Fatigue Properties of Weakened and Non-weakened Roots Restored with CAD-CAM Milled Fiber Post, Prefabricated Fiber Post, or Cast Metal Post.

STATEMENT OF PROBLEM: Customized glass fiber posts using CAD-CAM technology have been suggested for restoring endodontically treated teeth. However, how weakened or non-weakened roots restored with anatomical CAD-CAM posts behave under cyclic fatigue is not clear. OBJECTIVE: To evaluate the load-bearing capacity under fatigue (fatigue failure load [FFL], the number of cycles for failure [CFF], and survival probabilities) and fracture pattern of weakened and non-weakened roots restored with CAD-CAM fiber post and cores, metal cast-post-core, and prefabricated fiber post and resin core. METHODS AND MATERIALS: A total of 60 crack-free bovine incisor roots (13 mm in length) with standard geometry were obtained and randomly allocated considering the factor "root condition" in two levels (weakened and non-weakened). Thus, half of the roots were weakened to obtain a wall thickness of 0.5 mm. After that, the endodontic treatment was executed, all roots embedded with acrylic resin and the specimens randomly allocated (n=10) considering the factor "post system" in three levels (CAD-CAM: CAD-CAM milled glass-fiber post and core; MBC: metallic-based post and core; and FRC: prefabricated glass-fiber post and composite resin core). The posts were luted with a dual-cure self-adhesive luting agent. Then, all teeth received a metallic crown. An initial load of 100 N at 20 Hz for 5000 cycles was applied for the step-stress fatigue test, followed by incremental steps of 50 N for 20,000 cycles each step, up to failure. A fracture pattern analysis was performed. RESULTS: CAD-CAM fiber post (FFL: 865 N; CFF: 311,000 cycles) presented similar fatigue performance (p>0.05) to FRC (FFL: 925 N; CFF: 335,000 cycles), with 100% of repairable fractures for non-weakened roots; however, both groups presented worse performance than MBC (p<0.05; FFL: 1265 N; CFF: 471,000 cycles) which led to 100% of catastrophic failures. No statistical difference was found in fatigue performance among the three systems for weakened roots (p>0.05; FFL: 1035-1170 N; CFF: 379,000-433,000 cycles), with a high rate of catastrophic failures. CONCLUSIONS: CAD-CAM fiber post presented similar fatigue performance to MBC and FRC approaches when restoring weakened roots. CADCAM was similar to FRC when restoring non-weakened roots, while MBC enhanced fatigue properties in this scenario.

Effect of Different Surface Treatments of Resin Relined Fiber Posts Cemented With Self-adhesive Resin Cement on Push-out and Microtensile Bond Strength Tests.

CLINICAL RELEVANCE: When luting relined fiber posts with self-adhesive cement, the surface treatment of the posts influences the adhesion of the fiber posts to root dentin. SUMMARY: This study evaluated the effect of surface treatment and silanization of resin composite on the bond strength of relined fiber posts cemented with self-adhesive resin cement. Push-out and microtensile bond strength (MTBS) tests were performed in this study. The endodontic treatment of 80 single-rooted bovine teeth was first performed in the push- out test segment, followed by weakening the intracanal walls by diamond bur. Then, the glass fiber posts were adapted with resin composite to fill the root canals, followed by photoactivation and resin surface conditioning according to four different experimental conditions: no conditioning as control, 10% hydrofluoric acid, 35% hydrogen peroxide, or air abrasion with alumina particle (all groups were subdivided into "with silanization" or "without silanization," thus totaling eight experimental groups). Self-adhesive resin cement was used for the post cementation. Four slices per tooth were obtained for the push-out tests. Next, 160 blocks of resin composite were first produced for the MTBS tests; their bonding surfaces were conditioned (as mentioned, ie, eight treatments), and they were cemented to each other. The 80 sets (n=10/treatment) were then cut into microbars (16/set): eight were immediately tested, while the other eight were thermocycled (12,000×) and stored (120 days) before MTBS. Failure modes and topographic analyses were performed after treatments. There was no statistically significant difference for the push-out results. In MTBS, surface treatment and silanization had a significant effect (p<0.001). Aging decreased bond strength for all groups. Considering the aged groups, air abrasion promoted the highest values and silanization improved bond strength for all treatments except air abrasion. The alumina particle air abrasion of the relining resin composite promoted the highest bond strengths when luting with self-adhesive resin cement.