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BMC Oral Health Aug 2023Large cavity designs and access cavities impair endodontically treated tooth fracture resistance. As the tooth's strength is known to reduce significantly after the root...
BACKGROUND
Large cavity designs and access cavities impair endodontically treated tooth fracture resistance. As the tooth's strength is known to reduce significantly after the root canal treatment, occlusal loading as a result of functions such as chewing, biting and certain parafunctional tendencies makes the endodontically treated tooth vulnerable to fracture. Hence, after endodontic treatment, it is vital to give adequate and appropriate restorative material to avoid tooth fractures. Accordingly, the choice of such restorative material should be dictated by the property of fracture resistance.
OBJECTIVE
The goal of this study was to conduct a systematic review and critical analysis of available data from in vitro studies examining the fracture resistance of endodontically treated posterior teeth restored with fiber-reinforced composites.
METHODOLOGY
The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRIS-MA) Statement was used to guide the reporting of this systematic review A comprehensive literature search was performed using MEDLINE (via PubMed), Scopus, ScienceDirect, Google Scholar, and LILACS. A manual search of the reference lists of the articles was also performed. The databases provided a total of 796 studies from the electronic systematic search. The databases provided a total of 796 studies from the electronic systematic search. Two reviewers scrutinized the papers for eligibility based on inclusion/exclusion criteria and extracted data. The studies were assessed for their potential risk of bias. Based on modified JBI & CRIS (checklist for reporting in vitro studies) guidelines, along with the methodology and treatment objective, we have formulated 13 parameters specifically to assess the risk of bias. A total of 18 studies met the inclusion criteria and were included for qualitative analysis. Considering the high heterogeneity of the studies included, a meta-analysis could not be performed.
RESULTS
The majority of the included studies had a moderate or high risk of bias. When compared to traditional hybrid composites, fiber-reinforced composites showed increased fracture resistance of endodontically treated teeth in the majority of investigations. On the other hand, limited evidence was found for the bulk fill composites. Moreover, moderate evidence was found for the fracture resistance of inlays and fiber posts with fiber-reinforced composites for core build-up in endodontically treated teeth. No evidence could be found comparing the fracture resistance of endo crowns and fiber-reinforced composites in endodontically treated teeth.
CONCLUSION
According to the research, using fiber-reinforced composites instead of conventional hybrid composites improves the fracture resistance of endodontically treated teeth. However, there was a high risk of bias in the research considered. No judgments could be reached about the superiority of one material over another based-on comparisons between other core restorations.
Topics: Humans; Tooth, Nonvital; Dental Materials; Crowns; Tooth Fractures; Composite Resins; Dental Stress Analysis
PubMed: 37574536
DOI: 10.1186/s12903-023-03217-2 -
Dento Maxillo Facial Radiology Sep 2021To assess the influence of field of view (FOV) size, scanning position within the FOV and scanning mode on the detection of root fracture and artifact perception.
Influence of size of field of view (FOV), position within the FOV, and scanning mode on the detection of root fracture and observer's perception of artifacts in CBCT images.
OBJECTIVE
To assess the influence of field of view (FOV) size, scanning position within the FOV and scanning mode on the detection of root fracture and artifact perception.
METHODS
Forty single-rooted premolars restored with NiCr and AgPd posts were divided into two groups: fractured and sound. All teeth were scanned using four CBCT scanning protocols varying FOV sizes (80 × 80 mm and 50 × 55 mm) and scanning modes (Standard and High Definition). The sample was positioned within the FOV in two pre-set positions (central and lateral) and in four positions established by the operator (quadrants). Detection of root fracture and artifact perception were assessed by two observers using 5-point and 4-point scales. Sensitivity, specificity, accuracy, and AUC values were calculated and compared by ANOVA two-way and Tukey's test. Chi-square and Fisher's exact test were used to assess artifact perception. The level of significance was set at p < 0.05.
RESULTS
The central position within the FOV presented higher sensitivity, specificity, accuracy, and AUC values and differed from the lateral position within the FOV for the studied metal posts (p<0.05). Quadrant 2 presented the best sensitivity, accuracy, and AUC values (p<0.05). The lateral position within the FOV, AgPd posts, quadrants 1 and 3 and protocols 1 (SM, 80 × 80) and 2 (HD, 80× 80) presented higher frequency of artifacts classified as "severe".
CONCLUSION
Positioning the object in the center or closer to the anterior periphery of the FOV while using a small FOV improved the detection of root fracture and decreased artifact perception.
Topics: Artifacts; Cone-Beam Computed Tomography; Humans; Perception; Spiral Cone-Beam Computed Tomography; Tooth Fractures; Tooth Root
PubMed: 33565884
DOI: 10.1259/dmfr.20200563 -
Brazilian Dental Journal 2007This study evaluated, in vitro, the loss of tooth substance after cavity preparation for direct and indirect restorations and its relationship with fracture strength of...
This study evaluated, in vitro, the loss of tooth substance after cavity preparation for direct and indirect restorations and its relationship with fracture strength of the prepared teeth. Sixty sound human maxillary first premolars were assigned to 6 groups (n=10). MOD direct composite cavities (Groups I, II and III) and indirect inlay cavities (Groups IV, V and VI) were prepared maintaining standardized dimensions: 2-mm deep pulpal floors, 1.5-mm wide gingival walls and 2-mm high axial walls. Buccolingual width of the occlusal box was established at 1/4 (Groups I and IV), 1/3 (Groups II and V) or 1/2 (Groups III and VI) of the intercuspal distance. Teeth were weighed (digital balance accurate to 0.001 g) before and after preparation to record tooth substance mass lost during cavity preparation. The prepared teeth were submitted to occlusal loading to determine their fracture strength using a universal testing machine at a crosshead speed of 0.5 mm/min. Data were analyzed by two-way ANOVA and Tukey test (alpha= 0.05). 1/4-inlay cavities had higher percent mean mass loss (9.71%) than composite resin cavities with the same width (7.07%). 1/3-inlay preparations also produced higher percent mean mass loss (13.91%) than composite resin preparations with the same width (10.02%). 1/2-inlay cavities had 21.34% of mass loss versus 16.19% for the 1/2-composite resin cavities. Fracture strength means (in kgf) were: GI = 187.65; GII = 143.62; GIII = 74.10; GIV = 164.22; GV = 101.92; GVI = 50.35. Statistically significant difference (p<0.05) were observed between Groups I and IV, II and V, III and VI. Higher tooth structure loss and lower fracture strength were recorded after preparation of inlay cavities, regardless of the width of the occlusal box, compared to the direct composite resin cavities.
Topics: Bicuspid; Bite Force; Composite Resins; Dental Cavity Preparation; Dental Materials; Dental Porcelain; Dental Pulp; Dental Restoration, Permanent; Humans; Inlays; Materials Testing; Organ Size; Stress, Mechanical; Tooth Crown; Tooth Fractures
PubMed: 17982553
DOI: 10.1590/s0103-64402007000200009 -
Clinical Oral Investigations Jan 2020The aim was to explore the fracture behavior and marginal gap within the root canal of endodontically treated (ET) premolars restored with different fiber-reinforced...
OBJECTIVES
The aim was to explore the fracture behavior and marginal gap within the root canal of endodontically treated (ET) premolars restored with different fiber-reinforced post-core composites (FRCs). Further aim was to evaluate the composite curing at different depths in the canal.
MATERIALS AND METHODS
Eighty-seven intact upper premolars were collected and randomly divided into six groups. After endodontic procedure, standard MOD cavities were prepared and restored with their respective fiber-reinforced post-core materials: group 1: prefabricated unidirectional FRC-post + conventional composite core; group 2: prefabricated unidirectional FRC-post + short fiber composite (SFRC) core; group 3: individually formed unidirectional FRC-post + conventional composite core; group 4: randomly oriented SFRC directly layered as post and core; group 5: individually formed unidirectional FRC + randomly oriented SFRC as post and core. After restorations were completed, teeth (n = 3/group) were sectioned and then stained. Specimens were viewed under a stereo microscope and the percentage of microgaps within the root canal was calculated. Fracture load was measured using universal testing machine.
RESULTS
SFRC application in the root canal (groups 4 and 5) showed significantly higher fracture load (876.7 N) compared to the other tested groups (512-613 N) (p < 0.05). Post/core restorations made from prefabricated FRC-post (group 1) exhibited the highest number of microgaps (35.1%) at the examined interphase in the root canal.
CONCLUSIONS
The restoration of ET premolars with the use of SFRC as post-core material displayed promising performance in matter of microgap and load-bearing capacity.
CLINICAL SIGNIFICANCE
Fracture resistance of ET premolar restored by bilayered composite restoration that includes both SFRC as post-core material and surface conventional resin seems to be beneficial.
Topics: Composite Resins; Dental Stress Analysis; Humans; Materials Testing; Post and Core Technique; Tooth Fractures; Tooth, Nonvital
PubMed: 31098711
DOI: 10.1007/s00784-019-02902-3 -
Canadian Journal of Rural Medicine :... 2021
Topics: Humans; Tooth Fractures
PubMed: 34643558
DOI: 10.4103/cjrm.cjrm_79_20 -
Odontology Oct 2022The aim was to investigate the vertical root fracture (VRF) resistance and crack formation of root canal-treated teeth restored with different post-luting systems. Human...
The aim was to investigate the vertical root fracture (VRF) resistance and crack formation of root canal-treated teeth restored with different post-luting systems. Human maxillary lateral incisors of similar size were decoronated, assigned to five groups (n = 18, power = 0.9) and embedded in acrylic blocks with artificial periodontal ligament. After root canal filling, post spaces were prepared to place coated fiber-reinforced composite (FRC) or sandblasted titanium (Ti) posts of the same shape and size. Half of the posts were zinc phosphate cemented (C), while the other half was adhesively luted (A). Untreated teeth served as control. After thermal cycling and staircase loading in a chewing simulator, the crack formation on the root dentin surface was microscopically examined and classified as no defect, craze line, vertical crack, and horizontal crack. Subsequently, the samples were loaded until root fracture. Data were analyzed by one-way ANOVA, Tukey's test, and Fisher's exact test. All samples survived the chewing simulation without VRF, but crack formation was significantly different between the groups (P = 0.009). The control showed significantly fewer defects than FRC/C, Ti/C, and Ti/A (P = 0.001, P = 0.008, P = 0.008, respectively). FRC/C showed the highest incidence of vertical cracks. FRC/A had the lowest incidence of defects. There was no significant difference in VRF resistance between the groups (P = 0.265). Adhesively luted FRC posts did not increase VRF resistance but reduced the risk of defects. Most defects were craze lines and vertical root cracks.
Topics: Composite Resins; Dental Pulp Cavity; Dental Stress Analysis; Humans; Incisor; Post and Core Technique; Root Canal Therapy; Tooth Fractures
PubMed: 35523910
DOI: 10.1007/s10266-022-00709-5 -
Dental Materials Journal Jul 2022This study aimed to clarify the effects of vertical bone defect width and a ferrule on fracture of the fragments of fractured tooth reattached with adhesive resin cement...
This study aimed to clarify the effects of vertical bone defect width and a ferrule on fracture of the fragments of fractured tooth reattached with adhesive resin cement (reattached tooth). The reattached tooth was built up by a fiber post and composite resin core for abutment and formed to the abutment with or without a ferrule. The vertical bone defect was fabricated with a V-shaped defect in different widths. The fracture load was evaluated using a universal testing machine. The vertical bone defect did not affect the fracture load, but a ferrule increased the root fracture load. For the specimens without a ferrule, debonding between the composite resin core and the root at the coronal loading side and fractures at the apical side of the root were found. In conclusion, the ferrule at abutment could affect fracture load and modes, and the bone defect width did not.
Topics: Composite Resins; Crowns; Dental Cements; Dental Prosthesis Design; Dental Stress Analysis; Humans; Post and Core Technique; Resin Cements; Tooth Fractures; Tooth, Nonvital
PubMed: 35321975
DOI: 10.4012/dmj.2021-287 -
BMC Oral Health Jun 2023This study aimed to investigate the effects of different ferrule heights and crown-to-root ratios on the fracture resistance of endodontically-treated premolars restored...
The effect of different ferrule heights and crown-to-root ratios on fracture resistance of endodontically-treated mandibular premolars restored with fiber post or cast metal post system: an in vitro study.
BACKGROUND
This study aimed to investigate the effects of different ferrule heights and crown-to-root ratios on the fracture resistance of endodontically-treated premolars restored with fiber post or cast metal post system.
METHODS
Eighty extracted human mandibular first premolars with single root canal were treated endodontically and cut from 2.0 mm above the buccal cemento-enamel junction, to create horizontal residual roots. The roots were randomly divided into two groups. The roots in group FP were restored with a fiber post-and-core system, while the roots in group MP were restored with a cast metal post-and-core system. Each group was divided into five subgroups with different ferrule heights (0: no ferrule; 1: 1.0 mm ferrule; 2: 2.0 mm ferrule; 3: 3.0 mm ferrule; 4: 4.0 mm ferrule). All specimens were subsequently restored with metal crowns and embedded in acrylic resin blocks. The crown-to-root ratios of the specimens were controlled at approximately 0.6, 0.8, 0.9, 1.1, and 1.3 of the five subgroups, respectively. Fracture strengths and fracture patterns of the specimens were tested and recorded by a universal mechanical machine.
RESULTS
Mean fracture strengths (mean ± standard deviation (kN)) of FP/0 to FP/4 and MP/0 to MP/4 were: 0.54 ± 0.09, 1.03 ± 0.11, 1.06 ± 0.17, 0.85 ± 0.11; 0.57 ± 0.10, 0.55 ± 0.09, 0.88 ± 0.13, 1.08 ± 0.17, 1.05 ± 0.18 and 0.49 ± 0.09, respectively. Two-way ANOVA revealed significant effects of different ferrule heights and crown-to-root ratios on the fracture resistance (P < 0.001), but no difference in fracture resistance between two post-and-core systems (P = 0.973). The highest fracture strengths of the specimen were found with the ferrule length of 1.92 mm in group FP and 2.07 mm in group MP, the crown-to-root ratio of which in 0.90 and 0.92 respectively., there is a significant difference in fracture patterns among the groups(P < 0.05).
CONCLUSIONS
When a certain height of ferrule is prepared and a cast metal or fiber post-and-core system is restored for the residual root, the clinical crown-to-root ratio of the tooth after restoration should be kept within 0.90 to 0.92, so as to improve the fracture resistance of endodontically-treated mandibular first premolars.
Topics: Humans; Bicuspid; Post and Core Technique; Tooth Fractures; Tooth, Nonvital; Crowns; Dental Stress Analysis; Composite Resins; Dental Restoration Failure
PubMed: 37270602
DOI: 10.1186/s12903-023-03053-4 -
Journal (Canadian Dental Association) Dec 1998The case presented is designed to draw attention to the increasingly common occurrence of tooth fracture as a result of trauma incurred from a barbell inserted during... (Review)
Review
The case presented is designed to draw attention to the increasingly common occurrence of tooth fracture as a result of trauma incurred from a barbell inserted during tongue piercing. Oral piercing is on the rise. Of concern to health personnel are the associated risks, which include damage to dentition, infection, speech impediment and nerve damage. Also of concern is the belief that in some cases, clients considering body piercing may not be receiving sufficient care instructions, hence putting them at greater risk of post-operative complications. We conclude that a public health campaign in the form of health promotion and education is mandatory to ensure safe responsible piercing, and recommend that workshops, forums and educational leaflets aimed at the piercers, the clientele and the health care workers be developed in Alberta.
Topics: Adult; Humans; Male; Punctures; Risk Factors; Self Mutilation; Tongue; Tooth Fractures
PubMed: 9879145
DOI: No ID Found -
Journal of Oral Science Dec 2010Accuracy in defining a disease makes it easier to study and understand. Similarly, with injuries to the teeth, a comprehensive classification is an aid to correct... (Review)
Review
Accuracy in defining a disease makes it easier to study and understand. Similarly, with injuries to the teeth, a comprehensive classification is an aid to correct diagnosis and treatment planning. A thorough review of various classifications of tooth fractures shows that, despite an emphasis on traumatic dental injuries, a consensus needs to be arrived at, especially among clinicians and general/family dentists. The ideal classification would be applicable to both primary and permanent dentition, based on tooth fractures in both the horizontal and vertical planes, encompassing all possible sites, easy to comprehend, communicable amongst health professionals and clinically relevant. With recent improvements in conservative techniques, it is now clinically possible to preserve natural teeth even if they have been horizontally or vertically fractured, and thus an in-depth understanding and knowledge of tooth fractures, together with a simplified classification, is now more than ever essential.
Topics: Humans; Needs Assessment; Tooth Fractures
PubMed: 21206153
DOI: 10.2334/josnusd.52.517