Bond strength of various post-core restorations with different lengths and diameters following cycle loading

This in vitro study aims to evaluate the bonding strengths of Polyether ether ketone (PEEK), Polyether ketone (PEKK), Fiber, and Zirconia (ZrO₂) post-core restorations with posts in different diameter and length following chewing simulator.

Endodontic treatment was performed on 256 intact maxillary central teeth. The test specimens were prepared in four groups according to the types of materials: Glass fiber post-composite core (FB-n:64), Zirconia post-core (Zr-n:64), PEEK post-core (PE-n:64), and PEKK post-core (PK-n:64). The groups were divided into four subgroups according to diameter and length (n:16): Group 1: 10 mm length 1.75 mm diameter, Group 2: 10 mm length 1.5 mm diameter, Group 3: 7 mm length 1.75 mm diameter, Group 4: 7 mm length 1.5 mm diameter. Custom PEKK, PEEK, Zirconia post-cores, and Zirconia crowns were milled on the CAD/CAM. The post-cores and crowns were cemented to the teeth with dual-cure resin cement. After that, all subgroups were divided into control and cyclic loading groups. During the cycling, the control test group was kept in distilled water at 37±1^oC before the push-out test. Half of the specimens were loaded with 250,000 cycles and 50 N with a chewing simulator. All test specimens had 1.5 mm sections taken from their roots. Then, the push-out test was applied to these sections for bond strength. Data were analyzed by Mann-Whitney U test, Shapiro-Wilk, Kruskal-Wallis's test, and Chi-Square. The statistical significance level was determined as 0.05.

The bond strength of all test groups decreased after the cycling loading. The bond strength values of zirconia posts showed a statistically significant difference (p < 0.05). The 10 mm length 1.75 mm diameter posts made of Zirconium had the highest bond strength observed in all control and cyclic loading groups of test specimens (9.74 MPa-6.25 MPa). The PEEK test specimens with a 7 mm length and 1.75 mm diameter showed the weakest bond strength in all control and cyclic loading groups (5.44 MPa-3.37 MPa). The average of the cervical region's bond strength values was statistically significantly higher than the apical region (p < 0.05).

Within the limitations of this study, one-piece custom-milled Zirconia post-cores appear promising, as they perform well under functional forces, especially in the anterior region. In addition, custom-milled PEKK post-cores might be considered a suitable alternative to prefabricated fiber-reinforced posts.