Anatomical post: a simple and safe alternative

Objective: To describe a clinical case that called for an anatomical post to be made to support and retain an indirect restoration in the anterior tooth. Case report: A 72-year-old female patient came to the office complaining that the crown of tooth 22 had come loose. A clinical and radiographic examination of element 22 was performed, and showed a very broad root canal, total displacement of the cast metal crown-core set, and satisfactory endodontic treatment. The restorative planning for this patient included the making of an anatomical post from Exacto # 2 fiberglass post (Angelus, Brazil), and refilling it with Bulk One composite resin (3M, USA), using self-adhesive resin cement U200 (3M, USA). The reconstruction of the coronary portion of the post was also performed with the same composite resin (Bulk One 3M, USA). The preparation for full crown and temporary restoration was performed in the same session, using self-curing acrylic resin. The all-ceramic crown was molded and cemented in subsequent sessions. Conclusion: The use of anatomical posts with composite resin represents a technically viable alternative for rehabilitating endodontically treated teeth with wide root canals, in cases where conventional prefabricated fiber posts cannot be adapted easily. The advantages that stand out are that these posts can be applied easily, at low cost, and in a single session.

Objetivo: Descrever um caso clínico de confecção do pino anatômico para suporte e retenção de restauração indireta em dente anterior. Relato do Caso: Paciente feminina, 72 anos, compareceu ao consultório queixando-se que a coroa do dente 22 havia "soltado". Realizou-se exame clínico e radiográfico do elemento 22, que apresentou conduto radicular bastante amplo, deslocamento total do conjunto núcleo/coroa e tratamento endodôntico satisfatório. O planejamento restaurador para essa paciente incluiu a confecção de pino anatômico, com pino de fibra de vidro Exato #2(Angelus, Brasil) reembasado com resina composta Bulk One (3M, EUA), utilizando o cimento resinoso autoadesivo U200 (3M, EUA). Foi realizada a reconstrução da porção coronária do pino também com resina composta do tipo Bulk. Realizou-se, na mesma sessão de atendimento, o preparo para coroa total e restauração provisória utilizando dente de estoque e resinaacrílica autopolimerizável. Em sessões seguintes foi realizada a moldagem e cimentação da coroa total em cerâmica pura. Conclusão: A utilização de pinos anatômicos com resina composta representa uma alternativa tecnicamente viável, de fácil aplicabilidade, com baixo custo e em única sessão, para reabilitação de dentes tratados endodonticamente com conduto radicular onde os pinos em fibra pré-fabricados convencionais não apresentam boa adaptação.

Retratamiento y reparación de una perforación radicular. Informe clínico, radiográfico e histológico / Retreatment and healing of a case of root perforation. Clinical, radiographic and histological report

Objetivo: Describir los aspectos clínicos, radiográfi- cos e histológicos del retratamiento realizado en un segundo molar superior en el que se había producido previamente una perforación radicular durante el tratamiento original. Caso clínico: Un paciente masculino de 50 años con- currió a la consulta para realizar un retratamiento endodóntico en un segundo molar superior derecho. El examen radiográfi- co reveló la presencia de un tratamiento incompleto, un área radiolúcida periapical y una perforación radicular producida por un poste roscado insertado fuera del espacio del conducto mesio vestibular. Una vez retirado el poste, se selló la perfo- ración con Biodentine y se realizó el retratamiento. Luego de dos años, el paciente regresó a la consulta con dolor a la mas- ticación, localizado en el área correspondiente al segundo mo- lar superior derecho previamente tratado. Durante el examen clínico y radiográfico se detectó la presencia de una fractura vertical en la raíz palatina. A causa del severo compromiso radicular el molar fue extraído y derivado para su análisis his- tológico. El informe del laboratorio reveló que la perforación había sido reparada por medio de la aposición de un nuevo tejido calcificado y que el remanente periodontal adherido a la raíz se encontraba dentro de los límites normales. El presente caso clínico resalta la importancia que tiene el conocimiento cabal de la anatomía del sistema de conductos radiculares con el objeto de evitar errores de procedimiento que puedan influir negativamente en el pronóstico del tratamiento (AU)

Aim: To describe the clinical, radiographic and histo- logical aspects of the retreatment of a second upper molar in which root perforation had occurred during the original treatment. Clinical case: A 50-year old male was referred for endo- dontic retreatment of the right second maxillary molar. Radi- ographic examination revealed the presence of an incomplete root canal treatment, a radiolucent periapical area and a root perforation produced by a threaded post placed outside of the mesiobuccal root canal. After post removal, the root perfo- ration was sealed with Biodentine and the root canals were retreated. Two years later, the patient returned to the office com- plaining of severe pain during mastication, in the area of the previously retreated right second maxillary molar. Clinical and radiographic examination revealed the presence of a ver- tical fracture on the palatal root. Since this kind of root dam- age non-restorable, the tooth was extracted and submitted to histologic analysis. The laboratory report revealed that the perforation site had healed by the apposition of new calci- fied tissue, and that the remnants of periodontal tissue which persisted attached to the root were within normal limits. This clinical case highlights the importance of thorough knowl- edge of the anatomy of the root canal system in order to avoid procedural errors which may compromise the prognosis of the treatment (AU)

Novo sistema de retentor pré-fabricado perfurado e de iluminador em fibra óptica: estudo da resistência mecânica frente a variação dos cimentos resinosos / New system of hollow prefabricated post and optical fiber illuminator: study of the mechanical strength by varying resin cements

O presente estudo teve por objetivo avaliar a resistência à flexão de um pino experimental de fibra de vidro vazado, e a resistência adesiva entre este pino experimental à dentina radicular, associando a utilização de um dispositivo iluminador em fibra óptica, sob o processo de envelhecimento, além de determinar a distribuição de tensão pela Análise de Elementos Finitos (FEA). O pino experimental e o dispositivo iluminador de fibra óptica têm por finalidade aumentar a efetividade de fotoativação dos cimentos resinosos nos terços médios e apicais dos canais radiculares. Para o teste de flexão de 3 pontos, estritamente do pino de fibra de vidro, as amostras foram divididas em 4 grupos (n=10): pino convencional (pc), pino experimental sem preenchimento (pp), com preenchimento de cimento resinoso (ppc) e com preenchimento de fibra óptica (ppf). Para o teste de resistência adesiva Pull-out, 100 raízes de dentes bovinos foram restauradas com retentores intrarradiculares e coroas de resina composta, distribuídos em 10 grupos (n=10), tendo como variáveis: o tipo de pino de fibra de vidro [convencional (C) ou perfurado (P)], o sistema de fotoativação [com ou sem o iluminador de fibra óptica (O)], o tipo de cimento resinoso [fotoativado (F) ou polimerização dual (D)] e o envelhecimento das amostras [com e sem ciclagem mecânica (C)]. O processo de envelhecimento foi realizado através da ciclagem mecânica e as amostras foram submetidas ao teste de resistência adesiva Pull-out. A análise do modo de falha foi realizada em Estereomicroscópio. A Análise em Elementos Finitos avaliou a distribuição de tensão pela análise de von Mises, deformação total e tensão máxima principal no Software Ansys 19.3. A análise estatística foi constituída pelo teste de normalidade Shapiro-Wilk, análise de variância (ANOVA) 1, 2 e 3 fatores e teste Tukey 5%. As médias e desvios padrão de resistência à flexão foram (MPa): pc = 677 ± 81,1; ppc = 419 ± 23,2; ppf = 200 ± 32,5 e pp = 177 ± 32,8. As médias e desvios padrão de resistência adesiva foram (MPa): CD = 12,2 ± 1,21; PD = 11,1 ± 1,32; PF = 10,9 ± 1,29; POD = 13,7 ± 1,16; POF = 11,9 ± 1,48; CDC = 10,1 ± 1,33; PDC = 9,25 ± 1,11; PFC = 8,37 ± 1,25; PODC = 10,8 ± 0,95 e POFC = 9,82 ± 1,02. Os resultados do modo de falha foram: adesiva entre pino e cimento (56%), mista predominantemente adesiva entre cimento e dentina (22%), adesiva entre cimento e dentina (14%) e a mista predominantemente adesiva entre pino e cimento (8%). Concluiu-se que entre os pinos experimentais, o grupo do pino perfurado preenchido com cimento resinoso obteve o maior valor de resistência à flexão, a utilização do dispositivo iluminador aumentou os resultados de resistência adesiva nos grupos dos pinos perfurados e não houve diferença na distribuição de tensões entre os grupos. (AU)

The present study aimed to evaluate the flexural strength of an experimental hollow glass fiber post, and the bond strength between this experimental post and root dentin, associating the use of an optical fiber illuminating device, under the aging process, in addition to determine the stress distribution by Finite Element Analysis (FEA). The experimental post and optical fiber illuminating device are intended to increase the polymerization effectiveness of resin cements in the middle and apical regions of root canals. For the 3-point bending test, strictly of the fiber post, the samples were divided into 4 groups (n=10): conventional post (pc), experimental post without filling (pp), with resin cement filling (ppc) and with optical fiber filling (ppf). For the Pull-out test, 100 roots of bovine teeth were restored with intraradicular retainers and composite resin crowns, distributed into 10 groups (n=10), with the following variables: glass fiber post type [conventional (C) or hollow (P)], the photocuring system [with or without the optical fiber illuminating device (O)], the type of resin cement [light cured (F) or dual cured (D)] and aging of the samples [with and without mechanical cycling (C)]. The aging process was performed by mechanical cycling and the samples were submitted to the Pull-out bond strength test. Failure mode analysis was performed using a stereomicroscope. Finite Element Analysis evaluated the stress distribution by von Mises analysis, total strain and maximum principal stress in Ansys Software 19.3. Statistical analysis consisted of the Shapiro-Wilk normality test, 1-, 2- and 3-way analysis of variance (ANOVA) and Tukey test 5%. The means and standard deviations of flexural strength were (MPa): pc = 677 ± 81.1; ppc = 419 ± 23.2; ppf = 200 ± 32.5 and pp = 177 ± 32.8. The means and standard deviations of bond strength were (MPa): CD = 12.2 ± 1.21; PD = 11.1 ± 1.32; PF = 10.9 ± 1.29; POD = 13.7 ± 1.16; POF = 11.9 ± 1.48; CDC = 10.1 ± 1.33; PDC = 9.25 ± 1.11; PFC = 8.37 ± 1.25; PODC = 10.8 ± 0.95 and POFC = 9.82 ± 1.02. The failure mode results were: adhesive between post and cement (56%), mixed predominantly adhesive between cement and dentin (22%), adhesive between cement and dentin (14%) and mixed predominantly adhesive between post and cement (8 %). It was concluded that among the experimental posts, the hollow post group filled with resin cement obtained the highest flexural strength value, the use of the illuminating device increased the results of bond strength in the hollow post groups and there was no difference in the stress distribution among the groups (AU)

Influence of customization and light-curing device on the bond strength of glass fiber posts - in vitro study / Influência da reanatomização e do aparelho fotopolimerizador na resistência de união de pinos de fibra de vidro - estudo in vitro

Introduction: Endodontically treated teeth are usually affected by extensive structure loss requiring the use of intraradicular posts to provide retention and restoration. Objective: An in vitro assessment was performed on the bonding of glass fiber posts to the root dentin. Material and method: Ninety (n = 10) single bovine roots were used in a 3 x 3 x 3 factorial study with subdivided plots: post customization varying the presence and type of resin (without customization, conventional resin, and Bulk Fill resin), light-curing device (Valo, Radii-Cal, Rainbow), and root third (cervical, middle, and apical). Result: For the customization factor, Tukey's test (5%) showed the superiority of the Bulk Fill (8.16 MPa) and Z350 (7.40 MPa) groups compared to the control group (4.92 MPa), without differing from each other. All light-curing devices differed, showing the superiority of Valo (9.36 MPa), Radii (6.96 MPa) as an intermediate, and the inferiority of Rainbow (4.17 MPa). The cervical root third (7.81 MPa) was superior, the apical third was inferior (5.80 MPa), and the middle third (6.88 MPa) was an intermediate without differing from the others. Conclusion: The customization of glass fiber posts increases the bond strength to the root dentin, regardless of the resin used. There was a compromise in the apical third and when using light-curing devices with lower light intensity.

Introdução: Dentes com extensa perda de estrutura podem comprometer a retenção das restaurações ao remanescente dental, onde pinos intraradiculares são indicados. Objetivo: Avaliou-se in vitro a união de pinos de fibra de vidro à dentina radicular em função de diferentes modos de reanatomização, fotopolimerizadores e regionalização radicular. Material e método: Noventa (n=10) raízes bovinas uniradiculares foram usadas num estudo fatorial 3 x 3 x 3 com parcelas subdivididas: Reanatomização do pino, variando a presença e tipo de resina (Sem reanatomização, Resina Convencional e Resina Bulkfill); Fotopolimerizador (Valo, Radii-cal, Rainbow); e Terço radicular (cervical, médio e apical). Resultado: O teste de Tukey (5%) evidenciou para o Fator Reanatomização superioridade dos grupos BulkFill (8.16MPa) e Z350 (7.40MPa) ao grupo Controle (4.92MPa), sem diferirem entre si. Todos os fotopolimerizadores diferiram entre si, com superioridade de Valo (9.36MPa), Radii (6.96MPa) intermediário, e inferioridade de Raiwbow (4.17MPa). O terço radicular cervical (7.81MPa) foi superior e o apical inferior (5.80MPa), com o terço médio (6.88MPa) intermediário e sem diferir dos demais. Conclusão: Conclui-se que a reanatomização de pinos de fibra de vidro aumenta a resistência de união à dentina radicular, independentemente da resina utilizada, havendo prejuízo no terço apical e quando são empregados fotopolimerizadores com menor intensidade luminosa.

¿Cómo mejorar la función eréctil post-prostatectomía radical? / How to improve erectile function after radical prostatectomy?

La prostatectomía radical (PR) es uno de los pilares en el manejo del cáncer próstata. Esta cirugía constituye un reto para el urólogo, quien debe encontrar un balance entre el riesgo de extensión extraprostática y el grado de preservación del tejido neural. A pesar del avance en técnicas quirúrgicas, la incontinencia urinaria y disfunción eréctil (DE) post-prostatectomía continúan impactando considerablemente la calidad de vida de los pacientes. Por lo anterior, un abordaje transdisciplinario desde el momento del diagnóstico es esencial para mejorar los desenlaces funcionales y oncológicos.

Radical prostatectomy (RP) is one of the mainstays in the management of prostate cancer. This surgery constitutes a challenge for the urologist, who must find a balance between the risk of extraprostatic extension and the degree of preservation of neural tissue. Despite advances in surgical techniques, post-prostatectomy urinary incontinence and erectile dysfunction (ED) continue to significantly impact the quality of life of patients. Therefore, a transdisciplinary approach from the time of diagnosis is essential to improve functional and oncologic outcomes.

Estudio microtomográfico de la porosidad en la cementación de postes de fibra / Microtomographic study of the porosity in the cementation of fiber posts

El objetivo de este estudio fue evaluar con microto-mografía los poros existentes entre el cemento de resina, poste de fibra y paredes del conducto en los distintos tercios radiculares en premolares inferio-res. Se utilizaron 15 premolares inferiores unirra-diculares humanos recientemente extraídos. Se les realizó el tratamiento endodóntico, y se obturó con conos de gutapercha y cemento endodóntico a base de resina. Una vez desobturados se procedió a la ce-mentación de los postes. Cada muestra se posicionó en un accesorio personalizado y se escaneó utilizan-do un Microtomógrafo. Con el software CTAn v.1.12 (Bruker-microCT) se analizaron las microtomografías para obtener el volumen de interés (VOI) que permi-tió calcular el área de superficie (mm2) y volumen de cada poro (mm3) entre la dentina y el poste a nivel co-ronal, medio y apical. Los datos fueron analizados me-diante las pruebas estadísticas de Friedman o ANOVA de medidas repetidas. El volumen de los poros entre los tres tercios radiculares mediante la prueba de Friedman, encontró una diferencia global significativa (F = 30,00; p < 0,05). El tercio en donde los poros presentaron un mayor volumen (mm3) fue el tercio coronal (mediana: 0,29250), seguido por los tercios medio (mediana: 0,03200), y apical (mediana: 0,00140). La comparación de la superficie de los poros entre los 3 tercios brindó un resultado análogo al de la comparación del volumen. La mayor superficie (mm2) correspondió al tercio coronal (media ± DE = 1,66377 ± 0,27175), seguido por los tercios medio (media ± DE = 1,16210 ± 0,20343) y apical (media ± DE = 0,41074 ± 0,12641). La microtomografía permitió realizar un análisis cuantitativo y cualitativo de los poros en toda la muestra, sin deterioro de la misma. Se puede concluir que el tercio coronal presenta más poros que el tercio apical con la técnica de cementación utilizada. En cuanto a la superficie y volumen de los poros, los resultados encontrados son similares a los reporta-dos por diversos autores (AU)

The aim of this study was to evaluate with microtomography the existing pores between the resin cement, fiber post and canal walls in the different in thirds of the canal, in single-root lower premolars. Fifteen recently extracted human single root lower premolars were used, endodontically treated, and filled with gutta-percha cones and resin-based endodontic cement. Once unfilled, the posts were cemented. Each sample was positioned on a custom fixture and scanned using a Microtomograph. Each sample was evaluated using CTAn v.1.12 software (Bruker-microCT) to obtain the surface area (mm2), volume of interest (mm3) of each pore between dentin and post at the coronal, middle and apical levels. Data were analyzed using Friedman's tests or repeated measures ANOVA. The volume of the pores between the three root thirds using the Friedman test, a significant global difference was found (F = 30.00; p < 0.05). The third in which the pores presented a greater volume (mm3) was the coronal third (means: 0.29250), followed by the middle (means: 0.03200) and apical (means: 0.00140) thirds. The comparison of the pore surface between the 3 thirds gave an analogous result to that of the volume comparison. The largest surface area (mm2) corresponded to the coronal third (mean ± SD 1.66377 ± 0.27175), followed by the middle (mean ± 1.16210 ± 0.20343) and apical (mean ± 0.41074 ± 0.12641) thirds.Microtomography allowed a quantitative and qualitative analysis of the pores in the entire sample without deterioration. It can be concluded that the coronal third has more pores than the apical third with the cementation technique used. Regarding the surface and volume of the pores, the results found are similar to those reported by various authors (AU)

Influência de um novo dispositivo acessório de fotopolimerização com fibra óptica e pino de fibra de vidro experimental nas propriedades mecânicas, físicoquímicas e adesão dos cimentos resinosos / Influence of a new light curing device with optical fiber and an experimental glass fiber post on the physicochemical, mechanical properties and adhesion of resin cement

O objetivo deste estudo foi avaliar in vitro a influência de um novo dispositivo fotopolimerização e pino de fibra de vidro nas propriedades mecânicas, físicoquímicas e adesão dos cimentos resinosos. Foram utilizados oitenta dentes bovinos, submetidos ao tratamento endodôntico, distribuídos em 5 grupos (n=16): CD (Pino fibra vidro e cimento dual); PF (Pino perfurado e cimento fotoativado); PD (Pino perfurado e cimento dual); POF (Pino perfurado iluminador de fibra óptica e cimento fotoativado); POD (Pino perfurado iluminador de fibra óptica e cimento dual). Os dentes foram preparados para colocação de um protótipo de pino em fibra de vidro que possui um canal interno de diâmetro regular e com conicidade progressiva. A perfuração permite a inserção da fibra óptica ao longo da extensão do pino a fim de possibilitar a ação da luz ao longo de todo o comprimento do conduto radicular. Após a cimentação, os espécimes foram seccionados perpendicularmente, e obtida 1 fatia de 2 mm de espessura do terço apical, médio e cervical. A avaliação mecânica foi realizada através do ensaio de push-out para determinação da resistência adesiva nos terços cervical, médio e apical seguido pela análise da fratura em estereomicroscópio. Os retentores intrarradiculares foram também submetidos ao teste de flexão de 3 pontos para análise do material preenchedor do pino de fibra (n=10). As análises físico - químicas foram realizadas através da determinação do grau de conversão dos cimentos (RAMAN) e análise em espectroscopia de energia dispersiva (EDS) dos monômeros presentes. A adesão foi analisada pela interface de cimentação pelo MEV e reconstrução 3D do novo sistema através do Micro-CT. Os dados obtidos foram analisados estatisticamente pelo ANOVA (um e dois fatores) e comparação múltipla de Tukey, (p<0,05). Os resultados de resistência adesiva evidenciaram que o terço apical obteve o maior valor de resistência adesiva em comparação ao terço médio (p<0,001), o grupo POD do terço apical foi estatisticamente significante em relação ao grupo CD do terço médio (p<0,001). Na analise individual de cada terço, não houve diferença entre os grupos experimentais e o controle (p>0,05). A falha adesiva entre cimento e dentina foi a mais predominante entre todos os grupos e terços. O pino de fibra de vidro (controle) obteve o maior valor de resistência à flexão (p<0,001), seguido do pino de fibra de vidro perfurado preenchido com cimento resinoso (p<0,001). Os maiores valores de GC foram alcançados pelo grupo POD com 82,3% (cervical) 69,9 % (médio) e 76,21% (apical) e o EDS comprovou a presença de componentes químicos adequados. A análise da adesão do novo pino de fibra de vidro comprova uma excelente adaptação no interior do canal radicular nas regiões cervical, médio e apical. Portanto o novo dispositivo com fibra óptica e pino de fibra de vidro experimental aumentaram as propriedades mecânicas, físico-químicas e adesão do cimento resinoso (AU)

The aim of this study was to evaluate in vitro the influence of a new light curing device with optical fiber and experimental glass fiber post on the physicochemical, mechanical, and adhesion properties of resin cements. Eighty bovine teeth were used, submitted to an endodontic treatment, distributed in 5 groups (n=16): CD (Glass fiber post and dual cement); PF (Perforated post and light-cured cement); PD (Perforated post and dual cement); POF (Fiber optic illuminating with a perforated post and lightcured cement); POD (Fiber optic illuminating with a perforated post and dual cement). The teeth were prepared for placement of a glass fiber post prototype, which has an internal canal of regular diameter and progressive taper. The internal perforation extension allows the insertion of the optical fiber along the entire length of the post in order to allow the action of light along the entire length of the root canal.The specimens were sectioned perpendicularly for the tests, and 1 slice approximately 2 mm thick was obtained from the apical, middle and cervical thirds. The mechanical evaluation was carried out through the push-out test to determine the adhesive bond strength, in the cervical, middle and apical thirds, followed by the fracture analysis under a stereomicroscope, the intraradicular post were also submitted to the 3-point bending test for material analys of the fiber post filler (n=10). The physicochemical analyzes were performed by determining the degree of conversion of the cements (RAMAN) of each sample and the analysis of energy dispersive spectroscopy (EDS) of the monomers present. Adhesion was analyzed by the cementation interface and 3D reconstruction of the new system through micro-CT, and finally, SEM analysis of the adhesive interface. The data obtained were analyzed for normality and statistically by ANOVA (one and two ways) and Tukey's multiple comparison (p<0.05). The adhesive bond strength results showed that the apical third had the highest value of adhesive strength compared to the middle third (p<0.001), and the POD group of the apical third was statistically significant in relation to the CD group of the middle third (p<0.001). In the individual analysis of each third, there was no difference between the experimental and control groups (p>0.05). Adhesive failure between cement and dentin was the most prevalent among all groups and thirds. The conventional post (control) had the highest flexural strength value (p<0.001), followed by the perforated fiberglass post filled with resin cement (p<0.001). The POD group achieved the highest GC values with 82.3% (cervical), 69.9% (medium), and 76.21% (apical) and EDS confirmed the presence of adequate chemical components. The analysis of the adhesion of the new fiberglass post proves an excellent adaptation inside the root canal in the cervical, middle and apical regions. Therefore, the new light curing device with optical fiber and experimental glass fiber post improved the resin cement's mechanical, phycochemical, and adhesion. (AU)

Incidencia de fracturas dentales reportadas en la Ciudad de Chihuahua durante la pandemia por COVID-19 / Incidence of dental fractures reported in Chihuahua city during COVID-19 pandemic

Se presentan los casos de fracturas verticales sintomáticos que ameritaron la extracción de las órganos dentales afectados en un periodo de cinco meses durante la pandemia por COVID-19 en la ciudad de Chihuahua, México. Material y métodos: Se recolectaron 26 muestras para el estudio, proporcionadas por los cirujanos dentistas integrantes del Grupo de Egresados de la Facultad de Odontología de la Universidad Autónoma de Chihuahua. Resultados: Los resultados muestran diferencias a lo reportado previamente respecto al tipo de diente involucrado, sexo de los pacientes, restauraciones coronales y tratamientos endodóncicos previos. Conclusiones: Se puede suponer que las modificaciones en el estilo de vida de la población, sumadas a la angustia permanente, pueden ser factores que contribuyen a las fracturas dentales (AU)

There are cases of symptomatic vertical fractures that warranted the extraction of affected teeth are presented, over a period of five months during the COVID-19 pandemic in Chihuahua City, Mexico. Material and methods: 26 samples were collected for the study, provided by the dentist who were members of the Graduate Group of the Faculty of Dentistry of the Autonomous University of Chihuahua. Results: The results show differences from what was previously reported regarding the type of tooth involved, sex of patients, coronal restorations and previous endodontic treatments. Conclusions: It can be assumed that changes in the lifestyle of the population, added to permanent distress, may be factors to preserve dental fractures (AU)

Método de extrusión dentaria unitaria con fines protésicos: caso clínico / Single tooth extrusion method for prosthetic purposes: a clinical case

La pérdida de estructura dentaria por debajo del margen gingival y de la cresta ósea alveolar, ya sea por caries, fracturas traumáticas, desgaste, reabsorción radicular o perforaciones iatrogénicas, dificulta el tratamiento protésico y requiere un abordaje multidisciplinario para conseguir resultados óptimos y estables a largo plazo. Se presenta el caso de una paciente adulta que acude a consulta con la pieza 2.3, que no permite una adecuada restauración protésica sin invadir el espacio biológico. Dentro del abanico de posibilidades terapéuticas se selecciona la extrusión dentaria unitaria guiada, para poder exponer un remanente dentario adecuado supragingival, y conseguir un adecuado efecto ferrule para la posterior rehabilitación protésica. La técnica presentada es eficaz, simple, cómoda, higiénica y útil en pacientes que no desean realizarse tratamiento de ortodoncia en ambas arcadas (AU)

Caries temprana de la infancia: rehabilitación estética, funcional e integral en paciente preescolar. Caso clínico / Early childhood caries: esthetic, functional and comprehensive rehabilitation in preschool patient. A clinical case

La American Academy of Pediatric Dentistry (2020) define a la caries temprana de la infancia (CTI) como una forma severa de caries de etiología multifactorial que compromete la dentición primaria de niños pre-escolares. Afecta principalmente a los incisivos primarios superiores seguidos de los primeros molares primarios, pudiendo promover el desarrollo de hábitos parafuncionales, reducción de la eficacia masticatoria, pérdida de la dimensión vertical, alteraciones en la fonación y defectos estéticos que causan repercusiones emocionales e impacto psicosocial. La insuficiente cantidad y calidad de estructura coronaria remanente, luego de la eliminación del tejido cariado, puede comprometer la adhesión de los materiales de restauración. El objetivo de este trabajo es presentar la atención y el seguimiento a dos años de un paciente preescolar que presenta CTI, que concurrió para su atención a la Cátedra de Odontología Integral Niños de la Facultad de Odontología de la Universidad de Buenos Aires (AU)

Effect of the application of different concentrations of Edta on the adhesion of fiber posts using self-adhesive cements

Abstract The purpose of this study was to analyze the effect of the application of different concentrations of EDTA on the adhesion of fiber posts to root dentin using self-adhesive resin cements. After endodontic treatment, 78 single roots were randomly divided into six groups (n = 13) according to the combination of the following factors: surface dentin treatment - control (distilled water), 17% EDTA and 24% EDTA; and self-adhesive resin cement - RelyX U200 (RX); and Multilink Speed (ML). After fiber post cementation, six slices were obtained for each root. Ten roots of each group were used for bond strength (BS) and three for microhardness (MH) evaluations. Data obtained from BS and MH tests for each resin cement were subjected to two-way ANOVA (surface treatment vs. root region) and to a post-hoc Tukey's test (α = 0.05). The lowest BS value was observed in the 24% EDTA group for RX cement, whereas the highest values for ML cement were observed for the control group in the middle and apical regions. In the MH test, the lowest value for RX was observed for 24% EDTA in the cervical region, whereas and the highest value for the ML cement was observed in the control group. Regarding both self-adhesive resin cements tested, the application of 24% EDTA was not able to improve the adhesion of fiber posts to root canal.

Resistencia adhesiva de postes de fibra a los diferentes tercios del conducto radicular / Adhesive resistance of fiber posts to different thirds of the root canal

En los últimos años resulta de elección la utilización de postes de fib ra en la rehabilitación de piezas endodónticamente tratadas. La adhesión entre poste, agente cementante y dentina radicular permitiría lograr una retención de la estructura dentro de las paredes del conducto. El objetivo de este estudio fue comparar la resistencia adhesiva en los tercios cervical, medio y apical, entre la dentina del conducto radicular y el cemento adhesivo utilizado en la cementación de postes de fibra. Se utilizaron 30 premolares inferiores uniradiculares humanos, recientemente extraídos, se realizaron los tratamientos endodónticos, se desobturaron y realizaron las preparaciones con la fresa conformadora número 3 para la cementación de postes White Post DC especial número 3 con cemento Paracore utilizando el protocolo adhesivo del mismo sistema. Las muestras fueron incluidas en acrílico cristal, cortadas en forma perpendicular al eje mayor de la pieza con una máquina de corte y por último se procedió a medir los valores de adhesión de los postes a la superficie interna de los conductos en los tres tercios con la prueba push-out mediante una máquina de ensayo universal. Los resultados arrojaron que las resistencias (media +- DE, MPa) en los tercios cervical, medio y apical, fueron 8,74 +- 3,12, 9,38 +- 2,29 y 11,11 +- 2,95, respectivamente. En el tercio apical se registró mayor resistencia. Considerando las limitaciones de esta investigación, se puede concluir que la cementación de postes de fibra con cementos resinosos, presenta mayores valores en el tercio apical y menores en el tercio cervical del conducto radicular con técnica de Push-out (AU)

Application of polymeric porcelain color-masking cast posts in the aesthetic repair of anterior teeth: a case report / 华西口腔医学杂志

Many patients with large-area tooth defect need cast post-core crown restoration. However, the color defect of the cast post-core will affect the final restorative result, especially that of the anterior teeth. A new technology of color masking by applying CERAMAGE polymeric porcelain to the cast metal post-core surface improves the color of a full-ceramic restoration of anterior teeth and may provide a new alternative for the aesthetic repair of anterior teeth with a large area of defective tooth.

Potential of a new cone-beam ct software for blooming artifact reduction

Abstract This study evaluated the dimensions of intraradicular posts using a new cone beam CT (CBCT) software, and verified the potential of blooming artifact reduction. Sixty-three single-rooted human teeth were shaped, obturated, prepared for intracanal post placement and distributed into three groups: G1: anatomically customized prefabricated glass fiber posts; G2: low-fusion alloy posts; G3: gold alloy posts. After post fabrication and luting with RelyX U200®, specimens were sectioned axially at 9 mm from the root apex, and markings were made on the root surfaces (X-, Y- and Z-axes). The dimensions of the original posts (control group) were measured using a digital micrometer. CBCT scans of the teeth were obtained using a PreXion 3D Elite® scanner. Posts were measured on CBCT scans using DICOM files and the e-Vol DX software. A specific filter, Blooming Artefact Reduction (BAR), was developed to analyze intracanal posts. Statistical data were evaluated using the Van de Waerden nonparametric analysis of variance and, after that, normalized data were analyzed using the Tukey test. The level of significance was set at α = 5%. The measures of the anatomical prefabricated, low-fusion alloy and gold alloy intracanal posts obtained using the e-Vol DX CBCT software and a micrometer were not significantly different (p>0.05). The use of the BAR filter of the e-Vol DX software application did not induce any dimensional differences on CBCT scans of intracanal posts when compared with measurements made with a micrometer on original posts. The use of the BAR filter eliminated blooming artifacts.

Resumo Este estudo avaliou as dimensões de pinos intrarradiculares usando um novo software de tomografia computadorizada de feixe cônico (TCFC) e um micrômetro digital, e verificou o potencial da redução do artefato de contraste do branco. Sessenta e três dentes humanos unirradiculares foram modelados, obturados, preparados para colocação de pinos e distribuídos em três grupos: G1: pino de fibra de vidro pré-fabricado anatômico; G2: pino metálico de liga de baixa fusão; G3: pino metálico de liga de ouro. Após a confecção e cimentação dos pinos com RelyX U200®, os espécimes foram cortados no sentido axial a 9 mm do ápice radicular, sendo efetuadas marcações em suas superfícies radiculares (eixos X, Y e Z) para orientação das medidas e sincronizações das imagens. Foi utilizado um micrômetro digital para a mensuração das dimensões dos pinos originais (grupo controle) associado ao microscópio operatório. Posteriormente, as imagens em TCFC foram obtidas usando o PreXion 3D Elite®. Para a mensuração dos pinos nas imagens de TCFC utilizou-se o arquivo DICOM e a ferramenta de medida do software e-Vol DX, configurada para medidas milesimais, com o filtro BAR (Blooming Artifact Reduction). Os dados estatísticos foram avaliados com a análise de variância não-paramétrica de Van der Waerden, seguida pelo Teste de Tukey aplicado aos dados normalizados. O nível de significância foi de α = 5%. Os resultados mostraram que as medidas dos diâmetros dos pinos intrarradiculares (fibra de vidro anatômico, metálico liga de baixa fusão, e em liga de ouro) usando o software e-Vol DX e o micrômetro não mostram diferenças significativas entre si. O uso do filtro BAR do software e-Vol DX não induziu diferenças dimensionais nas imagens de TCFC dos pinos quando comparadas às medidas realizadas com o micrômetro sobre os pinos originais. O uso do filtro BAR eliminou artefatos de contraste do branco.

Influence of sonic vibration and cement type on the bond strength of fiberglass posts after aging / Influencia de la vibración sónica y el tipo de cemento en la fuerza de unión de los postes de fibra de vidrio después del envejecimiento

Introduction: This study evaluated the influence of sonic vibration and thermocycling on the bond strength of fiberglass posts using conventional dual-cured and self-adhesive resin cements. Material and Methods: Ninety-six single-rooted endodontically treated teeth were divided randomly into eight groups according to the cement used (dual-cured or self-adhesive resin cement), use of sonic vibration during post accommodation, and aging conditions (24h in distilled water or 5,000 thermal cycles). The fiberglass posts (White Post DC1, FGM) were cleaned with alcohol, treated with silane and cemented with dual-cured (Allcem Core, FGM) or with self-adhesive resin cement (seT, SDI). For groups in which sonic vibration was used, the posts were accommodated, and sonic vibration was applied for 10 s using a special tip placed on top of the post (Sonic Smart Device, FGM). Pull-out tests were performed after storage in distilled water for 24h at 37°C or after thermocycling (5000 cycles, at 5°C and 55°C). The results were evaluated using three-way ANOVA and Tukey's test (α=0.05). Results: Significant differences were not observed between the bond strengths of dual-cured (87.93±41.81 N) and self-adhesive cement (82.53±41.43 N). Bond strength for the sonic vibration groups (100.36±42.35 N) was significantly higher than for groups without sonic vibration (70.13±34.90 N). There were significant differences between specimens subjected to thermocycling (98.33±39.42 N) and those stored for 24h in distilled water (72.16±39.67 N). Conclusion: It can be concluded that both sonic vibration and thermocycling significantly improved bond strength of fiberglass posts with the two evaluated resin cements.

Introducción: Este estudio evaluó la influencia de la vibración sónica y el termociclado en la fuerza de unión de los postes de fibra de vidrio utilizando cementos de resina autoadhesivos y de curado dual convencionales Material y Métodos: Se dividieron aleatoriamente noventa y seis dientes tratados endodónticamente de raíz única en ocho grupos según el cemento utilizado (cemento de resina de curado dual o autoadhesivo), el uso de vibración sónica durante la acomodación posterior y las condiciones de envejecimiento (24 horas agua destilada o 5.000 ciclos térmicos). Los postes de fibra de vidrio (White Post DC1, FGM) se limpiaron con alcohol, se trataron con silano y se cementaron con cemento de curado dual (Allcem Core, FGM) o con cemento de resina autoadhesivo (seT, SDI). Para los grupos en los que se utilizó vibración sónica, se acomodaron los postes y se aplicó la vibración sónica durante 10 s utilizando una punta especial colocada en la parte superior del poste (Sonic Smart Device, FGM). Las pruebas de extracción se realizaron después del almacenamiento en agua destilada durante 24 horas a 37ºC o después del termociclado (5000 ciclos, a 5ºC y 55ºC). Los resultados se evaluaron mediante ANOVA de tres vías y la prueba de Tukey (α = 0.05). Resultados: No se observaron diferencias significativas entre las resistencias de adhesión del cemento de curado dual (87,93 ± 41,81 N) y el cemento autoadhesivo (82,53 ± 41,43 N). La fuerza de unión para los grupos de vibración sónica (100,36 ± 42,35 N) fue significativamente mayor que para los grupos sin vibración sónica (70,13 ± 34,90 N). Hubo diferencias significativas entre los especímenes sometidos a termociclado (98,33 ± 39,42 N) y los almacenados durante 24 h en agua destilada (72,16 ± 39,67 N). Conclusión: Se puede concluir que tanto la vibración sónica como el termociclado mejoraron significativamente la fuerza de unión de los postes de fibra de vidrio con los dos cementos de resina evaluados.

Effects of 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide on adhesion of posts in teeth obturated with different sealers

Abstract The aim of this study was to evaluate the effect of 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide (EDC) on bond strength of fiberglass posts in root canals obturated with different endodontic sealers. Seventy-eight mandibular premolars were obturated with three sealers (n=26): Endofill (END), AH Plus (AHP), and Endosequence BC Sealer (EBS). After preparation of the post space, two subgroups were formed according to the cementation of the posts (n=13): with EDC (EDC), and without EDC (control - CON). The specimens were submitted to a pull-out test, failure mode classification, and root canal surface evaluation by scanning electron microscopy after post displacement. Regarding the bond strength, a significant difference between the EDC and CON subgroups occurred only in the END (p=0.001). No difference was detected among the CON subgroups (p=0.339). However, among the EDC subgroups, AHP presented significantly higher values (END versus AHP: p=0.001; AHP versus EBS: p=0.016). Upon classification of failure modes, score 1 (≥ 50% of cement) was the most commonly observed, except for the END + EDC. Remains of endodontic sealers and resin cements were found in the cervical third, but without statistical difference (p=0.269), while in the middle third, difference occurred (p=0.004). In conclusion, EDC decreases bond strength when associated with END sealer, without changing the failure mode between the resin cement and fiberglass post. The best performance was observed when EDC was combined with AHP sealer.

Resumo O objetivo deste estudo foi avaliar o efeito da 1-etil-3- (3-dimetilaminopropil) carbodiimida (EDC) na resistência de união de pinos de fibra de vidro em canais radiculares obturados com diferentes cimentos endodônticos. Setenta e oito pré-molares inferiores foram obturados com três cimentos endodônticos (n=26): Endofill (END), AH Plus (AHP) e Endosequence BC Sealer (EBS). Após o preparo do espaço para pino, dois subgrupos formaram-se conforme a cimentação dos pinos (n=13): com EDC e sem EDC (controle - CON). Os espécimes foram submetidos ao teste pull-out, classificação do modo de falha e avaliação da superfície do canal radicular por microscopia eletrônica de varredura após o deslocamento. Quanto à força de resistência de união, uma diferença estatisticamente significativa ocorreu entre os subgrupos EDC e CON apenas no END (p=0,001). Não foi detectada diferença entre os subgrupos CON (p=0,339). Contudo, no subgrupo EDC, o AHP apresentou maiores valores (END versus AHP: p=0,001; AHP versus EBS: p=0,016). Acerca da classificação dos modos de falha, o escore 1 (≥50% de cimento) foi o mais comumente observado, exceto para END + EDC. Restos de cimentos endodônticos e cimentos resinosos foram encontrados no terço cervical, mas sem diferença estatística (p=0,269), enquanto no terço médio, houve diferença (p=0,004). Em conclusão, o EDC diminui a resistência de união quando associado ao cimento END, sem alterar o modo de falha entre o cimento resinoso e o pino de fibra de vidro. O melhor desempenho foi observado quanto o EDC foi usado com o cimento AHP.

Effect of silver antibacterial agents on bond strength of fiber posts to root dentin

Abstract This study was conducted to evaluate whether antibacterial pretreatment irrigation with silver nanoparticles (SNPs) and silver diamine fluoride (SDF) has any effect on bond strength of fiber posts cemented with three types of resin cements in root canal space. Fifty-four endodontically treated maxillary central incisor roots were prepared for fiber post (FRC Postec Plus NO.3, Ivoclar Vivadent) cementation and divided into nine groups in terms of three cement types and two pretreatments with silver antibacterial agents. The cements were as follows: an etch-and-rinse cement (ER, Excite DSC/Variolink N), a self-etch cement (SE, ED Primer/Panavia F2.0), and a self-adhesive cement (SA, Panavia SA Luting Plus). For each cement, the control group was with no treatment and two experimental groups were with SNPs and SDF treatments that were used after acid-etching for ER cement and after EDTA treatment for SE and SA cements. After fiber post cementation, each bonded root was horizontally sectioned into 1-mm thickness microslices to create two slices for each root region (apical, middle and coronal) and underwent push-out bond strength (PBS) test. Data in MPa were analyzed with two-way ANOVA and Tukey test (p=0.05). The interaction of the pretreatment type and cement type was significant (p<0.001). SNPs and SDF significantly increased PBS with ER cement (p≤0.04). This positive effect was also marginally significant for SDF with SE cement (p=0.049). For SA cement, SNPs showed a significant positive effect, but SDF had a significant adverse effect on PBS (p<0.001). The effect of pretreatment with silver antibacterial agents prior to adhesive cementation of fiber posts depends on the resin cement used. Contrary to SNPs with beneficial or no significant effect on bonding for all cements, SDF exhibited a deleterious effect with self-adhesive cement.

Resumo Este estudo foi conduzido para avaliar se a irrigação de pré-tratamento antibacteriano com nanopartículas de prata (SNPs) e fluoreto de diamina de prata (SDF) tem algum efeito na resistência de união de pinos de fibra cimentados com três tipos de cimentos resinosos no espaço do canal radicular. Cinquenta e quatro raízes de incisivos centrais superiores tratadas endodonticamente foram preparadas para cimentação de pino de fibra (FRC Postec Plus NO.3, Ivoclar Vivadent) e divididas em nove grupos em termos de três tipos de cimento e dois pré-tratamentos com agentes antibacterianos de prata. Os cimentos foram os seguintes: um cimento etch-and-rinse (ER, Excite DSC / Variolink N), um cimento autocondicionante (SE, ED Primer / Panavia F2.0) e um cimento autoadesivo (SA, Panavia SA Luting Plus). Para cada cimento, o grupo controle foi sem tratamento e dois grupos experimentais foram com SNPs e SDF tratamentos que foram usados após o condicionamento ácido para o cimento ER e após o tratamento com EDTA para os cimentos SE e SA. Após a cimentação do pilar de fibra, cada raiz ligada foi seccionada horizontalmente em microclimas de 1 mm de espessura para criar duas fatias para cada região da raiz (apical, média e coronal) e submetida ao teste de resistência de união por push-out (PBS). Os dados em MPa foram analisados ​​com ANOVA de dois fatores e teste de Tukey (p = 0,05). A interação do tipo de pré-tratamento e tipo de cimento foi significativa (p<0,001). SNPs e SDF aumentaram significativamente o PBS com cimento ER (p≤0,04). Este efeito positivo também foi marginalmente significativo para SDF com cimento SE (p = 0,049). Para o cimento SA, os SNPs mostraram um efeito positivo significativo, mas o SDF teve um efeito adverso significativo no PBS (p <0,001). O efeito do pré-tratamento com agentes antibacterianos de prata antes da cimentação adesiva dos pinos de fibra depende do cimento resinoso utilizado. Ao contrário dos SNPs com efeito benéfico ou nenhum efeito significativo na adesão para todos os cimentos, o SDF exibiu um efeito deletério com o cimento autoadesivo.

Preparación Ultrasónica del Espacio Protésico y su Influencia en la Resistencia Adhesiva de Postes de Fibroresina en Conductos Ovalados / Ultrasonic Preparation of the Prosthetic Space and its Influence on the Bond Strength of Fiber Post in Oval-Shaped Canals

RESUMEN: Paredes sin instrumentar y con material obturador endodóntico residual pueden elevar la posibilidad de la falla adhesiva de postes de fibroresina. Las fresas de desobturación y conformación del espacio protésico poseen una sección circular, lo que dificulta una adecuada preparación y limpieza de las paredes de los conductos ovales. El objetivo del presente estudio fue evaluar la capacidad de limpieza ultrasónica del espacio protésico y cómo ésta influyó en la resistencia a la tracción de postes de fibroresina en conductos ovales. Se utilizaron 30 premolares con conducto ovalado divididos aleatoriamente en 3 grupos de estudio (n=10), siendo: grupo A: preparación rotatoria con complemento ultrasónico, grupo B: preparación rotatoria y grupo C: grupo control. Postes de fibra de vidrio fueron cementados y luego de 7 días se realizaron cortes de un milímetro de grosor del tercio cervical y medio de cada muestra y se evaluó microscópicamente el área de gutapercha remanente y área efectiva de adhesión. Estos fueron sometidos a una prueba de push out evaluando la resistencia adhesiva de los postes. Finalmente fueron observados microscópicamente para analizar tipo de falla. Los resultados se analizaron mediante el test de ANOVA, Bonferroni, Kruskal-Wallis y Mann Whitney (p < 0.05), registrando diferencias estadísticamente significativas en la resistencia a tracción, área de gutapercha remanente y área disponible para la adhesión; además de una relación directa entre gutapercha remanente y menor resistencia a la tracción. Conclusiones: La preparación ultrasónica del espacio protésico aumenta la resistencia a la tracción de postes de fibroresinas cementados en conductos ovalados.

ABSTRACT: Untouched canal walls with residual filling materials can increase the probability of adhesive failure of fiber posts. The drills used for desobturation and conformation of the prosthetic space, has a circular cross section, which does not allow a proper preparation and cleaning of oval-shaped canal walls. The objective of the study was to evaluate the ultrasonic cleaning of the prosthetic space and how this influences the adhesive strength of fiber posts in oval-shaped canals. Thirty (30) oval-shaped canal premolars were randomly divided into 3 groups (n = 10): Group A: rotary desobturation with ultrasonic complement, group B: rotary desobturation without ultrasonic complement and group C: control group. Fiberglass posts were cemented; after 7 days, one-millimeter slices were performed, one of the cervical and another from the middle third of the root. The slices were analyzed under an optical microscope to evaluate remaining gutta percha and effective adhesion area. Samples were subjected to a push-out test to evaluate bond strength of the fiber resin posts. Finally, samples were evaluated microscopically to analyze the type of failure. The results were analyzed using ANOVA, Bonferroni, KruskalWallis and Mann Whitney test (p < 0.05), recording statistically significant differences in bond strength, remaining gutta-percha area and clean walls for adhesion; In addition, to a direct relationship between remaining gutta percha and lower adhesive strength, the ultrasonic preparation of the prosthetic space increases bond strength of fiber posts in oval canals.

Effect of ethanol-wet bonding on porosity and retention of fiberglass post to root dentin

Abstract: This in vitro study aimed to assess the effects of different pretreatments used to adapt glass-fiber posts cemented to root canals with different resin cements, regarding porosity percentage and bond strength. Twelve bovine incisor roots were prepared with Largo drills. After post space preparation, the specimens were randomized into two types of pretreatment groups (n = 3): water-wet bonding and ethanol-wet bonding. After the post were cemented, the roots were stored in 100% humidity at room temperature for 7 days. The samples were scanned by microcomputed tomography (micro-CT). Images were reconstructed by NRecon software, and CTAn software was used to analyze the porosity percentage (%) at the luting interface. Evaluation of the push-out bond strength was performed by serially cutting the roots, and submitting the slices to testing. Additionally, the resin cement post-gel shrinkage values (%) were measured using the strain-gauge method (n = 10). Data were analyzed by two-way ANOVA, Tukey's test and Student's t test (a = 0.05). The roots prepared with ethanol-wet bonding using RelyX™ U200 had significantly lower porosity in the coronal and apical thirds (p < 0.05). The group prepared with ethanol-wet bonding using RelyX™ ARC presented better bond strength results in the coronal and apical thirds (p < 0.05). RelyX™ ARC (0.97%) produced a higher post-gel shrinkage value than RelyX™ U200 (0.77%). Canals pretreated with ethanol-wet bonding presented better outcomes in regard to porosity percentage and push-out bond strength.

O uso de pino de fibra em dentes tratados endodonticamente / Glass fiber post use in endodontically treated teeth

Este estudo envolve um estudo in sílico, um ensaio clínico randomizado e duas revisões sistemáticas com o objetivo de compreender a influência dos pinos de fibra (PF) na resistência à fratura de dentes tratados endodonticamente e restaurados e também, avaliar o efeito de tratamentos químicos dentinários na resistência de união da cimentação do PF na dentina intrarradicular. Estudo in silico: seis modelos tridimensionais de incisivos centrais superiores foram projetados em um software de desenho e se diferenciaram de acordo com a presença ou ausência de PF de vidro e espessura das facetas diretas de resina composta (0,5, 0,7 e 1 mm). Foram transferidos para o software ANSYS 17.2, no qual movimentos funcionais foram simulados com carga de 100 N a 45º nas faces linguais. Os modelos com PF apresentaram melhor distribuição de tensões e menores valores de tensão máxima na região da dentina e faceta. Ensaio clínico randomizado: selecionou-se 50 pacientes com necessidade de faceta em um incisivo central ou lateral superior tratado endodonticamente. Foram divididos em dois grupos (n=25) de acordo com o uso ou não de PF de vidro. Após 6 e 12 meses do tratamento, avaliações clínicas e radiográficas em relação à presença e tipo de fratura, apontaram taxas de sucesso de 96% para o grupo sem PF e 100% para o grupo com PF, sem diferenças estatisticamente significativas. Revisão sistemática e metanálise: as bases de dados PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library e Embase foram acessadas com a estratégia de busca definida de acordo com a pergunta: ' O uso de PF influencia na resistência à fratura de dentes anteriores tratados endodonticamente e restaurados, quando comparados com o não uso de PF? ' Foram incluídos 32 estudos in vitro. Após a metanálise, pode-se concluir que o uso de PF favoreceu a resistência à fratura dos dentes, principalmente para dentes com preparo para faceta e cavidades cervicais e os PF de vidro mostraram resultados mais satisfatórios. Revisão sistemática e metanálise em rede: as bases PubMed, Scopus, Web of Science, LILACS, BBO e Cochrane Library foram acessadas com a estratégia de busca definida de acordo com a pergunta: ' Tratamentos químicos da dentina intrarradicular afetam a força de união de PF em dentes tratados endodonticamente? ' Foram incluídos 61 estudos in vitro. Foi realizada a avaliação do risco de viés para estudos in vitro. Após a metanálise em rede e análise de SUCRA para cada estratégia de cimentação (adesivo autocondicionante, adesivo de condicionamento total e cimento autoadesivo), concluiu-se que os tratamentos químicos da dentina intrarradicular que melhoram a força de união da cimentação de PF são o acetato de etila para adesivos autocondicionantes, NaOCl em baixa concentração para adesivos de condicionamento total e extrato de semente de uva para cimentos autoadesivos(AU)

This study involves an in silico study, a randomized clinical trial, and two systematic reviews to understand the influence of fiber posts (FP) on fracture strength of endodontically treated and restored teeth and also to evaluate the effect of dentin chemical treatments on bond strength of FP cementation in intraradicular dentin. In silico study: six three-dimensional models of maxillary central incisors were designed in a CAD software and differed according to the presence or absence of glass FP and thickness of composite resin direct veneer (0.5, 0.7 and 1 mm). They were transferred to the ANSYS 17.2 software, in which functional movements were simulated with a load of 100N at 45º on the lingual surfaces. The models with glass FP showed better stress distribution and lower maximum stress values in the dentin and veneer region. Randomized clinical trial: 50 patients who needed veneer treatment of an endodontically treated central or lateral maxillary incisor were selected. They were divided into two groups (n=25) according to the use or not of glass FP. Direct composite resin veneers were performed for two groups. In the FP group, they were cemented with self-adhesive resin cement. Descriptive data of the population and restored teeth were collected. After 6 and 12 months of treatment, clinical and radiographic evaluations regarding the presence and type of fracture indicated success rates of 96% for the group without FP and 100% for the group with FP, with no statistically significant differences. Systematic review and meta-analysis: PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library and Embase databases were accessed with the search strategy defined according to the question: "Does the use of FP influence on fracture strength of endodontically treated and restored anterior teeth when compared to non-use of fiber posts?" Thirty-two in vitro studies were included. Bias risk assessment was based on existing systematic reviews of in vitro studies. After the meta-analysis, it can be concluded that the use of FP favored the fracture resistance of teeth, especially for teeth with veneer preparation and cervical cavities and the glass FP showed more satisfactory results. Systematic review and network meta-analysis: PubMed, Scopus, Web of Science, LILACS, BBO and Cochrane Library databases were accessed with the search strategy defined according to the question: 'Do intraradicular dentin chemical pretreatments affect the bond strength of fiber posts for endodontically treated teeth?' Sixty-one in vitro studies were included. Bias risk assessment for in vitro studies was performed. After network meta-analysis and SUCRA analysis for each cementation strategy (self-etching adhesive, total etching adhesive and self-adhesive cement), it was concluded that the intraradicular dentin chemical treatments that improve the bond strength of FP cementation are ethyl acetate for self-etching adhesive, low concentration NaOCl for total etching adhesives and grape seed extract for selfadhesive cements(AU)