Effect of Hygroscopic Expansion on the Push-Out Resistance of Glass Ionomer-Based Cements Used for the Luting of Glass Fiber Posts

Long-term effect of simulated five years professional mechanical biofilm removal on the luting gap of ceramic restorations

BACKGROUND

Achieving sufficient professional mechanical biofilm removal (PMPR) can be challenging in supportive periodontal therapy (SPT), particularly in patients with prosthetic restorations. This experimental study aimed to simulate five years of SPT with periodic PMPR near the luting gap of ceramic restorations using a rubber cup with polishing paste (RCP), air polishing with two different low-abrasive powders (LAPA-1: glycine powder, LAPA-2: erythritol powder), and non-professional mechanical cleaning (control group) to measure the extent of volume loss in the luting gap after baseline (∆V = Vbaseline-V1-5; in µm3).

METHODS

Two operators randomly performed PMPR ten times for thirty seconds on one of four sides of 30 crown replicas fixed with glass-ionomer cement (CGIZ: n = 15) or adhesive bonding (CAB: n = 15). The replicas were separated in a template during PMPR, and afterward, cleaned for five seconds per side with a sonic brush under flowing water. The artificial aging process between two PMPRs simulated a 5-year SPT with two PMPRs per year. Profilometric measurements were performed at baseline and after each second PMPR to obtain the mean change of ∆V. The statistical evaluation of the data was carried out using nonparametric tests with Bonferroni correction applied for multiple tests.

RESULTS

Ninety-six out of 120 sides could be included in the analysis. PMPR methods showed a loss of substance in the luting gap with a ∆V (mean(standard deviation)) of -4.35 × 106(4.8 × 106)µm3 versus 8.79 × 104(1.05 × 106)µm3 for control at V5 (p ≤ 0.001). No significant differences of ∆V1-5 values could be identified in the control (p > 0.05), whereat all PMPRs showed a significant increasing loss of substance per simulated year (p ≤ 0.001). Intergroup comparison identified LAPA-1 as having the highest significant loss of substance determined on CAB (∆V: -1.05 × 107 (7,2 × 106) µm3), followed by LAPA-2 on CAB (∆V: -6.29 × 106 (4,24 × 106) µm3), LAPA-1 on CGIZ (∆V: -4.15 × 106 (3,25 × 106) µm3), LAPA-2 on CGIZ (∆V: -3.0 × 106 (2,23 × 106) µm3), RCP on CAB (∆V: -1.86 × 106 (2,23 × 106) µm3) and CGIZ (∆V: -1.2 × 106 (1,31 × 106) µm3; p ≤ 0.001)).

CONCLUSIONS

Within study limitations, all PMPRs caused a significantly higher loss of substance in the luting gap versus control without professional intervention, with the highest values in the CAB group for LAPA-1, LAPA-2 and RCP. Similar findings were observed for CGIZ, although the loss values were lower.

Customized Fiber Post Improves the Bond Strength and Dentinal Penetrability of Resin Cementation System to Root Dentin

OBJECTIVE

This study aimed to evaluate the effect of fiber post customization on the bond strength (24 hours and 6 months), resin cement thickness, and dentinal penetrability of Adper Scotchbond Multi-Purpose - RelyX ARC (AS-RA), RelyX U200 (R2), and Scotchbond Universal - RelyX Ultimate (SU-RU) cementation systems to root dentin from the cervical-, middle-, and apical-thirds of the post space.

METHODS

One hundred twenty bovine incisors were endodontically treated. After post space preparation, the roots were divided into six groups, according to the luting protocols (AS-RA, R2, SU- RU) and the type of fiber post [noncustomized post (NC) and customized post (C)]. Customization procedures were peformed using a resin composite (Z350 XT). 24 hours (n=60) or 6 months later (n=60), specimens from the cervical-, middle-, and apical-thirds of the post space were submitted to cementation system thickness measurement, bond strength evaluation, and dentinal penetrability analysis with Confocal Laser Scanning Microscopy (CLSM). Failure mode was classified as adhesive, cohesive, or mixed. Data were submitted to ANOVA and Tukey tests (α=0.05).

RESULTS

Cementation protocols with customized fiber posts presented the lowest cementation system thickness, regardless of the cementation system or post space-third (p<0.05), and the highest bond strength values (p<0.05), regardless of the third space (p>0.05), for both periods (24 hours or 6 months). The comparison of push-out bond strength values between 24 hours and 6 months showed a reduction in all groups for the cervical-third (p<0.05). For the middle-third, only noncustomized groups showed reduction (p<0.05). For the apical-third, no reduction was observed (p>0.05).

CONCLUSIONS

Anatomical customization favored both the bond strength of cements to dentin and the dentinal penetrability, but with lower cementation system thickness, regardless of cement composition and adhesive strategy.

The Effect of the Use of Different Types of Cement and Zirconium Post Systems on Endondontically Treated Teeth

BACKGROUND

Prefabricated zirconium upgrading systems were examined to satisfy aesthetic needs in endodontically treated teeth. Endodontically treated teeth, together with non-metallic posts and superstructure, are substructures that enable the production of prosthetic structures that will allow aesthetics, resulting from normal light transmission. To investigate and analyse the retention of zirconium post systems cemented with RelyX Unicem 2 Automix (RLX) cement with Pull-out test.

AIM

To examine the retention of zirconium post systems, cemented with Multi-Link Automix (MLA) cement and RelyX Unicem 2 Automix (RLX) cement with Pull-out test.

MATERIAL AND METHODS

In this study were used, 120 post systems of the company ZIRIX NORDIN - Switzerland, with different diameters d1 = 1.2, were used: d2 = 1.35, d3 = 1.5, and two types of resin cements: Multilink Automix-Ivoclar (MLA), and RelyX Unicem 2 Automix (RLX) - 3 M ESPE.

RESULTS

The analysis of the extraction force in newtons (N) zirconium post systems of Multilink Automix cement according to subgroups of three diameters is consequently 481.3 ± 1.9 vs 462.9 ± 4.5 vs 454.2 ± 2.2. The analysis of the extraction strength in the newtons (N) zirconium post systems of RelyX Unicem 2 Automix cement in the entire sample is 577.9 ± 6.1 N.

CONCLUSION

The largest diameter of the posts significantly increases the resistance of fractures compared to the smaller two diameters used in the experimental study.

Post Placement Affects Survival of Endodontically Treated Premolars

Clinical evidence is lacking regarding the influence of the amount of residual coronal dentin and of post placement on the failure risk of endodontically compromised teeth. The aim of this prospective clinical trial was to assess whether these factors significantly affect the two-year survival of restored pulpless premolars. A sample of 210 individuals provided six experimental groups of 40 premolars in need of endodontic treatment. Groups were defined based on the amount of dentin left at the coronal level. Within each group, in half of the teeth selected at random, a fiber post was inserted inside the root canal, whereas in the remaining half of the premolars, no post was placed. All teeth were covered with a crown. The Cox regression analysis revealed that post placement resulted in a significant reduction of failure risk (p < 0.001). Failure risk was increased for teeth under the “no ferrule” (p = 0.001) and “ferrule effect” conditions (p = 0.004).

An in vitro evaluation of the effects of desensitizing agents on microleakage of Class V cavities

Background

The aim of this study was to evaluate the effect of a desensitizing agent on microleakage of Class V cavities.

Material and Methods

72 premolar teeth were used. There were 6 groups. Class V restorations were prepared with two different restorative materials (Equia fil, GC, America and Grandio, VOCO, Germany) and two adhesive systems (Clearfil SE Bond, Kuraray, Japan and S3 Bond Plus, Kuraray, Japan) with and without desensitizing agent (Gluma Desensitizer, Heraeus Kulzer, Germany). Restorations were polished with aluminum oxide abrasive discs. Then a range of 5 - 55C thermocycling was performed 10.000 times. The microleakage of restorations was examined with dye penetration method (Basic fuchsine). Bonferroni corrections and Kruskal-Wallis test were used to determine the significance of differences in occlusal and gingival dye penetration scores between groups.

Results

There was no stastistical significance between the occlusal and gingival microleakage scores within the groups were shown.

Conclusions

It can be concluded that use of desensitizing agent under both high viscosity glass ionomer restorative materials and resin composites doesn’t affect the microleakage.

Key words:High viscosity glass ionomer cement, composite resin, desensitizing agent, microleakage.

Push-out bond strength of fiber posts to root dentin using glass ionomer and resin modified glass ionomer cements

Objective

The purpose of this study was to assess the push-out bond strength of glass fiber posts to root dentin after cementation with glass ionomer (GICs) and resin-modified glass ionomer cements (RMGICs).

Material and Methods

Fifty human maxillary canines were transversally sectioned at 15 mm from the apex. Canals were prepared with a step back technique until the application of a #55 K-file and filled. Post spaces were prepared and specimens were divided into five groups according to the cement used for post cementation: Luting & Lining Cement; Fuji II LC Improved; RelyX Luting; Ketac Cem; and Ionoseal. After cementation of the glass fiber posts, all roots were stored at 100% humidity until testing. For push-out test, 1-mm thick slices were produced. The push-out test was performed in a universal testing machine at a crosshead speed of 0.5 mm/minute and the values (MPa) were analyzed by Kolmogorov-Smirnov and Levene's tests and by two-way ANOVA and Tukey's post hoc test at a significance level of 5%.

Results

Fiber posts cemented using Luting & Lining Cement, Fuji II LC Improved, and Ketac Cem presented the highest bond strength to root dentin, followed by RelyX Luting. Ionoseal presented the lowest bond strength values (P>0.05). The post level did not influence the bond strength of fiber posts to root dentin (P=0.148). The major cause of failure was cohesive at the cement for all GICs and RMGICs.

Conclusions

Except for Ionoseal, all cements provided satisfactory bond strength values.

Push-out bond strengths of different dental cements used to cement glass fiber posts

STATEMENT OF PROBLEM

Since the introduction of glass fiber posts, irreversible vertical root fractures have become a rare occurrence; however, adhesive failure has become the primary failure mode.

PURPOSE

The purpose of this study was to evaluate the push-out bond strength of glass fiber posts cemented with different luting agents on 3 segments of the root.

MATERIAL AND METHODS

Eighty human maxillary canines with similar root lengths were randomly divided into 8 groups (n=10) according to the cement assessed (Rely X luting, Luting and Lining, Ketac Cem, Rely X ARC, Biscem, Duo-link, Rely X U100, and Variolink II). After standardized post space preparation, the root dentin was pretreated for dual-polymerizing resin cements and untreated for the other cements. The mixed luting cement paste was inserted into post spaces with a spiral file and applied to the post surface that was seated into the canal. After 7 days, the teeth were sectioned perpendicular to their long axis into 1-mm-thick sections. The push-out test was performed at a speed of 0.5 mm/min until extrusion of the post occurred. The results were evaluated by 2-way ANOVA and the all pairwise multiple comparison procedures (Tukey test) (α=.05).

RESULTS

ANOVA showed that the type of interaction between cement and root location significantly influenced the push-out strength (P<.05). The highest push-out strength results with root location were obtained with Luting and Lining (S3) (19.5 ±4.9 MPa), Ketac Cem (S2) (18.6 ±5.5 MPa), and Luting and Lining (S1) (18.0 ±7.6 MPa). The lowest mean values were recorded with Variolink II (S1) (4.6 ±4.0 MPa), Variolink II (S2) (1.6 ±1.5 MPa), and Rely X ARC (S3) (0.9 ±1.1 MPa).

CONCLUSIONS

Self-adhesive cements and glass ionomer cements showed significantly higher values compared to dual-polymerizing resin cements. In all root segments, dual-polymerizing resin cements provided significantly lower bond strength. Significant differences among root segments were found only for Duo-link cement.

Stress distribution on dentin-cement-post interface varying root canal and glass fiber post diameters. A three-dimensional finite element analysis based on micro-CT data

Objective

The aim of the present study was to analyze the influence of root canal and glass fiber post diameters on the biomechanical behavior of the dentin/cement/post interface of a root-filled tooth using 3D finite element analysis.

Material and Methods

Six models were built using micro-CT imaging data and SolidWorks 2007 software, varying the root canal (C) and the glass fiber post (P) diameters: C1P1-C=1 mm and P=1 mm; C2P1-C=2 mm and P=1 mm; C2P2-C=2 mm and P=2 mm; C3P1-C=3 mm and P=1 mm; C3P2-C=3 mm and P=2 mm; and C3P3-C=3 mm and P=3 mm. The numerical analysis was conducted with ANSYS Workbench 10.0. An oblique force (180 N at 45º) was applied to the palatal surface of the central incisor. The periodontal ligament surface was constrained on the three axes (x=y=z=0). Maximum principal stress (σ_max) values were evaluated for the root dentin, cement layer, and glass fiber post.

Results:

The most evident stress was observed in the glass fiber post at C3P1 (323 MPa), and the maximum stress in the cement layer occurred at C1P1 (43.2 MPa). The stress on the root dentin was almost constant in all models with a peak in tension at C2P1 (64.5 MPa).

Conclusion

The greatest discrepancy between root canal and post diameters is favorable for stress concentration at the post surface. The dentin remaining after the various root canal preparations did not increase the stress levels on the root.

Effect of luting cement and thermomechanical loading on retention of glass fibre posts in root canals

OBJECTIVES

To evaluate the effect of luting cement and thermomechanical loading on the retention of glass fibre posts in root canals.

METHODS

One hundred and forty-four single-rooted human premolars were endodontically treated and restored with RelyX Fibre Posts. The teeth were divided into four groups according to the cements used (Fuji I, Fuji CEM, RelyX Unicem and RelyX ARC). Each group was further divided into two subgroups according to the method of ageing (immediately tested and after thermomechanical loading). Bond strength was evaluated using a pull-out test. Microleakage was examined quantitatively with dye penetration. The dentine-cement-post bonding interface was assessed using scanning electron microscopy. Data were analysed with two-way ANOVA (pull-out test) and Kruskal-Wallis analysis (microleakage).

RESULTS

The pull-out bond strength and microleakage were significantly affected by the type of cement and ageing. Although RelyX ARC showed the highest bond strength before thermomechanical loading (p<0.05), the sealing ability of this cement was worse than those exhibited in Fuji CEM and RelyX Unicem (p<0.05). After thermomechanical loading, pull-out strengths of Fuji I and Fuji CEM were significantly increased, whereas that of RelyX ARC group significantly decreased (p<0.05). The sealing ability of Fuji CEM was significantly better than the two resin cement groups (p<0.05) after ageing.

CONCLUSION

Fuji CEM demonstrates increased pull-out strength after thermomechanical loading and favourable sealing ability compared with the other cements.

CLINICAL SIGNIFICANCE

Resin-modified glass ionomer cements have the potential benefit of achieving long-term retention when used for luting glass fibre post to root canal dentine. So it may be recommended for the cementation of glass fibre post in clinics.

Effect of cement type and water storage time on the push-out bond strength of a glass fiber post

This study investigated the effects of the cement type and the water storage time on the push-out bond strength of a glass fiber post. Glass fiber posts (Fibrekor, Jeneric Pentron) were luted to post spaces using a self-cured resin cement (C&B Cement [CB]), a glass ionomer cement (Ketac Cem [KC]) or a resin-modified glass ionomer cement (GC FujiCEM [FC]) according to the manufacturers' instructions. For each luting agent, the specimens were exposed to one of the following water storage times (n=5): 1 day (T1), 7 days (T7), 90 days (T90) and 180 days (T180). Push-out tests were performed after the storage times. Control specimens were not exposed to water storage, but subjected to the push-out test 10 min after post cementation. Data (in MPa) were analyzed by Kruskal-Wallis and Dunn`s test (α=0.05). Cement type and water storage time had a significant effect (p<0.05) on the push-out bond strength. CB showed significantly higher values of retention (p<0.05) than KC and FC, irrespective of the water storage time. Water storage increased significantly the push-out bond strength in T7 and T90, regardless of the cement type (p<0.05). The results showed that fiber posts luted to post spaces with the self-cured resin cement exhibited the best bonding performance throughout the 180-day water storage period. All cements exhibited a tendency to increase the bond strength after 7 and 90 days of water storage, decreasing thereafter.

Effect of relining on fiber post retention to root canal

One of the clinically relevant problems dentists face when restoring endodontically treated teeth is the mismatch between fiber post and post space diameters, which results in an excessively thick resin cement layer. Fiber post relining appears as a solution for this problem.

Crown pull-off test (crown retention test) to evaluate the bonding effectiveness of luting agents

OBJECTIVE

The purpose of this review was to assess the influencing factors which affect laboratory tests that evaluate the effectiveness of luting agents on the retention of crowns in prepared dentin and - based on the results of the review - to propose a reasonable experimental setup.

MATERIALS AND METHODS

The database MEDLINE was systematically searched for laboratory methods that evaluated the effectiveness of luting agents by pulling off crowns from prepared extracted teeth.

RESULTS

Eighteen studies were included into the systematic review. The studies varied largely with regard to tooth type (molars, premolars), number of specimens (9-25), stump height (3-6mm), convergence angle (4.8-33 degrees ), standardization and measurement of preparation surface, seating force (25-200N), artificial ageing, crosshead speed for tensile force and statistical analysis. The coefficient of variation of the test results varied from 3% to 100%. The most important influencing factors for the crown dislodgement were stump height and convergence angle as well as the luting agent. Panavia and RelyX Unicem generally produced the highest values followed by glass ionomer and zinc phosphate cements. When pooling and normalizing the data, the mean difference between glass ionomer and resin-based materials as well as between glass ionomer and zinc phosphate cements was statistically significant (Wilcoxon, p<0.05). Seating force, roughness, type of cutting bur and use of a desensitizing agent had all a negligible effect on the test results. Artificial ageing like thermocycling had no influence with glass ionomer cements whereas for resin-based cements thermocycling and prolonged water storage generated similar a failures stress than thermocycling alone. The comparison with clinical results did not reveal conclusive evidence that the results of the laboratory methods completely reflect the results of prospective clinical trials in conjunction with single crowns and fixed dental prostheses. A reasonable experimental setup includes: at least 20 specimens per group, stump height 3mm, convergence angle 20 degrees , thermocycling of specimens (5000x), avoidance of shearing forces during dislodgement and failure probability statistics (Weibull).

CONCLUSIONS

The results of pull-off tests with crowns that are cemented with luting agents varied largely and reflect only partially the results from clinical trials. The most influencing factors (standardized tooth preparation, avoidance of shearing stress during dislodgement of crown) had to be controlled to get meaningful results.

Influence of luting agents on time required for cast post removal by ultrasound: an in vitro study

Objective:

This in vitro study evaluated the influence of luting agents on ultrasonic vibration time for intraradicular cast post removal.

Material and Methods:

After endodontic treatment, 30 roots of extracted human canines were embedded in resin cylinders. The post-holes were prepared at 10 mm depth and their impressions were taken using autopolymerizing acrylic resin. After casting procedures using a nickel-chromium alloy, the posts were randomly distributed into 3 groups (n=10) according to the luting material: G1- zinc phosphate (SS White) (control group), G2 - glass ionomer cement (Vidrion C; SS White), and G3- resin cement (C&B; Bisco). In G3, the adhesive procedure was performed before post cementation. After 24 h, the cement line was removed at the post/tooth interface using a fine diamond bur, and the ST-09 tip of an Enac ultrasound unit was applied at maximum power on all surfaces surrounding the posts. The application time was recorded with a chronometer until the post was completely dislodged and data were analyzed by ANOVA and Tukey's test (p<0.05).

Results:

The roots were removed from the acrylic resin and inspected to detect cracks and/or fractures. The means for G1, G2, and G3 were 168.5, 59.5, and 285 s, respectively, with statistically significant differences among them. Two G3 posts resisted removal, one of which developed a vertical fracture line.

Conclusions:

Therefore, the cement type had a direct influence on the time required for ultrasonic post removal. Compared to the zinc phosphate and glass ionomer cements, the resin cement required a longer ultrasonic vibration time.

Effect of ethanol application on post-luting to intraradicular dentine

AIM

To examine the effect of the application of an ethanol rinse before luting fibre posts to intraradicular dentine with etch-and-rinse adhesive systems by means of push-out bond strength evaluation and scanning electron microscopic (SEM) analysis.

METHODOLOGY

Fibre posts were luted to single-canal premolars using Dual Link as a luting agent in combination with a three-step (All Bond 2) or a two-step (One Step Plus) etch-and-rinse adhesive system, which were applied as per manufacturers' instructions (control) or with the additional rinse of ethanol on acid-etched dentine prior to the bonding procedures (experimental). Bonded specimens were sectioned into 1-mm-thick slabs and subjected to push-out bond strength testing. In addition, specimens from each group were processed for SEM analysis. Data were analysed by Kruskal-Wallis followed by Dunn's post hoc test at P = 0.05.

RESULTS

Push-out bond strength of All Bond 2 was significantly increased if the adhesive was applied on ethanol-saturated dentine (P < 0.05), whilst no significant difference (P > 0.05) was detected amongst experimental and control groups for One Step Plus. Irrespective of the adhesive, the SEM analysis revealed good impregnation patterns when both bonding techniques were employed.

CONCLUSIONS

The use of the additional ethanol rinse on acid-etched dentine revealed higher bond strength of All Bond 2 when compared with the control application procedure, used in combination with a resin-based cement to lute fibre posts into the dowel space. However, no bond strength improvements were detected using One Step Plus. Further investigations are needed to develop a clinically applicable ethanol/bonding/luting technique.

Microhardness of resin cements in the intraradicular environment: effects of water storage and softening treament

OBJECTIVES

To analyze the microhardness of four dual-cure resin cements used for cementing fiber-reinforced posts under the following conditions: after 7 days of storage in water, after additional 24h of immersion in 75% ethanol, and after 3 months of storage in water. Hardness measurements were taken at the cervical, middle and apical thirds along the cement line.

METHODS

Root canals of 40 bovine incisors were prepared for post space. Fibrekor glass fiber-reinforced posts (Jeneric/Pentron) of 1mm in diameter were cemented using Panavia F 2.0 (Kuraray), Variolink (Ivoclar-Vivadent), Rely X Unicem (3M ESPE) or Duolink (Bisco) (N=10). After 7 days of water storage at 37 degrees C, half the sample (N=5) was longitudinally sectioned and the initial microhardness measured along the cement line from cervical to apex. These same samples were further immersed in 75% ethanol for 24h and reassessed. The remaining half (N=5) was kept unsectioned in deionized water at 37 degrees C for 3 months, followed by sectioning and measuring. Data were analyzed by a series of two-way ANOVA and Tukey tests at alpha=5%.

RESULTS

Statistically significant differences were identified among the cements, thirds and conditions. Significant interactions were also observed between cements and thirds and between cements and conditions. Panavia F exhibited significantly higher initial microhardness than the other three cements, which showed no statistical difference among themselves. Variolink and Duolink showed significantly higher microhardness values in the cervical third, without significant difference among the thirds for the other cements. Immersion in ethanol significantly reduced the hardness values for all cements, regardless of the thirds. Storage in water for 3 months had no influence on the hardness of most of the cements, with the exception of Unicem that showed a significant increase in the hardness values after this period.

SIGNIFICANCE

Results showed heterogeneity in the microhardness of the cements inside the canal. All cements presented some degree of softening after ethanol treatment, which suggests instability of the polymer. The quality of curing of resin cements in the root canal environment seems unpredictable and highly material dependent.

Influence of endodontic post type (glass fiber, quartz fiber or gold) and luting material on push-out bond strength to dentin in vitro

OBJECTIVES

To determine the influence of post type and luting material on bond strength to dentin.

METHODS

The root canals of extracted human upper central incisors were instrumented and post space was prepared using the respective drills for each post system. Glass fiber posts (Luscent Anchor, Dentatus [LA]) were luted using three dual-curing adhesive systems (Excite DSC/Variolink II, Vivadent [VL2]; EnaBond/EnaCem, Micerium [ENA]; Prime & Bond NT/Calibra, DentSply DeTrey [CAL]). A different brand of glass fiber post (EasyPost, DentSply Maillefer [EP]) and quartz fiber post (DT Light Post, VDW [DT]) were luted using CAL. Gold posts (Perma-dor, VDW) were luted either adhesively following tribo-chemical silicate coating (Rocatec, ESPE-Sil, 3M ESPE; CAL) or conventionally using glass ionomer cement (Ketac Cem, 3M ESPE). Three slices of 2mm height were cut perpendicular to the post from each restored root. Bond strength was determined by pushing out the post using a universal testing machine (/1449, Zwick).

RESULTS

For all experimental groups combined, bond strength increased from the coronal to the apical section (Friedman test: P<0.001). Significant differences were observed among the fiber posts (DT/CAL>LA/CAL; Mann-Whitney U-test with Bonferroni-Holm adjustment: P<0.05; EP/CAL ranging in between) but not among luting materials (LA/VL2, LA/ENA, LA/CAL: n.s.). The gold posts were equivalent to DT/CAL with both luting procedures.

SIGNIFICANCE

Selection of post type may be more important for bond strength than luting material. Bond strength of fiber posts was equivalent but not superior to adhesively or conventionally luted gold posts.

Laboratory assessment of the retentive potential of adhesive posts: a review

OBJECTIVES

This review aimed at summarizing the laboratory evidence collected on the retentive ability of adhesive posts since their introduction in dentistry.

DATA

Data were searched in articles published or in press in peer-review journals listed in MEDLINE.

SOURCES

Papers were retrieved through PubMed.

STUDY SELECTION

To collect the evidence of interest, the following search terms were used: bond* AND fiber post AND in vitro; lut* AND fiber post AND in vitro; push-out AND fiber post; pull-out AND fiber post; microtensile AND fiber post. "Related Links" were also considered and articles cited in the initially retrieved papers were included if relevant. No time limit was given to the query.

CONCLUSIONS

Seventy relevant papers were reviewed. The retentive ability of adhesive posts has been tested with the microtensile technique, post-pull-out and push-out tests. If small-sized specimens are obtained, such as in microtensile and thin-slice push-out, stress uniformity is favoured, local differences in bonding conditions can be discerned, and the number of teeth needed for the test can be reduced. Although adhesion to intraradicular dentin is more challenging to achieve than bonding to crown tissues, the post-retention achieved with current luting systems and techniques is adequate to ensure the clinical success of adhesive post-retained restorations. To enhance the bond at the post-core and post-cement interfaces, several chemical pre-treatments of the post-surface have been tested with positive results. Self-adhesive resin cements, recently proposed to simplify the post-luting procedure, should be investigated further with regard to durability.

Cements for use in esthetic dentistry

Dental cements are designed to retain restorations, appliances, and post and cores in a stable and, presumably, long-lasting position in the oral environment. Conventional glass ionomer and zinc phosphate cements are among the most popular materials for luting metallic restorations and posts, whereas resin-based cements are preferred for esthetic applications. Successful cementation of esthetic restorations is largely dependent on the appropriate treatment and silane application to the internal surface of the restoration. Clinicians are frequently advised to use three-step total-etch or two-step self-etch adhesive for luting purposes to avoid problems of incompatibility between adhesives and chemical- or dual-cure cements. A reliable cementation procedure can only be achieved if the operator is aware of the mechanisms involved and the material limitations.