{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T06:14:25Z","timestamp":1791612865702,"version":"4.3.4"},"reference-count":41,"publisher":"Operative Dentistry","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>SUMMARY<\/jats:title>\n        <jats:sec>\n          <jats:title>Statement of problem<\/jats:title>\n          <jats:p>Customized glass fiber posts using CAD-CAM technology have been suggested for restoring endodontically treated teeth. However, how weakened or non-weakened roots restored with anatomical CAD-CAM posts behave under cyclic fatigue is not clear.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Objective<\/jats:title>\n          <jats:p>To evaluate the load-bearing capacity under fatigue (fatigue failure load [FFL], the number of cycles for failure [CFF], and survival probabilities) and fracture pattern of weakened and non-weakened roots restored with CAD-CAM fiber post and cores, metal cast-post-core, and prefabricated fiber post and resin core.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Methods and Materials<\/jats:title>\n          <jats:p>A total of 60 crack-free bovine incisor roots (13 mm in length) with standard geometry were obtained and randomly allocated considering the factor \u201croot condition\u201d in two levels (weakened and non-weakened). Thus, half of the roots were weakened to obtain a wall thickness of 0.5 mm. After that, the endodontic treatment was executed, all roots embedded with acrylic resin and the specimens randomly allocated (n=10) considering the factor \u201cpost system\u201d in three levels (CAD-CAM: CAD-CAM milled glass-fiber post and core; MBC: metallic-based post and core; and FRC: prefabricated glass-fiber post and composite resin core). The posts were luted with a dual-cure self-adhesive luting agent. Then, all teeth received a metallic crown. An initial load of 100 N at 20 Hz for 5000 cycles was applied for the step-stress fatigue test, followed by incremental steps of 50 N for 20,000 cycles each step, up to failure. A fracture pattern analysis was performed.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Results<\/jats:title>\n          <jats:p>CAD-CAM fiber post (FFL: 865 N; CFF: 311,000 cycles) presented similar fatigue performance (<jats:italic>p<\/jats:italic>&gt;0.05) to FRC (FFL: 925 N; CFF: 335,000 cycles), with 100% of repairable fractures for non-weakened roots; however, both groups presented worse performance than MBC (<jats:italic>p<\/jats:italic>&lt;0.05; FFL: 1265 N; CFF: 471,000 cycles) which led to 100% of catastrophic failures. No statistical difference was found in fatigue performance among the three systems for weakened roots (<jats:italic>p<\/jats:italic>&gt;0.05; FFL: 1035-1170 N; CFF: 379,000-433,000 cycles), with a high rate of catastrophic failures.<\/jats:p>\n        <\/jats:sec>\n        <jats:sec>\n          <jats:title>Conclusions<\/jats:title>\n          <jats:p>CAD-CAM fiber post presented similar fatigue performance to MBC and FRC approaches when restoring weakened roots. CADCAM was similar to FRC when restoring non-weakened roots, while MBC enhanced fatigue properties in this scenario.<\/jats:p>\n        <\/jats:sec>","DOI":"10.2341\/21-032-l","type":"journal-article","created":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T13:01:48Z","timestamp":1666011708000},"page":"658-669","source":"Crossref","is-referenced-by-count":6,"title":["Fatigue Properties of Weakened and Non-weakened Roots Restored with CAD-CAM Milled Fiber Post, Prefabricated Fiber Post, or Cast Metal Post"],"prefix":"10.2341","volume":"47","author":[{"given":"GR","family":"Oliveira","sequence":"first","affiliation":[{"name":"Gabriel Rodrigues Oliveira, DDS, Graduate Program in Dentistry, Atitus Education, Passo Fundo, Rio Grande do Sul, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"RV","family":"Machry","sequence":"additional","affiliation":[{"name":"Renan Vaz Machry, PhD, Post-Graduate Program in Oral Science, Prosthodontics Unit, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AC","family":"Cadore-Rodrigues","sequence":"additional","affiliation":[{"name":"Ana Carolina Cadore-Rodrigues, PhD, Post-Graduate Program in Oral Science, Prosthodontics Unit, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Sarkis-Onofre","sequence":"additional","affiliation":[{"name":"Rafael Sarkis-Onofre, PhD, Graduate Program in Dentistry, Atitus Education, Passo Fundo, Rio Grande do Sul, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LF","family":"Valandro","sequence":"additional","affiliation":[{"name":"Luiz Felipe Valandro, PhD, Post-Graduate Program in Oral Science, Prosthodontics Unit, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Bacchi","sequence":"additional","affiliation":[{"name":"Ata\u00eds Bacchi, PhD, Post-Graduate Program in Dentistry, Paulo Pican\u00e7o School of Dentistry, Fortaleza, Brazil."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"GKR","family":"Pereira","sequence":"additional","affiliation":[{"name":"*Gabriel Kalil Rocha Pereira, PhD, Post-Graduate Program in Oral Science, Prosthodontics Unit, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AO","family":"Spazzin","sequence":"additional","affiliation":[{"name":"Alo\u00edsio Oro Spazzin, PhD, Graduate Program in Dentistry, Atitus Education, Passo Fundo, Rio Grande do Sul, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1188","reference":[{"issue":"1","key":"i1559-2863-47-6-658-b1","series-title":"Journal of Endodontics","first-page":"119","article-title":"Influence of ferrule, post system, and length on biomechanical behavior of endodontically treated anterior teeth","volume":"40","year":"2014","unstructured":"Santos-Filho\n              PCF\n            ,\n\t\t\t\t\t\tVer\u00edssimoC,\n\t\t\t\t\t\tSoaresPV,\n\t\t\t\t\t\tSaltareloRC,\n\t\t\t\t\t\tSoaresCJ, &\n\t\t\t\t\t\tMarcondes MartinsLR(2014)\n\t\t\t\t\tInfluence of ferrule, post system, and length on biomechanical behavior of endodontically treated anterior teethJournal of Endodontics40(1)\n\t\t\t\t\t119\u2013123. https:\/\/doi.org\/10.1016\/j.joen.2013.09.034"},{"issue":"5","key":"i1559-2863-47-6-658-b2","series-title":"Journal of Dentistry","first-page":"582","article-title":"Cast metal vs. glass fibre posts: A randomized controlled trial with up to 3 years of follow up","volume":"42","year":"2014","unstructured":"Sarkis-Onofre\n              R\n            ,\n\t\t\t\t\t\tJacintoRDC,\n\t\t\t\t\t\tBoscatoN,\n\t\t\t\t\t\tCenciMS, &\n\t\t\t\t\t\tPereira-CenciT(2014)\n\t\t\t\t\tCast metal vs. glass fibre posts: A randomized controlled trial with up to 3 years of follow upJournal of Dentistry42(5)\n\t\t\t\t\t582\u2013587. https:\/\/doi.org\/10.1016\/j.jdent.2014.02.003"},{"issue":"3","key":"i1559-2863-47-6-658-b3","series-title":"Journal of Endodontics","first-page":"309","article-title":"Do metal post-retained restorations result in more root fractures than fiber post-retained restorations? A systematic review and meta-analysis","volume":"41","year":"2015","unstructured":"Figueiredo\n              FED\n            ,\n\t\t\t\t\t\tMartins-FilhoPRS, &\n\t\t\t\t\t\tFaria-E-SilvaAL(2015)\n\t\t\t\t\tDo metal post-retained restorations result in more root fractures than fiber post-retained restorations? A systematic review and meta-analysisJournal of Endodontics41(3)\n\t\t\t\t\t309\u2013316. https:\/\/doi.org\/10.1016\/j.joen.2014.10.006"},{"issue":"3","key":"i1559-2863-47-6-658-b4","series-title":"Operative Dentistry","first-page":"273","article-title":"Ferrule design does not affect the biomechanical behavior of anterior teeth under mechanical fatigue: An in vitro evaluation","volume":"44","year":"2019","unstructured":"Figueiredo\n              FE\n            ,\n\t\t\t\t\t\tSantosRC,\n\t\t\t\t\t\tSilvaAS,\n\t\t\t\t\t\tVald\u00edviaAD,\n\t\t\t\t\t\tOliveira-NetoLA,\n\t\t\t\t\t\tGrizaS,\n\t\t\t\t\t\tSoaresCJ, &\n\t\t\t\t\t\tFaria-E-SilvaAL(2019)\n\t\t\t\t\tFerrule design does not affect the biomechanical behavior of anterior teeth under mechanical fatigue: An in vitro evaluationOperative Dentistry44(3)\n\t\t\t\t\t273\u2013280. https:\/\/doi.org\/10.2341\/17-296-L"},{"issue":"2","key":"i1559-2863-47-6-658-b5","series-title":"Journal of Adhesive 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https:\/\/doi.org\/10.1016\/j.msec.2017.03.152"},{"issue":"2","key":"i1559-2863-47-6-658-b8","series-title":"Operative Dentistry","first-page":"223","article-title":"Influence of post and resin cement on stress distribution of maxillary central incisors restored with direct resin composite","volume":"34","year":"2009","unstructured":"Oro Spazzin\n              A\n            ,\n\t\t\t\t\t\tGalafassiD,\n\t\t\t\t\t\tDe Meira-JuniorAD,\n\t\t\t\t\t\tBrazR, &\n\t\t\t\t\t\tGarbinCA(2009)\n\t\t\t\t\tInfluence of post and resin cement on stress distribution of maxillary central incisors restored with direct resin compositeOperative Dentistry34(2)\n\t\t\t\t\t223\u2013229. https:\/\/doi.org\/10.2341\/08-73"},{"issue":"12","key":"i1559-2863-47-6-658-b9","series-title":"International Endodontic Journal","first-page":"1098","article-title":"Biomechanical behaviour of a fractured maxillary incisor restored with direct composite resin only or with different post systems","volume":"43","year":"2010","unstructured":"Garbin\n              CA\n            ,\n\t\t\t\t\t\tSpazzinAO,\n\t\t\t\t\t\tMeira-J\u00faniorAD,\n\t\t\t\t\t\tLorettoSC,\n\t\t\t\t\t\tLyraAMVC, &\n\t\t\t\t\t\tBrazR(2010)\n\t\t\t\t\tBiomechanical behaviour of a fractured maxillary incisor restored with direct composite resin only or with different post systemsInternational Endodontic Journal43(12)\n\t\t\t\t\t1098\u20131107. https:\/\/doi.org\/10.1111\/j.1365-2591.2010.01782.x"},{"issue":"11","key":"i1559-2863-47-6-658-b10","series-title":"Journal of Endodontics","first-page":"1770","article-title":"Dentin-like versus rigid endodontic post: 11-year randomized controlled pilot trial on no-wall to 2-wall defects","volume":"43","year":"2017","unstructured":"Naumann\n              M\n            ,\n\t\t\t\t\t\tSterzenbachG,\n\t\t\t\t\t\tDietrichT,\n\t\t\t\t\t\tBitterK,\n\t\t\t\t\t\tFrankenbergerR, &\n\t\t\t\t\t\tvon Stein-LausnitzM(2017)\n\t\t\t\t\tDentin-like versus rigid endodontic post: 11-year randomized controlled pilot trial on no-wall to 2-wall defectsJournal of Endodontics43(11)\n\t\t\t\t\t1770\u20131775. https:\/\/doi.org\/10.1016\/j.joen.2017.06.030"},{"issue":"5","key":"i1559-2863-47-6-658-b11","series-title":"Journal of Prosthetic Dentistry","first-page":"376","article-title":"Influence of adhesive techniques on fracture resistance of endodontically treated premolars with various residual wall thicknesses","volume":"110","year":"2013","unstructured":"Scotti\n              N\n            ,\n\t\t\t\t\t\tRotaR,\n\t\t\t\t\t\tScansettiM,\n\t\t\t\t\t\tPaolinoDS,\n\t\t\t\t\t\tChiandussiG,\n\t\t\t\t\t\tPasqualiniD, &\n\t\t\t\t\t\tBeruttiE(2013)\n\t\t\t\t\tInfluence of adhesive techniques on fracture resistance of endodontically treated premolars with various residual wall thicknessesJournal of Prosthetic Dentistry110(5)\n\t\t\t\t\t376\u2013382. https:\/\/doi.org\/10.1016\/j.prosdent.2013.08.001"},{"issue":"Special Issue 9","key":"i1559-2863-47-6-658-b12","series-title":"Compendium of Continuing Education in Dentistry","first-page":"2","article-title":"The current state of adhesive dentistry : a guide for clinical practice","volume":"34","year":"2013","unstructured":"Mante\n              FK\n            ,\n\t\t\t\t\t\tOzerF,\n\t\t\t\t\t\tWalterR,\n\t\t\t\t\t\tAtlasAM,\n\t\t\t\t\t\tSalehN,\n\t\t\t\t\t\tDietschiD, &\n\t\t\t\t\t\tBlatzMB(2013)\n\t\t\t\t\tThe current state of adhesive dentistry : a guide for clinical practiceCompendium of Continuing Education in Dentistry34(Special Issue 9)\n\t\t\t\t\t2\u20138."},{"issue":"5","key":"i1559-2863-47-6-658-b13","series-title":"Journal of Prosthetic Dentistry","first-page":"1225","article-title":"The effect of post material on the characteristic strength of fatigued endodontically treated teeth","volume":"112","year":"2014","unstructured":"Pereira\n              JR\n            ,\n\t\t\t\t\t\tLins Do ValleA,\n\t\t\t\t\t\tShiratoriFK,\n\t\t\t\t\t\tGhizoniJS, &\n\t\t\t\t\t\tBonfanteEA(2014)\n\t\t\t\t\tThe effect of post material on the characteristic strength of fatigued endodontically treated teethJournal of Prosthetic Dentistry112(5)\n\t\t\t\t\t1225\u20131230. https:\/\/doi.org\/10.1016\/j.prosdent.2014.03.014"},{"issue":"1","key":"i1559-2863-47-6-658-b14","series-title":"Operative Dentistry","first-page":"53","article-title":"CADCAM polymer vs direct composite resin core buildups for endodontically treated molars without ferrule","volume":"41","year":"2016","unstructured":"G\u00fcth\n              JF\n            ,\n\t\t\t\t\t\tEdelhoffD,\n\t\t\t\t\t\tGoldbergJ, &\n\t\t\t\t\t\tMagneP(2016)\n\t\t\t\t\tCADCAM polymer vs direct composite resin core buildups for endodontically treated molars without ferruleOperative Dentistry41(1)\n\t\t\t\t\t53\u201363. https:\/\/doi.org\/10.2341\/14-256-L"},{"issue":"2","key":"i1559-2863-47-6-658-b15","series-title":"Journal of Prosthetic Dentistry","first-page":"242","article-title":"Scanning of root canal impression for the fabrication of a resin CAD-CAM-customized post-and-core","volume":"120","year":"2018","unstructured":"Falc\u00e3o Spina\n              DR\n            ,\n\t\t\t\t\t\tda CostaRG,\n\t\t\t\t\t\tCorrerGM, &\n\t\t\t\t\t\tRachedRN(2018)\n\t\t\t\t\tScanning of root canal impression for the fabrication of a resin CAD-CAM-customized post-and-coreJournal of Prosthetic Dentistry120(2)\n\t\t\t\t\t242\u2013245. https:\/\/doi.org\/10.1016\/j.prosdent.2017.08.009"},{"key":"i1559-2863-47-6-658-b16","series-title":"Journal of the Mechanical Behavior of Biomedical Materials","first-page":"187","article-title":"Mechanical properties and superficial characterization of a milled CAD-CAM glass fiber post","volume":"82","year":"2018","unstructured":"Ruschel\n              GH\n            ,\n\t\t\t\t\t\tGomes\u00c9A,\n\t\t\t\t\t\tSilva-SousaYT,\n\t\t\t\t\t\tPinelliRGP,\n\t\t\t\t\t\tSousa-NetoMD,\n\t\t\t\t\t\tPereiraGKR, &\n\t\t\t\t\t\tSpazzinAO(2018)\n\t\t\t\t\tMechanical properties and superficial characterization of a milled CAD-CAM glass fiber postJournal of the Mechanical Behavior of Biomedical Materials82(\n\t\t\t\t\tMarch)\n\t\t\t\t\t187\u2013192. https:\/\/doi.org\/10.1016\/j.jmbbm.2018.03.035"},{"issue":"1","key":"i1559-2863-47-6-658-b17","series-title":"Acta Odontologica Scandinavoca","first-page":"175","article-title":"Influence of cement thickness on the bond strength of tooth-colored posts to root dentin after thermal cycling","volume":"71","year":"2013","unstructured":"Egilmez\n              F\n            ,\n\t\t\t\t\t\tErgunG,\n\t\t\t\t\t\tCekic-NagasI,\n\t\t\t\t\t\tVallittuPK, &\n\t\t\t\t\t\tLassilaLVJ(2013)\n\t\t\t\t\tInfluence of cement thickness on the bond strength of tooth-colored posts to root dentin after thermal cyclingActa Odontologica Scandinavoca71(1)\n\t\t\t\t\t175\u2013182. https:\/\/doi.org\/10.3109\/00016357.2011.654257"},{"issue":"5","key":"i1559-2863-47-6-658-b18","series-title":"Operative Dentistry","first-page":"541","article-title":"Preliminary results of the survival and fracture load of roots restored with intracanal posts: Weakened vs nonweakened roots","volume":"39","year":"2014","unstructured":"Wandscher\n              VF\n            ,\n\t\t\t\t\t\tBergoliCD,\n\t\t\t\t\t\tLimbergerIF,\n\t\t\t\t\t\tArdenghiTM, &\n\t\t\t\t\t\tValandroLF(2014)\n\t\t\t\t\tPreliminary results of the survival and fracture load of roots restored with intracanal posts: Weakened vs nonweakened rootsOperative Dentistry39(5)\n\t\t\t\t\t541\u2013555. https:\/\/doi.org\/10.2341\/12-465"},{"issue":"1","key":"i1559-2863-47-6-658-b19","series-title":"Operative Dentistry","first-page":"E23","article-title":"Use of a direct anatomic post in a flared root canal: A three-year follow-up","volume":"41","year":"2016","unstructured":"Gomes\n              GM\n            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Dentistry","first-page":"595","article-title":"Influence of no-ferrule and no-post buildup design on the fatigue resistance of endodontically treated molars restored with resin nanoceramic CAD-CAM crowns","volume":"39","year":"2014","unstructured":"Magne\n              P\n            ,\n\t\t\t\t\t\tCarvalhoAO,\n\t\t\t\t\t\tBruziG,\n\t\t\t\t\t\tAndersonRE,\n\t\t\t\t\t\tMaiaHP, &\n\t\t\t\t\t\tGianniniM(2014)\n\t\t\t\t\tInfluence of no-ferrule and no-post buildup design on the fatigue resistance of endodontically treated molars restored with resin nanoceramic CAD-CAM crownsOperative Dentistry39(6)\n\t\t\t\t\t595\u2013602. https:\/\/doi.org\/10.2341\/13-004-L"},{"key":"i1559-2863-47-6-658-b22","series-title":"Journal of Dentistry","first-page":"41","article-title":"Restoration of severely damaged endodontically treated premolars: The influence of the endo-core length on marginal integrity and fatigue resistance of lithium disilicate CAD-CAM ceramic 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