Accelerated fatigue resistance and color stability of endodontically treated bleached maxillary incisors restored with and without a post.

Abstract

Purpose: The present study aimed to assess fatigue resistance and color modifications of endodontically treated incisors (ETIs) submitted to internal bleaching and restored using three different techniques.

Materials and methods: Forty-five maxillary central incisors received endodontic treatment and were internally bleached. After the completion of bleaching, the ETIs were divided into three groups (n = 15) according to the different restoration procedures: 1) glass-ionomer cement base covered with composite resin (GI); 2) short fiber-reinforced composite resin base with composite resin (SF); 3) composite resin restoration over a fiberglass post (FP). Specimens were subjected to accelerated fatigue testing: frequency of 5 Hz, beginning with a load of 100 N for 5000 cycles and a 25-N load increase applied every 1700 cycles until a load of 1200 N was reached. Samples were loaded until fracture. The Kaplan-Meier survival analysis with the log-rank post hoc test were performed (α = 0.05). Tooth color was measured 4 weeks after the bleaching treatment and again after the final restoration procedure using a spectrophotometer and the Commission Internationale de l'Eclairage (CIE) L*a*b* system. L* values of the specimens were analyzed using the Shapiro-Wilk and paired sample t tests (α = 0.05).

Results: All groups showed similar survival mean cycles until failure (P = 0.332) and presented a major number of nonrestorable failures. The GI group presented the lowest number of nonrepairable fractures (GI = 68%, SF = 79%, FP = 86%) and showed the most stable L* value (P = 0.987).

Conclusions: The fatigue survival of internally bleached ETIs was not affected by the restorative technique utilized. Retaining the glass-ionomer base and covering the surface with composite resin should provide optimal color stability.