Department of Conservative Dentistry, Jordan University of Science and Technology, P.O. BOX 3030, Irbid 22110, Jordan.
Department of Conservative Dentistry, Jordan University of Science and Technology, P.O. BOX 3030, Irbid 22110, Jordan.
J Dent. 2024 Aug;147:105106. doi: 10.1016/j.jdent.2024.105106. Epub 2024 Jun 1.
To assess the influence of ferrule and core type on the fracture strength of endodontically treated anterior teeth (ETAT) and identify the failure mode type and distribution across different core types and ferrule conditions.
Sixty extracted human central incisors were endodontically treated, decoronated and divided into two main groups (F=with ferrule, NF=no ferrule). Each main group was further subdivided into three subgroups according to the core material used: direct composite cores (DC), Ribbond fibre-reinforced composite cores (RIB-DC), and glass fibre post (GFP) with direct composite cores (GFP-DC). All specimens received E.max crowns and underwent thermal cycling and cyclic loading. Subsequently, the fracture resistance was tested with static loads applied to the crown restoration. Two-Way ANOVA and Chi square tests identified significant differences among the groups (p < 0.05).
The means and standard deviations (SD) of fracture loads in Newtons (N) for specimens in the F subgroups were RIB-DC: 465.0 (104.20), GFP-DC: 367.6 (79.59), DC: 275.8 (68.48), and in NF subgroups were RIB-DC: 110.8 (24.33), GFP-DC: 95.6 (25.47), DC: 67.4 (7.46). Specimens with ferrule yielded significantly higher fracture loads than those without ferrule (p = 0.0054). In the F groups, fracture loads of specimens with RIB-DC cores were significantly higher than those with GFP-DC (p = 0.0019) and those with DC (p = 0.0001). Moreover, fracture loads for the GFP-DC were significantly higher than those for the DC (p = 0.0026). The GFP-DC specimens showed the highest incidence of catastrophic failures (p = 0.0420).
Using fibre-reinforced composite (FRC) cores significantly increased fracture resistance in ETAT with ferrule. The failure modes repairable and possibly repairable were dominant in most specimens.
When restoring ETAT with insufficient coronal tooth structure, preserving 2 mm of tooth structure ferrule and preparing cores with FRC can increase fracture resistance and reduce the incidence of non-repairable catastrophic fractures of teeth.
评估套简和核类型对根管治疗前牙（ETAT）的抗折强度的影响，并确定不同核类型和套简条件下的失效模式类型和分布。
将 60 颗人离体中切牙进行根管治疗、去冠并分为两组（F 组有套简，NF 组无套简）。每组根据使用的核材料进一步分为三组：直接复合核（DC）、Ribbond 纤维增强复合核（RIB-DC）和玻璃纤维桩（GFP）与直接复合核（GFP-DC）。所有样本均制作 E.max 冠，并进行热循环和循环加载。随后，将静态载荷施加到冠修复体上，测试抗折强度。采用双因素方差分析和卡方检验比较各组之间的差异（p<0.05）。
F 组中 RIB-DC 的断裂载荷平均值和标准差（SD）为 465.0（104.20）N，GFP-DC 为 367.6（79.59）N，DC 为 275.8（68.48）N；NF 组中 RIB-DC 为 110.8（24.33）N，GFP-DC 为 95.6（25.47）N，DC 为 67.4（7.46）N。有套简的试件比无套简的试件产生的断裂载荷高（p=0.0054）。在 F 组中，RIB-DC 核的试件的断裂载荷显著高于 GFP-DC（p=0.0019）和 DC（p=0.0001）核的试件。此外，GFP-DC 核的试件的断裂载荷也显著高于 DC 核的试件（p=0.0026）。GFP-DC 试件的灾难性失效发生率最高（p=0.0420）。
使用纤维增强复合材料（FRC）核显著提高了有套简的 ETAT 的抗折强度。在大多数试件中，可修复和可能修复的失效模式占主导地位。
当修复牙冠结构不足的 ETAT 时，保留 2mm 的牙体结构套简并制备 FRC 核可以提高抗折强度，降低牙齿非可修复性灾难性骨折的发生率。
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