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Published on: December 20, 2024
Fracture Resistance of Endodontically Treated Premolars Reconstructed by Traditional Casting and CAD-CAM Milling Post
Davood Nodehi1, Azizollah Moraditalab1, Shahrzad Shafiee2
1Dental Research Center, Department of Prosthodontics, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
Purpose:
Restoration of endodontically treated premolars has always been considered as a challenging procedure. This study compared the fracture strength and mode of failure of root canal treated premolars reconstructed with various post and core systems.
Materials And Methods:
Twenty healthy extracted premolars were selected and underwent root canal treatment and then randomly assigned into 4 groups (n = 5). The teeth in group 1 restored with amalgam, whereas others reconstructed with post and cores made by cobalt-chromium (Co-Cr) casting (group 2), nonprecious gold (NPG) casting (group 3), or computer-aided design (CAD) and computer-aided manufacturing (CAM) milling (group 4). The force at fracture was measured in a universal testing machine, and the failure mode was recorded as repairable or nonrepairable.
Results:
ANOVA revealed a significant difference in fracture resistance between groups (P=0.001). The control group displayed significantly lower strength than that of the CAD-CAM or CO-Cr groups (P < 0.05). The CAD-CAM posts were also more resistant to fracture than the NPG group (P < 0.05). The frequencies of repairable fracture in the control, Co-Cr, NPG, and CAD-CAM groups were 40%, 20%, 20%, and 60%, respectively. The chi-square test revealed no significant difference in the distribution of failure modes between groups (P=0.415).
Conclusion:
The teeth reconstructed with post and cores were more resistant to fracture than those restored with amalgam alone. CAD-CAM milling could be considered as the best system for reconstruction of endodontically treated teeth, as it provided the highest fracture strength with less risk of nonrepairable tooth fracture.

