Post and Core Technique

后与核心技术
  • 文章类型: Case Reports
    背景:具有广泛牙齿缺损的多根牙通常面临稳定性和生物力学失败的挑战。高性能聚合物PEEK材料,属性更接近牙本质,在减少应力集中和保持牙齿结构方面显示出希望。本报告旨在探索使用高保持性聚醚醚酮(PEEK)制造定制的分裂柱和核,以恢复严重破坏的牙髓治疗磨牙。
    方法:一名40岁女性患者主诉下颌后牙的牙齿物质丢失。此案例涉及PEEK分裂柱和核心的数字设计和制造,以恢复牙齿组织残留物不足的多根磨牙。使用世界联合会标准(FDI)在3年的随访中对修复进行了评估。修复通过口腔内检查进行临床评估,射线照相评估,和患者的主观满意度,根据FDI标准被认为是临床良好的。
    结论:PEEK的优异机械性能,再加上分裂柱的结构,为弱化的多根牙齿提供有效的治疗选择。同时,恢复配置有效地解决了不同插入后方向的挑战,主柱和辅助柱之间的互锁机制增强了柱和芯的稳定性。
    BACKGROUND: Multi-rooted teeth with extensive dental defects often face challenges in stability and biomechanical failure. High-performance polymer PEEK materials, with properties closer to dentin, show promise in reducing stress concentration and preserving tooth structure. This report aimed to explore the use of a highly retentive polyetheretherketone (PEEK) for manufacturing custom-made split post and core for the restoration of grossly destroyed endodontically treated molars.
    METHODS: A 40-year-old female patient presented with complaints of loss of tooth substance in the posterior mandibular tooth. This case involved the digital design and fabrication of PEEK split post and core to restore multirooted molar with insufficient dental tissue remnants. The restorations were evaluated over a 3-year follow-up using the World Federation criteria (FDI). The restoration was clinically evaluated through intraoral examination, radiographic assessment, and subjective patient satisfaction, and was deemed clinically good according to FDI criteria.
    CONCLUSIONS: The outstanding mechanical properties of PEEK, coupled with the structure of the split post, provide an effective treatment option for weakened multirooted teeth. Simultaneously, the restoration configuration effectively addressed the challenge of varying postinsertion directions, and the interlocking mechanism between the primary and auxiliary posts enhanced the stability of the post and core.
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  • 文章类型: Journal Article
    目的:本研究旨在研究不同加固技术对纤维桩对过度扩张根管的挤出粘结强度的影响。材料和方法:对48颗拔除的人单管前磨牙进行牙髓治疗,过度燃烧,随机分为四组(N=12),包括SARC:用自粘树脂水泥浸渍,DCC:用双固化型芯堆积树脂复合材料浸渍,CRR:用散装填充树脂复合材料修复根管管壁,和DAP:用散装填充树脂复合材料重新衬砌纤维柱。24小时后,将根切片以获得三个子宫颈,中间,和顶端3mm切片。进行推出测试并检查故障模式。使用Kruskal-Wallis和事后Dunn-Bonferroni检验进行统计学分析(P<0.05)。结果:在所有三个地区,在SARC和DAP组中发现了最低和最高的粘结强度,分别。在中部地区,SARC组与DCC组的粘结强度差异有统计学意义(P=0.044),CRR(P=0.021),和DAP组(P<0.001)。根尖区无明显差别。在顶端区域观察到最低的粘结强度,最高的与宫颈区域有关。粘合失效是所有组中最常见的失效模式。结论:根据我们的结果DCC,CRR和DAP方法增加了过度扩张的根部区域的中部和颈部的粘结强度。考虑到DCC是最简单和最实用的方法,我们建议CRR和DAP可以在临床手术中用这种方法代替。
    Objectives: This study aimed to investigate the effect of different reinforcement techniques on the push-out bond strength of fiber posts to over-flared root canals. Materials and Methods: Forty-eight extracted human single-canal premolars were endodontically treated, over-flared, and randomly divided into four groups (N=12) including SARC: luting with self-adhesive resin cement, DCC: luting with dual-cure core build-up resin composite, CRR: relining root canal walls with bulk-fill resin composite, and DAP: relining fiber post with bulk-fill resin composite. After 24 hours, the roots were sectioned to obtain three cervical, middle, and apical 3mm slices. The push-out test was performed and failure pattern was examined. Kruskal-Wallis and post-hoc Dunn-Bonferroni tests were used for statistical analysis (P<0.05). Results: In all three regions, the lowest and highest bond strength was found in the SARC and DAP groups, respectively. In the middle region, there was a statistically significant difference between the bond strength of the SARC group and that of the DCC (P=0.044), CRR (P=0.021), and DAP (P<0.001) groups. There was no significant difference in the apical region. The lowest bond strength was observed in the apical region, and the highest was related to the cervical region. Adhesive failure was the most common failure pattern in all groups. Conclusion: Based on our results DCC, CRR and DAP methods increased bond strength in the middle and cervical sections of over-flared root regions. Considering that DCC is the easiest and most practical method, we propose that CRR and DAP can be replaced with this method in clinical procedures.
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  • 文章类型: Journal Article
    用于金属后去除的超声波振动似乎是牙髓医师和全科医生之间的一致选择,以提供最佳结果并具有最高的安全性。这项研究比较了使用1或2个超声设备时,超声振动去除金属柱(MP)所需的时间。
    105颗患者的MPs的115颗牙齿,根据所使用的超声装置(G1-1装置)和(G2-2装置)的数量,将非手术牙髓再治疗的患者分为2组.在G1中,MP带有跨金属钻头,旁边的水泥线的磨损(约2毫米深)。然后,连接到超声波装置的超声波尖端,100%的功率被激活的水平的职位,在齿的轴向表面上方1毫米的水平处持续喷水。每10秒在颊和舌面之间改变尖端的位置,直到去除MP。在G2中,进行了与G1中所述相同的程序,但是在颊和舌面同时激活了两个超声尖端,直到去除MP。使用计时器记录除去各MP所需的振动时间。
    使用一个超声波设备去除MP的平均时间为131.10±29.68秒(平均值±平均值的标准误差),和24.86±6.88秒的两个设备。使用两个超声装置去除MP所需的时间明显少于使用一个超声装置时(P<0.001)。
    具有2个超声波设备的技术被证明比仅使用1个超声波设备的技术更有效。
    UNASSIGNED: Ultrasonic vibration for metallic post removal seems to be a unanimous choice between endodontists and general practitioners for providing the best results and having the highest safety. This study compared the time required by ultrasonic vibration for removing metallic post (MP) when 1 or 2 ultrasonics devices are used.
    UNASSIGNED: One hundred and fifteen teeth with MPs from 105 patients, indicated for nonsurgical endodontic retreatment were divided into 2 groups according to the number of ultrasonic devices used (G1-1 device) and (G2-2 devices). In G1, the MP was worn with a transmetal bur, alongside the wear of the cement line (around 2 mm deep). Then, an ultrasonic tip attached to an ultrasonic unit, with a power of 100% was activated at the level of the post, with constant water spray at a level of 1 mm above the axial surface of the tooth. The position of the tip was changed between buccal and lingual surfaces every 10 seconds until the MP was removed. In G2 the same procedures were performed as described in G1, but two ultrasonic tips were activated simultaneously at buccal and lingual surfaces until the MP was removed. The vibration time necessary for removing each MP was recorded using a chronometer.
    UNASSIGNED: The mean time was 131.10±29.68 seconds (mean±standard error of the mean) for MP removal using one ultrasonic device, and 24.86±6.88 seconds for two devices. The time required for MP removal using two ultrasonic devices was significantly less than when using one ultrasonic device (P<0.001).
    UNASSIGNED: The technique with 2 ultrasonic devices proved to be more efficient than the one using only 1 ultrasonic device.
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  • 文章类型: Journal Article
    This study explores the potential application of computer aided design (CAD)/computer aided manufac-turing (CAM) for one-piece glass fiber posts and cores in restoring tooth defects post-removal of a broken fiber post using a digital guide plate. This paper reports a fractured left upper incisor fiber post removed using a customized needle and digital guide plate. Following root canal retreatment, CAD/CAM integrated fiber post-core and zirconia full crown restoration were completed. The occlusion testing was conducted using the T-Scan Ⅲ system. This study offers insights for managing secondary repair after fiber post fractures.
    探讨采用数字化导板去除折断纤维桩后计算机辅助设计(CAD)/计算机辅助制造(CAM)一体化纤维桩核修复牙体缺损的应用前景。本文报道1例左上侧切牙纤维桩折断后采用定制车针及数字化导板引导下拆除,完成根管再治疗后CAD/CAM一体化纤维桩核及氧化锆全冠修复,并采用T-Scan Ⅲ系统进行咬合测试,为纤维桩折断后行二次修复提供参考。.
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  • 文章类型: Journal Article
    这项研究旨在评估在针状牙本质的不同三分之一中具有不同复合树脂混浊度的相关玻璃纤维桩之间的粘结强度。对30个单根前磨牙进行了牙髓治疗,分为三组(n=10):玻璃纤维桩用半透明复合树脂加固,玻璃纤维柱与不透明的复合树脂,和玻璃纤维柱没有重新衬砌。在胶结柱子后,将标本垂直于牙齿的长轴切成大约1.3毫米的切片,每三分之一进行分析(子宫颈,中间,和顶端),然后进行推出测试。粘结强度(MPa)数据进行Shapiro-Wilk正态检验和双向重复测量方差分析,将实验组和不同地区作为研究因素。Tukey的事后检验(p<.05)用于组间比较。在子宫颈第三,发现与半透明树脂相关的组的粘结强度值较高,其他组的差异具有统计学意义。在其他地区,不透明和半透明树脂都显示出相似的结果,但是与没有重新衬砌的玻璃纤维柱相比,两者都显示出更高的粘结强度值。玻璃纤维桩与针内牙本质的不同三分之一的粘结强度受复合树脂重新衬砌以及树脂不透明度的影响。半透明复合树脂的使用是玻璃纤维柱换衬的更有效替代方法。
    This study aimed to evaluate the bond strength between relined fiberglass posts with different composite resin opacities in different thirds of the intraradicular dentin. Thirty single-rooted premolars were endodontically treated and divided into three groups (n=10): fiberglass posts relined with translucent composite resin, fiberglass posts relined with opaque composite resin, and fiberglass posts without relining. After cementation of the posts, the specimens were cut perpendicular to the long axis of the tooth in slices of approximately 1.3 mm of each third to be analyzed (cervical, middle, and apical) and then subjected to the push-out test. The bond strength (MPa) data were subjected to Shapiro-Wilk normality tests and two-way repeated measures analysis of variance, considering the experimental groups and different regions as study factors. Tukey\'s post-hoc test (p<.05) was applied for comparisons between the groups. In the cervical third, higher values of bond strength were found for the group relined with translucent resin, with a statistically significant difference for the other groups. In the other regions, both opaque and translucent resins showed similar results, but both showed higher values of bond strength compared to fiberglass posts without relining. The bond strength of fiberglass posts to different thirds of intraradicular dentin is influenced by composite resin relining as well as the opacity of the resin. The use of translucent composite resin is a more effective alternative for fiberglass posts relining.
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  • 文章类型: Journal Article
    这项研究旨在通过静态和循环载荷测试,阐明在牙髓处理的根部与剩余的冠状牙齿上建造的树脂基台的抗断裂性。经牙髓处理的牛根,剩余的冠状牙齿在拉伸侧覆盖了四分之一和一半的圆周,或者在拉伸侧和压缩侧覆盖了圆周,被制造成树脂基台。通过对齿轴施加30°的载荷,通过静态和循环载荷测试来评估抗断裂性。剩余冠状牙的一半周长显示出明显更高的静态骨折负荷和存活率。压缩侧剩余的冠状牙齿改善了与严重骨折相关的动态骨折阻力。剩余冠状牙的占用面积和位置影响静态和动态断裂阻力。
    This study aimed to clarify the fracture resistance of resin abutments built on endodontically treated roots with the remaining coronal teeth via static and cyclic loading tests. Endodontically treated bovine roots, which had a remaining coronal tooth covered with an occupied area for a quarter and half of the circumference at the tensile side or covered the circumference at both the tensile and compressive sides, were fabricated to build up to the resin abutment. Fracture resistance was evaluated via static and cyclic loading tests by applying a load of 30° to the tooth axis. Half of the circumference of the remaining coronal tooth showed a significantly higher static fracture load and survival rate. The remaining coronal tooth on the compressive side improved the dynamic fracture resistance associated with severe fractures. The occupied area and location of the remaining coronal tooth affected the static and dynamic fracture resistances.
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  • 文章类型: Journal Article
    这项研究使用推出(PO)和径向压缩(DC)评估了玻璃纤维桩与牙根牙本质的粘结强度,测试乙醇酸作为调理剂和不同的牙本质水分。另一个目的是测试DC是否可以替代PO进行粘合强度评估。将80颗牛齿分为八组(n=10),其定义是在潮湿或潮湿的牙本质上使用37%的乙醇酸或37%的磷酸(PA),然后与AdapterSingleBond/RelyXARC或OneStepPlus/Duo-LinkBisco粘合。每个齿提供内径为2毫米的圆盘,外径5毫米,和2毫米的高度,经历了PO和DC。对三维模型进行了有限元分析。通过线性回归分析PO结果时,在宫颈和牙齿的三分之二的湿牙本质上使用乙醇酸观察到最高的粘结强度值。分析直流结果,对值的唯一统计影响是牙齿三分之一。DC结果和PO键强度值的散点图表明两个测试的结果之间没有关系(r=0.03;p=0.64)。PO测试检测到比DC更敏感的粘结强度值变化。
    This study evaluated bond strength of glass fiber posts to root dentin using push-out (PO) and diametral compression (DC), testing glycolic acid as a conditioner and varying dentin moisture. An additional aim was to test whether DC can be an alternative test to PO for bond strength assessment. Eighty bovine teeth were divided into eight groups (n = 10) defined by the use of either 37% glycolic acid or 37% phosphoric acid (PA) on moist or wet dentin before bonding with either Adapter SingleBond/RelyX ARC or One Step Plus/Duo-Link Bisco. Each tooth provided discs with an internal diameter of 2 mm, external diameter of 5 mm, and height of 2 mm, which underwent PO and DC. Finite element analysis (FEA) was carried out on 3D models. When analyzing PO results through linear regression, the highest values of bond strength were observed using glycolic acid on wet dentin in the cervical and middle thirds of the teeth. Analyzing DC results, the only statistical influence on values was the dental thirds. The scatterplot of the DC results and the PO bond strength values indicated no relationship between the results of the two tests (r = 0.03; p = 0.64). PO test detected more sensitive changes in bond strength values than DC.
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  • 文章类型: Journal Article
    目的:评估牙髓治疗(ET)前牙牙冠修复的唇舌直径和结构对咬合负荷下应力分布和生物力学安全性的影响。
    方法:对全瓷冠修复的上颌中切牙建立三维有限元模型。牙齿的唇舌直径,定义为唇面和舌面突起之间的水平距离,变化如下:(D1)6.85毫米,(D2)6.35mm,和(D3)5.85毫米。模型构建如下:(S0)活髓牙;(S1)ET牙;(S2)带2mm套圈的ET牙,用纤维桩和复合树脂芯修复;(S3)无套圈的ET齿,用纤维柱和复合树脂芯修复。共开发了12个模型。总的来说,两个力载荷(100N)以与牙齿纵轴成45°斜角施加到牙冠的切缘和腭表面。分析了模型的VonMises应力分布和最大应力。
    结果:无论装载位置如何,所有模型的应力集中和最大应力(34.07〜66.78MPa)发生在每个根部的唇颈1/3。唇舌直径和结构都影响残余牙齿组织的最大应力,唇舌直径的影响更大。唇舌直径的减小导致整个牙齿的最大应力增加。套圈降低了S2型芯的最大应力(7.15~10.69MPa),与S3型号(19.45~43.67MPa)相比较低。
    结论:唇舌直径对内皮素前牙冠修复的生物力学特性影响较大,超越建筑的影响。套圈可以减小芯的最大应力并保持应力分布的均匀性。
    OBJECTIVE: To evaluate the effect of the labiolingual diameter and construction of an endodontically treated (ET) anterior tooth with crown restoration on stress distribution and biomechanical safety under occlusal loading.
    METHODS: Three-dimensional finite element models were generated for maxillary central incisors with all-ceramic crown restorations. The labiolingual diameters of the tooth, defined as the horizontal distance between the protrusion of the labial and lingual surfaces, were changed as follows: (D1) 6.85 mm, (D2) 6.35 mm, and (D3) 5.85 mm. The model was constructed as follows: (S0) vital pulp tooth; (S1) ET tooth; (S2) ET tooth with a 2 mm ferrule, restored with a fiber post and composite resin core; (S3) ET tooth without a ferrule, restored with a fiber post and composite resin core. A total of 12 models were developed. In total, two force loads (100 N) were applied to the crown\'s incisal edge and palatal surface at a 45° oblique angle to the longitudinal axis of the teeth. The Von Mises stress distribution and maximum stress of the models were analyzed.
    RESULTS: Regardless of the loading location, stress concentration and maximum stress (34.07~66.78MPa) in all models occurred in the labial cervical 1/3 of each root. Both labiolingual diameter and construction influenced the maximum stress of the residual tooth tissue, with the impact of the labiolingual diameter being greater. A reduction in labiolingual diameter led to increased maximum stress throughout the tooth. The ferrule reduced the maximum stress of the core of S2 models (7.15~10.69 MPa), which is lower compared with that of S3 models (19.45~43.67 MPa).
    CONCLUSIONS: The labiolingual diameter exerts a greater impact on the biomechanical characteristics of ET anterior teeth with crown restoration, surpassing the influence of the construction. The ferrule can reduce the maximum stress of the core and maintain the uniformity of stress distribution.
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  • 文章类型: Journal Article
    目的:本研究旨在评估超声激活蚀刻和冲洗和自蚀刻粘合剂体系对树脂水泥与辐照牙根牙本质的粘结强度的影响。
    方法:将80颗上颌前牙分为8组(n=10),根据所用粘合剂系统的类型(蚀刻和冲洗和自蚀刻),粘合剂系统的超声波激活,和牙本质状况(辐照或未辐照-70Gy)。进行牙髓治疗,然后进行玻璃纤维后空间准备。玻璃纤维柱润滑后,在牙本质盘上横切根部,并进行推出粘结强度试验(0.5mm/min)。在立体显微镜和扫描电子显微镜(SEM)下分析断裂的试样,以进行失效模式分类。在SEM下分析其中一个牙质盘,以评估粘合剂界面的特性。
    结果:辐照样品的粘结强度低于未辐照样品(P<0.0001)。两种粘合剂体系的超声活化均增加了树脂粘固剂与辐照牙本质的粘合强度(P<0.0001)。放射治疗显着影响中段(P=0.024)和顶端(P=0.032)(粘附失败)的失败模式。
    结论:未照射的样本具有更均匀的粘附界面。当超声激活时,两种粘合剂系统都显示出更多的树脂标签,不管牙本质状况如何。
    结论:超声激活粘合剂系统是提高肿瘤患者玻璃纤维桩固位的可行策略。
    OBJECTIVE: This study aimed to evaluate the effect of ultrasonic activation of etch-and-rinse and self-etch adhesive systems on the bond strength of resin cement to irradiated root dentin.
    METHODS: Eighty human maxillary anterior teeth were distributed into 8 groups (n = 10), according to the type of adhesive system used (etch-and-rinse and self-etch), the ultrasonic activation of the adhesive systems, and the dentin condition (irradiated or non-irradiated - 70 Gy). Endodontic treatment was performed followed by fiberglass post-space preparation. After fiberglass posts\' luting, the roots were transversely sectioned on dentin discs and submitted to the push-out bond strength test (0.5 mm/min). The fractured specimens were analyzed under a stereomicroscope and Scanning Electron Microscope (SEM) for failure mode classification. One of the dentin discs was analyzed under SEM to evaluate the characteristics of the adhesive interface.
    RESULTS: Irradiated specimens had lower bond strength than non-irradiated specimens (P < 0.0001). Ultrasonic activation of both adhesive systems increased the bond strength of the resin cement to irradiated dentin (P < 0.0001). Radiotherapy significantly affected the failure mode in the middle (P = 0.024) and apical thirds (P = 0.032) (adhesive failure).
    CONCLUSIONS: Non-irradiated specimens had a more homogeneous adhesive interface. When ultrasonically activated, both adhesive systems showed a greater number of resinous tags, regardless of the dentin condition.
    CONCLUSIONS: Ultrasonic activation of adhesive systems is a feasible strategy to enhance fiberglass posts retention in oncological patients.
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  • 文章类型: Journal Article
    概述了一种在美学情况下使用三维网格中玻璃纤维增强的聚合物复合材料作为后芯的技术。临床程序包括获得根管空间的印模,扫描最终的演员阵容,和铣削纤维增强复合材料桩芯。随后,使用粘合剂树脂水泥来粘合神经根内桩核。使用定制的计算机辅助设计-计算机辅助制造(CAD-CAM)纤维增强复合材料桩芯促进了可修复性,提供更好的适应根管空间,避免水泥厚度不均匀,确保树脂水泥的化学附着力,并促进有利的美学时,结合全瓷冠。
    A technique is outlined for utilising a polymeric composite reinforced with glass fibres in a three-dimensional mesh as a post-core in aesthetic cases. The clinical procedure involves obtaining an impression of the root canal space, scanning the definitive cast, and milling a fibre-reinforced composite post-core. Subsequently, the intra-radicular post-core is cemented using an adhesive resin cement. The use of custom-made computer-aided design-computer-aided manufacturing (CAD-CAM) fibre-reinforced composite post-core facilitates repairability, provides better adaptation to the root canal space, avoids uneven cement thickness, ensures chemical adhesion to resin cement, and promotes favourable aesthetics when combined with all-ceramic crowns.
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