ABSTRACT
The evidence base on minimally invasive endodontic (MIE) treatment is limited. This study investigated the influence of MIE shaping on vertical root fracture (VRF) resistance and crack formation of root canal filled teeth. Human maxillary central incisors were randomized into six groups (n = 18, power = 0.9) and embedded in acrylic blocks with artificial periodontal ligaments. The root canals were either instrumented to size #40 and 0.04 taper (+MIE) or enlarged to ISO size #80 (-MIE). The canals were filled with cement-based (C) or adhesive resin-based (A) sealers in single-cone technique. The controls received no treatment or were left unfilled. After chewing simulation (staircase method, 25-150 N, 120,000×), the crack formation on the root surface was analyzed using stereomicroscope/digital imaging and classified (no defect, craze line, vertical crack, horizontal crack). Subsequently, the samples were loaded until fracture. The incidence of defects (56% vertical cracks) was not significantly different between the groups (p ≥ 0.077). VRF resistance was significantly higher in untreated teeth than in +MIE/C (p = 0.020) but did not significantly differ between the other groups (p ≥ 0.068). Minimal canal shaping did not reduce the risk of vertical root fracture and defects of root canal filled teeth.
Subject(s)
Tooth Fractures , Tooth Root , Humans , Tooth Root/injuries , Root Canal Therapy/methods , Incisor/injuries , Minimally Invasive Surgical Procedures/methods , Root Canal Preparation/methods , Root Canal Preparation/adverse effectsABSTRACT
The aim was to investigate the vertical root fracture (VRF) resistance and crack formation of root canal-treated teeth restored with different post-luting systems. Human maxillary lateral incisors of similar size were decoronated, assigned to five groups (n = 18, power = 0.9) and embedded in acrylic blocks with artificial periodontal ligament. After root canal filling, post spaces were prepared to place coated fiber-reinforced composite (FRC) or sandblasted titanium (Ti) posts of the same shape and size. Half of the posts were zinc phosphate cemented (C), while the other half was adhesively luted (A). Untreated teeth served as control. After thermal cycling and staircase loading in a chewing simulator, the crack formation on the root dentin surface was microscopically examined and classified as no defect, craze line, vertical crack, and horizontal crack. Subsequently, the samples were loaded until root fracture. Data were analyzed by one-way ANOVA, Tukey's test, and Fisher's exact test. All samples survived the chewing simulation without VRF, but crack formation was significantly different between the groups (P = 0.009). The control showed significantly fewer defects than FRC/C, Ti/C, and Ti/A (P = 0.001, P = 0.008, P = 0.008, respectively). FRC/C showed the highest incidence of vertical cracks. FRC/A had the lowest incidence of defects. There was no significant difference in VRF resistance between the groups (P = 0.265). Adhesively luted FRC posts did not increase VRF resistance but reduced the risk of defects. Most defects were craze lines and vertical root cracks.
Subject(s)
Post and Core Technique , Tooth Fractures , Composite Resins , Dental Pulp Cavity , Dental Stress Analysis , Humans , Incisor , Root Canal Therapy , Tooth Fractures/prevention & controlABSTRACT
PURPOSE: To evaluate post-to-composite bonds in terms of their durability, achieved either by physical vapor deposition (PVD) or tribochemical silica coating (TSC) compared to coupling strategies for fiber posts at chairside. MATERIALS AND METHODS: Thirty uncoated fiber posts (DT Light) each were either left untreated (control) or silanized with a one-bottle (Monobond Plus) or a two-bottle (Clearfil SE Bond/Porcelain Bond Activator) silane at the chairside. Thirty coated fiber posts each had already been silica coated and silanized by the manufacturer using PVD (DT Light SL) or TSC (DentinPost Coated) deposition techniques. Surface analysis was carried out by profilometry and x-ray microanalysis. All the posts were surrounded by 2-mm-thick disks of a dual-curing composite resin (MultiCore Flow). After water storage for 24 h at 37°C, the specimens in each group were randomly divided into three subgroups (n=10) and subjected to 0, 1500, and 20,000 thermocycles (5°C to 55°C) prior to push-out testing. Failure modes were evaluated by optical and scanning electron microscopy. The statistical significance was determined with two-way ANOVA, the Student-Newman-Keuls test, and Fisher's exact test. RESULTS: The conditioned posts had significantly higher interfacial bond strengths than the control posts after thermocycling (p<0.05). Extended thermocycling significantly reduced the interfacial strength of chairside silanized posts (p<0.05). This effect was not significant with industrially coated posts (p>0.05). Coatings deposited by TSC reached the highest bond values (p<0.05) and showed predominantly adhesive failures in the form of coating delamination (p<0.0001). In contrast, the other coupling strategies showed significantly lower values and adhesive failures between the post and the composite. CONCLUSION: PVD and TSC techniques enhanced the bond durability of fiber posts. TSC led to a superior post-tocomposite bond, probably based on more effective micromechanical adhesion due to the higher surface roughness.