Fracture Resistance of CAD/CAM Tooth-colored Versus Cast Metal Post-and-core Restorations in Root Filled Teeth: An in Vitro Study

Overview

Journal Saudi Dent J

Specialty Dentistry

Date 2024 Sep 17

PMID 39286579

Authors

Buthaina Jrab

Abdul Rahman Saleh

Anas Al-Jadaa

Carlos A Jurado

Musab H Saeed

Kelvin I Afrashtehfar

Affiliations

Soon will be listed here.

Abstract

Purpose: This study investigated the fracture resistance and failure modes of custom-fabricated post- and core dental restorations using various CAD/CAM materials.

Materials And Methods: Seventy-five mandibular second premolars were allocated to five groups (n = 15) and prepared for standardized post and core restorations. The groups included a control group comprising cast metal and four CAD/CAM materials: Vita Enamic, Shofu HC, Trilor, and PEKK. Fracture resistance was assessed using a compressive force at a crosshead speed of 1 mm/min until failure occurred. Data were analyzed using one-way analysis of variance (ANOVA) and chi-square tests.

Results: The metal group had the highest fracture resistance (244.41 ± 75.20 N), with a significant variance compared to that in the CAD/CAM groups (p < 0.001). No significant differences were observed among the non-metallic groups.

Conclusions: While several CAD/CAM materials displayed satisfactory flexural properties, cast metal posts showed superior fracture resistance in endodontically treated teeth but were mostly associated with catastrophic failure. The clinical application of CAD/CAM materials for post-core restorations presents a viable alternative to traditional metal posts, potentially reducing the risk of unfavorable fractures.

Citing Articles

A Preliminary Stability Assessment of Three State-of-the-Art CAD/CAM Materials Under Human Gingival Cell Culture.

Gatin E, Iordache S, Iordache A, Totan Ripsvki A, Moldovan A, Luculescu C Polymers (Basel). 2025; 17(2).

PMID: 39861293 PMC: 11769571. DOI: 10.3390/polym17020221.

References

Bergman B, Lundquist P, Sjogren U, Sundquist G . Restorative and endodontic results after treatment with cast posts and cores. J Prosthet Dent. 1989; 61(1):10-5. DOI: 10.1016/0022-3913(89)90099-1. View

Stricker E, Gohring T . Influence of different posts and cores on marginal adaptation, fracture resistance, and fracture mode of composite resin crowns on human mandibular premolars. An in vitro study. J Dent. 2005; 34(5):326-35. DOI: 10.1016/j.jdent.2005.07.007. View

Mangold J, Kern M . Influence of glass-fiber posts on the fracture resistance and failure pattern of endodontically treated premolars with varying substance loss: an in vitro study. J Prosthet Dent. 2011; 105(6):387-93. DOI: 10.1016/S0022-3913(11)60080-2. View

Afrashtehfar K, Ahmadi M, Emami E, Abi-Nader S, Tamimi F . Failure of single-unit restorations on root filled posterior teeth: a systematic review. Int Endod J. 2016; 50(10):951-966. DOI: 10.1111/iej.12723. View

Plotino G, Grande N, Bedini R, Pameijer C, Somma F . Flexural properties of endodontic posts and human root dentin. Dent Mater. 2006; 23(9):1129-35. DOI: 10.1016/j.dental.2006.06.047. View

Soares C, Pizi E, Fonseca R, Martins L . Influence of root embedment material and periodontal ligament simulation on fracture resistance tests. Braz Oral Res. 2005; 19(1):11-6. DOI: 10.1590/s1806-83242005000100003. View

Weiser F, Behr M . Self-adhesive resin cements: a clinical review. J Prosthodont. 2014; 24(2):100-8. DOI: 10.1111/jopr.12192. View

Bru E, Forner L, Llena C, Almenar A . Fibre post behaviour prediction factors. A review of the literature. J Clin Exp Dent. 2014; 5(3):e150-3. PMC: 3892248. DOI: 10.4317/jced.50619. View

Salameh Z, Ounsi H, Aboushelib M, Sadig W, Ferrari M . Fracture resistance and failure patterns of endodontically treated mandibular molars with and without glass fiber post in combination with a zirconia-ceramic crown. J Dent. 2008; 36(7):513-9. DOI: 10.1016/j.jdent.2008.03.014. View

10.

Bilgin M, Erdem A, Dilber E, Ersoy I . Comparison of fracture resistance between cast, CAD/CAM milling, and direct metal laser sintering metal post systems. J Prosthodont Res. 2015; 60(1):23-8. DOI: 10.1016/j.jpor.2015.08.001. View

11.

He J, Zheng Z, Wu M, Zheng C, Zeng Y, Yan W . Influence of restorative material and cement on the stress distribution of endocrowns: 3D finite element analysis. BMC Oral Health. 2021; 21(1):495. PMC: 8491409. DOI: 10.1186/s12903-021-01865-w. View

12.

Rexhepi I, Santilli M, DAddazio G, Tafuri G, Manciocchi E, Caputi S . Clinical Applications and Mechanical Properties of CAD-CAM Materials in Restorative and Prosthetic Dentistry: A Systematic Review. J Funct Biomater. 2023; 14(8). PMC: 10455074. DOI: 10.3390/jfb14080431. View

13.

Alkhatri R, Saleh A, Kheder W . Evaluating Fracture Resistance And Failure Modes Of Root Filled Teeth Restored With CAD/CAM-Fabricated Post And Core. Clin Cosmet Investig Dent. 2019; 11:349-355. PMC: 6863363. DOI: 10.2147/CCIDE.S219712. View

14.

Pang J, Feng C, Zhu X, Liu B, Deng T, Gao Y . Fracture behaviors of maxillary central incisors with flared root canals restored with CAD/CAM integrated glass fiber post-and-core. Dent Mater J. 2018; 38(1):114-119. DOI: 10.4012/dmj.2017-394. View

15.

Awada A, Nathanson D . Mechanical properties of resin-ceramic CAD/CAM restorative materials. J Prosthet Dent. 2015; 114(4):587-93. DOI: 10.1016/j.prosdent.2015.04.016. View

16.

Anchieta R, Rocha E, Almeida E, Freitas Jr A, Martin Jr M, Martini A . Influence of customized composite resin fibreglass posts on the mechanics of restored treated teeth. Int Endod J. 2011; 45(2):146-55. DOI: 10.1111/j.1365-2591.2011.01955.x. View

17.

Rasimick B, Wan J, Musikant B, Deutsch A . A review of failure modes in teeth restored with adhesively luted endodontic dowels. J Prosthodont. 2010; 19(8):639-46. DOI: 10.1111/j.1532-849X.2010.00647.x. View

18.

Martinez-Insua A, da Silva L, Rilo B, Santana U . Comparison of the fracture resistances of pulpless teeth restored with a cast post and core or carbon-fiber post with a composite core. J Prosthet Dent. 1998; 80(5):527-32. DOI: 10.1016/s0022-3913(98)70027-7. View

19.

Barcellos R, Correia D, Farina A, Mesquita M, Ferraz C, Cecchin D . Fracture resistance of endodontically treated teeth restored with intra-radicular post: the effects of post system and dentine thickness. J Biomech. 2013; 46(15):2572-7. DOI: 10.1016/j.jbiomech.2013.08.016. View

20.

Teixeira K, Duque T, Maia H, Goncalves T . Fracture Resistance and Failure Mode of Custom-made Post-and-cores of Polyetheretherketone and Nano-ceramic Composite. Oper Dent. 2020; 45(5):506-515. DOI: 10.2341/19-080-L. View