Strain measurements and fracture resistance of endodontically treated premolars restored with all-ceramic restorations. 2015

Liang Lin Seow, and Chooi Gait Toh, and Nairn H F Wilson
School of Dentistry, International Medical University, 126, Jalan Jalil Perkasa 19, 57000 Kuala Lumpur, Malaysia. Electronic address: lianglin_seow@imu.edu.my.

OBJECTIVE The aim of this study was to investigate the recovery of cuspal stiffness and fracture resistance in endodontically treated maxillary premolars restored with bonded ceramic inlays and onlays of various designs. METHODS Seventy intact premolars were selected for this study; six cavity designs were investigated: (i) mesio-occlusal-distal (MOD) inlay (I), (ii) MOD inlay with palatal cusp coverage (IPC), (iii) MOD onlay (O), (iv) MOD inlay with pulp chamber extension (IPE), (v) MOD inlay with palatal cusp coverage and pulp chamber extension (IPCPE), and (vi) MOD onlay with pulp chamber extension (OPE). Intact teeth acted as control. Strain gauges were attached to the buccal and palatal surfaces of the teeth to measure cuspal stiffness under static loading. All specimens were eventually subjected to compressive load to failure. Cuspal stiffness and fracture resistance data were analyzed using ANOVA and Tukey test. RESULTS The I and IPE restorations restored cuspal stiffness to 75% of the sound tooth value. The O and OPE restored teeth had stiffness values greater than that of a sound tooth. The I, IPC, O, IPE, IPCPE and OPE restored teeth demonstrated fracture strength values of 938N±113 N (s.d.), 1073N±176 N and 1317N±219 N, 893N±129 N, 1062N±153 N and 1347N±191 N respectively. CONCLUSIONS Within the limitations of this study, it was concluded that the all-ceramic onlay or inlay with palatal cusp coverage provided best biomechanical advantage in restoring an endodontically treated maxillary premolar tooth. CONCLUSIONS The onlay approach which is more conservative compared to full coverage restoration is considered an appropriate approach to the restoration of endodontically treated maxillary premolars. The addition of a pulpal extension to the all-ceramic restorations, apart from being technically challenging, was not found to offer any biomechanical advantage to the restored teeth.

UI MeSH Term Description Entries
D007284 Inlays Restorations of metal, porcelain, or plastic made to fit a cavity preparation, then cemented into the tooth. Onlays are restorations which fit into cavity preparations and overlay the occlusal surface of a tooth or teeth. Onlays are retained by frictional or mechanical factors. Dental Inlays,Dental Onlays,Onlays,Dental Inlay,Dental Onlay,Inlay, Dental,Inlays, Dental,Onlay, Dental,Onlays, Dental,Inlay,Onlay
D002516 Ceramics Products made by baking or firing nonmetallic minerals (clay and similar materials). In making dental restorations or parts of restorations the material is fused porcelain. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed & Boucher's Clinical Dental Terminology, 4th ed) Ceramic
D003737 Dental Cavity Preparation An operation in which carious material is removed from teeth and biomechanically correct forms are established in the teeth to receive and retain restorations. A constant requirement is provision for prevention of failure of the restoration through recurrence of decay or inadequate resistance to applied stresses. (Boucher's Clinical Dental Terminology, 4th ed, p239-40) Cavity Preparation, Dental,Cavity Preparations, Dental,Dental Cavity Preparations,Preparation, Dental Cavity,Preparations, Dental Cavity
D003776 Dental Porcelain A type of porcelain used in dental restorations, either jacket crowns or inlays, artificial teeth, or metal-ceramic crowns. It is essentially a mixture of particles of feldspar and quartz, the feldspar melting first and providing a glass matrix for the quartz. Dental porcelain is produced by mixing ceramic powder (a mixture of quartz, kaolin, pigments, opacifiers, a suitable flux, and other substances) with distilled water. (From Jablonski's Dictionary of Dentistry, 1992) Porcelain,Porcelain, Dental,Dental Porcelains,Porcelains,Porcelains, Dental
D003793 Dental Restoration, Permanent A restoration designed to remain in service for not less than 20 to 30 years, usually made of gold casting, cohesive gold, or amalgam. (Jablonski, Dictionary of Dentistry, 1992) Dental Fillings, Permanent,Dental Filling, Permanent,Dental Permanent Filling,Dental Permanent Fillings,Dental Restorations, Permanent,Filling, Dental Permanent,Filling, Permanent Dental,Fillings, Dental Permanent,Fillings, Permanent Dental,Permanent Dental Filling,Permanent Dental Fillings,Permanent Dental Restoration,Permanent Dental Restorations,Permanent Filling, Dental,Permanent Fillings, Dental,Restoration, Permanent Dental,Restorations, Permanent Dental
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001641 Bicuspid One of the eight permanent teeth, two on either side in each jaw, between the canines (CUSPID) and the molars (MOLAR), serving for grinding and crushing food. The upper have two cusps (bicuspid) but the lower have one to three. (Jablonski, Dictionary of Dentistry, 1992, p822) Premolar,Bicuspids,Premolars
D012390 Root Canal Therapy A treatment modality in endodontics concerned with the therapy of diseases of the dental pulp. For preparatory procedures, ROOT CANAL PREPARATION is available. Therapy, Root Canal,Canal Therapies, Root,Canal Therapy, Root,Root Canal Therapies,Therapies, Root Canal
D014082 Tooth Fractures Break or rupture of a tooth or tooth root. Fracture, Tooth,Fractures, Tooth,Tooth Fracture
D017220 Dentin-Bonding Agents Cements that act through infiltration and polymerization within the dentinal matrix and are used for dental restoration. They can be adhesive resins themselves, adhesion-promoting monomers, or polymerization initiators that act in concert with other agents to form a dentin-bonding system. Dentin Bonding Agent,Dentin-Bonding Agent,Bonding Agents, Dentin,Agent, Dentin Bonding,Agent, Dentin-Bonding,Agents, Dentin Bonding,Agents, Dentin-Bonding,Bonding Agent, Dentin,Dentin Bonding Agents

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