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Journal of Dentistry May 2020This study aimed to assess the survival and success of glass fiber posts compared to cast metal posts in teeth without ferrule. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
This study aimed to assess the survival and success of glass fiber posts compared to cast metal posts in teeth without ferrule.
MATERIAL AND METHODS
An equivalency, prospective, double-blind (patient and outcome evaluator) randomized controlled trial (RCT) with parallel groups was designed to compare the clinical performance of cast metal and glass fiber posts cemented in endodontically treated teeth without ferrule (NCT01461239). Teeth were randomly allocated to the glass fiber or cast-metal post groups. All teeth were restored with single metal-ceramic crowns. Kaplan-Meier analysis with the log-rank test was used to test the success and survival between glass fiber and cast metal posts considering a cut-off value of P = 0.05. The annual failure rates were calculated considering the survival data for all restorations and separated by type of post after five years.
RESULTS
A hundred and nineteen patients and 183 posts (72 cast metal posts and 111 glass fiber posts) were analyzed. The median follow-up was 62 months (IQR 37-81). The log-rank test for success (P = 0.26) and survival (P = 0.63) analyses did not present statistically significant differences. The AFR of both posts after 5 years was 1.5%. Considering the posts separately and after 5 years, cast metal posts presented AFR of 1.2% and glass fiber posts AFR of 1.7%. Most failures were in posterior teeth (16/23), 10 failures were classified as root fractures and 5 as post debonding. The follow-up rate was 95.3%.
CONCLUSIONS
Glass fiber and cast metal posts showed good and similar clinical performance.
CLINICAL SIGNIFICANCE
Results of this randomized controlled trial can help dentists to answer how the best technique to rehabilitate endodontically treated teeth with no remaining coronal wall.
Topics: Composite Resins; Crowns; Dental Stress Analysis; Glass; Humans; Metals; Post and Core Technique; Tooth Fractures; Tooth, Nonvital
PubMed: 32302640
DOI: 10.1016/j.jdent.2020.103334 -
The Saudi Dental Journal Nov 2021Fracture resistance of endodontically treated tooth is affected due to large cavity designs and access cavities and an appropriate material capable to resist fracture... (Review)
Review
BACKGROUND
Fracture resistance of endodontically treated tooth is affected due to large cavity designs and access cavities and an appropriate material capable to resist fracture plays an important role. This review aims to evaluate the effect of fibre-reinforced composite (FRC) as a post-obturation material on fracture resistance of endodontically treated teeth.
OBJECTIVES
To systematically gather and evaluate the fracture resistance of fibre-reinforced composite as a post-obturation restorative material in endodontically treated teeth.
DATA SOURCES
A systematic search was conducted using PubMed, Ebsco Host, Scopus, Google Scholar, Hinari and manual search library resources from 1st Jan 2000 to 30th November 2019 to identify appropriate studies.
RESULT
A total of 157 articles were examined out of which 55 articles were selected after reading the title. After removing the duplicates, 27 articles were screened for abstract and 1 article was eliminated as it did not meet the eligibility criteria. A thorough reading of the full text of the remaining 26 selected articles was assessed for eligibility. Amongst these, 1 article was then excluded from the study as the full text was not accessible. Lastly, 25 articles were included in the study.
CONCLUSION
FRC as a core material increases fracture resistance of endodontically treated teeth but they do not have the fracture resistance similar to the intact tooth. Both polyethylene and short fibre-reinforced composites showed greater fracture resistance when compared to glass FRC and restoration without reinforcement. Also, the fracture resistance increases if restored with FRC along with retention slots and are placed on the occlusal third surfaces of cavities. Also, favourable fractures were most commonly seen and it usually occurred at the level of enamel and dentin and adhesive fractures were seen.
PubMed: 34803275
DOI: 10.1016/j.sdentj.2021.07.006 -
International Endodontic Journal Apr 2022Consensus on the treatment of choice for complicated crown fractures of teeth is limited. Recent guidance recommends vital-pulp-therapy; however, the preferred type is... (Review)
Review
BACKGROUND
Consensus on the treatment of choice for complicated crown fractures of teeth is limited. Recent guidance recommends vital-pulp-therapy; however, the preferred type is not specified. Higher success rates for pulpotomy compared to pulp-capping have been documented, which suggests pulpotomy may be a preferable option for complicated crown-fractures.
OBJECTIVES
The purpose of this systematic review was to determine the success rate of pulpotomy (partial and complete) on teeth that suffered complicated crown fractures.
PARTICIPANTS
patients who have suffered a complicated crown fracture to an anterior permanent tooth.
INTERVENTION
pulpotomy (partial or complete). Comparator: pulp-capping or root canal treatment.
OUTCOME
combined clinical and radiographic success at or after 12 months.
METHODS
A systematic literature using key search terms was conducted using PubMed, Web of Science and Cochrane-Central-Register-of-Controlled-Trials (CENTRAL) as well as a grey literature search from inception to May 2021 and without language restricted to English. Strict inclusion criteria were applied. A standardized tool with defined criteria to assess the risk of bias in each study was used. For non-randomized comparative trials, the Robins-I tool was used while the Newcastle-Ottawa scale was used for non-comparative non-randomized studies.
RESULTS
Seven retrospective clinical studies were included. The studies reported high success rates for pulpotomy with overall success ranges for partial or complete pulpotomy ranging from 75% to 96%. One study compared the success rates of pulpotomy to an alternative treatment option pulp capping (90.9% vs. 67%, respectively). Due to the lack of homogeneity in the included studies, a meta-analysis was not possible.
DISCUSSION
This review highlights the limited evidence based for the current guidance on treatment of complicated crown fractures. The findings of the review indicate high success rates for pulpotomy; however, there is a moderate risk of bias and small sample sizes in the included studies with the result that the overall results should be interpreted with caution.
CONCLUSION
Within the limitations of this review, the benefits and high success rates reported for partial pulpotomy suggest this procedure, rather than pulp-capping, should be considered as the treatment of choice for both immature and mature teeth that have suffered complicated crown-fractures.
Topics: Crowns; Dental Pulp Capping; Dentition, Permanent; Humans; Pulpotomy; Retrospective Studies; Treatment Outcome
PubMed: 35076954
DOI: 10.1111/iej.13690 -
Indian Journal of Dental Research :... 2020Laboratory reports show that fiber-reinforced composites have improved fracture resistance over traditional composites. However, limitations in the biomechanics of tests...
BACKGROUND
Laboratory reports show that fiber-reinforced composites have improved fracture resistance over traditional composites. However, limitations in the biomechanics of tests to evaluate the fracture resistance of fiber-reinforced composites need to be considered for accurate clinical applications.
AIM
To assess the fracture resistance of particulate filler composites, glass fiber-reinforced composites, and polyethylene-fiber reinforced composites by analyzing the different fracture types and failure patterns.
MATERIALS AND METHODS
A standardized incisal (Group I) and mesioincisal fractures (Group II) were prepared on human maxillary central incisors. The test samples were further subdivided according to the restorative material used; particulate filler composites (Filtek Z 250), glass fiber-reinforced composites (fibre splint), and polyethylene-reinforced composites (Ribbond). The type of fractures was evaluated under the stereomicroscope and the failure patterns were analyzed using the graphical output from Universal Testing Machine.
STATISTICAL ANALYSIS
The Chi-square test of association was used to test the association between fiber-reinforced composites and fracture resistance of tooth restoration complex.
RESULTS
No statistical association was observed between fiber-reinforced composites to the type of fractures in both incisal (P = 0.29) and mesioincisal restoration (P = 0.27). A significant association was observed between the fiber-reinforced composites to the failure patterns in both the incisal (P = 0.005) and mesioincisal restoration (P = 0.007).
CONCLUSION
The glass and polyethylene fiber-reinforced composites showed improved fracture resistance properties than the traditional particulate filler composites in both incisal and mesioincisal restorations.
Topics: Composite Resins; Dental Materials; Dental Restoration Failure; Dental Restoration, Permanent; Dental Stress Analysis; Glass; Humans; Materials Testing; Stress, Mechanical; Tooth Fractures
PubMed: 32246697
DOI: 10.4103/ijdr.IJDR_465_18 -
International Journal of Environmental... Jan 2020The aim of the present study is to verify the knowledge of risks and complications of oral piercings, and to observe the main complications associated with piercings,...
The aim of the present study is to verify the knowledge of risks and complications of oral piercings, and to observe the main complications associated with piercings, using a sample from central Italy of patients wearing intraoral piercings. Through piercing and tattoo studios selected randomly in Rome, Latina and Campobasso, and a tattoo and piercing convention in Latina, a group of 387 individuals with oral piercings were selected and asked to complete an anonymous questionnaire. After filling in questionnaires, 70 individuals of the 387 selected agreed to be visited to allow the observation of the integrity of their teeth and gums (especially close to the oral piercing), oral hygiene conditions, piercing cleaning, bad habits and gingival recession. Among the respondents, 46.8% said they had not been informed about these risks, 48.5% claimed not to clean the piercing, 70.6% stated that they had not been made aware of gingival problems that can arise, 60.4% subjects stated that they were not informed about the complications of piercings concerning teeth, 52.8% had insufficient oral hygiene conditions, 42% showed signs of generalised gingivitis, 20% had 3-4 mm recessions and 22% had tooth fracture(s) due to piercing. From this study, it emerged that oral piercings can represent a risk to oral health and that there is a widespread lack of awareness of the complications and correct methods of maintaining oral piercings. Periodic checks by both dentists and dental hygienists, for patients with oral piercings, could play a decisive role in preventing, intercepting and treating the complications that they can cause.
Topics: Adult; Body Piercing; Female; Health Knowledge, Attitudes, Practice; Humans; Italy; Male; Oral Health; Rome; Young Adult
PubMed: 31963636
DOI: 10.3390/ijerph17020613 -
Dental Traumatology : Official... Jun 2022An accurate, clear, and easy-to-use traumatic dental injury (TDI) classification and definition system is a prerequisite for proper diagnosis, study, and treatment....
An accurate, clear, and easy-to-use traumatic dental injury (TDI) classification and definition system is a prerequisite for proper diagnosis, study, and treatment. However, more than 50 classifications have been used in the past. The ideal solution would be that TDIs are adequately classified within the International Classification of Diseases (ICD), endorsed by the World Health Organization (WHO). TDI classification provided by the 11th Revision of the ICD (ICD-11), released in 2018, and previous Revisions, failed to classify TDIs satisfactorily. Therefore, in December 2018, a proposal was submitted by Dr's Stefano Petti, Jens Ove Andreasen, Ulf Glendor, and Lars Andersson, to the ICD-11, asking for a change of the existing TDI classification. Proposal #2130 highlighted the TDI paradox, the fifth most frequent disease/condition neglected by most public health agencies in the world, and the limits of ICD-11 classification. Namely, injuries of teeth and periodontal tissues were located in two separate blocks that did not mention dental/periodontal tissues; infraction, concussion, and subluxation were not coded; most TDIs lacked description; and tooth fractures were described through bone fracture descriptions (e.g., comminuted, compression, and fissured fractures). These limitations led to TDI mis-reporting, under-reporting, and non-specific reporting by untrained non-dental healthcare providers. In addition, no scientific articles on TDIs, present in PubMed, Scopus, and Web-of-Science, used the ICD classification. Proposal #2130 suggested to adopt the Andreasen classification, the most widely acknowledged classification used in dental traumatology. The Proposal was reviewed by two WHO teams, two scientific Committees, one WHO Collaborating Center, and the Department of Non-Communicable Disease Prevention at WHO headquarters, and it underwent two voting sessions. In March 2022, the Andreasen classification was accepted integrally. A new entity was generated, called NA0D, "Injury of teeth or supporting structures" (https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f1413338122). Hopefully, this will contribute to increasing the public awareness, and the dental profession's management, of TDIs.
Topics: Humans; Prevalence; Tooth Fractures; Tooth Injuries; World Health Organization
PubMed: 35481941
DOI: 10.1111/edt.12753 -
Interface Focus Oct 2021Until recently, there had been little attempt in the literature to identify and quantify the underlying mechanics of tooth durability in terms of materials engineering... (Review)
Review
Until recently, there had been little attempt in the literature to identify and quantify the underlying mechanics of tooth durability in terms of materials engineering concepts. In humans and most mammals, teeth must endure a lifetime of sustained occlusal mastication-they have to resist fracture and wear. It is well documented that teeth are resilient, but what are the unique features that make this possible? The present article surveys recent materials engineering research aimed at addressing this fundamental question. Elements that determine the mechanics and micromechanics of tooth fracture and wear are analysed: at the macrostructural level, the geometry of the enamel shell and cuspal configuration; and at the microstructural level, interfacial weakness and property gradients. Inferences concerning dietary history in relation to evolutionary pressures are discussed.
PubMed: 34938431
DOI: 10.1098/rsfs.2020.0070