The effect of different variables on push-out tests in 3D-printed oval and round-shaped root canals: a methodological study
DOI:
https://doi.org/10.2340/aos.v84.42958Keywords:
3D printing, artificial root canal, dislocation resistance, push-out test, root canal treatmentAbstract
Objective: This study aimed to evaluate the effect of slice thickness (ST), plunger size (PS), shape and region of the root canal on push-out tests using standardized artificial root canals.
Materials and methods: Two teeth with round and oval root canal anatomy were selected using cone beam computed tomography. Teeth were prepared, scanned with micro computed tomography and stereolithography data were obtained. Seventy-two round and 72 long oval artificial root canals were produced using a 3D printer. Root canals were obturated, then divided into two main groups (oval-round) and further divided into six subgroups (n = 12) according to ST (1, 1.5, and 2-mm) and PS (0.5, 0.75, and 1-mm). Push-out tests were performed and dislocation resistance values were calculated. The data were analyzed using the ANOVA two-way test (p = 0.05).
Results: Different STs showed similar results in oval canals (p > 0.05). 1-mm ST showed higher results in round canals (p < 0.05). There was a significant difference between 0.75 and 1-mm PSs (p < 0.05). Middle and coronal regions showed similar results in oval canals (p > 0.05), and coronal region showed lower results in round canals (p < 0.05).
Conclusion: ST, PS, root canal shape and region variables affected the dislocation resistance of core material in standardized root-filled canals.
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References
De-Deus G, Souza E, Versiani M. Methodological considerations on push-out tests in endodontics. Int Endod J. 2015;48:501–3. https://doi.org/10.1111/iej.12445 DOI: https://doi.org/10.1111/iej.12445
Brichko J, Burrow MF, Parashos P. Design variability of the push-out bond test in endodontic research: a systematic review. J Endod. 2018;44:1237–45. https://doi.org/10.1016/j.joen.2018.05.003 DOI: https://doi.org/10.1016/j.joen.2018.05.003
Collares FM, Portella FF, Rodrigues SB, Celeste RK, Leitune VCB, Samuel SMW. The influence of methodological variables on the push-out resistance to dislodgement of root filling materials: a meta-regression analysis. Int Endod J. 2016;49:836–49. https://doi.org/10.1111/iej.12539 DOI: https://doi.org/10.1111/iej.12539
Nagas E, Uyanik O, Durmaz V, Cehreli ZC. Effect of plunger diameter on the push-out bond values of different root filling materials. Int Endod J. 2011;44:950–5. https://doi.org/10.1111/j.1365-2591.2011.01913.x DOI: https://doi.org/10.1111/j.1365-2591.2011.01913.x
Chen WP, Chen YY, Huang SH, Lin CP. Limitations of push-out test in bond strength measurement. J Endod. 2013;39:283–7. https://doi.org/10.1016/j.joen.2012.11.002 DOI: https://doi.org/10.1016/j.joen.2012.11.002
Galhano G, de Melo RM, Valandro LF, Bottino MA. Comparison of resin push-out strength to root dentin of bovine- and human-teeth. Indian J Dent Res. 2009;20:332–6. https://doi.org/10.4103/0970-9290.57378 DOI: https://doi.org/10.4103/0970-9290.57378
Pane ES, Palamara JE, Messer HH. Critical evaluation of the push-out test for root canal filling materials. J Endod. 2013;39:669–73. https://doi.org/10.1016/j.joen.2012.12.032 DOI: https://doi.org/10.1016/j.joen.2012.12.032
Neelakantan P, Ahmed HMA, Wong MCM, Matinlinna JP, Cheung GSP. Effect of root canal irrigation protocols on the dislocation resistance of mineral trioxide aggregate-based materials: a systematic review of laboratory studies. Int Endod J. 2018;51:847–61. https://doi.org/10.1111/iej.12898 DOI: https://doi.org/10.1111/iej.12898
De-Deus G. Research that matters – root canal filling and leakage studies. Int Endod J. 2012;45:1063–4. https://doi.org/10.1111/j.1365-2591.2012.02104.x DOI: https://doi.org/10.1111/j.1365-2591.2012.02104.x
Ivancik J, Naranjo M, Correa S, Ossa A, Tay FR, Pashley DH, et al. Differences in the microstructure and fatigue properties of dentine between residents of North and South America. Arch Oral Biol. 2014;59:1001–12. https://doi.org/10.1016/j.archoralbio.2014.05.028 DOI: https://doi.org/10.1016/j.archoralbio.2014.05.028
Reis T, Barbosa C, Franco M, Baptista C, Alves N, Castelo-Baz P, et al. 3D-printed teeth in endodontics: why, how, problems and future – a narrative review. Int J Environ Res Public Health. 2022;19(13):7966. https://doi.org/10.3390/ijerph19137966 DOI: https://doi.org/10.3390/ijerph19137966
Marending M, Biel P, Attin T, Zehnder M. Comparison of two contemporary rotary systems in a pre-clinical student course setting. Int Endod J. 2016;49:591–8. https://doi.org/10.1111/iej.12481 DOI: https://doi.org/10.1111/iej.12481
Eken R, Sen OG, Eskitascioglu G, Belli S. Evaluation of the effect of rotary systems on stresses in a new testing model using a 3-dimensional printed simulated resin root with an oval-shaped canal: a finite element analysis study. J Endod. 2016;42:1273–8. https://doi.org/10.1016/j.joen.2016.05.007 DOI: https://doi.org/10.1016/j.joen.2016.05.007
Gok T, Capar ID, Akcay I, Keles A. Evaluation of different techniques for filling simulated C-shaped canals of 3-dimensional printed resin teeth. J Endod. 2017;43:1559–64. https://doi.org/10.1016/j.joen.2017.04.029 DOI: https://doi.org/10.1016/j.joen.2017.04.029
Kessler A, Hickel R, Reymus M. 3D printing in dentistry-state of the art. Oper Dent. 2020;45:30–40. https://doi.org/10.2341/18-229-L DOI: https://doi.org/10.2341/18-229-L
Liang X, Liao W, Cai H, Jiang S, Chen S. 3D-printed artificial teeth: accuracy and application in root canal therapy. J Biomed Nanotechnol. 2018;14:1477–85. https://doi.org/10.1166/jbn.2018.2599 DOI: https://doi.org/10.1166/jbn.2018.2599
Cui Z, Wei Z, Du M, Yan P, Jiang H. Shaping ability of protaper next compared with waveone in late-model three-dimensional printed teeth. BMC Oral Health. 2018;18:115. https://doi.org/10.1186/s12903-018-0573-8 DOI: https://doi.org/10.1186/s12903-018-0573-8
Tracy SL. From bench-top to chair-side: how scientific evidence is incorporated into clinical practice. Dent Mater. 2014;30:1–15. https://doi.org/10.1016/j.dental.2013.08.200 DOI: https://doi.org/10.1016/j.dental.2013.08.200
Arslan AK, Yaşar Ş, Çolak C, Yoloğlu S. WSSPAS: an interactive web application for sample size and power analysis with R using shiny. Turkiye Klinikleri J Biostat. 2018;10:224–46. https://doi.org/10.5336/biostatic.2018-62787 DOI: https://doi.org/10.5336/biostatic.2018-62787
Wu MK, R’Oris A, Barkis D, Wesselink PR. Prevalence and extent of long oval canals in the apical third. Oral Surg Oral Med Oral Pathol Oral Radiol. 2000;89:739–43. https://doi.org/10.1067/moe.2000.106344 DOI: https://doi.org/10.1067/moe.2000.106344
Pereira RD, Brito-Junior M, Leoni GB, Estrela C, de Sousa-Neto MD. Evaluation of bond strength in single-cone fillings of canals with different cross-sections. Int Endod J. 2017;50:177–83. https://doi.org/10.1111/iej.12607 DOI: https://doi.org/10.1111/iej.12607
Uzun I, Keles A, Arslan H, Guler B, Keskin C, Gunduz K. Influence of oval and circular post placement using different resin cements on push-out bond strength and void volume analysed by micro-CT. Int Endod J. 2016;49:1175–82. https://doi.org/10.1111/iej.12568 DOI: https://doi.org/10.1111/iej.12568
Yamin PA, Pereira RD, Lopes FC, Queiroz AM, Oliveira HF, Saquy PC, et al. Longevity of bond strength of resin cements to root dentine after radiation therapy. Int Endod J. 2018;51:1301–12. https://doi.org/10.1111/iej.12945 DOI: https://doi.org/10.1111/iej.12945
Jainaen A, Palamara JE, Messer HH. Push-out bond strengths of the dentine-sealer interface with and without a main cone. Int Endod J. 2007;40:882–90. https://doi.org/10.1111/j.1365-2591.2007.01308.x DOI: https://doi.org/10.1111/j.1365-2591.2007.01308.x
Nunes VH, Silva RG, Alfredo E, Sousa-Neto MD, Silva-Sousa YT. Adhesion of epiphany and AH plus sealers to human root dentin treated with different solutions. Braz Dent J. 2008;19:46–50. https://doi.org/10.1590/s0103-64402008000100008 DOI: https://doi.org/10.1590/S0103-64402008000100008
Decurcio DA, Lim E, Chaves GS, Nagendrababu V, Estrela C, Rossi-Fedele G. Pre-clinical endodontic education outcomes between artificial versus extracted natural teeth: a systematic review. Int Endod J. 2019;52:1153–61. https://doi.org/10.1111/iej.13116 DOI: https://doi.org/10.1111/iej.13116
Reymus M, Fotiadou C, Kessler A, Heck K, Hickel R, Diegritz C. 3D printed replicas for endodontic education. Int Endod J. 2019;52:123–30. https://doi.org/10.1111/iej.12964 DOI: https://doi.org/10.1111/iej.12964
De-Deus G, Simoes-Carvalho M, Belladonna FG, Versiani MA, Silva E, Cavalcante DM, et al. Creation of well-balanced experimental groups for comparative endodontic laboratory studies: a new proposal based on micro-CT and in silico methods. Int Endod J. 2020;53:974–85. https://doi.org/10.1111/iej.13288 DOI: https://doi.org/10.1111/iej.13288
Goracci C, Fabianelli A, Sadek FT, Papacchini F, Tay FR, Ferrari M. The contribution of friction to the dislocation resistance of bonded fiber posts. J Endod. 2005;31:608–12. https://doi.org/10.1097/01.don.0000153841.23594.91 DOI: https://doi.org/10.1097/01.don.0000153841.23594.91
Coniglio I, Magni E, Cantoro A, Goracci C, Ferrari M. Push-out bond strength of circular and oval-shaped fiber posts. Clin Oral Investig. 2011;15:667–72. https://doi.org/10.1007/s00784-010-0448-0 DOI: https://doi.org/10.1007/s00784-010-0448-0
Webber MBF, Bernardon P, Franca FMG, Amaral FLB, Basting RT, Turssi CP. Oval versus circular-shaped root canals: bond strength reached with varying post techniques. Braz Dent J. 2018;29:335–41. https://doi.org/10.1590/0103-6440201801937 DOI: https://doi.org/10.1590/0103-6440201801937
Alster D, Feilzer AJ, de Gee AJ, Davidson CL. Polymerization contraction stress in thin resin composite layers as a function of layer thickness. Dent Mater. 1997;13:146–50. https://doi.org/10.1016/S0109-5641(97)80115-7 DOI: https://doi.org/10.1016/S0109-5641(97)80115-7
Goracci C, Tavares AU, Fabianelli A, Monticelli F, Raffaelli O, Cardoso PC, et al. The adhesion between fiber posts and root canal walls: comparison between microtensile and push-out bond strength measurements. Eur J Oral Sci. 2004;112:353–61. https://doi.org/10.1111/j.1600-0722.2004.00146.x DOI: https://doi.org/10.1111/j.1600-0722.2004.00146.x
Zorba YO, Erdemir A, Turkyilmaz A, Eldeniz AU. Effects of different curing units and luting agents on push-out bond strength of translucent posts. J Endod. 2010;36:1521–5. https://doi.org/10.1016/j.joen.2010.04.026 DOI: https://doi.org/10.1016/j.joen.2010.04.026
Scotti N, Forniglia A, Bergantin E, Paolino DS, Pasqualini D, Berutti E. Fibre post adaptation and bond strength in oval canals. Int Endod J. 2014;47:366–72. https://doi.org/10.1111/iej.12156 DOI: https://doi.org/10.1111/iej.12156
Kremeier K, Fasen L, Klaiber B, Hofmann N. Influence of endodontic post type (glass fiber, quartz fiber or gold) and luting material on push-out bond strength to dentin in-vitro. Dent Mater. 2008;24:660–6. https://doi.org/10.1016/j.dental.2007.06.029 DOI: https://doi.org/10.1016/j.dental.2007.06.029
Lo Giudice G, Cutroneo G, Centofanti A, Artemisia A, Bramanti E, Militi A, et al. Dentin morphology of root canal surface: a quantitative evaluation based on a scanning electronic microscopy study. Biomed Res Int. 2015;2015:164065. https://doi.org/10.1155/2015/164065 DOI: https://doi.org/10.1155/2015/164065
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