Roberto Elias Campos

Fracture Resistance and Stress Distribution in Endodontically Treated Maxillary Premolars Restored with Composite Resin

PURPOSE The aim of this study was to evaluate the effect of endodontic and restorative treatment on the fracture resistance of posterior teeth. MATERIALS AND METHODS Fifty intact premolars were selected and randomly placed into five groups (n = 10): G1, intact teeth (control); G2, mesial-occlusal-distal (MOD) preparation; G3, MOD preparation restored with composite resin (Z-250, 3M ESPE); G4, MOD preparation and endodontic treatment; and G5, MOD preparation, endodontic treatment, and composite resin restoration. The specimens were submitted to an axial compression load in a mechanical test machine (EMIC), at a speed of 0.5 mm/min. Fracture patterns were analyzed at four levels. Five 2D numerical models were created by Ansys 10.0 for finite element analysis (FEA). RESULTS Mean values of compressive strength for all groups were (Kgf): G1 (83.6 +/- 25.4); G2 (52.7 +/- 20.2); G3 (82.1 +/- 24.9); G4 (40.2 +/- 14.2); G5 (64.5 +/- 18.1). Statistical analysis (ANOVA and Tukeys test) showed that fracture resistance of G1 was significantly higher than that of G5, G2, and G4. Resistance of G3 was also higher than that of G2 and G4. Results showed that the tooth resistance is completely maintained when MOD preparation is restored with composite resin and partially recovered when MOD preparation associated with an endodontic access is restored in the same way. The endodontic treatment and composite resin restoration influenced stress distribution in the dental structure. CONCLUSIONS Composite resin restoration plays an important role in recovering tooth strength. With regard to fracture mode, restoration and endodontic treatment increased the incidence of periodontal involvement, which was demonstrated by association with the finite element mechanical test method.

In Vitro Study of Fracture Load and Fracture Pattern of Ceramic Crowns: A Finite Element and Fractography Analysis

PURPOSE This in vitro study investigated the null hypothesis that metal-free crowns induce fracture loads and mechanical behavior similar to metal ceramic systems and to study the fracture pattern of ceramic crowns under compressive loads using finite element and fractography analyses. MATERIALS AND METHODS Six groups (n = 8) with crowns from different systems were compared: conventional metal ceramic (Noritake) (CMC); modified metal ceramic (Noritake) (MMC); lithium disilicate-reinforced ceramic (IPS Empress II) (EMP); leucite-reinforced ceramic (Cergogold) (CERG); leucite fluoride-apatite reinforced ceramic (IPS d.Sign) (SIGN); and polymer crowns (Targis) (TARG). Standardized crown preparations were performed on bovine roots containing NiCr metal dowels and resin cores. Crowns were fabricated using the ceramics listed, cemented with dual-cure resin cement, and submitted to compressive loads in a mechanical testing machine at a 0.5-mm/min crosshead speed. Data were submitted to one-way ANOVA and Tukey tests, and fractured specimens were visually inspected under a stereomicroscope (20×) to determine the type of fracture. Maximum principal stress (MPS) distributions were calculated using finite element analysis, and fracture origin and the correlation with the fracture type were determined using fractography. RESULTS Mean values of fracture resistance (N) for all groups were: CMC: 1383 ± 298 (a); MMC: 1691 ± 236 (a); EMP: 657 ± 153 (b); CERG: 546 ± 149 (bc); SIGN: 443 ± 126 (c); TARG: 749 ± 113 (b). Statistical results showed significant differences among groups (p < 0.05) represented by different lowercase letters. Metal ceramic crowns presented fracture loads significantly higher than the others. Ceramic specimens presented high incidence of fractures involving either the core or the tooth, and all fractures of polymer crown specimens involved the tooth in a catastrophic way. Based on stress and fractographic analyses it was determined that fracture occurred from the occlusal to the cervical direction. CONCLUSIONS Within the limitations of this study, the results indicated that the use of ceramic and polymer crowns without a core reinforcement should be carefully evaluated before clinical use due to the high incidence of failure with tooth involvement. This mainly occurred for the polymer crown group, although the fracture load was higher than normal occlusal forces. High tensile stress concentrations were found around and between the occlusal loading points. Fractographic analysis indicated fracture originating from the load point and propagating from the occlusal surface toward the cervical area, which is the opposite direction of that observed in clinical situations.

Comparative evaluation of 3 microbond strength tests using 4 adhesive systems: Mechanical, finite element, and failure analysis

Statement of problem. Bond strength (BS) values from in vitro studies are useful when dentists are selecting an adhesive system, but there is no ideal measuring method. Purpose. The purpose of this in vitro study was to investigate the influence of the evaluation method in the BS between dentin and composite resin. Material and methods. Molars with exposed superficial dentin (N=240) were divided into 3 groups according to the test: microtensile (&mgr;TBS), microshear (&mgr;SBS), and micropush‐out (&mgr;PBS). Each one was subdivided into 4 groups according to the adhesive system: total etch, 3‐ and 2‐step; and self‐etch, 2‐ and 1‐step). For the &mgr;PBS test, a conical cavity was prepared and restored with composite resin. An occlusal slice (1.5 mm in thickness) was obtained from each tooth. For the &mgr;SBS test, a composite resin cylinder (1 mm in diameter) was built on the dentin surface of each tooth. For the &mgr;TBS test, a 2‐increment composite resin cylinder was built on the dentin surface, and beams with a sectional area of 0.5 mm2 were obtained. Each subgroup was divided into 2 (n=10) as the specimens were tested after 7 days and 1 year of water storage. The specimens were submitted to load, and the failure recorded in units of megapascals. Original BS values from the &mgr;TBS and &mgr;SBS tests were normalized for the area from &mgr;PBS specimens. Original and normalized results were submitted to a 3‐way ANOVA (&agr;=.05). The correlation among mechanical results, stress distribution, and failure pattern was investigated. Results. Significant differences (P<.05) were found among the adhesive systems and methods within both the original and normalized data but not between the storage times (P>.05). Within the 7 days of storage, the original BS values from &mgr;TBS were significantly higher (P<.001) than those from &mgr;PBS and &mgr;SBS. After 1 year, &mgr;SBS presented significantly lower results (P<.001). However, after the normalization for area, the BS values of the &mgr;TBS and &mgr;PBS tests were similar, and both were higher (P<.001) than that of &mgr;SBS in both storage times. In the &mgr;SBS and &mgr;TBS specimens, cohesive and adhesive failures were observed, whereas &mgr;PBS presented 100% of adhesive failures. The failure modes were compatible with the stress distribution. Conclusions. The storage time did not affect the results, but differences were found among the adhesives and methods. For comparisons of bond strength from tests with different bonding areas, the normalization for area seemed essential. The microshear bond test should not be used for bond strength evaluation, and the microtensile test needs improvement to enable reliable results regarding stress concentration and failure mode. The micropush‐out test may be considered more reliable than the microtensile in the bond strength investigation, as demonstrated by the uniform stress concentration and adhesive failure pattern.

Effect of a bonding resin layer associated with a self-etching adhesive system on the bond strength of indirect restorations

The aim of this study was to evaluate the influence of a low-viscosity bonding resin applied over a self-etching adhesive system on the microtensile bond strength (μTBS) of indirect restorations. Comparisons were made using One Up Bond F (OB) self-etching adhesive system, Single Bond (SB) one-bottle adhesive system and Scotchbond Multi Purpose Plus (SMP) bonding component. Thirty bovine incisors were extracted and decoronated at the cementoenamel junction. The labial surfaces were ground so that superficial dentin and deep dentin were exposed. The specimens were randomized to three groups (n=10): G1- OB; G2- OB + SMP; G3- SB. In G2, a layer of the SMP bonding was applied over the OB adhesive system. Indirect composite restorations were bonded using dual-cure cement under 500 g load for 5 min. The specimens were serially sectioned with a bonding area of ± 1.0 mm2 in 3 regions: enamel (E), superficial dentin (SD) and deep dentin (DD). The sticks were fixed with cyanoacrylate adhesive and submitted to μTBS test at a crosshead speed of 0.5 mm/min in a mechanical testing machine (EMIC DL 2000). The fractured specimens were examined under scanning electron microscopy to determine the failure mode. Data were analyzed by one-way ANOVA followed by Tukeys test (p<0.05). μTBS means (in MPa) were: G1/E: 15.5 ± 3.5b; G1/SD: 22.7 ± 7.6a; G1/DD: 19.4 ± 9.4a; G2/E: 15.9 ± 5.8b; G2/SD: 19.9 ± 6.9a; G2/DD: 15.3 ± 4.9a; G3/E: 23.2 ± 7.3a; G3/SD: 20.4 ± 8.2a; G3/DD: 19.1 ± 8.7a. The results showed that the use of a low viscosity bonding resin did not affect the μTBS means when associated with a self-etching adhesive system. The self-etching adhesive system was significantly more efficient in dentin than in enamel, while the one-bottle system was significantly more efficient in enamel when compared to the self-etching adhesive system.