不同桩核金属烤瓷全冠修复后前牙抗剪切力的实验研究

目的 探讨不同桩核系统金属烤瓷全冠修复上颌前牙后修复体抗剪切力的差异.方法 对40颗大小相似的新鲜上颌中切牙行根管充填后截冠,随机分成4组,每组10颗.其中3组分别用纤维增强树脂桩和树脂核、预成钛合金桩和树脂核,铸造镍铬合金桩核修复,桩核与金属烤瓷全冠均用树脂粘接剂粘固;另1组用玻璃离子粘固剂粘固铸造镍铬合金桩核和金属烤瓷全冠作为对照组.经温度循环疲劳实验,用万能力学实验机测试样本牙的抗剪切力,并观测折裂型,进行统计学分析.结果 纤维增强树脂桩组、预成钛合金桩组、铸造桩核组及对照组的抗剪切力分别为(534.4±145.7)N、(499.8±168.9)N、(412.6±99.3)N、(337.4±121.2)N.纤维增强树脂桩组和预成钛合金桩组的抗剪切力大于对照组,差异有统计学意义(P＜0.05);纤维增强树脂桩组中可再修复折裂型样本牙数量多于其他组,差异有统计学意义(P＜0.05).结论 纤维增强树脂桩核金属烤瓷全冠修复有较好的抗剪切力,且折裂型多为可再修复型,修复后残根保存率高.     

Survival rate and fracture strength of endodontically treated maxillary incisors with moderate defects restored with different post-and-core systems: an in vitro study

PURPOSE: This study compares the survival rate and fracture strength of endodontically treated maxillary incisors with moderate coronal defects restored with different post-and-core systems after exposure to an artificial mouth. MATERIALS AND METHODS: Sixty-four caries-free human maxillary central incisors were selected for standardized size and quality, endodontically treated, and decoronated 2 mm coronal to the cementoenamel junction. Group 1 was restored with titanium posts and composite cores, group 2 received zirconia posts and a composite core, and in group 3 zirconia posts with a heat-pressed ceramic core were used. Teeth restored with cast posts and cores served as controls. All teeth were prepared and restored with complete cast crowns. All samples were exposed to 1.2 million cycles in a computer-controlled chewing simulator with simultaneous thermocycling. In addition, the samples were loaded until fracture in a static testing device. RESULTS: The survival rates of the different groups were: 94% for titanium/composite, 63% for zirconia/composite, 100% for the all-ceramic post and core, and 94% for the cast post and core. The following mean fracture strengths were obtained: titanium/composite = 425 +/- 155 N, zirconia/composite = 202 +/- 212 N, zirconia/ceramic = 378 +/- 64 N, cast post and core = 426 +/- 178 N. The lower fracture load in the group with zirconia posts and composite cores was statistically significant. The use of zirconia posts resulted in fewer oblique root fractures. CONCLUSION: Prefabricated titanium posts with composite cores, zirconia posts with heat-pressed ceramic cores, and cast posts and cores yield comparable survival rates and fracture strengths for the restoration of crowned maxillary incisors with moderate coronal defects. Survival rates and fracture strengths for zirconia posts with composite cores are significantly lower, so this combination cannot be recommended for clinical use.     

Fracture strength after dynamic loading of endodontically treated teeth restored with different post-and-core systems

STATEMENT OF PROBLEM: Prefabricated metal and ceramic posts can be used with direct or indirect cores as an alternative to the conventional cast post and core. It is unclear how the fracture strength of zirconia posts with composite or ceramic cores and titanium posts with composite cores compares to the fracture strength of gold posts and cores after dynamic loading. PURPOSE: This study compared the fracture strength of endodontically treated, crowned maxillary incisors with limited ferrule length and different post-and-core systems after fatigue loading. MATERIAL AND METHODS: Sixty-four caries-free, human maxillary central incisors were divided into 4 groups. After root canal treatment, Group 1 was restored with titanium posts and composite cores, Group 2 with zirconia posts and composite cores, and Group 3 with zirconia posts and heat-pressed ceramic cores. Teeth restored with cast-on gold posts and cores served as the controls (Group 4). Teeth were prepared with a circumferential shoulder including a 1 to 2 mm ferrule; all posts were cemented with an adhesive resin cement, restored with complete-coverage crowns, and exposed to 1.2 million load cycles (30 N) in a computer-controlled chewing simulator. Simultaneous thermocycling between 5 degrees C and 55 degrees C was applied for 60 seconds with an intermediate pause of 12 seconds. All specimens that did not fracture during dynamic loading were loaded until fracture in a universal testing machine at a crosshead speed of 1.5 mm/min; loads were applied at an angle of 130 degrees at the incisal edge. Fracture loads (N) and modes (repairable or catastrophic) were recorded. The Kruskal-Wallis test was used to compare fracture loads among the 4 test groups. Analyses were conducted both with and without the specimens that failed during the chewing simulation. A Fisher exact test was performed to detect group differences in fracture modes. A significance level of P<.05 was used for all comparisons. RESULTS: The following survival rates were recorded after the chewing simulation: 93.8% (Group 1), 93.8% (Group 2), 100% (Group 3), and 87.5% (Group 4). The median fracture strengths for Groups 1 to 4 were 450 N, 503 N, 521 N, and 408 N, respectively. No significant differences were detected among the groups. The use of zirconia posts resulted in a nonsignificant lower number of catastrophic root fractures. CONCLUSION: Within the limitations of this study, the results suggest that zirconia posts with ceramic cores can be recommended as an alternative to cast posts and cores. If a chairside procedure is preferred, zirconia or titanium posts with composite cores can be used. Clinical trials are required to verify these in vitro results.     

Resistance to cyclic loading of teeth restored with posts

This in vitro study evaluated the effect of presence of post, presence of core, and of shape, type, and surface treatment of posts on resistance to cyclic loading of crowned human teeth. For all teeth, crowns designed without ferrule were cast in sterling silver and luted with resin cement (Panavia F). Each tooth underwent cyclic loading of 600 N at two loads per second until failure. Teeth that had only been crowned showed significantly higher resistance to cyclic loading than teeth with cores or with post and cores. No significant differences were found between teeth restored with cores only or with post and cores, irrespective of surface-treatment of the posts. Teeth restored with parallel-sided cast post (ParaPost XP) and cores showed significantly higher resistance to cyclic loading than teeth with either tapered cast posts or untreated prefabricated posts of titanium alloy (ParaPost XH) or glass fiber composite (ParaPost Fiber White). No significant difference was found between teeth restored with parallel-sided cast post and cores and teeth restored with untreated prefabricated posts of zirconia (Cerapost). Surface treatment of posts significantly increased the resistance to cyclic loading compared with untreated posts. When posts are used, surface treatment is recommended.     

Microleakage and fracture patterns of teeth restored with different posts under dynamic loading

STATEMENT OF PROBLEM: Many studies concerned with the microleakage of endodontically treated teeth restored with posts and cores and subjected to loading can be found in the literature. However, no studies have investigated microleakage under dynamic loading with simultaneous dye penetration, which is more relevant to clinical situations. PURPOSE: The purpose of this study was to compare microleakage and to classify fracture patterns of endodontically treated teeth restored with various post systems under dynamic loading. MATERIAL AND METHODS: The crown portions of 40 human mandibular incisors were sectioned at the cementoenamel junction, and the teeth were endodontically treated. Teeth were divided into 4 groups (n=10): teeth restored with a cast post and core, prefabricated metal post (ParaPost), fiber-reinforced composite resin post (FRC Postec), and ceramic post (Cosmopost). After preparing the post space, each post was cemented with dual-polymerized resin cement (DuoLink). With the exception of the cast post-and-core group, the cores were formed directly using a light-polymerized composite resin (Light-Core). An intermittent load of 98 N at 1 Hz was applied for 50,000 cycles at an angle of 135 degrees to the long axis of the restored teeth, which were immersed in a 0.5% basic fuchsin solution. The ratio of the dyed surface area to the total area of the sectioned root surface was determined using an image analysis program. The data were analyzed by a 1-way ANOVA and Duncan's multiple range test (alpha =.05). The fracture patterns of the teeth were classified according to their fracture propagation lines. RESULTS: The cast post group showed a significantly higher level of microleakage compared to the other groups (P=.001). Regarding the failure mode, the FRC Postec and Cosmopost groups showed fracture patterns that would favor retreatment. The number of cycles of repeated loading was not significantly different among the groups (P=.161). CONCLUSIONS: Both FRC Postec and Cosmopost groups showed less microleakage under dynamic loading and fracture patterns favoring a retreatment of fractured specimens.     

An in vitro study evaluating the effect of ferrule length on fracture resistance of endodontically treated teeth restored with fiber-reinforced and zirconia dowel systems

STATEMENT OF PROBLEM: There are few published studies analyzing the effects of different ferrule lengths of endodontically treated teeth in relationship to newly developed fiber-reinforced and zirconia dowel systems. PURPOSE: This in vitro study compared the effect of 3 different ferrule lengths on the fracture resistance and fracture patterns of crowned endodontically treated teeth restored with 4 different esthetic dowel systems. MATERIAL AND METHODS: The crowns of 123 human maxillary canines were removed at the cementoenamel junction and the roots were endodontically treated. Three master tooth models were prepared to ferrule lengths of 1.0 mm, 1.5 mm, and 2.0 mm to produce 3 master analogs. Each root was embedded in autopolymerizing resin with a 0.2-mm layer of silicone impression material to simulate the periodontal ligament. Forty analogs of each master tooth, with ferrule lengths of 1.0 mm, 1.5 mm, and 2.0 mm were produced with copy-milling (Celay system). Each group was further subdivided into 4 groups of 10 specimens each and restored with 4 different esthetic dowel systems (quartz fiber, glass fiber, glass fiber plus zirconia, and zirconia). All dowels were luted with adhesive resin cement (RelyX ARC), restored with composite cores (Valux Plus), and Ni-Cr alloy (Wiron 99) complete crowns. All specimens were loaded at 130 degrees to the long axes in a universal testing machine at a crosshead speed of 1 mm/min until fracture. Fracture patterns were classified as failures above or below the incisal third of the roots. The data were analyzed with 2-way ANOVA and Tukey HSD tests (alpha=.05). A Fisher exact test was conducted for evaluation of the mode of failure (alpha=.05). RESULTS: Mean failure loads (kg) for quartz fiber, glass fiber, glass fiber plus zirconia, and zirconia groups, respectively, with the 3 ferrule lengths were: 1.0-mm ferrule specimens: 98.09 +/- 2.90, 85.36 +/- 2.82, 80.24 +/- 1.88, 70.11 +/- 2.48; 1.5-mm ferrule specimens: 101.0 +/- 2.88, 87.58 +/- 2.83, 89.8 +/- 2.09, 82.71 +/- 2.14; 2.0-mm ferrule specimens: 119.5+/-1.78, 99.84+/-1.23, 98.6 +/- 1.64, 95.42 +/- 1.02. Teeth prepared with 2.0-mm ferrules demonstrated significantly higher fracture thresholds (P<.001). There were no significant differences in fracture patterns. CONCLUSION: Increasing the ferrule length of the endodontically treated teeth from 1 mm to 1.5 mm in specimens restored with quartz-fiber and glass-fiber dowels did not produce significant increases in the failure loads (P=.084, P=.119, respectively). No significant difference was detected between glass-fiber and glass-fiber plus zirconia dowels with 1.5-mm and 2.0-mm ferrules (P=.218, P=.244, respectively). However, fracture thresholds were higher for all 4 dowel systems when the specimens were prepared with a 2.0-mm ferrule length (P<.001).     

Comparative evaluation of fracture resistance of structurally compromised canals restored with different dowel methods

Purpose: The objective of this in vitro study was to evaluate and compare the fracture resistance and fracture mode of endodontically treated teeth with wide root canals restored with various dowel methods. Materials and Methods: Fifty human uniradicular mandibular premolar teeth were decoronated and endodontically treated. The canals were widened with diamond points. The specimens were divided into five groups on the basis of type of dowel method used: conventional custom‐made cast metal dowel; single glass fiber‐reinforced resin dowel; glass fiber‐reinforced resin dowel with accessory fiber dowels; relined glass fiber‐reinforced resin dowel; and dowels formed with the help of polyethylene fiber ribbon‐reinforced resin composite. Specimens were restored with indirect composite crowns, and 150,000 cycles of cyclic loading were applied. The specimens were loaded to test the fracture resistance and fracture mode (repairable and nonrepairable). Results: The cast metal dowel groups had the highest fracture resistance but showed nonrepairable fracture in 90% of specimens. Conclusions: Cast metal dowels had the highest fracture resistance but led to nonrepairable fracture while restoring the wide root canals under cyclic loading. Specimens restored with fiber dowels, accessory dowels, relined dowels, and ribbon‐reinforced resin provided adequate fracture resistance with increased incidence of repairable fractures.     

The use of reinforced composite resin cement as compensation for reduced post length

STATEMENT OF PROBLEM: Cements that yield high retentive values are believed to allow use of shorter posts. PURPOSE: This study investigated the use of reinforced composite resin cement as compensation for reduced dowel length. MATERIAL AND METHODS: The retention values of stainless steel posts (parallel-sided ParaPost and tapered Dentatus in 5-, 8-, and 10-mm lengths) luted with Flexi-Flow titanium-reinforced composite resin and zinc phosphate cements were evaluated. Single-rooted extracted human teeth with crowns (n = 120), removed at the cementoenamel junction, were randomly divided into 4 groups of 30 samples each. Different post lengths were luted with either Flexi-Flow or zinc phosphate. Each sample was placed into a specialized jig and on a tensile testing machine with a crosshead speed of 2 mm/min, applied until failure. The effect of different posts and cements on the force required to dislodge the dowels was evaluated with multiple analyses of variance (ANOVA). One-way ANOVA with Scheffé contrast was applied to determine the effect of different post lengths on the retentive failure of posts luted with the 2 agents. RESULTS: Flexi-Flow reinforced composite resin cement significantly increased retention of ParaPost and Dentatus dowels (P<.001) compared with zinc phosphate. One-way ANOVA revealed no statistically significant difference (P>.05) between mean retention of both dowels luted with Flexi-Flow for all posts length used (5 mm = 8 mm = 10 mm). Mean retention values of the groups luted with zinc phosphate showed a statistically significant difference (P<.001) for the different post lengths (10 > 8 > 5 mm). Parallel-sided ParaPost dowels demonstrated a higher mean retention than tapered Dentatus dowels (P<.001). CONCLUSION: In this study, Flexi-Flow reinforced composite resin cement compensated for the reduced length of shorter parallel-sided ParaPost and tapered Dentatus dowels.     

Fracture strength and survival rate of endodontically treated maxillary incisors with approximal cavities after restoration with different post and core systems: an in-vitro study

OBJECTIVES: This study compared the fracture strength and survival rate of endodontically treated crowned maxillary incisors with approximal class III cavities and different core build-ups. METHODS: Sixty-four caries free human maxillary central incisors were selected for standardized size and quality, endodontically treated and prepared with approximal cavities 3mm in diameter. Group 1 was restored with titanium posts, group 2 received zirconia posts, in group 3 the root canal was partially filled with a hybrid composite. In the control group, only the access opening was restored. All teeth were prepared for and restored with full cast metal alloy crowns and subsequently exposed to 1.2 million cycles in a computer-controlled chewing simulator with simultaneous thermocycling. In addition, the samples were loaded until fracture in a static testing device. RESULTS: One specimen with composite reinforced root canal did not survive the dynamic load test. The following median fracture strengths in Newtons for the different groups were: titanium post 1038, zirconia 1057, composite resin 750, control (no post) 1171. The fracture load in group 3 (composite resin) was significantly lower (P<0.05) than in the other groups. CONCLUSIONS: The reconstruction of endodontically treated single rooted teeth with approximal cavities can be successfully performed by closure of the endodontic and additional cavities with composite. Cementation of endodontic posts offers comparable but no advantageous fracture resistance. Enlargement of the root canal space after completion of endodontic treatment should be avoided and cannot be compensated for by injection of composite resin. Less catastrophic failures were observed without post reconstruction.     

In vitro assessment of retention of four esthetic dowels to resin core foundation and teeth

STATEMENT OF PROBLEM: Several new esthetic dowel systems are currently available for the restoration of endodontically treated teeth. These dowel systems enhance the esthetic quality of all-ceramic restorations better than metallic dowel systems. PURPOSE: The purpose of this study was to evaluate the retentive strength of composite and ceramic endodontic dowel systems to the tooth and to the core foundation. MATERIAL AND METHODS: The following dowel systems were tested: resin dowels (Fibrekor [FR]; Luscent [LU]; Twin Luscent Anchor [TLU]); ceramic dowels (Cerapost [CR]; Cosmopost [CO]); and a titanium dowel (ParaPost XH [Ti]). In Part I of the study, core retention was tested by forming Bis-Core resin (n=12) cores around dowels followed by separation using a universal testing machine. In Part II, 60 (n=12) extracted human canines were endodontically treated, and dowel spaces were prepared using the corresponding drill for each dowel system. Nine-millimeter resin and ceramic dowels were cemented with C & B resin luting agent. Additionally, 2 groups (n=12) of Ti dowels cemented with C & B resin luting agent and zinc phosphate luting agent served as control groups. Retention was tested using a universal testing machine to separate the dowels from teeth. One-way analysis of variance and Student Newman-Keuls tests were conducted for statistical analysis (alpha=.05). Surface texture of all dowel systems tested was examined using SEM at original magnification x25 and x250. RESULTS: Core retention of Ti was higher than all esthetic dowels tested (alpha<.05), but FR had higher core retention than the other esthetic dowels tested. Resin dowels had better retention to teeth than ceramic dowels (alpha<.05). CONCLUSION: The esthetic dowel systems were less retentive for the resin core material than the titanium control. Resin dowel systems were more retentive in the root than the ceramic dowels but were similar to the titanium control.     

Comparison of Two Luting Agents Used for the Retention of Cast Dowel and Cores

PURPOSE: The first purpose of this study was to compare the retentive values of zinc phosphate and Panavia F resin cements when used for luting cast dowel and cores. The second purpose was to determine whether the use of a lubricant when making the resin pattern for a custom dowel and core would have an effect on the final retention of dowels cemented with either zinc phosphate or Panavia F cements. METHODS AND MATERIALS: Sixty-three caries-free extracted single-rooted human teeth were randomly divided into three groups of 21. Root canal preparations were standardized for all 63 teeth. Clinical protocols for fabricating and cementing dowel and core restorations were examined, comparing zinc phosphate and Panavia F resin cements. Direct dowel patterns were fabricated using the Para Post system and cast in a noble metal alloy. Group I dowel spaces were lubricated with GC lubricant prior to dowel pattern fabrication and cleaned with Cavidry solvent before cementing the cast dowel and core with zinc phosphate cement. Group II dowel spaces were rinsed with water only prior to dowel pattern fabrication. The dowels and cores in this group were cemented with Panavia F resin cement. Group III dowel spaces were lubricated with GC lubricant prior to dowel pattern fabrication; the dowel spaces were cleaned with Cavidry solvent before the cast dowel and cores were cemented with Panavia F cement. The tensile force necessary to remove the cast dowel and cores was determined using a universal testing machine. Results were statistically analyzed using one-way ANOVA and Tukey's HSD test. RESULTS: The dowels and cores in Group I had significantly higher retentive values than either of the two Panavia F groups (p< or = 0.001). No difference in retentive values (p > 0.05) was found between dowels luted with either of the lubricating agents in the Panavia F groups. CONCLUSIONS: Zinc phosphate cement had higher retentive values when cementing cast dowel and cores than Panavia F. The type of lubricant used for the resin dowel fabrication (water or GC lubricant that was removed with a solvent) had no effect on the retention of cast dowels cemented with Panavia F.     

The effect of thermal change on various dowel-and-core restorative materials.

STATEMENT OF PROBLEM: Severe thermal stresses caused by food-induced temperature changes may result in dowel-and-core failure. PURPOSE: This study investigated the influence of thermal stresses on various combinations of dowel-and-core materials of a restored endodontically treated incisor. MATERIAL AND METHODS: A 2-dimensional finite element model was constructed in a labiolingual cross-sectional view of a maxillary central incisor, a dowel, a core, and the supporting tissues to investigate thermal stress distribution. Four combinations of dowel-and-core materials were used: (1) gold/gold, (2) stainless steel/resin composite, (3) stainless steel/amalgam, and (4) carbon fiber-reinforced composite/resin composite. For thermal analysis, a cold irritant (0 degrees C) was applied on the outer surface of a metal-ceramic crown for 7 seconds. RESULTS: The metal dowel and core generated lower thermal stresses in the restorations and dentin than the nonmetallic dowel and cores. CONCLUSION: Stress level is closely related to the degree of thermal gradient. The nonmetallic dowel and cores generated greater thermal stresses than metal dowel and cores.     

Fracture resistance of crowned incisors with different post systems and luting agents

This study evaluated the fracture resistance of crown-restored incisors with different post-and-core systems and luting cements. Fifty intact maxillary central incisors were randomly assigned to five groups of 10 teeth each. Group 1 was restored with fibre posts (Snowpost) luted with an adhesive composite resin cement (Panavia F). Group 2 was restored with titanium alloy posts (Parapost) luted with the resin cement, and Group 3 with titanium alloy posts and a glass-ionomer cement (Fuji I). Composite cores (Clearfil Photocore) were built up in groups 1, 2 and 3. Group 4 was restored with cast post-and-cores luted with the resin cement, and group 5 with the cast post-and-cores and the glass-ionomer-cement served as a control group. All teeth were restored with metal-ceramic crowns. After thermal stressing, the specimen was then secured in a universal testing machine. Fracture loads and modes were recorded. One-way ANOVA and a Tukey test were used to determine significant differences between the failure loads of groups. Chi-square test was conducted for evaluation of the fracture modes. The fracture loads of groups 1 and 2 were significantly higher than that of the control group (P<0.05). Group 1 had a significantly higher number of repairable fractures than the other four groups (P<0.001). Within the limitations of this study, the results suggest that fibre posts can be recommended as an alternative to cast and prefabricated metallic posts. Composite resin cement cannot significantly improve fracture resistance of metallic post and crown-restored incisors.     

Survival rates of endodontically treated teeth restored with fiber-reinforced custom posts and cores: a 97-month study

PURPOSE: This study aimed to assess the long-term survival rates of polyethylene fiber-reinforced posts and cores used in endodontically treated teeth over a 97-month period. MATERIALS AND METHODS: Sixty-nine patients from a private dental office who underwent endodontic treatment with coronoradicular fiber-reinforced restorations were selected and invited for evaluation. All teeth were restored with the same high-molecular-weight polyethylene fiber (Ribbond, Ribbond Inc) and resin composite cement (Enforce, Dentsply) post-and-core system by a single operator and then prepared and restored with complete cast crowns or direct resin composite. Survival functions of restorations were analyzed with Kaplan-Meier and log-rank tests (alpha = .05) and displayed according to the variable tooth location and material of the definitive restoration. RESULTS: Four posts fractured among the 36 anterior restorations evaluated, and 2 posts fractured among the 73 posterior restorations. The mean overall survival estimate was 90.2 (+/- 3.7) months (95% Cl: 82.8-97.5). There were no differences between survival functions regarding tooth location or type of restorative material as variables (P> .05). CONCLUSIONS: The results suggest that polyethylene fiber-reinforced posts with composite cores may be recommended for clinical use. Restorations evaluated in this study presented high survival rates after the 97-month follow-up period.     

In vitro evaluation of the fracture resistance of anterior endodontically treated teeth restored with glass fiber and zircon posts

STATEMENT OF PROBLEM: The published information is equivocal regarding the fracture resistance of endodontically treated teeth restored with fiber posts. Additionally, little is known about the biomechanical performance of glass fiber and zircon posts. PURPOSE: This in vitro study investigated the fracture resistance of anterior endodontically treated teeth prepared with a 2-mm ferrule, restored with glass fiber and zircon posts and composite resin cores or cast posts and cores. MATERIAL AND METHODS: Twelve matched pairs of teeth were obtained from 4 cadavers, and all were endodontically treated and prepared with a standardized 2-mm ferrule. According to a random number table, the 2 teeth from each matched pair were randomly divided into 2 groups. The test group consisted of 12 specimens restored with a glass fiber and zircon post (Fibio) and composite resin (Durafil) core. Twelve matching specimens restored with a nickel-chromium (NiCr) cast post and core served as the control. Specimens in both groups were cemented with resin cement (Panavia F). After cementation of cast NiCr complete crowns with zinc polycarboxylate cement (ShangChi), the specimens were loaded with an incremental static force at an angle of 135 degrees to the long axis of the root until failure occurred. A paired sample t test was used to compare the fracture resistance (N) of teeth restored with the 2 post-and-core systems (alpha=.05). RESULTS: The mean failure load of paired differences between the 2 groups was -261.3+/-237.3 N. The test group exhibited significantly lower failure loads than the control group (P=.004). All specimens displayed root fractures, most of which were oblique, with cracks initiating from the palatal cervical margin and propagating in a labial-apical direction. CONCLUSION: Within the limitations of this study, the teeth restored with glass fiber and zircon posts demonstrated significantly lower failure loads than those with cast NiCr post and cores. All specimens failed via root fractures.     

Fracture Resistance of Endodontically Treated Teeth: Three Walls versus Four Walls of Remaining Coronal Tooth Structure

Purpose: The purpose of this study was to evaluate the fracture resistance of endodontically treated teeth between those with four walls and those with three walls of remaining coronal tooth structure and the effect of the site of the missing coronal wall.
Materials and Methods: Thirty-two endodontically treated second mandibular premolars were decoronated, leaving 3 mm above the cementoenamel junction (CEJ). A 0.5-mm-wide chamfer was prepared 1 mm above the CEJ. The teeth were randomly divided into four groups. Group 1 had four walls of coronal tooth structure, whereas groups 2, 3, and 4 had only three walls, missing the buccal, lingual, and mesial wall, respectively. The cast dowel and cores and crowns (Ni–Cr alloy) were cemented with zinc phosphate cement. A compressive load was applied 45° to the long axis, 2 mm below the buccal cusp, with an Instron machine until failure at a crosshead speed of 5 mm/min. Failure load (kg) and mode of failure were recorded. Data were analyzed with one-way ANOVA and Scheffé tests ( p < 0.05).
Results: Group 1 had the highest fracture resistance (1190.3 ± 110.5 kg), significantly different from the other groups ( p < 0.05) (group 2: 578.5 ± 197.4 kg; group 3: 786.6 ± 132.8 kg; group 4: 785.4 ± 289.9 kg). There were no significant differences among the test groups. The mode of failure in group 1 was a horizontal root fracture, whereas that of the other groups was either vertical or oblique fracture.
Conclusions: Teeth with four walls of remaining coronal dentine had significantly higher fracture resistance than teeth with only three walls. The site of the missing coronal wall did not affect the fracture resistance of endodontically treated teeth.     

Esthetic enhancement of ceramic crowns with zirconia dowels and cores: a clinical report

There has been an increase in the use of esthetic metal-free ceramic crowns in restoring endodontically treated teeth or teeth with severe coronal destruction. Tooth-colored dowels and cores are used to enhance the esthetic result. This report describes the treatment of a patient with bilateral maxillary supernumerary lateral incisors, a severe malocclusion, and maxillary anterior tooth discoloration. Treatment included heat-pressed, metal-free ceramic crowns supported by zirconia ceramic dowel-and-core foundations.     

Tensile bond strength of cast commercially pure titanium and cast gold-alloy posts and cores cemented with two luting agents

STATEMENT OF PROBLEM: In vitro studies on the retentive strengths of various cements used to retain posts have reported conflicting results. PURPOSE: The purpose of this study was to compare the tensile strength of commercially pure titanium and type III cast gold-alloy posts and cores cemented with zinc phosphate or resin cement. MATERIAL AND METHODS: Forty-two extracted human canines were endodontically treated. The root preparations were accomplished using Largo reamers (10 mm in depth and 1.7 mm in diameter). Acrylic resin patterns for the posts and cores were made, and specimens were cast in commercially pure titanium and in type III gold alloy (n=7). Fourteen titanium cast posts and cores were submitted to surface treatment with Kroll acid solution and to scanning electron microscopy (SEM), before and after acid etching. The groups (n=7) were cemented with zinc phosphate cement or resin cement (Panavia F). Tensile strengths were measured in a universal testing machine at a crosshead speed of 0.5 mm/min. The results (Kgf) were statistically analyzed by 2-way ANOVA (alpha=.05). RESULTS: The 2-way ANOVA indicated that there were no significant differences among the groups tested. Retentive means for zinc phosphate and Panavia F cements were statistically similar. The bond strength was not influenced by the alloy, the luting material, or the etching treatment. SEM analysis indicated that the etched surfaces were smoother than those that did not receive surface treatment, but this fact did not influence the results. CONCLUSIONS: Commercially pure titanium cast posts and cores cemented with zinc phosphate and resin cements demonstrated similar mean tensile retentive values. Retentive values were also similar to mean values recorded for cast gold-alloy posts and cores cemented with zinc phosphate cement and resin cements.     

桩核修复方法对梭形根管牙断裂强度的影响

目的：比较3种不同桩核修复方法对梭形根管牙断裂强度的影响。方法：30颗近期拔除的上颌中切牙根管治疗后预备成梭形,随机分为3组,每组10颗。Ⅰ组行玻璃纤维桩、Luxacore树脂核和铸造全冠修复;Ⅱ组根管扩大预备后行铸造镍铬桩核和铸造全冠修复;Ⅲ组玻璃离子水门汀重塑根管后行铸造镍铬桩核和铸造全冠修复。Zwick z010型电子万能试验机测试断裂强度。结果：Ⅰ组与Ⅱ组、Ⅲ组试件牙的断裂强度差异有显著性,Ⅱ组与Ⅲ组差异无显著性。结论：梭形根管牙的断裂强度与其修复设计有关,采用玻璃纤维桩及树脂核修复有较高的断裂强度,且断裂方式利于再修复。     

Influence of endodontic posts on the fracture behavior of crowned premolars with Class II cavities

AIM: The aim of the study was to evaluate the influence of different posts and types of cementation on the fracture load and fracture mode of crowned, endodontically treated premolars with class II cavities in an ex vivo setting. METHODS: Forty-eight single-rooted human premolars were endodontically treated and prepared with standardized MO (mesio-occlusal) cavities and a circular chamfer preparation. Eight teeth each received either no posts or were restored with screws (BKS), glass fiber posts (DentinPost), or quartz fiber posts (DT Light SL). Sixteen teeth were restored with zirconium dioxide posts (CeraPost). BKS-screws and eight zirconium dioxide posts were cemented conventionally with glass ionomer cement; Panavia F was used for all others. The specimens were restored with composite cores and crowns cast from a non-precious metal. Eight sound premolars served as the controls. After thermomechanical fatigue testing, the samples were loaded until fracture occurred at an angle of 45 degrees. All specimens were evaluated for fracture lines. RESULTS: The sound teeth showed the significant highest fracture load (792.50+/-210.01 N). Conventionally cemented zirconium dioxide posts showed the lowest fracture load (327.00+/-45.84 N); the highest fracture load occurred with quartz fiber posts (421.75+/-90.19 N). Only the difference between these two groups was statistically significant. With glass fiber posts and conventionally cemented zirconia posts, restored teeth failed mostly in an "unfavourable" mode. CONCLUSIONS: With respect to the fracture load, there was no statistical difference between the restoration of non-vital premolars with class II cavities with crowns and posts or crowns alone.