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CAD/CAM Polymer vs Direct Composite Resin Core Buildups for Endodontically Treated Molars Without Ferrule
Operative Dentistry
|August 13, 2015
Summary
High-performance polymer core buildups significantly improved the fatigue resistance of glass ceramic crowns on endodontically treated teeth without a ferrule effect. Fiber-reinforced posts did not impact the crowns' survival rates.
Area of Science:
- Dental Materials Science
- Biomaterials Engineering
- Restorative Dentistry
Background:
- Restoring endodontically treated teeth without a ferrule effect presents a clinical challenge.
- All-ceramic crowns are esthetic but may lack sufficient fracture resistance in compromised teeth.
- Core buildup materials play a crucial role in the longevity of crown restorations.
Purpose of the Study:
- To evaluate the effectiveness of different core buildup materials for restoring endodontically treated molars lacking a ferrule effect.
- To compare the fatigue performance of glass ceramic crowns supported by high-performance polymer versus composite resin core buildups.
- To assess the influence of a glass-fiber-reinforced post on the fatigue strength of these restorations.
Main Methods:
- Forty-five endodontically treated teeth without ferrule were restored with semidirect computer-aided design/computer-aided manufacturing (CAD/CAM) high-performance polymer (HPP) or direct light-curing composite resin (Tetric EvoCeram) buildups, with or without a fiber post.
- All teeth received bonded glass ceramic crowns and underwent accelerated fatigue testing under cyclic isometric loading.
- Survival analysis and fracture load comparisons were performed using log rank and ANOVA tests.
Main Results:
- No specimens survived the maximum 185,000 cycles.
- The HPP group exhibited significantly higher mean fracture loads (975.27N) and survived cycles compared to both composite groups (TEC: 716.87N; TECP: 745.67N).
- No significant difference was found between the two composite groups (p=0.884), and the TECP group showed initial marginal gap failures.
Conclusions:
- Semidirect high-performance polymer core buildups enhance the fatigue performance of all-ceramic crowns on teeth without a ferrule.
- Direct composite resin core buildups, with or without fiber posts, offer inferior fatigue resistance.
- Fiber-reinforced posts do not significantly influence the fatigue strength of these all-ceramic crown restorations.
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