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Notre clinique de Morges – Saint-Louis déménage le 2 mai à Morges – Gare : Rue Centrale 27, 1110 Morges

The effect of a fiber reinforced cavity configuration on load bearing capacity and failure mode of endodontically treated molars restored with CAD/CAM resin composite overlay restorations.

ROCCA Giovanni, SARATTI Carlo Massimo, CATTANI-LORENTE Maria, FEILZER Albert, SCHERRER Susanne S., KREJCI Ivo

ABSTRACT

 

Objectives: To evaluate the fracture strength and the mode of failure of endodontically treated molars restored with CAD/CAM overlays with fiber reinforced composite build-up of the pulp chamber.

Methods: 40 Devitalized molars were cut over the CEJ and divided into five groups (n=8). The pulp chamber area was filled with: group 0 (control), no resin build-up; group 1, hybrid composite build-up (G-aenial posterior, GC); group 2, as in group 1 but covered with 3 nets of bi-directional E-glass fibers (EverStickNET, Stick Tech Ltd.); group 3, a FRC resin (EverX posterior, GC); group 4, as in group 3 but covered by the bi-directional fibers. The crowns were restored with CAD-CAM composite restorations (Lava Ultimate, 3M ESPE). Maximum fracture loads were recorded in Newton and data were analyzed using Kruskal-Wallis test (p<0.05). Fragments were analyzed using SEM.

Results: The mean static loads in Newton were: group 0: 2448 (546); group 1: 2817 (873); group 2: 2128 (952); group 3: 2429 (1091); group 4: 2577 (833). No significant differences were found between the groups (p>0.05). All specimens fractured in a catastrophic way, under the CEJ. The main crack evolved in the corono-apical direction. In groups 2 and 4 secondary fracture paths with apico-coronal direction were detected close to the bi-directional fibers’ layer.

Conclusions: For the restoration of endodontically treated molars, the incorporation of FRCs did not influence the load-bearing capacity of the tooth-restoration complex. The SEM analysis showed a low ability of the bi-directional fibers net in deviating the fracture but this effect was not sufficient to lead more favorable fracture patterns, over the CEJ.

Clinical significance: The use of FRCs to reinforce the “core” of devitalized molars against vertical fractures under static loads seems useless when the thickness of the CAD/CAM composite overlay restoration is high.

 

Keywords: CAD/CAM, Endocrown, Endodontically treated teeth, Fiber reinforced composite, Fractography.

 

https://pubmed.ncbi.nlm.nih.gov/26149065/

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