Fracture resistance of cementum-extended composite fillings in severely damaged deciduous incisors: An in vitro study

ABSTRACT

Objective: The aim of this study was to comparatively assess the fracture resistance of the cementum-extended and conventional composite fillings with or without intracanal composite posts in severely damaged deciduous incisors. Materials and Methods: This in vitro study was performed on 60 extracted deciduous maxillary incisors that were randomly divided into four groups: Group 1: Composite filling (CF); Group 2: Composite filling with composite posts (CF + CP); Group 3: Composite filling extended 0.5 mm to cementum (ceCF); Group 4: Composite filling extended 0.5 mm to cementum with composite posts (ceCF + CP). The fracture resistance was assessed by exerting a progressively increasing load with a cross-head speed of 0.5 mm/min in a Universal Testing Machine. Statistical Analysis: Data were analyzed by SPSS-18 using one-way analysis of variance at ⍱ < 0.05. Results: The mean fracture resistance (MFR) values of the experimental groups were 410.57 ± 139.44 N, 564.44 ± 92.63 N, 507.5 ± 76.37 N and 601.08 ± 96.04 N. A significant difference was found between the MFR of Groups 1 and 2, Groups 1 and 4 and Groups 3 and 4 (P < 0.05). Conclusion: A superior outcome was achieved by intracanal composite posts in both conventional and cementum-extended composite fillings.

Key words:

Composite resins - deciduous teeth - fracture resistance - post and core technique

• REFERENCES

• 1 Sharaf AA. The application of fiber core posts in restoring badly destroyed primary incisors. J Clin Pediatr Dent 2002; 26: 217-24
• 2 Motisuki C, Santos-Pinto L, Giro EM. Restoration of severely decayed primary incisors using indirect composite resin restoration technique. Int J Paediatr Dent 2005; 15: 282-6
• 3 Reisine ST, Psoter W. Socioeconomic status and selected behavioral determinants as risk factors for dental caries. J Dent Educ 2001; 65: 1009-16
• 4 Scotti N, Comba A, Gambino A, Paolino DS, Alovisi M, Pasqualini D. et al. Microleakage at enamel and dentin margins with a bulk fills flowable resin. Eur J Dent 2014; 8: 1-8
• 5 Gurbuz T, Sengul F, Altun C. Finite element stress analysis of short-post core and over restorations prepared with different restorative materials. Dent Mater J 2008; 27: 499-507
• 6 Ozcan N, Sahin E. In vitro evaluation of the fracture strength of all-ceramic core materials on zirconium posts. Eur J Dent 2013; 7: 455-60.6
• 7 D'Arcangelo C, De Angelis F, Vadini M, D'Amario M, Caputi S. Fracture resistance and deflection of pulpless anterior teeth restored with composite or porcelain veneers. J Endod 2010; 36: 153-6
• 8 Moura SK, Murad CG, Reis A, Klein-Júnior CA, Grande RH, Loguercio AD. The influence of air temperature for solvent evaporation on bonding of self-etch adhesives to dentin. Eur J Dent 2014; 8: 205-10
• 9 Silva GR, Santos-Filho PC, Simamoto-Júnior PC, Martins LR, Mota AS, Soares CJ. Effect of post type and restorative techniques on the strain and fracture resistance of flared incisor roots. Braz Dent J 2011; 22: 230-7
• 10 Tanalp J, Dikbas I, Malkondu O, Ersev H, Güngör T, Bayırlı G. Comparison of the fracture resistance of simulated immature permanent teeth using various canal filling materials and fiber posts. Dent Traumatol 2012; 28: 457-64
• 11 Nothdurft FP, Schmitt T, Rupf S, Pospiech PR. Influence of fatigue testing and cementation mode on the load-bearing capability of bovine incisors restored with crowns and FRC posts. Dent Mater J 2011; 30: 109-14
• 12 Schmoldt SJ, Kirkpatrick TC, Rutledge RE, Yaccino JM. Reinforcement of simulated immature roots restored with composite resin, mineral trioxide aggregate, gutta-percha, or a fiber post after thermocycling. J Endod 2011; 37: 1390-3
• 13 Marchi GM, Paulillo LA, Pimenta LA, De Lima FA. Effect of different filling materials in combination with intraradicular posts on the resistance to fracture of weakened roots. J Oral Rehabil 2003; 30: 623-9
• 14 Amaral FL, Colucci V, Palma-Dibb RG, Corona SA. Assessment of in vitro methods used to promote adhesive interface degradation: A critical review. J Esthet Restor Dent 2007; 19: 340-54
• 15 Naumann M, Metzdorf G, Fokkinga W, Watzke R, Sterzenbach G, Bayne S. et al. Influence of test parameters on in vitro fracture resistance of post-endodontic restorations: A structured review. J Oral Rehabil 2009; 36: 299-312
• 16 Kathuria A, Kavitha M, Khetarpal S. Ex vivo fracture resistance of endodontically treated maxillary central incisors restored with fiber-reinforced composite posts and experimental dentin posts. J Conserv Dent 2011; 14: 401-5
• 17 Rentes AM, Gavião MB, Amaral JR. Bite force determination in children with primary dentition. J Oral Rehabil 2002; 29: 1174-80
• 18 Mountain G, Wood D, Toumba J. Bite force measurement in children with primary dentition. Int J Paediatr Dent 2011; 21: 112-8
• 19 Salameh Z, Sorrentino R, Papacchini F, Ounsi HF, Tashkandi E, Goracci C. et al. Fracture resistance and failure patterns of endodontically treated mandibular molars restored using resin composite with or without translucent glass fiber posts. J Endod 2006; 32: 752-5
• 20 Newman MP, Yaman P, Dennison J, Rafter M, Billy E. Fracture resistance of endodontically treated teeth restored with composite posts. J Prosthet Dent 2003; 89: 360-7
• 21 Nothdurft FP, Schmitt T, Motter PJ, Pospiech PR. Influence of fatigue testing and cementation mode on the load-bearing capability of bovine incisors restored with crowns and zirconium dioxide posts. Clin Oral Investig 2008; 12: 331-6
• 22 al-Hazaimeh N, Gutteridge DL. An in vitro study into the effect of the ferrule preparation on the fracture resistance of crowned teeth incorporating prefabricated post and composite core restorations. Int Endod J 2001; 34: 40-6
• 23 Usha M, Deepak V, Venkat S, Gargi M. Treatment of severely mutilated incisors: A challenge to the pedodontist. J Indian Soc Pedod Prev Dent 2007; 25 Suppl S34-6
• 24 Meng QF, Chen LJ, Meng J, Chen YM, Smales RJ, Yip KH. Fracture resistance after simulated crown lengthening and forced tooth eruption of endodontically-treated teeth restored with a fiber post-and-core system. Am J Dent 2009; 22: 147-50
• 25 Tang W, Wu Y, Smales RJ. Identifying and reducing risks for potential fractures in endodontically treated teeth. J Endod 2010; 36: 609-17
• 26 Fukuyama T, Oda S, Yamashita H, Sekiguchi H, Yakushiji M. Clinical survey on type of restoration in deciduous teeth. Bull Tokyo Dent Coll 2008; 49: 41-50.26