Fiber Reinforcement of Endodontically Treated Teeth: What Options Do We Have? Literature Review.

The restoration of endodontically treated teeth (ETT), even though practiced for many years, remains a major concern in dentistry. There is a variety of materials and clinical techniques advocated for restoring ETT and hundreds of studies devoted to this subject have been published in the dental literature. This narrative review article was undertaken to answer a question regarding restoration of ETT with available evidence: What fiber reinforcement options do we have other than prefabricated fiber post? Using a Medline search (up to 2019) and resulting cross-references, authors selected original research on the topic of fiber-reinforced composite (FRC) and restoration of ETT. Of the assessed articles selected (n=79), most were laboratory-based research with various test specimen designs and only 15 articles were clinical reports. From the reviewed studies, using individually formed FRC posts and short-FRC resin showed promising characteristics, and therefore, might be recommended as an alternative treatment option in restoring ETT. However, long-term clinical trials are needed in order to evaluate the usefulness of these alternatives.

A prospective randomized clinical trial of one bis-GMA-based and two ormocer-based composite restorative systems in class II cavities: Five-year results.

OBJECTIVES: Ormocer composites, consisting of a silicon-based polymer, have been developed recently as a tooth-colored restorative material. The purpose of this prospective randomized clinical trial was to evaluate the performance of two small-particle hybrid ormocer-based restorative systems (AD, Admira/Admira Bond, VOCO; DE, Definite/Etch & Prime 3.0, Dentsply) and one small-particle hybrid bis-GMA-based composite restorative system (TC, Tetric-Ceram/Syntac, Ivoclar-Vivadent) in class II cavities. METHODS: From 128 occlusal-proximal restorations (44 AD, 43 DE and 41 TC) placed in 32 adult patients, eventually 77 (22 AD, 29 DE and 26 TC) remained available for evaluation after 5 years. Their clinical performance was scored according to the USPHS criteria and evaluation of bite-wing radiographs. RESULTS: After 5 years, eight AD, six DE and seven TC restorations had failed (p=0.10, log-rank test). The main reason was fracture or marginal gap formation, while secondary caries accounted for four failures. In all restorations the quality of surface, margins and contact point decreased significantly compared to baseline. DE had a significant poorer color match (p<0.01). Statistical evaluation using the KW test showed that failures were concentrated on specific patients. CONCLUSIONS: In a group of class II restorations, there was no significant difference in failures after 5 years between ormocer-based and bis-GMA-based restorative systems.

A prospective randomised clinical trial of one bis-GMA-based and two ormocer-based composite restorative systems in class II cavities: three-year results.

OBJECTIVES: Ormocer composites, consisting of a silicon-based polymer, have been developed recently as a tooth-coloured restorative material. The purpose of this prospective randomised clinical trial was to evaluate the performance of two small-particle hybrid ormocer-based restorative systems (AD, Admira/Admira Bond, VOCO; DE, Definite/Etch & Prime 3.0, Dentsply) and one small-particle hybrid bis-GMA-based composite restorative system (TC, Tetric-Ceram/Syntac, Ivoclar-Vivadent) in occlusal stress-bearing restorations. METHODS: One hundred and twenty-eight occlusal-proximal restorations (44 AD, 43 DE and 41 TC) were placed according to the manufacturer's instructions in thirty-two adult patients. Their clinical performance was scored according to the USPHS criteria and evaluation of bite-wing radiographs. RESULTS: After 3 years, four AD, five DE and four TC restorations had failed due to fracture or marginal gap formation. Surface roughness improved significantly when compared to the baseline in AD and TC (Friedman test, p<0.05) during the first year but returned to baseline values after 3 years. DE had a significant tendency towards discolouration (p<0.05). Bite-wing radiographs showed two AD and one TC restorations with internal porosities. ANOVA showed that larger restorations (> or = 3 surfaces) showed significantly more degradation than smaller ones. CONCLUSIONS: In a group of class II restorations, there was no significant difference in failures after 3 years between ormocer-based and bis-GMA-based restorative systems.