Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, Szeged, Hungary.
Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, Szeged, Hungary.
J Mech Behav Biomed Mater. 2021 Jun;118:104440. doi: 10.1016/j.jmbbm.2021.104440. Epub 2021 Mar 3.
The aim was to explore the survival of extensively damaged anterior teeth without ferrule restored with different fiber-reinforced composite (FRC) post-core foundations and composite crowns.
Sixty extracted upper central incisors were decoronated and randomly divided into four groups (n = 15). After endodontic treatment, the specimens were restored with different individualized fiber-reinforced post-core foundations as follows: control group (CTRL): multiple unidirectional FRC-post + dual-cure composite-core, PFC: multiple unidirectional FRC-post + packable short fiber-reinforced composite (SFRC), BPFC: Bioblock technique with only packable SFRC, BFFC: Bioblock technique with only flowable SFRC. After core build-up, the teeth were finalized with adhesively luted CAD/CAM composite crowns. Cyclic isometric loading (5 Hz) was applied at 100 N for 5000 cycles, and then 200 N and 300 N for 15,000 cycles each in a fluid chamber. The specimens were loaded until fracture occurred or when a total of 35,000 cycles were reached. Kaplan-Meyer survival analysis was conducted, followed by pairwise log-rank post hoc comparisons (Mantel-Cox).
The survival rates of the control (8279 cycles) and PFC (6161 cycles) were significantly higher compared to BPFC (3223 cycles) and BFFC (2271 cycles) (p < 0.05). Regarding fracture pattern, nearly all specimens fractured in a restorable manner.
For restoring extensively damaged anterior teeth, multiple unidirectional FRC posts are recommended.
Although different FRC post/core systems are available for the restoration of damaged root canal treated anterior teeth, multiple unidirectional FRC posts tend to be a good option when the ferrule is missing.
本研究旨在探讨不同纤维增强复合材料（FRC）桩核基底和复合树脂冠修复无金属全冠的大面积牙体缺损前牙的长期保存率。
本研究共纳入 60 颗上颌中切牙，截冠后随机分为 4 组（n=15）。根管治疗后，各组采用不同的纤维桩核系统修复：对照组（CTRL）：多根单向 FRC 桩+双固化复合树脂核；PFC 组：多根单向 FRC 桩+可压实短纤维增强复合材料（SFRC）核；BPFC 组：仅使用可压实 SFRC 的 Bioblock 技术；BFFC 组：仅使用流动性 SFRC 的 Bioblock 技术。核形成后，采用 CAD/CAM 复合树脂粘结剂全瓷冠最终修复。在液体室中，以 5Hz 的频率对试件施加 100N 的等距循环载荷 5000 次，然后以 200N 和 300N 分别循环加载 15000 次。加载直至试件发生破坏或达到 35000 次循环。采用 Kaplan-Meier 生存分析，随后进行两两对数秩检验（Mantel-Cox）。
CTRL 组（8279 次循环）和 PFC 组（6161 次循环）的存活率显著高于 BPFC 组（3223 次循环）和 BFFC 组（2271 次循环）（p<0.05）。关于骨折模式，几乎所有试件均以可修复的方式发生骨折。
对于大面积牙体缺损的前牙修复，推荐使用多根单向 FRC 桩。
虽然可用于修复根管治疗后受损前牙的 FRC 桩核系统种类繁多，但当牙体剩余高度不足时，多根单向 FRC 桩是一种较好的选择。
