The influence of operator variability on adhesive cementation of fiber posts

PURPOSE: The aim of this study was to evaluate the influence of the operator's experience on the outcome of fiber post cementation using an etch-and-rinse acetone-based adhesive. MATERIALS AND METHODS: Fifteen human anterior teeth were used in the study. One trained operator performed the endodontic procedures and prepared the roots for the insertion and cementation of the posts. At this point, teeth were divided into 3 groups and distributed to 3 operators to lute the posts: an expert operator (EO), a moderately experienced operator (ME), and an operator with a low level of experience (LE). Quartz fiber posts (DT Light Post #1 or #2, RTD) were used. Posts were cemented using Prime&Bond NT Dual Cure adhesive system (Dentsply Caulk) in combination with the dual-curing resin cement Calibra (Dentsply Caulk). The post retention was assessed with the "thin-slice" push-out test. One-way ANOVA was performed to examine the effect of the operator on push-out strength, followed by post-hoc multiple comparisons using Tukey's test, with the significance level set at alpha = 95%. RESULTS: The results of push-out strength testing were as follows: EO (12.44+/-3.63 MPa), ME (11.68+/-2.64 MPa), LE (11.18+/-3.12 MPa). No statistically significant differences were determined among the three groups. CONCLUSION: There was no statistically significant difference in the retention measured for fiber posts luted by operators with different levels of clinical experience. Given the parameters of this investigation, the level of operator experience in luting fiber posts does not affect post retention under laboratory conditions.     

不同黏结系统树脂水门汀与纤维桩的冠向渗漏

目的:比较3种不同黏结系统的树脂水门汀与纤维桩的冠向渗漏情况。方法:将9颗完善根管治疗后的上中切牙分为3组(n=3),分别使用全酸蚀(One-Step Plus/Duolink,OD)、自酸蚀(ParaCore Automix,PA)、自黏结(RelyXTMUnicem,RU)3种黏结系统的树脂水门汀黏结玻璃纤维桩并堆砌成核,经水浴冷热循环5000次后,采用0.1%碱性品红染色法比较3种黏结系统黏结界面的渗漏情况。采用SAS 6.0软件包对实验数据进行K-W多样本秩和检验。结果:不同黏结系统树脂水门汀与纤维桩黏结界面的冠向渗漏程度有显著差异(P<0.001)。结论:自黏结系统树脂水门汀黏结界面的渗漏最小,而自酸蚀系统树脂水门汀的边缘渗漏最为严重。     

Evaluation of the adhesion of fiber posts cemented using different adhesive approaches

The aim of this study was to investigate the adhesion of fiber posts cemented with luting agents that utilize three currently available adhesive approaches: etch‐and‐rinse, self‐etch, and self‐adhesive. Forty‐two intact single‐rooted human premolars were used in the study. Teeth were divided into six groups. In each group, a different resin cement with its adhesive system (if needed) and a fiber post were used. The groups were classified, according to the adhesive approach, into the following three categories. (i) Etch‐and‐rinse groups: Calibra resin cement/XPBond adhesive + self‐curing activator (SCA)/RadiX Fiber Post (Dentsply Caulk), FluoroCore 2 core build‐up material/XPBond + SCA/RadiX Fiber Post (Dentsply Caulk), and MultiCore Flow luting and core build‐up material/Excite DSC adhesive/FRC Postec Plus fiber post (Ivoclar Vivadent). (ii) Self‐etch group: Panavia F 2.0/ED primer (Kuraray)/RadiX Fiber Post (Dentsply Caulk). (iii) Self‐adhesive groups: experimental self‐adhesive cement/RadiX Fiber Post (Dentsply Caulk), and RelyX Unicem/RelyX Fiber Post (3M ESPE). The adhesion between the post and the root canal walls was assessed using the ‘thin‐slice’ push‐out test. In the test arrangement used, the self‐etching approach may offer less favourable adhesion to root canal dentin in comparison with etch‐and‐rinse and self‐adhesive approaches.     

纤维桩和粘接系统对粘接界面形态及破坏方式影响的研究

目的 比较不同粘接系统粘接2种纤维桩后在桩道不同深度的粘接界面形态和界面破坏方式.方法 选取36颗新鲜上颌前磨牙,将其分成A、B、C、D组,A组:自粘接树脂黏固剂和POPO玻璃纤维桩;B组:全酸蚀粘接系统和POPO玻璃纤维桩;C组:自粘接树脂黏固剂和Para Post玻璃纤维桩;D组:全酸蚀粘接系统和Para Post...     

SEM evaluation of the cement layer thickness after luting two different posts

PURPOSE: To verify with SEM the cement layer thickness and uniformity of resin-relined translucent fiber posts (anatomic posts) and standard translucent fiber posts. MATERIALS AND METHODS: On 20 extracted maxillary anterior teeth, the roots were endodontically treated and prepared for the insertion of a fiber post. Translucent fiber posts (DT) were luted with a dual-curing resin cement (Duo-Link) in 10 specimens (group 1) after the canal walls had been treated with the One-Step bonding system. In the other 10 specimens (group 2), experimental anatomic posts (Anatomic Post'n Core) were tested. To these posts, a layer of light-curing resin is added to allow for a pre-cementation relining of the post, aimed at improving its fit into the endodontic space. For luting, the same adhesive-resin cement combination of group 1 was used. All the roots were sectioned and prepared for SEM observations. At the 1-mm, 4.5-mm, and 8-mm level of each root, cement thickness was measured, and the presence of gaps or voids within the luting material or at its interfaces was evaluated. A statistical analysis was performed to test the significance of differences in the cement layer thickness around the two types of post and at different levels of the same type of post. RESULTS: In the presence of anatomic posts, the cement layer was significantly thinner and more uniform at the coronal and middle level of the root. In both groups, voids and bubbles were detected within the luting material, within the abutment material, and between fiber post and cement. Gaps were also visible between post and relining material. CONCLUSIONS: The resin cement thickness was significantly lower in the anatomic post group than in the control group (standardized posts), except at the apical third of the canal, where there was no statistically significant difference. A good adaptation of anatomic posts was evident in all of the specimens.     

Push-out bond strengths of tooth-colored posts bonded with different adhesive systems

PURPOSE: To evaluate the effect of luting systems and root region on the push-out bond strengths of a glass fiber-reinforced post and a zirconia post. METHODS: Thirty-two extracted human anterior teeth (central incisors and canines) were endodontically treated with lateral condensation of gutta percha and AH26 sealer. Teeth were randomly assigned to eight groups (n = 4 per group). Two post systems from the same manufacturer (Cosmopost, a zirconia post; or FRC Postec, a glass fiber-reinforced post) were placed with a luting system (bonding agent and resin luting agent). C-Post was cemented with One-Step and Post Cement Hi-X was used as the light-polymerized adhesive control. ParaPost Fiber White cemented with ParaPost Adhesive and ParaPost Resin Cement was used as an auto-polymerized adhesive control. The roots were sectioned in equal thirds (apical, middle and cervical). A push-out test was performed in each section to measure regional bond strengths in MPa. Means were analyzed with two-way ANOVA and Duncan's post-hoc test (alpha = 0.05). RESULTS: The fiber posts ranked in the highest statistical subset regardless of the luting system: ParaPost Fiber White (self-cure control), FRC Postec bonded with Excite DSC/Variolink II, FRC Postec bonded with Syntac/Variolink II, FRC Postec bonded with Excite DSC/Experimental Self Cure Cement, and C-Post bonded with One Step/Hi-X. The zirconia post Cosmopost ranked in the lowest subsets regardless of the adhesive system used at P < 0.05. Means for the medium region of the root (5.0 +/- 0.8 MPa) were not statistically different from those obtained either in the cervical or in the apical region. Means for the cervical root region (6.2 +/- 0.9 MPa) were statistically higher than those of the apical region (4.5 +/- 1.1 MPa) at P < 0.001.     

Regional bond strengths to root canal dentin of fiber posts luted with three cementation systems

This study evaluated the influence of the cementation system on the regional push-out bond strength and failure pattern of fiber posts to radicular dentin. The roots of 48 extracted human incisors were prepared and divided into 3 groups (n = 16), according to the cementation system: AdperScotchbond Multi-Purpose + resin cement RelyX ARC (SBMP+ARC); Adper SingleBond 2 + RelyX ARC (SB+ARC) and; RelyX U100 self-adhesive resin cement (U100). The posts were cemented as per manufacturer's instructions for each cementation system. After 1 week, the roots were sectioned transversely into 6 discs. Two discs were obtained from the cervical, middle and apical thirds and the push-out test was carried out. The failure pattern was examined on all debonded specimens. The data were analyzed by two-way repeated measures ANOVA and Tukey's test. When U100 was used, no statistically significant difference (p>0.05) was observed among the different root regions. Statistically higher push-out bond strength values were detected in the cervical third for SBMP+ARC and SB+ARC (p<0.05). The U100 showed significantly more mixed failures than SBMP+ARC in the apical third (p<0.05). In conclusion, the self-adhesive cement RelyX U100 was the only cement not sensitive to the root canal region.     

两种不同粘接系统在玻璃纤维桩修复中的临床效果

目的 比较两种不同粘接系统用于玻璃纤维桩核修复的临床效果.方法 选取136颗已行根管治疗的患牙随机分为自酸蚀Multilink N和自粘接RelyX Unicem两组,行玻璃纤维桩+全冠修复.分别在修复后进行随访观察,比较两组患牙的临床修复成功率.结果 修复后6、12、24月,两组成功率均在97%以上,且两组间比较差异无统计学意义(P>0.05).结论 Multilink N自酸蚀树脂水门汀和RelyX Unicem自粘接树脂水门汀用于粘接纤维桩均能获得良好的临床修复效果.     

An SEM evaluation of several adhesive systems used for bonding fiber posts under clinical conditions.

OBJECTIVES: The objective of this investigation was to evaluate the effectiveness of three 'one-bottle' and two 'three step' adhesive systems (as controls) in the formation of resin tags, adhesive lateral branches and a resin dentin interdiffusion zone (RDIZ) when used to bond fiber posts under clinical conditions. This study was performed using standardized SEM observations and scoring resin tag formation and density. METHODS: Fifty root canal treated teeth, already scheduled for extraction for endodontic or periodontal reasons, were selected for this study. The patients were informed and their written consent was obtained. The samples were randomly allocated to five groups of ten samples each. Group 1: All Bond 2 with C & B (Bisco); Group 2: Scotchbond Multipurpose Plus with Opal Luting Composite (3M); Group 3: Scotchbond 1 in combination with Rely X ARC resin cement (3M); Group 4: One-step with C & B resin cement (Bisco); Group 5: All Bond Experimental with Post Cement HI-X (Bisco). The adhesive systems and resin cements were used strictly according to the manufacturers' instructions. The priming-adhesive solution of each 'one-bottle' system was light-cured before placing the resin cement and the post. Fifty Aestheti-Plus posts (white quartz fiber posts, RTD, France) were used. A week later, the roots were extracted and processed for SEM observations. RESULTS: All the adhesive systems showed a RDIZ and resin tag and adhesive lateral branch formation. Microscopic examination of the restored interfaces of Groups 1 and 2 showed a higher percent of RDIZ than those found in samples of Groups 3, 4 and 5. RDIZ morphology was easily detectable and uniform in the first two thirds of the root canals, whilst in the apical third the RDIZ was not uniformly present. Resin tag morphology and formation were significantly more detectable in the cervical and middle areas than in the apical zone. No statistically significant differences were found among the five groups coronally, while in the apical and middle thirds two 'one-bottle' systems (Groups 3 and 4) showed significantly less resin tags than the control Groups 1, 2 and the experimental Group 5. No statistically significant differences were found among the three 'one-bottle' systems in the three evaluated areas. The standardization of SEM observations and scoring resin tag formation allowed statistical evaluation. CONCLUSIONS: The 'three step' adhesive systems can create a wider micromechanical interlocking between adhesive materials and etched dentin than 'one-step' systems.     

Void and gap evaluation using microcomputed tomography of different fiber post cementation techniques

Statement of problem

Few studies have investigated the voids and gaps produced during the cementation of fiber posts using different techniques.

Effect of curing modes of dual-curing luting systems and root regions on retention of translucent fiber posts in root canals

PURPOSE: To evaluate the effect of different curing modes of dual-curing luting systems and root regions on the push-out strength of fiber posts to intraradicular dentin. MATERIALS AND METHODS: Forty-two extracted premolars with a single root canal were sectioned at the cementoenamel junction and the roots were endodontically treated. The roots were divided into two groups according to two dual-curing luting systems: (1) XP BOND-Dual Cure/Calibra resin cement; (2) XP BOND-Dual Cure/FluoroCore 2. For each luting system, three different curing modes were applied to the dentin adhesive and resin cement: "Self-cure and Self-cure (SC&SC)", "Self-cure and Dual-cure (SC&DC)", and "Dual-cure and Dual-cure (DC&DC)". Translucent Easy fiber posts (Dentsply Maillefer) were luted in the roots. A thin-slice push-out test was performed, and the data of push-out strength were analyzed using three-way ANOVA with luting system, curing mode, and root region (apical, middle and coronal) as factors. Tukey's test was used for post-hoc comparisons. RESULTS: The push-out strength of XP BOND-Dual Cure/Calibra was significantly lower when Calibra resin cement was self-cured than when it was dual-cured (SC&SC: 6.04 +/- 2.65 MPa; SC&DC: 10.69 +/- 3.01 MPa; DC&DC: 10.72 +/- 3.63 MPa; p < 0.05). The curing modes did not affect the push-out strength of XP BOND-Dual Cure/FluoroCore 2 (SC&SC: 7.90 +/- 3.94 MPa; SC&DC: 8.32 +/- 2.73 MPa; DC&DC: 9.27 +/- 4.12 MPa; p > 0.05). The coronal push-out strength was significantly higher than the apical push-out strength (p < 0.05). CONCLUSION: Retention of fiber posts in root canals was affected by the curing modes of dual-curing luting system and root regions.     

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目的 评价3种树脂黏结系统对纤维桩的黏结强度,为临床选择纤维桩黏结材料提供实验依据.方法 于2010年2-4月,在大连理工大学实验室将巧颗经根管治疗后的离体牙随机分为3组,每组5颗,分别选用One-step全酸蚀黏结系统(A组),Clearfil DC自酸蚀黏结系统(B组)和RelyX Unicem自黏结系统(C组)黏结玻璃纤维桩于离体牙根管内,切割制备2 mm厚的薄片样本,采用微推出法于试验机上进行微推出测试,计算并比较各组样本的黏结强度.扫描电镜下观察黏结界面微观形态.结果 微推出法测试各组样本的黏结强度结果为:A组(4.6860 ±1.84645)MPa、B组(6.1000±0.36350)MPa,C组(7.0490±0.92126)MPa,组间比较差异有统计学意义(P<0.05).扫描电镜观察显示:3组均可见树脂--纤维桩黏结界面较树脂--牙本质黏结界面贴合紧密,其中A组可见稀疏、短小树脂突.结论 3种黏结系统对纤维桩在根管内的黏结强度差异显著,自黏结组和自酸蚀组优于全酸蚀组.     

不同树脂核材料与纤维桩抗拉强度的实验研究

目的:研究不同种类树脂核材料与纤维桩的粘接性能.方法:用4 种树脂核材料(Multicore Heavy Body、LuxaCore、LIGHT-CORE、Z100)在纤维桩上分别制作桩核粘接试件,电子力学试验机测试抗拉强度,扫描电镜观察粘接界面.结果:不同树脂核材料与纤维桩的抗拉强度差异有显著性(P<0.05),其中LuxaCore粘接力均值最大,为(15.45±0.75) MPa;Z100粘接力最小,为(13.14±0.52) MPa.扫描电镜观察显示,Z100混合填料型复合树脂与纤维桩表面结合较差,结合界面有明显裂纹;LuxaCore双固化树脂核材料与纤维桩表面的结合较好,结合界面无明显裂纹.结论:树脂核材料种类对纤维桩树脂核粘接力有显著影响,流动性好的双固化树脂核材料(LuxaCore,Multicore Heavy Body)粘接性能优于光固化树脂核材料(LIGHT-CORE,Z100).     

Dentin bond strengths of three adhesive/composite core systems using different curing units

This study evaluated the tensile bond strengths of three adhesive/composite core materials to bovine dentin using three different curing units. Bovine dentin surfaces were ground with 600-grit SiC paper. Bonding area was demarcated with a vinyl tape (4-mm-diameter hole). Three adhesive/composite core systems--S6054 (experimental), UniFil Core, and Clearfil DC Core Automix--were used with three curing units--Curing Light XL3000 (quartz-tungsten-halogen), Hyper Lightel (high-power quartz-tungsten-halogen), and LEDemetronl (blue light-emitting diode)--according to manufacturers' instructions. After 24 hours of storage in water at 37 degrees C, tensile bond strengths were measured at a crosshead speed of 2 mm/min. Results were statistically analyzed with one-way ANOVA and Tukey's HSD test (p < 0.05). Highest tensile bond strength was obtained using Clearfil DC Core Automix with Hyper Lightel.     

Multilink(R) Automix粘结系统对玻璃纤维桩的粘结研究

目的:扫描电镜下观察和比较两种粘结系统粘结玻璃纤维桩后的牯结界面.方法:选取因牙周病拔除的单根管上前牙6颗,随机分为2组.分别使用Multilink(R) Automix和One Step(R) bonding system 2种粘结系统粘结玻璃纤维桩,切割后扫描电镜下观察.结果:扫描电镜下,Multilink(R) Automix牯结系统与牙本质和纤维桩都形成紧密粘结.结论:自酸蚀、自固化牯结系统Multilink(R) Automix适合玻璃纤维桩的粘结.     

Multilink Automix粘结系统对玻璃纤维桩的粘结研究

目的：扫描电镜下观察和比较两种粘结系统粘结玻璃纤维桩后的粘结界面。方法：选取因牙周病拔除的单根管上前牙6颗,随机分为2组。分别使用Multilink Automix和One Step bonding system2种粘结系统粘结玻璃纤维桩,切割后扫描电镜下观察。结果：扫描电镜下,Multilink Automix粘结系统与牙本质和纤维桩都形成紧密粘结。结论：自酸蚀、自固化粘结系统Multilink Automix适合玻璃纤维桩的粘结。     

Influence of cutting instruments and adhesive systems on hybrid layer formation

Influence of cutting instruments and The aim of this study was to analyze the hybrid layer in noncarious dentin prepared by different cutting instruments and restored with composite resin. The cavities were randomly prepared in 40 specimens using a high-speed diamond bur (KG Sorensen 1013) and an ultrasonic tip (CVDentus C22). The cavities were restored with composite resin by varying the adhesive system between the Adper? Single Bond (2 x 1 system, primer+adhesive) and the Prompt L-Pop? (3 x 1 system, self-etching). The restorations were hemisected longitudinally and analyzed in the SEM (Scanning electron microscopy) in order to evaluate the hybrid layer and resinous tags characteristics, using scores ranging from 1 to 6. The Pearson test revealed a high correlation coefficient and good significance levels for both intra- and inter-raters values (r=0.90). The data were statistically analyzed using the Mann-Whitney test (P≤0.05). A larger proportion of regular hybrid layers with numerous tags were observed in the dentin prepared using the high-speed diamond burs and restored with a 2 × 1 adhesive system. Alternatively, the 3 × 1 adhesive system promoted the generation of a thin hybrid layer with few tags. After preparation using an ultrasonic tip revealed few or no tags after the preparation and 2 × 1 or 3 × 1 adhesive system application. The high-speed diamond burs produced a dentin surface that was more favorable to restorative material adhesion than the ultrasonic tips, regardless of the adhesive system used.