In the world of dental restoration, endocrowns have emerged as a promising alternative to traditional post-and-core treatments. These conservative restorations rely on the pulp chamber for retention, offering a more natural and minimally invasive approach. However, the choice of material used to fabricate endocrowns can significantly impact their long-term performance and survival. In a recent in-vitro study, researchers delved into the tensile strength of endocrowns created from various computer-aided design and manufacturing (CAD-CAM) materials, shedding light on their potential for clinical success. Join us as we explore the fascinating findings of this research and uncover the insights that could revolutionize the way we approach endocrown restorations.
Endocrowns: A Promising Solution for Damaged Teeth
Endocrowns are a unique type of dental restoration that have gained increasing attention in the field of restorative dentistry. Unlike traditional post-and-core treatments, which involve drilling into the root canal to create a space for a post, endocrowns rely on the natural pulp chamber for retention. This approach preserves more of the tooth structure, making it a more conservative and minimally invasive option. However, the success of endocrowns is heavily dependent on the materials used to fabricate them.
Exploring the Tensile Strength of CAD-CAM Materials
In the recent study, researchers compared the tensile strength of endocrowns fabricated from three different CAD-CAM materials: lithium disilicate glass-ceramic (e.max CAD), resin-modified ceramic (HC), and reinforced composite (Brilliant Crios). Sixty human mandibular third molars were divided into three groups, and the endocrowns were fabricated and cemented using a self-adhesive resin cement.
After undergoing thermal cycling to simulate the conditions of the oral cavity, the endocrowns were subjected to a tensile force test using a universal testing machine. The results were quite revealing:
Lithium Disilicate Shines with Highest Tensile Strength
The endocrowns fabricated from lithium disilicate glass-ceramic (e.max CAD) showed the highest mean tensile force value, significantly outperforming the other two materials. This finding suggests that lithium disilicate endocrowns may have a promising impact on the long-term survival of these restorations.
Resin-Modified Ceramic and Reinforced Composite Lag Behind
The endocrowns made from resin-modified ceramic (HC) and reinforced composite (Brilliant Crios) exhibited lower tensile force values compared to the lithium disilicate group. The researchers attributed this to the lack of chemical bonds between the materials and the adhesive resin cement, as well as the susceptibility of these materials to surface fatigue and fracture under tensile loads.
Failure Modes Reveal Material-Specific Behaviors
The study also examined the failure modes of the endocrowns, providing insights into the materials’ performance. Lithium disilicate endocrowns predominantly exhibited adhesive and cohesive failures, suggesting a strong bond between the restoration and the tooth structure. In contrast, the resin-modified ceramic and reinforced composite endocrowns were more prone to adhesive failures, indicating weaker bonding at the restoration-tooth interface.
Implications for Clinicians and Patients
The findings of this study have important implications for clinicians and patients alike. Lithium disilicate endocrowns, with their superior tensile strength, may offer a more reliable and long-lasting solution for extensively damaged molars. However, the choice of material should also consider the priority – whether it is preserving the tooth structure or ensuring the longevity of the restoration.
Pushing the Boundaries of Endocrown Research
While this study provides valuable insights, the researchers acknowledge the limitations of an in-vitro setting. Further investigations, including long-term clinical studies, are necessary to fully understand the performance of these materials in real-world scenarios. As the field of dental restoration continues to evolve, researchers and clinicians alike are committed to pushing the boundaries and finding the most effective solutions for their patients.
Author credit: This article is based on research by Ahmed Ismail Taha, Aya Ehab Saad.
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