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Survival of extensively damaged endodontically treated incisors restored with different types of posts-and-core foundation restoration material.
J Prosthet Dent. 2018 May; 119(5):769-776.JP

Abstract

STATEMENT OF PROBLEM

Which post-and-core combination will best improve the performance of extensively damaged endodontically treated incisors without a ferrule is still unclear.

PURPOSE

The purpose of this in vitro study was to investigate the restoration of extensively damaged endodontically treated incisors without a ferrule using glass-ceramic crowns bonded to various composite resin foundation restorations and 2 types of posts.

MATERIAL AND METHODS

Sixty decoronated endodontically treated bovine incisors without a ferrule were divided into 4 groups and restored with various post-and-core foundation restorations. NfPfB=no-ferrule (Nf) with glass-fiber post (Pf) and bulk-fill resin foundation restoration (B); NfPfP=no-ferrule (Nf) with glass-fiber post (Pf) and dual-polymerized composite resin core foundation restoration (P); NfPt=no-ferrule (Nf) with titanium post (Pt) and resin core foundation restoration; and NfPtB=no-ferrule (Nf) with titanium post (Pt) and bulk-fill resin core foundation restoration (B). Two additional groups from previously published data from the same authors (FPf=2mm of ferrule (F) and glass-fiber post (Pf) and composite resin core foundation restoration; and NfPf=no-ferrule (Nf) with glass-fiber post (Pf) and composite resin core foundation restoration), which were tested concomitantly and using the same experimental arrangement, were included for comparison. All teeth were prepared to receive bonded glass-ceramic crowns luted with dual-polymerized resin cement and were subjected to accelerated fatigue testing under submerged conditions at room temperature. Cyclic isometric loading was applied to the incisal edge at an angle of 30 degrees with a frequency of 5 Hz, beginning with a load of 100 N (5000 cycles). A 100-N load increase was applied every 15000 cycles. The specimens were loaded until failure or to a maximum of 1000 N (140000 cycles). The 6 groups (4 groups from the present study and 2 groups from the previously published study) were compared using the Kaplan-Meier survival analysis (log-rank post hoc test at α=.05 for pairwise comparisons).

RESULTS

None of the tested specimen withstood all 140 000 cycles. All specimens without a ferrule were affected by an initial failure phenomenon (wide gap at the lingual margin between the core foundation restoration/crown assembly and the root). NfPfP, NfPt, and NfPtB had similar survival (29649 to 30987 mean cycles until initial failure). NfPfB outperformed NfPt and NfPtB. None of the post-and-core foundation restoration materials were able to match the performance of the ferrule group FPf (72667 cycles). In all groups, 100% of failures were catastrophic.

CONCLUSIONS

The survival of extensively damaged endodontically treated incisors without a ferrule was slightly improved by the use of a fiber post with a bulk-fill composite resin core foundation restoration. However, none of the post-and-core techniques was able to compensate for the absence of a ferrule. The presence of the posts always adversely affected the failure mode.

Authors+Show Affiliations

Predoctoral student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil.Predoctoral student, Department of Prosthodontics and Periodontology, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil.Professor, Department of Prosthodontics and Periodontology, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil.The Don and Sybil Harrington Professor of Esthetic Dentistry, Division of Restorative Sciences, Ostrow School of Dentistry, University of Southern California, Los Angeles, Calif. Electronic address: magne@usc.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28923548

Citation

Lazari, Priscilla Cardoso, et al. "Survival of Extensively Damaged Endodontically Treated Incisors Restored With Different Types of Posts-and-core Foundation Restoration Material." The Journal of Prosthetic Dentistry, vol. 119, no. 5, 2018, pp. 769-776.
Lazari PC, de Carvalho MA, Del Bel Cury AA, et al. Survival of extensively damaged endodontically treated incisors restored with different types of posts-and-core foundation restoration material. J Prosthet Dent. 2018;119(5):769-776.
Lazari, P. C., de Carvalho, M. A., Del Bel Cury, A. A., & Magne, P. (2018). Survival of extensively damaged endodontically treated incisors restored with different types of posts-and-core foundation restoration material. The Journal of Prosthetic Dentistry, 119(5), 769-776. https://doi.org/10.1016/j.prosdent.2017.05.012
Lazari PC, et al. Survival of Extensively Damaged Endodontically Treated Incisors Restored With Different Types of Posts-and-core Foundation Restoration Material. J Prosthet Dent. 2018;119(5):769-776. PubMed PMID: 28923548.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Survival of extensively damaged endodontically treated incisors restored with different types of posts-and-core foundation restoration material. AU - Lazari,Priscilla Cardoso, AU - de Carvalho,Marco Aurélio, AU - Del Bel Cury,Altair A, AU - Magne,Pascal, Y1 - 2017/09/18/ PY - 2016/11/7/received PY - 2017/5/17/revised PY - 2017/5/18/accepted PY - 2017/9/20/pubmed PY - 2018/12/14/medline PY - 2017/9/20/entrez SP - 769 EP - 776 JF - The Journal of prosthetic dentistry JO - J Prosthet Dent VL - 119 IS - 5 N2 - STATEMENT OF PROBLEM: Which post-and-core combination will best improve the performance of extensively damaged endodontically treated incisors without a ferrule is still unclear. PURPOSE: The purpose of this in vitro study was to investigate the restoration of extensively damaged endodontically treated incisors without a ferrule using glass-ceramic crowns bonded to various composite resin foundation restorations and 2 types of posts. MATERIAL AND METHODS: Sixty decoronated endodontically treated bovine incisors without a ferrule were divided into 4 groups and restored with various post-and-core foundation restorations. NfPfB=no-ferrule (Nf) with glass-fiber post (Pf) and bulk-fill resin foundation restoration (B); NfPfP=no-ferrule (Nf) with glass-fiber post (Pf) and dual-polymerized composite resin core foundation restoration (P); NfPt=no-ferrule (Nf) with titanium post (Pt) and resin core foundation restoration; and NfPtB=no-ferrule (Nf) with titanium post (Pt) and bulk-fill resin core foundation restoration (B). Two additional groups from previously published data from the same authors (FPf=2mm of ferrule (F) and glass-fiber post (Pf) and composite resin core foundation restoration; and NfPf=no-ferrule (Nf) with glass-fiber post (Pf) and composite resin core foundation restoration), which were tested concomitantly and using the same experimental arrangement, were included for comparison. All teeth were prepared to receive bonded glass-ceramic crowns luted with dual-polymerized resin cement and were subjected to accelerated fatigue testing under submerged conditions at room temperature. Cyclic isometric loading was applied to the incisal edge at an angle of 30 degrees with a frequency of 5 Hz, beginning with a load of 100 N (5000 cycles). A 100-N load increase was applied every 15000 cycles. The specimens were loaded until failure or to a maximum of 1000 N (140000 cycles). The 6 groups (4 groups from the present study and 2 groups from the previously published study) were compared using the Kaplan-Meier survival analysis (log-rank post hoc test at α=.05 for pairwise comparisons). RESULTS: None of the tested specimen withstood all 140 000 cycles. All specimens without a ferrule were affected by an initial failure phenomenon (wide gap at the lingual margin between the core foundation restoration/crown assembly and the root). NfPfP, NfPt, and NfPtB had similar survival (29649 to 30987 mean cycles until initial failure). NfPfB outperformed NfPt and NfPtB. None of the post-and-core foundation restoration materials were able to match the performance of the ferrule group FPf (72667 cycles). In all groups, 100% of failures were catastrophic. CONCLUSIONS: The survival of extensively damaged endodontically treated incisors without a ferrule was slightly improved by the use of a fiber post with a bulk-fill composite resin core foundation restoration. However, none of the post-and-core techniques was able to compensate for the absence of a ferrule. The presence of the posts always adversely affected the failure mode. SN - 1097-6841 UR - https://www.unboundmedicine.com/medline/citation/28923548/Survival_of_extensively_damaged_endodontically_treated_incisors_restored_with_different_types_of_posts_and_core_foundation_restoration_material_ DB - PRIME DP - Unbound Medicine ER -