Luis Roberto Marcondes Martins

Influence of root embedment material and periodontal ligament simulation on fracture resistance tests

The aim of this study was to evaluate the influence of the embedment material and periodontal ligament simulation on fracture resistance of bovine teeth. Eighty bovine incisor teeth were randomized into 8 groups (n = 10), embedded in acrylic or polystyrene resin using 4 types of periodontal ligament simulation: 1--absence of the ligament; 2--polyether impression material; 3--polysulfide impression material; 4--polyurethane elastomeric material. The specimens were stored at 370C and 100% humidity for 24 hours. Specimens were submitted to tangential load on the palatal surface at 0.5 mm/minute crosshead speed until fracture. The fracture modes were analyzed as follows: 1--coronal fracture; 2--cemento-enamel junction fracture; 3--partial root fracture; 4--total root fracture. Statistical analyses by two-way ANOVA and Tukeys test were applied (p < 0.05). The results showed that root embedment method and periodontal ligament simulation have a significant effect on fracture resistance. Artificial periodontal ligament modified the fracture modes.

Influence of restorative technique on the biomechanical behavior of endodontically treated maxillary premolars. Part I: Fracture resistance and fracture mode

STATEMENT OF PROBLEM Unresolved controversy exists concerning the preferred cavity design and restorative technique used to restore endodontically treated maxillary premolars to improve their resistance to fracture under occlusal load. PURPOSE The purpose of this study was to evaluate the fracture resistance, stress distribution, and cusp deformation of endodontically treated human maxillary premolars restored with different materials. The study is divided into 2 parts. In Part I, fracture resistance and fracture mode were determined. MATERIAL AND METHODS Seventy noncarious human maxillary premolars were selected and divided into 7 groups (n=10). The control group, ST, consisted of sound unprepared teeth. Teeth in the other 6 groups were endodontically treated and each received 1 of 2 cavity preparation designs: MODd, direct mesio-occlusal-distal preparation; MODi, indirect mesio-occlusal-distal preparation. Teeth were restored with 4 types of material: AM, MODd restored with amalgam; CR, MODd restored with composite resin; LPR, MODi restored with laboratory-processed composite resin; and LGC, MODi restored with leucite-reinforced glass ceramic. The fracture resistance (N) was assessed under compressive load in a universal testing machine. The data were analyzed by 1-way ANOVA and the Tukey HSD test (alpha =.05). Fracture modes were recorded based on the degree of tooth structure involvement and restoration damage. RESULTS Statistical analysis showed that the ST group presented the highest fracture resistance values. The restored groups showed significantly higher fracture resistance values compared to the nonrestored groups. The groups restored with adhesive techniques (LPR, CR, and LGC) presented significantly higher fracture resistance values than the group restored with the nonadhesive technique (AM) (P<.001). The catastrophic fractures were prevalent in MODd, MODi, AM, and LPR groups, and less severe fractures were found in ST and LGC groups. For the CR group, there was no prevalent fracture mode. CONCLUSIONS Teeth with the greatest amount of remaining tooth structure and those restored using adhesive technology showed higher fracture resistance values. There was great variation in the type of fracture among groups.

Influence of restorative technique on the biomechanical behavior of endodontically treated maxillary premolars.: Part II: Strain measurement and stress distribution

STATEMENT OF PROBLEM Unresolved controversy exists concerning the preferred cavity design and restorative technique used to restore endodontically treated maxillary premolars to minimize strain and improve stress distribution under occlusal load. PURPOSE The purpose of this study was to analyze the influence of cavity design and restorative material on strain measurement and stress distribution in maxillary premolars under occlusal loading conditions, and correlate these influences with the failure modes analyzed in Part I. MATERIAL AND METHODS For the strain gauge test, 21 additional specimens were prepared as described in Part 1 of this study (n=3). Two strain gauges were fixed on the buccal (B) and palatal (P) cusps of each specimen with cyanoacrylate adhesive. The specimens were submitted to continuous axial compression loading at a speed of 0.5 mm/min, using a 6-mm sphere, to a maximum limit of 150 N in a universal testing machine. Total strain values were obtained by combining the B and P cusp strain values. These values were submitted to 2-way ANOVA and the Dunnet test (alpha=.05). For finite element analyses, 7 numerical 2-D models were generated: MODd, direct mesio-occlusal-distal preparation; MODi, indirect mesio-occlusal-distal preparation; AM, MODd restored with amalgam; CR, MODd restored with composite resin; LPR, MODi restored with laboratory-processed composite resin; and LGC, MODi restored with leucite-reinforced glass ceramic; each corresponding to 1 of the experimental groups tested in Part I of this study. The models were analyzed with finite element software, using the von Mises criteria for stress distribution analysis. RESULTS With the strain gauge test, MODd, MODi, and AM groups showed significantly higher strain values than the CR, LPR, and LGC. Finite element analyses revealed that tooth structure removal and the type of restorative material altered the stress distribution pattern. The MODd, MODi, AM, and LPR models showed higher stress concentration within the tooth structure. CONCLUSIONS The specimens with adhesive restorations were shown to behave in a manner similar to the biomechanical behavior of healthy teeth, while the behavior of those restored with amalgam restorations was more like that observed for teeth with nonrestored cavity preparations. These results directly correlate with the fracture mode results obtained in Part I of this study.

Effect of cement type, relining procedure, and length of cementation on pull-out bond strength of fiber posts.

INTRODUCTION As opposed to the cementation metal posts, the cementation of fiber posts has several details that can significantly influence the success of post retention. This study evaluated the effect of the relining procedure, the cement type, and the luted length of the post on fiber posts retention. METHODS One hundred eighty bovine incisors were selected to assess post retention; after endodontic treatment, the canals were flared with diamonds burs. Post holes were prepared in lengths of 5, 7.5, and 10 mm; the fiber posts were relined with composite resin and luted with RelyX ARC, RelyX Unicem, or RelyX Luting 2. All cements are manufactured by 3M ESPE (St. Paul, MN). Samples were subjected to a pull-out bond strength test in a universal testing machine; the results (N) were submitted to a three-way analysis of variance and the Tukey post hoc test (alpha = 0.05). RESULTS The improvement of post retention occurred with the increase of the post length luted into the root canal; the relining procedure improved the pull-out bond strength. RelyX Unicem and RelyX ARC showed similar values of retention, both showing higher values than RelyX Luting 2. CONCLUSION Post length, the relining procedure, and the cement type are all important factors for improving the retention of fiber posts.

Fiber post etching with hydrogen peroxide: effect of concentration and application time.

INTRODUCTION Etching is necessary to expose the fibers and enable both mechanical and chemical bonding of the resin core to the fiber post. This study evaluated the effect of concentration and application time of hydrogen peroxide on the surface topography and bond strength of glass fiber posts to resin cores. METHODS Fiber posts were etched with 24% or 50% hydrogen peroxide for 1, 5, or 10 min (n = 10). Posts without any treatment were used as a control. After etching, the posts were silanated and adhesive resin was applied. The posts were positioned into a mold to allow a self-cured resin core to be inserted. The post/resin assembly was serially sectioned into five beams that were subjected to a tensile bond strength test. Data were subjected to two-way ANOVA and Tukey test (α = 0.05). The surface topography was analyzed using scanning electronic microscopy. RESULTS Non-etched post presents a relatively smooth surface without fiber exposure. Application of hydrogen peroxide increased the surface roughness and exposed the fibers. All experimental conditions yielded similar bond strength values that were higher than those obtained in the control group. CONCLUSION Both 24% and 50% hydrogen peroxide exposure increased the bond strength of resin to the posts, irrespective of the application time.

Influence of ferrule, post system, and length on biomechanical behavior of endodontically treated anterior teeth.

INTRODUCTION The aim of this study was to evaluate the influence of post system, length, and ferrule on biomechanical behavior of endodontically treated anterior teeth. METHODS The investigation was conducted by using laboratory tests and 3-dimensional finite element analysis. Eighty bovine incisors were selected and divided into 8 treatment groups (n = 10) with absence of ferrule and 2.0 mm of ferrule, restored with glass fiber post or cast post and core, and 12.0 and 7.0 mm of post length. The specimens were loaded at 135° angle, and the strain was measured by using strain gauge method. Specimens were subsequently loaded until fracture. Strain and fracture resistance results were analyzed by 3-way analysis of variance and Tukey honestly significant difference tests (α = 0.05). Three-dimensional models of a maxillary central incisor were generated with the same treatment variations used in laboratory tests. Each model was subjected to 100 N oblique loads. Results were evaluated by von Mises criterion. RESULTS Ferrule was a determining factor in the strain, fracture resistance, and fracture pattern. In the absence of ferrule, the use of fiberglass posts represents a conservative choice from the standpoint of the fracture patterns observed. The length of 7 mm for cast post and cores produced high rates of root fractures. Finite element analysis showed that glass fiber post showed homogeneous stress distribution, whereas cast post showed stress concentration into root canal. CONCLUSIONS Post length influenced only the cast post strain and stress distribution. The ferrule groups always showed more satisfactory stress distribution and fracture resistance.

EFFECT OF RELINING ON FIBER POST RETENTION TO ROOT CANAL

One of the clinically relevant problems dentists face when restoring endodontically treated teeth is the mismatch between fiber post and post space diameters, which results in an excessively thick resin cement layer. Fiber post relining appears as a solution for this problem. Objectives: The aim of this study was to evaluate the effect of fiber post relining with composite resin on push-out bond strength. Material and Methods: Twenty bovine incisors were selected to assess post retention. The crowns were removed below the cementoenamel junction and the root canals were treated endodontically and flared with diamond burs. The roots were allocated into two groups (n=10): G1: fiber posts without relining and G2: fiber posts relined with composite resin. The posts were cemented with a dual-cured resin cement and the specimens were sectioned transversally. Three 1.5-mm thick slabs were obtained per root and identified as cervical, medium and apical thirds. The push-out test was performed at a crosshead speed of 0.5 mm/min until post dislodgement occurred. The failure mode of fractured specimens was analyzed under scanning electron microscopy. Data were analyzed by split-plot ANOVA and post-hoc Tukeys test at a pre-set alpha of 0.05. Results: Relined fiber posts presented higher retention values than non-relined post in all thirds. No statistically significant differences (p>0.05) were found among thirds for relined posts. All failures occurred at the interface between resin cement and root dentin. Conclusions: Relining with composite resin seems to be an effective method to improve the retention of fiber posts to flared root canals.

Effect of surface treatments of laboratory-fabricated composites on the microtensile bond strength to a luting resin cement

The purpose of this study was to evaluate the influence of different surface treatments on composite resin on the microtensile bond strength to a luting resin cement. Two laboratory composites for indirect restorations, Solidex and Targis, and a conventional composite, Filtek Z250, were tested. Forty-eight composite resin blocks (5.0 x 5.0 x 5.0mm) were incrementally manufactured, which were randomly divided into six groups, according to the surface treatments: 1- control, 600-grit SiC paper (C); 2- silane priming (SI); 3- sandblasting with 50 mm Al2O3 for 10s (SA); 4- etching with 10% hydrofluoric acid for 60 s (HF); 5- HF + SI; 6 - SA + SI. Composite blocks submitted to similar surface treatments were bonded together with the resin adhesive Single Bond and Rely X luting composite. A 500-g load was applied for 5 minutes and the samples were light-cured for 40s. The bonded blocks were serially sectioned into 3 slabs with 0.9mm of thickness perpendicularly to the bonded interface (n = 12). Slabs were trimmed to a dumbbell shape and tested in tension at 0.5mm/min. For all composites tested, the application of a silane primer after sandblasting provided the highest bond strength means.

Effect of post type and restorative techniques on the strain and fracture resistance of flared incisor roots

Restoring flared endodontically treated teeth continues to be a challenge for clinicians. This study evaluated the effect of post types and restorative techniques on the strain, fracture resistance, and fracture mode of incisors with weakened roots. One hundred five endodontically treated bovine incisors roots (15 mm) were divided into 7 groups (n=15). The two control groups were (C) intact roots restored with Cpc (cast posts and core) or Gfp (glass fiber posts). The five experimental groups were (F) flared roots restored with GfpAp (Gfp associated with accessory glass fiber posts), GfpRc (anatomic Gfp, relined with composite resin), and GfpRcAp (anatomized Gfp with resin and accessory glass fiber posts). All teeth were restored with metal crowns. Mechanical fatigue was performed with 3x10(5)/50 N. Specimens were loaded at 45º, and the strain values (μS) were obtained on root buccal and proximal surfaces. Following that, the fracture resistance (N) was measured. One-way ANOVA and Tukeys HSD tests (α=0.05) were applied, and failure mode was checked. No significant difference in strain values among the groups was found. Cpc presented lower fracture resistance and more catastrophic failures in flared roots. Gfp associated with composite resin or accessory glass fiber posts seems to be an effective method to improve the biomechanical behavior of flared roots.

Degree of Conversion of Etch-and-Rinse and Self-etch Adhesives Light-cured Using QTH or LED

In the current study, the degree of conversion (DC) of bonding agents photoactivated using QTH or LED light-curing units (LCUs) was evaluated by Fourier Transform infrared spectroscopy with an attenuated total reflectance (ATR) device. Four LCUs were evaluated: one QTH (Optilux 501; Demetron Kerr) and three LEDs: Radii Cal (SDI), Elipar FreeLight 2 (3M ESPE) and Bluephase (Ivoclar Vivadent). Two etch-and-rinse (Scotchbond Multi-Purpose-SBMP and Single Bond 2-SB2) and two self-etch adhesives (Clearfil SE Bond-CSE, and Clearfil S3 Bond-CS3) were tested. For SBMP and CSE, the primer was not used. The irradiance and spectral emission of the LCUs were obtained with a radiometer and spectrometer. The materials were placed onto the ATR cell as thin films, the solvent was evaporated (when necessary) and photoactivation was carried out for 20 seconds. The DC (%) was evaluated after five minutes (n = 5). The data were statistically analyzed (p < 0.05). The irradiance for Optilux, Radii, FreeLight 2 and Bluephase was 760, 600, 1000 and 1100 mW.cm(-2), respectively. The wavelength of emission for Optilux was between 375 and 520 nm (peak at 496 nm), while for Radii, it was between 420 and 520 nm (peak at 467 nm). Freelight 2 presented an emission spectrum between 415 and 520 nm, and for Bluephase, it was between 410 and 530 nm, both having a peak at 454 nm. SB2 generally showed higher DC compared with the other bonding agents. When cured using the QTH unit, the DC results were SB2 = CS3 > CSE > SBMP; for all LEDs, the DC results showed SB2 > CSE > SBMP > CS3. For SB2, the highest DC was observed when the material was cured with Radii, while there were no significant differences among the other LCUs. CSE and CS3 showed higher DC when cured using the QTH unit, but similar results were observed among the LEDs. For SBMP, no significant differences among the LCUs were detected. In conclusion, the combination bonding agent vs curing unit had a significant effect on DC, mainly for the self-etch adhesives.