Influence of technique and manipulation on self-adhesive resin cements used to cement intraradicular posts

Light Transmission of Various Aesthetic Posts at Different Depths and Its Effect on Push-Out Bond Strength, Microhardness of Luting Cement

Background and Objectives: One requirement for the cemented post is the light transmittance on its entire length up to the deepest portion of a root canal to ensure the complete polymerization of resin cement. This study aimed to determine the light transmission ability in different aesthetic posts at different depths and its effect on the push-out bond strength and microhardness of luting cement at the corresponding interface. Materials and Methods: Twenty endodontic posts from glass fiber posts (GFP), zirconia ceramic posts (ZCP), and highly translucent zirconium oxide posts (HTZP) were sequentially sectioned into 12.8 and 4 mm lengths after recording the light intensity using a dental radiometer. Sixty single rooted premolar teeth root canals were treated and implanted vertically in a resin block. The post space was prepared and cemented with GFP, ZCP, and HTZP posts with twenty samples each. The root portion of teeth samples were sectioned into cervical, middle, and apical portion. A universal testing machine was utilized for the push-out bond strength test for the first ten samples from each group. The remaining ten samples from each group were used for the microhardness test using a micro-indenter instrument. The data were statistically analyzed using one-way Analysis of variance and Tukey HSD tests at p < 0.05. Results: The GFP endodontic postpresented with significant highest light translucency compared to HTZP, which was significantly higher than ZCP. GFP posts showed significantly higher bond strength per unit area compared to ZCP at analogous cross sections. The hardness of luting cement was also significantly higher amongst all tested endodontic posts. Conclusions: GFP high light translucency enhanced the curing of the luting resin cement that resulted in harder cement and a stronger bond supported by hardness and push-out tests. These findings suggest that GFP is preferred to be used with light-cured luting cements for restoration of endodontically treated teeth.

Surface modification of glass fiber-reinforced composite posts to enhance their bond strength to resin-matrix cements: an integrative review

BACKGROUND

Endodontically treated teeth usually can reveal an extensive loss of dental structure and require the use of intraradicular posts to provide adequate support and retention. Retention of the post depends on the surface treatment of the endodontic post itself and on the root canal dentin as well as on the type of resin-matrix cement.

PURPOSE

The main aim of this study was to conduct an integrative review on the influence of different surface treatment methods of glass fiber-reinfored resin composite (GFRC) posts on their push-out bond strength to resin-matrix cements in endodontically treated teeth rehabiliation.

METHOD

A literature search was performed on PubMed (via National Library of Medicine) regarding articles published within the last 10 years, using the following combination of search terms: "intracanal post" OR "endodontic post" OR "root canal post" OR "intraradicular post" OR "glass fiber" AND "resin cement" AND "adhesion" OR "bond strength" OR "shear bond strength" OR "push out".

RESULTS

Results from the selected studies recorded the highest push-out bond strength around 22.5 MPa) on GFRC posts to resin-matrix cements when the surfaces were pre-treated by grit-blasting with silicate followed by silane conditioning. However, high values of push-out bond strength (21.5 MPa) were also noticed for GFRC posts after etching with hydrogen peroxide followed by silance conditioning. Thus, the highest values of bond strength of endodontic posts to the resin-matrix cements were recorded when a combined physico-chemical approach was assessed. Non-treated surfaces showed the lowest bond strength values between 5 to and 9 MPa. Surface analyses of GFRC posts showed an increased roughness after grit-blasting or etching that promoted a mechanical interlocking of the adhesive and resin-matrix cements.

CONCLUSION

The combined treatment of glass fiber-reinforced resin composite post surfaces by physical and chemical methods can promote the increase in roughness and chemical functionalization of the surfaces prior to cementation., That results in a high mechanical interlocking of the resin-matrix cements and a stable retention of the teeth root intracanal posts.

CLINICAL RELEVANCE

Combining chemical and physical modification methods of surfaces can provide the most promising adhesion-enhancing pathways of GFRC posts to resin-matrix cements, that can decrease the risk of clinical failures by fracture and detachment of endodontic posts.

Root canal adaptation and intra-tubular penetration of three fiber-post cementation systems

Background

To measure the penetration of three bonding systems for the luting of fiber glass posts in endodontically treated teeth, using confocal laser scanning microscopy (CLSM).

Material and Methods

A total of 30 maxillary incisors were shaped with the Mtwo system and filled with gutta-percha and Top Seal cement. The sample was divided into three groups (ni=10) according to the bonding system used to cement the posts: Group 1 (Prime&Bond NT and Rebilda DC with a total-etch technique); Group 2 (Futurabond DC and Rebilda DC with a dentin self-etch technique); and Group 3 (BisCem self-adhesive cement). Rhodamine B was added to the bonding systems to allow visualization by CLSM. Three 1-mm thick cross-sections were obtained of each root at a distance of 2, 5 and 8 mm from the coronal limit of the root. The specific software of the CLSM system was used to measure the percentage of the root canal perimeter showing penetration of the bonding system in the dentinal tubules, together with the maximum depth of penetration. Comparison between groups were made by Kruskal Wallis test, and comparison two by two groups with Mann-Whitney U-test.

Results

Depth of penetration of the resin tags, were distributed from greater to lesser depth as follows: BisCem > Prime&Bond NT > Futurabond DC. BisCem showed significantly greater penetration in the middle and apical thirds than the rest of the systems (906.14±67.42 and 699.27±76.26 µm, respectively). The percentage perimeter exhibiting penetration in the coronal third was significantly greater with BisCem versus Futurabond DC (56.08±7.24 and 44.38±5.23%, respectively). No significant differences were recorded in the middle and apical thirds among the three systems.

Conclusions

BisCem resulted in greater depth of intratubular penetration at all studied levels. The percentage perimeter of the canal showing penetration was similar for all the bonding systems.

Key words:Fiber post luting, sealer adaptation, confocal laser scanning microscope.

Can intra-radicular cleaning protocols increase the retention of fiberglass posts? A systematic review

The presence of residues within the root canal after post-space preparation can influence the bond strength between resin cement and root dentin when using fiberglass posts (FGPs). Currently, there is no consensus in the literature regarding what is the best solution for the removal of debris after post-space preparation. This systematic review involved "in vitro" studies to investigate if cleaning methods of the root canal after post-space preparation can increase the retention of FGPs evaluated by the push-out test. Searches were carried out in PubMed (MEDLINE) and Scopus databases up to July2017. English language studies published from 2007 to July 2017 were selected. 475 studies were found, and 9 were included in this review. Information from the 9 studies were collected regarding the number of samples, storage method after extraction, root canal preparation, method of post-space preparation, endodontic sealer, resin cement, cleaning methods after post-space and presence of irrigant activation. Five studies presented the best results for the association of sodium hypochlorite (NaOCl) and ethylenediamine tetra-acetic acid (EDTA), while in the other 4 studies, the solutions that showed improved retention of FGPs were photon-induced photoacoustic streaming (PIPS), Qmix, Sikko and EDTA. The results showed heterogeneity in all comparisons due to a high variety of information about cleaning methods, different concentrations, application time, type of adhesive system and resin cements used. In conclusion, this review suggests that the use of NaOCl/EDTA results in the retention of FGPs and may thus be recommended as a post-space cleaning method influencing the luting procedure.

Bond strength of adhesive resin cement with different adhesive systems

BACKGROUND

To assess the immediate bond strength of a dual-cure adhesive resin cement to the hybridized dentin with different bonding systems.

MATERIAL AND METHODS

Fifty-six healthy human molars were randomly divided into 7 groups (n=8). After 3 longitudinal sections, the central cuts were included in PVC matrix and were submitted to dentin hybridization according to the groups: G1 - etch & rinse system with 3-step (Apder™ Scotchbond™ Multi-Purpose, 3M ESPE), G2 - etch & rinse system with 3-step (Optibond™ FL, Kerr), G3 - etch & rinse system with 3-step (All-Bond 3®, Bisco), G4 - etch & rinse simplified system (Adper™ Single Bond 2, 3M ESPE), G5 - self-etching system with one step (Bond Force, Tokuyama), G6 - universal system in moist dentin (Single Bond Universal, 3M ESPE), G7 - universal system in dry dentin (Single Bond Universal, 3M ESPE). Then all groups received the cementing of a self-adhesive resin cement cylinder (Duo-link, Bisco) made from a polypropylene matrix. In the evaluation of bond strength, the samples were subjected to the microshear test and evaluated according to the fracture pattern by optical microscopy.

RESULTS

The Kruskal-Wallis test suggests a statistically significant difference between groups (p=0,039), and Tukey for multiple comparisons, indicating a statistically significant difference between G3 and G4 (p<0.05). It was verified high prevalence of adhesive failures, followed by mixed failure and cohesive in dentin.

CONCLUSIONS

The technique and the system used to dentin hybridization are able to affect the immediate bond strength of resin cement dual adhesive. Key words:Adhesion, adhesive resin cement, adhesive systems, microshear.

Does hybridized dentin affect bond strength of self-adhesive resin cement?

Background

Evaluate the influence of different hybridization bonding techniques of a self-adhesive resin cement.

Material and Methods

30 human health molars were divided into six groups (n=10). The specimens received three longitudinal sections, allowing insertion of central cuts in PVC matrices. Each group received a different dentin pretreatment according to the manufacturer’s recommendations, except the control group (G1), as follows. G2 - a 3-step total-etch adhesive system (Optibond™ FL, Kerr); G3 - a 3-step total-etch adhesive system (Adper™ Scotchbond™ Multi-Purpose, 3M ESPE); G4 - a 2-step total-etch adhesive system (Adper™ Single Bond 2, 3M ESPE); G5 - a single-step self-etching system (Bond Force, Tokuyama); and G6 - universal bonding system (Single Bond Universal, 3M ESPE). Then, cylinders made of self-adhesive resin cement with polypropylene matrix was cemented in all groups (RelyX U200, 3M ESPE). Bond strength was assessed by submitting the specimens to micro-shear test and was characterized according to the fracture pattern observed through optical microscopy.

Results

The results were submitted to the Kruskal-Wallis test, which indicated a statistically significant difference between the groups (p=0.04), and Tukey’s multiple comparisons, which indicated a statistically significant difference between G1 and G3 (p<0.05). The microscopic analysis revealed a high prevalence of adhesive failures, followed by mixed fractures, and cohesive failures in the dentin.

Conclusions

The use of a previous dentin hybridization protocol is able to increase adhesive bonding resistance of self-adhesive resin cement, especially when used Adper™ Scotchbond™ Multi-Purpose system.

Key words:Bonding, self-adhesive resin cement, adhesive systems, microshear.

A systematic review of factors associated with the retention of glass fiber posts

This study aimed to identify factors that can affect the retention of glass fiber posts to intra-radicular dentin based on in vitro studies that compared the bond strength (BS) of GFPs cemented with resin cements. Searches were carried out in PubMed and Scopus until December 2013. Bond strength values and variables as type of tooth, presence of endodontic treatment, pretreatment of the post, type of bonding agent (if present), type of cement and mode of cement application were extracted from the 34 included studies. A linear regression model was used to evaluate the influence of these parameters on BS. The presence of endodontic treatment decreased the BS values in 22.7% considering the pooled data (p = 0.013). For regular cement, cleaning the post increased BS when compared to silane application without cleaning (p = 0.032), considering cleaning as ethanol, air abrasion, or phosphoric acid application. Applying the cement around the post and into root canal decreased the resistance compared to only around the post (p = 0.02) or only into root canal (p = 0.041), on the other hand, no difference was found for self-adhesive resin cement for the same comparisons (p = 0.858 and p = 0.067). Endodontic treatment, method of cement application, and post pretreatment are factors that might significantly affect the retention of glass-fiber posts into root canals mainly when cemented with regular resin cement. Self-adhesive resin cements were found to be less technique-sensitive to luting procedures as compared with regular resin cements.

Clinical outcomes and success rates of quartz fiber post restorations: A retrospective study

STATEMENT OF PROBLEM

Cast metal posts and dowels are inherently dark and, when metal-free restorations are used, could impair the definitive esthetic appearance. Quartz fiber posts could represent a reliable choice for restoring abutment teeth.

PURPOSE

The purpose of this study was to evaluate the long-term success rate of teeth restored with quartz fiber posts and fixed dental prostheses (FDPs).

MATERIAL AND METHODS

Ninety-nine teeth restored with 114 quartz fiber posts and FDPs were evaluated. The evaluation time ranged from 7 months to 9.25 years. The Kaplan-Meier method was used to obtain success curves. The influence of the tooth location, definitive restoration, and failure pattern upon the success function was analyzed with the log-rank test. The Cox regression test was used to evaluate possible predictors among the interactions of the observed parameters.

RESULTS

The success rate of the restorations was 85.86% in a mean period of 5.88 ±1.37 years, with an estimated success probability of 85% at 6.17 years. The statistical analysis identified the factors related to the arch (P=.045) and type of definitive restoration (P=.021) as significantly associated with success. Post debonding was the most frequent failure mode, followed by endodontic failure, with the latter not necessarily being related to the post itself. No root fractures were recorded. Twelve teeth out of the 14 that failed were restored again, bringing the overall survival rate of the teeth to 98%.

CONCLUSIONS

The rehabilitation of abutment teeth with quartz fiber posts can be considered a reliable procedure; however, adhesive techniques and luting materials require improvement.

Effect of antioxidants on push-out bond strength of hydrogen peroxide treated glass fiber posts bonded with two types of resin cement

Objectives

Hydrogen peroxide (H₂O₂) surface treatment of fiber posts has been reported to increase bond strength of fiber posts to resin cements. However, residual oxygen radicals might jeopardize the bonding procedure. This study examined the effect of three antioxidant agents on the bond strength of fiber posts to conventional and self-adhesive resin cements.

Materials and Methods

Post spaces were prepared in forty human maxillary second premolars. Posts were divided into five groups of 8 each: G1 (control), no pre-treatment; G2, 10% H₂O₂ pre-treatment; G3, G4 and G5. After H₂O₂ application, Hesperidin (HES), Sodium Ascorbate (SA) or Rosmarinic acid (RA) was applied on each group respectively. In each group four posts were cemented with Duo-Link conventional resin cement and the others with self-adhesive BisCem cement. Push-out test was performed and data were analyzed using 2-way ANOVA and tukey's post-hoc test (α = 0.05).

Results

There was a statistically significant interaction between the cement type and post surface treatment on push-out bond strength of fiber posts (p < 0.001, F = 16). Also it was shown that different posts' surface treatments significantly affect the push-out bond strength of fiber posts (p = 0.001). H₂O₂ treated posts (G2) and control posts (G1) cemented with Duo-link showed the highest (15.96 ± 5.07MPa) and lowest bond strengths (6.79 ± 3.94) respectively.

Conclusions

It was concluded that H₂O₂ surface treatment might enhance the bond strength of fiber posts cemented with conventional resin cements. The effect of antioxidants as post's surface treatment agents depends on the characteristics of resin cements used for bonding procedure.

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.

The influence of different cements on the pull-out bond strength of fiber posts

STATEMENT OF PROBLEM

Glass fiber posts are commonly used to provide adequate support and retention for the restoration of endodontically treated teeth, but their resistance to dislodgement depends on their adhesion to root dentin.

PURPOSE

The purpose of this study was to assess the effect of cement type on the pull-out bond strength of fiber posts.

MATERIAL AND METHODS

Seventy maxillary canines were endodontically treated and then divided into 7 groups according to the cement used for fiber post cementation as follows (n = 10): RelyX Unicem, BisCem, RelyX Luting 2, RelyX ARC, Panavia F, Enforce, and Allcem. The specimens were subjected to a pull-out bond strength test in a universal testing machine at a crosshead speed of 0.5 mm/min. The results, in newtons, were analyzed with 1-way ANOVA and the Tukey post hoc test (α = .05).

RESULTS

RelyX Unicem (472.3 ± 8.9 N), BisCem (506.6 ± 9.2 N), RelyX ARC (498.0 ± 8.2 N), Panavia F (502.3 ± 7.0 N), and Allcem (470.0 ± 11.3 N) presented significantly higher bond strength than RelyX Luting 2 (241.8 ± 9.70 N) and Enforce (309.5 ± 6.3 N) cements (mean ± SD; P < .05).

CONCLUSIONS

Except for Enforce, all resin cements produced pull-out bond strength values twice that of resin modified glass ionomer cement. However, all cements promoted adequate retention to fiber posts to withstand functional loads.