[Preparation for reconstruction of reduced crowns in nonvital teeth using para-pulpal posts].
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This pilot study concerned the cyclic fatigue of five different endodontic post systems (AccessPost(R), Flexi-Flange(R), Flexi-Post(R), ParaPost(R), and Vlock(R)) with four different core materials (Tytin(R) Silver amalgam, Ti-Core(R), Ketac-Silver(R) and G-C Miracle Mix(R)). In vitro cyclic fatigue was performed using a fatigue machine that simulates masticatory fatigue forces. An instantaneous force of 5 lb was applied to each post and core combination for a test configuration of 4 000 000 repetitions or until failure occurred. The type of failure and number of repetitions at failure was recorded for each sample tested. Two-way ANOVA was used to compare groups. All posts/core samples with Ti-Core and Tytin Silver amalgam completed the test configuration of 4 000 000 cycles without failures. All posts/core samples with Ketac-Silver failed before the 4 000 000 test cycle configuration, all as a result of core failures. All posts/core samples with G-C Miracle Mix failed in a similar way. The Newman-Keuls multiple comparison test illustrated that Ti-Core and Tytin Silver amalgam were similar to each other and were superior to both G-C Miracle Mix and Ketac-Silver. Similar fatigue test results are found in the literature.
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Fabrication of multiple direct cast dowel-and-core patterns is time-consuming and difficult because the clinician must assess the adequacy of the reduction of the final restoration and the path of insertion for the patterns. This article describes a technique for making impressions of multiple endodontically treated teeth for the indirect fabrication of cast dowel and cores, which are waxed up via three putty indexes obtained from the diagnostic waxup. This enables clinicians and technicians to communicate in a manner that facilitates predictable and consistent prosthetic therapy.
The restoration of root canal treated teeth--because of the significant loss of tooth structure--is often achieved with post and core. However, post may generate stresses which lead to vertical root fracture and loss of the tooth. Since post design, material used and the post space preparation has significant influence on vertical fracture prevalence, broad investigation is in progress to find out the optimum procedure. During the last decade new prefabricated passive posts were introduced for postendodontic restorations. In order to collect information clinical trials have been performed on the reconstruction of root canal treated teeth using carbon fibe posts (COMPOSIPOST, RTD, France; C-POST, Bisco, USA). Adhesive technique was applied to cement posts in the root canal and for composite core reconstruction. The physical properties of carbon fiber posts and the composite core are very close to those of dentin. Post application is simple, does not require special skill and for the patients means minimum hazard. The position of the posts was controlled by radiography. During the 24 months observation period no failure was registered in patients treated (n = 55). Hence, we attribute our good results to the homogeneous reconstruction of the teeth. This procedure seems to be a good alternative to traditional cast metal dowel/cores or metal prefabricated posts.
An unfilled Bis-GMA composite resin can be used advantageously for making an accurate cast post and core pattern. The technique is faster and easier than normal pattern fabrication methods using an unfilled acrylic resin, wax, or a combination of the two.
A method has been presented that minimizes coronal fracture of endodontically treated anterior teeth. Preparation of the headed post-core is practical because the techniques uses readily available materials and equipment.
There is not one post, core, or final restoration that can be used in all clinical situations. If this were the case, there would not be the need for the numerous books on restoration that have been written over the last 3 decades. This article has not discussed the merits and shortcomings of the numerous restorative concepts and techniques that exist, but rather has concentrated on those that we feel are valid and have application today. Dentistry, like the other health professions, does not have the luxury of being able to limit those variables that occur daily in our clinical practice. We must learn to work with these variables and spend less time trying to find the one that applies to all cases: the ideal restoration that can be produced for the masses. When we understand the basic concepts of how to retain the various restorative components and how to protect remaining tooth structure, our ability to answer the numerous questions that arise during the restorative process will be facilitated and will result in final restorations that are based on sound design principles.
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PURPOSE: The aim of this study was to evaluate the bond strengths between various resin composites used as core materials (Multicore Flow, Ivoclar-Vivadent; Tetric Flow, Ivoclar-Vivadent; Filtek Flow, 3M-ESPE; Tetric Ceram, Ivoclar-Vivadent; Filtek Z250, 3M-ESPE), and an FRC post (FRC Postec Plus, Ivoclar-Vivadent) by means of the microtensile nontrimming technique. MATERIALS AND METHODS: Five experimental groups were used. For the microtensile nontrimming technique, 45 to 50 beam-shaped specimens per group were obtained from cylinders of core material, which had been built up around the post by progressively adding small increments of composite resin. Each specimen was loaded in tension until failure at either one of the two post/core interfaces present in each stick. The differences in interfacial bond strength amongthe groups were tested for statistical significance with the one-way ANOVA test, followed by the Dunnett test for post-hoc comparisons. RESULTS: The measured bond strengths in MPa were 17.29 +/- 6.02 for FRC+MultiCore Flow, 16.37 +/- 6.92 for FRC+Tetric Flow, 13.14 +/- 5.35 for FRC + Filtek Flow, 12.38 +/- 4.34 for FRC + Tetric Ceram, and 10.75 +/- 5.43 for FRC + Filtek Z250. The statistical analysis revealed that MultiCore Flow achieved significantly higher bond strengths than Filtek Flow (p = 0.03), Tetric Ceram (p < 0.001), and Filtek Z250 (p < 0.001). The bond strength of Tetric Flow was significantly higher than that of Filtek Z250 (p = 0.003). CONCLUSION: For core buildup on a fiber post, dual-cure composites appear to be preferable to light-curing composites.
PURPOSE: 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. MATERIALS AND METHODS: 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. RESULTS: 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.
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Forty acrylic resin duplicates of an endodontically treated and extracted human molar were restored with two resin composite materials for core restorations. Two different manipulation techniques, bulk insertion and syringe application, were used. In a simulated clinical setup, the core buildups produced by the different manipulation techniques were investigated for voids. In 20 duplicates, a post was placed to simulate a metal post and resin composite core buildup. The syringe technique produced significantly fewer incorporated voids for both resin composite core materials than did the bulk insertion technique. It was not possible to demonstrate a relationship between the presence of voids and the presence of a metal post.