Biomechanical behavior of endodontically treated premolars using different preparation designs and cad/cam materials
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Universidade Federal de Minas Gerais
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Artigo de periódico
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Objectives: To evaluate the effect of restoration design (‘2.5-mm deep endocrown’, ‘5-mm deep
endocrown’ or ‘5-mm deep post&crown’) and CAD/CAM material type (composite or lithium disilicate
glass-ceramic) on the load-to-failure of endodontically treated premolars in absence of any ferrule.
Methods: The crowns of 48 single-rooted premolars were cut and the roots were endodontically treated.
Teeth were randomly divided into six groups (n = 8); teeth in each group were restored using one of the
two tested materials with standardized CAD/CAM fabricated endocrowns (with either 2.5-mm or 5-mm
deep intra-radicular extension) or conventional crowns (5-mm deep post&crown). After cementation
using luting composite, the specimens were immersed in distilled water and subjected to 1,200,000
chewing cycles with a load of 50 N applied parallel to the long axis of the tooth (0 ). After cyclic loading, a
compressive load was applied at 45 to the tooth’s long axis using a universal testing machine until
failure. Load-to-failure was recorded (N) and the specimens were examined under a stereomicroscope
with 3.5x magnification to determine the mode of failure.
Results: All specimens survived the 1,200,000 chewing cycles. A significant interaction between
restoration design and CAD/CAM material was found using two-way ANOVA. In the ‘2.5-mm deep
endocrown’ groups, the composite achieved a significantly higher load-to-failure than the lithium
disilicate glass-ceramic, while no differences between materials were found in the ‘5-mm deep
endocrown’ and ‘5-mm deep post&crown’ groups. More unfavorable failures (root fractures) were
observed for higher load-to-failure values.
Conclusions: Only following a ‘2.5-mm deep endocrown’ design, composite appeared more favorable than
lithium disilicate glass-ceramic as crown material; this may be explained by their difference in elastic
modulus.
Clinical significance: Shallow endocrown preparations on premolars present less surface for adhesive
luting and a difference in crown material becomes apparent in terms of load-to-failure. The use of a more
flexible composite crown material appeared then a better option
Abstract
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Endodontics, Bicuspid, Tooth crown
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https://www.sciencedirect.com/science/article/pii/S0300571217300362?via%3Dihub