Effects of composite restorations on resistance to cuspal fracture in posterior teeth

Joynt, Robert B.; Wieczkowski, G; Klockowski, Richard; Davis, Elaine L.

doi:10.1016/0022-3913(87)90008-4

Cited by 72 publications

(63 citation statements)

References 8 publications

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“…Therefore, a restoration technique that can reinforce the weakened remaining tooth structure is fundamental to reducing the possibility of fractures. Moreover, in the selected teeth, standardized MOD cavities were prepared because this clinical condition strongly reduces resistance to cuspal fractures [2,[26][27][28][29] due to the absence of mesial and distal walls, which cause a high strain on vestibular and lingual cusps [18]. Soares et al confirmed that MOD preparation and endodontic treatment accentuated the concentration of stress inside the dental structure, mainly due to the greater removal of the dental structure [30].…”

Section: Discussionmentioning

confidence: 99%

Effects of fiber-glass-reinforced composite restorations on fracture resistance and failure mode of endodontically treated molars

Scotti

Forniglia

Tempesta

et al. 2016

Journal of Dentistry

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A B S T R A C TObjectives: The study evaluated the fracture resistance and fracture patterns of endodontically treated mandibular first molars restored with glass-fiber-reinforced direct composite restorations. Methods: In total, 60 extracted intact first molars were treated endodontically; a mesio-occluso-distal (MOD) cavity was prepared and specimens were then divided into six groups: sound teeth (G1), no restoration (G2), direct composite restoration (G3), fiber-post-supported direct composite restoration (G4), direct composite reinforced with horizontal mesio-distal glass-fibers (G5), and buccal-palatal glassfibers (G6). Specimens were subjected to 5000 thermocycles and 20,000 cycles of 45 oblique loading force at 1.3 Hz and 50 N; they were then loaded until fracture. The maximum fracture loads were recorded in Newtons (N) and data were analyzed with one-way ANOVA and post-hoc Tukey tests (p < 0.05). Fractured specimens were analyzed with a scanning electron microscope (SEM). Results: The mean static loads (in Newtons) were: G1, 831.83; G2, 282.86; G3, 364.18; G4, 502.93; G5, 499.26; and G6, 582.22. Fracture resistance did not differ among G4, G5, and G6, but was significantly higher than G3 (p = 0.001). All specimens fractured in a catastrophic way. In G6, glass fibers inducted a partial deflection of the fracture, although they were not able to stop crack propagation. Conclusions: For the direct restoration of endodontically treated molars, reinforcement of composite resins with glass-fibers or fiber posts can enhance fracture resistance. The SEM analysis showed a low ability of horizontal glass-fibers to deviate the fracture, but this effect was not sufficient to lead to more favorable fracture patterns above the cement-enamel junction (CEJ). Clinical significance: The fracture resistance of endodontically treated molars restored with direct composite restorations seems to be increased by reinforcement with fibers, even if it is insufficient to restore sound molar fracture resistance and cannot avoid vertical fractures.

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Section: Discussionmentioning

confidence: 99%

Effects of fiber-glass-reinforced composite restorations on fracture resistance and failure mode of endodontically treated molars

Scotti

Forniglia

Tempesta

et al. 2016

Journal of Dentistry

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“…7,19,[27][28][29] When comparing the deflection values of sound teeth with those of restored teeth, the restored teeth exhibited a capacity of cuspal reinforcement with lowered resistance to breaking. The adhesive approaches of indirect and direct restorations promote the bond between hard dental tissues and restorative materials, 19,30 cuspal reinforcement and reducing deflection.…”

Section: Discussionmentioning

confidence: 99%

Effects of Toothbrushing with Fluoride Abrasive and Whitening Dentifrices on Both Unbleached and Bleached Human Enamel Surface in Terms of Roughness and Hardness: An in vitro Study

Zamboni

Nogueira

Bottino

et al. 2012

The Journal of Contemporary Dental Practice

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Aim: This study assessed the effect of fatigue load cycling on human premolars restored with MOD restorations (direct and indirect approaches) on cuspal deflection, compared to intact teeth (unprepared) and unrestored teeth with an inlay preparation. Materials and methods:MOD inlay preparations were performed on sixty premolars with their roots embedded in acrylic resin. These teeth were divided into six groups (n = 10): (1) intact teeth; (2) unrestored and prepared teeth; (3) teeth restored with direct composite resin; (4) teeth restored with an indirect composite resin; (5) teeth restored with injected ceramic inlays (IPS Empress 2 (Ivoclar); (6) teeth restored with CAD/CAM inlays made of feldspathic ceramic (Vita Mark II). All of the indirect restorations were adhesively cemented. Strain-gauges were bonded to the buccal and lingual surfaces of the specimens. Compressive axial loading of 100N was applied on the occlusal face of the specimens to measure the cuspal deflection (microstrain) under compressive loading. These measurements were obtained before and after mechanical cycling (1 Hz, 37°C, 100,000x). Results:Comparing the results obtained before and after fatiguing, the cuspal deflection increased only in the CAD/CAM approach. The prepared tooth group had the highest cuspal deflection, before and after mechanical cycling. Conclusion:The evaluated restoring approaches decrease the cuspal deflection, consequently appear to improve the cuspal reinforcement.

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“…Resin bonded composite (RBC) restorations showed a strengthening effect on the tooth structure, with fracture resistance similar to that of unaltered teeth. [3][4][5] For many years, direct adhesive restorations have been used for anterior teeth with conservative endodontic access and intact marginal ridges. 1,[6][7] Posterior non-vital teeth with an intracoronal conservative access only have also been restored with direct RBC.…”

Section: Introductionmentioning

confidence: 99%

Direct Fiber-reinforced Composite Restoration in an Endodontically-treated Molar: A Three-year Case Report

Deliperi¹

2008

Operative Dentistry

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SUMMARYThe reconstruction of structurally compromised non-vital posterior teeth may represent one of the most challenging adhesive-based restorative procedures. Several factors may influence the longevity of direct fiber-reinforced resin composite restorations: endodontic procedures prior to post cementation, dentin and/or post surface treatments, selection of the appropriate post design and architecture, resin composite polymerization and layering techniques. Thus, different specialties, such as endodontics and restorative dentistry, should work as a team to improve the longevity of restorations. This article presents three-year clinical results following reconstruction of a severely damaged endodonticallytreated molar using direct fiber reinforced resin composite systems. INTRODUCTIONEndodontically-treated teeth are weakened because of a decrease in water content and loss of dentin.1 The decay process and/or tooth fracture may be responsible for the structural weakening of non-vital teeth; the tooth preparation required for adequate endodontic treatment may also contribute to the increased fragility. 2After endodontic therapy, selecting the appropriate reconstruction for each non-vital tooth should be based on the remaining hard tooth structure, the number and thickness of the residual cavity walls, the position of the tooth in the arch and the load implied. Resin bonded composite (RBC) restorations showed a strengthening effect on the tooth structure, with fracture resistance similar to that of unaltered teeth.3-5 For many years, direct adhesive restorations have been used for anterior teeth with conservative endodontic access and intact marginal ridges.1,6-7 Posterior non-vital teeth with an intracoronal conservative access only have also been restored with direct RBC. 4 Conversely, for many years, full coverage restorations have been indicated when the teeth are weakened by additional cavities on both the anterior and posterior area. [8][9] With the use of improved adhesive systems in the last decade, clinicians started Clinical RelevanceThe proper utilization of fiber-reinforced resin composite restorations in endodontically-treated molars may preclude the use of more extensive restorative treatment, possibly delaying the need for expensive indirect restorations.

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Effects of composite restorations on resistance to cuspal fracture in posterior teeth

Cited by 72 publications

References 8 publications

Effects of fiber-glass-reinforced composite restorations on fracture resistance and failure mode of endodontically treated molars

Effects of fiber-glass-reinforced composite restorations on fracture resistance and failure mode of endodontically treated molars

Effects of Toothbrushing with Fluoride Abrasive and Whitening Dentifrices on Both Unbleached and Bleached Human Enamel Surface in Terms of Roughness and Hardness: An in vitro Study

Direct Fiber-reinforced Composite Restoration in an Endodontically-treated Molar: A Three-year Case Report

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