Aim. The aim of this study was to evaluate the radiographic technical quality of endodontic treatment performed by undergraduate students at the School of Dentistry, Faculty of Medicine, University of Novi Sad, Serbia. Materials and Methods. Electronic records of 220 patients treated by final-year undergraduate students during the school year 2011/2012 were examined, and the final sample consisted of 212 patients, 322 teeth, and 565 root canals. The criteria for overall radiographic adequacy of root canal fillings were defined as the presence of adequate length and density and absence of iatrogenic errors (ledge, fractured instrument, untreated canal, and apical transportation). Chi-square test was used to determine statistical significance between different parameters. Results. Adequate root canal fillings were found in 74.22% of the teeth. The percentage of root fillings with adequate length and density was 89.73% and 92.6%, respectively. Fractured instruments and ledges were present in 16 root canals (2.8%), while the presence of missed canal and apical transportation was observed in 2 cases, each (0.3%). Conclusions. Overall, the technical quality of root canal fillings performed by undergraduate students was satisfactory.
AimTo analyze the influence of cavity design preparation on stress values in three-dimensional (3D) solid model of maxillary premolar restored with resin composite.Methods3D solid model of maxillary second premolar was designed using computed-tomography (CT) data. Based on a factorial experiment, 9 different mesio-occlusal-distal (MOD) cavity designs were simulated, with three cavity wall thicknesses (1.5 mm, 2.25 mm, 3.0 mm), and three cusp reduction procedures (without cusp reduction, 2.0 mm palatal cusp reduction, 2.0 mm palatal and buccal cusp reduction). All MOD cavities were simulated with direct resin composite restoration (Gradia Direct Posterior, GC, Japan). Finite element analysis (FEA) was used to calculate von Mises stress values.ResultsThe von Mises stresses in enamel, dentin, and resin composite were 79.3-233.6 MPa, 26.0-32.9 MPa, and 180.2-252.2 MPa, respectively. Considering the influence of cavity design parameters, cuspal reduction (92.97%) and cavity wall thickness (3.06%) significantly (P < 0.05) determined the magnitude of stress values in enamel. The influence of cavity design parameters on stress values in dentin and resin composite was not significant. When stresses for enamel, dentine, and resin composite were considered all together, palatal cusp coverage was revealed as an optimal option. Cavity wall thickness did not show a significant effect on stress values.ConclusionBased on numerical simulations, a palatal cusp reduction could be suggested for revealing lower stress values in dental tissues and restorative material. This type of cavity design should contribute to better biomechanical behavior of tooth-restoration complex, consequently providing the long-lasting clinical results.
An endodontically treated tooth with mesial-occlusal-distal (MOD) cavity is often restored with composite resin. Palatal and buccal cusp reduction (MODP, MODPB), and/or fiber-reinforced composite posts (P), are used in an attempt to improve the longevity of the restoration. The aim of this study was to determine the effects of these procedures on von Mises stress values and distribution in dental tissues and restorative materials using finite element analysis. Based on CT scans of an extracted second upper premolar, six 3D endodontically treated tooth models (MOD, MODP, MODPB, MOD+P, MODP+P, MODPB+P) were created. Each model was subjected to a summary force of 150 N on the occlusal surface simulating the normal biting pattern and maximal von Mises stresses were calculated. MODP seems to reduce von Mises stress values in dental tissues and P seems to transfer some of the stresses from dental tissues to the composite filling.
In order to investigate the influence of cusp reduction, cavity isthmus width, and restorative material on stress values in premolar with mesio-occlusal-distal (MOD) cavity, numerical simulations were done on three-dimensional (3D) models of a maxillary second premolar designed using computerized tomography (CT) scan images. The use of four restorative materials (direct resin composite, direct resin composite with resin-modified glass-ionomer cement as the base, indirect resin composite, ceramic), three cavity preparation designs (without cusp coverage, 2-mm palatal cusp coverage, 2-mm palatal and buccal cusp coverage), and two cavity isthmus widths (1/2 and 2/3 intercuspal width) were simulated. After applying a static load of 200 N on the occlusal surface of the tooth, von Mises stresses in the enamel, dentin, and restoration were calculated using finite element analysis (FEA). Stress values in the enamel were primarily influenced by cavity preparation design, while restorative material showed higher contribution in dentin. The lowest stress values were obtained in models with cusp coverage and indirect restorations. Cavity isthmus width had minimal influence on stress values in tooth structures. None of the investigated factors determined stress values in the restoration. In conclusion, the use of ceramic restoration covering both palatal and buccal cusp provided the most favourable stress distribution of premolars with MOD cavity. Graphical abstract ᅟ.
The objective of this study was observation of the adhesive interface on original tooth samples, as well as their epoxy replicas, under SEM. A light-cure flowable composite was incrementally placed and light-polymerized in previously prepared cylindrical dentinal cavities on the buccal surfaces of extracted human third molars. After finishing procedures, impressions of the composite/dentin margin were made using polyvinylsiloxane in order to obtain accurate epoxy replicas for SEM analysis. Ultrastructural morphology of the adhesive surface was observed at high magnifications (≥1,000×) on original tooth samples, which were previously prepared to expose the part of the dentin surface, which participates in the formation of adhesive bond. SEM micrographs showed that marginal adaptation was mostly of acceptable quality. In some of the SEM micrographs of original tooth samples, marginal gap formation, and resin tag breakdown were noted, which were ascribed to polymerization shrinkage. Profound understanding of ultrastructural morphology is necessary for achieving more predictable and durable margin between composite restorations and surrounding tooth structures, and SEM analysis can serve that purpose.
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