KALOJI NARAYANA RAO UNIVERSITY OF HEALTH

SCIENCES, WARANGAL, TELANGANA – 506007

PROFORMA FOR REGISTRATION OF SUBJECT FOR

DISSERTATION:

1.
NAME OF THE CANDIDATE Dr. MOHAMMED AAMER KHAN
AND ADDRESS
HNO: 16-2-742/F/1/12, ASMANGADH, T.V. TOWER,
MALAKPET, HYDERABAD, 500036

PH: 040-24066558

2.
NAME OF THE INSTITUTION PANINEEYA MAHAVIDYALAYA INSTITUTE OF
AND ADDRESS DENTAL SCIENCES
ROAD NO: 5, KAMALANAGAR
DILSUKHNAGAR,
HYDERABAD - 500060

3.
COURSE OF STUDY AND
MASTERS OF DENTAL SURGERY(MDS);
SPECIALITY
CONSERVATIVE DENTISTRY AND ENDODONTICS

4.
DATE OF ADMISSION TO THE 4th June 2018
COLLEGE

5.
TITLE OF THE TOPIC IMPACT OF VARIOUS FIBER-REINFORCED,
METHACRYLATE AND METHACRYLATE FREE
COMPOSITE RESIN SYSTEMS ON THE FRACTURE
RESISTANCE OF ENDODONTICALLY TREATED
TEETH: An In Vitro Study
6. BRIEF RESUME OF Restoration of endodontically treated teeth is one of the biggest
STUDY/INTENDED challenges in the field of Operative Dentistry. Root canal treatment is
WORK: incomplete until a permanent restoration is placed. For this very
reason, placement of a crown following an endodontic procedure is
considered to be the gold standard. However, there are certain
scenarios where the tooth is still in its eruptive stage, or when the
endodontic treatment has a questionable prognosis, or when the
clinician wants to wait and evaluate the healing of a periapical lesion
before proceeding with full-coverage crown restorations. Besides that,
the tooth preparation required for a full-coverage crown restoration
removes a sufficient amount of remaining sound tooth structure thus
compromising the strength to fracture of endodontically treated teeth.

Advances in adhesive restorations have significantly contributed to

improved fracture resistance of teeth by creating conservative
aesthetic restorations bonded to the teeth. Dual-cure composite resins
have been developed as core build-up materials that help in
overcoming the limitations of extended chair-side time, reduced
interlayer strength, increased interfacial porosity and depth of cure.
Composites reinforced with fibers such as polyethylene and glass
fibers have shown significant improvements in the marginal integrity
and fracture strength of composite resins by the application of a fiber
layer beneath the restoration. These methacrylate based composite
resin systems show polymerization shrinkage, to reduce the same, low
shrinkage silorane based composite resin systems have also been
developed.

This study deals with the influence of various fiber reinforced,

methacrylate and methacrylate free composite resin systems and their
fracture resistance on endodontically treated maxillary premolars.
Fracture strength testing will be performed using a Universal Testing
Machine and the results will be analyzed by 1-way ANOVA (Analysis
of Variance) and Tukey’s post hoc test. Fracture patterns for each
sample will also be examined under a light microscope to determine
the level of fractures.
A. NEEDS AND The purpose of this in vitro study is to comparatively evaluate the
OBJECTIVES OF THE fracture resistance of endodontically treated teeth restored with 2
STUDY: fiber-reinforced composite resins systems, 1 conventional composite
resin and a methacrylate free composite resin system.

The objectives of the study are:

i) -To examine the teeth samples taken for this study
for any aberrations and to perform optimum
endodontic procedures followed by ideal post-
endodontic restorations.

ii) -To prepare Mesio-Occluso-Distal cavities within

the standardized dimensions and restore the teeth
with various composite resin systems used in this
study.

iii) -To subject the teeth samples to fracture testing and

evaluate the fracture resistance of the restored teeth and obtain
statistical data for comparison.
 1. Garoushi S, Mangoush E, Mangoush V, Lassila L (2013) aimed
to determine the static load-bearing capacity of direct composite onlay
B)REVIEW OF restorations made of novel filling composite resin system which
LITERATURE combines short fiber-reinforced composite resins and conventional
particulate filler composite resin system. Three groups of onlay
restorations were fabricated with different composite resin systems
taken for this study. The Specimens were incrementally polymerized
before being statically loaded with two different sized steel balls until
fracture. Failure modes were visually examined. Data was analyzed
using ANOVA. The data revealed that onlay restorations made from
fiber-reinforced composite resin as substructure and surface layer of
conventional composite resin had statistically significantly higher
load-bearing capacity than the other groups.

2. Belli. S, Erdemir. A, Yildirim. C (2016)compared two different

fibre placement techniques on reinforcement of root-filled molar teeth
with (MOD) cavities. In this study, they evaluated 50sound extracted
human mandibular molars which were endodontically treated. The
samples were restored with composite resin. A groove was prepared on
the occlusal surface of the finished restorations and Polyethylene
fibers were inserted in the groove in combination with flowable resin.
Compressive loading of the teeth was performed by a Universal
Testing Machine at a crosshead speed of 0.5mm/min until failure. The
data was recorded in Newtons and submitted to ANOVA and Tukey’s
post hoc. The results concluded that the Polyethylene fibres used over
or under the (MOD) composite restorations significantly increased the
fracture strength. However, when the fibre was placed on the occlusal
surface of the restoration in buccal to lingual direction, significantly
higher resistance was observed.

3. Priyanka SB, Nimisha CS, Parth PP, Deepa SV (2017) evaluated

the fracture resistance of endodontically treated premolars restored
with conventional nanohybrid, silorane composite with glass fibers
and newer fiber-reinforced composite resins in (MOD) cavities in
which 60 human maxillary premolars were selected and randomly
divided into 4 groups and restored with various composite resin
systems. Fracture resistance was measured by Instron Universal
Testing Machine and statistical analysis was done using 1-way
ANOVA and Tukey’s post hoc test. This study concluded that fiber-
reinforced composite resin showed highest fracture resistance
 Preparation of samples :
7. MATERIALS AND 50 intact non-carious unrestored human maxillary premolars are to be
METHODS: collected, endodontically treated and randomly divided into 5 groups
(n=10). Group 1 is Negative Control and Group 2 is the positive
control; the remaining 30 prepared teeth are to be randomly divided
into 3 experimental groups.

Group 1 – Endodontically treated teeth (Negative Control) - 10

Group 2 – Restored with Nanohybrid dual-cure composite (Positive
Control) - 10
Group 3 – Restored with Methacrylate free composite - 10
Group 4 - Restored with Short-Fiber reinforced composite - 10
Group 5 - Restored with Leno Weave Polyethylene fibers - 10

A Pre-operative Intraoral Periapical Radiograph shall be taken for all

the teeth. This is to assess the canal anatomy and morphology of the
teeth prior to endodontic treatment.

Preparation of root canals :

In groups1, 2, 3, 4, and 5 root canals will be negotiated with size 10 K-
type file until its tip is visualized on the apical foramen, and the
working length will be established at 1.0 mm short of the apex. The
canals are to be prepared using Pro-Taper file system upto size F2.
Irrigation will be done with 5.25% Sodium Hypochlorite and after
entire instrumentation, irrigation is to be completed with 17% EDTA
solution as a final rinse. Canals will be dried using paper points and
filled with Gutta percha and AH PLUS endodontic sealer.

Preparation of Occlusal Cavities for Restoration :

Post-operative Intraoral Periapical Radiographs are to be taken to
evaluate the endodontic procedures. Following this, MOD (Mesio-
Occluso-Distal) cavities shall be prepared on the extracted teeth. These
cavities will be restored with various Composite resin systems taken
for this study. The restorations will be finished and polished using
SHOFU Super-Snap polishing kit.

Preparation for the fracture test :

All specimens will be stored in 100% humidity for one day and
embedded in self-cured acrylic resin covering each root upto the
Cemento-Enamel Junction.
Finally the acrylic blocks will be attached to the lower plate of a
UNIVERSAL TESTING MACHINE.

A steel ball with a modified shape will be mounted on the testing

machine and shall be centered over the restored surfaces .The tip will
be lowered vertically parallel to the long axis of the teeth and
 compressive loading will be applied vertically at a speed of 0.5
mm/min until fracture occurs .The forces necessary to fracture each
restoration shall be recorded in Newtons and the type of fracture i.e.,
i) Restorable
ii) Non-restorable shall be noted.

STATISTICAL ANALYSIS:
For evaluation of fracture toughness, the data that will be obtained
from the Universal testing Machine will be compiled systematically. A
master table will be prepared in Microsoft Excel worksheet, and SPSS
version 10.5 software package will be used for data entry and analysis.
The data will be subdivided and distributed meaningfully and
presented as individual tables along with graphs. The results will be
averaged (mean ± standard deviation) for each parameter for
continuous data. 1-way ANOVA test shall be used to determine
whether there is a statistical difference between the groups in the
parameters measured and the results will be re-analysed by Tukey’s
post hoc test for confirmation. P<0.05 will be considered statistically
significant.

B) DOES YOUR STUDY NO

REQUIRE ANY
INVESTIGATION OR
INTERVENTION TO BE
CONDUCTED ON
HUMANS OR
ANIMALS? IF SO,
PLEASE DESCRIBE
BRIEFLY

C) HAS ETHICAL APPLIED

CLEARANCE BEEN
OBTAINED FROM
YOUR INSTITUTION
8. LIST OF
REFERENCES:
1. Eapen AM, Amirtharaj LV, Sanjeev K, Mahalaxmi S.
Fracture resistance of Endodontically Treated Teeth Restored
with 2 Different Fiber-reinforced Composite and 2
Conventional Composite Resin Core Buildup Materials: An in
vitro study. J Endod 2017 Sep;43(9):1499-1504

2. Bilgi PS, Shah NC, Patel PP, Vaid DS. Comparison of

fracture resistance of endodontically treated teeth restored with
nanohybrid, silorane, and fiber reinforced composite: An in
vitro study. J Conserv Dent 2016;19:364-7

3. Belli S, Erdemir A, Yildirim C. Reinforcement effect of

Polyethylene fiber in root filled teeth: Comparison of two
restoration techniques. Int Endod J 2016;39:136-42

4. Garoushi S, Mangoush E, Vallittu M, Lassila L. Short Fiber

Reinforced Composite: A New Alternative for Direct Onlay
Restorations Open Dent J 2013;7:181-185

5. Sengun A, Cobankara FK, Orucoglu H. Effect of a new

restoration technique on fracture resistance of endodontically
treated teeth. Dent Traumatol 2008;24:214-9.

6. Moezizadeh M, Mokhtari N. Fracture resistance of

endodontically treated premolars with direct composite
restorations. J Conserv Dent 2011;14:277-81.

7. Schmidt M, Kirkevang LL, Horsted-Bindslev P, Poulsem S.

Marginal adaptation of a low-shrinkage silorane-based resin
composite: 1-year randomized clinical trial. Clin Oral Investig
2011;15:291-5.

8. Agarwal VS, Parekh VV, Shah NC. Comparative evaluation

of microleakage of silorane-based composite and nanohybrid
composite with and without polyethylene fiber inserts in class
II restorations: An in vitro study. Oper Dent 2012;37:E1-7

9. Yasa B, Arslan H, Yasa E, Akcay M, Hatirli H. Effect of

novel restorative materials and retention slots on fracture
resistance of endodontically treated teeth. Acta Odontol Scand
2016;74:96-102
9. SIGNATURE OF THE
CANDIDATE

10. REMARKS OF THE GUIDE

11. NAME AND DESIGNATION OF

THE GUIDE/CO GUIDE AND
THE HEAD OF THE
DEPARTMENT (IN BLOCK
LETTERS)

A)GUIDE DR. M.S RANGA REDDY

( Professor)
B)SIGNATURE

Dr.B. SHRAVAN KUMAR

C)CO-GUIDE
( Senior Lecturer)
D)SIGNATURE
 E) HEAD OF THE DR.P.KARUNAKAR.(Head of The
DEPARTMENT
Department & Principal)
DEPARTMENT OF CONSERVATIVE DENTISTRY AND
ENDODONTICS.
PANINEEYA MAHAVIDYALAYA INSTITUTE OF DENTAL
SCIENCES AND RESEARCH CENTER,
ROAD NO-5, KAMALANAGAR,
DILSUKHNAGAR,
HYDERABAD-500060, TELANGANA

F) SIGNATURE

12. A)REMARKS OF THE

PRINCIPAL

B)SIGNATURE