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Tomson, P. L.
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article
The impact of endodontic access on the biaxial flexure strength of dentine-bonded crown substrates – an in vitro study
Abstract
<p>Aim: To investigate how preparation of a simulated access cavity into ceramic materials suitable for the manufacture of dentine-bonded crowns (DBCs) impacted on biaxial flexural strength (BFS) determined as a monolithic structure and in a more clinically representative resin-cemented form. Methodology: One hundred and twenty feldspathic and 120 leucite-reinforced ceramic disc-shaped specimens were divided into eight groups (n = 30). All groups received ‘fit’ surface treatments representative of pre-cementation modifications and of cementation prior to preparation of a representative endodontic access cavity through the sample. BFS was determined for both ‘intact’ and the ‘annular’ disc-shaped specimens which had received simulated endodontic access. Newly reported analytical solutions were used to calculate BFS of the ‘annular’ specimens. Statistical analysis included two-way anovas (α = 0.05) and Weibull analysis. Fractographic examination provided insight into the fracture mechanisms. Results: A two-way anova identified a significant impact of material (P < 0.01) and of resin coating (P < 0.01) on the mean BFS of intact specimens. For the annular ceramic specimens, the substrate material significantly impacted on mean BFS (P < 0.01), but the effect of resin coating was dependent on the substrate type (P < 0.01). Conclusions: Endodontic access cavity preparation modified the critical defect population of the all-ceramic restorative materials investigated. The strength of a predominantly glassy ceramic following endodontic access can be maintained if adhesive cementation was used; however, the beneficial effects of adhesive cementation on ceramic reinforcement were lost on leucite-reinforced ceramics following access cavity preparation. Replacement restoration for these materials would be recommended clinically following endodontic access as opposed to repair of the access cavity using a direct restorative material.</p>