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Fatigue and failure analysis of restored endodontically treated maxillary incisors without a dowel or ferrule.
J Prosthet Dent. 2022 Jun 12 [Online ahead of print]JP

Abstract

STATEMENT OF PROBLEM

Information on the survival and mode of failure of endodontically treated incisors without a ferrule and restored without dowels is lacking.

PURPOSE

The purpose of this in vitro study was to compare the survival and failure mode of endodontically treated incisors without a ferrule and restored with bonded ceramic crowns and various composite resin foundation restorations without dowels with a control group with fiber dowels.

MATERIAL AND METHODS

Forty-five decoronated endodontically treated bovine incisors without ferrule were divided into 3 experimental groups and restored with different adhesive foundation restorations without dowel: nanohybrid composite resin (Nd), bulk-fill composite resin foundation restoration (NdB), and fiber-reinforced bulk-fill composite resin (NdFR). A control group with conventional foundation restorations (glass-fiber dowel with nanohybrid composite resin foundation restoration without ferrule) (D) was included for comparison. All teeth were prepared to receive bonded lithium disilicate ceramic crowns luted with dual-polymerizing composite resin cement and were subjected to accelerated fatigue testing. Cyclic isometric loading was applied to the incisal edge at an angle of 30 degrees and a frequency of 5 Hz, beginning with a load of 100 N (5000 cycles). A 100-N load increase was applied each 15 000 cycles. Specimens were loaded until failure or to a maximum for cycles endured of 1000 N (140 000 cycles). Groups were compared by using the Kaplan-Meier survival analysis (log rank test at α=.05 and pairwise post hoc comparisons) and life table analysis for load-at-failure (followed by Wilcoxon pairwise comparison α=.05).

RESULTS

All the specimens failed before 140 000 load cycles. Even though no statistically significant differences were found between the experimental groups without dowel (P>.127), the fiber-reinforced foundation restoration yielded the highest mean ±standard deviation cycles to failure (46 023 ±4326) compared with Nd (38 899 ±2975) and NdB (39 751 ±2998). NdFR, however, outperformed the foundation restoration with glass-fiber dowel (35 026 ±2687) (P<.05). Most failure in groups without dowel were restorable, while 100% of catastrophic failure (unrestorable) were found in the group with dowels.

CONCLUSIONS

Based on the present in vitro study, dowels did not improve the performance of the adhesive restoration of endodontically treated incisors without a ferrule. The use of a short fiber-reinforced composite resin foundation restoration without a dowel was able to not only improve the resistance of the restorations compared with adhesive foundation restorations with dowels but also minimize catastrophic failures.

Authors+Show Affiliations

Professor, Department of Oral Rehabilitation, School of Dentistry, Evangelic University of Goias (UniEVANGÉLICA), Anápolis, GO, Brazil.Professor, Department of Oral Rehabilitation, School of Dentistry, Evangelic University of Goias (UniEVANGÉLICA), Anápolis, GO, Brazil. Electronic address: lazari.pcl@gmail.com.Full Professor, Department of Prosthodontics and Periodontology, Piracicaba Dental School, State University of Campinas (UNICAMP), Piracicaba, SP, Brazil.Tenured Associate Professor, Don & Sybil Harrington Foundation Professor of Esthetic Dentistry, Department of Restorative Sciences, The Herman Ostrow School of Dentistry, University of Southern California (USC), Los Angeles, Calif.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

35705432

Citation

de Carvalho, Marco Aurelio, et al. "Fatigue and Failure Analysis of Restored Endodontically Treated Maxillary Incisors Without a Dowel or Ferrule." The Journal of Prosthetic Dentistry, 2022.
de Carvalho MA, Lazari-Carvalho PC, Del Bel Cury AA, et al. Fatigue and failure analysis of restored endodontically treated maxillary incisors without a dowel or ferrule. J Prosthet Dent. 2022.
de Carvalho, M. A., Lazari-Carvalho, P. C., Del Bel Cury, A. A., & Magne, P. (2022). Fatigue and failure analysis of restored endodontically treated maxillary incisors without a dowel or ferrule. The Journal of Prosthetic Dentistry. https://doi.org/10.1016/j.prosdent.2021.07.007
de Carvalho MA, et al. Fatigue and Failure Analysis of Restored Endodontically Treated Maxillary Incisors Without a Dowel or Ferrule. J Prosthet Dent. 2022 Jun 12; PubMed PMID: 35705432.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fatigue and failure analysis of restored endodontically treated maxillary incisors without a dowel or ferrule. AU - de Carvalho,Marco Aurelio, AU - Lazari-Carvalho,Priscilla Cardoso, AU - Del Bel Cury,Altair Antoninha, AU - Magne,Pascal, Y1 - 2022/06/12/ PY - 2020/07/27/received PY - 2021/07/11/revised PY - 2021/07/12/accepted PY - 2022/6/15/entrez PY - 2022/6/16/pubmed PY - 2022/6/16/medline JF - The Journal of prosthetic dentistry JO - J Prosthet Dent N2 - STATEMENT OF PROBLEM: Information on the survival and mode of failure of endodontically treated incisors without a ferrule and restored without dowels is lacking. PURPOSE: The purpose of this in vitro study was to compare the survival and failure mode of endodontically treated incisors without a ferrule and restored with bonded ceramic crowns and various composite resin foundation restorations without dowels with a control group with fiber dowels. MATERIAL AND METHODS: Forty-five decoronated endodontically treated bovine incisors without ferrule were divided into 3 experimental groups and restored with different adhesive foundation restorations without dowel: nanohybrid composite resin (Nd), bulk-fill composite resin foundation restoration (NdB), and fiber-reinforced bulk-fill composite resin (NdFR). A control group with conventional foundation restorations (glass-fiber dowel with nanohybrid composite resin foundation restoration without ferrule) (D) was included for comparison. All teeth were prepared to receive bonded lithium disilicate ceramic crowns luted with dual-polymerizing composite resin cement and were subjected to accelerated fatigue testing. Cyclic isometric loading was applied to the incisal edge at an angle of 30 degrees and a frequency of 5 Hz, beginning with a load of 100 N (5000 cycles). A 100-N load increase was applied each 15 000 cycles. Specimens were loaded until failure or to a maximum for cycles endured of 1000 N (140 000 cycles). Groups were compared by using the Kaplan-Meier survival analysis (log rank test at α=.05 and pairwise post hoc comparisons) and life table analysis for load-at-failure (followed by Wilcoxon pairwise comparison α=.05). RESULTS: All the specimens failed before 140 000 load cycles. Even though no statistically significant differences were found between the experimental groups without dowel (P>.127), the fiber-reinforced foundation restoration yielded the highest mean ±standard deviation cycles to failure (46 023 ±4326) compared with Nd (38 899 ±2975) and NdB (39 751 ±2998). NdFR, however, outperformed the foundation restoration with glass-fiber dowel (35 026 ±2687) (P<.05). Most failure in groups without dowel were restorable, while 100% of catastrophic failure (unrestorable) were found in the group with dowels. CONCLUSIONS: Based on the present in vitro study, dowels did not improve the performance of the adhesive restoration of endodontically treated incisors without a ferrule. The use of a short fiber-reinforced composite resin foundation restoration without a dowel was able to not only improve the resistance of the restorations compared with adhesive foundation restorations with dowels but also minimize catastrophic failures. SN - 1097-6841 UR - https://www.unboundmedicine.com/medline/citation/35705432/Fatigue_and_failure_analysis_of_restored_endodontically_treated_maxillary_incisors_without_a_dowel_or_ferrule_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3913(21)00400-5 DB - PRIME DP - Unbound Medicine ER -
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