Aksoy Yüksek Merve, Kedici Alp Cemile, Sarı Ceyda, Bala Oya
Department of Restorative Dentistry, Faculty of Dentistry, Van Yüzüncü Yıl University, Van, Türkiye.
Department of Restorative Dentistry, Faculty of Dentistry, Gazi University, Ankara, Türkiye.
Clin Oral Investig. 2025 Apr 4;29(4):220. doi: 10.1007/s00784-025-06297-2.
This study aimed to investigate the influence of various cusp reduction amounts, localization, and the use of coronal polyethylene fiber on cusp deflection in endodontically treated molar teeth.
The 120 intact molar teeth observed in the study were divided into 12 groups, and standard MOD cavities were prepared after the root canal treatment was completed. Groups 1 and 2 were determined as positive and negative control groups, respectively. Two cusp reductions were applied to Groups 3, 4, 5, and 6, and functional cusps reduction were applied to Groups 7, 8, 9, and 10. The cusp reductions were either 1.5 mm or 3 mm. After preparation, Groups 3, 5, 7, 9, and 11 were restored with Filtek One Bulk-Fill, while Groups 4, 6, 8, 10, and 12 were restored with Filtek One Bulk-Fill + Ribbond. As the teeth were restored, the amount of cusp deflection was measured with a twin channel deflection gauge device. The fracture strength of the teeth was measured using a universal test machine. The experimental results were statistically evaluated with two-way and one-way ANOVA tests.
The reinforcement of the coronal structure with fiber reduced cusp deflection and increased fracture strength. The statistically significantly less cusp deflection was obtained in the groups with the same cavity design of having fiber placed than in the groups without fiber placed (p < 0.001). The statistically significantly lower fracture strength was obtained in Group 11 than all the reduced groups except Groups 5 and 7 (p < 0.05). The statistically lower fracture strength was obtained in Group 12, than in Group 4 (p < 0.05). Experimental groups with cusp reduction showed less cusp deflection (p < 0.001) and higher fracture strength (p < 0.05) than experimental groups without cusp reduction.
Fiber application and cusp reduction may have positive effects in terms of reducing cusp deflection and increasing fracture strength in direct restoration cases involving excessive substance loss in endodontically treated teeth.
Incorporating cusp reduction and coronal fiber applications in treatment plans for endodontically treated teeth ensures that restorations are both functional and durable.
本研究旨在探讨不同的尖牙降低量、位置以及冠部聚乙烯纤维的使用对根管治疗后磨牙尖牙偏斜的影响。
本研究中观察的120颗完整磨牙被分为12组,在完成根管治疗后制备标准的MOD洞形。第1组和第2组分别被确定为阳性和阴性对照组。第3、4、5和6组进行两次尖牙降低,第7、8、9和10组进行功能尖牙降低。尖牙降低量为1.5毫米或3毫米。制备完成后,第3、5、7、9和11组用Filtek One Bulk-Fill进行修复,而第4、6、8、10和12组用Filtek One Bulk-Fill + Ribbond进行修复。在牙齿修复过程中,使用双通道偏斜测量仪测量尖牙偏斜量。使用万能试验机测量牙齿的断裂强度。实验结果采用双向和单向方差分析进行统计学评估。
用纤维增强冠部结构可减少尖牙偏斜并提高断裂强度。在具有相同洞形设计且放置纤维的组中,获得的尖牙偏斜在统计学上显著低于未放置纤维的组(p < 0.001)。第11组获得的断裂强度在统计学上显著低于除第5和第7组之外的所有降低组(p < 0.05)。第12组获得的断裂强度在统计学上低于第4组(p < 0.05)。与未进行尖牙降低的实验组相比,进行尖牙降低的实验组尖牙偏斜更小(p < 0.001)且断裂强度更高(p < 0.05)。
在涉及根管治疗牙齿大量物质损失的直接修复病例中,应用纤维和降低尖牙可能在减少尖牙偏斜和提高断裂强度方面具有积极作用。
在根管治疗牙齿的治疗计划中纳入尖牙降低和冠部纤维应用可确保修复体既具有功能性又耐用。