface were predominant. CONCLUSIONS The type of posts and cements did not affect the bond strength of glass fiber posts. The cervical root thirds had better bonding performance than the apical thirds.
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Affiliation(s)
- Djulyeny Adolfo Cheniski
- Master's student, Graduate Program in Dentistry, School of Medicine and Life Sciences, Pontifical Catholic University of Paraná (PUCPR), Curitiba, Brazil
| | - Andrea Freire
- Professor, Faculty of Dentistry, Federal University of Mato Grosso do Sul (UFMS), Campo Grande, Brazil
| | - Elisa Souza Camargo
- Professor, Graduate Program in Dentistry, School of Medicine and Life Sciences, Pontifical Catholic University of Paraná (PUCPR), Curitiba, Brazil
| | - Rogério Goulart da Costa
- Professor, Dental Prosthesis Course, Federal Institute of Paraná (IFPR), and Dental Course, School of Medicine and Life Sciences, Pontifical Catholic University of Paraná (PUCPR), Curitiba, Brazil
| | - Evelise Machado de Souza
- Professor, Graduate Program in Dentistry, School of Medicine and Life Sciences, Pontifical Catholic University of Paraná (PUCPR), Curitiba, Brazil
| | - Rodrigo Nunes Rached
- Professor, Graduate Program in Dentistry, School of Medicine and Life Sciences, Pontifical Catholic University of Paraná (PUCPR), Curitiba, Brazil.
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Hordones Ribeiro MT, Felipe de Bragança G, Sales Oliveira LR, Lourenço Braga SS, Quirino de Oliveira HL, Price RB, Soares CJ. Effect of pre-heating methods and devices on the mechanical properties, post-gel shrinkage, and shrinkage stress of bulk-fill materials. J Mech Behav Biomed Mater 2023; 138:105605. [PMID: 36516543 DOI: 10.1016/j.jmbbm.2022.105605] [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: 10/03/2022] [Revised: 11/27/2022] [Accepted: 12/05/2022] [Indexed: 12/13/2022]
Abstract
This study evaluated the effect of using two different pre-heating methods on the three resin-based composite (RBCs). Three paste viscosity bulk-fill RBCs (VisCalor Bulk [VC]; VOCO; x-tra fil Caps [XF], VOCO; Filtek One Bulk Fill [FO], 3 M) were pre-heated using either a VisCalor Dispenser (VOCO) to 65 °C, or the Caps Warmer (VOCO) to 37 °C, 54 °C, or 68 °C. The temperature inside the capsules and cavity was monitored before and after insertion into the matrix. Within 30 s of inserting the RBC, they were light-activated using a VALO (Ultradent) curing light for 20 s. The post-gel shrinkage (Shr - %), Flexural Strength (FS - MPa), Elastic Modulus (E - MPa), degree of conversion (DC - %), Knoop Hardness (KH - N/mm2), diametral tensile strength (DTS - MPa), and compressive strength (CS - MPa) of the RBCs were measured (10 specimens per group). The shrinkage stress was calculated using three-dimensional finite element analysis. Data were analyzed using one-way, two-way ANOVA and Tukey's test (α = 0.05). The temperature fell rapidly after the RBC was inserted into the cavity. Pre-heating the RBCs did not affect the mechanical properties. FO had the lowest E, DC, and KH values, VC had intermediate values, and XF achieved the highest values. The DTS and CS values were not affected by the various pre-heating methods, the temperature, or RBC. Pre-heating methods at 37 °C produced higher shrinkage for all RBCs. VC pre-heated to 65 °C produced the lowest stress when measured at 10 min after light activation.
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Affiliation(s)
- Maria Tereza Hordones Ribeiro
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
| | - Gabriel Felipe de Bragança
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
| | - Laís Rani Sales Oliveira
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
| | - Stella Sueli Lourenço Braga
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
| | - Helena Letícia Quirino de Oliveira
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
| | - Richard Bengt Price
- Department of Dental Clinical Sciences, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Carlos José Soares
- Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil.
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Oishi S, Komada W, Tsukahara R, Yoshimatsu S, Kondo D, Omori S, Nozaki K, Miura H, Fueki K. A composite resin core with a new zirconia tube reduces the surface strain at the cervical area of a mandibular molar: A model tooth study. J Prosthodont Res 2023; 67:70-76. [PMID: 35249930 DOI: 10.2186/jpr.jpr_d_21_00243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE This study aimed to evaluate the surface strain at the cervical area of endodontically treated molars with a large pulp chamber restored using a composite resin core with three different types of core build-up systems. METHODS Reproduction models of human mandibular molars with prepared post spaces were used in this study. Roots duplicated with a composite resin were used as the experimental teeth. Three types of core build-up systems were used: composite resin core(RC), composite resin core with fiber posts (FC), and composite resin core with a prefabricated zirconia tube (ZC). Each group comprised eight specimens. Crowns made of yttria partially stabilized zirconia were cemented with dual-cure resin cement. Four strain gauges were attached to the surfaces of each specimen: the cervical area of the root and crown, on the buccal and lingual sides. The surface strain at each cervical area was measured using a static loading test and statistically analyzed. RESULTS In the case of static loading to the buccal cusp inner slope, ZC showed a significantly lower strain than RC in the crown on the buccal side and in the root and FC in the root. In the central fossa, ZC showed a significantly lower strain than FC in the root on the lingual side. CONCLUSIONS The prefabricated zirconia tube reduced the surface strain at the cervical area of the buccal/lingual root in molars; however, the effect was small in the cervical area of the crown.
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Affiliation(s)
- Shinya Oishi
- Department of Masticatory Function and Health Science, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Wataru Komada
- Department of Masticatory Function and Health Science, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Ruri Tsukahara
- Department of Masticatory Function and Health Science, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Shu Yoshimatsu
- Department of Masticatory Function and Health Science, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Daiki Kondo
- Department of Masticatory Function and Health Science, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Satoshi Omori
- Department of Masticatory Function and Health Science, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Kosuke Nozaki
- Department of Masticatory Function and Health Science, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Hiroyuki Miura
- Department of Fixed Prosthodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Kenji Fueki
- Department of Masticatory Function and Health Science, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Luo B, Sun X, He L, Zhao L, Liu X, Jiang Q. Impact of different axial wall designs on the fracture strength and stress distribution of ceramic restorations in mandibular first molar. BMC Oral Health 2022; 22:549. [PMID: 36456942 PMCID: PMC9714140 DOI: 10.1186/s12903-022-02577-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 11/08/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The purpose of this study was to investigate the fracture strength and stress distribution of four ceramic restorations. METHODS Forty human mandibular first molars were collected and randomized into four groups after establishing the distal defect: full crown group with 4 mm axial wall height (AWH) (FC4); short AWH crown group with 2 mm AWH (SC2); occlusal veneer group with 0 mm AWH (OV0); occlusal distal veneer group with only the distal surface prepared, and 4 mm AWH (OD4). The teeth were prepared according to the groups and the ceramic restorations were completed using celtra duo ceramic blocks. The ceramic thickness of the occlusal surface is about 1.5 mm and the edge is about 1 mm. The failure load values and fracture modes of each group were detected by mechanical test in vitro. According to the groups to establish three-dimensional finite element analysis (FEA) models, a 600 N loading force was applied vertically using a hemispherical indenter with a diameter of 6 mm. and compare the stress distribution under the condition of different restorations. RESULTS In vitro mechanical tests showed that the failure load values were SC2 (3232.80 ± 708.12 N) > OD4 (2886.90 ± 338.72 N) > VO0 (2133.20 ± 376.15 N) > FC4(1635.40 ± 413.05 N). The failure load values of the short AWH crown and occlusal distal veneer were significantly higher than that of occlusal veneer and full crown (P<0.05). The fracture modes of the full crown and occlusal veneer groups were mainly ceramic fractures and some were restorable tooth fractures. The short AWH crown and occlusal distal veneer groups presented with three fracture modes, the proportion of non-restorable tooth fracture was higher. The results of FEA show that under the spherical loading condition, the stress of ceramic was concentrated in the contact area of the loading head, the maximum von Mises stress values were FC4 (356.2 MPa) > VO0 (214.3 MPa) > OD4 (197.9 MPa) > SC2 (163.1 MPa). The stress of enamel was concentrated in the area where the remaining enamel was thinner, the maximum von Mises stress values was OD4 (246.2 MPa) ≈ FC4 (212.4 MPa) > VO0 (61.8 MPa) ≈ SC2 (45.81 MPa). The stress of dentin is concentrated in the root furcation and the upper third region of the root. However, stress concentration was observed at the tooth cervix in the full crown. CONCLUSION Under certain conditions, the occlusal distal veneer shows better performance than the full crown.
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Affiliation(s)
- Bin Luo
- grid.24696.3f0000 0004 0369 153XDepartment of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 100050 Beijing, China
| | - Xiaolu Sun
- grid.479671.a0000 0004 9154 7430Shunyi Hospital, Beijing Traditional Chinese Medicine Hospital, 100010 Beijing, China
| | - Lin He
- grid.24696.3f0000 0004 0369 153XDepartment of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 100050 Beijing, China
| | - Lidan Zhao
- grid.410737.60000 0000 8653 1072Department of Prosthodontics, Affiliated Stomatology Hospital of Guangzhou Medical University, 510013 Guangzhou, China
| | - Xinggang Liu
- grid.24696.3f0000 0004 0369 153XDepartment of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 100050 Beijing, China
| | - Qingsong Jiang
- grid.24696.3f0000 0004 0369 153XDepartment of Prosthodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, 100050 Beijing, China
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Oliveira L, Melo C, Cavalcanti K, Soares P, Cardenas A, Soares CJ. Effects of Adjacent Tooth Type and Occlusal Fatigue on Proximal Contact Force of Posterior Bulk Fill and Incremental Resin Composite Restoration. Oper Dent 2022; 47:64-75. [PMID: 35090036 DOI: 10.2341/20-019-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To measure the proximal contact force in newtons (N) between incremental and bulk fill class II resin composite restorations and implant molar teeth or adjacent premolar teeth with simulated periodontal ligament. METHODS The model used was created with a typodont first molar tooth with two bilateral occlusal-proximal class II cavities, an adjacent tooth simulating an implanted molar tooth (Titamax CM, Neodent, Curtiba, PR, Brazil) and a premolar with simulated periodontal ligament. Two resin composite restorative techniques were used: Inc-Z350XT, (Filtek Z350, 3M Oral Care, St. Paul, MN, USA) inserted incrementally and Bulk-OPUS, (Opus Bulk Fill APS, FGM, Joinville, SC, Brazil) high viscosity bulk fill resin composite (n=10). As a control, a typodont having intact teeth without restorations was used. After the restorative procedure, each specimen was radiographed using a digital system (Dürr Dental, Bietigheim-Bissingen, Germany). The proximal contact force (N) was measured using dental floss with a microtensile machine (Microtensile ODEME, Luzerna, SC, Brazil). The specimens were then subjected to mechanical fatigue cycling to simulate 5 years of aging. All the parameters were measured after aging. The X-rays were blindly qualitatively analyzed by two operators to identify the loss of proximal contact. One-way ANOVA was used for comparing the initial contact force between restored and intact teeth. Two-way ANOVA followed by Tukey testing was performed for contact area data and for the contact force/contact area ratio. The proximal contact force data were analyzed using one-way repeated measurement ANOVA followed by Tukey testing (α=0.05). The X-ray proximal contact analyses were described by the frequency. RESULTS The initial proximal contact force was similar for intact and restored teeth. The contact force and contact area with the molar were significantly higher than with the premolar; however the contact force/contact area ratio was similar for all tested groups. The bulk fill technique showed a contact force similar to the incremental filling technique. Fatigue resulted in a significant reduction in the proximal contact force (p<0.001), irrespective of the region analyzed or restorative material used. The digital X-rays detected no alteration in the proximal contact after occlusal fatigue. CONCLUSIONS Larger contact area resulted in higher proximal contact force. Proximal contact force decreased with 5 years of simulated occlusal fatigue. The bulk fill technique showed a proximal contact force similar to that of the incremental filling technique.
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Affiliation(s)
- Lrs Oliveira
- Lais Rani Sales Oliveira, DDS, MSc, PhD student, Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlandia, MG, Brazil
| | - C Melo
- Calebe de Melo, DDS, Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlândia, MG, Brazil
| | - Kgba Cavalcanti
- Karoline Guará Brusaca Almeida Cavalcanti, DDS, MSc, PhD student, School of Dentistry, CEUMA University, São Luis, MA, Brazil
| | - Pbf Soares
- Priscilla Barbosa Ferreira Soares, DDS, MSc, PhD, professor, Department of Periodontology and Implantology, School of Dentistry, Universidade de Uberlândia, Uberlândia, MG, Brazil
| | - Afm Cardenas
- Andres Felipe Millan Cardenas, DDS, MSc, PhD, professor, Postgraduate Program in Dentistry, CEUMA University, São Luis, MA, Brazil
| | - C J Soares
- *Carlos José Soares, DDS, MSc, PhD, professor, Department of Operative Dentistry and Dental Materials, School of Dentistry, Federal University of Uberlandia, Minas Gerais, Brazil
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Pereira R, Soares P, Bicalho AA, Barcelos LM, Oliveira L, Soares CJ. Impact of the Porosity from Incremental and Bulk Resin Composite Filling Techniques on the Biomechanical Performance of Root-Treated Molars. Oper Dent 2021; 46:197-207. [PMID: 34192325 DOI: 10.2341/19-297-l] [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: 05/20/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To analyze the effect of the porosity caused by incremental and bulk resin composite filling techniques using low- and high-viscosity composite resins on the biomechanical performance of root-treated molars. METHODS Forty intact molars received standardized mesio-occlusal-distal (MOD) cavity preparation, were root treated, and randomly divided into four groups with different filling techniques (n=10). The first involved two incremental filling techniques using VIT/Z350XT, a nanofilled composite resin (Filtek Z350XT, 3M ESPE) associated with a resinmodified glass ionomer cement, and resin-modified glass ionomer cement (RMGIC; Vitremer, 3M ESPE) for filling the pulp chamber. The second involved TPH/VIT, a microhybrid composite resin TPH3 Spectrum associated with Vitremer. The third and fourth involved two bulk-fill composite resins: SDR/TPH, a low-viscosity resin composite (Surefill SDR flow, Dentsply) associated with TPH3 Spectrum, and POST, a high-viscosity bulkfill resin composite (Filtek Bulk Fill Posterior, 3M ESPE). The volume of the porosity inside the restoration was calculated by micro-CT. The cusp deformation caused by polymerization shrinkage was calculated using the strain-gauge and micro-CT methods. The cusp deformation was also calculated during 100 N occlusal loading and loading to fracture. The fracture resistance and fracture mode were recorded. Data were analyzed by one-way analysis of variance and Tukey test. The fracture mode was analyzed by the χ2 test. The volume of the porosity was correlated with the cusp deformation, fracture resistance, and fracture mode (α=0.05). RESULTS Incremental filling techniques associated with RMGIC resulted in a significantly higher porosity than that of both bulk-fill techniques. However, no significant difference was found among the groups for the fracture resistance, fracture mode, and cusp deformation, regardless of the measurement time and method used. No correlation was observed between the volume of the porosity and all tested parameters. CONCLUSIONS The porosity of the restorations had no influence on the cuspal deformation, fracture resistance, or fracture mode. The use of the RMGIC for filling the pulp chamber associated with incremental composite resins resulted in similar biomechanical performance to that of the flowable or regular paste bulk-fill composite resin restorations of root-treated molars.
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Effect of cervical lesion centered access cavity restored with short glass fibre reinforced resin composites on fracture resistance in human mandibular premolars- an in vitro study. J Mech Behav Biomed Mater 2021; 122:104654. [PMID: 34325237 DOI: 10.1016/j.jmbbm.2021.104654] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/15/2021] [Accepted: 06/21/2021] [Indexed: 12/25/2022]
Abstract
AIM The aim of this study was to evaluate the fracture resistance of cervical lesion centered access cavity restored with short glass fibre reinforced resin materials in human mandibular premolars. MATERIALS AND METHODS Sixty freshly extracted human mandibular premolars were collected and assigned to positive control group (G1- Intact teeth) and other experimental groups (G2, G3. G4, G5, G6), Traditional Access Cavity(TAC) and Cervical Lesion Centered Access Cavity(CLCAC). Following endodontic therapy, samples were grouped accordingly, G2-CLCAC without restoration (Negative Control), G3-CLCAC restored with conventional nano-hybrid composite (Tetric-N-Ceram), G4-TAC restored with short glass fibre reinforced resin composite (Ever-X Posterior), G5-CLCAC restored with short glass fibre reinforced resin composite (Ever-X Posterior), G6- CLCAC restored with individually formed unidirectional fibre-reinforced post (Everstick post) and short glass fibre-reinforced resin composite (Ever-X Posterior). The samples were thermocycled (35 °C/28s, 15 °C/2s, 35 °C/28s, 45 °C/2s/10,000 cycles) and cyclically fatigued(2,50,000 cycles/15-30N/2 Hz) and then subsequently loaded to failure. The mean load to fracture (Newtons) were statistically analyzed using one-way ANOVA and Tukey's post HOC test and failure mode analysis was also done. RESULTS The mean fracture resistance of the CLCAC design restored with fibre reinforced materials was higher when compared to the TAC design but the difference was not statistically significant. The negative control group (CLCAC without restoration) showed significantly the least fracture resistance (P < 0.05) when compared to all the other groups except for group 3 (CLCAC restored with conventional composites). CONCLUSIONS Within the limitations of the study, it can be concluded that short glass fibre reinforced resin composites improved the fracture resistance of endodontically treated mandibular premolars irrespective of the type of access cavity designs. Favourable fractures were seen more in cervical lesion centered access cavity restored with short glass fibre reinforced composite materials. Nevertheless, the applicability of this design in multirooted teeth, canal cleanliness efficacy, and long term clinical performance are yet to be explored to complement this new access design.
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da Silva Pereira RA, de Bragança GF, Vilela ABF, de Deus RA, Miranda RR, Veríssimo C, Soares CJ. Post-gel and Total Shrinkage Stress of Conventional and Bulk-fill Resin Composites in Endodontically-treated Molars. Oper Dent 2020; 45:E217-E226. [DOI: 10.2341/19-187-l] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2020] [Indexed: 11/23/2022]
Abstract
Clinical Relevance
The clinician should consider the polymerization shrinkage stress when selecting a composite resin for posterior restorations. The use of post-gel shrinkage values should guide the selection of a composite resin for posterior teeth.
SUMMARY
Objectives: The objective of this study was to evaluate the effect of the method used for calculation of polymerization shrinkage, total or post-gel, on the shrinkage stress of conventional and bulk-fill composite resins for restoring endodontically treated teeth using finite element analysis.
Methods and Materials: Four composite resins were tested for post-gel shrinkage (P-Shr) by the strain-gauge test and total shrinkage (TShr) using an optical method (n=10). Two conventional composite resins, Filtek Z350 XT (3M-ESPE; Z350) and TPH3 Spectrum (Dents-ply; TPH3) and two bulk-fill composite resins. Filtek Bulk-Fill Posterior (3M-ESPE; POST) SureFil SDR flow (Dentsply; SDR) were tested. Elastic modulus (E), diametral tensile strength (DTS), and compressive strength (CS) were also determined (n=10). The residual shrinkage stress was evaluated by finite element analysis with four restorative techniques: incremental with Z350 and TPH3; SDR/TPH3 (two bulk increments of 4 mm and two occlusal increments); and two bulk increments of 5 mm for POST. Data for P-Shr, T-Shr, E, DTS, and CS were analyzed by analysis of variance and Tukey’s test (α=0.05), and residual shrinkage was analyzed quantitatively and qualitatively by the modified von Mises criteria.
Results: SDR had the lowest CS values, POST and TPH3 had similar and intermediate values, and Z350 had the highest CS. TPH3 and Z350 had similar DTS values and values higher than SDR. Z350 and POST had higher P-Shr, and SDR had lower T-Shr. T-Shr resulted in higher shrinkage stress than P-Shr values. SDR/TPH3 resulted in higher shrinkage stress when using T-Shr and lower values when using the P-Shr value.
Conclusion: T-Shr resulted in higher stress in the enamel and in root dentin close to the pulp chamber than P-Shr values. The selection of the T-Shr or P-Shr changed the ranking of the shrinkage stress of the tested composite resin.
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Rodrigues MDP, Soares PBF, Gomes MAB, Pereira RA, Tantbirojn D, Versluis A, Soares CJ. Direct resin composite restoration of endodontically-treated permanent molars in adolescents: bite force and patient-specific finite element analysis. J Appl Oral Sci 2020; 28:e20190544. [PMID: 32348440 PMCID: PMC7185981 DOI: 10.1590/1678-7757-2019-0544] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 02/20/2020] [Indexed: 12/14/2022] Open
Abstract
Objective To evaluate the influence of three levels of dental structure loss on stress distribution and bite load in root canal-treated young molar teeth that were filled with bulk-fill resin composite, using finite element analysis (FEA) to predict clinical failure. Methodology Three first mandibular molars with extensive caries lesions were selected in teenager patients. The habitual occlusion bite force was measured using gnathodynamometer before and after endodontic/restoration procedures. The recorded bite forces were used as input for patient-specific FEA models, generated from cone-beam computed tomographic (CT) scans of the teeth before and after treatment. Loads were simulated using the contact loading of the antagonist molars selected based on the CT scans and clinical evaluation. Pre and post treatment bite forces (N) in the 3 patients were 30.1/136.6, 34.3/133.4, and 47.9/124.1. Results Bite force increased 260% (from 36.7±11.6 to 131.9±17.8 N) after endodontic and direct restoration. Before endodontic intervention, the stress concentration was located in coronal tooth structure; after rehabilitation, the stresses were located in root dentin, regardless of the level of tooth structure loss. The bite force used on molar teeth after pulp removal during endodontic treatment resulted in high stress concentrations in weakened tooth areas and at the furcation. Conclusion Extensive caries negatively affected the bite force. After pulp removal and endodontic treatment, stress and strain concentrations were higher in the weakened dental structure. Root canal treatment associated with direct resin composite restorative procedure could restore the stress-strain conditions in permanent young molar teeth.
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Affiliation(s)
- Monise de Paula Rodrigues
- Departamento de Dentística e Materiais Odontológicos, Faculdade de Odontologia, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brasil
| | - Priscilla Barbosa Ferreira Soares
- Departamento de Periodontia e Implantologia, Faculdade de Odontologia, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brasil
| | - Márcio Alex Barros Gomes
- Departamento de Dentística e Materiais Odontológicos, Faculdade de Odontologia, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brasil
| | - Renata Afonso Pereira
- Departamento de Dentística e Materiais Odontológicos, Faculdade de Odontologia, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brasil
| | - Daranee Tantbirojn
- Department of Restorative Dentistry, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Antheunis Versluis
- Department of Memphis, College of Dentistry, University of Tennessee Health Science Center, Tennessee, USA
| | - Carlos Jose Soares
- Departamento de Dentística e Materiais Odontológicos, Faculdade de Odontologia, Universidade Federal de Uberlândia, Uberlândia, Minas Gerais, Brasil
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Lins RBE, Cordeiro JM, Rangel CP, Antunes TBM, Martins LRM. The effect of individualization of fiberglass posts using bulk-fill resin-based composites on cementation: an in vitro study. Restor Dent Endod 2019; 44:e37. [PMID: 31799165 PMCID: PMC6875538 DOI: 10.5395/rde.2019.44.e37] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 09/15/2019] [Accepted: 09/15/2019] [Indexed: 11/29/2022] Open
Abstract
Objectives This study evaluated the bond strength of various fiberglass post cementation techniques using different resin-based composites. Materials and Methods The roots from a total of 100 bovine incisors were randomly assigned to 5 treatment groups: G1, post + Scotchbond Multi-Purpose (SBMP) + RelyX ARC luting agent; G2, relined post (Filtek Z250) + SBMP + RelyX ARC; G3, individualized post (Filtek Z250) + SBMP; G4, individualized post (Filtek Bulk-Fill) + SBMP; G5, individualized post (Filtek Bulk-Fill Flow) + SBMP. The samples were subjected to the push-out (n = 10) and pull-out (n = 10) bond strength tests. Data from the push-out bond strength test were analyzed using 2-way analysis of variance (ANOVA) with the Bonferroni post hoc test, and data from the pull-out bond strength test were analyzed using 1-way ANOVA. Results The data for push-out bond strength presented higher values for G2 and G5, mainly in the cervical and middle thirds, and the data from the apical third showed a lower mean push-out bond strength in all groups. No significant difference was noted for pull-out bond strength among all groups. The most frequent failure modes observed were adhesive failure between dentine and resin and mixed failure. Conclusions Fiberglass post cementation using restorative and flowable bulk-fill composites with the individualization technique may be a promising alternative to existing methods of post cementation.
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Affiliation(s)
- Rodrigo Barros Esteves Lins
- Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
| | - Jairo Matozinho Cordeiro
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Carolina Perez Rangel
- Department of Restorative Dentistry, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
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de Kuijper M, Gresnigt M, van den Houten M, Haumahu D, Schepke U, Cune MS. Fracture Strength of Various Types of Large Direct Composite and Indirect Glass Ceramic Restorations. Oper Dent 2019; 44:433-442. [PMID: 30702412 DOI: 10.2341/18-111-l] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The objective of this study was to investigate the mechanical behavior of severely compromised endodontically treated molars restored by means of various types of composite buildups, full-contour lithium disilicate crowns (with or without post) or a lithium disilicate endocrown. METHODS AND MATERIALS One hundred five sound molars were endodontically treated and randomly assigned to 1 control group (endodontic access cavity only) and 6 experimental groups (n=15): glass fiber reinforced composite (GFRC group), direct microhybrid composite (C group), direct microhybrid composite restoration with glass fiber post (CP group), composite buildup and full-contour lithium disilicate crown (LDS group), additional glass fiber post (P-LDS group), and endocrown (EC group). Molar crowns in the treatment groups were removed 1 mm above the cementoenamel junction and restored. All specimens were thermomechanically aged (1.2×106 cycles at 1.7 Hz/50N, 8000 cycles 5°C to 55°C) and axially loaded until failure. Data were analyzed using analysis of variance and Tukey post hoc test (α=0.05). RESULTS Fracture strength was significantly affected by the type of restoration (p=0.000; statistically similar groups identified with superscript letters): LDSB (3217±1052 N), P-LDSAB (2697±665 N), ECAB (2425±993 N), CA (2192±752), controlA (1890±774 N), CPA (1830±590 N), and GFRCA (1823±911 N). Group GFRC obtained significantly more repairable fractures than the other groups. CONCLUSIONS Significant differences in fracture strength were obtained between LDS, the composite restorations, and control group. Direct composite restorations showed similar fracture strength as P-LDS and EC. Incorporating a glass fiber reinforced composite resulted in significantly more repairable failures.
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