In Vitro Comparison of Fracture Resistance of Severely Damaged Primary Anterior Teeth Restored with Different Post and Core Systems

Abstract

Objectives. This study aimed to compare the fracture resistance (FR) of severely damaged primary anterior teeth restored with five different post and core systems. Materials and Methods. This in vitro, experimental study evaluated 60 extracted primary maxillary central incisors. The teeth were horizontally sectioned at 1 mm above their cementoenamel junction (CEJ), underwent pulpectomy, and their root canals were filled with Metapex paste. After post space preparation and sealing of root fillings with light-cure glass ionomer (1 mm thickness), the teeth were randomly assigned to five groups (n = 12) of (1) glass fiber post and everX composite (reinforced with short fibers), (2) glass fiber post and bulk-fill composite, (3) everX composite post and core, (4) bulk-fill composite post and core, and (5) Filtek conventional composite post and core. The teeth underwent 5,000 thermal cycles between 5°C and 55°C, and their FR was measured in a universal testing machine (0.5 mm/min, 148°). The mode of failure was also determined. Data were analyzed by ANOVA and Tukey’s test at 0.05 level of significance. Results. The FR was the highest in fiber post and everX composite, and the lowest in Z250 conventional composite post and core group ( P < 0.001 ). The FR of fiber post and everX composite group was significantly higher than that of everX composite post and core ( P = 0.04 ), bulk-fill composite post and core ( P = 0.001 ), and Z250 composite post and core ( P < 0.001 ) groups. The frequency of repairable fractures was the highest in glass fiber post plus everX composite (91.66%) and the lowest in Filtek conventional post and core group (66.66%) ( P > 0.05 ). Conclusion. Within the limitations of this in vitro study, the results showed that restoration of severely damaged primary maxillary central incisors with glass fiber post and everX composite reinforced with short fibers enhanced their FR, and increased the chance of reparability in case of restoration fracture. This technique may be recommended for the restoration of primary anterior teeth since it is simple and saves time.

Effects of glass fibers reinforced and non-reinforced composite resin on fracture behavior of severely destructed primary incisors and restored with post and core system

“…In line with this study, Alamdari et al (2023) revealed that Fiber post and EverX Flow core increased fracture resistance of restored incisors more than Bulk fill composite post and core, EverX Flow post and core, Fiber post and Bulk fill composite core, and Conventional composite post and core. Also, Uctasli et al (2021) assessed fracture resistance of restored anterior permanent teeth with different post and core systems using either Grandio Core or EverX Flow as post-luting materials.…”

“…The rationale behind placement of PFC final restoration instead of crown was that crown could mask fracture resistance of post and core foundation ( Uctasli et al, 2021 ). The loading force was applied to mid-palatal surface at oblique angle (148°) to long axis of restored incisors to simulate normal incisal force ( Alamdari et al, 2023 ). In addition, applying force at this angle represents worst-case scenario of fracture resistance as it places heavy stress on coronal portion of incisor as well as post-root canal interface ( Fráter et al, 2021b ).…”

“…The present study was conducted after approval of Dental Research Ethics Committee of the Faculty of Dentistry, Mansoura University with Code number (M109023PP). Sample size of the present study was calculated based on the previously published studies of Alamdari et al who compared fracture resistance of incisors restored with different post and core materials ( Alamdari et al, 2023 ). The analysis was performed using G*Power program version 3.1.9.7. at 80 % power with 0.05 significance and showed that fracture resistance of each group could be evaluated using 12 primary incisors.…”

“…Severe destruction of maxillary primary incisors is a common sequala of early childhood caries and in available literature, no standardized restorative technique has been documented for these teeth ( Alamdari et al, 2023 , Baghalian et al, 2014 , Memarpour et al, 2013 , Mehra et al, 2016 ). Different types of post have been proposed as intracanal retention when restoring severely destructed primary incisors ( Mittal et al, 2015 , Vafaei et al, 2016 ).…”

Evaluation of Different Post and Core Systems for Restoring Pulpectomized Primary Incisors: An In-Vitro Study

“…These factors make Metapex a material that is widely used for primary tooth root fillings. 21,22,23,24 Several authors used post's drill to prepare the post space. 14,18,21 In our study, the space for the post was created using a post's drill of 1.5 mm diameter, in which a stopper was attached to the drill to ensure that 3 mm of the canal was prepared to receive the post.…”