Influence of a Retentive Shoulder Design to Prevent Early Failure of Three Core Build-Ups

Abstract This study evaluated the influence of a retentive shoulder design to prevent early failure of three resin composite build-ups on molars. Ninety-six intact extracted human maxillary third molars were assigned to two groups (n=48) based on occlusal, buccal cusps only and all cusps reduction. The groups were divided into two subgroups: pin retained and non-pin retained build-ups resulting in four groups (n=24), according the cusps reduction: pin retained/partial, pin retained/complete, non-pin retained/partial, non-pin retained/complete. Occlusal reduction was 3 mm with a semi-lunar retentive shoulder of 3 mm and an axial wall height of 1.5 mm. Groups were restored using a microhybrid, flowable or titanium reinforced resin composite. Modified self-curing acrylic resin provisional crowns were fabricated, cemented with non-eugenol temporary cement and thermal cycled. An instron machine applied tension to the provisional crowns parallel to the long axis of the tooth until dislodgement. A three-way analysis of variance was conducted on the influence of the variables on the retention of the core build-up. Ninety-three build-ups were retained under tensile load, while three core build-ups without pins were dislodged. Three-way analysis of variance showed no statistically significant difference between core build-ups using a retentive shoulder and pin retained core build-ups when tested under tensile load. With the advent of adhesive systems, increased surface area and retentive shoulder design can provide a retentive core foundation to prevent early failures of core build-ups during indirect restoration fabrication which will contribute to the longevity of final restorations.