Influence of different post-endodontic restorations on the fatigue survival and biomechanical behavior of central incisors.

PURPOSE: To evaluate the influence of different post-endodontic techniques on the fatigue survival and biomechanical behavior of crowned restored central incisors. METHODS: The crowns of 69 bovine incisors were cut, and the roots were treated endodontically and assigned randomly into three groups (n=23): resin composite buildup (BUP), glass fiber post-retained resin composite buildup (GFP), and cast post-and-core (CPC). They received full crown preparation with 2 mm ferrule, and a leucite-reinforced ceramic crown was cemented adhesively. Three specimens from each group were tested monotonically. The remaining specimens were subjected to the stepwise stress fatigue test until fracture or suspension after 1.5 x 106 cycles in a chewing simulator. The load and step at which each specimen failed were analyzed by Kaplan-Meier and Mantel-Cox (log-rank test) statistics, followed by multiple pairwise comparisons, at 5% significance level. The three groups tested (BUP, GFP, and CPC) were 3D modeled (Rhinoceros 4.0) and the maximum principal stress (MPa) criteria were used to calculate the results using FEA. RESULTS: There was no statistical difference between the treatments regarding the load or the number of cycles (Mantel-Cox log-rank test for trend, X²= 0.015, df=1, P= 0.901, X²=3.171, df=1, P= 0.995). Crown cracks were the predominant failure mode, and oblique root fractures were only observed in groups GFP and CPC. In endodontically treated incisors with a 2-mm ferrule, the post-endodontic treatment had no significant effect on fatigue survival. Non-restorable fractures only occurred in teeth restored with posts. CLINICAL SIGNIFICANCE: Although the clinical significance of laboratory studies has some limitations, this study suggests that composite buildups without posts may be an option for restoring endodontically treated incisors with 2 mm ferrule height.

Scanning electron microscopy comparison of the resin-dentin interface using different specimen preparation methods.

Microscopy has been widely used to complement the data of studies related to dentin bonding; however, different specimen preparation methods may influence the analysis. Aiming to contribute to the reported scenario, this study evaluated the effect of two specimen-sectioning methods (cleavage and diamond disk cut) on the quality of the scanning electron microscopy (SEM) images. Four crowns of human molars were selected and had an area of approximately 6 mm2 of dentin exposed. They were then divided into two groups according to the universal adhesive application: total and self-etching modes. Then, composite blocks were built up and the specimens were stored in deionized water to allow the postcuring. The specimens were further divided according to the sectioning method: cleavage or diamond disk cut. Four specimens were obtained from each tooth. They were desiccated, placed on aluminum stubs, sputter-coated with gold, and observed in a scanning electron microscope, with ×2000 of magnification. The quality of the SEM images were evaluated by two calibrated examiners and classified into four scores (1-4). Mann-Whitney test (p < .05) showed that the diamond disk provided significantly higher scores than cleavage, whereas no significant difference was observed when comparing the total-etching and self-etching modes of application. The diamond disk cut method is preferable to the cleavage method to ensure the quality of the SEM analysis in studies involving the resin-dentin interface.