Bromberg Carolina Ritter, Alves Caroline Beatriz, Stona Deborah, Spohr Ana Maria, Rodrigues-Junior Sinval Adalberto, Melara Rafael, Burnett Luiz Henrique
J Am Dent Assoc. 2016 Dec;147(12):952-958. doi: 10.1016/j.adaj.2016.08.001. Epub 2016 Sep 10.
Because of the many possibilities for endodontically restoring the posterior teeth and the high prevalence of restoration failures, this topic continues to be of major concern. A composite resin (CR) restoration reinforced by a horizontal fiberglass post may improve the fracture resistance of endodontically treated teeth. The authors investigated this possibility by comparing the fracture resistance of molars restored with direct techniques with that of molars restored with indirect techniques.
The authors divided 50 extracted sound third molars into 5 groups: sound teeth, onlay (ON), inlay (IN), direct CR, and transfixed fiberglass post (TFP) plus direct CR. The authors performed standardized mesio-occlusodistal cavity preparations and endodontic treatments. The authors cemented indirect restorations of Lava Ultimate (3M ESPE) adhesively in the ON and IN groups. The authors restored CR group teeth directly with Filtek Z230 XT (3M ESPE). In the TFP group, the authors transfixed 2 fiberglass posts horizontally and restored the teeth directly with CR. Thereafter, the authors submitted the teeth to cyclic fatigue loading with 500,000 cycles at 200 newtons. The authors tested fracture resistance in newtons in a universal testing machine. The authors analyzed data with 1-way analysis of variance and a Tukey test (P < .05).
Sound teeth had the highest fracture resistance. ON had the highest recovery of resistance, followed by TFP. CR had the lowest recovery, which was similar to that of IN.
Endodontically treated molars restored with TFP plus CR had fracture resistance similar to those restored with ON, which was higher than that for IN or CR only.
Horizontal TFPs placed inside a composite restoration had the same performance as did ON restorations.
由于后牙牙髓治疗修复存在多种可能性且修复失败率较高,该主题一直备受关注。用水平玻璃纤维桩增强的复合树脂(CR)修复可能会提高牙髓治疗后牙齿的抗折性。作者通过比较直接技术修复的磨牙与间接技术修复的磨牙的抗折性来研究这种可能性。
作者将50颗拔除的健康第三磨牙分为5组:健康牙齿组、高嵌体(ON)组、嵌体(IN)组、直接CR组和贯穿式玻璃纤维桩(TFP)加直接CR组。作者进行了标准化的近中-咬合-远中窝洞预备和牙髓治疗。作者在ON组和IN组中用粘结剂粘结Lava Ultimate(3M ESPE)间接修复体。作者用Filtek Z230 XT(3M ESPE)直接修复CR组牙齿。在TFP组中,作者水平贯穿2根玻璃纤维桩并用CR直接修复牙齿。此后,作者在200牛顿的力下对牙齿进行500,000次循环的循环疲劳加载。作者在万能试验机上以牛顿为单位测试抗折性。作者用单因素方差分析和Tukey检验分析数据(P <.05)。
健康牙齿的抗折性最高。ON组的抗折性恢复最高,其次是TFP组。CR组的抗折性恢复最低,与IN组相似。
用TFP加CR修复的牙髓治疗后磨牙的抗折性与用ON修复的磨牙相似,高于仅用IN或CR修复的磨牙。
置于复合修复体内的水平TFP的性能与ON修复体相同。