Fracture resistance of bleached teeth restored with different procedures

This study evaluated the fracture resistance of teeth submitted to internal bleaching and restored with different non-metallic post. Eighty mandibular incisors were endodontically treated and randomly divided in 10 groups (n = 8): G1- restored with composite resin (CR), G2- CR + fiber-reinforced composite post (FRC, Everstick post, Sticktech) cemented with resin cement self-etch adhesive (RCS, Panavia F 2.0, Kuraray), G3- CR + FRC + self-adhesive resin cement (SRC, Breeze, Pentral Clinical), G4- CR+ glass fiber post (GF, Exacto Post, Angelus) + RCS, G5- CR + GF + SRC. The G6 to G10 were bleached with hydrogen peroxide (HP) and restored with the same restorative procedures used for G1 to G5, respectively. After 7 days storage in artificial saliva, the specimens were submitted to the compressive strength test (N) at 0.5 mm/min cross-head speed and the failure pattern was identified as either reparable (failure showed until 2 mm below the cement-enamel junction) or irreparable (the failure showed <2 mm or more below the cement-enamel). Data were analyzed by ANOVA and Tukey test (α = 0.05). No significant difference (p < 0.05) was found among G1 to G10. The results suggest that intracoronal bleaching did not significantly weaken the teeth and the failure patterns were predominately reparable for all groups. The non-metallic posts in these teeth did not improve fracture resistance.

Customized fiber glass posts. Fatigue and fracture resistance

Purpose: To evaluate the root fracture strength of human single-rooted premolars restored with customized fiberglass post-core systems after fatigue simulation. Methods: 40 human premolars had their crowns cut and the root length was standardized to 13 mm. The teeth were endodontically treated and embedded in acrylic resin. The specimens were distributed into four groups (n=10) according to the restorative material used: prefabricated fiber post (PFP), PFP+accessory fiber posts (PFPa), PFP+unidirectional fiberglass (PFPf), and unidirectional fiberglass customized post (CP). All posts were luted using resin cement and the cores were built up with a resin composite. The samples were stored for 24 hours at 37 degrees C and 100% relative humidity and then submitted to mechanical cycling. The specimens were then compressive-loaded in a universal testing machine at a crosshead speed of 0.5 mm/minute until fracture. The failure patterns were analyzed and classified. Data was submitted to one-way ANOVA and Tukey's test (alpha= 0.05). Results: The mean values of maximum load (N) were: PFP - 811.4 +/- 124.3; PFPa - 729.2 +/- 157.2; PFPf - 747.5 +/- 204.7; CP - 762.4 +/- 110. Statistical differences were not observed among the groups. All groups showed favorable restorable failures. Fiberglass customized post did not show improved fracture resistance or differences in failure patterns when compared to prefabricated glass fiber posts. (Am J Dent 2012;25:35-38).

Fracture resistance of endodontically treated teeth with different heights of crown ferrule restored with prefabricated carbon fiber post and composite resin core by intermittent loading

This study evaluated the fracture resistance of endodontically treated teeth restored with prefabricated carbon fiber posts and varying quantities of coronal dentin. Sixty freshly extracted upper canines were randomly divided into groups of 10 teeth each. The specimens were exposed to 250,000 cycles in a controlled chewing simulator. All intact specimens were subjected to a static load (N) in a universal testing machine at 45 degrees to the long axis. Data were analyzed by 1-way analysis of variance and Tukey test (alpha = .05). Significant differences (P < .001) were found among the mean fracture forces of the test groups (positive control, 0 mm, 1 mm, 2 mm, 3 mm, and negative control groups: 1022.82 N, 1008.22 N, 1292.52 N, 1289.19 N, 1255.38 N, and 1582.11, respectively). These results suggested that the amount of coronal dentin did not significantly increase the fracture resistance of endodontically treated teeth restored with prefabricated carbon fiber post and composite resin core. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:e52-e57)

Finite element analysis and fracture resistance testing of a new intraradicular post

Objectives: The objective of the present study was to evaluate a prefabricated intraradicular threaded pure titanium post, designed and developed at the Sao Jose dos Campos School of Dentistry - UNESP, Brazil. This new post was designed to minimize stresses observed with prefabricated post systems and to improve cost-benefits. Materials and and methods: Fracture resistance testing of the post/core/root complex, fracture analysis by microscopy and stress analysis by the finite element method were used for post evaluation. The following four prefabricated metal post systems were analyzed: group 1, experimental post; group 2, modification of the experimental post; group 3, Flexi Post, and group 4, Para Post. For the analysis of fracture resistance, 40 bovine teeth were randomly assigned to the four groups (n=10) and used for the fabrication of test specimens simulating the situation in the mouth. The test specimens were subjected to compressive strength testing until fracture in an EMIC universal testing machine. After fracture of the test specimens, their roots were sectioned and analyzed by microscopy. For the finite element method, specimens of the fracture resistance test were simulated by computer modeling to determine the stress distribution pattern in the post systems studied. Results: The fracture test presented the following averages and standard deviation: G1 (45.63 +/- 8.77), G2 (49.98 +/- 7.08), G3 (43.84 +/- 5.52), G4 (47.61 +/- 7.23). Stress was homogenously distributed along the body of the intraradicular post in group 1, whereas high stress concentrations in certain regions were observed in the other groups. These stress concentrations in the body of the post induced the same stress concentration in root dentin. Conclusions: The experimental post (original and modified versions) presented similar fracture resistance and better results in the stress analysis when compared with the commercial post systems tested (08/2008PA/CEP).

Effect of resin luting film thickness on fracture resistance of a ceramic cemented to dentin

Purpose: The aim of this study was to evaluate the fracture resistance of ceramic plates cemented to dentin as a function of the resin cement film thickness. Materials and Methods: Ceramic plates (1 and 2 mm thicknesses) were cemented to bovine dentin using resin composite cement. The film thicknesses used were approximately 100, 200, and 300 μm. Noncemented ceramic plates were used as control. Fracture loads (N) were obtained by compressing a steel indenter in the center of the ceramic plates. ANOVA and Tukey tests (α = 0.05) were used for each ceramic thickness to compare fracture loads among resin cement films used. Results: Mean fracture load (N) for 1-mm ceramic plates were: control - 26 (7); 100 μm - 743 (150); 200 μm - 865 (105); 300 μm - 982 (226). Test groups were significantly different from the control group; there was a statistical difference in fracture load between groups with 100 and 300 μm film thicknesses (p < 0.01). Mean fracture load for 2-mm ceramic plates were: control - 214 (111); 100 μm - 1096 (341); 200 μm - 1067 (226); 300 μm - 1351 (269). Tested groups were also significantly different from the control group (p < 0.01). No statistical difference was shown among different film thicknesses. Conclusions: Unluted specimens presented significantly lower fracture resistance than luted specimens. Higher cement film thickness resulted in increased fracture resistance for the 1-mm ceramic plates. Film thickness did not influence the fracture resistance of 2-mm porcelain plates. Copyright © 2007 by The American College of Prosthodontists.

Fracture resistance of composite resin cores with or without prefabricated posts over different substrates

The fracture resistance of endodontically treated teeth has been an obstacle to the durability of the remaining teeth and restorations. The aim of this study was to evaluate the fracture resistance of endodontically treated bovine and human teeth that were restored with either prefabricated metal posts, glass fiber posts, or composite resin cores. Statistical analysis revealed significant difference between different substrates, but there was no statistically significant difference between different types of intraradicular posts or in the interaction between substrate and post types. The intraradicular posts do not increase the fracture resistance of endodontically treated teeth. The metal posts presented more unfavorable fracture modes when compared to glass fiber posts and composite resin cores.

Fracture resistance of bovine incisors restored with different glass fiber posts: Effect of the diameter of fiber post

Aim: Compare the effect of three post designs on the fracture resistance and failure modes of composite core-fiber post-crownless tooth sets. Materials and Methods: Ninety bovine incisors were selected and divided into nine groups of 10 specimens. The teeth were assigned to three groups based on the post design: Cylindrical, tapered, and double-tapered. Each group was subdivided into three subgroups in accordance with the diameter of the post: Small (No.1), medium (No.2), and large (No.3). The Panavia F system was used for post cementation. The specimens were mounted in acrylic resin blocks with a layer of silicone rubber covering the roots. A universal testing machine compressively loaded the specimens from the palatal side at a crosshead speed of 1 mm/min and at an angle of 135I to the long axis of the teeth, until failure occurred. The failure mode was determined by a stereomicroscope inspection of all the specimens. Data were analyzed by one-way ANOVA and the Tukey test (P < 0.05). Results: The fracture resistance was affected by the type of post (P < 0.0001). A narrower diameter for all of the post systems allowed for higher resistance. The main failure mode in the large cylindrical group was catastrophic fractures, while the main failures in the other eight groups were favorable. Conclusion: Narrower diameter posts showed higher fracture resistance. The dominant failure pattern was repairable fracture, except for those with large cylindrical groups.

Influence of convergence angle of tooth preparation on the fracture resistance of Y-TZP-based all-ceramic restorations

Objective: To investigate the influence of the convergence angle of tooth preparation on the fracture load of Y-TZP-based ceramic (YZ-Vita YZ) substructure (SB) veneered with a feldspathic porcelain (VM9-Vita VM9). Methods: Finite element stress analysis (FEA) was performed to examine the stress distribution of the system. Eighty YZ SB were fabricated using a CAD-CAM system and divided into four groups (n = 20), according to the total occlusal convergence (TOC) angle: G6-6° TOC; G12-12° TOC; G20-20° TOC; and G20MOD-20° TOC with modified SB. All SB were veneered with VM9, cemented in a fiber reinforced epoxy resin die, and loaded to failure. Half of the specimens from each group (n = 10) were cyclic fatigued (106 cycles) before testing. Failure analysis was performed to determine the fracture origin. Data were statistically analyzed using Anova and Tukey's tests (α = 0.05). Results: The greatest mean load to fracture value was found for the G20MOD, which was predicted by the FEA. Cyclic fatigue did not significantly affect the load of fracture. Catastrophic failure originating from the internal occlusal surface of the SB was the predominant failure mode, except for G20MOD. Significance: The YZ-VM9 restorations resisted greater compression load than the usual physiological occlusal load, regardless of the TOC angle of preparations. Yet, the G20MOD design produced the best performance among the experimental conditions evaluated. © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

The fracture resistance of a CAD/CAM Resin Nano Ceramic (RNC) and a CAD ceramic at different thicknesses

Objective. This study aimed to investigate the influence of restoration thickness to the fracture resistance of adhesively bonded Lava (TM) Ultimate CAD/CAM, a Resin Nano Ceramic(RNC), and IPS e. max CAD ceramic.Methods. Polished Lava (TM) Ultimate CAD/CAM (Group L), sandblasted Lava (TM) Ultimate CAD/CAM (Group LS), and sandblasted IPS e.max CAD (Group ES) discs (n=8, phi=10 mm) with a thickness of respectively 0.5 mm, 1.0 mm, 1.5 mm, 2.0 mm, and 3.0 mm were cemented to corresponding epoxy supporting discs, achieving a final thickness of 3.5 mm. All the 120 specimens were loaded with a universal testing machine at a crosshead speed of 1 mm/min. The load (N) at failure was recorded as fracture resistance. The stress distribution for 0.5 mm restorative discs of each group was analyzed by Finite Element Analysis (FEA). The results of facture resistances were analyzed by one-way ANOVA and regression.Results. For the same thickness of testing discs, the fracture resistance of Group L was always significantly lower than the other two groups. The 0.5 mm discs in Group L resulted in the lowest value of 1028 (112) N. There was no significant difference between Group LS and Group ES when the restoration thickness ranged between 1.0 mm and 2.0 mm. There was a linear relation between fracture resistance and restoration thickness in Group L (R = 0.621, P < 0.001) and in Group ES (R = 0.854, P < 0.001). FEA showed a compressive permanent damage in all groups.Significance. The materials tested in this in vitro study with the thickness above 0.5 mm could afford the normal bite force. When Lava Ultimate CAD/CAM is used, sandblasting is suggested to get a better bonding. (C) 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Effect of two formulations of 10% sodium ascorbate on fracture resistance of endodontically treated tooth submitted to dental bleaching with hydrogen peroxide associated titanium dioxide nanoparticles

Purpose: This study evaluated the effect of 10% sodium ascorbate (10SA), in gel (10SAg) or aqueous solution (10SAs) formulations, on fracture resistance of endodontically treated tooth submitted to dental bleaching procedures with 15% hydrogen peroxide associated with titanium dioxide (15HP-TiO2) nanoparticles and photoactivated by LED-laser. Material and methods: Forty maxillary premolars were endodontically-treated and embedded in acrylic resin up to the cement-enamel junction. The specimens were divided into four groups (n=10): G1 (negative control): no bleaching, coronal access restored with composite resin; G2 (positive control): three dental bleaching sessions using 15HP-TiO2 and LED-laser photoactivation and restored with composite resin (positive control); G3 (10SAg): similar procedures to G2, but applied 10SA, in gel formulation, for 24 hours before restoration; G4 (10SAs): similar procedures to G3, but applied 10SA, in aqueous solution formulation. The 15HP-TiO2 was applied on buccal and lingual surfaces of the crown tooth and inside the pulp chamber and photoactivated by LED-laser. Between each bleaching session, the teeth were maintained in artificial saliva, at 37oC, for 7 days. In sequence, the teeth were submitted to fracture resistance testing using an eletromechanical machine test. The data was analyzed using Kruskal Wallis test (p = 0.05) Results: There are no differences significant among the groups in relation to fracture resistance of endodontically treated teeth (p>0.05). Conclusions: The use of 10% sodium ascorbate, in gel or aqueous solution formulations, did not interfered on the fracture resistance teeth after dental bleaching using 15HP-TiO2 and LED-laser photoactivation.

Fracture resistance of teeth submitted to several internal bleaching protocols

Aim: The aim of this study was to evaluate the fracture resistance of teeth submitted to several internal bleaching protocols using 35% hydrogen peroxide (35HP), 37% carbamide peroxide (37CP), 15% hydrogen peroxide with titanium dioxide nanoparticles (15HPTiO2) photoactivated by LED-laser or sodium perborate (SP). Materials and methods: After endodontic treatment, fifty bovine extracted teeth were divided into five groups (n = 10): G1-unbleached; G2-35HP; G3-37CP; G4-15HPTiO2 photoactivated by LED-laser and G5-SP. In the G2 and G4, the bleaching protocol was applied in 4 sessions, with 7 days intervals between each session. In the G3 and G5, the materials were kept in the pulp teeth for 21 days, but replaced every 7 days. After 21 days, the teeth were subjected to compressive load at a cross head speed of 0.5 mm/min, applied at 135° to the long axis of the root using an eletromechanical testing machine, until teeth fracture. The data were submitted to ANOVA and Tukey tests (α = 5%). Results: The 35HP, 37CP, 15HPTiO2 and SP showed similar fracture resistance teeth reduction (p > 0.05). All bleaching treatments reduced the fracture resistance compared to unbleached teeth (p < 0.05). Conclusion: All bleaching protocols reduced the fracture resistance of endodontically-treated teeth, but there were no differences between each other. Clinical significance: There are several internal bleaching protocols using hydrogen peroxide in different concentrations and activation methods. This study evaluated its effects on fracture resistance in endodontically-treated teeth.

Fracture resistance of endodontically-treated teeth submitted to bleaching treatment with hydrogen peroxide and titanium dioxide nanoparticles photoactivated by LED-laser

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Fracture resistance of simulated immature teeth after different intra-radicular treatments

The aim of this study was to evaluate the fracture resistance of simulated immature teeth after different intra-radicular treatments. Crowns and roots of bovine incisors were cut transversally and removed to simulate immature teeth. Root canal preparation and flaring were performed using a bur in crown-apex and apex-crown direction. The samples were distributed into 5 groups (n=10): Positive control (PoC) - no root canal flaring or filling; Negative control (NeC) - teeth were sectioned and their root canals were flared; Direct anatomical glass fiber post (RaP) - #2 Reforpost main glass fiber post relined with composite resin; Double tapered conical glass fiber posts (ExP) - #3 Exacto glass fiber post; and #2 Reforpost main glass fiber + Reforpin accessory glass fiber posts (RrP). In RaP, ExP and RrP, 4.0-mm apical plugs were done with MTA Angelus. The specimens were embedded in polystyrene resin inside cylinders and the periodontal ligament was simulated with a polyether-based impression material. The specimens were submitted to compressive fracture strength test (0.5 mm/min at 135° relative to the long axis of the tooth) in a servo-hydraulic mechanical testing machine MTS 810. Data were subjected to one-way ANOVA and Dunnett's C or Tukey's tests (α=0.05). The control groups (PoC and NeC) showed lower fracture strength than the experimental groups. NeC presented the lowest resistance and ExP presented the highest resistance among the experimental groups. The flaring procedures produced a detrimental effect on the fracture resistance of the bovine teeth. Glass fiber intra-radicular posts increased significantly the fracture resistance of simulated immature teeth.

Fatigue surviving, fracture resistance, shear stress and finite element analysis of glass fiber posts with different diameters

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Fracture resistance of weakened bovine teeth after long-term use of calcium hydroxide

In some parts of the world, revascularization may not be the most feasible treatment option for necrotic immature teeth. Therefore, apexification remains the most widely utilized treatment option for these cases. This study aimed to evaluate the fracture resistance of weakened bovine tooth roots treated with various irrigant solutions as well as long-term application of calcium hydroxide intracanal medication (ICM). One hundred seventy bovine teeth were randomly divided into three experimental groups (n = 50) and two control groups (n = 10). Group SS was irrigated with physiologic solution; group CHX was treated with 2% chlorhexidine gel and group NaOCl was irrigated with 1% sodium hypochlorite. After instrumentation, root canals were dressed with calcium hydroxide and evaluated at different periods (15, 60, 90, 180, and 360 days). The specimens were loaded at a 45° angle to measure fracture resistance through the use of an EMIC test machine. A decrease in fracture resistance was observed during the time of ICM dressing. The highest values of fracture resistance were observed in group SS with 15 days of ICM, not differing from the control group. Irrigation with NaOCl associated with ICM for 15 days presented the lowest fracture resistance; however, a statistically significant difference was not observed when compared with SS and CHX in the same time period. In longer periods of exposure to ICM (180 and 360 days), root canals irrigated with NaOCl and CHX showed significantly lower fracture resistance than SS (P < 0.05). Apexification with periodic changes of calcium hydroxide medicament leads to weakness of the teeth independent of the irrigation solution used.