Stiffness of Endodontically-treated Teeth Related to Restoration Technique

Abstract

Endodontically-treated posterior teeth are susceptible to fracture; consequently, full-occlusal-coverage restorations are recommended. We designed this study to examine the potential for alternative restorative techniques for pulpless teeth, using strain gauges mounted on extracted maxillary second premolars to measure strains generated by nondestructive occlusal loading. Cuspal stiffness was evaluated on the following sequentially performed procedures: unaltered tooth, completion of all endodontic procedures, appropriate restorative preparation, and restoration. The restorative procedures evaluated were: (1) amalgam, (2) cast gold onlay, (3) composite restoration with enamel etch, and (4) composite restoration with enamel and dentin etch. Finally, all teeth were loaded to fracture. Cast gold was the strongest restorative material tested (2.11 relative stiffness, compared with that of the unaltered tooth at 1.00), and amalgam was the weakest (0.35 relative stiffness). Composite restoration and enamel plus dentin etch were almost as strong as the unaltered tooth (0.87 relative stiffness), while enamel-etch-only yielded lower stiffness (0.51).

Get full access to this article

View all access options for this article.

References

Anderson, D.J. (1956a): Measurement of Stress in Mastication I, J Dent Res 35:664-670.

Anderson, D.J. (1956b): Measurement of Stress in Mastication II, J Dent Res 35:671-673.

Carter, J.M. ; Sorensen, S.E. ; Johnson, R.L. ; Teitel-Baum, R.L. ; and Levine, M.S. (1983): Punch Shear Testing of Extracted Vital and Endodontically Treated Teeth, J Biomech 16:841-848.

Colton, T. (1974): Clinical Trials. In: Statistics in Medicine, Boston: Little, Brown and Company, Inc., Chap. 10, p. 253.

Deboever, J.A. ; McCall, W.D. ; Holden, S. ; and Ash , M.M. (1978): Functional Occlusal Forces: An Investigation by Telemetry, J Prosthet Dent 40:326-333.

Delong, R. and Douglas, W.H. (1983): Development of an Artificial Oral Environment for the Testing of Dental Restoratives: Bi-axial Force and Movement Control , J Dent Res 62:32-36.

Eakle, W.S. (1986a): Fracture Resistance of Teeth Restored with Class II Bonded Composite Resin, J Dent Res 65:149-153.

Eakle, W.S. (1986b): Increased Fracture Resistance of Teeth: Comparison of Five Bonded Posterior Composite Systems, Quintessence Int 17:17-20.

Gelb, M.N. ; Barouch, E. ; and Simonsen, R.J. (1986): Resistance to Cusp Fracture in Class II Prepared and Restored Premolars, J Prosthet Dent 55:184-185.

10.

Gibbs, C.H. ; Mahan, P.E. ; Lundeen, H.C. ; Brehnan, K. ; Walsh, E.K. ; and Holbrook, W.B. (1981): Occlusal Forces During Chewing and Swallowing as Measured by Sound Transmission, J Prosthet Dent 46:443-448.

11.

Gwinnett, A.J. (1977): The Morphologic Relationship Between Dental Resins and Etched Dentin, J Dent Res 56:1155-1160.

12.

Helkimo, E. and Ingervall, B. (1978): Bite Force and Functional State of the Masticatory System in Young Men, Swed Dent J 2:167-175.

13.

Hood, J.A.A. (1985): Methods to Improve Fracture Resistance of Teeth . In: International Symposium on Posterior Composite Resin Dental Restorative Materials, G. Vanherle and D.C. Smith, Eds., St. Paul, MN: 3M, pp. 443-450.

14.

Ingle, J.I. and Taintor, J.F. (1985): Endodontic Cavity Preparation. In: Endodontics, 3rd ed., Philadelphia : Lea and Febiger, pp. 138-141.

15.

Lewinstein, I. and Grajower, R. (1981): Root Dentin Hardness of Endodontically Treated Teeth, J Endod 7:421-422.

16.

Mondelli, J. ; Steagall, L. ; Ishikiriama, A. ; Navarro, M.F.L. ; and Soares, F.B. (1980): Fracture Strength of Human Teeth with Cavity Preparations , J Prosthet Dent 43:419-422.

17.

Morin, D. ; Delong, R. ; and Douglas, W.H. (1984): Cusp Reinforcement by the Acid-Etch Technique , J Dent Res 63 :1075-1078.

18.

Munechika, T. ; Iizuka, H. ; Sudo, T. ; Nasu, T. ; Nishi-Yama, M. ; and Ohashi, M. (1984): Tensile Bond Strengths of Restorative Composite Materials to Etched Human Dentin, J Nihon Univ Sch Dent 26:291-294.

19.

Ross, I.F. (1980): Fracture Susceptibility of Endodontically Treated Teeth, J Endod 6:560-565.

20.

Salis, S.G. ; Hood, J.A.A. ; Stokes, A.N. ; and Kirk, E.E.J. (1987): Patterns of Indirect Fracture in Intact and Restored Human Premolar Teeth, Endod Dent Traumatol 3:10-14.

21.

Sorenson, J.A. and Martinoff, J.T. (1984): Intracoronal Reinforcement and Coronal Coverage: A Study of Endodontically Treated Teeth, J Prosthet Dent 51:780-784.

22.

Sorenson, J.A. and Martinoff, J.T. (1985): Endodontically Treated Teeth as Abutments, J Prosthet Dent 53:631-636.

23.

Trope, M. ; Langer, I. ; Maltz, D. ; and Tronstad, L. (1986): Resistance to Fracture of Restored Endodontically Treated Premolars, Endod Dent Traumatol 2:35-38.

24.

Wendt, S.L., Jr. ; Harris, B.M. ; and Hunt, T.E. (1987): Resistance to Cusp Fracture in Endodontically Treated Teeth, Dent Mater 3:232-235.