Comparison of the Effect of Indirect Restorations on the Fracture Resistance of Open-Apex Maxillary Anterior Teeth Following Revitalization Therapy: An In-Vitro Study

Project no. 33002 · Status: Kapanmış (Yayın bekleniyor) · 2025

Summary

<p>To&nbsp;date,&nbsp;no&nbsp;study&nbsp;has&nbsp;been&nbsp;identified&nbsp;in&nbsp;the&nbsp;literature&nbsp;investigating&nbsp;the&nbsp;effect&nbsp;of&nbsp;indirect&nbsp;restorative&nbsp;materials&nbsp;and&nbsp;restoration&nbsp;types&nbsp;on&nbsp;the&nbsp;fracture&nbsp;resistance&nbsp;of&nbsp;revitalized&nbsp;immature&nbsp;maxillary&nbsp;anterior&nbsp;teeth&nbsp;with&nbsp;open&nbsp;apices.&nbsp;Therefore,&nbsp;the&nbsp;aim&nbsp;of&nbsp;this&nbsp;study&nbsp;is&nbsp;to&nbsp;evaluate&nbsp;the&nbsp;effect&nbsp;of&nbsp;different&nbsp;indirect&nbsp;restorations&nbsp;on&nbsp;the&nbsp;fracture&nbsp;resistance&nbsp;of&nbsp;immature&nbsp;anterior&nbsp;teeth&nbsp;following&nbsp;revitalization&nbsp;treatment&nbsp;and&nbsp;to&nbsp;determine&nbsp;the&nbsp;most&nbsp;durable&nbsp;indirect&nbsp;restorative&nbsp;material&nbsp;and&nbsp;restoration&nbsp;design,&nbsp;thereby&nbsp;contributing&nbsp;to&nbsp;the&nbsp;existing&nbsp;literature.</p><p>A&nbsp;total&nbsp;of&nbsp;48&nbsp;extracted&nbsp;human&nbsp;permanent&nbsp;maxillary&nbsp;central&nbsp;incisors&nbsp;with&nbsp;a&nbsp;single&nbsp;root&nbsp;and&nbsp;a&nbsp;single&nbsp;canal,&nbsp;extracted&nbsp;for&nbsp;periodontal,&nbsp;prosthetic,&nbsp;or&nbsp;orthodontic&nbsp;reasons,&nbsp;will&nbsp;be&nbsp;included&nbsp;in&nbsp;the&nbsp;study.&nbsp;To&nbsp;simulate&nbsp;immature&nbsp;teeth&nbsp;with&nbsp;open&nbsp;apices,&nbsp;root&nbsp;canals&nbsp;will&nbsp;be&nbsp;enlarged&nbsp;using&nbsp;Peeso&nbsp;reamers&nbsp;sizes&nbsp;1–4.&nbsp;To&nbsp;simulate&nbsp;tooth&nbsp;loss&nbsp;due&nbsp;to&nbsp;trauma,&nbsp;a&nbsp;fracture&nbsp;line&nbsp;will&nbsp;be&nbsp;created&nbsp;on&nbsp;the&nbsp;central&nbsp;incisor,&nbsp;starting&nbsp;halfway&nbsp;along&nbsp;the&nbsp;crown&nbsp;length&nbsp;mesially&nbsp;and&nbsp;progressing&nbsp;obliquely,&nbsp;leaving&nbsp;tooth&nbsp;tissue&nbsp;above&nbsp;the&nbsp;enamel-cementum&nbsp;junction&nbsp;at&nbsp;the&nbsp;distal&nbsp;end&nbsp;of&nbsp;the&nbsp;tooth&nbsp;for&nbsp;approximately&nbsp;one-third&nbsp;of&nbsp;the&nbsp;crown&nbsp;length.</p><p>Revitalization&nbsp;procedures&nbsp;will&nbsp;be&nbsp;performed&nbsp;according&nbsp;to&nbsp;the&nbsp;guidelines&nbsp;of&nbsp;the&nbsp;European&nbsp;Society&nbsp;of&nbsp;Endodontology,&nbsp;and&nbsp;Biodentine&nbsp;will&nbsp;be&nbsp;placed&nbsp;into&nbsp;the&nbsp;root&nbsp;canal.&nbsp;Subsequently,&nbsp;teeth&nbsp;will&nbsp;be&nbsp;randomly&nbsp;assigned&nbsp;to&nbsp;four&nbsp;groups&nbsp;according&nbsp;to&nbsp;the&nbsp;type&nbsp;of&nbsp;indirect&nbsp;coronal&nbsp;restoration.&nbsp;In&nbsp;Group&nbsp;1,&nbsp;endocrown&nbsp;restorations&nbsp;will&nbsp;be&nbsp;fabricated&nbsp;indirectly&nbsp;using&nbsp;a&nbsp;polymer&nbsp;composite&nbsp;disk,&nbsp;whereas&nbsp;in&nbsp;Group&nbsp;2,&nbsp;indirect&nbsp;endocrown&nbsp;restorations&nbsp;will&nbsp;be&nbsp;fabricated&nbsp;using&nbsp;Gradia&nbsp;Plus&nbsp;composite&nbsp;resin.&nbsp;In&nbsp;Groups&nbsp;3&nbsp;and&nbsp;4,&nbsp;a&nbsp;core&nbsp;structure&nbsp;will&nbsp;be&nbsp;constructed&nbsp;over&nbsp;the&nbsp;Biodentine&nbsp;using&nbsp;a&nbsp;Trinia&nbsp;CAD/CAM&nbsp;fiber&nbsp;block,&nbsp;followed&nbsp;by&nbsp;standardized&nbsp;tooth&nbsp;preparation.&nbsp;Crown&nbsp;restorations&nbsp;will&nbsp;then&nbsp;be&nbsp;fabricated&nbsp;using&nbsp;a&nbsp;HIPC&nbsp;polymer&nbsp;composite&nbsp;disk&nbsp;in&nbsp;Group&nbsp;3&nbsp;and&nbsp;Gradia&nbsp;Plus&nbsp;composite&nbsp;resin&nbsp;in&nbsp;Group&nbsp;4.</p><p>All&nbsp;restored&nbsp;teeth&nbsp;will&nbsp;be&nbsp;embedded&nbsp;in&nbsp;silicone&nbsp;impression&nbsp;material&nbsp;and&nbsp;acrylic&nbsp;resin&nbsp;to&nbsp;simulate&nbsp;periodontal&nbsp;tissues.&nbsp;Specimens&nbsp;will&nbsp;be&nbsp;subjected&nbsp;to&nbsp;thermal&nbsp;aging&nbsp;(10,000&nbsp;cycles)&nbsp;and&nbsp;subsequently&nbsp;tested&nbsp;for&nbsp;fracture&nbsp;resistance.&nbsp;The&nbsp;maximum&nbsp;load&nbsp;at&nbsp;fracture&nbsp;will&nbsp;be&nbsp;recorded&nbsp;in&nbsp;Newtons&nbsp;(N).&nbsp;Fracture&nbsp;resistance&nbsp;values&nbsp;and&nbsp;fracture&nbsp;patterns&nbsp;among&nbsp;the&nbsp;different&nbsp;indirect&nbsp;restoration&nbsp;techniques&nbsp;and&nbsp;materials&nbsp;will&nbsp;be&nbsp;compared&nbsp;using&nbsp;either&nbsp;a&nbsp;two-way&nbsp;ANOVA&nbsp;or&nbsp;a&nbsp;two-way&nbsp;robust&nbsp;ANOVA,&nbsp;depending&nbsp;on&nbsp;the&nbsp;normality&nbsp;of&nbsp;data&nbsp;distribution,&nbsp;with&nbsp;the&nbsp;level&nbsp;of&nbsp;significance&nbsp;set&nbsp;at&nbsp;p&lt;&nbsp;0.05.</p><p></p>

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