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The fracture strength of endocrowns manufactured from different hybrid blocks under axial and lateral forces

Abstract

Aim

This in vitro study was conducted to compare the fracture strength of endocrowns manufactured from different hybrid blocks under axial and lateral forces.

Material and methods

Following root-canal treatment, 100 permanent mandibular first molars were randomly distributed among 5 groups according to restoration material. Endocrown restorations were produced from IPS e.max CAD (IPS), Vita Enamic (VE), GC Cerasmart (GC), Shofu (SH), and Brilliant Crios (BC) using CAD/CAM technology. Specimens were cemented, subjected to artificial aging, and further divided into 2 subgroups (n = 10) per group for fracture testing. Each specimen was placed on a universal testing machine and subjected to axial or lateral forces applied at a crosshead speed of 1 mm/min. Fracture data were analyzed using one-way ANOVA, Tukey, Tamhane T2, and Weibull tests.

Results

Statistically significant differences in fracture-strength (FS) values under axial and lateral forces were observed among the groups (P < 0.05). Group BC had the highest FS value under axial forces, whereas group IPS had the highest FS value under lateral forces. According to Weibull analysis, VE exhibited the highest reliability under axial forces (7.62), whereas IPS exhibited the highest reliability under lateral forces (4.68). No statistically significant differences were detected in the distribution of failure types under either axial or lateral forces among the groups (P > 0.05).

Conclusion

All of the hybrid blocks tested showed sufficient fracture strength for use as CAD/CAM-fabricated endocrowns.

Clinical relevance

Hybrid blocks can be used as an alternative to lithium disilicate blocks in endocrown restorations.

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References

  1. Ray HA, Trope M (1995) Periapical status of endodontically treated teeth in relation to the technical quality of the root canal filling and the coronal restoration. Int Endod J 28:12–18

    Article  Google Scholar 

  2. Robbins JW (2002) Restoration of the endodontically treated tooth. Dent Clin N Am 46:367–384

    Article  Google Scholar 

  3. Sedrez-Porto JA, da Rosa WLDO, da Silva AF, Münchow EA, Pereira-Cenci T (2016) Endocrown restorations: a systematic review and meta-analysis. J Dent 52:8–14. https://doi.org/10.1016/j.jdent.2016.07.005

    Article  PubMed  Google Scholar 

  4. Pissis P (1995) Fabrication of a metal-free ceramic restoration utilizing the monobloc technique. Pract Periodontics Aesthet Dent 7:83–94

    PubMed  Google Scholar 

  5. Bindl A, Mormann WH (1999) Clinical evaluation of adhesively placed Cerec endo-crowns after 2 years-preliminary results. J Adhes Dent 1:255–266

    PubMed  Google Scholar 

  6. Gresnigt MM, Özcan M, van den Houten ML, Schipper L, Cune MS (2016) Fracture strength, failure type and Weibull characteristics of lithium disilicate and multiphase resin composite endocrowns under axial and lateral forces. Dent Mater 32:607–614. https://doi.org/10.1016/j.dental.2016.01.004

    Article  PubMed  Google Scholar 

  7. Rocca GT, Sedlakova P, Saratti CM, Sedlacek R, Gregor L, Rizcalla N, Feilzer AJ, Krejci I (2016) Fatigue behavior of resin-modified monolithic CAD–CAM RNC crowns and endocrowns. Dent Mater 32:338–350. https://doi.org/10.1016/j.dental.2016.09.024

    Article  Google Scholar 

  8. Liu PR (2005) A panorama of dental CAD/CAM restorative systems. Compend 26:507–513

    Google Scholar 

  9. Zhi L, Bortolotto T, Krejci I (2016) Comparative in vitro wear resistance of CAD/CAM composite resin and ceramic materials. J Prosthet Dent 115:199–202. https://doi.org/10.1016/j.prosdent.2015.07.011

    Article  PubMed  Google Scholar 

  10. Altier M, Erol F, Yildirim G, Dalkilic EE (2018) Fracture resistance and failure modes of lithium disilicate or composite endocrowns. Niger J Clin Pract 21:821–826

    PubMed  Google Scholar 

  11. Spitznagel FA, Horvath SD, Guess PC, Blatz MB (2014) Resin bond to indirect composite and new ceramic/polymer materials: a review of the literature. J Esthet Restor Dent 26:382–393. https://doi.org/10.1111/jerd.12100

    Article  PubMed  Google Scholar 

  12. Awada A, Nathanson D (2015) Mechanical properties of resin-ceramic CAD/CAM restorative materials. J Prosthet Dent 114:587–593. https://doi.org/10.1016/j.prosdent.2015.04.016

    Article  PubMed  Google Scholar 

  13. Stawarczyk B, Liebermann A, Eichberger M, Güth JF (2016) Evaluation of mechanical and optical behavior of current esthetic dental restorative CAD/CAM composites. J Mech Behav Biomed Mater 55:1–11. https://doi.org/10.1016/j.jmbbm.2015.10.004

    Article  Google Scholar 

  14. Hampe R, Theelke B, Lümkemann N, Eichberger M, Stawarczyk B (2019) Fracture toughness analysis of ceramic and resin composite CAD/CAM material. Oper Dent 44:190–201. https://doi.org/10.2341/18-161-l

    Article  Google Scholar 

  15. Matzinger M, Hahnel S, Preis V, Rosentritt M (2018) Polishing effects and wear performance of chairside CAD/CAM materials. Clin Oral Investig 23:725–737. https://doi.org/10.1007/s00784-018-2473-3

    Article  PubMed  Google Scholar 

  16. Belleflamme MM, Geerts SO, Louwette MM, Grenade CF, Vanheusden AJ, Mainjot AK (2017) No post-no core approach to restore severely damaged posterior teeth: an up to 10-year retrospective study of documented endocrown cases. J Dent 63:1–7. https://doi.org/10.1016/j.jdent.2017.04.009

    Article  PubMed  Google Scholar 

  17. Dejak B, Młotkowski A (2018) Strength comparison of anterior teeth restored with ceramic endocrowns vs custom-made post and cores. J Prosthodont Res 62:171–176. https://doi.org/10.1016/j.jpor.2017.08.005

    Article  PubMed  Google Scholar 

  18. Kanat Ertürk B, Saridağ S, Köseler E, Helvacioğlu Yiğit D, Avcu E, Yildiran Avcu Y (2018) Fracture strengths of endocrown restorations fabricated with different preparation depths and CAD/CAM materials. Dent Mater J 37:256–265. https://doi.org/10.4012/dmj.2017-035

    Article  PubMed  Google Scholar 

  19. Lin CL, Chang YH, Pai CA (2011) Evaluation of failure risks in ceramic restorations for endodontically treated premolar with MOD preparation. Dent Mater 27:431–438. https://doi.org/10.1016/j.dental.2010.10.026

    Article  PubMed  Google Scholar 

  20. Guo J, Wang Z, Li X, Sun C, Gao E, Li H (2016) A comparison of the fracture resistances of endodontically treated mandibular premolars restored with endocrowns and glass fiber post-core retained conventional crowns. J Adv Prosthodont 8:489–493. https://doi.org/10.4047/jap.2016.8.6.489

    Article  PubMed  PubMed Central  Google Scholar 

  21. Aktas G, Yerlikaya H, Akca K (2016) Mechanical failure of endocrowns manufactured with different ceramic materials: an in vitro biomechanical study. J Prosthodont 27:340–346. https://doi.org/10.1111/jopr.12499

    Article  PubMed  Google Scholar 

  22. Carvalho AO, Bruzi G, Anderson RE, Maia HP, Giannini M, Magne P (2016) Influence of adhesive core buildup designs on the resistance of endodontically treated molars restored with lithium disilicate CAD/CAM crowns. Oper Dent 41:76–82. https://doi.org/10.2341/14-277-l

    Article  PubMed  Google Scholar 

  23. Bindl A, Richter B, Mörmann W (2005) Survival of ceramic computer-aided design/manufacturing crowns bonded to preparations with reduced macroretention geometry. Int J Prosthodont 18:219–224

    PubMed  Google Scholar 

  24. Hayes A, Duvall N, Wajdowicz M, Roberts H (2017) Effect of endocrown pulp chamber extension depth on molar fracture resistance. Oper Dent 42:327–334. https://doi.org/10.2341/16-097-l

    Article  PubMed  Google Scholar 

  25. Soares CJ, Pizi ECG, Fonseca RB, Martin LRM (2005) Influence of root embedment material and periodontal ligament simulation on fracture resistance tests. Braz Oral Res 19:11–16

    Article  Google Scholar 

  26. Skouridou N, Pollington S, Rosentritt M, Tsitrou E (2013) Fracture strength of minimally prepared all-ceramic CEREC crowns after simulating 5 years of service. Dent Mater 29:70–77. https://doi.org/10.1016/j.dental.2013.03.019

    Article  Google Scholar 

  27. Chang CY, Kuo JS, Lin YS, Chang YH (2009) Fracture resistance and failure modes of CEREC endo-crowns and conventional post and core-supported CEREC crowns. J Dental Sci 4:110–117

    Article  Google Scholar 

  28. Ramírez-Sebastià A, Bortolotto T, Cattani-Lorente M, Giner L, Roig M, Krejci I (2014) Adhesive restoration of anterior endodontically treated teeth: influence of post length on fracture strength. Clin Oral Investig 18:545–554. https://doi.org/10.1007/s00784-013-0978-3

    Article  PubMed  Google Scholar 

  29. Marchionatti AME, Wandscher VF, Broch J, Bergoli CD, Maier J, Valandro LF, Kaizer OB (2014) Influence of periodontal ligament simulation on bond strength and fracture resistance of roots restored with fiber posts. J Appl Oral Sci 22:450–458. https://doi.org/10.1590/1678-775720140067

    Article  PubMed  PubMed Central  Google Scholar 

  30. Varga S, Spalj S, Lapter Varga M, Anic Milosevic S, Mestrovic S, Slaj M (2011) Maximum voluntary molar bite force in subjects with normal occlusion. Eur J Orthod 33:427–433. https://doi.org/10.1093/ejo/cjq097

    Article  PubMed  Google Scholar 

  31. Jassim ZM, Majeed MA (2018) Comparative evaluation of the fracture strength of monolithic crowns fabricated from different all-ceramic CAD/CAM materials (an in vitro study). Biomed Pharmacol J 11:1689–1697

    Article  Google Scholar 

  32. Matinlinna JP, Lung CYK, Tsoi JKH (2018) Silane adhesion mechanism in dental applications and surface treatments: A review. Dent Mater 34:13–28. https://doi.org/10.1016/j.dental.2017.09.002

    Article  PubMed  Google Scholar 

  33. Yamaguchi S, Inoue S, Sakai T, Abe T, Kitagawa H, Imazato S (2017) Multi-scale analysis of the effect of nano-filler particle diameter on the physical properties of CAD/CAM composite resin blocks. Comput Method Biomec 20:714–719. https://doi.org/10.1080/10255842.2017.1293664

    Article  Google Scholar 

  34. El Ghoul W, Özcan M, Silwadi M, Salameh Z (2019) Fracture resistance and failure modes of endocrowns manufactured with different CAD/CAM materials under axial and lateral loading. J Esthet Restor Dent 31:378–387. https://doi.org/10.1111/jerd.12486

    Article  PubMed  Google Scholar 

  35. Nguyen HH, Fong H, Paranjpe A, Flake NM, Johnson JD, Peters OA (2014) Evaluation of the resistance to cyclic fatigue among ProTaper Next, ProTaper Universal, and Vortex Blue rotary instruments. J Endod 40:1190–1193. https://doi.org/10.1016/j.joen.2013.12.033

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors wish to thank GC Group, Shofu Dental, and Coltene Group for their experimental support.

Funding

This study was funded by the Scientific Research Projects Support Commission of Ondokuz Mayis University (grant No. PYO. DIS.1904.18.005).

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Correspondence to Duygu Hazal Acar.

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The study was approved by the Ondokuz Mayis University Institutional Review Board’s Human Ethics Committee (OMU-TAEK 2017/92).

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Acar, D.H., Kalyoncuoğlu, E. The fracture strength of endocrowns manufactured from different hybrid blocks under axial and lateral forces. Clin Oral Invest 25, 1889–1897 (2021). https://doi.org/10.1007/s00784-020-03495-y

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  • DOI: https://doi.org/10.1007/s00784-020-03495-y

Keywords

  • CAD/CAM
  • Endocrown
  • Fracture strength
  • Hybrid block