Comprehensive analyses of how tubule occlusion and advanced glycation end-products diminish strength of aged dentin.

In clinical dentistry, since fracture is a major cause of tooth loss, better understanding of mechanical properties of teeth structures is important. Dentin, the major hard tissue of teeth, has similar composition to bone. In this study, we investigated the mechanical properties of human dentin not only in terms of mineral density but also using structural and quality parameters as recently accepted in evaluating bone strength. Aged crown and root dentin (age ≥ 40) exhibited significantly lower flexural strength and toughness than young dentin (age < 40). Aged dentin, in which the dentinal tubules were occluded with calcified material, recorded the highest mineral density; but showed significantly lower flexural strength than young dentin. Dentin with strong alignment of the c-axis in hydroxyapatite exhibited high fracture strength, possibly because the aligned apatite along the collagen fibrils may reinforce the intertubular dentin. Aged dentin, showing a high advanced glycation end-products (AGEs) level in its collagen, recorded low flexural strength. We first comprehensively identified significant factors, which affected the inferior mechanical properties of aged dentin. The low mechanical strength of aged dentin is caused by the high mineral density resulting from occlusion of dentinal tubules and accumulation of AGEs in dentin collagen.

The use of a fiber sleeve to improve fracture strength of pulpless teeth with flared root canals.

OBJECTIVES: This study aimed to investigate how use of a fiber sleeve may reduce interfacial debonding and improve fracture strength of pulpless teeth with flared root canals. METHODS: Pulpless premolars with flared root canals were restored either with a fiber-reinforced post (FRP) alone or with an FRP wrapped in a hollow tubular fiber sleeve. A normal root restored with an FRP alone served as a control. The integrity of resin-dentin and resin-fiber interfaces in the restored roots was evaluated by a stereoscopic system after penetrating a dye. Four roots were tested for each experimental group. Fracture resistance in pulpless premolars with flared root canals restored with an FRP alone or with an FRP/sleeve combination were investigated under bonded and non-bonded conditions with static fracture testing (n=8), and stress distribution in these restored premolars were tested by finite element analysis (FEA). RESULTS: Flared root canals restored with an FRP/sleeve combination demonstrated superior integrity at the cervical resin-dentin interface to root canals with an FRP alone. Premolars with a flared root canal restored with an FRP/sleeve combination showed significantly greater fracture resistance compared with premolars restored with an FRP alone. FEA showed that once interfacial de-bonding extended to the cervical region of the root, stress concentration in the root dentin dramatically increased. SIGNIFICANCE: The FRP/sleeve combination was effective in reducing debonding and, hence, improving the fracture strength of pulpless premolars with flared root canals.