بررسی اثر بکارگیری گلاس فایبر به همراه کامپوزیت بالک فیل بر مقاومت به شکست دندان‌های پره مولر درمان ریشه شده

ﻣﻘﺪﻣﻪ: ﮐﺎﻫﺶ ﻣﻘﺎوﻣﺖ ﺑﻪ ﺷﮑﺴﺖ و اﺳﺘﺤﮑﺎم دﻧﺪانﻫﺎی ﭘﺮه ﻣﻮﻟﺮ درﻣﺎن رﯾﺸﻪ ﺷﺪه ﮐﻪ ﻫﺮ دو ﻣﺎرﺟﯿﻨﺎل رﯾﺞ ﺧﻮد را از دﺳﺖ داده اﻧﺪ، ﯾﮑﯽ از ﺷﺎﯾﻊﺗﺮﯾﻦ ﻣﺸﮑﻼت دﻧﺪاﻧﭙﺰﺷﮑﯽ ﺑﻪ ﺷﻤﺎر ﻣﯽرود. ﻫﺪف از ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ، ﺑﺮرﺳﯽ اﺛﺮ ﺑﮑﺎرﮔﯿﺮی ﮔﻼس ﻓﺎﯾﺒﺮ ﺑﻪ ﻫﻤﺮاه ﮐﺎﻣﭙﻮزﯾﺖ ﺑﺎﻟﮏ ﻓﯿﻞ ﺑﺮ ﻣﻘﺎوﻣﺖ ﺑﻪ ﺷﮑﺴﺖ دﻧﺪانﻫﺎی ﭘﺮه ﻣﻮﻟﺮ درﻣﺎن رﯾﺸﻪ ﺷﺪه ﺑﻮد. ﻣﻮاد و روشﻫﺎ: در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺗﺠﺮﺑﯽ آزﻣﺎﯾﺸﮕﺎﻫﯽ، 60 دﻧﺪان ﭘﺮﻣﻮﻟﺮ اﻧﺴﺎﻧﯽ ﺳﺎﻟﻢ ﺑﻪ 5 ﮔﺮوه ﻣﺴﺎوی n=12 ﺗﻘﺴﯿﻢ ﺷﺪﻧﺪ. ﮔﺮوه اول ﺷﺎﻣﻞ دﻧﺪانﻫﺎی ﺳﺎﻟﻢ ﺑﺪون ﻫﯿﭻ ﺣﻔﺮه آﻣﺎدهﺳﺎزی ﺑﻮد. اﯾﻦ دﻧﺪانﻫﺎ ﺑﻪ ﻋﻨﻮان ﮔﺮوه ﺷﺎﻫﺪ ﮐﻨﺘﺮل ﻣﻨﻔﯽ در ﻧﻈﺮ ﮔﺮﻓﺘﻪ ﺷﺪﻧﺪ. در ﮔﺮوه 2 ﺣﻔﺮه mod ﺗﻬﯿﻪ ﺷﺪ، اﻣﺎ ﺗﺮﻣﯿﻢ ﻧﺸﺪه و ﺑﻪ ﻋﻨﻮان ﮐﻨﺘﺮل ﻣﺜﺒﺖ در ﻧﻈﺮ ﮔﺮﻓﺘﻪ ﺷﺪﻧﺪ. در ﮔﺮوه 3 ﺗﻬﯿﻪ ﺣﻔﺮه mod ﻣﺸﺎﺑﻪ ﮔﺮوه 2 اﻧﺠﺎم ﺷﺪ ،ﺣﻔﺮه ﺑﺎ ﮐﺎﻣﭙﻮزﯾﺖ ﺑﻪ ﺻﻮرت ﺗﻮدهای ﺗﺮﻣﯿﻢ ﺷﺪ. ﮔﺮوه4: ﺗﻬﯿﻪ ﺣﻔﺮه mod و ﻣﺮاﺣﻞ اچ و ﺑﺎﻧﺪﯾﻨﮓ ﻣﺸﺎﺑﻪ ﮔﺮوه ﻗﺒﻞ اﻧﺠﺎم ﺷﺪ. در ﮐﻒ ﭘﺎﻟﭙﺎل ﺣﻔﺮه ﻻﯾﻪای از ﮐﺎﻣﭙﻮزﯾﺖ ﻗﺮار ﮔﺮﻓﺖ و ﻗﺒﻞ از ﮐﯿﻮر ﮐﺮدن، ﮔﻼس ﻓﺎﯾﺒﺮ در ﺟﻬﺖ ﺑﺎﮐﻮ ﻟﯿﻨﮕﻮاﻟﯽ ﺑﺮ ﮐﺎﻣﭙﻮزﯾﺖ ﻗﺮار ﮔﺮﻓﺖ و ﺑﻪ ﻣﺪت 40 ﺛﺎﻧﯿﻪ ﮐﯿﻮر ﺷﺪ . در ﮔﺮوه 5 ﺗﻬﯿﻪ ﺣﻔﺮه و ﺑﺎﻧﺪﯾﻨﮓ ﻣﺸﺎﺑﻪ ﮔﺮوهﻫﺎی ﻗﺒﻠﯽ اﻧﺠﺎم ﺷﺪ. ﺣﻔﺮهﻫﺎ ﺑﻪ وﺳﯿﻠﻪ ﮐﺎﻣﭙﻮزﯾﺖ ﺗﺎ ﺿﺨﺎﻣﺖ 4 ﻣﯿﻠﯿﻤﺘﺮ ﭘﺮ ﺷﺪ. ﺳﭙﺲ ﺑﺮ روی ﮐﺎﻣﭙﻮزﯾﺖ، ﮔﻼس ﻓﺎﯾﺒﺮ اﻣﺘﺪاد ﯾﺎﻓﺖ و ﺳﭙﺲ ﻧﻤﻮﻧﻪ ﻫﺎ ﺑﻪ ﻣﺪت 40 ﺛﺎﻧﯿﻪ ﮐﯿﻮر ﺷﺪﻧﺪ. ﻣﻘﺎوﻣﺖ ﺑﻪ ﺷﮑﺴﺖ دﻧﺪانﻫﺎ ﺑﺎ دﺳﺘﮕﺎه ﺗﺴﺖ ﯾﻮﻧﯿﻮرﺳﺎل ﺑﺮرﺳﯽ ﺷﺪ و در ﻧﻬﺎﯾﺖ دادهﻫﺎ ﺑﺎ ﻧﺮم اﻓﺰار spss ﻣﻮرد ﺗﺠﺰﯾﻪ و ﺗﺤﻠﯿﻞ ﻗﺮار ﮔﺮﻓﺘﻨﺪ. ﯾﺎﻓﺘﻪﻫﺎ: در ﮔﺮوه ﺗﻘﻮﯾﺖ ﺷﺪه ﺑﺎ ﻓﺎﯾﺒﺮ ﺟﯿﻨﺠﯿﻮال، ﻣﻘﺎوﻣﺖ ﺷﮑﺴﺖ ﺑﻪ ﻃﻮر ﻣﻌﻨﺎداری از ﮔﺮوه ﺗﺮﻣﯿﻢ ﺷﺪه ﺑﺎ ﮐﺎﻣﭙﻮزﯾﺖ ﺑﺎﻟﮏ ﺑﻪ ﺗﻨﻬﺎﯾﯽ ﺑﺎﻻﺗﺮ ﺑﻮد p=0/01 اﻣﺎ اﯾﻦ اﺧﺘﻼف در ﮔﺮوه ﻓﺎﯾﺒﺮ اﮐﻠﻮزال ﻣﻌﻨﯽ دار ﻧﺒﻮد p=0/087 . ﺗﻔﺎوﺗﯽ ﻣﻌﻨﯽ داری ﺑﯿﻦ ﮔﺮوه ﻓﺎﯾﺒﺮ اﮐﻠﻮزال و ﺟﯿﻨﺠﯿﻮال ﻣﺸﺎﻫﺪه ﻧﺸﺪ. p=0/38 ﻧﺘﯿﺠﻪ ﮔﯿﺮی: ﺗﺮﻣﯿﻢ دﻧﺪان ﭘﺮﻣﻮﻟﺮ درﻣﺎن رﯾﺸﻪ ﺷﺪه ﺑﺎ ﮐﺎﻣﭙﻮزﯾﺖ ﺑﺎﻟﮏ ﻓﯿﻞ، ﻣﻘﺎوﻣﺖ ﺷﮑﺴﺖ رادر ﺣﺪ دﻧﺪان ﺳﺎﻟﻢ اﻓﺰاﯾﺶ ﻣﯽدﻫﺪ و ﻗﺮاردﻫﯽ ﻓﺎﯾﺒﺮ ﺟﯿﻨﺠﯿﻮال اﯾﻦ اﺛﺮ را ﺗﻘﻮﯾﺖ ﻣﯿﮑﻨﺪ.

evaluation of the effect of glass fiber inserts along with bulk-fill composite on fracture resistance of endodontically -treated premolar teeth

compromised fracture resistance of endodontically treated premolars, is one of the most common dental problems. the aim of the present study was to investigate the effect of using fiberglass with bulk fill composite on fracture resistance of premolars.materials and methods: in this in vitro study, 60 healthy human premolar teeth were divided into 5 equal groups (n=12). the first group included healthy teeth without any cavity preparation. these teeth were considered as control group (negative control). in group 2, mod cavity was prepared but not repaired and they were considered as positive control. group 3, mod cavity preparation was done similarly to group 2. the cavity was repaired with composite. group 4: preparation of the mod cavity and etching and bonding steps were carried out in the same way as the previous group. a layer of composite was placed on the pulpal floor of the cavity and before curing, glass fiber was placed on the composite in the bucco-lingual direction and cured for 40 seconds. in group 5, cavity preparation and bonding were performed similar to the previous groups. cavities were filled with composite up to a thickness of 4 mm. then, glass fiber was extended on the composite and then the sample was cured for 40 seconds. the fracture resistance of the teeth was checked with a universal test device and finally the data was analyzed with spss software.results: in the gingival fiber-reinforced group, the fracture toughness was significantly higher than the bulk composite-restored group (p=0.01), but this difference was not significant in the occlusal fiber group (p=0.870). no significant difference was observed between occlusal and gingival fiber groups. (p=0.38)conclusion: restoring endodontically treated premolars with bulk fill composite increases their fracture resistances, equal to an intact tooth, and using glass fibers in the gingival area of the cavity enhances its effect.