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      Fracture resistance of endodontically treated premolars with direct composite restorations

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          Abstract

          Purpose:

          To determine the fatigue resistance and failure mode of endodontically treated premolars using direct composite resin restorations.

          Materials and Methods:

          Eighty-four human premolars were divided into seven groups of 12, prepared as follows: Intact teeth used in Group 1 as control, the second group covers the endodontically treated teeth, restored with direct onlays using Z250 composite resin, the next two groups (i.e. 3,4) were similar to the second group, but subjected to 1 and 2 million fatigue load cycles, respectively. Groups 5, 6, 7 were similar to groups 2, 3, 4, however, in these groups Tetric Ceram was used as the restorative material. All specimens were loaded using a Universal Testing Machine until fracture occurred. One-way Anova andTukey's HSD tests were used to analyze the data of onlay groups.

          Results:

          All specimens withstood the masticating simulation. The mean fracture strength for Goups 1 to 7 was: 1276.92, 1373.47, 1269/70, 486/35, 484/12, 1130/49, 1113/79 Newton, respectively. No statistically significant differences were found between the groups in fracture strength and failure mode.

          Conclusions:

          No statistically significant differences in fracture strength were found between sound teeth and composite onlays that were subjected to 1 and 2 million fatigue load cycles.

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          Most cited references24

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          Study of water sorption, solubility and modulus of elasticity of light-cured dimethacrylate-based dental resins.

          Polydimethacrylate resins were prepared by photopolymerization of Bis-GMA, TEGDMA, UDMA or Bis-EMA (4) monomer, initiated by camphoroquinone/N,N-dimethylaminoethyl methacrylate system. The study of physical properties of these resins showed that TEGDMA seems to create the most dense polymer network, which however is the most flexible (0.74GPa), absorbs the highest amount of water (6.33 wt%) and releases the lowest amount of unreacted monomer (2.41 microg/mm(3)). UDMA and Bis-EMA (4) create more rigid networks, which absorb lower water and release higher unreacted monomer than TEGDMA. Bis-EMA (4) absorbs the lowest water amount (1.79 wt%) and releases the highest amount of unreacted monomer (14.21 microg/mm(3)). Bis-GMA leads to the formation of the most rigid network (1.43 GPa), which absorbs lower water than the resin made by TEGDMA but higher than the resin made by UDMA and Bis-EMA (4). Copolymers of Bis-GMA with the other monomers were also prepared, using various monomer combinations and molar ratios. Copolymers Bis-GMA/TEGDMA (50/50 and 70/30 wt%) showed significantly higher values for Young's modulus (1.83 and 1.78 GPa) than those predicted by the linear dependence of the values on the copolymer composition. Gradual replacement of TEGDMA with UDMA or/and Bis-EMA (4) in copolymerization with Bis-GMA resulted in more flexible resins with lower water sorption and higher solubility values, depending on the TEGDMA content.
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            Fracture strength after dynamic loading of endodontically treated teeth restored with different post-and-core systems.

            Prefabricated metal and ceramic posts can be used with direct or indirect cores as an alternative to the conventional cast post and core. It is unclear how the fracture strength of zirconia posts with composite or ceramic cores and titanium posts with composite cores compares to the fracture strength of gold posts and cores after dynamic loading. This study compared the fracture strength of endodontically treated, crowned maxillary incisors with limited ferrule length and different post-and-core systems after fatigue loading. Sixty-four caries-free, human maxillary central incisors were divided into 4 groups. After root canal treatment, Group 1 was restored with titanium posts and composite cores, Group 2 with zirconia posts and composite cores, and Group 3 with zirconia posts and heat-pressed ceramic cores. Teeth restored with cast-on gold posts and cores served as the controls (Group 4). Teeth were prepared with a circumferential shoulder including a 1 to 2 mm ferrule; all posts were cemented with an adhesive resin cement, restored with complete-coverage crowns, and exposed to 1.2 million load cycles (30 N) in a computer-controlled chewing simulator. Simultaneous thermocycling between 5 degrees C and 55 degrees C was applied for 60 seconds with an intermediate pause of 12 seconds. All specimens that did not fracture during dynamic loading were loaded until fracture in a universal testing machine at a crosshead speed of 1.5 mm/min; loads were applied at an angle of 130 degrees at the incisal edge. Fracture loads (N) and modes (repairable or catastrophic) were recorded. The Kruskal-Wallis test was used to compare fracture loads among the 4 test groups. Analyses were conducted both with and without the specimens that failed during the chewing simulation. A Fisher exact test was performed to detect group differences in fracture modes. A significance level of P<.05 was used for all comparisons. The following survival rates were recorded after the chewing simulation: 93.8% (Group 1), 93.8% (Group 2), 100% (Group 3), and 87.5% (Group 4). The median fracture strengths for Groups 1 to 4 were 450 N, 503 N, 521 N, and 408 N, respectively. No significant differences were detected among the groups. The use of zirconia posts resulted in a nonsignificant lower number of catastrophic root fractures. Within the limitations of this study, the results suggest that zirconia posts with ceramic cores can be recommended as an alternative to cast posts and cores. If a chairside procedure is preferred, zirconia or titanium posts with composite cores can be used. Clinical trials are required to verify these in vitro results.
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              Wear of composite resin veneering materials in a dual-axis chewing simulator.

              The attritional wear of human enamel and four different composite resins for the veneering of crowns was evaluated in a dual-axis chewing simulator over up to 1200000 loading cycles. Enamel showed less wear than the composite resins. However, an ultrafine compact-filled composite resin (Targis) showed a wear not statistically significantly different from that of enamel. The other composite resins showed a statistically significantly higher wear than enamel regardless whether microfine, ultrafine midway-filled or ultrafine compact-filled.
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                Author and article information

                Journal
                J Conserv Dent
                JCD
                Journal of Conservative Dentistry : JCD
                Medknow Publications (India )
                0972-0707
                0974-5203
                Jul-Sep 2011
                : 14
                : 3
                : 277-281
                Affiliations
                [1]Department of Operative Dentistry, School of Dentistry, Tehran Azad University of Medical Sciences, Tehran, Iran
                Author notes
                Address for correspondence: Dr. Maryam Moezizadeh, Department of Operative Dentistry, School of Dentistry, Shaheed Beheshti University of Medical Sciences, Tehran - Iran E mail: mamoezizadeh@ 123456yahoo.com
                Article
                JCD-14-277
                10.4103/0972-0707.85816
                3198559
                22025833
                e0c8c414-dda8-4924-b202-7a42eedbe156
                Copyright: © Journal of Conservative Dentistry

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 20 September 2010
                : 28 December 2010
                : 20 January 2011
                Categories
                Original Article

                Dentistry
                fatigue resistance,fracture strength,composite onlay
                Dentistry
                fatigue resistance, fracture strength, composite onlay

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