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Post-fatigue fracture resistance of premolar teeth restored with endocrowns: An in vitro investigation.
J Dent. 2020 09; 100:103426.JD

Abstract

OBJECTIVES

To evaluate the post-fatigue load-to-failure and failure modes of endodontically treated premolar teeth restored with endocrowns fabricated from different CAD/CAM materials.

MATERIALS AND METHODS

A total of 60 extracted human, single-rooted premolar teeth were endodontically treated and sectioned horizontally 2 mm above the cementoenamel junction. Sectioned teeth were restored using two reconstruction designs: endocrowns (Cendo) or post-crowns (Cpost) (n = 30 p/g). In each group, reconstructions were fabricated from 3 different CAD/CAM substrates (n = 10 p/g); a resin-based composite (Cera), a lithium disilicate glass ceramic (LiSi) and a monolithic, translucent zirconia (Zir). Additional 10 intact teeth were used as control. Restored teeth were subjected to dynamic fatigue test (10-50 N, 600,000 cycles) and thermocycling (5-55 °C, 1500 cycles). Load-to-failure and failure mode was determined following application of a static, 45° oblique compressive load on each specimen. One-way and Two-way analysis of variance (ANOVA), Tukey's post hoc and chi-square tests were used to determine statistically significant interactions among experimental and control groups.

RESULTS

All specimens survived the mechanical and thermal fatigue tests. A statistically significant interaction between reconstruction design and material type was observed (p  <  0.001). CpostZir and CendoCera groups exhibited significantly higher post-fatigue load-to-failure when compared to other materials of the same reconstruction design (p ≤ 0.001). The highest frequency of catastrophic failures was observed with Zir reconstructions in both designs. Intact teeth exhibited significantly higher load-to-failure when compared to all groups (p ≤ 0.042) except CpostZir (p = 0.345).

CONCLUSION

Single piece, CAD/CAM resin composite endocrowns can present a reliable option for restoring endodontically treated premolar teeth.

CLINICAL SIGNIFICANCE

Endocrowns can be as effective as post-crowns provided appropriate preparation; material selection; and bonding protocols are utilized. Clinicians need to be cautious when prescribing zirconia endocrowns to restore premolar teeth owing to the low fracture resistance and high risk of catastrophic failures.

Authors+Show Affiliations

University of Leeds, School of Dentistry, Division of Restorative Dentistry, Leeds LS2 9JT, United Kingdom.Jordan University of Science and Technology, Faculty of Dentistry, Department of Conservative Dentistry, P.O Box 3030, Irbid 22110, Jordan. Electronic address: aajuma@just.edu.jo.University of Leeds, School of Dentistry, Division of Restorative Dentistry, Leeds LS2 9JT, United Kingdom; University of Siena, Department of Medical Biotechnologies, Division of Fixed Prosthodontics, Siena, Italy.University of Leeds, School of Dentistry, Division of Oral Biology, Leeds LS2 9JT, United Kingdom.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32628987

Citation

Hassouneh, Layla, et al. "Post-fatigue Fracture Resistance of Premolar Teeth Restored With Endocrowns: an in Vitro Investigation." Journal of Dentistry, vol. 100, 2020, p. 103426.
Hassouneh L, Jum'ah AA, Ferrari M, et al. Post-fatigue fracture resistance of premolar teeth restored with endocrowns: An in vitro investigation. J Dent. 2020;100:103426.
Hassouneh, L., Jum'ah, A. A., Ferrari, M., & Wood, D. J. (2020). Post-fatigue fracture resistance of premolar teeth restored with endocrowns: An in vitro investigation. Journal of Dentistry, 100, 103426. https://doi.org/10.1016/j.jdent.2020.103426
Hassouneh L, et al. Post-fatigue Fracture Resistance of Premolar Teeth Restored With Endocrowns: an in Vitro Investigation. J Dent. 2020;100:103426. PubMed PMID: 32628987.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Post-fatigue fracture resistance of premolar teeth restored with endocrowns: An in vitro investigation. AU - Hassouneh,Layla, AU - Jum'ah,Ahmad A, AU - Ferrari,Marco, AU - Wood,David J, Y1 - 2020/07/03/ PY - 2020/04/15/received PY - 2020/06/30/revised PY - 2020/07/02/accepted PY - 2020/7/7/pubmed PY - 2021/2/20/medline PY - 2020/7/7/entrez KW - CAD/CAM KW - Endocrowns KW - Endodontic treatment KW - Fracture resistance KW - Lithium disilicate KW - Post-crowns KW - Resin based composite KW - Zirconia SP - 103426 EP - 103426 JF - Journal of dentistry JO - J Dent VL - 100 N2 - OBJECTIVES: To evaluate the post-fatigue load-to-failure and failure modes of endodontically treated premolar teeth restored with endocrowns fabricated from different CAD/CAM materials. MATERIALS AND METHODS: A total of 60 extracted human, single-rooted premolar teeth were endodontically treated and sectioned horizontally 2 mm above the cementoenamel junction. Sectioned teeth were restored using two reconstruction designs: endocrowns (Cendo) or post-crowns (Cpost) (n = 30 p/g). In each group, reconstructions were fabricated from 3 different CAD/CAM substrates (n = 10 p/g); a resin-based composite (Cera), a lithium disilicate glass ceramic (LiSi) and a monolithic, translucent zirconia (Zir). Additional 10 intact teeth were used as control. Restored teeth were subjected to dynamic fatigue test (10-50 N, 600,000 cycles) and thermocycling (5-55 °C, 1500 cycles). Load-to-failure and failure mode was determined following application of a static, 45° oblique compressive load on each specimen. One-way and Two-way analysis of variance (ANOVA), Tukey's post hoc and chi-square tests were used to determine statistically significant interactions among experimental and control groups. RESULTS: All specimens survived the mechanical and thermal fatigue tests. A statistically significant interaction between reconstruction design and material type was observed (p  <  0.001). CpostZir and CendoCera groups exhibited significantly higher post-fatigue load-to-failure when compared to other materials of the same reconstruction design (p ≤ 0.001). The highest frequency of catastrophic failures was observed with Zir reconstructions in both designs. Intact teeth exhibited significantly higher load-to-failure when compared to all groups (p ≤ 0.042) except CpostZir (p = 0.345). CONCLUSION: Single piece, CAD/CAM resin composite endocrowns can present a reliable option for restoring endodontically treated premolar teeth. CLINICAL SIGNIFICANCE: Endocrowns can be as effective as post-crowns provided appropriate preparation; material selection; and bonding protocols are utilized. Clinicians need to be cautious when prescribing zirconia endocrowns to restore premolar teeth owing to the low fracture resistance and high risk of catastrophic failures. SN - 1879-176X UR - https://www.unboundmedicine.com/medline/citation/32628987/Post_fatigue_fracture_resistance_of_premolar_teeth_restored_with_endocrowns:_An_in_vitro_investigation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0300-5712(20)30172-X DB - PRIME DP - Unbound Medicine ER -