Análise comparativa de comportamento in vivo e in vitro de protocolos de reabilitação de dentes tratados endodonticamente

Abstract

The restoration of endodontically treated teeth have been a challenge for restorative dentistry because usually the amount of remaining coronal dentin of these teeth are not enough to retain the restorative material, requiring the use of intra-radicular posts to provide retention for the core and restorative crown. This study aimed to evaluate the effect of rehabilitation protocols of endodontically treated teeth for the comparison of in vivo and simultaneous in vitro tests, employing mechanical tests and computational by finite element method; also aims to validate the computational and experimental testing laboratory through comparative analysis with clinical parameters. This study was divided into four specific objectives; specific objective 1: to evaluate the influence of the surface treatments of fiberglass posts on bond strength to root dentin using push-out test; specific objective 2: to develop protocol and validate the generation of three-dimensional patient specific model of anterior central incisors with different ferrule design restored with glass fiber post and CAD- CAM all-ceramic restoration using cone-beam computed tomography and specific software combination for finite elements analysis; specific objective 3: to evaluate the strain before and after thermo-mechanical fatigue aging, the fracture resistance and fracture mode of endodontically treated incisors restored using a fiberglass post and CAD/CAM all ceramic crown with and without ferrule; specific objective 4: generate manuscript that summarize the main findings of specific objective 1, 2 and 3 designated to Brazilian clinical fulfilling the social function of knowledge generation. After analyzing the results it can be concluded that the post surface treatment with 24% hydrogen peroxide for 1 min yielded significantly higher bond strength on the fiberglass posts cementation. The definition of protocol of individualized models provided the sequence necessary for the application of the methodology on patient, the stress distribution on evaluated teeth showed that stresses on left incisor, which had no-uniform ferrule were higher compared with the right incisor, regardless of the loading method. The maintenance of uniform ferrule was more relevant than localized higher ferrule. The ferrule presence prevented the post detaching maintain the root dentin strain after thermal-mechanical aging. The no ferrule group showed increase root dentin strain after aging process. The ferrule group had higher fracture resistance, lower stress concentration on root dentin and 14 less catastrophic fractures. The use of glass fiber post associated to the all ceramic crown allowed the restoration of biomechanics aesthetics and functionality of endodontically treated tooth with periodontal intervention in order to achieve a favorable condition for the restorative procedures.