A review of failure modes in teeth restored with adhesively luted endodontic dowels.
ABSTRACT Previous clinical studies indicated loss of retention between dowel and tooth was a major cause of failure for passive endodontic dowels. Advances in luting cement technology may have improved the retention of dowels. The purpose of this systematic review was to determine the clinical failure modes for dowel/core/crown restorations luted using resin-based cements that are either self-etching or used in conjunction with a bonding agent.
PubMed was searched for English language, peer-reviewed clinical research following restorations for 2 years or longer. For inclusion, a study group must have followed more than 50 permanent teeth restored using a dowel luted with resin cement and a bonding agent. Furthermore, more than 80% of the restorations must have received a nonresin crown.
Fifteen studies met the inclusion criteria and reported a total of 187 failures from 3046 restorations. The commonly reported causes of failure were dowel debonding (37% of all failures and primary cause in 8 of the 17 reporting study groups) and endodontic lesions (37% of all failures and primary cause in 6 of the 11 reporting study groups).
Loss of retention remains a major mode of failure even for passive, nonmetal dowels luted by resin cements with a bonding agent. The exact nature and underlying causes of debonding have not been adequately investigated.
- SourceAvailable from: Leontine A Jongsma03/2012, Degree: PhD, Supervisor: Cornelis J. Kleverlaan; Albert J. Feilzer
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ABSTRACT: Het succesvol bevestigen van tandrestauraties is een belangrijke en veeleisende procedure. Met behulp van cement wordt het restauratiemateriaal aan de tandstructuur verbonden. Op die manier worden twee hechtvlakken gecreëerd: het raakvlak tussen tand en cement, en het raakvlak tussen cement en restauratie. De cementlaag is in de meeste gevallen de zwakste schakel binnen het restauratieve systeem. Leontine Jongsma onderzocht het restaureren van endodontisch behandelde gebitselementen (o.m. wortelkanaalbehandelingen). Zulke gebitselementen zijn vaak verzwakt door tandweefselverlies als gevolg van ziekteprocessen en invasieve restauratieve behandeling. Jongsma richtte zich onder meer op de invloed van de polymerisatiewijze, krimp en krimpspanning op de hechting tussen restauratiematerialen, cementen en tandweefsel. Daarnaast onderzocht ze het effect van voorbehandeling van een glasvezelversterkte compositiestift op de hechting aan cementen.
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ABSTRACT: This is the first clinical long-term pilot study that tested the biomimetic concept of using more flexible, dentine-like (low Young modulus) glass fiber-reinforced epoxy resin posts (GFREPs) compared with rather rigid, stiff (higher Young modulus) titanium posts (TPs) in order to improve the survival rate of severely damaged endodontically treated teeth. Ninety-one subjects in need of postendodontic restorations in teeth with 2 or less remaining cavity walls were randomly assigned to receive either a tapered TP (n = 46) or a tapered GFREP (n = 45). The posts were adhesively luted using self-adhesive resin cement. The composite core build-ups were prepared ensuring a circumferential 2-mm ferrule. The primary endpoint was a loss of restoration for any reason. To study group differences, the log-rank test was calculated (P < .05). Hazard plots were constructed. After 84 months of observation (mean = 71.2 months), 7 restorations failed (ie, 4 GFREPs and 3 TPs). The failure modes were as follows: GFREP:root fracture (n = 3), core fracture (n = 1) and TP:endodontic failure (n = 3). No statistical difference was found between the survival rates (GFREPs = 90.2%, TPs = 93.5%, P = .642). The probability of no failure was comparable for both post materials (risk ratio; 95% confidence interval, 0.965-0.851/1.095). When using self-adhesive luted prefabricated posts in severely destroyed abutment teeth with 2 or less cavity walls and a 2-mm ferrule, postendodontic restorations achieved high long-term survival rates irrespective of the post material used (ie, glass fiber vs titanium).Journal of endodontics 12/2012; 38(12):1557-63. DOI:10.1016/j.joen.2012.08.015 · 2.79 Impact Factor