Considerations for the Restoration of Endodontically Treated Molars

Leprince, Julian; Leloup, Gaëtane; Hardy, Chloé

doi:10.1007/978-3-662-52901-0_7

Cited by 8 publications

(8 citation statements)

References 87 publications

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“…First, the bonding conditions in the root canal are not favorable because of the high C-factor, the difficulty of drying and the poor arrangement of the dentin fibers [ 34 ], resulting in a major reduction of bond strength in the canal beyond the coronal third [ 35 ]. Secondly, it has been stated that clinical data are insufficient to justify the need of fiber posts both for the reinforcement of endodontically treated molars [ 6 , 36 , 37 ] and for the restoration retention [ 6 , 38 ]. This is especially true for teeth with ferrule, which was identified along with the maintenance of cavity walls as the dominant factors as regards both tooth and restoration survival [ 37 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

“…In any case, the teeth requiring a full crown are often severely damaged, with large structural loss and, as a result, often root canal-treated. Whether the root canal treatment additionally weakens the tooth is debated [ 5 , 6 ], but most agree that the loss of tooth structure at the coronal level represents the major cause for increased risk of tooth fracture [ 7 ]. The low amount of remaining tooth tissue represents a major restorative challenge for the practitioner to ensure the best possible longevity of both the restoration and the tooth.…”

Section: Introductionmentioning

confidence: 99%

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Core build-up resin composites: an in-vitro comparative study

Spinhayer

Bui

Leprince

et al. 2020

Biomaterial Investigations in Dentistry

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Aim Resin composite (RC) are commonly used under full crowns. However, independent information is lacking to guide practitioners regarding core RC material selection. This study aimed at comparing the flexural properties of a large selection of commercially-available core build-up RCs (CBU-RC), either light-, self- or dual-cure, to conventional light-cure RCs. Methods RCs were injected into a 25 × 2×2mm Teflon mold, and either light-cured during 20 s (materials with claimed light-cure characteristics) or covered by aluminum during 10 min (dual- and self-cure CBU-RCs). They were subjected after a one-week water storage at 37.5 °C to three-point bending, and Flexural modulus ( E flex ) and Flexural Strength ( σ f ) were calculated ( n = 20). Thermogravimetric analysis ( n = 3) was performed to determine inorganic filler content (%). Results For dual-cure CBU-RCs, both RC ( p < .0001) and light-curing ( p = .0007) had a significant influence on E flex , while only RC was significant for σ f ( p < .0001). Between all conventional RCs and CBU-RCs, significant differences were observed ( p < .0001), both regarding E flex and σ f , with values ranging from 3.9 to 15.5 GPa and from 76 to 130.3 MPa, respectively. Higher E flex values were observed for light-cure RCs than for self- and dual-cure ones, while no clear trend was noticed regarding σ f . Good linear correlation was found between inorganic filler content and E flex ( R 2 =0.85, p < .0001), but not with σ f ( R 2 =0.08, p = .1609). Conclusion This work demonstrated a positive influence of light-curing on dual-cure CBU-RC’s E flex . It also highlighted large differences in flexural properties (especially E flex ) among the investigated materials, questioning the use of some CBU-RCs as dentin replacement in case of large tissue loss.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Core build-up resin composites: an in-vitro comparative study

Spinhayer

Bui

Leprince

et al. 2020

Biomaterial Investigations in Dentistry

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“…Another preparation has been described as flat surface preparation with no axial wall height, with no pulp chamber anchorage, since adhesive strategies have become more and more reliable, and dental preservation has been searched [14–16].…”

Section: Introductionmentioning

confidence: 99%

Fracture Resistance of CAD/CAM Lithium Disilicate of Endodontically Treated Mandibular Damaged Molars Based on Different Preparation Designs

Clausson

Schroeder

Goloni

et al. 2019

International Journal of Biomaterials

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The aim of this study was to evaluate the fracture resistance of 2 different types of all-ceramic crown using immediate dentin sealing (IDS), obtained using a CAD/CAM system on molars with different preparations. Forty extracted lower molars were endodontically treated and divided into four groups (n = 10) according to the dental preparation. Group 1 (SP0) was prepared without filling the pulp chamber and crown-root junction was located at the cementoenamel junction (CEJ). Group 2 (SP1) was prepared without filling the pulp chamber and crown-root junction was located 1-mm above the CEJ. Groups 3 and 4 contained a flat preparation surface with no axial wall height. Group 3 (CP0) was made IDS with complete filling of the pulp chamber with composite resin and crown-root junction was located at the CEJ. Group 4 (CP1) was prepared with complete filling of the pulp chamber and crown-root junction was located 1-mm above the CEJ. All groups were restored with CAD/CAM lithium disilicate ceramic crowns. Specimens were subjected to the fracture test and statistically analyzed using analysis of variance (ANOVA). Fracture mode was determined using a stereoscopic microscope, classified as repairable or nonrepairable, and analyzed using Fischer’s exact test. Results indicated that there were no significant differences between the groups in terms of fracture resistance or fracture pattern (p >0.05). Fracture resistance was the lowest in the SP0 group, followed by the SP1 group (1634.38 N) of CP0 (1821.50 N), and it was the highest in the CP1 group. There was a predominance of nonrepairable fractures and there were no significant differences in the fracture resistance and fracture mode of CAD/CAM lithium disilicate molar all-ceramic crowns. Endodontically treated molars teeth might be restored with endocrowns or all-ceramic crowns on flat preparation; however tooth fracture failures that affect reliability of these types of restorations should be considered.

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“…The presence of the ferrule has been claimed mandatory to consider a tooth restorable 8,9 . Instead, when dealing with molars, the clinical relevance of the ferrule effect is questionable while the pulp chamber is taken into consideration since it contributes to increase the resistance and retention of the coronal restoration 32,33 . Ferrule has been generally identified as the 1.5 mm height collar of at least 1 mm‐thick residual dentin after tooth preparation, with 10–15° tapered walls above the prosthetic margin necessary to enhance the biomechanical prognosis of the restored endodontically treated abutments teeth 6,18,34 .…”

Section: Methodsmentioning

confidence: 99%

Structurally compromised teeth. Part I: Clinical considerations and novel classification proposal

Fichera,

Mazzitelli,

Picciariello

et al. 2023

J Esthet Restor Dent

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ObjectiveA comprehensive classification of structurally compromised teeth (SCT) was introduced.Clinical ConsiderationsDental injuries or operative mismanagement undermine the structural integrity of the tooth abutment, reducing its biomechanical strength and rendering restorative procedures challenging. To standardize the overall pre‐operative evaluations and determine the biological and mechanical features, a classification of the coronal and cervical tooth defects, as well as an attentive analysis of the most apical location of the residual cervical tooth structure along the whole perimeter and the most coronal location of the bucco/lingual residual structure was presented. Considering the residual cervical structure, five possible clinical scenarios were individuated with respect to the gingival margin, gingival sulcus, supracrestal tissue attachment and bone crest (BC). The latter prevents the isolation procedures rendering the adhesive restorations unfeasible. Instead, the location of the most apical portion of residual cervical structure within subgingival/intrasulcular depth (>1.5 mm above BC) can be considered restorable.ConclusionsThis classification is threefold: to enclose all the possible clinically encountered tooth defects, to identify the apical problems of SCT to appropriately manage the perio‐restorative interfaces, and to evaluate the tooth resistance capacity of SCT, as to plan and perform the most adequate biomechanical restorative approach.Clinical SignificanceThe present classification is proposed to provide a complete perspective of structurally compromised teeth to standardize the biologic and biomechanical evaluations during planning of restorative procedures.

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Considerations for the Restoration of Endodontically Treated Molars

Cited by 8 publications

References 87 publications

Core build-up resin composites: an in-vitro comparative study

Core build-up resin composites: an in-vitro comparative study

Fracture Resistance of CAD/CAM Lithium Disilicate of Endodontically Treated Mandibular Damaged Molars Based on Different Preparation Designs

Structurally compromised teeth. Part I: Clinical considerations and novel classification proposal

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