Evaluation of fracture behavior in short fiber-reinforced direct and indirect overlay restorations.

OBJECTIVES: The aim was to assess how incorporating a short-fiber composite (SFC) core would affect the fracture behavior of direct and indirect overlays. Furthermore, to examine the relationship between the thickness ratio of SFC core to particulate-filled composite (PFC) veneering and the fracture-behavior of bilayered-structured restorations. MATERIALS AND METHODS: A total of 120 molars were used to create MOD cavities, with palatal cusps removed. Four different groups of direct overlays were then made (n = 15/group), all of which featured a SFC core (everX Flow) with varying thicknesses (0, 1, 4, and 5 mm), as well as a surface layer of PFC (G-aenial Posterior), with the overall thickness of the bilayered-structured restoration set at 5 mm. Additionally, four groups of CAD/CAM restorations were created (Cerasmart 270 and Initial LiSi Block), with or without 2 mm of SFC core reinforcement. Following the fabrication of these restorations, cyclic fatigue aging was carried out for a total of 500,000 cycles, with an applied maximum load (Fmax) of 150 N. Subsequently, each restoration underwent quasi-static loading until fracture. The fracture mode was subsequently evaluated using optical microscopy and SEM. RESULTS: There were no statistically significant differences (p > 0.05) observed in the fracture resistance of indirect overlays reinforced with a 2-mm SFC core compared to those made solely from restorative materials. Direct overlays constructed using plain SFC or with a 4-mm layer thickness of SFC core exhibited significantly higher fracture resistance values (2674 ± 465 and 2537 ± 561 N) (p < 0.05) when compared to all other groups tested, according to the statistical analysis ANOVA. CONCLUSIONS: The most effective method for restoring large MOD cavities was found to be direct restoration using SFC either alone or as a bulk core in combination with PFC composite. CLINICAL RELEVANCE: The use of SFC as bulk reinforcing base will significantly improve the loading performance of directly layered restorations.

A conservative multidisciplinary approach for improved aesthetic results with traumatised anterior teeth.

A subgingival crown-root fracture presents a restorative problem to the clinician because restoration is complicated by the need to maintain the health of the periodontal tissues. If the remaining portion of the root is thought to be enough to support a definitive restoration, the root may be extruded by orthodontic forced eruption after root canal treatment. Extrusion enables the remaining root portion to be elevated above the epithelial attachment. Endodontic posts may be useful in exerting vertical forces to the root for extrusion without buccal tipping. The following case shows multidisciplinary management of a case of dental trauma. Orthodontic forced eruption is incorporated using endodontic posts and restoration with porcelain fused to metal crowns--leading to successful restoration of the traumatised teeth.

Coating of silicone-based impression materials in a glow-discharge system by acrylic acid plasma.

OBJECTIVES: The main purpose of this study was to demonstrate an increase in the wettability of silicone-based impression materials after coating them with a hydrophilic film in a glow-discharge system. METHODS: Two vinyl polysiloxane impression materials, Extrude (Kerr) and Accuflex (GC America Inc.) were used. Impression specimens were treated in a glow-discharge reactor at a radio frequency of 13.56 MHz at different discharge powers (5-20 W) and exposure times (5-60 min). Surface analysis of the specimens was done by FTIR. Surface contact angles were obtained by a captive-bubble method. These results were analyzed by ANOVA and Duncan's Multiple Range test (p < 0.05). The total number of voids on the die stone casts was observed microscopically. Linear dimensional accuracy, detail reproducibility, and surface hardness of the die stone casts were also determined. A Student t-test was performed for statistical analysis of these parameters (p > 0.05). RESULTS: FTIR spectra indicated that the number of hydroxyl groups on the surfaces increased (p > 0.05) because of the glow-discharge treatment. Contact angle measurements showed an increase (p < 0.05) in surface hydrophilicity. Total void formation in the stone casts decreased. There were no significant differences in the linear dimensional accuracy, detail reproducibility, and hardness, before and after glow-discharge treatment (p > 0.05). SIGNIFICANCE: It was concluded that the surface wettability of the impression materials may be increased by plasma deposition, and therefore, the formation of voids was reduced in the stone casts.