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Mossad Hassan Negm H, Yousry Elkharadly D, Badawy S, Rashad Omar Omar Taha R. Fracture Resistance in Fibre-Reinforced Resin Composite Restorations in Deciduous and Permanent Molars: An Ex Vivo Study. Saudi Dent J 2024; 36:1197-1202. [PMID: 39286592 PMCID: PMC11402000 DOI: 10.1016/j.sdentj.2024.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 06/05/2024] [Accepted: 06/11/2024] [Indexed: 09/19/2024] Open
Abstract
Aim The aim of this study was to compare the fracture resistance levels of restored deciduous teeth and permanent molars restored with different materials, including ultra-polyethylene fibre tape (Ribbond-Ultra), fibre-reinforced resin composite EverX posterior, fibre-reinforced flowable resin composite EverX Flow and bulk-fill flow restorative material (Tetric N-flow) in the posterior region. Methods We tested sixty-four caries-free human mandibular molars (32 deciduous molars and 32 permanent molars). Deep and wide Class I cavities were prepared in each tooth. The teeth were embedded in poly(methyl methacrylate) resin up to the cementoenamel junction, leaving the crown completely exposed. Oral temperature fluctuations were then simulated using two thousand thermocycling cycles, each lasting 30 seconds in the hot phase (approximately 35 °C). The loading rate for our force-fracture tests was set at 0.5 mm/min. Direct restorations were made using a spherical tip and applying the force perpendicular to the sample surface. Visual inspection of the fractured specimens, in combination with adhesive scanning electron microscopy (SEM) and finite element analysis (FEA), provided detailed insights into the failure modes and stress distribution at the restoration-tooth interface. Results Teeth restored with fibre-reinforced composite (EverX Posterior) had the highest fracture resistance, followed by fibre-reinforced flowable resin composite (EverX Flow). Teeth restored with the ultra- polyethylene fibre tape (Ribbond-Ultra), followed by the flowable bulk-fill composite (Tetric N-flow) had the lowest resistance. Statistical analysis revealed significant differences between the groups, except for EverX Posterior and EverX Flow. A predictive algorithm was also proposed for the likelihood of restoration failure. Conclusion Modern fibre-reinforced resin composites, such as EverX Posterior, effectively reinforce teeth against fractures, with success in both restored deciduous and permanent molars. Meanwhile, the use of polyethylene fibre tapes is less effective, and they involve a time-consuming application.
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Affiliation(s)
| | | | - Sherine Badawy
- Department of Pediatric Dentistry, University of Science and Technology of Fujairah, UAE
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Lehmann A, Nijakowski K, Jankowski J, Donnermeyer D, Ramos JC, Drobac M, Martins JFB, Hatipoğlu Ö, Omarova B, Javed MQ, Alharkan HM, Bekjanova O, Wyzga S, Alkhawas MBAM, Kudenga R, Surdacka A. Clinical Difficulties Related to Direct Composite Restorations: A Multinational Survey. Int Dent J 2024:S0020-6539(24)00164-3. [PMID: 39048490 DOI: 10.1016/j.identj.2024.06.012] [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: 03/26/2024] [Revised: 06/14/2024] [Accepted: 06/18/2024] [Indexed: 07/27/2024] Open
Abstract
AIMS Composite materials are widely used in dentistry for direct tooth restorations. However, they are highly sensitive to the working technique employed during the restorative procedure. Even minor procedural errors can have a significant impact on the quality including the longevity of the restoration. Hence the aim of this study was to determine the material preferences and analyse the clinical problems associated with direct composite restorations in a cohort of dentists. METHODS A 20-item online questionnaire was created in English and administered 1830 general dentists and specialists in 13 countries. The first section of the questionnaire included four questions to elicit demographic data, and the second section comprised 16 questions focused on material preferences for conservative restorations, durability of composite restorations, and the most challenging stages the dentists faced during the composite restorative procedures. RESULTS Respondents decided most often to use composite materials for the tooth restorations (OR 997.4, 95% CI 233.8-4254.8, P value <.001). Most respondents indicated that the durability of composite restorations was approximately 7 to 10 years (41.5%). Among the factors affecting durability, maintenance of a dry cavity was the most often reported reason (47.1%) and the foremost challenge faced by dentists (61.0%) during the composite restorative procedures. CONCLUSIONS Our study confirmed that resin-based composites are the most popular material for direct restoration in many countries. Although working with this material is difficult and involves multiple steps, maintaining a dry cavity during bonding, and material application may affect the therapeutic success and durability of these restorations. Clinicians need to be attentive to this issue and be prepared to adapt their decision-making and consider opting for alternative restorative materials, if appropriate.
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Affiliation(s)
- Anna Lehmann
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Poznan, Poland
| | - Kacper Nijakowski
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Poznan, Poland.
| | - Jakub Jankowski
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Poznan, Poland
| | - David Donnermeyer
- Department of Periodontology and Operative Dentistry, University Münster, Münster, Germany
| | - João Carlos Ramos
- Center for Innovation and Research in Oral Sciences (CIROS) and Institute of Operative Dentistry, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Milan Drobac
- Department of Dental Medicine, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - João Filipe Brochado Martins
- Departments of Endodontology Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ömer Hatipoğlu
- Department of Restorative Dentistry, Niğde Ömer Halisdemir University, Niğde, Turkiye
| | - Bakhyt Omarova
- Department of Therapeutic Dentistry, Kazakh National Medical University by S.D. Asfendiyarov, Almaty, Kazakhstan
| | - Muhammad Qasim Javed
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraydah, Qassim, Saudi Arabia
| | - Hamad Mohammad Alharkan
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraydah, Qassim, Saudi Arabia
| | - Olga Bekjanova
- Department of Faculty Therapeutic Dentistry, Tashkent State Dental Institute, Tashkent, Uzbekistan
| | - Sylvia Wyzga
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Rutendo Kudenga
- Department of Odontology, University of Pretoria, Riviera, Pretoria, Republic of South Africa
| | - Anna Surdacka
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Poznan, Poland
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Peskersoy C, Oguzhan A. Evaluation of the Mechanical and Adhesion Characteristics of Indirect Restorations Manufactured with Three-Dimensional Printing. Polymers (Basel) 2024; 16:613. [PMID: 38475296 DOI: 10.3390/polym16050613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 02/18/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
The aim of this study was to investigate the marginal fit and bond strength characteristics of onlay restorations manufactured by three-dimensional printing (Varseo XS, Bego GmbH, Bremen, Germany) and CAD/CAM (CAMcube, Montreal, QC, Canada) systems. Class II onlay cavities on sixty mandibular molars were prepared in cavities and restored in three separate groups using different fabrication methods. Digital and conventional impressions were taken to design the restorations in the CAD system (DWOS, Straumann GmbH, Freiburg, Germany). To evaluate the marginal fit and void volumes, all specimens were scanned with microcomputed tomography. A microshear test was performed to compare the bond strength of the restorations to the tooth surface. The marginal fit values measured for the 3D-printed and CAD/CAM onlay restorations were found to be at clinically acceptable levels (<120 µm), and no significant difference could be observed between the three different fabrication methods (p > 0.05). According to the microshear test results, the CAD/CAM group had the highest bond strength values before (34.82 MPa) and after (26.87 MPa) thermal cycling (p < 0.05), while the 3D-printed and conventionally produced onlays had similar results (p < 0.05). 3D printing technology is a promising option for indirect restorations; however, the post-production phase is as crucial as the printing and cementation phases.
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Affiliation(s)
- Cem Peskersoy
- Faculty of Dentistry, Ege University, 35030 Izmir, Turkey
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Tsertsidou V, Mourouzis P, Dionysopoulos D, Pandoleon P, Tolidis K. Fracture Resistance of Class II MOD Cavities Restored by Direct and Indirect Techniques and Different Materials Combination. Polymers (Basel) 2023; 15:3413. [PMID: 37631470 PMCID: PMC10458958 DOI: 10.3390/polym15163413] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 08/04/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
This study aimed to evaluate the fracture resistance of class II MOD cavities restored using different techniques and materials. Sixty extracted maxillary molars were selected and standardized class II MOD cavities were prepared using a custom-made paralleling device. The specimens were divided into four groups based on the restoration technique used: Group 1 (direct resin composite), Group 2 (short-fiber-reinforced composite resin), Group 3 (composite polyethylene fiber reinforcement), and Group 4 (CAD/CAM resin inlays). Fracture resistance was assessed for each group after thermocycling aging for 10,000 cycles. The mode of fracture was assigned to five types using Burke's classification. To compare the fracture force among the tested materials, a paired sample t-test was performed. The significance level for each test was set at p < 0.05. Significant differences in fracture resistance were observed among the different restoration techniques. CAD/CAM inlays (2166 ± 615 N), short-fiber-reinforced composite resin (2471 ± 761 N), and composite polyethylene fiber reinforcement (1923 ± 492 N) showed superior fracture resistance compared to the group restored with direct resin composite (1242 ± 436 N). The conventional resin composite group exhibited the lowest mean fracture resistance. The choice of restoration material plays a critical role in the clinical survival of large MOD cavities. CAD/CAM inlays and fiber-reinforced composites offer improved fracture resistance, which is essential for long-term success in extensive restorations.
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Affiliation(s)
- Vasiliki Tsertsidou
- Department of Dental Tissues Pathology and Therapeutics, Division of Operative Dentistry, Faculty of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (V.T.); (D.D.); (K.T.)
| | - Petros Mourouzis
- Department of Dental Tissues Pathology and Therapeutics, Division of Operative Dentistry, Faculty of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (V.T.); (D.D.); (K.T.)
| | - Dimitrios Dionysopoulos
- Department of Dental Tissues Pathology and Therapeutics, Division of Operative Dentistry, Faculty of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (V.T.); (D.D.); (K.T.)
| | - Panagiotis Pandoleon
- Department of Prosthodontics, Faculty of Dentistry, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Kosmas Tolidis
- Department of Dental Tissues Pathology and Therapeutics, Division of Operative Dentistry, Faculty of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (V.T.); (D.D.); (K.T.)
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