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• W2296946898 abstract "Why do root-filled teeth fracture? For many years the increased risk of fracture exhibited by nonvital/root-filled teeth was thought to be a result of desiccation or premature loss of fluids supplied by vital pulps. This assumption appeared to be confirmed by the work of Helfer et al (1972) who reported that there was approximately 10% less collagenbound water in non-vital teeth and that such ‘drying out’ led to a deterioration in the tooth’s physical properties. It has also been suggested that root-filled teeth undergo changes in collagen cross-linking (Rivera EM, Yamauchi M, 1993). While these theories do carry some credence, increasingly it is believed that the ability of a root-treated tooth to resist fracture is directly related to the amount of remaining tooth structure (Vale WA, 1956; Larson TD et al, 1981; Mondelli J et al, 1980). Prior to Helfer’s findings, Fusayama and Maeda (1969) had shown that there is no difference in the modulus of elasticity, hardness or fracture resistance of pulpless teeth. In other words, as more tooth structure is removed, the resistance to occlusal forces is diminished and the likelihood of fracture increases – more on this later when we discuss the choice of final restoration. Modern endodontic practice prefers an access cavity preparation that gives endodontic instruments straight-line access into the canal space. This, along with the concept of ‘crown down’ in endodontic therapy, means that considerable amounts of sound coronal and radicular dentine must be removed for efficient cleaning and shaping of the root canal system. Studies examining the relationship between dentine removal from the root canal and resistance of the tooth to fracture – e.g. Trope (1985) – consistently show that such preparation of the canal further weakens the root." @default.
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• W2296946898 date "2011-01-01" @default.
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• W2296946898 title "The restoration of root-filled posterior teeth" @default.
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