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Endocrown restorations in premolars: influence of remaining axial walls of tooth structure and restorative materials on fatigue resistance

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Abstract

Objectives

To evaluate the effect of the remaining tooth structure and different CAD/CAM materials on the fatigue performance and failure mode of endodontically treated premolars restored with endocrowns.

Materials and methods

Ninety maxillary premolars were endodontically treated and assigned into 6 groups (n = 15) according to the number of remaining axial walls (four, three, and two) and restorative materials (ultra-translucent zirconia 5Y-PSZ [KATANA UTML] and lithium disilicate [IPS e.max-CAD]). The specimens were subjected to cyclic fatigue loading test (initial load 200 N; 20 Hz). An incremental step load of 100 N per 10,000 cycles was applied until failure. The fatigue failure load (FFL) and number of failure cycles (CFFs) data were statistically analyzed with two-way ANOVA and Kaplan–Meier test (α = 0.05). Failed specimens were examined under a stereomicroscope 25 × and failure modes were determined.

Results

FFL and CFF were significantly influenced by restorative material (p < 0.05). 5Y-PSZ endocrowns showed significantly higher FFL when compared with lithium disilicate. The number of remaining walls did not affect the fatigue behavior or failure mode of the specimens. Of the lithium disilicate restorations, 51% had repairable failures, while 95% 5Y-PSZ restorations had non-repairable failures.

Conclusions

Zirconia endocrowns showed better FFL than lithium disilicate endocrowns, regardless of the number of remaining axis walls. Lithium disilicate and 5Y-PSZ endocrowns showed FFL higher than the normal masticatory loads.

Clinical relevance

Restoring endodontically treated premolars with endocrown could be a promising treatment, regardless of the remaining axial walls. However, precaution should be taken in material selection since it affects the fatigue resistance and failure mode.

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Data availability

The obtained data and the scientific work produced from these data were stored on Google Drive through UNESP’s Gsuite, which can be accessed through the institutional login of UNESP VPN (Virtual Private Network).

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Funding

This study was supported by the Brazilian Federal Agency for the Coordination of Improvement of Higher Education Personnel (CAPES) finance code # 88887.595423/2020–00.

Author information

Authors and Affiliations

  1. Department of Dental Materials and Prosthodontics, Institute of Science and Technology, São Paulo State University (UNESP), Av. Engenheiro Francisco José Longo,777. 12245000, São José Dos Campos, São Paulo, Brazil

    Amir Mohidin Demachkia & Renata Marques de Melo

  2. Post-Graduate Program in Oral Science, Faculty of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Rio Grande Do Sul State, Brazil

    Helder Callegaro Velho & Luiz Felipe Valandro

  3. Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, Dar Al-Uloom University, Riyadh, Saudi Arabia

    Mohiddin Rida Dimashkieh & Abdulaziz Samran

  4. Department of Oral Regenerative Medicine, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands

    João Paulo Mendes Tribst

Authors
  1. Amir Mohidin Demachkia
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  2. Helder Callegaro Velho
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  3. Luiz Felipe Valandro
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  4. Mohiddin Rida Dimashkieh
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  5. Abdulaziz Samran
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  7. Renata Marques de Melo
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Contributions

Demachkia, AM: Conceptualization, methodology, investigation, writing (original draft), review and editing.

Velho, HC: Writing (original draft), investigation, formal analysis, data curation

Valandro, LF: Methodology, validation, formal analysis, supervision

Dimashkieh, MR: Conceptualization, methodology, validation, supervision

Samran, A: Resources, methodology, writing—review and editing

Tribst, JPM: Conceptualization, methodology, writing (review and editing), supervision

Melo, RM: Conceptualization, methodology, validation, writing (review and editing), funding acquisition, supervision, project administration

Corresponding author

Correspondence to Amir Mohidin Demachkia.

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Ethical approval

This project was approved by the scientific research committee at Dar Al-Uloom University (SRC No: 001-06-2020) and conducted in accordance with the Declaration of Helsinki on ethical principles for medical research.

Competing interests

The authors declare no competing interests.

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Demachkia, A.M., Velho, H.C., Valandro, L.F. et al. Endocrown restorations in premolars: influence of remaining axial walls of tooth structure and restorative materials on fatigue resistance. Clin Oral Invest 27, 2957–2968 (2023). https://doi.org/10.1007/s00784-023-04895-6

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