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      Comparison of fracture resistance of endodontically treated teeth using different coronal restorative materials: An in vitro study

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          Abstract

          Aim/Objective:

          To evaluate the in vitro effect of bonded restorations on the fracture resistance of root canal-treated teeth.

          Materials and Methods:

          One hundred twenty extracted, maxillary, permanent premolars were collected. After preparing the access cavity, the teeth were biomechanically prepared and obturated. Samples were divided into six groups based on the type of restorative material used to restore them. Teeth were embedded in acrylic resin and their fracture strength was measured using a Universal Testing Machine. Data were evaluated statistically using one-way ANOVA-F and unpaired t-test.

          Results:

          Teeth restored with bonded amalgam and composite resin showed higher fracture resistance than those restored with conventional amalgam. Fracture strengths of bonded restorations and intact teeth were not statistically different. The results suggested that the group restored with conventional amalgam had the lowest fracture resistance. No statistically significant differences were found between the bonded amalgam and composite resin groups.

          Conclusion:

          Conventional amalgam core showed the least fracture resistance whereas; composite resin and bonded amalgam core showed fracture resistance was similar to that of natural tooth.

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          Most cited references24

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          Three-year clinical comparison of survival of endodontically treated teeth restored with either full cast coverage or with direct composite restoration.

          Little information exists regarding the outcome of crown build-ups on endodontically treated teeth restored with metal-ceramic crowns or with only a direct-placed composite. The aim of this study was to evaluate the clinical success rate of endodontically treated premolars restored with fiber posts and direct composite restorations and compare that treatment with a similar treatment of full-coverage with metal-ceramic crowns. Subjects included in this study had one maxillary or mandibular premolar for which endodontic treatment and crown build up was indicated and met specific inclusion/exclusion criteria. Only premolars with Class II carious lesions and preserved cusp structure were included. Subjects were randomly assigned to 1 of the following 2 experimental groups: (1) teeth endodontically treated and restored with adhesive techniques and composite or (2) teeth endodontically treated, restored with adhesive techniques and composite, and then restored with full-coverage metal-ceramic crowns. Sixty teeth were included in the first group and 57 in the second. All restorations were performed by one operator. Causes of failure were categorized as root fracture, post fracture, post decementation, clinical and/or radiographic evidence of marginal gap between tooth and restoration, and clinical and/or radiographic evidence of secondary caries contiguous with restoration margins. Subjects were examined for the listed clinical and radiographic causes of failure by 2 calibrated examiners at intervals of 1, 2, and 3 years. Exact 95% confidence intervals for the difference between the 2 experimental groups were calculated. At the 1-year recall, no failures were reported. The only failure modes observed at 2 and 3 years were decementations of posts and clinical and/or radiographic evidence of marginal gap between tooth and restoration. There was no difference in the failure frequencies of the 2 groups (95% confidence interval, -17.5 to 12.6). There was no difference between the number of failures caused by post decementations and the presence of marginal gaps observed in the 2 groups (95% confidence intervals, -9.7 to 16.2 and -17.8 to 9.27). Within the limitations of this study, the results upheld the research hypothesis that the clinical success rates of endodontically treated premolars restored with fiber posts and direct composite restorations after 3 years of service were equivalent to a similar treatment of full coverage with metal-ceramic crowns.
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            Reinforcement effect of polyethylene fibre in root-filled teeth: comparison of two restoration techniques.

            To compare in vitro two different fibre placement techniques on reinforcement of root-filled molar teeth with mesio-occluso-distal (MOD) cavities. Fifty sound extracted human mandibular molars were used (n = 10). Group 1 served as control. From group 2-5, endodontic access and standard MOD cavities were prepared. Following root canal treatment, group 2 was kept unrestored. In groups 3 and 4, the teeth were restored with composite resin (AP-X; Kuraray, Japan). A groove was prepared on occlusal surface of the finished restorations in group 4 from buccal to lingual direction. Polyethylene woven fibre (Ribbond; Seattle, WA, USA) was inserted in the groove in combination with flowable resin that was cured for 20 s and covered with composite resin. Cavity surfaces were covered with flowable resin in group 5, and polyethylene fibre was placed into the bed of resin in a buccal to lingual direction before the composite restoration was placed. All specimens were stored in 100% humidity at 37 degrees C for 24 h. Compressive loading of the teeth was performed by a universal testing machine at a crosshead speed of 0.5 mm min(-1) until failure. The data were recorded in Newton and submitted to anova and Tukey post hoc test. The mean load necessary to fracture the samples in each group was: G1: 1671.57 +/- 131.54(a); G2: 375.21 +/- 34.30(b); G3: 749.47 +/- 124.54(c); G4: 1224.36 +/- 132.17(d); G5: 926.88 +/- 118.28(e). Different superscript letters demonstrate significant difference between groups. Polyethylene fibre use over or under MOD composite restorations significantly increased fracture strength. However, when the fibre was placed on the occlusal surface of the restoration in buccal to lingual direction, significantly higher fracture resistance was observed.
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              Dentin: microstructure and characterization.

              Dentin consists of several identifiable structures: tubules with cell processes and fluid; highly mineralized peritubular dentin; and intertubular dentin consisting mainly of collagen and deposited apatite. The structural organization and microstructural variations reflect formative influences, such as tooth size and shape, and alterations caused by age, insult, and disease. However, details of structure-chemistry-property relationships for this anisotropic biologic composite are limited. Materials scientists are focusing on an array of new spectroscopic, analytical, and imaging techniques that are yielding improved understanding of structural variations and their dependence on specimen preparation, tooth type, location, storage conditions, and chemical and physical modifications. Such studies should lead to the major refinements in structure-properties models for dentin that are required for continued advances in dental composite resins and adhesives.
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                Author and article information

                Journal
                J Conserv Dent
                JCD
                Journal of Conservative Dentistry : JCD
                Medknow Publications (India )
                0972-0707
                0974-5203
                Oct-Dec 2009
                : 12
                : 4
                : 154-159
                Affiliations
                Departments of Conservative Dentistry and Endodontics, D.J. College of Dental Sciences and Research, Modinagar, U.P, India
                Author notes
                Address for correspondence: Dr. Vivek Sharma, Departments of Conservative Dentistry and Endodontics, D.J. College of Dental Sciences and Research, Modinagar, U.P., India. E-mail: doc_vivek@ 123456yahoo.com
                Article
                JCD-12-154
                10.4103/0972-0707.58338
                2879728
                20543925
                61a5229d-967f-411b-ac5f-eb0b5e9ddff4
                © Journal of Conservative Dentistry

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 04 February 2009
                : 20 February 2009
                : 01 March 2009
                Categories
                Original Article

                Dentistry
                fracture resistance,root-filled teeth,bonded restorations
                Dentistry
                fracture resistance, root-filled teeth, bonded restorations

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