A Novel Concept for Developing a Precise and Predictable Post and Core Complex Using the Injectable Resin Technique (Part 2).

Post and core systems have long been used in dentistry for the purposes of replacing missing coronal tooth structure, retaining the core, and providing sufficient retention and resistance form to the final restoration to re-establish original form and function. While Part 1 of this two-part article provided a history of post and core systems and materials and discussed empirical data regarding fiber-reinforced post systems, this second part of the article focuses on an alternative approach for developing a fiber-reinforced post and core system using a monoblock system via the injectable resin technique and a recently developed fiber-optic post. The present article explains the concept of a ferrule effect and demonstrates the novel restorative procedure.

Clinical evaluation of resorbable polylactic acid (PLA) intracanal posts for primary incisor restoration. Randomized controlled clinical trial.

This randomized, controlled clinical trial compares the clinical performance of glass-fibre and resorbable polylactic acid (PLA) intracanal posts used to restore carious primary incisors in young patients. The study sample includes 180 primary upper central incisors of 90 children aged 3 to 4 years. All patients were randomly divided into two equal groups of 45 children who received PLA and glass-fibre (GFP) intracanal posts. The clinical assessment of incisor restorations was carried out immediately upon completion and at months 3, 6 and 12 according to the following criteria: anatomical form, marginal adaptation, surface roughness, marginal pigmentation, colour match, secondary caries and contact point. The Gingival Index (GI), the Bleeding Index (Cowell modification; mBI), and bite force (BF) were measured. At the 3-month follow-up, the occlusal BF of patients who received PLA posts was higher than the baseline; the GI and mBI scores were lower, by contrast (p < 0.05). This tendency was even more pronounced 6 and 12 months after the restoration. The incidence of side effects or symptoms (apical inflammation, cervical fracture, loosening of the crown) after the PLA posts was significantly lower than after the GFP (p < 0.05). No statistically significant differences were present between the two groups with respect to colour matching, anatomical form, marginal adaptation, marginal pigmentation, surface roughness, occlusal contact and secondary caries. Based on the results, applying PLA intracanal posts and cyanoacrylate to residual anterior crowns in young children can improve their gingival health, reduce side effects, and increase the likelihood of successful restoration.

Comparative analysis of stress distribution in residual roots with different canal morphologies: evaluating CAD/CAM glass fiber and other post-core materials.

BACKGROUND: The selection of post-core material holds significant importance in endodontically treated teeth, influencing stress distribution in the dental structure after restoration. The use of computer-aided design/computer-aided manufacturing (CAD/CAM) glass fiber post-core possesses a better adaptation for different root canal morphologies, but whether this results in a more favorable stress distribution has not been clearly established. MATERIALS AND METHODS: This study employed finite element analysis to establish three models of post-core crown restoration with normal, oversized, and dumbbell-shaped root canals. The three models were restored using three different materials: CAD/CAM glass fiber post-core (CGF), prefabricated glass fiber post and resin core (PGF), and cobalt-chromium integrated metal post-core (Co-Cr), followed by zirconia crown restoration. A static load was applied and the maximum equivalent von Mises stress, maximum principal stress, stress distribution plots, and the peak of maximum displacement were calculated for dentin, post-core, crown, and the cement acting as the interface between the post-core and the dentin. RESULTS: In dentin of three different root canal morphology, it was observed that PGF exhibited the lowest von Mises stresses, while Co-Cr exhibited the highest ones under a static load. CGF showed similar stress distribution to that of Co-Cr, but the stresses were more homogeneous and concentrated apically. In oversized and dumbbell-shaped root canal remnants, the equivalent von Mises stress in the cement layer using CGF was significantly lower than that of PGF. CONCLUSIONS: In oversized root canals and dumbbell-shaped root canals, CGF has shown good performance for restoration of endodontically treated teeth. CLINICAL RELEVANCE: This study provides a theoretical basis for clinicians to select post-core materials for residual roots with different root canal morphologies and should help to reduce the occurrence of complications such as root fracture and post-core debonding.

Evaluation of mechanical properties of anatomically customized fiber posts using E-glass short fiber-reinforced composite to restore weakened endodontically treated premolars.

OBJECTIVE: This study was conducted to assess the influence of combining different forms of fiber-reinforced composites (FRC) on the mechanical behavior and bond strength of compromised endodontically treated teeth (ETT). MATERIALS AND METHODS: Eighty extracted human premolar teeth were randomly divided into five experimental groups according to the type of intra-radicular restoration and the canal preparation design which was either non-flared (Group 1), flared (Groups 2-5), closed-apex (Groups 1,3,5) or open-apex (Groups 2,4). Standard prefabricated fiber posts were used as intra-radicular restoration for Groups 1-3 while Groups 4-5 were restored with anatomically customized relined fiber posts. After composite core fabrication, all samples were sent for an artificial aging process. Fracture resistance and push-out bond strength tests were then carried out through a universal testing machine followed by mode of failure analysis via a stereomicroscope and scanning electron microscope. RESULTS: Pairwise Log-Rank comparisons revealed that the survival rate of Group 2 and Group 3 was significantly lower than all other groups after artificial aging. The highest fracture resistance value (1796 N) was recorded in Group 5 and was significantly higher than that of the other groups (p < 0.05), while Group 2 exhibited the lowest fracture resistance (758 N), which was significantly lower compared to the other groups. Group 5 and Group 4 demonstrated a significantly higher push-out bond strength, at all root thirds, than Group 3, Group 2, and Group 1 (p < 0.05). The most frequently observed failure mode in the tested groups occurred between the resin cement and radicular dentin. CONCLUSION: The use of short fiber-reinforced composite (SFRC) to reline the prefabricated FRC post has been proven to have superior fracture resistance with favorable failure patterns and increased push-out bond strength values compared to standard prefabricated FRC posts.

Radiographic Assessment of 121 Glass Fiber Post Procedures in 32 Patients Aged 21-60 Years Performed by 6th-Year Dental Students During the 2022-2023 Academic Year at the College of Dentistry, Jazan University, Saudi Arabia.

BACKGROUND The restoration of endodontically treated teeth (ETT) and severely damaged teeth has been a concern of clinicians. Glass Fiber Post (GFPs) combine the strength of carbon fiber posts with the esthetic appearance of glass to resemble natural dentin during dental restoration procedures. This radiographical study assessed the GFP carried out by students enrolled in the Clinical Comprehensive Course at the College of Dentistry, Jazan University. MATERIAL AND METHODS A total of 32 patients treated by 18 6th-year dental students with 121 GFPs were assessed in this cross-sectional radiographic study. The assessment covered tooth type, arch, post-to-root width, length of post in relation to the crown and root lengths, amount of remaining gutta percha (GP), and gap between GP and post. Data were analyzed using SPSS, and associations between variables were determined using the chi-square test. RESULTS Maxillary teeth were the most frequently restored with posts (88.4%) with most being (58.7%) anterior teeth, and 50.4% of posts had widths that were one-third that of the root. The percentage of posts was twice (71.1%) or equal to (26.4%) the crown length, whereas two-thirds of the tested GFPs were >5 mm of the remaining GP. Significant differences were observed in location and position of teeth with post width, post length in relation to crown or root length, and amount of remaining GP, with P values of 0.018, 0.000, and 0.001, respectively. CONCLUSIONS The assessed radiographs revealed that the performance of sixth year students in accomplishment GFP radiographically was satisfactory and within the values recommended in the literature.

Evaluation of the Mechanical Properties of 3D-Printed Post and Core Systems.

PURPOSE: To evaluate and compare the fracture resistance and elastic modulus of 3D-printed post and core systems and fiber posts and composite cores. MATERIALS AND METHODS: Endodontic treatment was performed on 30 mandibular premolars, and post space preparation was performed. The teeth were then randomly divided into two groups (n = 15 per group): the 3D-printed (3DP) group and the fiber post and composite core (FPC) group. In the FPC group, fiber posts (Cytec Blanco 43.604, Hahnenkratt) were bonded with resin cement (RelyX U200, 3M), and the composite core dimension was standardized with a silicone index. In the 3DP group, the impression of the post space for each specimen was taken with pattern resin (Pattern Resin, GC America), and the coronal core was produced with the same silicone index. The impressions of the posts and cores were scanned, and then the custom post and core structures were fabricated from permanent crown resin material (Permanent Crown Resin, Formlabs) with a 3D printer (Form3B, Formlabs). Specimens were subjected to load tests with a universal testing machine (M500-25AT, Testometric). After fracture occurred, the fracture force and elastic modulus were calculated. The data were analyzed by independent sample t test (α = .05) Results: There was no statistically significant difference between the two groups in terms of peak fracture force (P = .626) and elastic modulus (P = .125), and no catastrophic root fractures were observed in either group. CONCLUSIONS: The fracture resistance of endodontically treated teeth was not significantly influenced by the post material. 3D-printed, custom-made resin posts were as effective as fiber glass posts with regard to fracture resistance.

Removal Efficiency and Effectiveness of Four Different Fiber Posts Using Five Different Drill Systems in Multirooted Teeth.

AIM: In comparing the effectiveness and efficiency of different types of post removal systems in removing different types of fiber posts (FPs), this study aims to shed light on the success of removal by currently available drill systems. MATERIALS AND METHODS: A total of 200 maxillary first molars, were root canal treated and prepared to receive posts. The molars were divided into four groups corresponding to four different FPs: Group RX, Radix FP; Group RF, Reforpost Glass Fiber; Group HI; Hi-Rem Endodontic Post; and Group DT, D.T. Light-Post Illusion X-RO. Fiber posts were done with luting by Gradia Core (GC America, Inc.). Groups were again divided into five subgroups corresponding to the technique by which the FP was removed into as follows: Subgroup P, PD-25-1.1 Drill; subgroup G, GC FP Drill; subgroup E, EasyPost Precision Drill; subgroup R, Reaccess Carbide Double Taper Kit; and subgroup H; H-Endodontic Drill. After posts were removed, effectiveness and efficiency were documented. Data were tabulated and statistically analyzed. RESULTS: Strong significant differences regarding efficiency among groups (FP type) and subgroups (drills used) (p = 0.00) were shown by the one-way analysis of variance (ANOVA) test. Subgroup DT-G scored the longest mean removal time (20.9 minutes) while Subgroup RX-R scored the shortest mean removal time (1.4 minutes) Regarding effectiveness, strong significant differences among groups (p = 0.00) and subgroups (p = 0.00) were shown by one-way ANOVA. Subgroup RF-G scored the highest scale (5.2) whereas subgroup HI-R scored the lowest mean scale (1.2). CONCLUSION: The difference was strongly significant between tested post-removal kits and between tested FPs. Re-access Carbide Double Taper Kit performed superiorly in both effectiveness and efficiency, followed by PD-25-1.1 Drill. Hi-Rem post showed the best retrieving results among other FPs. CLINICAL SIGNIFICANCE: Knowing the best technique and tools for post removal could spare the practitioner any unwanted complications during post removal. How to cite this article: Sayed M, Alahmad AM, Alhajji KS, et al. Removal Efficiency and Effectiveness of Four Different Fiber Posts Using Five Different Drill Systems in Multirooted Teeth. J Contemp Dent Pract 2024;25(1):72-78.

A Novel Concept for Developing a Precise and Predictable Post and Core Complex Using the Injectable Resin Technique.

Post systems have long been used in the roots of teeth to retain dental restorations. The primary objectives of current post and core systems are to replace missing coronal tooth structure, retain the core, and provide sufficient retention and resistance form to the final restoration to restore original form and function. Many varieties of user-friendly post and core systems are available today for different endodontic, restorative, and esthetic requirements. The present article provides a history of post and core usage in dentistry, describes various systems and materials for this purpose, and discusses empirical data regarding fiber-reinforced post systems.

Evaluation the stress distribution in root canals by 3D finite element analysis after the materials used in reattaching the vertically root fractured fragments.

The aim was to evaluate the effect of stress distribution on vertical, horizontal, and oblique forces on the tooth model after reattaching the fragments of the maxillary incisor with vertical root fracture (VRF) using different materials, by 3D finite element analysis (FEA). Tooth with a root canal, spongious, and cortical bone models were designed. VRF was modeled on a tooth with 4 different re-attachment models: Group 1: dual-cure cement (DC)+fiber reinforced composite (FRC), Group 2: DC+polyethylene fiber, Group 3: DC+glass fiber, and Group 4:DC. 100 N force was applied in 3 different directions. Maximum principal stresses (σmax) of dentin, and re-attachment materials were evaluated on colored images. The highest σmax values ​​were on the repair materials under vertical forces for Groups 1 and 4, respectively; Groups 2 and 3 showed similarity. The highest σmax values in repair materials under horizontal and oblique forces were observed in Group 3 however the lowest σmax values in repair materials under oblique and horizontal forces were observed in Group 1. The stress values ​​on repair materials gradually increased respectively starting from horizontal to vertical. As the elasticity modulus of the repair materials increased, the stress values ​​on root dentin increased. Through all force directions, except vertical forces, lower stress values were observed with FRC. The fracture resistance was bigger when using solely FRC or dual-cure resin cement in comparison to fiber-supported designs. Adding polyethylene fiber to re-restorations decreased stress values ​​compared to glass fiber addition. Therefore, when adding fibers, polyethylene fiber will be advantageous.

How long must a post be? A retrospective survival analysis on a large cohort with long follow-ups.

OBJECTIVES: Post and core (PC) is frequently used, but clinical evidence concerning how long a post must be is scarce. Recommendations in dental literature range from half of the root which should be incorporated, to post space preparations conducted as deep as possible increasing the risk for root perforation thus tooth loss. Therefore, the aim of this retrospective survival analysis is to evaluate the post length as well as the post-clinical crown ratio on a large patient cohort with long follow-ups. MATERIALS AND METHODS: Overall 1026 PC in 731 patients could be included in this study (2004-2023). The files were analysed due to the parameters post length and post-clinical crown ratio on X-Ray. Furthermore, the influence of the type of covering prosthetic restoration, location, type of tooth, luting material, PC material, bone attachment and therapist was evaluated. The statistical analysis was assessed using Kaplan-Meier (univariate influences) and Cox regression (multifactorial influences). RESULTS: Survival until extraction as well as decementation was significantly influenced by bone attachment and covering prosthetic restoration. Posts reaching the middle third of the root showed highly significant (p < 0.001) better survival probabilities than those reaching the coronal or apical third. Regarding the post-clinical crown ratio, no significant difference was found for post = crown/post > crown, whereas post

[Root canal post for build-up restorations: necessary or redundant?] / Wortelstift bij funderingsrestauraties: noodzakelijk of overbodig?

The purpose of root canal posts is to obtain additional retention for build-up restorations of endodontically treated teeth so they can be functionally reconstructed. Due to developments in adhesive dentistry and a lack of clinical evidence, root canal posts are used less and less. Currently, the advice of the European Society of Endodontology is to use a root canal post only in front teeth and premolars in the absence of remaining coronal dentine walls. It is important to avoid additional preparation when placing a root canal post, because this causes (additional) weakness of the tooth. The loss of dental tissue due to preparation cannot be compensated for by placing a post.

Bond strength of prefabricated and CAD-CAM milled glass fiber post-and-cores luted with conventional, universal, and self-adhesive composite resin cement.

STATEMENT OF PROBLEM: Little is known about the effect of different composite resin cements on the bond strength of prefabricated and milled glass fiber post-and-cores. PURPOSE: The purpose of this in vitro study was to compare the push-out bond strengths of root dentin and standard, relined, or computer-aided design and computer-aided manufacturing (CAD-CAM) glass fiber post-and-cores luted with conventional, universal, or self-adhesive composite resin cement. MATERIAL AND METHODS: Post spaces were prepared in 90 premolars. Standard and relined prefabricated and CAD-CAM-milled glass fiber post-and-cores were luted with conventional (RelyX ARC; 3M ESPE), universal (RelyX Ultimate; 3M ESPE), and self-adhesive (RelyX U200; 3M ESPE) composite resin cement (n=10). All specimens were thermally aged (5000 cycles at 5°C and 55°C with a 20-second dwell time) and mechanical fatigue (1 000 000 cycles at 2 Hz, 50-N load). The specimens were sectioned perpendicularly to the root long axis into 1-mm-thick sections (apical, middle, and cervical root thirds), the push-out bond strength was determined, and the mode of failure recorded. Data were submitted to the Kruskal-Wallis test followed by the Bonferroni-Dunn multiple comparison test (α=.05). RESULTS: Push-out bond strength values did not differ (P>.05) among posts at the same root thirds. Standard posts showed higher bond strength than CAD-CAM at the apical third for data grouped by composite resin cements (P<.001). The cervical root thirds had higher bond strength than the apical thirds (P<.05). The cervical, middle, and apical root thirds showed decreasing bond strength values for each type of post for data grouped by composite resin cement (P<.001). Adhesive failures at the dentin-cement interface were predominant. CONCLUSIONS: The type of posts and cements did not affect the bond strength of glass fiber posts. The cervical root thirds had better bonding performance than the apical thirds.

Evaluation of Bond Strength of Three Glass Fiber Post-systems Cemented to Large Root Canals.

The aim of this study was to evaluate the push-out bond strength and the failure mode of single adjustable posts (SPLENDOR SAP), anatomical posts (AP), or computer-aided design/computer-aided manufacturing (CAD-CAM) posts cemented to flared root canal dentin with self-adhesive dual-cure resin cement. Thirty single-rooted premolars received endodontic treatment with gutta-percha and a calcium hydroxide-based endodontic cement. After 24 hours, the canal spaces were enlarged with burs. The tooth specimens were divided equally into three groups (n=10), according to the glass fiber post (GFP) system: AP-prefabricated GFP (Reforpost #2, Angelus) was relined with composite resin (Filtek Z350 XT, 3M ESPE); SPLENDOR SAP-GFP was used with a glass fiber sleeve to adjust the adaptation (Splendor SAP, Angelus); and CAD-CAM-a resin pattern was obtained and scanned to produce a CAD-CAM GFP (Fiber CAD Lab, Angelus) milled using a subtractive technique. The three GFP systems were cemented with self-adhesive resin cement (Rely X U200, 3M ESPE). The roots were fixed to an acrylic resin plate used to section them into specimens of cervical, middle, and apical thirds. Then, the slices were attached to a universal testing machine to perform the push- out test at a speed of 0.5 mm/min and a load of 50 Kgf. The posttest specimens were examined under a stereoscopic microscope to evaluate the failure mode. The bond strength variable was analyzed using a generalized linear model, following a split-plot design. Failure mode analysis was performed using Fisher exact test. The significance level adopted was 5%. There was no significant difference among the GFP systems or among the thirds, in terms of bond strength (p>0.05), nor was there any significant association between the systems and the failure mode (p>0.05). Most specimens presented mixed or adhesive failure between resin cement and dentin. It was concluded that the bond strength to flared root dentin was not influenced by the GFP system or the root third.

Stress analysis of horizontal mid-root fracture managed with different intraradicular fixation protocols: A 3D-finite element study.

The current study evaluated the stress distribution in a maxillary central incisor with mid-root fracture after splinting with different intra-radicular posts using 3D-finite element analysis (FEA). Five 3D-FEA models were constructed. Model 1 was an intact tooth with no fracture, Model 2: A tooth with a horizontal mid-root fracture, with no treatment. Model 3: Same as model 2, and intraradicular splinting using fiber post. Model 4: Same as model 2 and intra-radicular splinting using Protaper Gold file F3. Model 5: Same as model 2, and with intraradicular splinting with Ribbond. The FEA of all models was done to obtain the maximum Von-Mises stress in the root canal space, the dentin, the periodontal ligament, and the bone. The highest Von Mises stresses for the root canal space and the dentin were found in Model 3, followed by models 4, 5, and 2, and least in Model 1. The Von Mises stress of the periodontal ligament was the least in model 1. The Von Mises stress of bone was higher in all experimental models than in the baseline model. The results suggest that in cases where intra-radicular splinting is indicated, fiber posts and Ribbond are better alternatives to endodontic files due to the lower stresses exerted.

Single crown vs. composite for glass fiber post-retained restorations: An 8-year randomized clinical trial.

OBJECTIVES: This study aimed to compare the success and survival rates of metal-ceramic crowns and composite resin restorations applied in root filled teeth that received a glass fiber post. METHODS: A prospective, randomized controlled trial, with equivalent parallel groups was designed. Eighty-two teeth were randomly allocated to the metal-ceramic or composite resin groups. Multivariate Cox regression analysis with shared frailty for patients and Kaplan-Meier curves were performed using success and survival rates (p<0.05). RESULTS: Seventy-five post-retained restorations (34 metal-ceramic crowns and 41 composite restorations) in 62 patients were analyzed. The median follow-up was 8.1 years [IQR 4.0-9.9]. Twenty-seven failures were observed. Twenty-two failures (81.5 %) were observed in the composite resin group, of which six (27.3 %) were not repairable. Five failures (18.5 %) were observed in the metal-ceramic crown group, of which three (66.6 %) were non-repairable. The cumulative success rate at 8 years was 85.0 % for crowns (AFR=1.31 %) and 43.2 % for composite resins (AFR=6.58 %), while the survival rate was 93.8 % for crowns (AFR=0.52 %) and 97.6 % for composite resins (AFR=0.20 %). Considering the success rates, adjusted multivariate Cox regression showed that composite resin had a Hazard Ratio of 5.07 (95 %CI, 1.99-12.89) greater than the metal-ceramic crown. No significant difference in the failure risk was observed when the survival rates were considered (HR=0.38, 95 %CI (0.10 - 1.44), p = 0.156). Co-variables did not affect the success and survival rates (p>0.05). CONCLUSIONS: Metal-ceramic crowns showed a higher success rate than composite restorations. The survival rates were similar, but composite restorations presented a higher need for repairs. CLINICAL SIGNIFICANCE: Post-retained composite restorations may need more reinterventions during the lifecycle, although more preservation of sound tooth structure is expected with a large restoration of resin post-and-core. These aspects have to be discussed with the patient for decision-making planning.

Push-out bond strength and SEM fractographical analysis of hollow fibre posts used with self-adhesive resin cement: a pilot study.

Detachment is the major cause of failure of endodontic fibre posts. Hollow posts have been recently introduced to overcome such issue. The primary aim of this pilot study was to compare the push-out bond strength of hollow posts and traditional solid posts. Eight round-shaped single-canal premolars extracted for periodontal reason were selected as sample and equally randomized into two groups: (i) traditional solid fibre posts-TECH21xop and ii) hollow fibre posts-TECHOLE. A dual-curing self-adhesive cement (new TECHCEM) was used for posts placement. Six horizontal sections-two from each portion of the root (coronal, middle and apical)-were obtained from each sample root, yielding a total of 24 sections for each group. Push-out test was performed on the sections and bond strength values were compared between groups and within each group. Scanning electron microscope (SEM) fractographical analysis was conducted on each section. Additional SEM and EDX analyses were performed on new samples of both posts, to assess fibres density and distribution, and the chemical composition of the fibres and the matrix. Hollow posts showed a significantly higher push-out bond strength (6.36 ± 1.22 MPa) than solid posts (3.64 ± 1.62 MPa). Among the three root portions of the same group, there was no significant difference in bond strength. In both groups, the most frequent type of fracture was a mixed adhesive failure with the cement covering 0 to 50% of the post perimeter. Hollow post fibres appear more similar in size and have a more homogeneous distribution, compared to solid posts. The two post types also have different chemical compositions.

Influence of Different Post-endodontic Restorations on the Survival Rate Against Fracture of Endodontically Treated Anterior Teeth Affected by Cervical Lesions with Pulpal Involvement: A Retrospective Clinical Study.

OBJECTIVE: To compare the survival rate against fracture of endodontically treated anterior teeth (ETT) affected by cervical (class V) lesions with pulpal involvement restored with resin composite or a post/core and crown, and to identify the prognostic factors for fracture. METHODS: Dental records and radiographs of ETT affected by cervical lesions with pulpal involvement restored with resin composite or a post/core and crown during a recall period from 2009-2022 were selected according to the inclusion and exclusion criteria. The number of tooth fracture, the restorability after fracture and any possible risk factors were identified. The survival rate against ETT fracture were analyzed and com- pared between the two restoration groups by Kaplan-Meier survival analysis and the Tarone-Ware test. Non- proportional hazard models were used to identify the prognostic factors. The sub-analysis in each restoration group was also performed. RESULTS: The study comprised 175 ETT restored with resin composite (n=125) or a crown (n=50). With a mean recall period of 32.9+-15.8 months, the survival rate against ETT fracture with resin composite (85.6%) was not significantly different from those with a crown (88%) (p≥0.05). The most frequent mode of fracture was crown-root fracture, which accounted for 78% and 83.30% of the fractures in the resin composite and crown groups, respectively. A significant prognostic factor for ETT fracture affected by cervical lesions with pulpal involve- ment was additional tooth structure loss from a class III, class IV or another class V lesion on the opposite side (p<0.05). The ETT affected by cervical lesions with pulpal involvement combined with additional tooth structure loss had a 7.25-fold higher risk of fracture than those with single-surface affected by cervical lesions with pulpal involvement (hazard ratio [HR] = 7.25; 95% confidence interval [CI], 1.68-31.30). The sub-analysis in the crown and resin composite groups revealed that the survival rates of ETT with single-surface affected by cervical lesions with pulpal involvement was 100% and 96.15%, respectively, which were significantly higher than those of ETT with additional tooth loss at 80.65% and 78.08%, respectively (p<0.05). CONCLUSION: With a mean 33-month recall period, the survival rate against ETT fracture affected by cervical lesions with pulpal involvement restored with resin composite or crown were not significantly different. Additional tooth structure loss was a significant prognostic factor for fracture.

Formulations of NaOCl-based in liquid, gel form or with surfactants on dentin deproteinization before fiber post cementation.

The objective of the study was to evaluate the effects of dentin deproteinization protocols for post space using different formulations containing sodium hypochlorite before fiber post cementation with self-adhesive resinous cement. The groups were divided according to the irrigation protocol (DWC, SHS, SHT and SHG). The residue cleanliness, bond strength, adhesive failure pattern, and tag formation at the adhesive interface between the self-adhesive cement and the dentin were evaluated. For this, analysis in scanning electron microscope, push-out test and confocal laser scanning microscopy were performed. The SHT protocol showed the highest residue cleanliness on the dentin surface of the post space (p<0.05). In addition, SHT protocol showed highest bond strength and tag formation in the cervical and middle thirds (p<0.05). Dentin deproteinization with sodium hypochlorite with surfactant provided the best dentin cleaning of residues, bond strength and tag formation after cementation of the fiber post with self-adhesive cement.

Influence of using different translucent composite resins for customizing fiber post on the bond strength of self-adhesive cement to root dentin.

This study evaluated the influence of different translucent resins (Z350 and Opallis) for customizing fiber posts and light-curing the cementation system using different LED equipment (V, Valo or R, Radii-Cal) on the bond strength and adhesive failure pattern at 24 h and 6 months. Eighty roots were prepared and divided into 4 groups (n=20): ZV (Z350 resin and LED Valo), ZR (Z350 resin and LED Radii-Cal), OV (Opallis resin and LED Valo), OR (Opallis resin and LED Radii-Cal). After post space preparation, the fiber post was customized and cemented with self-adhesive cement and light-curing using V or R LED equipment. Bond strength values were submitted to 2-way ANOVA test. ZV and ZR showed higher bond strength values than the other groups at 6 months of evaluation (p<0.05). The Z350 resin has a favorable influence on the bond strength of self-adhesive cement to root dentin, regardless of the LED polymerization equipment used.

Influence of restorative materials on the mechanical properties of maxillary first molars with different degrees of cryptic fractures and defects: A finite element analysis.

This study aimed to apply finite element analysis to evaluate the effects of pile materials with different elastic moduli and cement materials on the stress distribution between the remaining tooth tissue and cryptic fracture defects. A three-dimensional finite element model was established for 20 maxillary first molars with hidden fissures and mesial tongue-tip defects. Two levels of hidden cracks and three types of pile and adhesive materials were used in the design. The stress distribution and maximum stress peak in the remaining tooth tissue and crack defects were determined by simulating the normal bite, maximum bite, and lateral movement forces. When titanium posts, zinc phosphate binders, and porcelain crowns were used to repair the two types of deep cracked teeth, the maximum principal stress at the crack and dentin was the smallest. As the crack depth increased, the maximum principal stress of the residual dentin and crack defects increased.