Effect of Composite Core Materials on Fracture Resistance of Endodontically Treated Teeth: A Systematic Review and Meta-Analysis of In Vitro Studies

Żarow, Maciej; Dominiak, Marzena; Szczeklik, Katarzyna; Hardan, Louis; Bourgi, Rim; Cuevas‐Suárez, Carlos Enrique; Zamarripa-Calderón, Juan Eliezer; Kharouf, Naji; Filtchev, Dimitar

doi:10.3390/polym13142251

Cited by 18 publications

(13 citation statements)

References 27 publications

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“…Risk of bias was determined for each article by three authors, independently. The following parameters were used to determine the risk of bias, according to previous systematic reviews: the presence of a control group; sample size calculation; standardization of the preparation of the samples; sample randomization; sample preparation by a single operator; blindness of the operator; failure mode evaluation [ 18 , 19 ]. For each article, the amount of these parameters that were mentioned in the article was counted.…”

Section: Methodsmentioning

confidence: 99%

Mechanical Performance of Direct Restorative Techniques Utilizing Long Fibers for “Horizontal Splinting” to Reinforce Deep MOD Cavities—An Updated Literature Review

Jakab

Volom²,

Sáry

et al. 2022

Polymers

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Excessive cavity preparation and root canal treatment leads to a weakened tooth structure with a lower resistance to fracture. Fiber reinforcement is frequently used to reinforce such teeth, and multiple fiber types and possible applications exist. Various methods for utilizing long fibers to internally splint the remaining cavity walls in the case of large mesio-occluso-distal (MOD) cavities have been proposed; however, no summary of their performance has been written up to now. Our study aims to review the available literature to evaluate and compare the mechanical performance of the different materials and methods utilized for horizontal splinting in large MOD cavities. Three independent authors performed a thorough literature search using PubMed, ScienceDirect, and Google Scholar up until January 2022. The authors selected in vitro studies that used long fibers placed horizontally in posterior teeth with large MOD cavities to reinforce these teeth. From 1683 potentially relevant articles, 11 publications met our inclusion criteria. Seven out of eleven studies showed that horizontal splinting with long fibers improved the fracture resistance of the restored teeth. Three articles showed no significant difference between the fracture resistance of the restored groups. Only one article reported a lower fracture resistance to the horizontally splinted group, compared to conventional direct composite restoration. Within the limitations of this review, evidence suggests that long fiber reinforcement could be used to improve the fracture resistance of heavily restored teeth.

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Section: Methodsmentioning

confidence: 99%

Mechanical Performance of Direct Restorative Techniques Utilizing Long Fibers for “Horizontal Splinting” to Reinforce Deep MOD Cavities—An Updated Literature Review

Jakab

Volom²,

Sáry

et al. 2022

Polymers

View full text Add to dashboard Cite

show abstract

“…Two authors (EM, SG) independently assessed the risk of bias of the included studies. This was undertaken according to two previous systemic reviews [24,25]. The following eight parameters were used to evaluate the risk of bias: presence of control group; samples preparation standardization; samples randomization; samples preparation by single operator; materials used according to manufacturer's instruction; blindness of the operator during testing; clarification of calculation of sample size; failure mode evaluation (this one only applied for fracture resistance studies).…”

Section: Quality Assessmentmentioning

confidence: 99%

Effect of Fiber Reinforcement Type on the Performance of Large Posterior Restorations: A Review of In Vitro Studies

et al. 2021

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To reinforce extensively prepared cavities, different types of fiber reinforcement are utilized. Polyethylene and glass fibers are the most commonly used fibers in that purpose; each type has its own advantages over the other type. Therefore, the aim of this study is to review the literature to evaluate and compare the influence of different fiber reinforcement types on the performance of posterior large composite restorations. Two independent authors performed a comprehensive literature search using MEDLINE/PubMed, Google Scholar, and a manual search for cross references until July 2021. Authors selected only studies that contain comparisons between glass (continuous or short) and polyethylene (woven) fiber-reinforced composites (FRCs) in posterior cavities of human teeth, and that report the effect of fiber inclusion on fracture resistance, microleakage, and marginal adaptation of restorations. A number of 2711 potentially relevant articles were obtained from the electronic search. After extensive assessment, 2696 articles were ineligible to be included in the review, and only 15 articles met the inclusion criteria. Four out of nine studies, which tested the fracture resistance of FRC restorations, revealed similar performance of the glass and polyethylene fibers. The rest of the studies (n = 5) revealed statistically significant differences between the two types of fiber reinforcement, with the majority showed superior reinforcement of glass fiber. Moreover, the reviewed studies revealed that, using fibers within the composite restorations would reduce the microleakage and improve the marginal adaptation of the restoration regardless of the fiber type. FRCs tend to strengthen the restorations of structurally compromised teeth and improve their performance compared to plain composite restorations.

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“…Choosing the best material for core build-up in root canaltreated teeth is a hot, yet unsolved topic. In a current systematic review and meta-analysis, Zarow et al concluded that highly filled core composite materials could be a better option compared to classic composite materials [50].…”

mentioning

confidence: 94%

Fatigue performance of endodontically treated premolars restored with direct and indirect cuspal coverage restorations utilizing fiber-reinforced cores

Fráter

Sáry

et al. 2021

Clin Oral Invest

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Objectives The aim of this in vitro study was to investigate the fatigue survival and fracture behavior of endodontically treated (ET) premolars restored with different types of post-core and cuspal coverage restorations. Materials and methods MOD cavities were prepared on 108 extracted maxillary premolars. During the endodontic treatment, all teeth were instrumented with rotary files (ProTaper Universal) to the same apical enlargement (F2) and were obturated with a matched single cone obturation. After the endodontic procedure, the cavities were restored with different post-core and overlay restorations (n = 12/group). Three groups (A1–A3) were restored with either conventional composite core (PFC; control) or flowable short-fiber-reinforced composite (SFRC) core with/without custom-made fiber posts and without overlays. Six groups had similar post-core foundations as described above but with either direct PFC (B1–B3) or indirect CAD/CAM (C1–C3) overlays. Fatigue survival was tested for all restorations using a cyclic loading machine until fracture occurred or 50,000 cycles were completed. Kaplan-Meyer survival analysis was conducted, followed by pairwise post hoc comparisons. Results None of the restored teeth survived all 50,000. Application of flowable SFRC as luting-core material with fiber post and CAD/CAD overlays (Group C3) showed superior performance regarding fatigue survival (p < 0.05) to all the other groups. Flowable SFRC with fiber post and direct overlay (Group B3) showed superior survival compared to all other direct techniques (p < 0.05), except for the same post-core foundation but without cuspal coverage (Group A3). Conclusions Custom-made fiber post and SFRC as post luting core material with or without cuspal coverage performed well in terms of fatigue resistance and survival when used for the restoration of ET premolars. Clinical relevance The fatigue survival of direct and indirect cuspal coverage restorations in ET MOD premolars is highly dependent on whether the core build-up is fiber-reinforced or not. The combination of short and long fibers in the form of individualized post-cores seems to offer a favorable solution in this situation.

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Effect of Composite Core Materials on Fracture Resistance of Endodontically Treated Teeth: A Systematic Review and Meta-Analysis of In Vitro Studies

Cited by 18 publications

References 27 publications

Mechanical Performance of Direct Restorative Techniques Utilizing Long Fibers for “Horizontal Splinting” to Reinforce Deep MOD Cavities—An Updated Literature Review

Mechanical Performance of Direct Restorative Techniques Utilizing Long Fibers for “Horizontal Splinting” to Reinforce Deep MOD Cavities—An Updated Literature Review

Effect of Fiber Reinforcement Type on the Performance of Large Posterior Restorations: A Review of In Vitro Studies

Fatigue performance of endodontically treated premolars restored with direct and indirect cuspal coverage restorations utilizing fiber-reinforced cores

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