Influence of luting material filler content on post cementation

Dental Resin-Based Luting Materials-Review

As cementation represents the last stage of the work involved in making various indirect restorations (metal ceramic crowns and bridges, full ceramic crowns and bridges, inlays, onlays, and fiber posts), its quality significantly contributes to the clinical success of the therapy performed. In the last two decades, the demand for ceramic indirect restorations in everyday dental practice has considerably increased primarily due to the growing significance of esthetics among patients, but also as a result of hypersensitivity reactions to dental alloys in some individuals. In this context, it is essential to ensure a permanent and reliable adhesive bond between the indirect restoration and the tooth structure, as this is the key to the success of aesthetic restorations. Resin-based luting materials benefit from excellent optical (aesthetic) and mechanical properties, as well as from providing a strong and durable adhesive bond between the restoration and the tooth. For this reason, resin cements are a reliable choice of material for cementing polycrystalline ceramic restorations. The current dental material market offers a wide range of resin cement with diverse and continually advancing properties. In response, we wish to note that the interest in the properties of resin-based cements among clinicians has existed for many years. Yet, despite extensive research on the subject and the resulting continued improvements in the quality of these materials, there is still no ideal resin-based cement on the market. The manuscript authors were guided by this fact when writing the article content, as the aim was to provide a concise overview of the composition, properties, and current trends, as well as some future guidelines for research in this field that would be beneficial for dental practitioners as well as the scientific community. It is extremely important to provide reliable and succinct information and guidelines for resin luting materials for dental dental practitioners.

Dental Fiber-Post Systems: An In-Depth Review of Their Evolution, Current Practice and Future Directions

The field of dental medicine is constantly evolving and advancing toward minimally invasive techniques. Several studies have demonstrated that bonding to the tooth structure, particularly enamel, yields the most predictable results. In some instances, however, significant tooth loss, pulpal necrosis, or irreversible pulpitis may limit the options available to the restorative dentist. In these cases, placement of a post and core followed by a crown is the preferred treatment option, provided all requirements are met. This literature review provides an overview of the historical development of dental FRC post systems as well as a comprehensive examination of the currently available posts and their bonding requirements. In addition, it offers valuable insights for dental professionals seeking to understand the current state of the field and the prospects of dental FRC post systems.

Influence of New Sleeve Composite on Fracture Behavior of Anterior Teeth with Flared Root Canals

We evaluated the fracture strength and failure mode of non-ferrule teeth with flared root canals that were restored using new experimental sleeve composites. Fifty endodontically treated anterior teeth with flared root canals were restored with direct restorations utilizing different techniques. Group A had teeth (non-ferrule) restored using commercialized MI glass fiber post + Gradia Core as core build-up. Group B had teeth (non-ferrule) restored with commercialized i-TFC glass fiber post + sleeve system. In Group C, the teeth (non-ferrule) were restored with an experimental sleeve composite with commercialized MI glass fiber post and Gradia Core. Group D, teeth (non-ferrule), were restored using custom-made tapered E-glass filling post and Gradia Core. Group E, teeth (with ferrule), were restored with commercialized MI glass fiber post + Gradia Core. After core construction, all specimens underwent direct composite crown restoration and were loaded until fracture using a universal testing machine. Average fracture loads were compared, and the failure modes were observed. Group C exhibited significantly greater fracture strength than other groups (p < 0.05). Favorable fracture teeth ratio of group C was more than that of the other groups. Thus, the new experimental sleeve composite could be clinically useful for core construction of non-ferrule teeth.

Evaluation of Micro-Tensile Bond Strength of Fibre Post with Titanium Dioxide Nanoparticles as Fillers in Experimental Dental Composite Resin

Background: The clinical success of post-core restorations is determined by the composite utilized and the strength of the post-core adhesion. The effectiveness of titanium dioxide nanoparticles (TiO₂ NPs) as a multifunctional material with photo-induced activities and better mechanical characteristics are observed as particle size is reduced to under 50 nm. Aim: The purpose of this study is to determine the bond strength of fibre-reinforced composite (FRC) posts with TiO₂ NP as fillers and to compare it with conventional composite resin core material. Materials and Methods: 30 single-rooted mandibular premolars were selected and routine root canal procedures were done. A quantity of 5% TiO₂ NPs were synthesized and added as silanized filler to the experimental composite resin. Post space was prepared and fibre-reinforced composite (FRC) post luting was performed. The specimens were then grouped into the following groups: Group I consisted of the experimental composite resin containing 5% TiO₂ fillers, Group II consisted of core X flow, and Group III consisted of Multicore Flow. All test groups were submitted for thermocycling. After this, the samples were tested for micro tensile bond strength. A stereomicroscope with a magnification of 20× was used to examine the fractured surfaces. The data were analysed using one-way ANOVA and Tukey HSD tests. Results: Statistical analysis revealed that Group I showed the highest mean bond strength value of 35.6180 Mpa. The results obtained with Group III showed the lowest mean bond strength value of 19.4690 Mpa. Adhesive failures were identified by stereomicroscopy of the fractured surfaces. Conclusion: The experimental composite resin comprising 5% TiO₂ NP had a greater bond to the FRC post than other materials tested.

Influence of Dimethacrylate Monomer on the Polymerization Efficacy of Resin-Based Dental Cements-FTIR Analysis

The degree of polymerization for dimethacrylate resin-based materials (BisGMA, TEGDMA, UDMA, HEMA) ranges from 55 to 75%. Literature data indicate that polymerization efficacy depends, among other factors, on the type of methacrylate resin comprising the material. The aim of this study was to evaluate the polymerization efficacy of four dental cement materials characterized by different polymerization mechanisms using FTIR analysis. In the present study, the FTIR method was adopted to analyze the degree of polymerization efficacy of four resin-based dental cement materials, two of which were self-cured and two were dual-cured cements. The IR spectral analysis was performed 24 h after the polymerization of the cementitious material. RelyX ARC cement exhibits the lowest polymerization efficacy (61.3%), while that of Variolink II (85.8%) and Maxcem Elite is the highest (90.1%). Although the efficacy of self-cured cements appears to be superior, the difference is not statistically significant (p = 0.280). Polymerization efficacy largely depends on the chemical structure of the material in terms of the presence of a particular methacrylate resin and less on the polymerization mechanism itself, i.e., whether it is a self-cured or dually cured dental cement. Thus, in clinical practice, cementitious materials with a higher proportion of TEGDMA compared with BisGMA are recommended.

Fracture strength of teeth with coronal destruction after core build-up restoration with bulk fill materials

OBJECTIVE

This study aimed to evaluate the fracture strength and failure modes of different core techniques in teeth with simulated coronal destruction.

MATERIALS AND METHODS

Forty teeth were endodontically prepared and the specimens were divided into four experimental groups (n = 10) according to the core composition: Filtek One Bulk Fill-FOBF, Filtek Z350 XT-FZ350 (standard group), Filtek Bulk Fill Flow-FBFF, and LuxaCore Z-LCZ. CAD/CAM Monolithic zirconia crowns were obtained and cemented with RelyX U200. After storage in distilled water at 37°C for 48 h, the specimens were subjected to thermal cycling and to compressive strength mechanical tests. Statistical analyses (α = 0.05) were performed by non-parametric Kruskal-Wallis, Dunn post hoc, and Fisher's exact tests.

RESULTS

No significant differences (p > 0.05) were observed among FOBF, FZ350, and FBFF (mean ranks = 20.30, 12.20, and 23.20, respectively). LCZ (mean rank = 26.30) produced results similar to those of FOBF and FBFF (p > 0.05) and higher than those of FZ350 (p = 0.042). The most frequent type of failure was irreparable, regardless of the experimental condition. The lowest percentages of reparable fractures were produced by FOBF group (10%).

CONCLUSIONS

The use of bulk fill materials, including the "core-and-post" LCZ dual-cure resin composite, did not impair the fracture strength of endodontically treated teeth with coronal destruction.

CLINICAL SIGNIFICANCE

Resin composite bulk fill materials that can be used as a core-and-post cementation in an only stage are interesting, since they enable clinicians to work with one only material, and avoid several materials interfaces, technical sensitivity, and longer chair-time due to multistep procedures.

Flexural Strength of Resin Core Build-Up Materials: Correlation to Root Dentin Shear Bond Strength and Pull-Out Force

The aims of this study were to investigate the effects of root dentin shear bond strength and pull-out force of resin core build-up materials on flexural strength immediately after setting, after one-day water storage, and after 20,000 thermocycles. Eight core build-up and three luting materials were investigated, using 10 specimens (n = 10) per subgroup. At three time periods-immediately after setting, after one-day water storage, and after 20,000 thermocycles, shear bond strengths to root dentin and pull-out forces were measured. Flexural strengths were measured using a 3-point bending test. For all core build-up and luting materials, the mean data of flexural strength, shear bond strength and pull-out force were the lowest immediately after setting. After one-day storage, almost all the materials yielded their highest results. A weak, but statistically significant, correlation was found between flexural strength and shear bond strength (r = 0.508, p = 0.0026, n = 33). As the pull-out force increased, the flexural strength of core build-up materials also increased (r = 0.398, p = 0.0218, n = 33). Multiple linear regression analyses were conducted using these three independent factors of flexural strength, pull-out force and root dentin shear bond strength, which showed this relationship: Flexural strength = 3.264 × Shear bond strength + 1.533 × Pull out force + 10.870, p = 0.002). For all the 11 core build-up and luting materials investigated immediately after setting, after one-day storage and after 20,000 thermocycles, their shear bond strengths to root dentin and pull-out forces were correlated to the flexural strength in core build-up materials. It was concluded that the flexural strength results of the core build-up material be used in research and quality control for the predictor of the shear bond strength to the root dentin and the retentive force of the post.

Kinetics of polymerization shrinkage of self-adhesive and conventional dual-polymerized resin luting agents inside the root canal

STATEMENT OF PROBLEM

Information regarding the shrinkage kinetics and monomer conversion of dual-polymerized conventional and self-adhesive resin luting agents (RLA) in situ is lacking.

PURPOSE

The purpose of this in vitro study was to evaluate the shrinkage strain and ratio of 1 conventional and 1 self-adhesive RLA by using fiber optic sensors based on Bragg gratings and Vickers hardness in the root canal.

MATERIAL AND METHODS

The root canals of 34 single-rooted premolars were endodontically treated and assigned to 2 groups according to the RLA: RelyX ARC (ARC) and RelyX U200 (U200). Two Bragg grating sensors were attached to fiber posts (n=10), and both post and RLA were placed inside the root canal so that shrinkage strain and ratio values could be measured at the cervical and apical root thirds. For hardness analysis (n=7), two 1-mm-thick slices of each root-third (cervical and apical) were obtained, and 4 indentations were made on the RLA layer. The shrinkage strain and rate, as well as hardness data, were evaluated by using 2-way repeated-measures ANOVA followed by the Bonferroni post hoc test when a significant interaction between factors was detected (α=.05).

RESULTS

The shrinkage strain and rate values of both RLAs were higher at the cervical third than those at the apical third. ARC showed higher shrinkage strain than U200 at the cervical third. The highest hardness values were observed at the cervical third, while ARC showed the lowest hardness values at the apical third.

CONCLUSIONS

The shrinkage kinetics profile and hardness of self-adhesive RLA may differ from those of conventional RLA depending on the root third.

Effects of Polymerization Mode and Interaction with Hydroxyapatite on the Rate of pH Neutralization, Mechanical Properties, and Depth of Cure in Self-Adhesive Cements

Objective The aim of the study was to evaluate the physicochemical properties of self-adhesive resin cements associated with hydroxyapatite (HAp) according to the polymerization activation.

Materials and Methods Specimens of cements (PermaCem 2.0 [DMG]; MaxCem Elite [Kerr], and RelyX U200 [3M ESPE]) were distributed into three groups: activation mode; self-cured and dual-cured modes; and association or not with HAp powder mode. The pH neutralization was evaluated as a function of time. Flexural strength and elastic modulus were also tested (0.5 mm/min.). The depth of cure was also analyzed using the scraping test (ISO 4049). Infrared spectroscopy was also used to collect the spectra of specimens to evaluate the chemical bonds. Statistical comparisons were conducted at 5% of significance.

Results The aggressiveness of the self-adhesive resin cements evaluated varied among the materials with a tendency for neutralization. Self-cure groups exhibited lower pH throughout the entire evaluation when compared with that of the dual-cure ones, irrespective of the addition of HAp. MaxCem Elite when photoactivated was the only cement influenced by the addition of the HAp in terms of mechanical properties. The self-adhesive cements tested presented equivalent depth of cure based on the ISO 4049 requirements, regardless of the evaluated factors.

Conclusions Based on the parameters evaluated, the results demonstrated that most of the self-adhesive cements remained unaltered or improved when mixed with HAp, regardless of the activation mode.

Application of a Novel Modification of the Microbond Test for Evaluation of Adhesive Bond Strength Between Fiber Posts and Dual-Cure Dental Resin Cement

Background

While several tests can be used in the laboratory evaluation of composite resin-based cement materials, the push-out test remains the most prevalent. Due to difficulties in sample preparation, as well as a highly complex procedure, we attempted to develop an alternative method for testing the bond strength of dental resin cement materials.

Material/Methods

Ninety-six experimental samples of 2 dual-cure resin cements and 1 fiber post system were prepared for the 2 testing procedures: the push-out test and the modified Microbond test. The degree of monomer conversion was measured by Fourier-transform infrared spectroscopy.

Results

The push-out test results indicated that the bond strength of dual-cure resin cement differs depending on the tooth root region to which it is applied (p<0.05), In addition, our findings show that Variolink II exhibits a much lower bond strength relative to RelyX ARC. These findings were confirmed by the modified Microbond test results. The monomer conversion rate results indicate average conversion rates of 85.81% and 61.35% for RelyX ARC and Variolnik II, respectively.

Conclusions

Our study confirms the practical utility of the modified Microbond test in the assessment of bond strength of dental cement resin-based materials. The proposed test method is particularly useful given that, relative to the push-out test, it requires a much smaller number of preparation and execution steps, thus reducing the potential for introducing errors, while increasing the reliability of the obtained findings.

Effects of the application techniques of self-adhesive resin cements on the interfacial integrity and bond strength of fiber posts to dentin

Objective:

To evaluate the influence of an application technique of a glass-fiber post using self-adhesive resin cements on the push-out bond strength and the presence of bubbles in the root thirds. The cements were either applied according to the manufacturer's instruction or using a commercial delivering system (Centrix), at which the cement pastes were collected and applied after manipulation.

Material and Methods:

Self-adhesive resin cements (RelyX U200/3M ESPE-U200; Maxcem Elite/Kerr-MAX; Clearfil SA Cement/Kuraray-CSA) and a conventional cement (RelyX ARC/3M ESPE-ARC) were used to cement a post and applied either based on the manufacturer's instructions or using a Centrix syringe to deliver the cements directly onto the post of choice, or directly into canal. The roots were scanned with a micro-computed tomography (μCT) and then sectioned into nine 1-mm thick slices for a push-out bond strength test. The μCT images showed the percentage of bubbles in the root thirds (cervical, medium, and apical). Data were analyzed with three-way ANOVA/Tukey (α=0.05).

Results:

Triple interaction was not significant (p>0.05). The interaction “material” vs “root third” was not significant. A significant interaction was observed between “material” vs “application technique” (p<0.05). For ARC, U200, and MAX, significantly lower percentages of bubbles were observed when the Centrix syringe delivered the cements. Equivalent percentages of voids were observed for CSA, irrespective of the application technique (p>0.05). Significantly higher bond strength was observed when the self-adhesive resin cements were applied using the Centrix delivery system, in comparison with the manufacturer's instructions (p<0.05). Bond strength varied with the root third: cervical>medium>apical (p<0.05). No correlations were found between the bond strength and voids.

Conclusions:

Bond strength and voids are negatively influenced by the conventional application technique for luting fiber posts. The delivery system (Centrix) seems to produce better results when cementing fiber posts.

Comparison of the Physical and Mechanical Properties of Resin Matrix with Two Photoinitiator Systems in Dental Adhesives

This study evaluated the physical and mechanical properties of resin matrices in dental adhesives with two photoinitiator systems. Resin matrix specimens were made with five different kinds of photoinitiators. Neat resin consisted of 60% 2,2-bis[4-2(2-hydroxy-3-methacryloxypropoxy)phenyl]propane (Bis-GMA) and 40% hydroxyethyl methacrylate (HEMA) by weight, along with camphorquinone (CQ, 1 mol %) and additional components (1 mol % each) as follows: Group 1, 2-(dimethylamino)ethyl methacrylate (DMAEMA); Group 2, ethyl-4-(dimethylamino) benzoate (EDMAB); Group 3, diphenyliodonium hexafluorphosphate (DPIHFP); Group 4, DMAEMA+DPIHFP; Group 5, EDMAB+DPIHFP. The degree of conversion (DC), flexural strength, flexural modulus, microhardness, and ultimate tensile strength were tested. The contribution of each photoinitiator to the DC in a selected group was analyzed with contour plots. One-way ANOVA and Tukey tests (p < 0.05) were used for statistical analyses. The DC of Groups 2, 4, and 5 was similar. The flexural strength was similar in all groups, but flexural modulus was significantly different. Group 3 had the lowest values for all physical and mechanical properties. Among all methods, the microhardness test revealed the greatest degree of difference among the five specimens. CQ, EDMAB, and DPIHFP were the most effective photoinitiators and CQ was the most influential factor for the DC rate.

An in situ evaluation of the polymerization shrinkage, degree of conversion, and bond strength of resin cements used for luting fiber posts

STATEMENT OF PROBLEM

The behavior and magnitude of the deformations that occur during polymerization and the behavior of the luting agents of glass fiber posts inside the root canal require quantification.

PURPOSE

The purpose of this in vitro study was to investigate the in situ polymerization shrinkage, degree of conversion, and bond strength inside the root canal of resin cements used to lute fiber posts.

MATERIAL AND METHODS

Thirty maxillary canines were prepared to lute fiber posts. The teeth were randomly divided into 2 groups (n=15) according to the cementation system used, which included ARC, the conventional dual-polymerized resin cement RelyX ARC, and the U200 system, a self-adhesive resin cement, RelyX U200. Two fiber optic sensors with recorded Bragg gratings (FBG) were attached to each post before inserting the resin cement inside the root canal to measure the polymerization shrinkage (PS) of the cements in the cervical and apical root regions (με). Specimens were sectioned (into cervical and apical regions) to evaluate bond strength (BS) with a push-out test and degree of conversion (DC) with micro-Raman spectroscopy. Data were statistically analyzed with 2-way ANOVA and the Tukey honestly significant difference post hoc test (α=.05).

RESULTS

The ARC and U200 system showed similar PS values (-276.4 ±129.2 με and -252.1 ±119.2 με, respectively). DC values from ARC were higher (87.5 ±2.7%) than those of U200 (55.9 ±9.7%). The cervical region showed higher DC values (74.8 ±15.2%) and PS values (-381.6 ±53.0 με) than those of the apical region (68.5 ±20.1% and -146.9 ±43.5 με, respectively) for both of the resin cements. BS was only statistically different between the cervical and apical regions for ARC (P<.05).

CONCLUSIONS

The ARC system showed the highest PS and DC values compared with U200; and for both of the resin cements, the PS and DC values were higher at the cervical region than at the apical region of the canal root. BS was higher in the cervical region only for ARC.

A resin composite material containing an eugenol derivative for intracanal post cementation and core build-up restoration

OBJECTIVES

To formulate and evaluate new dual cured resin composite based on the inclusion of eugenyl methacrylate monomer (EgMA) with Bis-GMA/TEGDMA resin systems for intracanal post cementation and core build-up restoration of endodontically treated teeth.

METHODS

EgMA was synthesized and incorporated at 5% (BTEg5) or 10% (BTEg10) into dual-cure formulations. Curing properties, viscosity, Tg, radiopacity, static and dynamic mechanical properties of the composites were determined and compared with Clearfil™DC Core-Plus, a commercial dual-cure, two-component composite. Statistical analysis of the data was performed with ANOVA and the Tukey's post-hoc test.

RESULTS

The experimental composites were successfully prepared, which exhibited excellent curing depths of 4.9, 4.7 and 4.2 mm for BTEg0, BTEg5 and BTEg10 respectively, which were significantly higher than Clearfil™DC. However, the inclusion of EgMA initially led to a lower degree of cure, which increased when measured at 24 h with values comparable to formulations without EgMA, indicating post-curing. The inclusion of EgMA also lowered the polymerization exotherm thereby reducing the potential of thermal damage to host tissue. Both thermal and viscoelastic analyses confirmed the ability of the monomer to reduce the stiffness of the composites by forming a branched network. The compressive strength of BTEg5 was significantly higher than the control whilst flexural strength increased significantly from 95.9 to 114.8 MPa (BTEg5) and 121.9 MPa (BTEg10). Radiopacity of the composites was equivalent to ∼3 mm Al allowing efficient diagnosis.

SIGNIFICANCE

The incorporation of EgMA within polymerizable formulations provides a novel approach to prepare reinforced resin composite material for intracanal post cementation and core build-up and the potential to impart antibacterial properties of eugenol to endodontic restorations.

The influence of cement filler load on the radiopacity of various fibre posts ex vivo

AIM

To verify whether the filler load of luting agents influences the radiopacity of intraradicularly placed posts.

METHODOLOGY

Digital radiographs of the following posts were taken: RelyX Fiber Post (3M ESPE), GC Fiber Post (GC Corporation), DT Light Post Illusion (RTD), DT Light SL Post (RTD), Endo-Composipost (RTD), FibreKleer Parallel Post (Jeneric Pentron Incorporated), FRC Postec (Ivoclar Vivadent), Parapost Taper Lux (Còltene/Whaledent AG), Radix Fiber Post (Dentsply Maillefer), EverStick Post (Stick Tech Ltd), Dentin Post X (Komet), Tech 21 X-op (Isasan), ENA Post (Micerium). Post radiopacity was measured in millimetres of aluminium (mmAl) with reference to an aluminium step wedge. Two extracted contralateral premolars were root filled. After post space preparation, taking the midpoint of the post hole as a reference, each tooth was cut longitudinally into two halves in a mesiodistal direction. On each half, the exposed root dentine was ground flat to the deepest point of the post space, and an even layer of cement was placed and light-cured. To obtain a clinically relevant layer of cement, the material thickness was reduced to 75 μm by grinding with wet abrasive paper. A cement formulation with 30 wt% of filler was tested in one premolar, whilst a formulation with 70 wt% of filler was utilized in the contralateral tooth. Posts were then placed between the two facing root halves of each premolar, and radiopacity was measured in mmAl. Data were analysed using t-test for paired samples (P < 0.05).

RESULTS

Radiopacity of posts ranged between 1.44 (ENA Post) and 5.78 mmAl (FibreKleer). In the presence of the more heavily filled cement, significantly higher values of post radiopacity were measured (P < 0.001).

CONCLUSION

The radiopacity of the luting agent contributed to the overall post radiovisibility within the root. Even when the cement with lower filler content was used in combination with the least radiodense dowels, the post was detectable within the root.

Four-year Survival of Endodontically Treated Premolars Restored with Fiber Posts

The objective of this prospective clinical trial was to investigate the influence of the residual coronal structure of endodontically treated teeth and the type of cement used for luting fiber posts on four-year clinical survival. Two groups (n = 60) were defined, depending on the amount of residual coronal dentin after abutment build-up and final preparation: (1) more than 50% of coronal residual structure; and (2) equal to or less than 50% of coronal residual structure. Within each group, teeth were randomly divided into 2 subgroups (n = 30) according to the material used for luting fiber posts: (A) resin core build-up material, Gradia Core; or (B) self-adhesive universal cement GCem Automix. The rate of success was assessed based on clinical and intra-oral radiographic examinations at the follow-up after 6, 12, 24, 36, and 48 months. The highest 48-month success and survival rates were recorded in group 1A (90% and 100%, respectively), whereas teeth in group 2B exhibited the lowest performance (63.3% success rate, 86.6% survival rate). Cox regression analysis revealed that neither the amount of coronal residual structure nor the luting material significantly influenced the failure risk (p > .05) (ClinicalTrials.gov, NCT01532947).

Analysis of resin-dentin interface morphology and bond strength evaluation of core materials for one stage post-endodontic restorations

Purpose

Restoration of endodontically treated teeth using fiber posts in a one-stage procedure gains more popularity and aims to create a secondary monoblock. Data of detailed analyses of so called “post-and-core-systems” with respect to morphological characteristics of the resin-dentin interface in combination with bond strength measurements of fiber posts luted with these materials are scarce. The present study aimed to analyze four different post-and-core-systems with two different adhesive approaches (self-etch and etch-and-rinse).

Materials and Methods

Human anterior teeth (n = 80) were endodontically treated and post space preparations and post placement were performed using the following systems: Rebilda Post/Rebilda DC/Futurabond DC (Voco) (RB), Luxapost/Luxacore Z/Luxabond Prebond and Luxabond A+B (DMG) (LC), X Post/Core X Flow/XP Bond and Self Cure Activator (Dentsply DeTrey) (CX), FRC Postec/MultiCore Flow/AdheSE DC (Ivoclar Vivadent) (MC). Adhesive systems and core materials of 10 specimens per group were labeled using fluorescent dyes and resin-dentin interfaces were analyzed using Confocal Laser Scanning Microscopy (CLSM). Bond strengths were evaluated using a push-out test. Data were analyzed using repeated measurement ANOVA and following post-hoc test.

Results

CLSM analyses revealed significant differences between groups with respect to the factors hybrid layer thickness (p<0.0005) and number of resin tags (p = 0.02; ANOVA). Bond strength was significantly affected by core material (p = 0.001), location inside the root canal (p<0.0005) and incorporation of fluorescent dyes (p = 0.036; ANOVA). CX [7.7 (4.4) MPa] demonstrated significantly lower bond strength compared to LC [14.2 (8.7) MPa] and RB [13.3 (3.7) MPa] (p<0.05; Tukey HSD) but did not differ significantly from MC [11.5 (3.5) MPa].

Conclusion

It can be concluded that bond strengths inside the root canal were not affected by the adhesive approach of the post-and-core-system. All systems demonstrated homogenous hybrid layer formation and penetration into the dentinal tubules in spite of the complicating conditions for adhesion inside the root canal.

Effect of 2% chlorhexidine digluconate on bond strength of a glass-fibre post to root dentine

AIM

To assess the immediate influence of dentine bonding systems (DBS) associated with 2% chlorhexidine digluconate (CHX) on glass-fibre post-bond strength to root dentine, in terms of coronal, middle and apical thirds.

METHODOLOGY

Sixty bovine roots were root filled and randomly assigned to 1 of 6 groups (n = 10): SBMP (3-step etch-and-rinse system, Scotchbond Multi-Purpose), SB (2-step etch-and-rinse system, Single Bond 2), SE (2-step self-etching system, Clearfil SE Bond) and SBMP-CHX, SB-CHX and SE-CHX, respectively, associated with CHX. For all groups, a glass-fibre post was luted with a dual-cure resin cement, RelyX ARC. After 7-day storage, specimens were subjected to the push-out test. Failure modes were analysed under optical microscopy (40x). Bond strength values were statistically analysed by two-way anova and Bonferroni tests (P < 0.05).

RESULTS

The effect of DBS was significant (P < 0.05), and SE reached higher bond strength in comparison with the other DBS tested. CHX association did not show improvement with any DBS (P > 0.05); rather, it negatively affected SE, which was detected for all thirds. There was no difference between thirds (P > 0.05), except for the SE-CHX, which presented lower values for the apical third (P < 0.05). Adhesive cement/dentine adhesive failure was predominant for all groups. CHX did not influence the failure mode for any DBS (P > 0.05).

CONCLUSIONS

The performance of the dentine bonding systems was material dependent. CHX did not improve immediate bond strength; however, CHX negatively affected the bond strength of the self-etching system, especially in the third apical.

Push-out bond strength and SEM evaluation of a new bonding approach into the root canal

Objective

This study evaluated the performance of different adhesive systems in fiber post placement aiming to clarify the influence of different hydrophobic experimental blend adhesives, and of one commercially available adhesive on the frictional retention during a luting procedure.

Material and Methods

One luting agent (70 Wt% BisGMA, 28.5% TEGDMA; 1.5% p-tolyldiethanolamine) to cement fiber posts into root canals was applied with 4 different adhesive combinations: Group 1: The etched roots were rinsed with water for 30 s to remove the phosphoric acid, then rinsed with 99.6% ethanol for 30 s, and blotdried. A trial adhesive (base to catalyst on a 1:1 ratio) was used with an experimental luting agent (35% Bis-GMA, 14.37% TeGDMA, 0.5% eDMAB, 0.13% CQ); Group 2: A trial adhesive (base to catalyst on a 1:2 ratio) was luted as in Group 1; Group 3: One-Step Plus (OSP, Bisco Inc.) following the ethanol bonding technique in combination with the luting agent as in Group 1; Group 4: OSP strictly following the manufacturer's instructions using the luting agent as in Group 1. The groups were challenged with push-out tests. Posted root slices were loaded until post segment extrusion in the apical-coronal direction. Failure modes were analyzed under scanning electron microscopy.

Results

Push-out strength was not significantly influenced by the luting agent (p>0.05). No statistically significant differences among the tested groups were found as Group 1 (exp 1 - ethanol-wet bonding technique)=Group 2 (exp 2 - ethanol-wet bonding technique)=Group 3 (OSP - ethanol-wet bonding technique)=Group 4 (control, OSP - water-wet bonding technique) (p>0.05). The dominating failure modes in all the groups were cohesive/adhesive failures, which were predominantly observed on the post/luting agent interface.

Conclusions

The results of this study support the hypothesis that the proposal to replace water with ethanol to bond fiber posts to the root canal using highly hydrophobic resin is plausible, but this seems to be more the proof of a concept than a clinically applicable procedure.

Fiber post placement with core build-up materials or resin cements-an evaluation of different adhesive approaches

OBJECTIVE

To compare push-out bond strength of fiber-posts luted with different adhesive approaches to root canal dentin.

MATERIALS AND METHODS

Forty maxillary first incisors were decoronated and endodontically treated. Specimens were randomly distributed into five groups (n = 8) and fiber-posts (DentinPost coated, Komet) were inserted using five different luting materials: etch-and-rinse adhesive systems and corresponding core-and-post material in groups 1 (DentinBond/DentinBuild, Komet) and 2 (XP Bond + SCA/Core-X flow, Densply), self-adhesive resin cements in groups 3 (RelyX Unicem, 3M Espe) and 4 (SmartCem 2, Dentsply) and a self-etch adhesive/resin cement in group 5 (ED-Primer II/Panavia F 2.0, Kuraray). The roots were sectioned into eight 1 mm thick serial slices and within 48 h push-out bond strength was investigated. Statistical analyses were performed using non-parametrical Kruskal-Wallis H-test and Mann-Whitney U-test for differences between experimental groups at p < 0.05. The failure modes were analyzed using Chi square test.

RESULTS

The bond strength [MPa] (mean/min-max) for groups 3 (12.35/3.60-32.44), 4 (13.52/4.48-30.69) and 2 (11.15/5.23-35.58) were significantly higher (p < 0.001) compared to groups 1 (6.66/2.34-24.89) and 5 (7.41/0.28-34.18). Adhesive failure between dentin and luting agent was the most frequent failure mode.

CONCLUSIONS

Bond strength of fiber-posts adhesively luted to root canal dentin was significantly higher when self-adhesive resin cements were used. One (group 2) of the tested core-and-post materials/etch-and-rinse adhesive achieved comparable bond strength values.

Current perspectives on post systems: a literature review

This literature review summarizes the most recent and reliable evidence on post systems. A search was limited to review articles published over the last 10 years in dental journals with an impact factor. Papers cited in the initially retrieved review articles were also included if significant. Preservation of tooth tissue, presence of a ferrule effect, and adhesion are regarded as the most effective conditions for long-term success of post-endodontic restorations. Adhesively luted fibre-reinforced composite post restorations have demonstrated satisfactory survival rates over relatively long follow-up periods. The clinical effectiveness of such restorations has been mainly ascribed to the more biomimetic behaviour of fibre-reinforced composite posts that reduces the risk of vertical root fractures. The most common type of failure when using fibre posts is post debonding and it is generally agreed that achieving stable adhesion to intraradicular dentine is more challenging than to coronal dentine. Several factors related to endodontic treatment, root canal shape, post space preparation, post translucency, adhesive cement handling and curing may have an influence on the outcome of the luting procedure. The most reliable results in fibre post cementation are obtained by etch-and-rinse adhesives in combination with dual-cure resin cements. The use of self-adhesive resin cements has also been proposed. Simplification is an obvious advantage of these new materials. However, the durability of their bond still needs to be verified with long-term clinical studies. Several techniques for pre-treating the fibre-reinforced composite post surface have been tested with the aim of improving the bond strength at the post-core and post-cement interfaces. Silicoating followed by silanization currently appears to be the most effective and convenient method for this purpose. In conclusion, the available evidence validates the use of fibre posts as an alternative to metal posts and preferably to other tooth-coloured posts, such as zirconia dowels, in the restoration of endodontically treated teeth. Longer term clinical trials are expected to further strengthen this evidence.