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Azerbaycan Saytlari

 »  Home  »  Endodontic Articles 6  »  Stainless steel bands in endodontics: effects on cuspal flexure and fracture resistance
Stainless steel bands in endodontics: effects on cuspal flexure and fracture resistance
Discussion - References.

This study found that a band reduced cuspal deflection compared with the same teeth without a band. The range of cuspal deflections was large: without a band, the deflections varied from 5.8 m to 33.4 m, and after band placement the deflection was 3.6 m to 15.9 m. The variation of the deflections related to differences in tooth morphology and stiffness, and the difficulty of standardization of cavity preparation and measurement despite careful attempts. By using each tooth as its own control, however, the effect of band placement could be determined on an individual tooth basis.
The experimental design required that all teeth were tested in the same sequence: first, without a band, then with the band cemented, and then loaded to fracture. It is unlikely that teeth were damaged by loading to 100 N without a band. The load of 100 N has been used in numerous studies previously without reported damage (Reeh et al. 1989, Panitvisai & Messer 1995), and was well below the subsequently measured fracture load (minimum 469 N).
The mean deflection of both cusps in this study (8.1 m) was similar to that reported for intact teeth (11 m, Hood 1991). The band clearly acts as a barrier for extensive deflection, and the teeth reacted in much the same way as an intact tooth with continuity of the enamel (Hood 1991).
With preformed bands, the size and type of band and the quality of fit could affect the extent of outward deflection of the cusps. This study used only one band product, a universal type, and it was found that not all teeth matched the available sizes ideally. It is possible that an inward displacement could occur during cementation of a tightly fitting band. However, this study did not evaluate whether an inward displacement occurred.
For temporary restoration of a broken-down posterior tooth, amalgam restoration without cuspal coverage is not recommended. Some authors have recommended that the temporary restoration should be a pin-retained cuspal coverage amalgam restoration (Barkmeier et al. 1980), a cuspal coverage amalgam restoration (Messer & Wilson 1996), or a bonded composite or glass ionomer cement (Kahn 1982, Gutmann & Lovdahl 1997). Based on the results of this study, stainless steel bands could be recommended for teeth with an unsupported cusp present. Taking a tooth ‘out of occlusion’ by reduction of cuspal height is also recommended. The fracture resistance of a tooth with a band (this study) is greater than for a tooth with an amalgam restoration (Reeh et al. 1989). Reeh et al. (1989) found that teeth restored with an amalgam restoration fractured at a load of approximately 60 kg (588 N), which is similar to our result for teeth without a band (729 N) and less than the load needed to fracture a tooth with a band in this study (1282 N).
This study demonstrated that stainless steel bands reduced the cuspal flexure by one-half compared to teeth without bands and, furthermore, doubled the fracture strength. If these results can be applied to the clinical situation, stainless steel bands are able to provide a protective effect for teeth undergoing root canal treatment and in the immediate management of cracked–tooth syndrome.


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