Dental Materials (2006) 22, 477485

www.intl.elsevierhealth.com/journals/dema

Fracture resistance of pulpless teeth restored

with post-cores and crowns
Mikako Hayashi*, Yutaka Takahashi, Satoshi Imazato, Shigeyuki Ebisu
Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry,
1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
Received 14 December 2004; accepted 24 March 2005

KEYWORDS
Root fracture;
Fracture resistance;
Fracture load;
Pulpless teeth;
Fiber post;
Metallic post;
Cast metallic postcore

Summary Objectives. The present study was designed to test the null hypothesis
that there is no difference in the fracture resistance of pulpless teeth restored with
different types of post-core systems and full coverage crowns.
Methods. Extracted human upper premolars were restored with a fiber post,
prefabricated metallic post or cast metallic post-core. Teeth with full crown
preparations without post-core restorations served as a control. All teeth were
restored with full coverage crowns. A 90-degree vertical or 45-degree oblique load
was applied to the restored teeth with a crosshead speed of 0.5 mm/min, and the
fracture loads and mode of fracture were recorded.
Results. Under the condition of vertical loading, the fracture load of teeth restored
with the cast metallic post-cores was greatest among the groups (two-factor
factorial ANOVA and Scheffes F test, P!0.05). All fractures in teeth restored with all
types of post-core systems propagated in the middle portions of roots, including the
apices of the posts. Under the condition of oblique loading, the fracture load of teeth
restored with pre-fabricated metallic posts was significantly smaller than that in
other groups. Two-thirds of fractures in the fiber post group propagated within the
cervical area, while most fractures in other groups extended beyond the middle of
the roots.
Significance. From the results of the present investigations, it was concluded that
under the conditions of vertical and oblique loadings, the combination of a fiber post
and composite resin core with a full cast crown is most protective of the remaining
tooth structure.
Q 2005 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Introduction

* Corresponding author. Tel.: C81 6 6879 2927; fax: C81 6

6879 2928.
E-mail address: mikarin@dent.osaka-u.ac.jp (M. Hayashi).

Restorative methods for pulpless teeth with postcore systems have been widely investigated with
the aim of achieving long-term promising prognoses
[1,2]. Despite the various attempts that have been

0109-5641/$ - see front matter Q 2005 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.
doi:10.1016/j.dental.2005.03.017

478
made, vertical root fractures of pulpless teeth are
still encountered in everyday clinical practice [35].
Although it is acknowledged that minimal tooth
cutting in endodontic and restorative procedures is
the most effective measure for preventing vertical
root fractures in pulpless teeth [6], it is often
necessary to restore teeth with extensive loss of
structure such as those without coronal portions. In
such cases, the best restorative methods for
effectively reinforcing pulpless teeth need to be
identified.
In recent years, various types of fiber posts have
been introduced [7], and excellent long-term
clinical performances of pulpless teeth restored
with a combination of fiber posts and resin cores in
conjunction with dentin bonding systems were
reported [810]. In particular, very few root
fractures have been detected in these clinical
findings. Furthermore, in vitro studies on the
mechanical strengths of pulpless incisors restored
with fiber posts showed lower incidences of root
fractures during fracture tests [1115]. On the basis
of these encouraging in vivo and in vitro findings
[815], restoration using fiber posts might have
potential in reinforcing pulpless teeth; however,
little is known about the effectiveness of fiber posts
with adhesive materials in reinforcing extensively
damaged pulpless molar teeth against occlusal
force [16,17].
Recent finite element analyses presented the
different stress distributions in pulpless teeth
restored with different post-core systems [1821].
It needs to be confirmed, however, if the stress
distribution with vertical or oblique loading,
presented in the finite element analyses, significantly affects the fracture resistance of teeth
restored with different types of restoration.
The purpose of this ongoing series of studies,
an element of which is reported in the present
paper, is to establish effective restorative
methods for reinforcing pulpless teeth with
extensive loss of tooth structure. The investigations reported in the present paper were
designed to test the null hypothesis that there
is no difference in the fracture strengths of
pulpless premolars restored with different types
of post-core systems and full coverage crowns
under vertical or oblique loading.

Materials and methods

A total of 48 extracted human upper premolar teeth
were stored in saline solution at 4 8C and used
within 3 months following extraction. Premolars

M. Hayashi et al.
with double root canals were selected for use in this
study only if they were free from caries and tooth
fractures on visual inspection. Materials used in the
present study are summarized in Table 1.
Bucco-palatal and mesio-distal dimensions and
root lengths of all teeth selected were measured
using digital calipers (Digimatic Calipers, Mitsutoyo,
Tokyo, Japan). Then teeth were divided into eight
groups (nZ6 teeth each) so that there were no
significant differences among groups in terms of
bucco-palatal and mesio-distal dimensions by
means of the Bartlett test and ANOVA at a 95%
level of confidence (Tables 2 and 3).
Coronal sections of teeth to be restored with
post-cores were removed with a low speed diamond
saw (Isomet III, Buehler, Lake Bluff, IL, USA) at the
level of the cementoenamel junction. The teeth
were then endodontically instrumented to a size 40
file and the root canals were obturated with guttapercha. After the root canal treatments, the teeth
underwent post space preparation to 2/3 of the
root length by means of a preparation drill (D.T #3,
Bisco Inc., Schaumburg, IL, USA) (Fig. 1A). All teeth
with the post preparation were reconstructed with
one of the following three types of post-core
restorations (Table 1).

Fiber post group

A quartz fiber post (D.T. Light Post #3, Bisco, Inc.)
was luted into the post space using a self-etching
primer (Tyrian SPE, Bisco, Inc.), a light-cured
dentin adhesive (One-Step Plus, Bisco, Inc.) and
dual-cured resin cement (Duo-Link, Bisco, Inc.).
First, the self-etching primer was applied to the
dentin surface of the post space followed by drying
with a paper point to remove moist spots. The
dentin adhesive was applied and light-cured for
10 s. The surface of the fiber post was also coated
with dentin adhesive. Then, the dual-cured resin
cement and fiber post were inserted into the post
space, consecutively. After removal of excessive
cement, the resin cement was cured by irradiation
for 40 s (Fig. 1B). Core build-up procedures were
performed in a custom made metallic mold as
depicted in Fig. 1C. The shape of the core portion is
described in Fig. 1D. To simulate the periodontal
ligament, the root surface of the restored tooth was
coated with polyvinylsiloxane impression material
(Duplicone, Shofu, Kyoto, Japan) with a thickness
of approximately 200 mm. Finally, the root was
embedded in a clear acrylic resin block (Uni-Fast II,
GC Co, Tokyo, Japan) at a depth of 2 mm below the
cementoenamel junction (Fig. 1E).

Dual-cured
resin cement
DUOLINK
(Bisco Inc.)
[UDMA,
Bis-GMA,
TEGDMA,
glass filler]
(Batch:
0300007422/
0300007423)
Light-curved adhesive, ONE-STEP
PLUS (Bisco Inc.), [Bis-GMA, BPDM,
HEMA, acetone, glass filler],
(Batch: 0300001627)

(1) Self-etching primer, TYRIAN

SPE (Bisco Inc.), [2-acrylamido-2methyl propanesulfonic acid,
bis(2-(methacryloxy)ethyl) phosphate, ethanol], (Batch:
0300000056/0300000056)
(2) Light-curved adhesive, ONESTEP PLUS (Bisco Inc.), [Bis-GMA,
BPDM, HEMA, acetone, glass filler],
(Batch: 0300001627)

479

Prefabricated metallic post group

A prefabricated stainless steel post (AD Post #4,
Kuraray Medical Inc., Tokyo, Japan) was adhered to
the post space using dual-cured resin cement in
conjunction with a metal primer (Alloy Primer,
Kuraray Medical, Inc.). Other restorative procedures
were identical to those in the fiber post group.

Cast metallic post-core group

A cast metallic post-core was fabricated from a wax
pattern, the core portion shape of which was copied
from the metallic mold (Fig. 1C,e) to obtain a shape
identical to that of the resin core. The pattern was
then invested and cast with gold alloy (Casting Gold
Type II, Morita Co., Osaka, Japan). The cast
metallic post-core coated with metal primer was
luted into a post space using the dentin bonding
system and dual-cured resin cement.

Fiber post, D.T. LIGHTPOST #3 (Bisco Inc.),

[quartz fibers, epoxy
resin], (Batch:
0300012338)

Prefabricated metallic
post, AD POST #4
(Kuraray Medical Inc.),
[stainless steel], (Batch:
M30827)

Casting gold alloy, Casting Gold Type II (Morita Co.),

[Au, Ag, Pt, Cu], (Batch: 1404086)

Prefabricated
metallic post
group

Cast metallic
post-core
group

Crown preparation group

Fiber post
group

Dual-cured composite, BISCORE (Bisco Inc.), [UDMA,

Bis-GMA, TEGDMA, glass
filler], (Batch: 030009247/
0300009277)

Metallic primer, Alloy Primer,

(Kuraray Medical Inc.), [6-(4vinylbenzyl-n-propyl)amino-1,3,5triazine-2,4-dithione, 10-methacryloyloxydecyl dihydrogen phosphate, acetone], (Batch: 00127A)

Resin cement
Surface treatment of post
Dentin bonding system
Materials (Manufactureres) [Ingredients]
Post
Core
Experimental
groups

Table 1

Restorative materials used for post-core build-up.

Fracture resistance of pulpless teeth

The teeth in two groups received crown preparation

instead of post-core preparation. The crown
preparations were performed by means of a precise
copy-milling machine (Celey, Mikrona Technologie
AG., Spreitenbach, Switzerland) to reproduce a
shape identical to that of the resin core. First, a
resin pattern of the core portion was fabricated in
the metallic mold described above. The resin
pattern and a premolar were then fixed on the
Celey machine. Copy milling procedures were
carried out with three-dimensional mechanical
scanning and milling. When scanning tools traced
the surface of the resin pattern, milling of the
premolar took place by means of diamond disks
moving synchronously to the scanning movements.
As a consequence, the coronal portion of the
prepared premolar was identical to the resin
pattern.
All teeth were restored with cast metallic full
crowns. A wax pattern was fabricated using a
template to shape standardized full crowns with a
chamfer margin designed to locate 1 mm below the
core-root interface, and subsequently cast in gold
alloy (Casting Gold Type III, Morita Co). A crown was
luted to a tooth with dual-cured resin cement and a
metal primer. All specimens were stored in a
condition of 100% humidity at 37 8C for 24 h prior
to the fracture test.
A 90-degree vertical or 45-degree oblique load
was applied to the restored teeth with a crosshead
speed of 0.5 mm/min by means of a universal
testing machine (Autograph AG500-A, Shimadzu

480
Table 2

M. Hayashi et al.
Size, fracture load, and mode of fracture of plupless teeth subjected to the 90-degree vertical loading.
Bucco-lingual
dimension
(!10 mm)

Mesio-distal dimension
(!10 mm)

Root
length
(!10 mm)

Fracture
load (kgf)

Mode of
root
fracturea

468
569
438
506
484
483
491 (44)

1309
1303
1571
1316
1547
1449
1416 (124)

312
409
445
508
604
441
453 (98)c
c.v.Z
21.6(%)

crack
crack
crack
crack
crack
crack

Prefabricated metallic post group

1
922
471
2
761
510
3
865
482
4
848
482
5
799
460
6
873
557
Mean (SD)
845 (57)
494 (35)

1117
1220
923
1109
1499
1298
1194 (196)

306
345
529
545
547
560
472 (114)c
c.v.Z
24.2(%)

crack
crack
crack
crack
crack
crack

Cast metallic post-core group

1
817
484
2
861
491
3
888
487
4
856
470
5
892
486
6
945
534
Mean (SD)
876 (43)
492 (22)

1341
1236
1422
1384
1351
1394
1335 (65)

873
811
791
857
984
1217
922 (159)d
c.v.Z
17.2(%)

crack
crack
crack
fracture
crack
crack

Prepared teeth group

1
988
2
899
3
943
4
839
5
888
6
991
Mean (SD)
925 (60)

1314
1239
1054
1317
1092
1443
1243 (148)

301
322
348
348
354
412
347 (38)c
c.v.Z
11.0(%)

crack
crack
crack
crack
crack
crack

Fiber post group

1
934
2
811
3
793
4
885
5
871
6
892
Mean (SD)
864 (53)

662
475
488
473
478
568
524 (77)

Crack/fracture propagation in rootsb

cervical
cervical
cervical

cervical

cervical
cervical

cervical
cervical
cervical
cervical

cervical
cervical

cervical

Fracture
including
the apex
of post

middle
middle
middle
middle
middle
middle

apical
apical
apical
apical
apical
apical

K
C
C
C
C
K

middle
middle
middle
middle
middle
middle

apical
apical
apical
apical
apical
apical

C
C
C
C
C
C

middle
middle
middle
middle
middle
middle

apical
apical
apical
apical
apical
apical

C
C
C
C
C
C

middle
middle
middle
middle
middle

c.v., the coefficients of variationZSD/Mean!100 (%).

a
Crack, only hairline-like vertical crack without visible gap was detected; fracture, vertical fracture with visible gap accompanied
by partial or complete separation of fracture fragment was detected.
b
Crack/fracture propagation was classified into the three categories as follows; cervical, fracture extended to 1/3 depth
longitudinally from the cervical portion; middle, fracture extended between 1/3 and 2/3 from the cervical toward the apical
portion; apical, fracture extended in 1/3 depth longitudinally in the apical portion.
c ,d
Values with the same letter showed no significant differences in fracture load by means of two-factor factorial ANOVA and the
Scheffes F test at a 95% level of confidence.

Co., Kyoto, Japan) until fracture, and the fracture

loads were recorded. The vertical load was applied
to the center of the occlusal surface, while the
oblique load was applied to the center of the cusp

beneath which the post was located (Fig. 1F). Mode

of fracture was observed by visual inspection with
the aid of trans-illumination, and internal crack
propagation was detected by means of a digital

Fracture resistance of pulpless teeth

Table 3

481

Size, fracture load, and mode of fracture of pulpless teeth subjected to the 45-degree oblique loading.
Buccolingual
dimension
(!10 mm)

Fiber post group

1
878
2
898
3
913
4
894
5
847
6
851
Mean (SD) 880 (27)

Mesiodistal
dimension
(!10 mm)

Root
length
(!
10 mm)

Fracture
load (kgf)

Mode of
root
fracturea

Crack/fracture propagation
in rootsb

Fracture
including
the apex
of post

495
524
516
463
476
507
497 (24)

1449
1396
1286
1103
1473
1201
1318
(147)

211
333
433
296
191
360
304 (92)c
c.v.Z
27.5 (%)

fracture
fracture
fracture
fracture
fracture
crack

cervical
cervical
cervical
cervical
cervical
cervical

K
K
K
K
K
K

1226
1316
1215
1191
976
1235
1193
(115)

191
145
193
133
219
168
175 (32)d
c.v.Z
16.7 (%)

fracture
fracture
fracture
fracture
fracture
fracture

cervical
cervical
cervical
cervical
cervical
cervical

middle
middle

apical

middle
middle

apical

1048
1320
1098
1363
1290
1109
1205
(135)

294
260
393
270
248
268
289 (53)c
c.v.Z
16.9(%)

fracture
fracture
fracture
fracture
fracture
fracture

cervical
cervical
cervical
cervical
cervical
cervical

middle
middle
middle

apical
apical
apical

middle
middle

apical

1271
786
1217
1030
1227
1087
1103
(180)

281
262
268
450
374
454
348 (90)c
c.v.Z
23.6(%)

fracture
fracture
fracture
fracture
fracture
fracture

cervical
cervical
cervical
cervical
cervical
cervical

middle
middle
middle
middle
middle
middle

Prefabricated metallic post group

1
879
513
2
898
519
3
924
534
4
892
478
5
858
474
6
848
502
Mean (SD) 883 (28)
503 (24)

Cast metallic post-core

1
883
2
906
3
908
4
883
5
820
6
848
Mean (SD) 875 (34)

Prepared teeth group

1
874
2
894
3
919
4
887
5
869
6
845
Mean (SD) 881 (25)

group
505
506
524
473
474
491
496 (20)

512
505
521
456
479
479
492 (25)

middle

apical

middle

C
K
K
K
K
K

C
K
K
K
K
K

c.v., the coefficients of variationZSD/Mean!100 (%).

a
Crack, only hairline-like vertical crack without visible gap was detected; fracture, vertical fracture with visible gap accompanied
by partial or complete separation of fracture fragment was detected.
b
Crack/fracture propagation was classified into the three categories as follows; cervical, fracture extended to 1/3 depth
longitudinally from the cervical portion; middle, fracture extended between 1/3 and 2/3 from the cervical toward the apical
portion; apical, fracture extended in 1/3 depth longitudinally in the apical portion.
c ,d
Values with the same letter showed no significant differences in fracture load by means of two-factor factorial ANOVA and the
Scheffes F test at a 95% level of confidence.

radiograph system (SMX-1000, Shimadzu Co.). Crack

propagation was classified into the three categories
as follows; cervical, fracture extended to 1/3 depth
longitudinally from cervical portion; middle,

fracture extended between 1/3 and 2/3 from

cervical toward apical portion; apical, fracture
extended in 1/3 depth longitudinally in apical slat
portion.

482

M. Hayashi et al.

Figure 1 Schematic diagram of the preparation procedures of a specimen with a prefabricated post and full coverage
crown for the fracture test. (A) A post space was prepared in an upper premolar tooth; a: upper premolar tooth,
b: prepared post space, c: root canals obturated with gutta-percha. (B) A prefabricated post was luted in the post space
with dual-cured resin cement; d: prefabricated post. (C) The core was built-up in a custom made metallic mold;
e, metallic mold; f, dual-cured resin core. (D) The shape of the resin core. (E) The restored tooth was embedded in
acrylic resin after coating the root surface with polyvinylsiloxane impression material simulating periodontium; g,
acrylic resin; h, artificial periodontium. (F) The tooth restored with a full coverage crown was subjected to the fracture
test with a vertical or oblique load; i, cast metallic crown; j, 90-degree vertical load; k, 45-degree oblique load.

Fracture loads among groups with different types

of post-core systems and between the two types of
loadings were compared using two-factor factorial
ANOVA and Scheffes F test at a 95% level of
confidence.

Results
The fracture loads and mode of fracture with
vertical load are summarized in Table 2. The
fracture load in the cast metallic post-core group
was the greatest among the four groups, while
that in the crown preparation group was the
smallest. There was no significant difference in
fracture loads between the fiber and prefabricated metallic post groups. Typical fractures in
each group are presented by radiographs in
Fig. 2. Almost all fractures with vertical loadings
in the three post restoration groups were found
as cracks propagated in the middle and apical
portions of the roots, including the apices of the
posts, while no fracture in the crown preparation
group extended to the apical portion of the
roots.

The results for the 45-degree oblique load are

summarized in Table 3. The fracture load in the prefabricated metallic posts group was significantly
smaller than those in the other three groups.
Typical fractures in each group are presented by
radiographs in Fig. 3. All specimens except one
showed complete fractures. In all teeth restored
with all types of posts, dislodgement of posts and
fracture, including the interfaces between the
cores and root dentin, were found. Sixty-seven
percent of fractures in the fiber post group were
limited to the cervical area, while the fracture
extended over the middle of the roots in 67 and 83%
of the specimens in the prefabricated metallic post
and cast metallic post-core groups, respectively. In
the crown preparation group, complete oblique
fractures propagated in the cervical and middle
portions of the roots were observed.
Comparison of fracture resistance between
groups with the same restorations and with
different types of loading indicated that resistance
against vertical loading was significantly greater
than that against oblique loading in the three post
restoration groups, while there was no significant
difference between the crown preparation groups
with vertical and oblique load.

Fracture resistance of pulpless teeth

483

Figure 2 Typical root fractures with 90-degree vertical load detected by radiographs in teeth restored with a fiber
post (A), prefabricated metallic post (B) and cast metallic post-core (C); cracks were detected in the apical portions
including the post apices. In a tooth with a crown preparation (D), a crack vertically propagated in the cervical and
middle portions of the root. / fracture line.

Discussion
Size deviations are inevitable when using natural
teeth; therefore, in the present study, premolars
were allocated to eight experimental groups so that
the mesio-distal and bucco-palatal dimensions
presented no significant differences among groups
with different types of post-core systems (Tables 2
and 3). In considering variation in root length, the
relative post length was set to 2/3 of the root
length. Consequently, the coefficients of variation
for the fracture loads were in the range of 11.0
27.5%, which can be considered relatively small.
These coefficients of variation confirm the validity
of the teeth allocation method in the present study.
Under the condition of vertical loading, the
fracture loads of teeth restored with all types of
post-core systems were significantly greater than
those with crown preparation without posts. Most
of the cracks propagated in the middle and apical
portions of teeth restored with posts were found as
vertical splits, due to buckling of root dentin. It
can, therefore be considered that the posts
significantly contributed to the reinforcement and
strengthening of pulpless teeth by supporting

remaining tooth structure against vertical compressive force.

Under the condition of oblique loading, although
there was no significant difference in fracture
resistance between the cast metallic post-core
and fiber post groups, the majority of fractures in
the cast metallic post-core group were propagated
over the middle portion of the roots, while twothirds of those in the fiber post groups were limited
to the cervical portion. This difference in fracture
propagation can be explained by the stress distribution in pulpless teeth restored with post-core
systems reported in recent finite element analysis
studies [1820]. When a 45-degree oblique load was
applied to teeth restored with a cast metallic postcore, the stress distributed inside the post, all over
the interface between the post and root dentin, and
in the apex of the post. Reflecting this stress
distribution, fractures propagated along the metallic post over the middle portion of the root
including the post apex were seen in the present
study. This indicates that most of the fractured
teeth restored with cast metallic post-cores were
not reparable. In contrast, the majority of fractures
in the fiber post group were limited to the cervical

Figure 3 Typical root fractures detected with 45-degree oblique load by radiographs in a tooth restored with a fiber
post (A); the root fracture propagated within the cervical portion accompanied by dislodgement of the post. In teeth
restored with a prefabricated metallic post (B) or cast metallic post-core (C); oblique fractures propagated in the
cervical and middle portions accompanied by dislodgement and deformation of the posts. In a tooth with crown
preparation (D), complete oblique fractures propagated in the cervical and middle portions. / fracture line.

484
portion of the root including the core-dentin
interface, since the stress was concentrated in
the cervical area and the outer root surface. This
type of fracture is most easy for repeated repair.
Although the fracture load in the cast metallic
post-core group was markedly greater than those in
the other three groups under the condition of
vertical loading, it was equivalent in the fiber post
and crown preparation groups with oblique loading.
Furthermore, the fracture resistance against oblique loads in the cast and prefabricated metallic
post groups was reduced to 31 and 37% of that
against the vertical load, respectively, while it was
67% in the fiber post group. This difference in the
reduction of fracture resistance against oblique
load among groups with different post-core systems
can be explained by the modulus of elasticity of the
post materials. When a post-core with a high
modulus of elasticity, such as a stainless steel
post, is forced against radicular dentin with much
lower modulus, the stress is transferred from the
rigid post to the less rigid dentin. When a post with a
similar modulus of elasticity to that of radicular
dentin, such as a fiber post, is used for restoration,
less stress is transferred from the post to the
dentin. These phenomena can be exaggerated by
applying an oblique load, which induces bending
stress in the restored roots. This might be the
reason for the significant reduction in fracture
resistance of teeth restored with metallic posts in
the present study, and the lowered clinical
incidence of root fractures in pulpless teeth
restored with a fiber post compared to those
restored with a conventional metallic post
system [810].
Root fractures originate from regions with
excessive stress concentration and propagate by
exploring mechanically inferior areas in the
restored teeth. Under the condition of oblique
loading, all teeth restored with post-core systems
fractured at the interface between the post-core
and root dentin accompanied by dislodgement of
the posts. These fractures could have originated
from the adhesive interface between the cores and
root dentin, and propagated down towards the post
by exploring an inferior adhesive area. These
results support the previous finite element analysis
findings, where oblique force was found to transfer
to the full crown and stress was distributed to the
cervical margin of the crown and post-dentin
interface [18,19]. Therefore, successful adhesion
between the restoratives and root dentin might be
critical for the durability of pulpless teeth
restorations.
The limitation of the present study was the use
of an artificial periodontal ligament, which was

M. Hayashi et al.
generated using polyvinylsiloxane impression
material. This material was selected because its
width and modules of elasticity were similar to
those of natural ligament [22,23]. According to
preliminary experiments, the fracture strengths of
restored teeth without artificial ligaments were
approximately two times greater than those with
ligament. This might be because the restored teeth
were directly held by acrylic resin when testing
without the artificial ligament, and the acrylic resin
acted as a ferrule, which showed a significant effect
in preventing root fracture. Therefore, in the
current situation, the usage of artificial ligament
was the most appropriate method, even though it
was not a natural one.
It has been reported that the ordinary chewing
force of adults ranges from 7 to 15 kg [24], and the
maximum bite force is up to 90 kg [25]. The fracture
loads in all groups were found to be sufficiently
greater than the ordinary chewing force, and even
greater than the maximum bite force. Further
studies are currently underway to investigate the
fatigue resistance of pulpless teeth restored
with different types of post-core systems. The
mechanical strength of pulpless teeth restored
with post-core systems needs to be evaluated by
both initial fracture and fatigue resistance, since
pulpless teeth have to endure both types of load in
the oral environment and both types of loading can
induce critical fracture of pulpless teeth. Fracture
resistance of pulpless molars with respect to
residual tooth structure also needs to be investigated to confirm the most effective restorative
method for protecting and reinforcing pulpless
molars.

Conclusions
From the results of the present investigations, it
can be concluded that under conditions of vertical
and oblique loading, the combination of a fiber post
and composite resin core with a full cast crown is
the most protective method for maintaining tooth
structure.

Acknowledgements
We gratefully acknowledge Bisco Inc. for donating
the materials used in the present study. We also
thank Shimadzu Co. for their technical support with
operating the digital radiograph system. This study
was supported, in part, by Grants-in-Aid for
Scientific Research (Nos. 16390545 and 16390546)

Fracture resistance of pulpless teeth

from the Japan Society for the Promotion of
Science, and by the 21st century COE program
entitled Origination of Frontier BioDentistry at
Osaka University Graduate School of Dentistry.

485

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