Computer-aided-design/computer-assisted-manufactured adhesive restoration of molars with a compromised cusp: effect of fiber-reinforced immediate dentin sealing and cusp overlap on fatigue strength.

Abstract

STATEMENT OF PROBLEM:

Cracked teeth may traditionally require the use of complete coverage crowns. Alternative conservative treatments involve the use of adhesive inlays/onlays with the possibility of including a fiber patch to reinforce the cracked cusp.

PURPOSE:

The purpose of this study was to evaluate the fatigue strength of compromised molars restored with computer-aided-design/computer-assisted-manufactured (CAD/CAM) composite resin inlays/onlays with and without fiber-reinforced immediate dentin sealing (IDS).

METHODS AND MATERIALS:

Large mesio-occluso-distal preparations with cracked/undermined palatal cusps were simulated on 40 extracted maxillary molars. All teeth received IDS (Optibond FL, Kerr, Orange, CA, USA), and composite resin (Paradigm MZ100, 3M-ESPE, St. Paul, MN, USA) inlays (N = 20) and onlays (N = 20). A fiber patch (Ribbond, Ribbond Inc., Seattle, WA, USA) was applied in half of the preparations. Restorations were adhesively luted with pre-heated composite resin (Z100, 3-M ESPE) and submitted to cyclic isometric loading at 5 Hz, starting with a load of 50 N (5,000 cycles), followed by stages of 150, 300, 450, 600, 750, 900, and 1,050 N at a maximum of 25,000 cycles each. Specimens were loaded until fracture or to a maximum of 180,000 cycles. Groups were compared using the life table survival analysis.

RESULTS:

Differences in survival probability were found (p = 0.04). The inlay group with fiber patch failed at an average load of 870 N, and none of the specimens withstood all 180,000 load cycles; survival rates of inlays and onlays without fibers, and onlays with fibers were 10, 30, and 50%, respectively.

CONCLUSIONS:

Onlays (with or without fibers) increased the fatigue resistance of compromised molars in this in vitro study.

• Authors: Pascal Magne, Luís L Boff, Elisa Oderich, Antônio C Cardoso
• Journal: Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.] (J Esthet Restor Dent) Vol. 24 Issue 2 Pg. 135-46 (Apr 2012) ISSN: 1708-8240 [Electronic] England
• PMID: 22524722 (Publication Type: Journal Article)
• Copyright: © 2011 Wiley Periodicals, Inc.

Chemical References

• Composite Resins
• Polyethylenes
• RIBBOND
• Resin Cements

Topics

• Composite Resins (chemistry)
• Computer-Aided Design
• Cracked Tooth Syndrome (therapy)
• Dental Prosthesis Design
• Dental Restoration Failure
• Dental Stress Analysis
• Humans
• Inlays
• Molar (injuries)
• Polyethylenes
• Resin Cements (therapeutic use)
• Survival Analysis
• Tooth Crown (injuries)