Effect of root canal preparation, type of endodontic post and mechanical cycling on root fracture strength

Objective: To evaluate the impact of the type of root canal preparation, intraradicular post and mechanical cycling on the fracture strength of roots. Material and Methods: eighty human single rooted teeth were divided into 8 groups according to the instruments used for root canal preparation (manual or rotary instruments), the type of intraradicular post (fiber posts- FRC and cast post and core- CPC) and the use of mechanical cycling (MC) as follows: Manual and FRC; Manual, FRC and MC; Manual and CPC; Manual, CPC and MC; Rotary and FRC; Rotary, FRC and MC; Rotary and CPC; Rotary, CPC and MC. The filling was performed by lateral compactation. All root canals were prepared for a post with a 10 mm length, using the custom #2 bur of the glass fiber post system. For mechanical cycling, the protocol was applied as follows: an angle of incidence of 45°, 37°C, 88 N, 4 Hz, 2 million pulses. All groups were submitted to fracture strength test in a 45° device with 1 mm/ min cross-head speed until failure occurred. Results: The 3-way ANOVA showed that the root canal preparation strategy (p<0.03) and post type (p<0.0001) affected the fracture strength results, while mechanical cycling (p=0.29) did not. Conclusion: The root canal preparation strategy only influenced the root fracture strength when restoring with a fiber post and mechanical cycling, so it does not seem to be an important factor in this scenario. .

Root Canal Filling: Fracture Strength of Fiber-Reinforced Composite-Restored Roots and Finite Element Analysis

The aims of this study were to evaluate the effect of root canal filling techniques on root fracture resistance and to analyze, by finite element analysis (FEA), the expansion of the endodontic sealer in two different root canal techniques. Thirty single-rooted human teeth were instrumented with rotary files to a standardized working length of 14 mm. The specimens were embedded in acrylic resin using plastic cylinders as molds, and allocated into 3 groups (n=10): G(lateral) - lateral condensation; G(single-cone) - single cone; G(tagger) - Tagger's hybrid technique. The root canals were prepared to a length of 11 mm with the #3 preparation bur of a tapered glass fiber-reinforced composite post system. All roots received glass fiber posts, which were adhesively cemented and a composite resin core was built. All groups were subjected to a fracture strength test (1 mm/min, 45°). Data were analyzed statistically by one-way ANOVA with a significance level of 5%. FEA was performed using two models: one simulated lateral condensation and Tagger's hybrid technique, and the other one simulated the single-cone technique. The second model was designed with an amount of gutta-percha two times smaller and a sealer layer two times thicker than the first model. The results were analyzed using von Mises stress criteria. One-way ANOVA indicated that the root canal filling technique affected the fracture strength (p=0.004). The G(lateral) and G(tagger) produced similar fracture strength values, while G(single-cone) showed the lowest values. The FEA showed that the single-cone model generated higher stress in the root canal walls. Sealer thickness seems to influence the fracture strength of restored endodontically treated teeth.

O objetivo deste estudo foi avaliar o efeito da técnica de obturação na resistência à fratura de raízes e analisar, por meio de análise de elementos finitos (AEF), a expansão do cimento endodôntico em duas diferentes técnicas de obturação. Trinta dentes humanos unirradiculares foram instrumentados com limas rotatórias, com um comprimento de trabalho padronizado (14 mm). Os espécimes foram embutidos em um cilindro plástico com resina acrílica, e distribuídos em 3 grupos (n=10): G(lateral) - condensação lateral; G(cone único) - cone único; G(tagger) - técnica híbrida de Tagger. Os canais radiculares foram preparados num comprimento de 11 mm com a broca de preparo do sistema de pinos de fibra reforçado por compósito. Todas as raízes receberam pinos de fibra de vidro, as quais foram adesivamente cimentadas, e a reconstrução do núcleo foi realizada com resina composta. Todos os grupos foram submetidos ao teste de resistência à fratura (1 mm/min, 45°). Os dados foram submetidos ao teste de análise de variância 1 fator. A AEF foi executada através de dois modelos: um simulou a técnica da condensação lateral e a técnica híbrida de Tagger, e o outro simulou a técnica do cone único. O último foi desenhado com a guta-percha duas vezes menor e com a espessura de cimento duas vezes maior que o primeiro modelo. Os resultados foram analisados usando o critério de tensão Von Mises. A análise de variância a um fator indicou que a técnica de obturação afetou a resistência à fratura (p=0.004). G(lateral) e G(tagger) obtiveram similares valores de resistência à fratura, enquanto G(cone único) apresentou os menores valores. A AEF mostrou que o modelo do cone único gerou um aumento de tensão nas paredes do canal radicular. A espessura do cimento pareceu influenciar a resistência à fratura dos dentes tratados endodonticamente e restaurados.

Fracture resistance of bovine incisors restored with different glass fiber posts: Effect of the diameter of fiber post.

Aim: Compare the effect of three post designs on the fracture resistance and failure modes of composite core - fiber post - crownless tooth sets. Materials and Methods: Ninety bovine incisors were selected and divided into nine groups of 10 specimens. The teeth were assigned to three groups based on the post design: Cylindrical, tapered, and double-tapered. Each group was subdivided into three subgroups in accordance with the diameter of the post: Small (No.1), medium (No.2), and large (No.3). The Panavia F system was used for post cementation. The specimens were mounted in acrylic resin blocks with a layer of silicone rubber covering the roots. A universal testing machine compressively loaded the specimens from the palatal side at a crosshead speed of 1 mm/min and at an angle of 135Ί to the long axis of the teeth, until failure occurred. The failure mode was determined by a stereomicroscope inspection of all the specimens. Data were analyzed by one-way ANOVA and the Tukey test (P < 0.05). Results: The fracture resistance was affected by the type of post (P < 0.0001). A narrower diameter for all of the post systems allowed for higher resistance. The main failure mode in the large cylindrical group was catastrophic fractures, while the main failures in the other eight groups were favorable. Conclusion: Narrower diameter posts showed higher fracture resistance. The dominant failure pattern was repairable fracture, except for those with large cylindrical groups.

Finite element analysis and fracture resistance testing of a new intraradicular post

OBJECTIVES: The objective of the present study was to evaluate a prefabricated intraradicular threaded pure titanium post, designed and developed at the São José dos Campos School of Dentistry - UNESP, Brazil. This new post was designed to minimize stresses observed with prefabricated post systems and to improve cost-benefits. MATERIAL AND METHODS: Fracture resistance testing of the post/core/root complex, fracture analysis by microscopy and stress analysis by the finite element method were used for post evaluation. The following four prefabricated metal post systems were analyzed: group 1, experimental post; group 2, modification of the experimental post; group 3, Flexi Post, and group 4, Para Post. For the analysis of fracture resistance, 40 bovine teeth were randomly assigned to the four groups (n=10) and used for the fabrication of test specimens simulating the situation in the mouth. The test specimens were subjected to compressive strength testing until fracture in an EMIC universal testing machine. After fracture of the test specimens, their roots were sectioned and analyzed by microscopy. For the finite element method, specimens of the fracture resistance test were simulated by computer modeling to determine the stress distribution pattern in the post systems studied. RESULTS: The fracture test presented the following averages and standard deviation: G1 (45.63±8.77), G2 (49.98±7.08), G3 (43.84±5.52), G4 (47.61±7.23). Stress was homogenously distributed along the body of the intraradicular post in group 1, whereas high stress concentrations in certain regions were observed in the other groups. These stress concentrations in the body of the post induced the same stress concentration in root dentin. CONCLUSIONS: The experimental post (original and modified versions) presented similar fracture resistance and better results in the stress analysis when compared with the commercial post systems tested (08/2008-PA/CEP).

Resistance to compression of weakened roots subjected to different root reconstruction protocols

OBJECTIVE: This study evaluated, in vitro, the fracture resistance of human non-vital teeth restored with different reconstruction protocols. MATERIAL AND METHODS: Forty human anterior roots of similar shape and dimensions were assigned to four groups (n=10), according to the root reconstruction protocol: Group I (control): non-weakened roots with glass fiber post; Group II: roots with composite resin by incremental technique and glass fiber post; Group III: roots with accessory glass fiber posts and glass fiber post; and Group IV: roots with anatomic glass fiber post technique. Following post cementation and core reconstruction, the roots were embedded in chemically activated acrylic resin and submitted to fracture resistance testing, with a compressive load at an angle of 45º in relation to the long axis of the root at a speed of 0.5 mm/min until fracture. All data were statistically analyzed with bilateral Dunnett's test (α=0.05). RESULTS: Group I presented higher mean values of fracture resistance when compared with the three experimental groups, which, in turn, presented similar resistance to fracture among each other. None of the techniques of root reconstruction with intraradicular posts improved root strength, and the incremental technique was suggested as being the most recommendable, since the type of fracture that occurred allowed the remaining dental structure to be repaired. CONCLUSION: The results of this in vitro study suggest that the healthy remaining radicular dentin is more important to increase fracture resistance than the root reconstruction protocol.

Comparison of fracture resistance of teeth restored with ceramic inlay and resin composite: An in vitro study.

Aim: The aim of this study was to evaluate the in vitro fracture resistance of teeth restored with bonded ceramic inlay and direct composite resin restoration in comparison to the normal tooth. Materials and Methods: This study evaluated the fracture strength of the teeth restored with bonded ceramic inlay and direct composite resin restoration in comparison to the normal teeth. Thirty intact human maxillary first premolars were assigned to three groups: Group 1 - comprising sound/unprepared teeth (control). Group 2 - comprising of Class-II direct composite resin restored teeth and Group 3 - comprising Class-II ceramic inlay restored teeth. Cavities were prepared with occlusal width of 1/3 intercuspal distance and 2 mm deep pulpally. Group 2 teeth were restored with hybrid composite resin (Z350 3M ESPE, USA) and group 3 teeth were restored with Vitadur Alpha alumina (Ivoclare Vivadent, Liechtenstein, Europe). Ceramic inlay was bonded with adhesive cement (rely X resin cement of 3MESPE, USA). The specimens were subjected to a compressive load until they fractured. Data were analyzed statistically by unpaired Student's t test. Results: The fracture resistant strength, expressed as kilonewton (KN), was group 1 - 1.51 KN, group 2 - 1.25 KN, and group 3 - 1.58 KN. Statistically, group III had highest fracture resistance followed by group I, while group II had the lowest average fracture resistance. Conclusion: The fracture resistant strength of teeth restored with ceramic inlay was comparable to that of the normal intact teeth or slightly higher, while teeth restored with direct composite resin restoration showed less fracture resistant strength than that of the normal teeth.

Influence of remaining coronal structure and finish line on the fracture strength of roots restored with metallic posts

The purpose of this study was to evaluate the fracture strength of roots that were prosthetically restored with metallic posts with or without any remaining coronal structure and with different finish lines. Sixty bovine incisors were sectioned below the cementoenamel junction, endodontically treated, and randomly divided into six experimental groups (n = 10) containing teeth with or without any remaining coronal structure, and with a beveled shoulder, a bevel, or a shoulder finish line design. The metallic posts were luted with dual-cured resin cement. The cores were made with composite resin, and metal crowns were cemented with zinc phosphate cement. The specimens were subjected to a tangential compressive load (135º angle) at a crosshead speed of 0.5 mm/min until failure, using a universal testing machine. The fracture strength data were analyzed using the ANOVA and LSMeans (least square means) tests (α= 0.05). The data indicated that the teeth with 2 mm of remaining coronal structure showed the highest fracture strength values when compared with the teeth without any remaining structure (p < 0.05). As to the different finish line designs, the highest fracture strength values were obtained for the beveled shoulder, followed by the bevel and then by the shoulder designs (p < 0.05). It may be concluded that, to increase fracture strength, a beveled shoulder and 2 mm of remaining coronal structure are the ideal conditions.

Effect of post type and restorative techniques on the strain and fracture resistance of flared incisor roots

Restoring flared endodontically treated teeth continues to be a challenge for clinicians. This study evaluated the effect of post types and restorative techniques on the strain, fracture resistance, and fracture mode of incisors with weakened roots. One hundred five endodontically treated bovine incisors roots (15 mm) were divided into 7 groups (n=15). The two control groups were (C) intact roots restored with Cpc (cast posts and core) or Gfp (glass fiber posts). The five experimental groups were (F) flared roots restored with GfpAp (Gfp associated with accessory glass fiber posts), GfpRc (anatomic Gfp, relined with composite resin), and GfpRcAp (anatomized Gfp with resin and accessory glass fiber posts). All teeth were restored with metal crowns. Mechanical fatigue was performed with 3x10(5)/50 N. Specimens were loaded at 45º, and the strain values (μS) were obtained on root buccal and proximal surfaces. Following that, the fracture resistance (N) was measured. One-way ANOVA and Tukey's HSD tests (α=0.05) were applied, and failure mode was checked. No significant difference in strain values among the groups was found. Cpc presented lower fracture resistance and more catastrophic failures in flared roots. Gfp associated with composite resin or accessory glass fiber posts seems to be an effective method to improve the biomechanical behavior of flared roots.

Restaurar dentes tratados endodonticamente continua sendo desafio para clínicos. Este estudo avaliou o efeito de pinos e técnicas na deformação, resistência à fratura e padrão de fratura de incisivos com canal radicular alargado. Cento e cinco raízes bovinas, tratadas endodonticamente (15 mm) foram divididas em 7 grupos (n=15). Os grupos controle (C), constituídos de raízes não alargadas, foram restauradas com Cpc (núcleo metálico fundido) ou Gfp (pino de fibra de vidro). Nos grupos experimentais os canais foram alargados (F) e restaurados com: GfpAp (Gfp associado com pinos de fibra de vidro acessórios); GfpRc (pino anatômico, reembasado com resina composta) e GfpRcAp (pino anatomizado com resina composta e pinos acessórios). Os dentes foram restaurados com coroas metálicas. Fadiga mecânica foi simulada com 3x10(5)/50 N ciclos. O teste foi realizado a 45º e a deformação (μS) obtida nas superfícies vestibular e proximal. Em seguida, a resistência à fratura (N) e o padrão de fratura foram verificados. Aplicou-se ANOVA e Teste de Tukey (α=0,05). Não houve diferença na deformação. Cpc resultou em menor resistência à fratura e com mais fraturas catastróficas em raízes fragilizadas. As técnicas de reembasamento do pino com resina composta ou o uso de pinos acessórios parecem ser efetivos para melhorar o comportamento biomecânico de raízes fragilizadas.

Evaluation of the effect of different types of filling materials and techniques on the fracture resistance of the teeth [comparative in vitro study]

In order to evaluate the effect of different restorative materials and techniques on the fracture resistance of tooth, forty caries free single rooted premolars were divided equally into four groups [A, Considered as control the group, without cavity preparation], [B, MOD cavity preparation, filled with amalgam alone], [C, MOD cavity preparation, filled by amalgam with bonding and adhesive], [D, MOD cavity, filled by light cured composite with bonding]. Using Instron testing machine to evaluate the fracture resistance, the results were highly significant in difference between the control group and all other groups, [B and C] and [B and D], where it was non significant between [C and D]. From these findings and under the conditions of this study, one can conclude that the normal tooth tissues [enamel, dentine] provide the best resistance to fracture, while the amalgam material provide the least, Amalgam with adhesive and, composite with bond locate in between

Influence of ferrule preparation with or without glass fiber post on fracture resistance of endodontically treated teeth

OBJECTIVE: This study evaluated the effect of ferrule preparation (Fp) on the fracture resistance of endodontically treated teeth, restored with composite resin cores with or without glass fiber posts. MATERIAL AND METHODS: Forty-four bovine teeth were sectioned 19 or 17 mm (2 mm ferrule) from the apex, endodontically treated and assigned to four groups (n = 11): Group 1: Fp and post; Group 2: Fp and without post; Group 3: without Fp and with post; Group 4: without Fp and without post. All specimens were restored with composite resin core and metal crown. Specimens were subjected to fracture resistance testing in a universal testing machine at a crosshead speed of 0.5 mm/min. The data were analyzed by two-way ANOVA and Tukey's tests (α=0.05). RESULTS: The mean fracture resistance values were as follows: Group 1: 573.3 N; Group 2: 552.5 N; Group 3: 275.3 N; Group 4: 258.6 N. Significantly higher fracture resistance was found for the groups with Fp (p<0.001). CONCLUSION: There was no statistically significant interaction between the "Fp" and "post" factors (p = 0.954). The ferrule preparation increased the fracture resistance of endodontically treated teeth. However, the use of glass fiber post showed no significant influence on the fracture resistance.

Fracture strength of flared bovine roots restored with different intraradicular posts

OBJECTIVE: The aim of this study was to evaluate the fracture strength and failure mode of flared bovine roots restored with different intraradicular posts. MATERIAL AND METHODS: Fifty bovine incisors with similar dimensions were selected and their roots were flared until 1.0 mm of dentin wall remained. Next, the roots were allocated into five groups (n=10): GI- cast metal post-and-core; GII- fiber posts plus accessory fiber posts; GIII- direct anatomic post; GIV- indirect anatomic post and GV- control (specimens without intraradicular post). A polyether impression material was used to simulate the periodontal ligament. After periodontal ligament simulation, the specimens were subjected to a compressive load at a crosshead speed of 0.5 mm/min in a servo-hydraulic testing machine (MTS 810) applied at 135¨¬ to the long axis of the tooth until failure. The data (N) were subjected to ANOVA and Tukey's post-hoc test (¥á=0.05). RESULTS: GI and GIV presented higher fracture strength (p<0.05) than GII. GIII presented intermediate values without statistically significant differences (p>0.05) from GI, GII and GIV. Control specimens (GV) produced the lowest fracture strength mean values (p<0.05). Despite obtaining the highest mean value, GI presented 100 percent of unfavorable failures. GII presented 20 percent of unfavorable failures. GIII, GIV and GV presented only favorable failures. CONCLUSIONS: Although further in vitro and in vivo studies are necessary, the results of this study showed that the use of direct and indirect anatomic posts in flared roots could be an alternative to cast metal post-and-core.

A comparison of impact strength of fragment-bonded anterior teeth using three different restorative materials: an in vitro study.

BACKGROUND AND OBJECTIVE: The purpose of this investigation was to estimate the impact strength of fractured anterior teeth reattached using three different restorative materials and compare their impact strengths to those of control. MATERIALS AND METHODS: Sixty human maxillary permanent central incisors were selected and divided into control and experimental groups. The teeth in the experimental groups were fractured and then bonded using Composite resin, Compomer and resin-modified GIC. Intact teeth served as control. All the specimens were then tested in an impact testing machine. RESULTS: The results revealed statistically significant differences between Compomer and resin-modified GIC groups, control and experimental groups. No statistically significant differences were observed between Composite resin and Compomer groups. CONCLUSION: Thus the fractured fragments bonded with Composite resin and Compomer provided better adhesion than resin-modified GIC.

Tooth structure and fracture strength of cavities

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 percent) than composite resin cavities with the same width (7.07 percent). 1/3-inlay preparations also produced higher percent mean mass loss (13.91 percent) than composite resin preparations with the same width (10.02 percent). 1/2-inlay cavities had 21.34 percent of mass loss versus 16.19 percent 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.

O objetivo deste estudo foi avaliar, in vitro, a perda de estrutura dentária após o preparo cavitário para restaurações diretas e indiretas e sua relação com a resistência à fratura do dente. 60 pré-molares superiores humanos foram divididos em 6 grupos (n=10). Cavidades MOD para resina composta direta (Grupos I, II e III) e cavidades "inlay" (Grupos IV, V e VI) foram preparadas mantendo dimensões padronizadas. A extensão vestíbulo-lingual da caixa oclusal foi estabelecida em 1/4 (Grupos I e IV), 1/3 (Grupos II e V) ou 1/2 (Grupos III e VI) da distância intercuspídea. Os dentes foram pesados, em uma balança de precisão, antes e após o preparo cavitário para aferir a perda de massa dentária. Os dentes preparados foram submetidos à força de compressão para determinar a resistência à fratura em uma máquina universal de ensaios sob uma velocidade de 0.5 mm/min. Os dados foram submetidos à análise de variância a dois critérios e ao teste de Tukey (alfa = 0.05). As cavidades do tipo "1/4-inlay" apresentaram maior percentual de perda de massa (9.71 por cento) em relação às cavidades para resina composta com mesma extensão (7.07 por cento). As cavidades do tipo "1/3-inlay" também apresentaram maior percentual de perda de massa (13.91 por cento) quando comparada às cavidades para resina composta com a mesma extensão (10.02 por cento). As cavidades do tipo "1/2-inlay" apresentaram 21.34 por cento de perda de massa, enquanto as cavidades com extensão de 1/2 para resina composta apresentaram uma perda de 16.19 por cento. As médias de resistência à fratura (em kgf) foram: GI = 187.65; GII = 143.62; GIII = 74.10; GIV = 164.22; GV = 101.92; GVI = 50.35. Diferenças estatisticamente significantes (p<0.5) foram observadas entre os Grupos I e IV, II e V, III e VI. Maior perda de estrutura dentária e menor resistência à fratura foram verificadas após os preparos do tipo "inlay" quando comparados aos preparos para resina composta direta.