Abstract

Objectives The aim of this study was to evaluate the influence of ferule and the post type on the fracture strength and stress distribution in premolars. Materials and Methods Forty human mandibular premolars were decoronated, allocated in four groups, and restored as follows: CPC-NF: cast post-and-core and absence of ferule; CPC-F: cast post-and-core and presence of ferule; FPC-NF: glass-fiber posts and absence of ferule; FPC-F: glass-fiber posts and presence of ferule. The fracture strength (FS) and failure patterns were evaluated. Finite element analysis (FEA) evaluated the stress distribution. Results FS did not differ between CPCs and FPC either in presence or in absence of ferule. The presence of ferule increased FS with both post types. Mean values of FS for ferule groups were higher than functional or parafunctional loads reported in literature, which was not the case for FPC-NF when compared to parafunctional loads. FEA with a functional load showed slightly higher compressive stresses in dentin in the group CPC-NF, which was much lower than the compressive strength of dentin. Lower percentage of catastrophic failures was observed in nonferule groups irrespective of post type, which was explained by the stress concentration in the cervical root region when FEA with the FS load was simulated. Conclusion Ferule effect was shown to be more important than post type in the analysis. Both posts showed potential to withstand functional loads irrespective of presence of ferule. However, the mean FS was lower than parafunctional loads for FPC in the absence of ferule.

Highlights

  • Teeth with severe loss of coronal structure constitute a daily challenge in clinical practice

  • The groups cast post-and-cores (CPCs)-F and FPC-F were similar to each other (p>0.05) and presented higher fracture strength than samples with the same intracanal post without ferule (NF) (p

  • This study showed that the “ferule effect” influences the biomechanical behavior of endodontically treated mandibular premolars

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Summary

Introduction

Teeth with severe loss of coronal structure constitute a daily challenge in clinical practice. When the remaining tooth structure is not considered adequate to retain a restoration, intracanal posts are used. The literature suggests that at least 1.5 mm of coronal structure would improve the biomechanical behavior of the restoration even with the use of intracanal posts [1]. Besides the interest in keeping the remaining coronal structure, the intracanal post material is still a topic of discussion in literature. The metallic cast post-and-cores (CPCs) were the most utilized, assuming that their higher elastic modulus would ensure better support to the restoration. The adequate juxtaposition to dentin of individualized CPCs is considered responsible for the conjunct withstand higher loads when compared to prefabricated posts [2, 3]. Besides the fact that these concepts were accepted for years, recent studies are in disagreement to the superiority of fracture strength caused by CPCs [4,5,6]

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