الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Summary
This study had two parts: In Vivo/ In Vitro
In Vivo Part:
In this part of the study, a single-blind randomized controlled clinical trial, parallel arm design was conducted on 20 patients who had 20 carious primary second molars indicated for pulpotomy. The patients were selected from the outpatient clinic of Pediatric Dentistry department, Faculty of Dentistry, Ain Shams University. Their age ranged from 4 to 6 years old.
All patients who fulfilled the eligibility criteria were randomly assigned into 2 groups; Stainless Steel (SSC) group and Endocrowns group (EC). Pulpotomy procedure was performed for both groups. Afterwards, SSC were cemented to the SSC group. As for the EC group, lower primary molars were prepared with a butt joint, and flaring of the pulp chamber. Endocrowns were cemented using self-adhesive dual cure resin cement. All teeth received clinical evaluations using FDI criteria at 3, 6, and 12 months and parental satisfaction postoperatively by another investigators. Wear analysis of the antagonist tooth was done after 12 months.
Both treatment modalities showed clinical success, acceptable wear to the antagonist, and children/parents were satisfied.
In vitro part was designed to evaluate the fracture resistance of hybrid ceramic endocrowns compared to SSCs crowns in pulpotomized primary molars.
Fourteen extracted human mandibular second primary molars, with at least one third of their roots remaining, and at least three of their axial walls intact, without visible fracture lines or cracks were selected. The teeth specimens were cleaned and disinfected then stored in distilled water until required.
The selected teeth were mounted in acrylic molds by a mounting surveyor. Then divided into two groups randomly, according to the type of restoration (SSC group and EC endocrowns group).
Pulpotomy procedure was done for the specimens followed by obturation with zinc oxide eugenol, a layer of GIC was placed to seal the orifice and block undercuts for endocrown group while complete filling with GIC for SSC group.
For all specimens, the milling surveyor was modified such that a straight hand piece and stones could be mounted to ensure standard preparations for both groups each according its preparation criteria.
Endocrown restorations were fabricated using CAD/CAM. The restorations were then polished and glazed.
Cementation and bonding step were then displayed for the two groups each according to its protocol, self-adhesive dual cure resin cement was used for this step.
For the fracture resistance test all samples were loaded in a universal testing machine until fracture occurred. Data were collected, presented as mean, standard deviation (SD), range (Minimum – Maximum) for values. Data were explored for normality by checking the data distribution and using Kolmogorov-Smirnov and Shapiro-Wilk tests. Student t-test used to compare mean values.
The following result were obtained from the current study:
It was found that (SSCs) recorded statistically significant higher fracture resistance with mean value (3439.8±869.6N) than (Endocrown) with mean value (957.9±276.8) as indicated by t-test (t=5.08, P=0.0001<0.05).
Conclusions
Within the limitations of this study, the following conclusions were obtained:
1. Clinical performance of endocrowns and SSCs was acceptable regarding functional and biological properties.
2. Endocrowns maintained their esthetics during the follow up intervals.
3. Children and parents were satisfied with both treatment modalities initially, however the degree of satisfaction of children/parents towards SSC varied with time
4. SSC preparation procedures caused more pain to children.
5. Wear of the opposing antagonists was acceptable for both treatment modalities.
6. Both treatment modalities can withstand normal occlusal force of children, however the fracture resistance of SSCs was higher than those of Endocrowns
Recommendations
1. Further long term Randomized Controlled Trials are needed to assess the clinical performance of endocrowns compared to SSC and Indirect restorations in the primary molars.
2. Laboratory investigations regarding the preparation design of endocrowns in primary teeth and its modifications would be of great value.
3. There are plenty of materials used in the fabrication of Endocrowns for permanent teeth, that need to be investigated for suitability in primary teeth.