Composite Resin Core Research Articles

The torsion test offers a new approach for evaluating CAD/CAM material bonding

This study assessed the validity of torsion test, by comparing it with shear test, in evaluating the bonding of resin composite core after different surface treatments to both zirconia and resin composite CAD/CAM blocks. In total, 108-resin composite core cylinders (3 mm × 3 mm) were prepared and stored in distilled water at 37 °C/48 h. The cylinders were subjected to no-treatment, sandblasting, or surface grinding. Cylinders from each treatment group were then bonded with either zirconia or resin composite CAD/CAM blocks using dual-cure resin cement and stored for 24 h. They were subjected to torsion (rotational speed, 0.25 rpm until failure) or shear (crosshead speed, 1.0 mm/min) tests (n = 9 for each core/block combination in each test). All fractured surfaces were observed by scanning electron microscopy, and the maximum principal stress (MPS) was assessed using finite element analysis (FEA). In the torsion test, the sandblasted composite core and resin CAD/CAM block showed significantly lower bond strength than the other groups (p < 0.05), but the shear test results showed no intergroup differences. While 39.89% of the specimens showed cohesion failures in the torsion test, 55.56% showed adhesion failures in the shear test. FEA demonstrated an even distribution of MPS from the outer edge to the center of the cement layer during the torsion test; however, MPS was unevenly concentrated at the bottom edge of the cement layer during the shear test. The torsion test was better than the shear test in bond testing because of the uniform tensile stress distribution and unidirectional displacement at the bond interface.

Effects of silica sputtering on adhesion between zirconia and composite resin cores.

Radiofrequency magnetron sputtering of silicon was applied onto zirconia surfaces by use of a non-doped Si wafer at 2%, 5%, 8%, and 10% oxygen volumes. Immediately after sputtering, the contact angle was practically 0 for all oxygen volume specimens. In terms of sustainability of the hydrophilicity, however, 5% oxygen volume was found to be optimal. Scanning electron microscopy and energy dispersive X-ray spectroscopy clearly suggested the presence of silica layer on zirconia surfaces. The shear bond strength of the pre-treated zirconia and resin was 35.03±4.97 MPa, which was approximately 3.5 times higher than that of zirconia without any sputtering treatment (9.26±1.21 MPa). The failure mode of the pre-treated zirconia specimen was cohesive failure, whereas that of the control specimen was observed to be interface failure.

Comparison of fracture resistance of endodontically treated maxillary first premolar with mesio-occlusal-distal access restored with composite resin, fiber post, and prefabricated metal posts restored with/without full-coverage metal crowns.

Background:A myriad of materials and procedures have been recommended for restoring the root-filled teeth with significant loss of tooth structure and the most common method being the use of “posts.”Material and Methods:A mesio-occluso-distal preparation was done on eighty intact maxillary first premolars, followed by access preparation and cleaning and shaping with rotary files. All samples were obturated and divided into four groups (n = 20). In Group 1, 3-mm gutta-percha was removed and restored using composite resin; Group 2 – Group 1 + crowns; Group 3 – prefabricated fiber post + crowns; and Group 4 – prefabricated metal post + crowns. All the groups were subdivided into eight groups (n = 10), fractured with 90° vertical and 45° oblique loading by a universal testing machine.Statistical Analysis:Fracture resistance was analyzed and compared by means of two-factorial two-way analysis of variance and Scheffe's post hoc test.Results:Under 90° loading, the fracture load of teeth restored with the Nayyar's composite resin core and crown was greatest. Under 45° loading, the fracture load of teeth restored with prefabricated metallic posts was significantly (P < 0.05) less than that in other groups. Under 45° load, group with fiber post exhibited significantly (P < 0.05) more number of favorable fractures than other groups.Conclusion:Under the conditions of vertical and oblique loadings, fiber post and composite resin core with a full-coverage crown is the most effective restorative modality for protecting the remaining tooth structure in pulpless teeth.

Stress Distribution in Maxillary Central Incisors without Ferrules: A Finite Element Analysis of Post and Core Systems

Purpose: The purpose of this study was to identify optimal post and core materials for central incisors without ferrules using three-dimensional finite element analysis and three-point bending tests. Methods: Stress analyses were performed with six models: cast metal post and core (MP), composite resin core alone, straight fiber-reinforced post-composite resin core (FSR), tapered fiber-reinforced post-composite resin core, straight titanium post-composite resin core (TSR), and tapered titanium post-composite resin core (TTR). A 100-N load was applied to the lingual surface at a 45° angle to the long axis of the tooth. Maximum von Mises stress distributions were calculated with finite element analysis software. Five samples each of composite resin, straight fiber-reinforced post, straight titanium post, straight fiber-reinforced post and composite resin, and straight titanium post and composite resin were subjected to three-point bending tests, followed by analysis of variance and Tukey’s multiple comparison test. Results: Stress distribution was optimal on TTR. Maximum von Mises stress on the cervical side of the post was greatest in TSR (693 MPa) and TTR (556 MPa). Maximum stress on the apical side of the post was greatest in MP (110 MPa). Maximum stress in surrounding dentin was lowest in MP (203 MPa) and TTR (250 MPa). Gap distance was smallest in MP (0.09 mm) and largest in FSR (0.26 mm). Mean maximum three-point bending force was lowest in composite resin (26.9 N/mm) and highest in titanium post and composite resin (97.1 N/mm). Titanium post bending strength was consistently greater than that of the fiber-reinforced post (p < 0.01). Conclusion: These results revealed optimal stress distribution and high bending strength with the tapered titanium post and resin combination, suggesting that this combination can most effectively prevent root or post fracture in an anterior tooth without a ferrule.

Fracture strength of endodontically treated teeth restored with novel CAD/CAM ceramic post systems

Aim: The purpose of this study was to investigate the fracture strength (FS) and fracture types of endodontically treated teeth that restored with CAD/CAM made novel ceramic posts.Materials and Methods: Seventy human maxillary central incisors were selected, endodontically treated and expanded to 1.8 mm diameter with leaving of 2-3 mm canal filling. The teeth were randomly divided into 7 post restoration groups (n=10); a glass fiber post system as control (GFbr), monolithic zirconia (GMzr), lithium disilicate (GLds), zirconia-reinforced lithium silicate (GZr_Lds) ceramics, nanoparticle-filled (GRmc_Cer), resin nano-ceramic (GRmc_Lu), and polymer-infiltrated (GRmc_En) resin matrix ceramic groups. Then composite cores were build-up, crown restorations fabricated, and incubated in a water bath (37 ± 10C, 24 hours). A dynamic load was applied at 135° to the long axis of each specimen with a crosshead speed of 1 mm/min. FS and fracture types (favorable-catastrophic) were recorded. The FS values were statistically analyzed with one-way ANOVA and Tukey HSD tests (α=.05). Results: While the FS values of GMzr (365.62 ± 28.52 N) was significantly higher than GFbr (261.07 ± 24.51 N), all other groups (167.09-191.64 N) significantly lower, according to the Tukey HSD (P.05). Catastrophic fractures were observed only for GMzr. Conclusion: The results of this study suggest that the novel CAD/CAM ceramic materials substantially be suitable for the rehabilitation of severely damaged teeth with composite resin core build-up in the anterior region. However, only the monolithic zirconia post restorations may be more durable than the glass fiber post systems.

Development of dental inspection method: nondestructive evaluation of a dentin-adhesive interface by acoustic emission.

Purpose The state of adhesion between root dentin and a resin composite core material was inspected using acoustic emission (AE).Methods A total of 14 human incisors and premolars were used to prepare "no-adhesive group" and "adhesive group" specimens. For "adhesive group" specimens, a bonding agent was applied to root canal dentin. The entire post space was subsequently filled with a resin composite for both specimen groups. The prepared specimens were fixed onto a jig on which an AE sensor was installed. A zirconia ball was used for the impact test, and a vibration wave generated by the collision was measured by the system using an AE sensor. The obtained data were subjected to time-frequency analysis using analysis software (LabVIEW), and the relationship between the amplitude indicating the loudness and the frequency indicating the sound component was analyzed.Results Zirconia-ball collision tests using AE revealed differences between the groups with respect to the waveform of vibration waves transmitted to the root dentin through the root dentin-resin interface. The time-frequency analysis of the obtained data confirmed that multiple peaks were observed for each specimen in the no-adhesive group, whereas a single characteristic vibration peak was observed for all specimens in the adhesive group.Conclusions The state of the adhesive interface was successfully evaluated by AE. This demonstration is expected to lead to the development of a device that can detect problems at the bonding interface between the prostheses and tooth substances.

The investigation of the stress distribution in abutment teeth for connected crowns

Background/purposeWith the advancement of an over aging society, the average number of remaining teeth has increased. However, these remaining teeth do not always have sufficient alveolar bone support, and sometimes fabricated connected crowns are applied. This study evaluated the influence of crown material, crown thickness, and alveolar bone resorption on the stress distribution within the abutment teeth of connected crowns. Materials and methodsUsing structural analysis software, a premolar crown model was fabricated. Three kinds of crown materials, two types of crown thickness, two types of post and core systems, and two levels of alveolar bone were assumed and evaluated for the stress distribution within the abutment teeth. ResultsThe higher material properties crown was, the more stress was concentrated at the marginal area. The composite resin core showed larger stress values around the marginal area, and the metal core showed larger stress values at the tip of the post. Alveolar bone resorption progressed, the marginal area stress value increased. ConclusionThe low elastic modulus crown material polyetheretherketone (PEEK) prevented stress concentrations at the marginal area of the crown and dentine, even with alveolar bone resorption. However, the amount of bone resorption has a great influence on the stress distribution around the tip of the post compared to the type of crown material.

Effect of apexification on occlusal resistance of immature teeth

BackgroundStrain distribution was investigated to assess the occlusal resistance alterations in immature teeth under different occlusal force.MethodsIn vitro apexification models of teeth with a funnel-shaped immature apex were obturated with mineral trioxide aggregate (MTA; ProRoot MTA) using different combinations of core materials (10/group): group 1, full-length orthograde obturation of MTA; group 2, a 5-mm MTA apical plug with a composite core; group 3, a 5-mm MTA apical plug and back-filling with warm gutta-percha. Teeth with calcium hydroxide (CH)-medicated canals and untreated teeth with normal apices were tested as controls. The teeth were arranged between two adjacent normal-apex teeth, embedded in a resin mold with a simulated periodontal ligament space. Strain data were recorded from the 3-unit teeth assembly under static compressive occlusal forces (50, 100, 200, and 300 N). Measurements were repeated 20 times for each condition, and the data were statistically analyzed.ResultsThe immature teeth showed altered occlusal force resistance, placing increased strain on adjacent teeth. Teeth with CH-medicated canals showed significantly inferior occlusal resistance under all tested forces (P < 0.05). Application of an MTA plug with deep composite resin core resulted in significantly better stress-bearing capacity especially under forces of 50 and 300 N (P < 0.05).ConclusionsThe pattern of occlusal force distribution in immature teeth differed according to the canal obturation materials used for apexification. Immature teeth with an MTA apical plug showed more favorable occlusal force resistance than those with CH-medicated canals.

Effect of surface treatment of CAD/CAM resin composites on the shear bond strength of self-adhesive resin cement.

This study examined the effects of sandblasting, hydrofluoric acid etching and priming on the shear bond strength of self-adhesive resin cement between seven different CAD/CAM resin composites and a resin composite core material at 24-h after cement mixing. Five surface treatments [control (C), sandblasting (S), priming (P), sandblasting with priming (SP), and 9% HF etching with priming (HFP)] were performed respectively for disc specimens of CAD/CAM blocks. There were no significant differences in bond strength among the C, S, and P, except for one block (p>0.05). SP showed a greater bond strength than S. Weibull moduli were not changed significantly among all treatments for all blocks, whereas the strengths with 5% and 95% failure probability of SP and HFP showed greater values than the others. The bond strengths of HFP were comparable to those of SP. Priming after sandblasting or HF etching could be effective to increase the bond strength of CAD/CAM blocks.

Evaluation of stress distribution in an endodontically treated tooth restored with four different post systems and two different crowns- A finite element analysis

Aim and objectivesThe study evaluated the stress distribution in an endodontically treated tooth with four different post systems and restored with two different prosthetic crown materials using finite element analysis (FEA). Material and methodsA total of eight 3D FEA models of maxillary central incisor were created and divided into two groups; group porcelain fused to metal (PFM) crown (n = 4) and group PEEK crown (n = 4). The endodontically treated tooth was restored using four different post materials such as fiber-reinforced composite (FRC), carbon fiber-reinforced polyetheretherketone (CFR-PEEK), glass fiber reinforced polyetheretherketone (GFR-PEEK) and polyetherketoneketone (PEKK) and composite resin core. A static load of 100 N was applied and von Mises stress was calculated. The stress ratio in dentin was analyzed by using the Mohr-Coulomb failure theory. ResultsIn dentin, under the applied forces for both, PFM group and PEEK group, it was observed that CFR-PEEK post exhibited minimum von Mises stress while PEKK post exhibited maximum von Mises stress values. The result obtained showed that low stresses were detected using CFR-PEEK post than FRC, GFR-PEEK, and PEKK posts. ConclusionStress observed in dentin, when CFR-PEEK post was used was lesser in comparison to the FRC post. It was noted that PEEK crown and the PFM crown showed similar effect in dentin in stress generation. Hence, PEEK crown can be used as an alternative to the PFM crown.

Influence of post material, post diameter, and substance loss on the fracture resistance of endodontically treated teeth: A laboratory study

Statement of problemThe influence of the flexural modulus of prefabricated posts on the fracture resistance of endodontically treated teeth is unclear. PurposeThe purpose of this in vitro study was to evaluate the influence of post material and post diameter on the fracture resistance of endodontically treated mandibular premolars. In addition, the influence of tooth substance loss was evaluated by comparing 1 with 2 residual dentinal walls. Material and methodsSixty-four extracted mandibular first premolars were endodontically treated and divided into 8 test groups (n=8) based on the number of residual walls (1 or 2), post material (glass fiber or titanium) and post diameter (International Standards Organization [ISO] 70 or ISO 90). After luting the posts, the specimens received a composite resin core and a crown preparation with a 2-mm ferrule. Cast Co-Cr crowns were cemented with glass ionomer cement. After 1 200 000 mastication cycles with a load of 49 N and simultaneous thermocycling (5 °C-55 °C), specimens were quasistatically loaded at 30 degrees to the longitudinal axis of the tooth until fracture. Fracture loads were analyzed by using 3-way ANOVA (α=.05). Fracture modes were examined with a stereomicroscope at ×25 magnification and recorded. ResultsFracture loads ranged from 954 ±35 N (1 residual wall–glass fiber–ISO 70) to 1286 ±202 N (1 residual wall–glass fiber–ISO 90). Titanium posts showed a statistically significant higher fracture resistance than glass fiber posts. A statistically significant increase in fracture resistance was also observed with increasing post diameter. However, no significant difference was found with respect to the number of residual walls (P>.05). ConclusionsTeeth restored with titanium posts exhibited higher fracture resistance than teeth restored with glass fiber posts, especially when smaller diameter posts were used.

Resin Composite Core and Fiber Post Improved the Fracture Parameters of Endodontically Treated Maxillary Premolars with Wedge-shaped Cervical Lesions

IntroductionThe aim of this study was to evaluate the fracture resistance and fracture patterns of endodontically treated maxillary premolars with wedge-shaped cervical lesions restored with a resin composite core with or without a fiber post under nonaxial loading. MethodsSixty extracted human maxillary premolars with 2 root canals were randomly allocated into 4 groups (n = 15). Forty-five teeth were prepared with a wedge-shaped lesion at the buccal cervical area and root canal treatment. There were 3 restoration groups: no restoration, restoration with a resin composite core, and restoration with a resin composite core and a fiber post. Intact teeth served as the control group. All teeth were subjected to thermocycling and cyclic loading. A 45° compressive load was applied to the palatal plane of the buccal cusp until tooth fracture. The fracture resistance and facture patterns were analyzed using 1-way analysis of variance and the chi-square test (α = 0.05), respectively. ResultsThe no restoration group demonstrated the lowest fracture resistance and was significantly different from the other groups (P < .001). The intact teeth presented the highest fracture resistance, which was not significantly different from the restoration with a resin composite core and a fiber post group (P > .05). The failure patterns were significantly different between groups (P < .001). Most intact teeth fractured coronally to the cementoenamel junction level, whereas most teeth in the other groups fractured at the gingival margin of the cervical lesion. ConclusionsEndodontically treated maxillary premolars with wedge-shaped cervical lesions restored with fiber posts and a resin composite cores had a fracture resistance equivalent to intact teeth. However, their fracture patterns were not improved by the fiber post and a resin composite core.

Evaluation of composite resin core with prefabricated polyetheretherketone post on fracture resistance in the case of flared root canals.

The aim of this study was to use polyetheretherketone (PEEK) for the post material and evaluate the fracture load of six restoration patterns in teeth with flared root canals; composite resin core alone (Group R); glass fiber sleeve (Group S); PEEK post (Group P); glass fiber post (Group F); PEEK post in glass fiber sleeve (Group PS); glass fiber post in glass fiber sleeve (Group FS). In this study, cylindroid specimens were prepared and underwent three-point-bending test in a steady condition and after water immersion. In the loading test, the materials in clinical conditions using bovine teeth were evaluated. In the bending test, groups using glass fiber posts and sleeves decreased in strength after water immersion. In the loading test, Groups F, FS and PS showed higher fracture load than other groups. This study showed PEEK posts and glass fiber sleeves are recommended in the case of flared root canals.

Ceramic veneers on teeth with non-carious cervical lesions: case report and finite element analysis

On ceramic veneers rehabilitation, teeth with non-carious cervical lesions (NCCLs), especially premolars, are often involved. Preparation to remove deep NCCLs may lead to excessive wear and a less conservative approach, which goes against the current principles of minimal wear and maximum preservation. However, no evidence exists indicating which technique could avoid excessive wear during the dental preparation for veneers associated with NCCL. Thus, this manuscript has two main purposes: 1) to present an aesthetic treatment with ceramic veneers and follow-up of 24 months of a patient with various levels of NCCL severity and 2) to evaluate various wear protocols for dental veneers associated with NCCL via Finite Element Analysis (FEA) to guide and justify the clinical decision of the clinical case described. A 37-year-old male patient presented for treatment with wear on the anterior teeth and with NCCLs of various severity degrees on the posterior teeth. The treatment chosen was rehabilitation with ceramic veneers on teeth 15 to 25. The best restorative approach for the NCCL teeth was evaluated via an FEA, simulating various protocols and lesion depths while also calculating the percentage of tooth structure loss. Restoring the premolar’s deeper NCCL with a composite resin core, before a ceramic veneer impression, presented better mechanical behavior in FEA and less tooth wear. For the 1.0 mm NCCL, beveling the lesion promoted good stress distribution, less invasive wear and an easier clinical procedure, as it did not involve a previous restorative procedure. It could be concluded that the restorative decision for premolars with NCCLs that will receive veneers should consider the set biomechanical behavior and especially the tooth structure wear necessary. For the case report presented, after two years of follow-up, no changes from the immediate result were observed, indicating that the cause of the lesions was eliminated, and that the treatment was effective, at least in the short-term. For FEA analysis, restoring the deeper NCCL prior to ceramic veneer impression, presented better mechanical behavior and less tooth wear. For the 1.0 mm NCCL, beveling the margin of the lesion generated the same good results.

Effect of different surface treatments of human occlusal sclerotic dentin on micro-tensile bond strength to resin composite core material.

The objectives of this study were to evaluate the micro-tensile bond strength (μTBS) of composite bonded to human occlusal sclerotic dentin following different surface treatments to determine the sclerotic dentin morphology. Human molars without (normal dentin; group 1) or with occlusal wear (sclerotic dentin; groups 2-5) were divided and subjected to different surface treatments, including the normal protocol for the Contax self-etch bonding system (group 1 and 2); doubled etch-prime time (group 3); pre-conditioning with 37% phosphoric acid before normal protocol (group 4); or pre-conditioning with 37% phosphoric acid before doubling the self-etching time (group 5). All teeth were restored with composite (Luxacore Z dual), sectioned into stick specimens and stored for 24h in water before specimens were subjected to the μTBS test (n=50 per group). The μTBS of normal dentin was not statistically significantly different from that of the sclerotic dentin groups, except for the doubled etch-prime time group which showed lower μTBS. Sclerotic dentin pre-treated with phosphoric acid resulted in less sclerotic casts and wider dentinal tubules, while doubled etch-prime time did not alter the morphology, as shown by scanning electron microscopy. In conclusion, the use of 37% phosphoric acid before applying self-etch bonding resulted in more tubule openings and a significantly higher μTBS when compared with the doubled etch-prime time group.

Effect of surface treatments on repair strength, roughness and morphology in aged metal-free crowns

Aim: The roughness and micromorphology of various surface treatments in aged metal-free crowns and the bond strength of these crowns repaired with composite resin (CR) was evaluated in vitro. Methods: A CR core build-up was confectioned in 60 premolars and prepared for metal-free crowns. Prepared teeth were molded with the addition of silicone, and the laboratory ceromer/fiber-reinforced crowns (SR Adoro/Fibrex Lab) were fabricated. Subsequently, the crowns were cemented and artificially aged in a mechanical fatigue device (1.2 X 106 cycles), then divided into 4 groups (n = 15) according to the surface treatment: 1) phosphoric acid etching (PA); 2) PA + silane application; 3) roughening with a diamond bur + PA; and 4) sandblasting with Al2O3 + PA. After the treatments, the crowns (n = 2) were qualitatively analyzed by scanning electron microscope (SEM) and surface roughness (n = 5) was analyzed before and after the surface treatment (Ra parameter). The remaining crowns (n = 8) received standard repair with an adhesive system (Tetric N-Bond) and a nanohybrid CR (Tetric N-Ceram), and the microshear bond strength (SBS) test was performed (0.5 mm/min). Roughness and SBS data were analyzed by one- and two-way ANOVA, respectively, as well as Tukey’s post-test (α = 0.05). Results: Sandblasting with Al2O3 + PA resulted in the highest final roughness and SBS values. The lowest results were observed in the PA group, whereas the silane and diamond bur groups showed intermediate values. Conclusion: It may be concluded that indirect ceromer crowns sandblasted with aluminum oxide prior to PA etching promote increased roughness surface and bond strength values.

Microtomographic Analysis of Resin Composite Core Material Porosity.

To nondestructively evaluate the porosity of ten contemporary resin composite core materials using microtomographic (microCT) analysis. Resin composite core material samples (n = 12) including dual-cure, visible light cure only, and a self-cure material were fabricated using a standardized mold following manufacturer's recommendations. After storage in phosphate buffered saline for one week, specimens were analyzed using a microCT unit at 5.3-µm resolution over a rotational range of 360°. Image 3D recombination and analysis was accomplished using microCT software. Evaluated parameters included material volume investigated, closed pore number and volume, as well as closed pore percentage. Parameter mean values were evaluated with Kruskal-Wallis/Dunn at a 95% confidence level (α = 0.05). Mean percent total porosity with standard deviation identified significant differences in decreasing order as Ti-Core: 2.2 (0.4) > Ti-Core Auto E: 1.3 (0.3) = Ti-Core Flow Plus: 1.1 (0.02) > Clearfil Photo Core: 0.94 (0.5) = Clearfil DC Core Plus: 0.6 (0.18) = MultiCore Flow: 0.58 (0.1) > Fluorocore 2+: 0.14 (0.2) = Build-It FR: 0.068 (0.02) = Gradia Core: 0.03 (0.02) = Rebilda DC: 0.02 (0.01). A pilot microCT evaluation evaluating a mixing tip revealed incomplete mixture between the two resins with porosity introduced from turbulence as the materials are forced through the tip during preparation. A wide range of porosity was identified between the ten materials evaluated. These preliminary results warrant more investigation evaluating additional resin composite core materials, the preparation capabilities of automix tips, and porosity presence in the unmixed materials.

Impact of different surface treatment methods on bond strength between fiber post and composite core material

PurposeTo assess the impact of different surface treatments on the push-out bond strength between fiber post and a composite resin core material. Material and methodsSeventy-two glass-fiber posts were randomly assigned into six groups according to the method of surface treatment: Control (no treatment), silane, sandblasting, hydrofluoric acid, hydrogen peroxide, and hydrogen peroxide with sandblasting. Two posts from each group were inspected under a scanning electron microscope to assess the surface modifications and 10 posts were employed for the push-out test. Each post was placed vertically in the middle of a cylindrical putty matrix and a dual-cure composite resin material was applied for core build-up. Two discs of each specimen were cut using a low-speed diamond saw (total 120 discs). The push-out test was executed using a universal testing machine at a crosshead speed of 0.5 mm/min. Statistical analysis was performed using one-way ANOVA and Tukey’s test (p ≤ 0.05). The mode of failure of each disc was evaluated under SEM. ResultsThe sandblasting and hydrofluoric acid groups presented significantly higher bond strength than control and hydrogen peroxide groups. The hydrogen peroxide groups exhibited significantly the lowest bond strength of all groups. There was no significant difference between the control and silane groups. All groups showed predominantly adhesive failure except the hydrogen peroxide with sandblasting, where the cohesive failure of the post was predominant. ConclusionsSandblasting and hydrofluoric acid surface treatments demonstrated superior results to silane and hydrogen peroxide. The combined method of hydrogen peroxide and sandblasting could weaken the fiber post and lead to clinical fractures.

Effect of Loading Direction, Crown Coverage, and Adjacent Teeth on Stresses in Post-Restored Premolars

The aims of this finite elemental stress analysis (FEA) study were to evaluate the effects of loading direction, crown coverage, and adjacent teeth on stress distribution in premolar tooth models restored using fiber-post restoration. Three 3D premolar tooth FEA models were created as follows: Model 1: sound tooth; Model 2: tooth-model including root filling, fiber-post and composite resin restoration; Model 3: tooth-model including root filling, fiber-post, composite resin core and ceramic crown. Three more models were created using Models 1, 2, and 3 with adjacent teeth (Models 4, 5, and 6). The Cosmoworks structural-analysis program was used for the stress analysis, which was based on the von Mises criterion. High stress concentrations were observed at the mesial side of the sound tooth models while the stresses were localized at both sides in the others. Loading with a nonzero inclination angle caused higher stress concentrations within the tooth structure than is other models with the normal/vertical loading. The presence of adjacent teeth strongly influenced stress distributions and concentrations in Models 4, 5, and 6, reducing the stress level. Meanwhile, crown restoration did not change the stress patterns.

Endodontic Access Effect on Full Contour Zirconia and Lithium Disilicate Failure Resistance.

To evaluate the effect of endodontic access on the failure load resistance of both adhesively and conventionally luted, full-contour monolithic yttria-stabilized zirconium dioxide (Y-TZP) and adhesively luted lithium disilicate (LD) crowns cemented on prepared teeth. Seventy-two human maxillary molars were prepared per respective guidelines for all-ceramic crowns with one group (n=24) restored with LD and the other (n=48) receiving Y-TZP crowns. Preparations were scanned using computer-aided design/computer-aided milling (CAD/CAM) technology, and milled crowns were sintered following manufacturer recommendations. All LD crowns and half (n=24) of the Y-TZP crowns were adhesively cemented, while the remaining Y-TZP specimens were luted using a conventional glass ionomer cement (GIC). One LD group, one Y-TZP adhesive group, and one GIC-luted group (all n=12) then received endodontic access preparations by a board-certified endodontist: the pulp chambers were restored with a dual-cure, two-step, self-etch adhesive and a dual-cure resin composite core material. The access preparations were restored using a nano-hybrid resin composite after appropriate ceramic margin surface preparation. After 24 hours, all specimens were loaded axially until failure; mean failure loads were analyzed using Mann-Whitney U test (α=0.05). Endodontic access did not significantly reduce the failure load of adhesively luted LD or Y-TZP crowns, but Y-TZP crowns with GIC cementation demonstrated significantly less failure load. These initial findings suggest that endodontic access preparation may not significantly affect failure load resistance of adhesively luted Y-TZP and LD crowns. Definitive recommendations cannot be proposed until fatigue testing and coronal seal evaluations have been accomplished.