Effect of proximal box elevation on fracture resistance and microleakage of premolars restored with ceramic endocrowns.
<h4>Background</h4>Restoration of endodontically treated premolar is in high risk for biomechanical failure, and often presents with subgingival margins. Proximal box elevation (PBE) has been used to relocate subgingival cavity outlines.<h4>Objective</h4>To evaluate the influ...
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| Autores principales: | , , , , , |
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| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
Public Library of Science (PLoS)
2021
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| Materias: | |
| Acceso en línea: | https://doaj.org/article/9ca2b8ea42e64e4eac487d0691c5387a |
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| Sumario: | <h4>Background</h4>Restoration of endodontically treated premolar is in high risk for biomechanical failure, and often presents with subgingival margins. Proximal box elevation (PBE) has been used to relocate subgingival cavity outlines.<h4>Objective</h4>To evaluate the influence of PBE on fracture resistance and gingival microleakage of premolars with endodontic access cavities following ceramic endocrown.<h4>Methods</h4>Eighty sound maxillary premolars with standardized Class II cavities on mesial surfaces were randomly assigned to four groups (n = 20 in each group). Groups E1, E2 and E3, with proximal margins located in dentin/cementum, 2 mm below the cemento-enamel junction (CEJ), simulated subgingival location. Group E4 (supragingival group), with proximal margins located in enamel, 1 mm above the CEJ, was used as the positive control. For margin elevation of the proximal cavities, bulk-fill Smart Dentin Replacement (SDR), a visible light cured resin composite, was applied in group E1, and conventional resin composite (3M Z350 XT, a light-activated composite) was placed in group E2. Group E3 was only treated with a ceramic crown and served as the negative control. In all groups, computer-aided design (CAD) ceramic endocrowns were adhesively inserted, and fracture resistance, failure mode and microleakage were evaluated.<h4>Results</h4>A higher fracture resistance value was observed in PBE groups E1 and E2, regardless of the materials used (P = 0.038, and 0.010, respectively, vs E3), and fracture resistance in group E1 was higher than that in group E2. In teeth without PBE, the percentage of catastrophic failures reached 70%. Compared to group E3, a lower frequency distribution of microleakage was detected in supragingival group E4 (P = 0.031). No increased percentage of microleakage was observed in groups treated with PBE.<h4>Conclusion</h4>For endodontically treated maxillary premolars restored with ceramic endocrowns, PBE increases fracture resistance but not microleakage. |
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