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Fatigue performance of endodontically treated molars reinforced with different fiber systems

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Abstract

Objective

The aim was to investigate the fatigue performance of root canal-treated (RCT) molars restored with different direct restorations utilizing discontinuous and continuous fiber-reinforced composite (FRC) systems. The impact of direct cuspal coverage was also evaluated.

Materials and methods

One hundred and twenty intact third molars extracted for periodontal or orthodontic reasons were randomly divided into six groups (n=20). Standardized MOD, regular cavities for direct restorations were prepared in all specimens, and subsequently, root canal treatment and root canal obturation was carried out. After the endodontic treatment, the cavities were restored with different fiber-reinforced direct restorations as follows: SFC group (control), discontinuous short fiber-reinforced composite (SFC) without cuspal coverage (CC); SFC+CC group, SFC with cuspal coverage; PFRC group, transcoronal fixation with continuous polyethylene fibers without CC; PFRC+CC group, transcoronal fixation with continuous polyethylene fibers with CC; GFRC group, continuous glass FRC post without CC; and GFRC+CC, continuous glass FRC post with CC. All specimens underwent a fatigue survival test in a cyclic loading machine until fracture occurred or 40,000 cycles were completed. The Kaplan-Meier survival analysis was conducted, followed by pairwise log-rank post hoc comparisons between the individual groups (Mantel-Cox).

Results

The PFRC+CC group was characterized by significantly higher survival compared to all the groups (p < 0.05), except for the control group (p = 0.317). In contrast, the GFRC group showed significantly lower survival compared to all the groups (p < 0.05), except for the SFC+CC group (p = 0.118). The control group (SFC) showed statistically higher survival than the SFRC+CC group (p < 0.05) and GFRC group (p < 0.05), but it did not differ significantly from the rest of the groups in terms of survival.

Conclusions

Direct restorations utilizing continuous FRC systems (in the form of polyethylene fibers or FRC post) to restore RCT molar MOD cavities performed better in terms of fatigue resistance when CC was performed compared to the same FRC restorations without CC. On the contrary, teeth restored with SFC restorations performed better without CC compared to the ones where SFC was covered.

Clinical relevance

In the case of fiber-reinforced direct restorations for MOD cavities in RCT molars, direct CC is recommended when utilizing long continuous fibers for reinforcement, however, should be avoided when only SFC is used for their reinforcement.

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Data Availability

Data is contained within the article.

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Acknowledgements

We would like to thank the University of Szeged, Center of Excellence for Interdisciplinary Research, Development and Innovation, 3D Centre for their support in our research.

Funding

This study was supported by the Bolyai János Research Scholarship (BO/701/20/5), by the ÚNKP-22-3-SZTE, by the ÚNKP-22-4-SZTE, and by the ÚNKP-22-5-SZTE New National Excellence Program of The Ministry for Innovation and Technology from the Source of National Research, Development and Innovation Fund, Hungary, and also by the EU through the Economic Development and Innovation Operational Programme (GINOP-2.3.3-15-2016-00040).

Author information

Author notes

  1. András Volom and Eszter Vincze-Bandi contributed equally to this work.

Authors and Affiliations

  1. Volom Dental, Budapest, Hungary

    András Volom

  2. Dr. Borbáth Mosolyközpont, Hódmezővásárhely, Hungary

    Eszter Vincze-Bandi

  3. Faculty of Dentistry, Department of Operative and Esthetic Dentistry, University of Szeged, Szeged, Hungary

    Tekla Sáry, András Jakab & Márk Fráter

  4. The Alleman Center for Biomimetic Dentistry, Provo, UT, USA

    David Alleman

  5. Urban Regeneration Institute, Budapest, Hungary

    András Forster

  6. dicomLAB Dental Ltd., Szeged, Hungary

    Gábor Braunitzer

  7. Department of Biomaterials Science and Turku Clinical Biomaterials Center (TCBC), Institute of Dentistry, University of Turku, Turku, Finland

    Sufyan Garoushi

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  1. András Volom
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Contributions

Conceptualization, A.V. and M.F.; methodology, S.G. and M.F.; software, G.B.; validation, G.B., T.S., and M.F.; formal analysis, G.B.; investigation, E.V.-B. and T.S.; resources, M.F.; data curation, G.B.; writing—original draft preparation, E.V.-B., A.J., A.V., and M.F.; writing—review and editing, A.F., S.G., and M.F.; visualization, T.S.; supervision, S.G. and M.F.; project administration, A.J., D.A., and T.S.; funding acquisition, A.J. and M.F. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Márk Fráter.

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Ethical approval

The study was approved by the Ethics Committee of the University of Szeged (4029), and the study design conformed to the Declaration of Helsinki in all respects.

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The authors declare no competing interests.

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Volom, A., Vincze-Bandi, E., Sáry, T. et al. Fatigue performance of endodontically treated molars reinforced with different fiber systems. Clin Oral Invest 27, 3211–3220 (2023). https://doi.org/10.1007/s00784-023-04934-2

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