Strength of core build-up materials in endodontically treated teeth

To compare the in vitro strength of a reinforced glass ionomer and a light-cured glass ionomer used as an alternative to amalgam in core construction to restore endodontically treated mandibular molar teeth.

The root canals of 120 extracted human mandibular molar teeth were prepared chemomechanically and obturated with laterally condensed cold gutta-percha. The crown of each tooth was sectioned leaving only one cusp standing. Gutta-percha was removed from the pulp chamber in all teeth. The volume of the pulp chamber was measured and the teeth ranked in ascending order of chamber volume. The specimens were divided into six groups of 20, allocating teeth with similar chamber volumes into each group. In three of the groups, gutta-percha was removed from the coronal 3-4 mm of each root canal. The teeth were restored with one of three materials, a cermet cement (Ketac-Silver), a resin-reinforced glass ionomer (Vitremer), or amalgam (Contour). Core preparation was carried out after 48 hours, reducing each core height to 6 mm. The specimens were thermocycled for 24 hours and then mounted in dental stone. A control group of 20 unrestored human mandibular molars was mounted in cold cure acrylic. Each tooth was tested in a Nene machine with a compressive load applied at 90 degrees to the occlusal surface at a crosshead speed of 5 mm/minute.

There was no statistically significant difference between the experimental groups (P > 0.05), but the control group was significantly stronger (P < 0.001). Extension of core material into the coronal root canal system did not increase the fracture resistance of any of the experimental materials. Regression analysis of the results revealed no correlation between the volume of the pulp chamber and the load to fracture.