Biomechanical considerations for the restoration of endodontically treated teeth: A systematic review of the literature, Part II (Evaluation of fatigue behavior, interfaces, and in vivo studies)

Department of Cariology and Endodontics, School of Dentistry, University of Geneva, Geneva, Switzerland.
Quintessence international (Berlin, Germany: 1985) (Impact Factor: 0.73). 03/2008; 39(2):117-29.
Source: PubMed


OBJECTIVE: The restoration of endodontically treated teeth has long been guided by empirical rather than biomechanical concepts. Part I of this literature review presented up-to-date knowledge about changes in tissue structure and properties following endodontic therapy, as well as the behavior of restored teeth in monotonic mechanical tests or finite element analysis. The aim of the second part is to review current knowledge about the various interfaces of restored, nonvital teeth and their behavior in fatigue and clinical studies. REVIEW METHOD: The basic search process included a systematic review of articles contained in the PubMed/Medline database, dating between 1990 and 2005, using single or combined key words to obtain the most comprehensive list of references; a perusal of the references of the references completed the review. RELEVANT INFORMATION AND CONCLUSIONS: Nonvital teeth restored with composite resin or composite resin combined with fiber posts resisted fatigue tests and currently represent the best treatment option. In comparison to rigid metal and/or ceramic posts, when composite resin or composite resin/fiber posts fail, the occurrence of interfacial defects or severe tooth breakdown is less likely. Adhesion into the root, however, remains a challenge because of the unfavorable ovoid canal configuration, as well as critical dentin microstructure in the deepest parts of the canal. Thus, specific combinations of adhesives and cements are recommended. The clinical performance of post-and-core restorations proved satisfactory overall, in particular with a contemporary restorative approach using composite resin and fiber posts. However, the clinical literature does not clearly isolate or identify exact parameters critical to success. This, in turn, emphasizes the importance and relevance of in vitro studies to further improve the quality and long-term stability of prosthetic foundations.

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    • "modulus of elasticity close to that of the dentin and, when bonded using resin cements and composite resins, are able to form a single unit, resulting in minimal tension to the root dentin when compared to cast posts.[3] [5] [7] Light activation is necessary for some dual-cure and light-cure cements, however, light propagation decreases through to the middle and apical thirds of the root, compromising bonding.[8] "
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    ABSTRACT: The aims of this study were (a) to evaluate the influence of glass fiber post translucency on the hardness of a light-cure resin cement within the root canal; (b) to assess dentin bond strength at different root levels. Fifty human canine roots were randomly divided into five groups. Translucent posts (Exacto, Angelus; White Post DC, FGM; FRC Postec Plus, Ivoclar Vivadent) were used in three groups, opaque posts (Exacto Opaco, Angelus) were used in one group and no posts were used in the last group. The posts were cemented using a light-cure resin cement (Variolink N Base, Ivoclar Vivadent). The roots were cross-sectioned into slices (two from the cervical, two from the middle, and two from the apical thirds) which were then submitted to microhardness and push-out tests. Two-way analysis of variance and Tukey test were performed. Cement microhardness was significantly higher in the translucent post groups when compared to opaque posts and no post. At the apical third, the White Post DC and FRC Postec groups showed higher microhardness values than those in the Exacto Translucido group. The type of glass fiber post did not significantly influence bond strength values. White Post DC and FRC Postec Plus provided higher resin cement microhardness values, especially at the most apical thirds. Bond strength was not dependent on the type of post used. Failure mode analysis suggested superior cement curing when the translucent posts were used.
    Full-text · Article · Nov 2015 · Journal of Adhesion Science and Technology
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    • "The quantity and quality of the coronal structure are crucial in this clinical scenario [4]. Cast metal cores or intracanal posts are frequently employed clinically. "
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    ABSTRACT: A common problem encountered by dentists is the restorative treatment of nonvital teeth. When the pulp chamber presents appropriate conditions for retention, the endocrown is indicated. This monolithic, ceramic adhesive restoration is singularly used yet warrants wider recognition and use. The endocrown allows preservation of the tooth structure and is minimally invasive. Currently, this treatment option, of a core buildup and full coverage restoration, reduces tooth structure excessively. This treatment presents not only functional limitations but also aesthetic concerns. Recently, the VITA-PM9 system, a leucite-reinforced glass ceramic, has been increasingly used in a variety of clinical situations due to its satisfactory physical-mechanical and aesthetic properties. Therefore, the present study describes a case of surgical restoration of a nonvital tooth using the endocrown technique and the VITA-PM9.
    Full-text · Article · Nov 2015
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    • "However, even though endodontic post and core may be considered a feasible treatment for endodontically-treated teeth, most traditional restorative techniques such as Nayyar cores [5] or Contents lists available at ScienceDirect journal homepage: cast post-cores require the removal of a vast amount of sound tooth structure to create a dowel/post space [4]. Minimally invasive restorations of endodontically-treated teeth are made possible by the use of new generation dentine bonding systems and composite resins that are bonded to the residual coronal root dentine as well as root canal dentine without the use of endodontic posts [6]. "

    Full-text · Dataset · Oct 2015
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