World Journal of Dentistry

Register      Login

VOLUME 14 , ISSUE 3 ( March, 2023 ) > List of Articles


Fracture Resistance of Endodontically Treated Tooth Restored with Fiber Reinforced Composite Core and Crown at Different Heights of Ferrule

Dara Khorsyiah Yakob, Rabihah Alawi, Nor Aidaniza Abdul Muttlib, Normastura Abd Rahman, Saleem D Makandar

Keywords : Ferrule, Fiber post, Fiber-reinforced composite, Fracture resistance, Metal post

Citation Information : Yakob DK, Alawi R, Muttlib NA, Rahman NA, Makandar SD. Fracture Resistance of Endodontically Treated Tooth Restored with Fiber Reinforced Composite Core and Crown at Different Heights of Ferrule. World J Dent 2023; 14 (3):238-244.

DOI: 10.5005/jp-journals-10015-2192

License: CC BY-NC 4.0

Published Online: 05-05-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Aims: The aim of this study was to compare the fracture resistance of endodontically treated teeth restored with fiber-reinforced composite core and crown using different postmaterials at different ferrule heights. Materials and methods: A total of 49 extracted single-rooted lower premolar teeth were grouped into control (sound teeth), prefabricated fiber posts—IA (no ferrule), IB (2 mm ferrule), IC (3 mm ferrule), and prefabricated metal posts—IIA (no ferrule), IIB (2 mm ferrule), IIC (3 mm ferrule), with seven teeth for each group. After root canal treatment, posts were cemented, fiber-reinforced composite cores were built-up, and then metal crowns were cemented. Teeth were subjected to thermal cycling and compressive load until fracture. Results: The control group exhibited the highest mean [standard deviation (SD)] fracture resistance [1041.31N (± 278.40)]. For comparison of the mean fracture resistance between fiber and metal posts at different heights of ferrule restored with fiber-reinforced composite cores, a significant difference was observed at 0 mm ferrule (p = 0.003). The association between fracture mode and types of prefabricated post was significant at 0 mm ferrule (p = 0.026). All teeth in fiber posts group had favorable fracture mode. Conclusion: In the presence of ferrule, the fracture resistance of endodontically restored teeth with fiber posts and fiber-reinforced composite cores was comparable to those restored with metal posts. The favorable fracture mode occurred in teeth restored with fiber posts and fiber-reinforced composite cores, either with or without the ferrule. Clinical significance: The fiber-reinforced composite cores increased the fracture resistance of tooth restored using fiber post with the presence of ferrule and resulted in favorable fracture mode in teeth with or without the ferrule. In the clinical situation, this material has the potential to be used for a core material in combination with the use of fiber posts for endodontically teeth with compromised coronal tooth structure.

PDF Share
  1. Mangold JT, Kern M. Influence of glass-fiber posts on the fracture resistance and failure pattern of endodontically treated premolars with varying substance loss: an in vitro study. J Prosthet Dent 2011;105(6):387–393. DOI: 10.1016/S0022-3913(11)60080-2
  2. Stankiewicz N, Wilson P. The ferrule effect. Dent Update 2008;35(4):222–228. DOI: 10.12968/denu.2008.35.4.222
  3. Tamse A, Fuss Z, Lustig J, et al. An evaluation of endodontically treated vertically fractured teeth. J Endod 1999;25(7):506–508. DOI: 10.1016/S0099-2399(99)80292-1
  4. Sidoli GE, King PA, Setchell DJ. An in vitro evaluation of a carbon fiber-based post and core system. J Prosthet Dent 1997;78(1):5–9. DOI: 10.1016/s0022-3913(97)70080-5
  5. Ichim I, Kuzmanovic DV, Love RM. A finite element analysis of ferrule design on restoration resistance and distribution of stress within a root. Int Endod J 2006;39(6):443–452. DOI: 10.1111/j.1365-2591.2006.01085.x
  6. Pereira JR, de Ornelas F, Conti PC, et al. Effect of a crown ferrule on the fracture resistance of endodontically treated teeth restored with prefabricated posts. J Prosthet Dent 2006;95(1):50–54. DOI: 10.1016/j.prosdent.2005.10.019
  7. Naumann M, Preuss A, Rosentritt M. Effect of incomplete crown ferrules on load capacity of endodontically treated maxillary incisors restored with fiber posts, composite build-ups, and all-ceramic crowns: an in vitro evaluation after chewing simulation. Acta Odontol Scand 2006;64(1):31–36. DOI: 10.1080/00016350500331120
  8. Cho H, Michalakis KX, Kim Y, et al. Impact of interproximal groove placement and remaining coronal tooth structure on the fracture resistance of endodontically treated maxillary anterior teeth. J Prosthodont 2009;18(1):43–48 DOI: 10.1111/j.1532-849X.2008.00379.x
  9. Schmitter M, Rammelsberg P, Lenz J, et al. Teeth restored using fiber-reinforced posts: in vitro fracture tests and finite element analysis. Acta Biomater 2010;6(9):3747–3754 DOI: 10.1016/j.actbio.2010.03.012
  10. Qing H, Zhu Z, Chao Y, et al. In vitro evaluation of the fracture resistance of anterior endodontically treated teeth restored with glass fiber and zirconia posts. J Prosthet Dent 2007;97(2):93–98. DOI: 10.1016/j.prosdent.2006.12.008
  11. Hayashi M, Sugeta A, Takahashi Y, et al. Static and fatigue fracture resistance of pulpless teeth restored with post-cores. Dent Mater 2008;24(9):1178–1186 DOI: 10.1016/
  12. Buttel L, Krastl G, Lorch H, et al. Influence of post fit and post length on fracture resistance. Int Endod J 2009;42(1):47–53. DOI: 10.1111/j.1365-2591.2008.01492.x
  13. Combe EC, Shaglouf AM, Watts DC, et al. Mechanical properties of direct core materials. Dent Mater 1999;15(3):158–165. DOI: 10.1016/s0109-5641(99)00027-5
  14. Burke FJ, Shaglouf AG, Combe EC, et al. Fracture resistance of five pin-retained core build-up materials on teeth with and without extracoronal preparation. Oper Dent 2000;25(5):388–394.
  15. Jayanthi N, Vinod V. Comparative evaluation of compressive strength and flexural strength of conventional core materials with nanohybrid composite resin core material an in vitro study. J Indian Prosthodont Soc 2013;13(3):281–289. DOI: 10.1007/s13191-012-0236-4
  16. Naumann M, Sterzenbach G, Dietrich T, et al. Dentin-like versus rigid endodontic post: 11-year randomized controlled pilot trial on no-wall to 2-wall defects. J Endod 2017;43(11):1770–1775. DOI: 10.1016/j.joen.2017.06.030
  17. Garoushi S, Vallittu PK, Lassila LV. Direct restoration of severely damaged incisors using short fiber-reinforced composite resin. J Dent 2007;35(9):731–736. DOI: 10.1016/j.jdent.2007.05.009
  18. Garoushi S, Vallittu PK, Watts DC, et al. Polymerization shrinkage of experimental short glass fiber- reinforced composite with semi-inter penetrating polymer network matrix. Dent Mater 2008;24(2):211–215. DOI: 10.1016/
  19. Garoushi S, Vallittu PK, Lassila LV. Short glass fiber reinforced restorative composite resin with semi-interpenetrating polymer network matrix. Dent Mater 2007;23(11):1356–1362. DOI: 10.1016/
  20. Bijelic-Donova J, Garoushi S, Vallittu PK. et al. Mechanical properties, fracture resistance, and fatigue limits of short fiber reinforced dental composite resin. J Prosthet Dent 2016;115(1):95–102. DOI: 10.1016/j.prosdent.2015.07.012
  21. Abouelleil H, Pradelle N, Villat C, et al. Comparison of mechanical properties of a new fiber reinforced composite and bulk filling composites. Restor Dent Endod 2015;40(4):262–270. DOI: 10.5395/rde.2015.40.4.262
  22. Schwartz RS, Robbins JW. Post placement and restoration of endodontically treated teeth: a literature review. J Endo 2004;30(5):289–301. DOI: 10.1097/00004770-200405000-00001
  23. Abo El-Ela OA, Atta OA, El-Mowafy O. Fracture resistance of anterior teeth restored with a novel nonmetallic post. J Can Dent Assoc 2008;74(5):441.
  24. Garoushi SK, Hatem M, Lassila LVJ, et al. The effect of short fiber composite base on microleakage and load-bearing capacity of posterior restorations. Acta Biomater Odontol Scand 2015;1(1):6–12. DOI: 10.3109/23337931.2015.1017576
  25. Zhang YY, Peng MO, Wong YN, et al. The effects of ferrule configurations on the anti-fracture ability of fiber post restored teeth. J Dent 2015;43(1):117–125. DOI: 10.1016/j.jdent.2014.10.003
  26. Le Bell-Rönnlöf AM, Lassila LV, Kangasniemi I, et al. Load-bearing capacity of human incisor restored with various fiber-reinforced composite posts. Dent Mater 2011;27(6):e107–115. DOI: 10.1016/
  27. Sirimai S, Riis DN, Morgano SM. An in vitro study of a fracture resistance and the incidence of vertical root fracture of the pulpless teeth restored with six post and core system. J Prosthet Dent 1999;81(3):262–269. DOI: 10.1016/s0022-3913(99)70267-2
  28. Bandlish RB, Mc Donald AV, Setchell DJ. Assessment of the amount of remaining coronal dentin in root-treated teeth. J Dent 2006;34(9):699–708. DOI: 10.1016/j.jdent.2006.01.002
  29. Al- Omiri MK, Mahmoud AA, Rayyan MR, et al. Fracture resistance of teeth restored with post-retained restorations: an overview. J Endod 2010;36(9):1439–1449. DOI: 10.1016/j.joen.2010.06.005
  30. Machado J, Almeida P, Fernandes S, et al. Currently used systems of dental posts for endodontic treatment. Procedia Structural Integrity 2017;5:27–33. DOI: 10.1016/J.PROSTR.2017.07.056
  31. Wandscher VF, Bergoli CD, Limberger IF, et al. Preliminary results of the survival and fracture load of roots restored with intracanal posts: weakened vs nonweakened roots. Oper Dent 2014;39(5):541–555. DOI: 10.2341/12-465
  32. Al-Wahadni AM, Hamdan S, Al-Omiri M, et al. Fracture resistance of teeth restored with different post systems: in vitro study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106(2): e77–83. DOI: 10.1016/j.tripleo.2008.03.038
  33. Makade CS, Meshram GK, Warhadpande M, et al. A comparative evaluation of fracture resistance of endodontically treated teeth restored with different post core systems—an in-vitro study. J Adv Prosthodont 2011;3(2):90–95. DOI: 10.4047/jap.2011.3.2.90
  34. Ferrari M, Vichi A, Mannocci F, et al. Retrospective study of the clinical performance of fiber posts. Am J Dent 2000;13(Spec no):9B–13B.
  35. Ferrari M, Cagidiaco MC, Goracci C, et al. Long-term retrospective study of the clinical performance of fiber posts. Am J Dent 2007;20(5):287–291.
  36. Alshabib A, Silicas N, Watts DC. Hardness and fracture toughness of resin composite materials with and without fibers. Dent Mater 2019;35(8):1194–1203. DOI: 10.1016/
  37. Soares CJ, Rodrigues MP, Faria-E-Silva AL, et al. How biomechanics can affect the endodontic treated teeth and their restorative procedures? Braz Oral Res 2018;32(suppl 1):e76. DOI: 10.1590/1807-3107bor-2018.vol32.0076
  38. Fráter M, Forster A, Kereszturi M, et al. In vitro fracture resistance of molar teeth restored with a short fiber reinforced composite material. J Dent 2014;42(9):1143–1150. DOI: 10.1016/j.jdent.2014.05.004
  39. Lazari PC, de Carvalho MA, Del Bel Cury AA, et al. Survival of extensively damaged endodontically treated incisors restored with different types of posts-and-core foundation restoration material. J Prosthet Dent 2018;119(5):769–776. DOI: 10.1016/j.prosdent.2017.05.012
  40. Torres-Sánchez C, Montoya-Salazar V, Cardoba P, et al. Fracture resistance of endodontically treated teeth restored with glass fibre reinforced posts and cast gold post and cores cemented with three cements. J Prosthet Dent 2013;110(2):127–133. DOI: 10.1016/S0022-3913(13)60352-2
  41. Lassila LV, Tanner J, Le Bell AM, et al. Flexural properties of fiber reinforced root canal posts. Dent Mater 2004;20(1):29–36. DOI: 10.1016/s0109-5641(03)00065-4
  42. Salameh Z, Sorrentino R, Ounsi HF, et al. The effect of different full-coverage crown systems on fracture resistance and failure pattern of endodontically treated maxillary incisors restored with and without glass fiber posts. J Endod 2008;34(7):842–846. DOI: 10.1016/j.joen.2008.03.025
  43. Juloski J, Apicella D, Ferraria M. The effect of ferrule height on stress distribution within a tooth restored with fiber posts and ceramic crown: a finite element analysis. Dent Mater 2014;30(12):1304–1315. DOI: 10.1016/
  44. Barcellos RR, Correia DP, Farina AP, et al. Fracture resistance of endodontically treated teeth restored with intra-radicular post: The effects of post system and dentin thickness. J Biomech 2013;46(15): 2572–2577. DOI: 10.1067/mpr.2002.123227
  45. Akkayan B, Gulmez T. Resistance to fracture of endodontically treated teeth restored with different post systems. J Prosthet Dent 2002;87(4):431–437. DOI: 10.1067/mpr.2002.123227
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.