Abstract

ObjectiveThis ex vivo study aimed to evaluate the strengthening effect of different ferrule and reattachment designs with fiber and adhesive materials on vertically fractured teeth.MethodsNinety extracted single-root premolars were instrumented and divided into nine groups (two control groups and seven experimental groups; n = 10). The negative control (NC) group comprised of intact teeth, while the positive control (PC) group comprised of root canal-treated teeth. The roots of the teeth in the experimental groups were vertically fractured into two equal fragments. The fragments were reattached with one of the followings: 4-methacryloxyethyl trimellitate anhydride/methacrylate-tri-n-butyl borane (4-META/MMA-TBB) resin, 4-META/MMA-TBB + quartz fiber post, 4-META/MMA-TBB + glass fiber bundles, 4-META/MMA-TBB + quartz fiber post + 1 mm ferrule, 4-META/MMA-TBB + glass fiber bundles + 1 mm ferrule, 4-META/MMA-TBB + quartz fiber post + 2 mm ferrule, and 4-META/MMA-TBB + glass fiber bundles + 2 mm ferrule. The core build-ups were made with composite resin. The specimens were subjected to compressive loading until failure occurred. Mean load necessary to fracture each sample and the fracture types of these samples were recorded.ResultsThe highest mean fracture load was recorded in the NC group (1,036.7 N), which was not significantly higher than the PC group (989.66 N) (p > 0.05). The roots reattached with quartz fiber post demonstrated significantly less fracture strength (871.9 N) as compared to the other test and control groups (p < 0.05). There was no significant difference between the PC group and reattached fragments with different ferrule designs in terms of fracture resistance (p > 0.05).ConclusionsThe customized fiber bundles may be more suitable for reattachment of vertically fractured teeth than the rigid fiber posts. For reattachment procedures, the ferrule design may be preferred to increase the fracture strength of vertically fractured teeth.

Highlights

  • Vertical root fracture (VRF) constitutes a longitudinal fracture of the root occurring at any level, usually directed buccolingually [1]

  • The highest mean fracture load was recorded in the negative control (NC) group (1,036.7 N), which was not significantly higher than the positive control (PC) group (989.66 N) (p > 0.05)

  • The roots reattached with quartz fiber post demonstrated significantly less fracture strength (871.9 N) as compared to the other test and control groups (p < 0.05)

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Summary

Introduction

Vertical root fracture (VRF) constitutes a longitudinal fracture of the root occurring at any level, usually directed buccolingually [1]. Rivera and Walton [2] described the following five types of longitudinal fractures: enamel craze lines, fractured cusps, cracked tooth, split tooth, and VRF. VRF can weaken the tooth to the point that it cannot withstand normal masticatory forces and is susceptible to fracture, complicating the restorative process [10]. Curved and narrow roots are most susceptible to VRF; these include the roots of maxillary second premolars, mandibular incisors, mandibular premolars, and mandibular molars and the mesiobuccal roots of maxillary molars [11]

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