Fatigue performance of endodontically treated molars reinforced with different fiber systems

Volom, András; Vincze-Bandi, Eszter; Sáry, Tekla; Alleman, David; Forster, András; Jakab, András; Braunitzer, Gábor; Garoushi, Sufyan; Fráter, Márk

doi:10.1007/s00784-023-04934-2

Cited by 6 publications

(10 citation statements)

References 41 publications

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“…2 ). This approach has been a trend in recent studies, aimed at providing a stronger and more durable solution by maximizing the amount of fibers to rebuild the entire missing structure [ 17 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of fracture behavior in short fiber–reinforced direct and indirect overlay restorations

Garoushi,

Akbaşak-Sungur,

Erkut

et al. 2023

Clin Oral Invest

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Objectives The aim was to assess how incorporating a short-fiber composite (SFC) core would affect the fracture behavior of direct and indirect overlays. Furthermore, to examine the relationship between the thickness ratio of SFC core to particulate-filled composite (PFC) veneering and the fracture-behavior of bilayered-structured restorations. Materials and methods A total of 120 molars were used to create MOD cavities, with palatal cusps removed. Four different groups of direct overlays were then made (n = 15/group), all of which featured a SFC core (everX Flow) with varying thicknesses (0, 1, 4, and 5 mm), as well as a surface layer of PFC (G-aenial Posterior), with the overall thickness of the bilayered-structured restoration set at 5 mm. Additionally, four groups of CAD/CAM restorations were created (Cerasmart 270 and Initial LiSi Block), with or without 2 mm of SFC core reinforcement. Following the fabrication of these restorations, cyclic fatigue aging was carried out for a total of 500,000 cycles, with an applied maximum load (Fmax) of 150 N. Subsequently, each restoration underwent quasi-static loading until fracture. The fracture mode was subsequently evaluated using optical microscopy and SEM. Results There were no statistically significant differences (p > 0.05) observed in the fracture resistance of indirect overlays reinforced with a 2-mm SFC core compared to those made solely from restorative materials. Direct overlays constructed using plain SFC or with a 4-mm layer thickness of SFC core exhibited significantly higher fracture resistance values (2674 ± 465 and 2537 ± 561 N) (p < 0.05) when compared to all other groups tested, according to the statistical analysis ANOVA. Conclusions The most effective method for restoring large MOD cavities was found to be direct restoration using SFC either alone or as a bulk core in combination with PFC composite. Clinical relevance The use of SFC as bulk reinforcing base will significantly improve the loading performance of directly layered restorations.

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Section: Discussionmentioning

confidence: 99%

“…This indicates that the restorations tested in the study were not weakened by low-load/high-cycle (500,000 cycles) fatigue testing. This is why some researchers [ 16 , 28 , 36 ] prefer to use an accelerated fatigue setup rather than a true fatigue test, which was the method used in this study.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of fracture behavior in short fiber–reinforced direct and indirect overlay restorations

Garoushi,

Akbaşak-Sungur,

Erkut

et al. 2023

Clin Oral Invest

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“…A total of 9 articles [ 13 – 17 ]2 [ 18 ] were eliminated after full text reading and the reason for exclusion has been discussed in Table 2 . After full-text reading, 18 papers [ 19 – 35 ] were identified as being eligible for this systematic review (Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

“…All indirect restorations showed a promising performance after in vitro fatigue-loading compared to direct composite and fiber reinforced composite. Volom et al 2023 [ 35 ] Fatigue performance of endodontically treated molars reinforced with diferent fiber systems Mandibular Molars Control (MOD Cavities restored with FRCs) MOD ProTaper upto F3, Irrigation with 5% NaOCl and 10% EDTA AH Plus and Matched Single Cone Round-shaped metallic tip 6 mm in diameter, Cross head speed not mentioned EverX Flow, EverX Flow + G-aenial Injectable, Ribbond + G-aenial Posterior, Ribbond + G-aenial Flow, Fiber Post (FibreKleer, Petron, Orange, CA, USA), Fiber Post (FibreKleer, Petron, Orange, CA, USA) + G-aenial Flow NM Teeth restored with Short Fiber reinforced Composite restorations performed better without Cuspal Coverage compared to the ones where Short Fiber reinforced Composite was covered. For MOD cavities in endodontically treated molars, direct cuspal coverage is recommended when utilizing long continuous fbers for reinforcement.…”

Section: Resultsmentioning

confidence: 99%

Systematic review fracture resistance of endodontically treated posterior teeth restored with fiber reinforced composites- a systematic review

et al. 2023

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Background Large cavity designs and access cavities impair endodontically treated tooth fracture resistance. As the tooth’s strength is known to reduce significantly after the root canal treatment, occlusal loading as a result of functions such as chewing, biting and certain parafunctional tendencies makes the endodontically treated tooth vulnerable to fracture. Hence, after endodontic treatment, it is vital to give adequate and appropriate restorative material to avoid tooth fractures. Accordingly, the choice of such restorative material should be dictated by the property of fracture resistance. Objective The goal of this study was to conduct a systematic review and critical analysis of available data from in vitro studies examining the fracture resistance of endodontically treated posterior teeth restored with fiber-reinforced composites. Methodology The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRIS-MA) Statement was used to guide the reporting of this systematic review A comprehensive literature search was performed using MEDLINE (via PubMed), Scopus, ScienceDirect, Google Scholar, and LILACS. A manual search of the reference lists of the articles was also performed. The databases provided a total of 796 studies from the electronic systematic search. The databases provided a total of 796 studies from the electronic systematic search. Two reviewers scrutinized the papers for eligibility based on inclusion/exclusion criteria and extracted data. The studies were assessed for their potential risk of bias. Based on modified JBI & CRIS (checklist for reporting in vitro studies) guidelines, along with the methodology and treatment objective, we have formulated 13 parameters specifically to assess the risk of bias. A total of 18 studies met the inclusion criteria and were included for qualitative analysis. Considering the high heterogeneity of the studies included, a meta-analysis could not be performed. Results The majority of the included studies had a moderate or high risk of bias. When compared to traditional hybrid composites, fiber-reinforced composites showed increased fracture resistance of endodontically treated teeth in the majority of investigations. On the other hand, limited evidence was found for the bulk fill composites. Moreover, moderate evidence was found for the fracture resistance of inlays and fiber posts with fiber-reinforced composites for core build-up in endodontically treated teeth. No evidence could be found comparing the fracture resistance of endo crowns and fiber-reinforced composites in endodontically treated teeth. Conclusion According to the research, using fiber-reinforced composites instead of conventional hybrid composites improves the fracture resistance of endodontically treated teeth. However, there was a high risk of bias in the research considered. No judgments could be reached about the superiority of one material over another based-on comparisons between other core restorations.

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“…In addition, one author stated that under occlusal load, the cusp that remains after MOD cavity preparation behaves as a cantilever beam: the cavity's floor functions as a fulcrum for cusp bending, and the cantilever's length rises as the cavity's depth [ 5 ]. Consequently, restorative technique and material selection of these MOD cavities require careful consideration [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Fracture behavior of short fiber-reinforced CAD/CAM inlay restorations after cyclic fatigue aging

et al. 2023

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The aim of this study was to assess the fracture behavior of molar teeth restored with MOD inlays made of experimental short fiber-reinforced CAD/CAM composite block (SFRC CAD) before and after cyclic fatigue aging. Standardized MOD cavities were prepared on 60 intact mandibular molars. Three groups of CAD/CAM made inlay restorations (Cerasmart 270, Enamic, and SFRC CAD) were fabricated (n = 20/group). All restorations were luted with self-adhesive dual-cure resin cement (G-Cem One). Half of restored teeth per each group (n = 10) were quasi-statically loaded until fracture without aging. The other half underwent cyclic fatigue aging for 500,000 cycles (Fmax = 150 N) before being loaded quasi-statically until fracture. Then, the fracture type was visually inspected. The microstructure and elemental content of CAD/CAM materials were assessed using SEM and EDS. Two-way analysis of variance (ANOVA) was used to statistically examine the data, and it was followed by the Tukey HSD test (α = 0.05). ANOVA demonstrated that both material type and aging had a significant effect (p < 0.05) on the load-bearing capacity values of the restorations. Teeth restored with SFRC CAD showed significantly the highest (p < 0.05) load-bearing capacity (2535 ± 830 N) after fatigue aging among all groups. SEM images showed the ability of short fibers in SFRC CAD composite to redirect and hinder crack propagation. With regard to fracture mode, Enamic group revealed 85% of catastrophic failure (vs. 45% and 10% for Cerasmart 270 and SFRC CAD, respectively). Large MOD cavities on molar teeth were most favorably restored with SFRC CAD inlays, yielding the highest load-bearing capacity and more restorable failures.

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Fatigue performance of endodontically treated molars reinforced with different fiber systems

Cited by 6 publications

References 41 publications

Evaluation of fracture behavior in short fiber–reinforced direct and indirect overlay restorations

Evaluation of fracture behavior in short fiber–reinforced direct and indirect overlay restorations

Systematic review fracture resistance of endodontically treated posterior teeth restored with fiber reinforced composites- a systematic review

Fracture behavior of short fiber-reinforced CAD/CAM inlay restorations after cyclic fatigue aging

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