Abstract
Statement of problem
Even without the use of an intraoral scanner, post-and-cores can be obtained by using
a part-digital fabrication workflow that requires pattern modeling (direct, indirect,
or impression); however, studies on the adaptation of computer-aided design and computer-aided
manufacturing (CAD-CAM) composite resin post-and-cores in comparison with metal cast
post-and-cores are sparse.
Purpose
The purpose of this in vitro study was to analyze the adaptation of CAD-CAM composite
resin post-and-cores fabricated through a part-digital fabrication workflow and to
compare it with that of metal cast post-and-cores fabricated through conventional
methods.
Method and materials
Eight extracted human premolars were endodontically treated and prepared for custom
post-and-cores. Metal cast post-and-cores were fabricated with Ni-Cr alloy (Fit Cast-Sb
Plus; Talmax) and conventional resin pattern modeling methods directly in the root
canal (conventional direct modeling) or indirectly in a stone cast (conventional indirect
modeling). Composite resin post-and-cores were milled from nanohybrid glass-ceramic
composite resin CAD-CAM blocks (Brava Block; FGM) by using the part-digital workflow.
A laboratory scanner was used to digitalize polyvinyl siloxane impressions (part-digital
scanned impression direct CAD-CAM [PSC]) of the root canals and resin patterns fabricated
directly (part-digital direct CAD-CAM [PDC]) or indirectly (part-digital indirect
CAD-CAM [PIC]). All post-and-cores were placed in the respectively prepared root canals,
scanned with microcomputed tomography, and measured in terms of volume of the cementation
space, the luting cement film thickness in each root third, and the apical gap between
the apical end of the post-and-cores and remaining gutta percha (apical gap). The
groups were compared for each adaptation parameter by using 2-way (volume of the cementation
space and apical gap) and 3-way (film thickness) ANOVA, and the Games-Howell multicomparison
post hoc test (α=.05).
Results
The conventional direct modeling group had lower mean volume of the cementation space
than all CAD-CAM composite resin post-and-cores (P<.041). The conventional indirect modeling group had a lower volume of the cementation
space mean than PDC (P<.024) but was not significantly different from PIC (P=.577) or PSC (P=.221). Regardless of the fabrication workflow, no differences were observed among
the CAD-CAM composite resin post-and-cores (P>.05). At the apical root third, conventional direct modeling and conventional indirect
modeling had lower film thickness means than PSC or PDC (P<.05). In the middle third, conventional direct modeling and conventional indirect
modeling had lower film thickness means than PDC (P≤.001). At the cervical third, no differences in film thickness means were observed
among the groups (P>.05). PDC had a lower apical gap mean than PSC (P=.013), while no significant differences were found for other pair comparisons (P>.05).
Conclusions
Metal post-and-cores had slightly better adaptation than the CAD-CAM composite resin
post-and-cores; however, the part-digital fabrication workflow of CAD-CAM composite
resin post-and-cores provided adaptation parameters within a clinically acceptable
range and is less time consuming.
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Article info
Publication history
Published online: October 27, 2020
Footnotes
Supported in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001.
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© 2020 by the Editorial Council for the Journal of Prosthetic Dentistry.
