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1.
BMC Oral Health ; 20(1): 300, 2020 11 03.
Artigo em Inglês | MEDLINE | ID: mdl-33143720

RESUMO

BACKGROUND: The aim was to analyze the fracture resistance of human teeth treated endodontically and restored with posts made of bovine dentin, human dentin, or glass fiber, and to evaluate the fracture pattern. METHODS: Cylindrical posts of 1.5 mm in diameter cemented to the roots of human maxillary canines presented a length of 15 mm, cervical diameter of 5-5.5 mm in the mesiodistal direction, and 7-7.5 mm in the vestibule-palatal direction. The groups studied were: Group I-10 glass fiber posts; Group II-10 human dentin posts; Group III-10 bovine dentin posts (self-adhesive resin cement); and Group IV-10 bovine dentin posts (resin-modified glass-ionomer cements). The coronal part of tooth was restored with a standardized core build-up using composite. All of the groups were submitted to a compression force test and the resistance to fracture was verified using a universal testing machine. The fracture pattern was likewise evaluated. RESULTS: The values of resistance to fracture were: 723.3N in group I, 561.5N in group II, 556.6N in group III, and, 613.27N in group IV. However, no statistically significant difference was observed among the groups. The fractures in groups I and II were most commonly found in the middle/apical third and were considered irreparable. For restored teeth in group III, half of the fractures appeared in the cervical third and were reparable. In group IV, all of the fractures were reparable, with the majority in the cervical thirds. CONCLUSION: Bovine dentin can be used as intraradicular post to substitute human dentin and glass fiber posts. The greater the malleability of the post, the greater the chances of survival of the teeth when subjected to fracture testing.


Assuntos
Técnica para Retentor Intrarradicular , Fraturas dos Dentes , Dente não Vital , Animais , Bovinos , Resinas Compostas , Análise do Estresse Dentário , Dentina , Humanos , Teste de Materiais , Cimentos de Resina , Fraturas dos Dentes/etiologia
2.
J Oral Sci ; 63(1): 70-74, 2020 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-33239485

RESUMO

PURPOSE: The aim of this study was to compare the influence of the number of coronal walls and post-endodontic restorations on the mechanical strength of 165 recently extracted endodontically treated maxillary premolars. METHODS: The teeth were divided into 3 control (no post) and 3 test groups according to the number of residual walls. Each test group was divided into subgroups according to the type of post-endodontic restoration (single, oval, and multi-post techniques). Samples were prepared conforming to the assigned subgroup. A universal loading machine applied a load parallel to the longitudinal axis of the teeth, thus simulating physiological occlusion. ANOVA and the Kruskal Wallis test were used for comparisons (P ≤ 0.05), and Tukey's test for multiple comparisons. RESULTS: For intact teeth, significant differences were found among all 3 subgroups, with single post showing the highest values. For 3 residual walls, oval post resulted in significantly lower values than single and multi-post systems. For 2 residual walls, the multi-post technique showed almost twice the resistance of oval post restorations. CONCLUSION: In oval canals the use of a single or multi-post technique increased post-and-core resistance even in intact teeth, whereas oval fiber posts showed no improvements. Multi-post design improved fracture resistance mostly in maxillary premolars lacking both marginal ridges.


Assuntos
Técnica para Retentor Intrarradicular , Fraturas dos Dentes , Dente não Vital , Dente Pré-Molar , Resinas Compostas , Falha de Restauração Dentária , Análise do Estresse Dentário , Resistência à Flexão , Humanos
3.
Clin Oral Investig ; 24(11): 3813-3819, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32965589

RESUMO

OBJECTIVES: To date, the relationship between cardiovascular disease (CVD) and endodontic treatment outcomes remains elusive with mixed reports. Thus, the purpose of this systematic review of longitudinal cohort studies was to evaluate whether CVD was a risk factor for endodontic outcome. MATERIALS AND METHODS: Two reviewers independently conducted a comprehensive electronic database search to July 2020. The bibliographies of all relevant articles, textbooks, and gray literature were manually searched. The methodological quality of evidence was appraised by the Newcastle-Ottawa Scale and GRADE. The authors considered any publication on CVD and endodontic outcome. Endodontic outcome referred to either healing or survival of endodontically treated tooth. Risk ratio (RR) with 95% confidence interval (CI) was used. RESULTS: Three articles met the inclusion criteria with a low risk of bias. Patients with CVD demonstrated a 67% higher risk for negative endodontic outcomes compared with patients who were healthy (RR = 1.67, P = 0.001, 95% confidence interval 1.53-1.81). CONCLUSION: With the limitations of this systematic review, the overall confidence by GRADE was moderate suggesting that CVD might be a risk factor for endodontic outcomes. CLINICAL RELEVANCE: The results support an association between CVD and endodontic outcomes.


Assuntos
Doenças Cardiovasculares , Dente não Vital , Doenças Cardiovasculares/epidemiologia , Humanos , Estudos Longitudinais , Fatores de Risco , Resultado do Tratamento
4.
J Oral Sci ; 62(4): 458-460, 2020 Sep 26.
Artigo em Inglês | MEDLINE | ID: mdl-32863316

RESUMO

The purpose of this case report is to describe a minimally invasive technique for non-vital tooth bleaching using traditional Japanese paper, known as washi. Non-vital tooth bleaching with a mixture of sodium perborate and 30% hydrogen peroxide rolled in Japanese paper for a traumatically injured tooth, and in-office vital-tooth bleaching for the upper front six teeth and first premolars, were performed. Five-year follow-up showed satisfactory stability in the bleaching effects and did not show any problems in the traumatically injured tooth. The use of Japanese paper for non-vital tooth bleaching may minimize damage to discolored non-vital teeth.


Assuntos
Clareamento Dental , Descoloração de Dente , Dente não Vital , Dente Pré-Molar , Humanos , Peróxido de Hidrogênio , Japão
5.
BMC Oral Health ; 20(1): 226, 2020 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-32811484

RESUMO

BACKGROUND: The purposes of this simulation study were to evaluate the stresses in the roots of endodontically treated molars with extensive coronal tissue loss which were restored by endocrowns (all-in-one core and crown) and traditional crowns with post-cores, during masticatory simulation using finite element analysis. METHODS: A mesio-distal cross-section of a lower right first molar was digitized and used to create 2-dimensional models of the teeth and supporting tissue; different crown designs, viz., endocrown with 2 mm occlusal clearance, endocrown with 4 mm occlusal clearance and post-core crown; different crown materials, viz., zirconia (Zr) and lithia-disilicate reinforced glass ceramic (LDRGC), and different post and core materials, viz., glass fiber (GF), stainless steel (SS) and metal cast (MC). An axial load of 600 N was applied to the central fossa of occlusal surface. RESULTS: The stress distributions were similar between Zr and LDRGC for periodontal ligament and alveolar bone. The root canal inner wall maximum principal stresses of SS post (70.8 MPa) and MC post (71.4 MPa) were higher than that of GF post (36.0 MPa) and endocrown (2.4 MPa). CONCLUSION: The endocrowns reduced stress concentration for the root canal inner wall in comparison with the conventional post-core crown. Molars restored with endocrowns are less prone to root fracture than those with posts.


Assuntos
Técnica para Retentor Intrarradicular , Dente não Vital , Coroas , Análise do Estresse Dentário , Análise de Elementos Finitos , Humanos , Teste de Materiais , Dente Molar
6.
J Prosthet Dent ; 124(6): 739.e1-739.e7, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32758371

RESUMO

STATEMENT OF PROBLEM: The influence of the flexural modulus of prefabricated posts on the fracture resistance of endodontically treated teeth is unclear. PURPOSE: The purpose of this in vitro study was to evaluate the influence of post material and post diameter on the fracture resistance of endodontically treated mandibular premolars. In addition, the influence of tooth substance loss was evaluated by comparing 1 with 2 residual dentinal walls. MATERIAL AND METHODS: Sixty-four extracted mandibular first premolars were endodontically treated and divided into 8 test groups (n=8) based on the number of residual walls (1 or 2), post material (glass fiber or titanium) and post diameter (International Standards Organization [ISO] 70 or ISO 90). After luting the posts, the specimens received a composite resin core and a crown preparation with a 2-mm ferrule. Cast Co-Cr crowns were cemented with glass ionomer cement. After 1 200 000 mastication cycles with a load of 49 N and simultaneous thermocycling (5 °C-55 °C), specimens were quasistatically loaded at 30 degrees to the longitudinal axis of the tooth until fracture. Fracture loads were analyzed by using 3-way ANOVA (α=.05). Fracture modes were examined with a stereomicroscope at ×25 magnification and recorded. RESULTS: Fracture loads ranged from 954 ±35 N (1 residual wall-glass fiber-ISO 70) to 1286 ±202 N (1 residual wall-glass fiber-ISO 90). Titanium posts showed a statistically significant higher fracture resistance than glass fiber posts. A statistically significant increase in fracture resistance was also observed with increasing post diameter. However, no significant difference was found with respect to the number of residual walls (P>.05). CONCLUSIONS: Teeth restored with titanium posts exhibited higher fracture resistance than teeth restored with glass fiber posts, especially when smaller diameter posts were used.


Assuntos
Técnica para Retentor Intrarradicular , Fraturas dos Dentes , Dente não Vital , Resinas Compostas , Coroas , Falha de Restauração Dentária , Análise do Estresse Dentário , Humanos , Laboratórios
7.
Wiad Lek ; 73(4): 691-695, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32731698

RESUMO

OBJECTIVE: The aim of this study was to determine the frequency of endodontic treatment in an adult Ukrainian population in relation to the age and its distribution depending on the type of the teeth. PATIENTS AND METHODS: Materials and methods: A total of 435 digital panoramic radiographs of adults (aged 18 to 72 years) were examined. A tooth was qualified as root filled (endodontically treated), if radiopaque root-filling material was determined in the pulp chamber and/or in the root canals. Pearson's chi-squared test (χ2) and Spearman's rank correlation were applied for data analysis. RESULTS: Results: It was revealed that 82.5% of patients had previously received endodontic treatment of the teeth. The overall percentage of root filled teeth in adult dentition is 12.08%. The analysis of the rate of endodontically treated teeth in different age groups identified an increasing of treated teeth with age - from 5.2% in the youngest cohort (18-19 years old) to 24.9% in the oldest cohorts. It was revealed that 822 teeth (14.2%) on maxilla and 569 (9.9%) on the mandible were endodontically treated. Most often root filled teeth were first mandibular molars (39.3%), first maxillary molars (26.7%) and second maxillary premolars (20.4%). Much lower rate of endodontic treatment were considered in lower mandibular incisors and canines (0.7%, 0.9% and 1.5% respectively). CONCLUSION: Conclusions: A total of 82.5% examined adults had one or more endodontically treated teeth in this study. The obtained results prove the necessity of prevention of carieswith special emphasis on the first maxillary and mandibular molars, and maxillary second premolars, which have significantly higher frequency of root canal treatment in comparison to other teeth groups.


Assuntos
Dente não Vital , Adolescente , Adulto , Idoso , Humanos , Pessoa de Meia-Idade , Dente Molar , Prevalência , Tratamento do Canal Radicular , Ucrânia , Adulto Jovem
8.
J Oral Rehabil ; 47(10): 1247-1253, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32668036

RESUMO

BACKGROUND: The vibrations created by post-space preparation during the first visit for endodontic treatment could have a significant effect on the intensity of post-operative pain than that association with post-space preparation at the second appointment. OBJECTIVE: The aim of this study was to evaluate the effect of vibrations generated during post-installation, on post-operative pain in endodontically treated teeth. METHODS: One hundred patients with asymptomatic teeth requiring primary root canal treatment and post-installation were enrolled in this study. Fifty patients underwent endodontic treatment with post-installation at the first visit (group 1), while the remaining 50 patients underwent post-installation at the second visit (group 2). The intensity of post-operative pain in both groups was evaluated 1, 2, 3 days and 1 week after the first visit using the visual analogue scale. The time required to achieve complete pain relief for each patient was also recorded. The patients' age, sex, tooth type, size of the periapical lesion and time required for complete post-operative pain relief for each tooth were recorded. RESULTS: The pain intensity score was significantly higher in group 1 than group 2 (P < .05). No significant differences were observed in parameters such as sex, tooth type, jaw and size of the periapical lesion (P > .05), whereas age had a significant effect on the post-operative pain scores (P < .05). CONCLUSION: Vibrations occurring during post-installation on the same visit as that of root canal filling may increase the post-operative pain.


Assuntos
Cavidade Pulpar , Dente não Vital , Humanos , Medição da Dor , Dor Pós-Operatória , Tratamento do Canal Radicular
9.
J Adhes Dent ; 22(4): 409-414, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32666067

RESUMO

PURPOSE: Immature teeth are characterized by short roots, thin root canal walls, and open apices, which makes them prone to fracture. The aim was to investigate whether fiber-post placement had an influence on the fracture resistance of endodontically treated immature teeth. MATERIALS AND METHODS: To simulate immature teeth, the apical third of 20 intact mandibular premolars was resected. After the access cavity was prepared, root canals and apices were enlarged. A 4-mm apical barrier was placed using calcium-silicate based material (Biodentine, Septodont). The teeth were then randomly assigned to two groups (n = 10). Root canals in group 1 were sealed using Acroseal (Septodont, France) and gutta-percha, followed by composite resin for the coronal restoration (Evetric, Ivoclar Vivadent). In group 2, fiber posts (FRC Postec Plus, Ivoclar Vivadent) were luted using self-adhesive composite cement (SpeedCEM Plus, Ivoclar Vivadent), followed by the same coronal restoration. The teeth were then subjected to fatigue and static load testing. RESULTS: The average loads (± SD) that led to tooth fracture were: 401.40 ± 296.83 N in group 1 and 636.20 ± 204.95 N in group 2. Unfavorable fractures were noted in 9 specimens from group 1 and in 7 specimens in group 2. No statistically significant difference in fracture resistance or fracture mode was found between the groups. CONCLUSION: Fiber-post placement had no significant influence on the fracture resistance of endodontically treated immature teeth.


Assuntos
Técnica para Retentor Intrarradicular , Fraturas dos Dentes , Dente não Vital , Dente Pré-Molar , Resinas Compostas , Análise do Estresse Dentário , Humanos , Teste de Materiais
10.
Int J Prosthodont ; 33(4): 457-464, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32639706

RESUMO

Cusp fractures occur frequently in endodontically treated teeth with large restorations and no cusp protection. These fractures often lead to challenging clinical decisions, such as whether to undertake complex restorative management or extraction of the affected teeth. This article reports the surgical and restorative management of two teeth with fractures exceeding the biologic width to juxtacrestal and subcrestal levels, respectively, and describes a new technique for such treatment.


Assuntos
Fraturas dos Dentes , Dente não Vital , Dente Pré-Molar , Resinas Compostas , Restauração Dentária Permanente , Humanos
11.
J Endod ; 46(10): 1465-1469, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32615172

RESUMO

INTRODUCTION: The purpose of this in vitro study was to determine whether the methods used to treat endodontically and restore anterior immature teeth with a necrotic pulp influence their resistance to fracture. METHODS: After access opening and cleaning and shaping, 80 specimen teeth were assigned into 5 groups according to the endodontic obturation method and coronal restoration as follows: A1, apexification with a composite restoration in the crown area; A2, apexification with a composite restoration in the crown and 3 mm into the root; IR, immediate revascularization with a composite restoration in the crown area; SR, successful revascularization with a composite in the crown area; and the control group, a mature tooth treated with gutta-percha and sealer with a composite restoration in the crown area. The teeth were mounted in acrylic blocks and brought to fracture under compressive forces in a universal testing machine. Both the fracture strength and the location where the fracture occurred were recorded. RESULTS: There were no statistically significant differences in the fracture resistance among the 5 groups (1-way analysis of variance, F4 = .545, P = .703). No statistically significant differences were found in the location where the fracture occurred either (χ24 = 4.1, P = .391). CONCLUSIONS: Within the limitations of this in vitro study, it can be concluded that the treatment options used to treat nonvital immature teeth provided the same resistance to fracture.


Assuntos
Materiais Restauradores do Canal Radicular , Fraturas dos Dentes , Dente não Vital , Resinas Compostas , Restauração Dentária Permanente , Análise do Estresse Dentário , Guta-Percha , Humanos , Obturação do Canal Radicular
12.
J Endod ; 46(10): 1501-1507, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32615176

RESUMO

INTRODUCTION: The purpose of this study was to investigate the influence of access cavities and tapers of canal preparations on fracture resistance of endodontically treated first molars by finite element method and Weibull analysis. METHODS: On the basis of the micro-computed tomography data of maxillary first molar, the models of endodontically treated teeth with conservative endodontic cavity, traditional endodontic cavity, and 4 tapers of canal preparations (0.02, 0.04, 0.06, and 0.08) were created. Four static loads (800 N in total) were applied vertically to the contact points. The stress distributions of maximum principal stress were recorded and analyzed. Weibull analysis was performed to analyze the failure risk in enamel and dentin. RESULTS: The stress distributions of maximum principal stress on occlusal surfaces were similar. In cervical region, the tensile stress was mainly concentrated on mesiobuccal root and root furcation. The finite element analysis and Weibull analysis showed that conservative endodontic cavity significantly reduced the maximum principal stress in cervical region and the failure probability, compared with traditional endodontic cavity. No significant difference was detected among tapers of prepared canals. CONCLUSIONS: Preserving coronal dentin by using conservative endodontic cavity significantly reduced the concentration of tensile stress and the failure probability of dentin, although the maximum principal stress and failure probability were less affected by taper of canal preparation.


Assuntos
Dente não Vital , Dente , Análise de Elementos Finitos , Humanos , Preparo de Canal Radicular , Microtomografia por Raio-X
13.
J Contemp Dent Pract ; 21(5): 490-493, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32690829

RESUMO

AIM: The aim of this study is to compare the effect of different root canal sealers on the fracture resistance of endodontically treated teeth using AH Plus, GuttaFlow 2, MTA-Fillapex, and TotalFill® BC™ sealers. MATERIALS AND METHODS: Sixty single-rooted mandibular premolar teeth were used in the study. After the decoronation of the crowns of the teeth, we got a 13 mm root length. All samples instrumented using ProTaper Next system reaching file size ×4 as the final master apical file. Gutta-percha (GP) with single cone as obturation technique was carried out to all experimental teeth. Then, the teeth were divided into five groups (n = 12) based on the type of sealer to be used. Group I: AH Plus sealer + GP, Group II: GuttaFlow 2 sealer + GP, Group III: MTA-Fillapex sealer + GP, Group IV: TotalFill BC sealer + GP, and Group V: control (instrumented but unobturated teeth). Embedding all teeth in acrylic resin blocks was carried out and fracture force was measured using a universal testing machine (Instron Corp., Canton, MA, USA) by using metal-like spreader tip on 0.5 mm/m speed. Then, the data were statistically evaluated using one-way analysis of variance (ANOVA) and post hoc test (Tukey's test). RESULTS: Group IV showed higher resistance to fracture than other groups significantly. There was a nonsignificant difference in fracture force between Group I, Group II, and Group III. Group V showed the least fracture resistance than other groups. CONCLUSION: Based on this in vitro study, TotalFill bioceramic-based sealer was more effective when compared with other sealers and the unobturated group showed the lowest mean fracture resistance. CLINICAL SIGNIFICANCE: The use of bioceramic sealer with BC cones enhanced the fracture resistance of endodontically treated teeth.


Assuntos
Materiais Restauradores do Canal Radicular , Dente não Vital , Cavidade Pulpar , Resinas Epóxi , Guta-Percha , Humanos , Obturação do Canal Radicular
14.
J Endod ; 46(10): 1371-1386.e8, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32673634

RESUMO

INTRODUCTION: This study aimed to summarize data on apical periodontitis (AP) and nonsurgical root canal treatment (NSRCT) prevalence and risk factors related to age, gender, and quality of restorative and endodontic treatment in the general population from cross-sectional studies published between 2012 and 2020. METHODS: An electronic search was performed in the following databases: Web of Science, Scopus, and PubMed. The conducted literature search covered studies published between 2012 and 2020, without restrictions on language. The STROBE and NOS tools were used for quality assessment of the included studies. RESULTS: Sixteen articles were included in the review. In total, 200,041 teeth were examined. On average, 6.3% of teeth had AP, and 7.4% had NSRCT. Forty-one percent of RCT teeth had AP, and 3.5% of untreated teeth had AP. Female patients were less prone to AP in endodontically treated teeth only, compared with male patients (P < .001). Variable stratification of age subgroups among included studies prevented us from conducting a meta-analysis. An increase in AP frequency was found in teeth with inadequate restorative and endodontic treatment (P < .001 and P < .001, respectively). Because of high heterogeneity, these results should be taken with caution. CONCLUSIONS: There is an increased AP prevalence in the adult general population compared with data from 2012 (6.3% versus 5.4%) in both endodontically treated (41.3% versus 35.9%) and untreated teeth (3.5% versus 2.1%). In addition, AP developed less frequently in female patients with endodontically treated teeth and in teeth with inadequate compared with adequate restorative and endodontic treatment.


Assuntos
Periodontite Periapical/epidemiologia , Periodontite Periapical/terapia , Dente não Vital/epidemiologia , Adulto , Estudos Transversais , Cavidade Pulpar , Feminino , Humanos , Masculino , Prevalência , Tratamento do Canal Radicular/efeitos adversos
15.
Int. j. odontostomatol. (Print) ; 14(2): 144-149, June 2020. graf
Artigo em Inglês | LILACS | ID: biblio-1090666

RESUMO

Loss of teeth vitality when root formation is incomplete, results in weaker structures leaving them prone to fractures and unfavourable long-term prognosis. Apexogenesis is currently the treatment of choice in immature teeth and is indicated in vital teeth without pulpal pathologies. The treatment aims to eliminate the causal agent of the damage, and provide the necessary conditions to preserve vitality in the tooth and induce apical root closure. A 6-year-old male patient was treated at the Endodontics Clinic, Universidad de La Frontera upon complaining of acute pain in tooth 30. The tooth presented incomplete root development due to dental caries with pulp exposure and a diagnosis of irreversible symptomatic pulpitis. Total pulpotomy was performed with the application of Mineral Trioxide Aggregate and controlled at 1, 4, 6, 7 and 12 months, achieving root development and apical closure in the permanent molar. The result was comparable with studies that support this therapy in teeth with irreversible pulpitis. This work seeks to contribute to the existing evidence on the management of immature permanent teeth with irreversible pulpitis to induce root development and apical closure, and maintain pulp vitality.


La pérdida de vitalidad en dientes con formación radicular incompleta trae como resultado el debilitamiento de estos, dejándolos propensos a fracturas con un desfavorable pronóstico a largo plazo. Las terapéuticas actuales de regeneración pulpar en dientes inmaduros estan principalmente indicadas en cuadros de pulpitis irreversible y buscan eliminar el agente causal de daño y brindarle al diente las condiciones y estímulos necesarios para preservar vitalidad e inducir el cierre apical radicular. Un paciente de 6 años de edad y de sexo masculino, acude a la Clínica de Especialidad de Endodoncia de la Universidad de la Frontera, consultando por un dolor agudo en diente 4.6 el cual presentaba un desarrollo radicular incompleto producto de una caries con exposición pulpar con diagnóstico de Pulpitis Irreversible Sintomática. Se realiza una pulpotomia total con aplicación de Mineral Trioxide Aggregate y se controla a los 1, 4, 6 y 7 meses obteniendo un interesante resultado comparable con estudios que avalan dicha terapeutica en dientes con pulpitis irreversible. Este trabajo busca contribuir a la evidencia existente sobre el manejo de dientes permanentes inmaduros con cuadros de pulpitis irreversible para inducir el desarrollo radicular, cierre apical y mantener vitalidad pulpar.


Assuntos
Humanos , Masculino , Criança , Óxidos/administração & dosagem , Pulpite/terapia , Pulpotomia/métodos , Silicatos/administração & dosagem , Compostos de Cálcio/administração & dosagem , Compostos de Alumínio/administração & dosagem , Regeneração , Materiais Restauradores do Canal Radicular , Dentição Permanente , Dente não Vital/terapia , Cárie Dentária , Combinação de Medicamentos , Apexificação
16.
Dent Mater J ; 39(6): 924-932, 2020 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-32595188

RESUMO

The aim of this study was to use polyetheretherketone (PEEK) for the post material and evaluate the fracture load of six restoration patterns in teeth with flared root canals; composite resin core alone (Group R); glass fiber sleeve (Group S); PEEK post (Group P); glass fiber post (Group F); PEEK post in glass fiber sleeve (Group PS); glass fiber post in glass fiber sleeve (Group FS). In this study, cylindroid specimens were prepared and underwent three-point-bending test in a steady condition and after water immersion. In the loading test, the materials in clinical conditions using bovine teeth were evaluated. In the bending test, groups using glass fiber posts and sleeves decreased in strength after water immersion. In the loading test, Groups F, FS and PS showed higher fracture load than other groups. This study showed PEEK posts and glass fiber sleeves are recommended in the case of flared root canals.


Assuntos
Técnica para Retentor Intrarradicular , Fraturas dos Dentes , Dente não Vital , Animais , Bovinos , Resinas Compostas , Cavidade Pulpar , Falha de Restauração Dentária , Análise do Estresse Dentário , Vidro , Cetonas , Polietilenoglicóis , Cimentos de Resina
17.
Dent Med Probl ; 57(2): 165-169, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32559025

RESUMO

BACKGROUND: The reinforcement of teeth with internal root resorption is essential to prevent their fracture. OBJECTIVES: The aim of this study was to assess the fracture resistance of the premolar teeth with internal root resorption cavities (IRCs), repaired with glass-ionomer cement (GIC), gutta-percha (GP) or EndoSequence® Root Repair MaterialTM (RRM). MATERIAL AND METHODS: Forty lower premolars, instrumented to size 50, were used. Ten teeth were assigned to the control group, which received the full obturation of the root canals. In the remaining 30, IRCs were prepared with Gates-Glidden burs. The apical 8 mm was obturated to the level of IRC using the single-cone technique. Then, the teeth were divided into 3 groups according to the material used for repairing the cavities (n = 10): GIC; GP; and RRM. The canals were filled with respective materials and backfilled with GP. All of the specimens were scanned at the level of IRC with a micro-computed tomography (micro-CT) system, and the volume of the IRCs and the percentages of voids in the filling materials were measured. The specimens were subjected to fracture testing. The force recorded at the time of fracture was analyzed with the Kruskal-Wallis test and the independent t-test. RESULTS: The control group showed a significantly higher mean value of fracture resistance as compared to the groups with IRCs (p < 0.05). No significant difference was found between GIC and RRM, whereas the GP group had a significantly lower fracture resistance than other tested IRC groups (p < 0.05). The percentage of voids was significantly higher in the GIC group as compared to the GP and RRM groups (p < 0.05). CONCLUSIONS: EndoSequence Root Repair Material provides more strength to the teeth than the GP/sealer technique when both are used to fill a resorption cavity. The fracture resistance of the teeth filled with RRM was close to that obtained with GIC.


Assuntos
Materiais Restauradores do Canal Radicular , Fraturas dos Dentes , Dente não Vital , Cimentos de Ionômeros de Vidro/uso terapêutico , Humanos , Fraturas dos Dentes/prevenção & controle , Microtomografia por Raio-X
18.
J Prosthet Dent ; 124(4): 485.e1-485.e10, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32522363

RESUMO

STATEMENT OF PROBLEM: Crown-lengthening procedures (CLPs) and orthodontic eruption procedures (OEPs) improve the biomechanical properties of residual root restoration. However, their use is limited by clinic time, cost, and crown-root ratio. An inner shoulder retention form (ISRF) overcomes these limits; however, whether ISRF meets the biomechanical requirements is unclear. PURPOSE: The purpose of this in vitro and finite element analysis (FEA) study was to evaluate the effects of 3 residual root treatments (ISRF, CLP, and OEP) on premolar fracture resistance and stress distribution after post-and-core restoration. MATERIAL AND METHODS: Thirty-two extracted mandibular second premolars were screened and randomly divided into 4 groups (n=8): a 2-mm ferrule restoration group (NPR2; control group) and 3 experimental groups (0.5×0.5-mm ISRF [ISRF0.5], 2-mm CLP [CLP2], and 2-mm OEP [OEP2]). After removal of the crown, endodontic treatment, and embedding and restoration, the specimens were loaded on a universal tester (crosshead speed of 0.1 mm per minute) at 30 degrees to the long axis of the tooth until fracture. Fracture resistance and pattern were analyzed. Four groups were added in FEA: 1-mm ferrule restoration group (NPR1), 1.0×1.0-mm ISRF (ISRF1), 1-mm CLP (CLP1), and 1-mm OEP (OEP1). The maximum principal stress peak (σmax), maximum displacement, and stress distribution were evaluated. RESULTS: Mean fracture load ±standard deviation was 796.23 ±155.61 N (NPR2), 650.32 ±150.43 N (ISRF0.5), 385.38 ±149.92 N (CLP2), and 542.93 ±79.34 N (OEP2); these differences were statistically significant (F=12.724; P<.001). The main fracture patterns were decementation from the lingual crown margin and oblique root fracture in ferrule restoration groups and post-and-core decementation and oblique fracture starting from the middle proximal surface in the ISRF groups without ferrules. In FEA, the results of NPR2, ISRF0.5, CLP2, and OEP2 were consistent with the in vitro experiments and provided stress distribution and displacement information. CONCLUSIONS: Teeth with crown dentin ferrules showed higher fracture resistance and lower stress concentration. For residual roots, ISRF and OEP showed no differences, but CLP had lower fracture resistance and higher stress concentration.


Assuntos
Técnica para Retentor Intrarradicular , Fraturas dos Dentes/terapia , Dente não Vital/terapia , Coroas , Falha de Restauração Dentária , Análise do Estresse Dentário , Análise de Elementos Finitos , Humanos
19.
J Contemp Dent Pract ; 21(4): 383-389, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32584273

RESUMO

AIM: This study aimed to investigate the influence of using dual-cure composite core materials for fiber post luting on the fracture resistance of endodontically treated maxillary central incisors. MATERIALS AND METHODS: Fifty sound and recently extracted maxillary central incisors were endodontically treated and distributed into five groups. In the control group, access cavities were restored with the composite resin. Experimental groups had the coronal structure trimmed 2 mm above the cementoenamel junction. Teeth were restored with fiber posts and different combinations of luting and core materials: RelyX Unicem for post luting and MultiCore for core buildup; MultiCore for post luting and core buildup; RelyX Unicem for post luting and LuxaCore for core buildup; or LuxaCore for post luting and core buildup. All teeth were restored with zirconium crowns and subjected to thermocycling (6000 cycles 5/55°C). Loading of the teeth was applied at 135° to the palatal surface, using a universal testing machine at a cross-speed of 0.5 mm/minute until failure. The mode of failure was analyzed under a digital microscope. RESULTS: The fracture resistance of the control group was significantly higher than the experimental groups (p < 0.05). There was no significant difference between the experimental groups (p > 0.05). All teeth demonstrated nonrestorable failures. CONCLUSION: With the presence of the ferrule effect and crown restoration, the selected materials for post luting and core buildup have no significant influence on the fracture resistance of the endodontically treated teeth. CLINICAL SIGNIFICANCE: The use of the same dual-cure composite core materials for fiber post luting and core buildup would simplify the clinical procedure without enhancement of the fracture resistance of the endodontically treated tooth.


Assuntos
Técnica para Retentor Intrarradicular , Fraturas dos Dentes , Dente não Vital , Resinas Compostas , Coroas , Falha de Restauração Dentária , Análise do Estresse Dentário , Humanos , Incisivo
20.
Ned Tijdschr Tandheelkd ; 127(4): 245-253, 2020 Apr.
Artigo em Holandês | MEDLINE | ID: mdl-32459220

RESUMO

The fracture strength of endodontically treated molars restored by means of various types of direct and indirect materials was studied in vitro. 105 sound molars were endodontically treated and randomly assigned to 1 control group (endodontic access cavity only) and 6 experimental groups (n = 15) with restorations of the following materials: glass fibre reinforced composite (GFRC); microhybrid composite (C); microhybrid composite restoration with glass fiber post (CP); full-contour lithium disilicate crown (LDS); full-contour lithium disilicate crown with glass fiber post (P-LDS); and an endocrown (EC). Specimens were thermo-mechanically aged and axially loaded until failure. Data were analysed using ANOVA and Tukey's post hoc test (α = 0.05). Fracture strength was significantly affected by the type of restoration (p = 0.000). LDS had significantly higher fracture strength than the control group and GFRC, C and CP groups. Groups EC, LDS and P-LDS were not statistically different from each other in fracture strength. This was also the case with EC, P-LDS and all composite groups. The glass fibre strength of composite restoration resulted in significantly fewer fatal fractures.


Assuntos
Técnica para Retentor Intrarradicular , Fraturas dos Dentes , Dente não Vital , Resinas Compostas , Falha de Restauração Dentária , Análise do Estresse Dentário , Resistência à Flexão , Humanos , Teste de Materiais , Dente Molar
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