The effects of different irrigation solutions on the bond strength of cemented fiber posts

The effect of ascorbic acid, QMix and other conditioning solutions on the bond strength of adhesively luted glass fiber-reinforced composite posts to root dentin, a laboratory study

PURPOSE

This study was designed to investigate the effect of post space conditioning with different solutions on the bond strength of glass FRC posts and evaluate the mode of resin failure.

METHODS

Sixty extracted human single rooted teeth were root filled using a resin sealer and suitable gutta-percha cones. Post spaces were prepared, and the teeth randomly allocated into 5 groups according to their irrigation regimens which included the following solutions: 17 % EDTA, 2 % CHX, 3 % NaOCl, 10 % ascorbic acid and QMix solutions. Post spaces were irrigated with 5 ml of the solution for 15 s and subsequently washed with distilled water and dried with paper points. Glass FRC posts were cemented into their spaces using a self-adhesive resin cement. The specimens were mounted in plexiglass molds using autopolymerizing acrylic resin. A universal testing machine was used to measure post retention at a crosshead speed of 2 mm/min. The results were analyzed by one-way ANOVA followed by Tukey HSD test (α = 0.05). Dislodged posts and post spaces were examined microscopically to evaluate retention failure.

RESULTS

The Ascorbic acid group exhibited the highest mean retentive strength value at 229 N, followed by QMix at 198 N, NaOCl at 186 N, CHX at 170 N, and EDTA at 124 N. The mean value of the ascorbic acid group was significantly higher than EDTA group, p = 0.012. The failure category was primarily mixed.

CONCLUSIONS

Rinsing post spaces with ascorbic acid exhibited significantly superior bond strength. The failure mode was mixed.

CLINICAL SIGNIFICANCE

Irrigating post spaces with ascorbic acid solution before luting FRC posts significantly improves their bond strength compared to irrigation with EDTA solution. Irrigation with QMix solution produced the second highest retentive strength but showed no statistical significance when compared to using ascorbic acid, NaOCl, CHX, or EDTA solutions.

Shelf life effects on the bond strength and microhardness of self-adhesive resin cements

Background

Among the main advantages of self-adhesive resin cements comprise good aesthetics, strong restoration-tooth bond and biocompatibility. However, some disadvantages, such as high viscosity level, color limitation and short shelf life should be mentioned. Thus, the aim of the current study was to assess bond strength between fiberglass post and root dentin in teeth subjected to self-adhesive resin cements with expired shelf life and hardness.

Material and Methods

Sixty (60) single-rooted human teeth were sectioned and divided into 2 groups of different cements: U200 3M and MaxCem Elite Kerr. Each group was divided into 3 subgroups, based on self-adhesive resin cements' shelf life, namely: Within the use-time recommended by the manufacturer or no expiration date; 6 months after opening the aluminum blister; 12 months after opening the aluminum blister. Bond strength was measured through push-out test conducted in universal testing machine; fracture pattern was analyzed, and microhardness was investigated through Knoop test, based on hardness readings. Data were subjected to Shapiro-Wilk normality test; nonparametric test was applied to hardness data, whereas parametric test was applied to bond strength data. Hardness data were subjected to Kruskal-Wallis test, whereas bond strength data were subjected to analysis of variance, which was followed by Tukey test; both tests were conducted at 5% significance level (α = 0.05).

Results

There was no statistically significant difference in knoop hardness values recorded for the material / time / root thirds combination (p=0.483). There was no statistically significant difference in bond strength values recorded for the Material / Time / Thirds combination (p=0.237).

Conclusions

It was possible concluding that shelf life did not influence material's hardness and bond strength. Key words:Dental cements, Resin Cements, Shelf Life of Products.

A novel mussel-inspired desensitizer based on radial mesoporous bioactive nanoglass for the treatment of dentin exposure: An in vitro study

OBJECTIVES

The dentin exposure always leads to dentin hypersensitivity and the acid-resistant/abrasion-resistant stability of current therapeutic approaches remain unsatisfatory. Inspired by the excellent self-polymerization/adherence activity of mussels and the superior mineralization ability of bioactive glass, a novel radial mesoporous bioactive nanoglass coated with polydopamine (RMBG@PDA) was developed for prevention and management of dentin hypersensitivity.

METHODS

Radial mesoporous bioactive nanoglass (RMBG) was synthesized by the sol-gel process combined with the cetylpyridine bromide template self-assembly technique. RMBG@PDA was synthesized by a self-polymerization process involving dopamine and RMBG in an alkaline environment. Then, the nanoscale morphology, chemical structure, crystalline phase and Zeta potential of RMBG and RMBG@PDA were characterized. Subsequently, the ion release ability, bioactivity, and cytotoxicity of RMBG and RMBG@PDA in vitro were investigated. Moreover, an in vitro experimental model of dentin hypersensitivity was constructed to evaluate the effectiveness of RMBG@PDA on dentinal tubule occlusion, including resistances against acid and abrasion. Finally, the Young's modulus and nanohardness of acid-etched dentin were also detected after RMBG@PDA treatment.

RESULTS

RMBG@PDA showed a typical nanoscale morphology and noncrystalline structure. The use of RMBG@PDA on the dentin surface could effectively occlude dentinal tubules, reduce dentin permeability and achieve excellent acid- and abrasion-resistant stability. Furthermore, RMBG@PDA with excellent cytocompatibility held the capability to recover the Young's modulus and nanohardness of acid-etched dentin.

CONCLUSION

The application of RMBG@PDA with superior dentin tubule occlusion ability and acid/abrasion-resistant stability can provide a therapeutic strategy for the prevention and the management of dentin hypersensitivity.

Formulations of NaOCl-based in liquid, gel form or with surfactants on dentin deproteinization before fiber post cementation

The objective of the study was to evaluate the effects of dentin deproteinization protocols for post space using different formulations containing sodium hypochlorite before fiber post cementation with self-adhesive resinous cement. The groups were divided according to the irrigation protocol (DWC, SHS, SHT and SHG). The residue cleanliness, bond strength, adhesive failure pattern, and tag formation at the adhesive interface between the self-adhesive cement and the dentin were evaluated. For this, analysis in scanning electron microscope, push-out test and confocal laser scanning microscopy were performed. The SHT protocol showed the highest residue cleanliness on the dentin surface of the post space (p<0.05). In addition, SHT protocol showed highest bond strength and tag formation in the cervical and middle thirds (p<0.05). Dentin deproteinization with sodium hypochlorite with surfactant provided the best dentin cleaning of residues, bond strength and tag formation after cementation of the fiber post with self-adhesive cement.

Caries affected disinfection using Phycocyanin activated by PDT, Holy Basil, and Ti-sapphire laser on adhesive bond strength, microleakage, and bond failure

AIM

To investigate the effect of different cavity disinfectants, Phycocyanin (PC), Ocimum Sanctum (OS), and Ti Sapphire Laser, on the bond integrity and microleakage of resin restorations.

MATERIAL AND METHOD

60 human mandibular molars were extracted and prepared based on ICDAS scores of 4 and 5. To obtain the CAD surface, a visual examination was supported by tactile sensation and a dye for caries detection. Samples were randomly allocated into 4 groups based on cavity disinfectants applied (n = 15). Group 1: Specimens disinfected with CHX, Group 2: Specimens disinfected with Ti sapphire laser, Group 3: Specimens disinfected with Phycocyanin activated by Photodynamic therapy, and Group 4: Specimens disinfected with OS. Following the disinfection of the CAD surfaces, composite bulk-fill restorative material was bonded to each specimen and all samples were subjected to thermocycling. Ten samples from each group underwent SBS testing performed on a universal testing machine. Five samples were subjected to a microleakage analysis.

RESULT

The maximum microleakage scores were displayed by Group 3: PC (0.521 nm) treated specimens. Whereas, and minimum microleakage was exhibited by Group 4: OS (0.471 nm). Group 4: OS (23.06±0.21 MPa) treated group displayed the maximum bond scores of resin adhesive to the CAD surface. However, Group 3: PC (21.67±0.24 MPa) treated specimens exhibited the lowest bond scores. Failure mode analysis revealed that among all the investigated groups the predominant type of failure was cohesive failure i.e., Group 1 (80%), Group 2 (80%), Group 3 (70%), and Group 4 (90%).

CONCLUSION

Ocimum Sanctum, Phycocyanin activated by Photodynamic therapy, and Ti-sapphire laser for disinfection of caries-affected dentin have shown promise in terms of improved bond strength and reduced microleakage.

Effect of irrigation protocols on smear layer removal, bond strength and nanoleakage of fiber posts using a self-adhesive resin cement

Objectives

This study aimed to investigate the effect of the application method of 2% chlorhexidine (CHX) and its influence on the adhesion of fiberglass posts cemented with a self-adhesive resin cement.

Materials and Methods

Sixty human mandibular premolars were endodontically treated and divided into 5 groups (n = 12), according to the canal irrigant and its application method: 2 groups with conventional syringe irrigation (CSI)-2.5% sodium hypochlorite (NaOCl) (control) and 2% CHX- and 3 groups with 2% CHX irrigation/activation-by passive ultrasonic irrigation (PUI), Easy Clean file, and XP-Endo Finisher file. Two roots per group were evaluated for smear layer (SL) removal by scanning electron microscopy. For other roots, fiber posts were luted using a self-adhesive resin cement. The roots were sectioned into 6 slices for push-out bond strength (BS) (7/group) and nanoleakage (NL) (3/group). Data from SL removal were submitted to Kruskal-Wallis and Student-Newman-Keuls tests (α = 0.05). Data from BS and NL were evaluated by 2-way analysis of variance and Tukey's test (α = 0.05).

Results

For SL removal and BS, the CHX irrigation/activation promoted better values than CSI with CHX (p < 0.05), but it was not significantly different from CSI with NaOCl (p > 0.05). For NL, the lowest values were obtained by the chlorhexidine irrigation/activation groups (p < 0.05).

Conclusions

Active 2% CHX irrigation can be used to improve the post space cleaning and adhesion before fiber post cementation with self-adhesive resin cements.

Effect of pretreatment of root dentin surface with cold atmospheric plasma on improving the bond strength of fiber post and resin cement: In vitro study

INTRODUCTION

Achieving stable adhesion between fiber post and interradicular dentin is a challenging process in the restoration of endodontically treated teeth. This study was conducted to investigate the effect of surface pretreatment with cold atmospheric plasma (CAP) on improving the bond strength between them.

MATERIALS AND METHODS

Forty-eight single-canal mandibular premolars were cut 1 mm above the cementoenamel junction to keep the root length of 14 mm or more. After endodontic treatment and preparation of the post space, the teeth were divided into four groups regarding the pretreatment of dentin surfaces, including normal saline, ethylenediaminetetraacetic acid (EDTA), CAP, and CAP + EDTA groups. The data were analyzed using paired and independent t-test and one-way analysis of variance and the significance level was set at p < .05.

RESULTS

The bond strength was significantly higher in the coronal third than in the apical third in all the groups. Moreover, the bond strength was significantly higher in the CAP + EDTA-treated group. The bond strength increased significantly in the CAP group compared to the normal saline group. In addition, the bond strength increased significantly in the CAP or EDTA groups compared to the control group. The lowest bond strength belonged to the control group (normal saline).

CONCLUSION

The surface pretreatment with CAP (alone or in combination with EDTA) played a significant role in improving the bond strength of fiber post and root canal dentin.

Use of final irrigant Potassium Titanyl Phosphate laser; Sapindus Mukorossi and Fotoenticine on the bond values of zirconia post-to-canal dentin

AIMS

Assessment of the efficacy of final root canal irrigants Sapindus mukorossi (SM), Potassium titanyl phosphate laser (KTPL), and Fotoenticine (FTC) on the push-out bond strength (PBS) of zirconia post.

MATERIALS AND METHODS

The root canal procedure was initiated using the 10 K file and the working length was determined on single-rooted human premolar teeth after decoration. The canals were then enlarged using ProTaper universal system and filled using single cone gutta-percha (GP) and AH Plus resin sealer. Post space was prepared by removing 10mm of GP from the canal. All the teeth were then allocated into four groups based on the final irrigating regime used (n=10) Group 1: 5.25% NaOCl+17% EDTA, Group 2: 5.25% NaOCl + KTPL, Group 3: 5.25% NaOCl + FTC and Group 4: 5.25% NaOCl+ SM. Zirconia posts were cemented in the canal space. The specimens were sectioned and implanted in auto-polymerizing acrylic resin. A universal testing machine and stereomicroscope at 40x magnification were used for PBS and failure mode analysis. ANOVA and Tukey post hoc test were used to make group comparisons(p=0.05).

RESULTS

Group 4 (5.25% NaOCl+ SM) coronal section displayed the highest PBS (9.29±0.24 MPa). However, group 3 (5.25% NaOCl+ FTC) apical third (4.08±0.14 MPa) showed the lowest bond values. Group 2 (5.25% NaOCl+ KTP laser) and Group 3 at all three-thirds unveiled no significant difference in PBS(p>0.05). However, Group 1 (5.25% NaOCl+17%EDTA) and Group 4 displayed comparable outcomes of bond strength(p>0.05) CONCLUSION: Sapindus mukorossi has the ability to be used as a final root canal irrigant alternative to EDTA. However, future studies are still required to conclude the outcomes of existing research.

Effect of different root canal irrigants on push-out bond strength of two novel root-end filling materials

BACKGROUND

The aim of this in vitro study was to evaluate push-out bond strength of different root-end filling materials using various irrigant solutions.

METHODS

A push-out bond strength test was performed to evaluate the bond strength of two experimental root-end filling materials: namely, nano-hybrid mineral trioxide aggregate (MTA) and polymethyl methacrylate (PMMA) cement filled with 20% weight nano hydroxyapatite (nHA) fillers compared to conventional MTA. The irrigant solutions employed were sodium hypochlorite (NaOCl) in concentrations 1%, 2.5% and 5.25% and 2% chlorhexidine gluconate (CHX) followed by application of 17% ethylene diamine tetra-acetic acid (EDTA). A freshly extracted sixty single-rooted human maxillary central incisors were used. The crowns were removed, the canal apex was widened to simulate immature teeth. Each type of irrigation protocols was performed. After application and setting of the root-end filling materials, a slice of one mm thickness was cut transversely from the apical end of each root. Specimens were stored for 1 month in artificial saliva and were subjected to a push-out test to evaluate the shear bond strength. Data were analyzed using two-way ANOVA and Tukey test.

RESULTS

The experimental nano-hybrid MTA showed the highest significant push-out bond strength values when irrigated by NaOCl at several concentrations (1%, 2.5% and 5.25%) (P< 0.05). Meanwhile, irrigation with 2% CHX resulted in highest bond strength values in nano-hybrid white MTA (18 MPa) and PMMA filled with 20% weight nHA (17.4 MPa) with nonsignificant difference between them (p = 0.25). In each root-end filling material, irrigation with 2% CHX led to the highest significant bond strength, followed by NaOCl 1%, while the least significant bond strength was produced after irrigation with NaOCl 2.5% and 5.25% (P< 0.05).

CONCLUSION

Considering the limitations of this study, it may be concluded that the application of 2% CXH and 17% EDTA provides superior push-out bond strength to root canal dentin compared with irrigation with NaOCl irrigants and 17% EDTA, experimental nano-hybrid MTA root-end filling material provides enhanced shear bond strength than conventional micron-sized MTA root-end filling material.

Effect on Martens Hardness and pushout bond strength of fiber post to canal dentin final irrigated with Fotoenticine, Chitosan, and ozone

AIMS

To estimate the effect of contemporary final root canal irrigants (Ozonated water (OW), Chitosan, and Fotoenticine (FTC) on the bond scores of glass fiber post (GFP) and Martens hardness (MH) of root dentin.

MATERIALS AND METHODS

Sixty extracted human premolars having a single straight canal that ends in a closed apex were included. Specimens were de-crowned till the cementoenamel junction preserving 12 mm of root length and were mounted vertically. Canal therapy was performed using a crown-down approach. Obturation was performed followed by post-space preparation. Samples were allocated into 4 groups based on chemical irrigations and photosensitizers used(n = 15). Group 1 (5.25% NaOCl + 17% EDTA), group 2 (5.25% NaOCl + FTC), group 3 (5.25% NaOCl + Chitosan), group 4 (5.25% NaOCl + OW). The ultra microhardness tester was put under a load of 5 mN at a speed of 1.5 mN/s for 1 s to assess the MH. The fiber post was luted with dual-cure cement and slices of 1 mm were prepared from each third of the tooth. PBS and failure mode analysis were performed using a universal testing machine (UTM) and stereomicroscope respectively. ANOVA and Tukey multiple comparisons t-tests for assessment of PBS and MH p > 0.05 RESULTS: Group 1 (5.25% NaOCl + 17% EDTA) exhibited the highest MH (0.19 ± 0.04 GPa). Whereas, group 2 (5.25% NaOCl + FTC) displayed the lowest MH (0.011 ± 0.14 GPa). The highest PBS was exhibited by the coronal third of group 1 (5.25% NaOCl + 17% EDTA) (7.11 ± 0.81 MPa). The apical section of group 3 specimens (5.25% NaOCl + Chitosan) (2.33 ± 0.26 MPa) unveiled the lowest PBS. Intergroup comparison analysis revealed that group 2 and group 3 displayed comparable outcomes of PBS. Group 1 and Group 4 also demonstrated no significant difference in the bond scores in all three sections.

CONCLUSION

OW as a final irrigant can be used as an alternative to EDTA as it improves the bond strength with minimum impact on marten hardness.

Push-Out Bond Strength Assessment of Different Post Systems at Different Radicular Levels of Endodontically Treated Teeth

This study assessed the bond strength of prefabricated post systems at different root levels of endodontically treated teeth. One-rooted human premolars (N = 70; n = 10) were cut to 2 mm above the cement-enamel junction. Root canals were treated and randomly assigned to one of the seven post systems: T: Titanium (Mooser), ZrO: Zirconia (Cosmopost), G: Fiber (FRC Postec Plus), E1: Fiber (Direct) (Everstick post), E2: Fiber (Indirect) (Everstick post), PP: Fiber (PinPost), and LP: Injectable Resin/Fiber composite (EverX Posterior). All posts were luted using a resin cement (Variolink II), and the roots were sectioned at the coronal, middle, and apical root levels. Push-out tests were performed in the Universal Testing Machine (0.5 mm/min). Data (MPa) were analyzed using two-way ANOVA and Tukey’s tests (α = 0.05). The results showed that the bond strength (mean ± SD) of E2 posts were highest (5.3 ± 2.7) followed by PP (4.1 ± 2.0); G (4.0 ± 1.6); LP (2.6 ± 1.9): T (2.2 ± 1.5) and ZrO (1.9 ± 1.0) posts systems. No significant differences were found in bond strength of all post systems. The bond strength in the coronal root level was the highest with 3.6 ± 2.2 MPa. The bond strength of FRC post systems was significantly higher than those of rigid posts of titanium or ZrO₂. Bond strength results were the highest in the coronal root level for all tested post systems but did not differ significantly from the other two root levels.

Endodontic cement penetration after removal of calcium hydroxide dressing using XP-endo finisher

We aimed to evaluate the penetration of endodontic cement following the removal of calcium hydroxide (Ca(OH)2) dressing using the XP-endo Finisher in association with different irrigating solutions. Sixty premolars were instrumented and applied with a Ca(OH)2 dressing. To remove Ca(OH)2, the teeth were divided into six groups, each with a different volume of sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA), as well as solution stirring time with XP-endo Finisher (0, 30, and 60 sec). Root canals were filled using the lateral condensation technique. Fluorescein dye was added to the cement for microscopic laser scanning analysis. In the generated images, linear measurements were taken in micrometers, and their averages were calculated. To analyze the perimeter penetration ratio of the cement, the total perimeter of the canal and the segment of the total perimeter of the canal where the endodontic cement penetrated into the dentinal tubules were measured in micrometers. We found that using an XP-endo Finisher in irrigation was more effective than using a needle and syringe during the extension and penetration of endodontic cement. Shaking with XP-endo Finisher with 17% EDTA increased the extent and perimeter of the penetration of the endodontic cement into the dentinal tubules. However, using the XP-endo Finisher with EDTA only was more efficient than using the instrument interchangeably in NaOCl and EDTA. Although XP-endo Finisher contributes to the removal of Ca(OH)2, none of the protocols or instruments used removed all Ca(OH)2 from the root system.

Comparing the bond strength of fiber post cementation in the root canal using pre- and co-curing procedures with the same self-etching bonding system

Background/purpose

Self-etching bonding systems are widely used in fiber post cementation. However, no clear guidelines are established for choosing pre- or co-curing procedures. We investigated the bond strength of fiber post cementation using pre-/co-curing methods in self-etching bonding systems and compared them with those of a self-adhesive system.

Materials and methods

Post spaces were prepared in 30 single-rooted premolars/canines, and the fiber posts were cemented in three ways (10 specimens per group): using a self-etching bonding system with either a pre-curing or simultaneous co-curing procedure (RelyX™ Ultimate; groups SE-pre and SE-co, respectively) and using a self-adhesive system (RelyX™ Unicem 2, group SA). Each specimen was embedded and sliced perpendicularly to the long axis into three 2.5-mm-thick sections. Microphotographs of the coronal and apical surfaces of each section were acquired, and push-out tests (1 mm/min) were performed. One-way analysis of variance was conducted on the data, followed by Tukey's honestly significant difference post hoc test.

Results

The bond strength in the whole root was not significantly different among the three groups. When independently evaluating each portion, group SE-co exhibited significantly lower coronal bond strength. The bond strength varied among root regions only in group SE-pre; the apical region had a significantly lower value.

Conclusion

No cementation method is superior in all portions. Regarding pre-curing methods, clinicians must caution the fit between the post and post space, which may be affected by the pre-polymerized bond layer. The co-curing method used in a larger coronal cement space contributes to the poor bond strength.

Influence of adjunctive non-surgical peri‑implant therapy on clinical and salivary cytokine profile in obese patients

AIM

The present study aimed to evaluate the impact of Photodynamic therapy (PDT) and Er,Cr:YSGG laser (ECL) adjunct to nonsurgical mechanical debridement (NSMD) in comparison to conventional NSMD in overweight individuals with peri‑implant disease on peri‑implant inflammatory parameters and cytokine levels of IL-6 and TNF-α in Peri-implant crevicular fluid (PICF) MATERIALS AND METHODS: Recruitment of volunteers was performed from the outpatient department according to predefined inclusion and exclusion criteria. Group 1 consisted of obese participants who underwent peri‑implant mechanical debridement (MD); group 2, obese participants who experienced MD adjunct to ECL, and in group 3, obese participants were treated with MD and adjunct PDT. Clinical periodontal parameters, plaque index (PI), bleeding index (BI) and probing depth (PD) along with crestal bone loss (CBL) were assessed at baseline, 3 months, and 6 months. PICF was collected to evaluate the levels of IL-6 and TNF-α. Kruskal-Wallis and Bonferroni post hoc test were employed for the comparison of peri‑implant inflammatory parameters and PICF cytokine profiles among the study groups.

RESULTS

Clinical peri‑implant parameters (PI, BI and PD) at baseline among subjects in group 1, group 2 and group 3 were comparable (p > 0.05). At 3 months follow up, mean scores of peri‑implant PI, BI, and PD (P <0.05) in group 1 (control) were significantly higher compared to group 2 (ECL) and 3 (PDT) (p < 0.05). At 6 months follow-up, PI and BI mean scores among groups 1, 2, and 3 were comparable (p>0.05). At 6 months participants in groups 2 and 3 noted significant difference (p<0.05) compared to baseline with no difference noted in the control group (p>0.05).

CONCLUSION

Photodynamic therapy and Er, Cr: YSGG adjunct to NSMD demonstrated significant improvement in peri‑implant inflammatory parameters in obese individuals. Multicentric clinical trials are suggested to extrapolate the findings of the present study.

Photodynamic therapy and gaseous ozone versus conventional post space treatment methods on the push-out bond strength of fiber posts luting with different resin cements

BACKGROUND

The aim of this study was to compare the push-out bond strength of fiber posts by using two different resin cement after the treatments of post space with photodynamic therapy, gaseous ozone and conventional disinfection solution.

METHODS

The root canal treatments of one hundred maxillary incisors were performed. The roots were randomly distributed into 5 groups (n = 20). NaOCl of 2.5% + EDTA of 17% in group 1, CHX of 2% in group 2, toluidine blue + diode laser as the photodynamic therapy (PDT) in group 3 and ozone in group 4 were applied to the post spaces. Group 5 was washed with distilled water as control group. Each group was divided into two subgroups according to the adhesive types and the posts were bonded by using RelyX and LinkForce. The bond strength was calculated using the push-out test method. Resin tag formations were photographed with SEM. The push-out bond strength was analyzed by ANOVA and Tukey tests (p = .05).

RESULTS

The PDT group, which showed the highest PBS among the groups bonded with LinkForce at all levels, was significantly higher than Ozone and DW groups (p<.05). NaOCl and ozone treatments provided the highest PBS among the groups bonded with RelyX for all levels and this difference was significant according to the DW group (p < .05).

CONCLUSION

Post space treatments improved the bond strength of the fiber post ​​in both types of resin cement.

Influence of methylthioninium chloride, curcumin and Er, Cr: YSGG on caries affected dentin bonded to bioactive and conventional bulk fill dental restorative material

AIM

The study aimed to determine the influence of Er, Cr: YSGG (ECL), methylene blue photosensitizer (MBP), and curcumin photosensitizer (CP) disinfection on CAD and its bond strength and microleakage to bioactive (BA) and multicore (MC) bulk-fill composite.

MATERIALS AND METHODS

Sixty carious mandibular molars were collected based on the criteria of ICDAS Code 6 (International Caries Detection and Assessment system). Specimens were embedded in polyvinyl pipes up to CEJ and subjected to preparation of standard class II cavity leaving CAD in situ for bonding. All samples were randomly assigned to eight groups based on disinfection regimes and type of bulk-fill material. Samples in group 5 and 6 didn't undergo any disinfection; group 1: ECL + BA, group 2: ECL+ MC; group 3 MBP + BA, group 4: MBP + MC; group 5: Conventional Etch and Rinse + BA (Control), group 6 Conventional Etch and Rinse + MC (Control); group 7: CP +BA and group 8 CP+MC. Specimens were tested for SBS using a universal testing machine and the debonded surfaces were evaluated under a stereomicroscope to determine modes of failure. A dye penetration test was performed for microleakage assessment. For intergroup comparison test analysis of variance (ANOVA) was performed using means and standard deviation from each group. Tukey HSD was used for multiple group comparison tests. The level of significance was established at p < 0.05.

RESULTS

The maximum mean bond strength was shown by group 6 (18.96 ± 0.31 MPa) conventional etch and rinse+ MC (control). Whereas, the minimum SBS was recorded in specimens of group 7 CP +BA (13.04 ± 0.81 MPa). SBS values among group 3 (14.05 ± 0.10 MPa- MBP+BA), group 4 (13.66 ± 0.39- MBP+MC) group 7 (13.04 ± 0.81 MPa- CP +BA and group 8 (14.21 ± 0.59 MPa- CP+MC) were found to be comparable (p>0.05). There was no statistically significant difference among the study groups concerning microleakage (p >0.05).

CONCLUSION

CAD treated with ECL for the adhesive bonding of BA and conventional bulk-fill composite MC has shown potential to be used clinically. Moreover, MBP and CP for conditioning of CAD need further investigation.

Protocols for Mechanical Cleaning of the Post Space on the Bond Strength Between Root Dentin and Cementation System

OBJECTIVE

To evaluate the effects of mechanical versus chemical cleaning protocols for cleaning the root dentin surface before cementation of fiberglass posts for their effect on the bond strength, failure mode, and dentinal penetration of the cementing agent using an etch-and-rinse adhesive system on dentin prepared to receive a fiberglass post.

METHODS

Forty roots of bovine teeth were endodontically treated and prepared for fiber post cementation. The specimens were randomized into 4 groups of 10: Control group (CO) - irrigation with 2.5% NaOCl; DW group- irrigation with distilled water; RB group - rotating brush for cleaning root canals, and CUI group - continuous ultrasonic irrigation. The fiberglass posts were cemented, and the specimens were immersed in distilled water for 6 months. A push-out test was performed on the cervical, middle, and apical thirds of the samples. Dentinal penetration of the cementing agent and the fracture pattern were evaluated by laser confocal microscopy. Statistical analysis was performed using analysis of variance (ANOVA) and post hoc Tukey tests (α=0.05). Results: The RB and CUI groups showed significantly higher bond strength values when compared to the Control and DW groups (p<0.05). In addition, in the control and DW groups, the apical third presented lower bond strength values when compared to middle and cervical thirds.

CONCLUSION

While DW showed the highest incidence of adhesive type failure, CUI resulted in the highest dentinal penetration of the cementing agent (p<0.05). RB and CUI resulted in the highest bond strength between cementation system and root dentin. In addition, CUI favored greater dentinal penetration of fiberglass post cementing agent.

Effect of Root Dentin Pretreatment on Micro-Push-Out Bond Strength of Fiber Posts to Root Canal Dentin: Cold Atmospheric Argon Plasma (CAAP) and Ethylenediaminetetraacetic Acid (EDTA)

Purpose

Debonding from the root canal dentin is the most common failure mode of fiber posts. This study aimed to assess the effects of cold atmospheric argon plasma (CAAP) and ethylenediaminetetraacetic acid (EDTA) on micro-push-out bond strength of fiber posts to root canal dentin.

Materials and Methods

Forty maxillary canine teeth were decoronated, underwent endodontic treatment, and were stored in an incubator for 7 days. After post space preparation, the teeth were randomly divided into four groups for different surface treatments: (I) saline, (II) 17% EDTA, (III) CAAP, and (IV) 17% EDTA + CAAP. Fiber posts (Whitepost no. 2, FGM) were cemented into the root canals using Panavia F2.0 resin cement, and 1 mm-thick sections were made at the coronal, middle, and apical thirds of the roots. The samples underwent micro-push-out bond strength test. The mode of failure was also determined under a stereomicroscope. Data were analyzed using three-way ANOVA and Tukey's post hoc test (α = 0.05). The mode of failure data were analyzed using the chi-square test.

Results

The mean micro-push-out bond strength of fiber posts was not significantly different in the four groups (P > 0.05). However, the bond strength values in the coronal third were significantly higher than the corresponding values in the apical third (P=0.01). There was no significant difference in the modes of failure between the groups (P > 0.05).

Conclusion

Application of CAAP alone or in combination with 17% EDTA could not successfully increase the bond strength of fiber posts to root canal dentin.

Push out bond strength of glass fiber post to radicular dentin irrigated with Nisin and MTAD compared to methylene blue photodynamic therapy

AIM

Present lab-based study intended to appraise the effect of nisin, Mixture of Tetracycline, Acid and Detergent (MTAD), and photodynamic therapy (PDT) when used as a canal disinfectant on push-out bond strength (PBS) of fiber post to radicular dentin MATERIALS AND METHODS: Forty uni-radicular premolar teeth were extracted and disinfected in 0.5 % thymol solution. All specimens were decoronated to achieve standardize root length of 14 mm. Cleaning and shaping of the canal were done using protaper NiTi system. The canal space was dried and obturated. Post space was prepared using peso reamers up to 10 mm length and samples were randomly divided into 4 groups (n = 10). Group 1 irrigated with 10 % Nisin with MTAD, group 2: 1.3 % NaOCl and MTAD, Group 3 irrigated with 2.5 % NaOCl and 17 % EDTA and post space of samples in group 4 with PDT with MTAD. Fiber-reinforced composite post (FRCP) was fitted in canal space using self-etch resin cement. Each sample was cut into 1 mm from coronal, middle, and apical and subjected to PBS via a universal testing machine. For comparison of means, Analysis of variance (ANOVA) and Tukey multiple comparison test was used maintaining the level of significance at p < 0.05.

RESULT

Samples in group 3 post space irrigated with 2.5 % NaOCl and 17 % EDTA demonstrated the highest PBS at all root levels (cervical: 8.83 ± 0.14 MPa, middle: 7.63 ± 0.82 MPa and apical: 5.82 ± 0.32 MPa) in comparison to other tested groups. Whereas, group 1 in which Nisin 10 % with MTAD was used as a canal disinfectant displayed the lowest PBS at all levels (cervical: 6.91 ± 0.54 MPa, middle: 6.15 ± 0.31 MPa, and apical: 3.62 ± 0.68 MPa).

CONCLUSION

Post space irrigated with 1.3 % NaOCl and MTAD shows PBS similar to control group 2.5 % NaOCl and 17 % EDTA. Both types of irrigation methods have potential and can be recommended in clinical scenarios. Whereas, 10 % Nisin and PDT with MTAD as chelator needs further inquiry.

Restoration of Root Filled Teeth; Current Opinions and Techniques

Purpose:

To examine current decision-making preferences of Jordanian dentists when Restoring Root Filled Teeth (RFT).

Materials and Methods:

834 Jordanian general dentists, prosthodontists and endodontists were invited to participate in a validated online survey with a 62% participation rate. Respondents were invited to answer 24 questions about their preferences for techniques and materials they use to restore RFT. The questions aimed at exploring restorative strategies commonly employed by Jordanian dentists when managing root filled teeth with extensive loss of tooth structure.

Results:

A minority of dentists consider direct resin restoration as the sole restoration for RFT with extensive loss of tooth structure. Full coverage metal-ceramic and all-ceramic crowns are more popular than endocrowns when restoring RFT with indirect restoration. Fiber posts are the most popular type of posts, followed by prefabricated metal posts. Glass ionomer is the most preferred cement for luting metal posts, while conventional dual resin cement with separate etch and rinse bonding strategy is the most employed when bonding fiber posts. The majority of dentists tend not to pretreat fiber posts. Loss of post/core retention or fracture of coronal tooth structure are the two most common reasons observed by dentists when RFT fail.

Conclusion:

Use of post and core is still preferred over more conservative approaches when restoring RFT with extensive loss of coronal tooth structure. Longevity of restorations can be enhanced by training practicing dentists on evidence-based adhesive strategies.

Comparison of adhesive bond strength among fiber reinforced post and core with different cementation techniques: In vitro study

AIM

To investigate push-out bond strength (PBS) of fiber post to radicular dentin after using different cementation techniques.

MATERIAL AND METHODS

Sixty single-rooted premolars were disinfected and cleaned by mechanical instrumentation. S1, S2, and SX were used for canal shaping and finishing of the canal was carried out using F1 and F2. This was followed by constant irrigation and smear layer removal using 17%EDTA. The canal was dried filled with gutta-percha and canal space was prepared using a peso reamer. Based on cementation techniques, samples were randomly allocated into six groups. Group 1: One-step Monoblock MC; Group 2: One-step, Monoblock MC-NA (no adhesive) GFP; Group 3: One-step, RX-MC-Monoblock; Group 4: Two-step, RX-MC; Group 5: Two-step, RX-FZ; and Group 6: Two-step RX-FZ-custom post. All specimens were mounted in polyvinyl pipes using acrylic resin up to cement enamel junction. All specimens were mounted in a universal testing machine subjected to push-out forces at a speed of 0.5 mm/min. Five samples from each group were sputter-coated with 6 nm gold thickness for 300 s at 250 mA. The coated specimens were assessed under the scanning electron microscope (SEM). Analysis of variance (ANOVA) and Tukey Kramer multiple comparisons tests were performed to compare means among groups maintaining the level of significance at (p < 0.001).

RESULTS

The highest PBS was displayed in RX-MC-Monoblock (199.020 ± 21.432 MPa). Whereas, lowest PBS was found in Monoblock MC-NA (no adhesive)-GFP (76.440 ± 9.468 MPa). Among one-step groups, RX-MC Monoblock exhibited the highest PBS (199.020 ± 21.432 MPa) comparable to one-step Monoblock MC (134.28 ± 19.37 MPa) (p > 0.05). Similarly, among two-steps groups, two-step RX-MC demonstrated significantly higher PBS values than two-step RX-FZ (143.340 ± 23.68 MPa) and RX-FZ-custom post (86.90 ± 7.41 MPa) (p < 0.05).

CONCLUSION

One-step RX-MC-Monoblock technique using self-adhesive cement and core foundation composite resin material multicore flow when cured simultaneously exhibited the highest bond integrity of post retention compared to other cementation technique.

Calcium hydroxide paste removal strategies and bond strengths of epoxy- and silicate-based sealers

This study evaluated the syringe/needle (SN), passive ultrasonic irrigation (PUI) and XP-endo Finisher (XP) in the removal of Ca(OH)₂ -based paste and the bond strength (BS) values of an epoxy resin (AH Plus) and silicate (MTA)-based sealers to root dentin. Eighty lower premolars were assigned: control group (CT), SN, PUI and XP, and subdivided according to the sealer (n = 10) for BS. SN has the lowest removal followed by PUI and XP. AH Plus had higher BS for CT compared with SN in all root thirds. CT and XP presented similar BS in the apical and middle thirds and higher than SN and PUI. For MTA, similar BS was observed in the cervical and apical thirds, and in the middle third, CT, PUI and XP presented similar values and higher than SN. PUI and XP methods presented higher efficiency in the Ca(OH)₂ removal, and the residual Ca(OH)₂ provides a reduction in BS of the AH Plus.

Assessment of sodium thiosulfate neutralizing effect on micro-hardness of dentin treated with sodium hypochlorite

Background

This study aims to evaluate the ability of sodium thiosulfate (STS) to neutralize the adverse effect of sodium hypochlorite (NaOCl) on dentin micro-hardness.

Methods

Fifty single-rooted teeth were longitudinally sectioned. The samples divided into a control and four sample groups (n = 20). All the samples were immersed in different solutions as follows, Control: Normal saline for 15 min, G1and G2: 2.5% NaOCl for 15 min, G3: 2.5% NaOCl for 15 min, followed by 5% STS for 10 min, G4: Normal saline for 15 min followed by 5% STS for 10 min. All groups except G1 incubated for one week before the test. The micro-hardness of samples was measured. Data were analyzed using the Kruskal–Wallis test for pairwise comparisons. A p value < 0.05 was considered significant.

Results

All groups showed a significant decrease in the micro-hardness value compared with the control group. NaOCl for one week (G2) reduced the micro-hardness of dentine compared with samples, tested immediately after immersion in NaOCl (G1) (p < 0.05). NaOCl alone (G2) or treated with STS (G3) resulted in a significant decrease in micro-hardness compared with the STS group (G4) (p < 0.05).

Conclusions

STS as a neutralizing agent could not prevent the dentin micro-hardness downturn caused by NaOCl.

Effect of dentin and fiber post surface treatments with fumaric acid on the bonding ability of fiber posts

This study investigated the effects of fumaric acid on push-out bond strength when applied to dentin surfaces and fiber posts. The root canals of 60 mandibular premolar teeth were instrumented and obturated. After removing two thirds of filling material, teeth were prepared according to six randomized groups (n = 10/group) defined by two fiber post surface treatments (0.7% fumaric acid or 9% hydrofluoric acid) and three dentin conditioning treatments [control (no conditioning); 17% ethylenediamine tetraacetic acid (EDTA); or 0.7% fumaric acid]. After fiber post-cementation, three 1-mm thick discs were obtained from each tooth by transverse sectioning, and each disc underwent push-out bond strength testing. Data were analyzed with a one-way analyses of variance (anova) and t tests; p < .05 was considered statistically significant. Failure modes were determined by stereomicroscopy, and the surface characteristics of dentin and fiber posts were observed by scanning electron microscopy. Push-out bond strength was greater for the group in which the post surface treated with hydrofluoric acid and the dentin surface treated with fumaric acid than the nontreated dentin and hydrofluoric acid-treated post group (p < .05). There were no significant differences between other comparison pairs (p > .05). A combination of fumaric acid dentin conditioning and hydrofluoric acid fiber post treatment strengthened the bonding ability of fiber posts.

The effect of a root-dentin pretreatment technique combining PIPS with MTAD aiming to improve the bond strength of glass fiber post

The aim of this study was to evaluate the combined effect of MTAD and photon-induced photoacoustic streaming (PIPS) technique on the smear layer removal and the bond strength of glass fiber post. Fifty-five human mandibular premolars were chosen. After root canal therapy and post space preparation, the teeth were equally divided to five groups according to the methods of root-dentin pretreatment: G1: distilled water (control); G2: 2.5% NaOCl+17% EDTA; G3: MTAD; G4: PIPS; G5: MTAD+PIPS. One sample was randomly selected from each group, and scanning electron microscope (SEM) was used to observe the microscopic morphology of the coronal, middle and apical level of the root-dentin. The remaining ten samples from each group were glued to glass fiber posts, and the bond strength was assessed by push-out test. SEM evaluation showed that the most complete smear layer removal was found in MTAD + PIPS group, especially in coronal third. Push-out test results exhibited that there was a statistically significant interaction between the experimental groups and root canal third (p < .0005). Significant differences could be found among five groups (p < .05): G5 > G4 > G3 > G2 > G1. G5 had the highest bond strength. In conclusion, post space pretreatments with MTAD or PIPS technique can significantly remove smear layer and improve the bond strength of glass fiber post, and combination of them works best.