Comparison of Two Luting Agents Used for the Retention of Cast Dowel and Cores

PURPOSE: The first purpose of this study was to compare the retentive values of zinc phosphate and Panavia F resin cements when used for luting cast dowel and cores. The second purpose was to determine whether the use of a lubricant when making the resin pattern for a custom dowel and core would have an effect on the final retention of dowels cemented with either zinc phosphate or Panavia F cements. METHODS AND MATERIALS: Sixty-three caries-free extracted single-rooted human teeth were randomly divided into three groups of 21. Root canal preparations were standardized for all 63 teeth. Clinical protocols for fabricating and cementing dowel and core restorations were examined, comparing zinc phosphate and Panavia F resin cements. Direct dowel patterns were fabricated using the Para Post system and cast in a noble metal alloy. Group I dowel spaces were lubricated with GC lubricant prior to dowel pattern fabrication and cleaned with Cavidry solvent before cementing the cast dowel and core with zinc phosphate cement. Group II dowel spaces were rinsed with water only prior to dowel pattern fabrication. The dowels and cores in this group were cemented with Panavia F resin cement. Group III dowel spaces were lubricated with GC lubricant prior to dowel pattern fabrication; the dowel spaces were cleaned with Cavidry solvent before the cast dowel and cores were cemented with Panavia F cement. The tensile force necessary to remove the cast dowel and cores was determined using a universal testing machine. Results were statistically analyzed using one-way ANOVA and Tukey's HSD test. RESULTS: The dowels and cores in Group I had significantly higher retentive values than either of the two Panavia F groups (p< or = 0.001). No difference in retentive values (p > 0.05) was found between dowels luted with either of the lubricating agents in the Panavia F groups. CONCLUSIONS: Zinc phosphate cement had higher retentive values when cementing cast dowel and cores than Panavia F. The type of lubricant used for the resin dowel fabrication (water or GC lubricant that was removed with a solvent) had no effect on the retention of cast dowels cemented with Panavia F.     

Comparison of titanium dowel retention using four different luting agents

STATEMENT OF PROBLEM: Luting material, surface properties, and loading conditions affect the retention of prefabricated dowels to varying degrees. PURPOSE: The purpose of this study was to evaluate the effect of roughening of the dentinal walls and artificial aging on the retention of prefabricated tapered titanium dowels, using 4 different luting materials. MATERIAL AND METHODS: One-hundred twenty-eight single-rooted teeth were selected, the coronal aspect of each tooth was removed, and the remaining root received endodontic therapy. All specimens were divided into 4 groups (n=32). Dowel spaces were prepared to a depth of 10 mm using ISO 90 rotary cutting instruments. Tapered titanium dowels were luted with the following luting materials: zinc-phosphate cement (Harvard cement), glass-ionomer cement (Ketac Cem EasyMix), resin composite luting agent (Panavia 21) with autopolymerizing dentin primer (ED-Primer), or a self-adhesive composite luting agent (RelyX Unicem). Both composite luting agents were used without acid etching of the canal dentin. Each luting agent was used under 2 conditions: in 1 subgroup (n=16) the dentinal walls were not roughened, and in the other subgroup (n=16), walls were roughened with a diamond rotary cutting instrument. Eight specimens from each subgroup were stored in water at 37 degrees C for 3 days; the other 8 specimens were stored for 150 days and subjected to simulated aging conditions using 37,500 thermal cycles (5 degrees C/55 degrees C) and 300,000 mechanical loading cycles with 30 N. Dowel retention (N) was measured using a universal testing machine with a crosshead speed of 2 mm/min. Data were analyzed using 2- and 3-way ANOVAs and the Tukey HSD test (alpha=.05). RESULTS: The dislodged dowels were examined microscopically to evaluate mode of failure. The nonroughened dentinal walls showed no significant differences between the different luting agents. Roughening the dentinal walls increased the retention significantly for all groups. This increase was significantly higher for the resin composite groups (P=.0001). Storage for 150 days with thermal cycling and mechanical loading caused a significant decrease in dowel retention (P=.001). The failure mode was purely adhesive at the luting material-dentin interface for all dowels cemented in nonroughened root canals. A mixed failure mode, adhesive at the luting material-dentin interface and cohesive in the luting material, was observed for dowels cemented in roughened root canals. CONCLUSION: Roughening the dentinal walls and the use of resin luting cements provided statistically significant increases in dowel retention values.     

In vitro assessment of retention of four esthetic dowels to resin core foundation and teeth

STATEMENT OF PROBLEM: Several new esthetic dowel systems are currently available for the restoration of endodontically treated teeth. These dowel systems enhance the esthetic quality of all-ceramic restorations better than metallic dowel systems. PURPOSE: The purpose of this study was to evaluate the retentive strength of composite and ceramic endodontic dowel systems to the tooth and to the core foundation. MATERIAL AND METHODS: The following dowel systems were tested: resin dowels (Fibrekor [FR]; Luscent [LU]; Twin Luscent Anchor [TLU]); ceramic dowels (Cerapost [CR]; Cosmopost [CO]); and a titanium dowel (ParaPost XH [Ti]). In Part I of the study, core retention was tested by forming Bis-Core resin (n=12) cores around dowels followed by separation using a universal testing machine. In Part II, 60 (n=12) extracted human canines were endodontically treated, and dowel spaces were prepared using the corresponding drill for each dowel system. Nine-millimeter resin and ceramic dowels were cemented with C & B resin luting agent. Additionally, 2 groups (n=12) of Ti dowels cemented with C & B resin luting agent and zinc phosphate luting agent served as control groups. Retention was tested using a universal testing machine to separate the dowels from teeth. One-way analysis of variance and Student Newman-Keuls tests were conducted for statistical analysis (alpha=.05). Surface texture of all dowel systems tested was examined using SEM at original magnification x25 and x250. RESULTS: Core retention of Ti was higher than all esthetic dowels tested (alpha<.05), but FR had higher core retention than the other esthetic dowels tested. Resin dowels had better retention to teeth than ceramic dowels (alpha<.05). CONCLUSION: The esthetic dowel systems were less retentive for the resin core material than the titanium control. Resin dowel systems were more retentive in the root than the ceramic dowels but were similar to the titanium control.     

Effect of zirconium-oxide ceramic surface treatments on the bond strength to adhesive resin

STATEMENT OF PROBLEM: Surface treatment methods used for resin bonding to conventional silica-based dental ceramics are not reliable for zirconium-oxide ceramics. PURPOSE: The aim of this study was to compare the effects of airborne-particle abrasion, silanization, tribochemical silica coating, and a combination of bonding/silane coupling agent surface treatment methods on the bond strength of zirconium-oxide ceramic to a resin luting agent. MATERIAL AND METHODS: Sixty square-shaped (5 x 5 x 1.5 mm) zirconium-oxide ceramic (Cercon) specimens and composite resin (Z-250) cylinders (3 x 3 mm) were prepared. The ceramic surfaces were airborne-particle abraded with 125-microm aluminum-oxide (Al(2)O(3)) particles and then divided into 6 groups (n = 10) that were subsequently treated as follows: Group C, no treatment (control); Group SIL, silanized with a silane coupling agent (Clearfil Porcelain Bond Activator); Group BSIL, application of the adhesive 10-methacryloyloxydecyl dihydrogen phosphate monomer (MDP)-containing bonding/silane coupling agent mixture (Clearfil Liner Bond 2V/ Porcelain Bond Activator); Group SC, silica coating using 30-microm Al(2)O(3) particles modified by silica (CoJet System); Group SCSIL, silica coating and silanization (CoJet System); and Group SCBSIL, silica coating and application of an MDP-containing bonding/silane coupling agent mixture (Clearfil Liner Bond 2V/Porcelain Bond Activator). The composite resin cylinders were bonded to the treated ceramic surfaces using an adhesive phosphate monomer-containing resin luting agent (Panavia F). After the specimens were stored in distilled water at 37 degrees C for 24 hours, their shear bonding strength was tested using a universal testing machine at a crosshead speed of 0.5 mm/min. Debonded specimen surfaces were examined with a stereomicroscope to assess the mode of failure, and the treated surfaces were observed by scanning electron microscopy. Bond strength data were analyzed using 1-way analysis of variance and the Duncan test (alpha = .05). RESULTS: The bond strengths (mean +/- SD; MPa) in the groups were as follows: Group C, 15.7 +/- 2.9; Group SIL, 16.5 +/- 3.4; Group BSIL, 18.8 +/- 2.8; Group SC, 21.6 +/- 3.6; Group SCSIL, 21.9 +/- 3.9; and Group SCBSIL, 22.9 +/- 3.1. The bond strength was significantly higher in Group SCBSIL than in Groups C, SIL, and BSIL (P<.001), but did not differ significantly from those in Groups SC and SCSIL. Failure modes were primarily adhesive at the interface between zirconium and the resin luting agent in Groups C and SIL, and primarily mixed and cohesive in Groups SC, SCSIL, and SCBSIL. CONCLUSION: Tribochemical silica coating (CoJet System) and the application of an MDP-containing bonding/silane coupling agent mixture increased the shear bond strength between zirconium-oxide ceramic and resin luting agent (Panavia F).     

Effect of an adhesive resin luting agent on the dowel-head retention of three different core materials

STATEMENT OF PROBLEM: A dowel-and-core restoration may fail due to failure at either the dowel-tooth or dowel head-core material interface. Long-term clinical success of a dowel-and-core restoration depends on retention of both the dowel to the tooth and the dowel head to the core material. Thus, strengthening of the dowel head-core interface is important. PURPOSE: This study evaluated the retention between a prefabricated dowel and 3 different core materials with or without a dual-polymerized adhesive resin luting agent. MATERIAL AND METHODS: Sixty prefabricated dowels (Gold Plated Anchorage Post) were divided into 3 groups (n=20) consisting of 1 of 3 core materials, amalgam (Standalloy F), light-polymerized resin composite (Clearfil Ray), or glass ionomer (Chelon-Silver). Each core group was divided into 2 subgroups (n=10), and a dual-polymerized adhesive resin luting agent (Panavia F) was applied to the dowel heads of 1 of these subgroups before application of the core material. The manufacturing procedure was standardized by using a plastic index (4.5-mm internal diameter and 5-mm height) and a custom-made dowel holder, which held the dowel head. Prepared specimens were stored in water at room temperature for 3 months and then loaded to fracture in a universal testing machine with a crosshead speed of 0.05 mm/min until failure. Bond strengths were recorded (MPa). Data were analyzed with 2-way analysis of variance (ANOVA) in a 2 x 3 factorial randomized design (alpha=.05). Afterward, core material differences were computed with 1-way ANOVA for both of the bonded and nonbonded groups. Post hoc multiple comparisons were made with the Dunnett C multiple range test. RESULTS: Dowel-head retention values (MPa) of the tested core materials (mean +/- SD) from the highest to the lowest were as follows: bonded amalgam core, 296.1 +/- 108; bonded composite core, 284.3 +/- 38.3; nonbonded composite core, 177.0 +/- 53.7; nonbonded amalgam core, 128.5 +/- 35.0; bonded glass-ionomer core (GIC), 128.0 +/- 24.5; nonbonded GIC, 61.8 +/- 13.3. Two-way ANOVA revealed significant differences between the core material groups and between the bonded and nonbonded groups (P <.001). The interaction between the core material and bond variables was also significant (P =.018). One-way ANOVA revealed statistically significant differences between the bonded (P <.001) and also between the nonbonded core material groups (P <.001). Post hoc multiple comparisons showed that the dowel-head retention of the GIC was significantly weaker than the post-head retention for amalgam and resin composite, whether bonded or not. CONCLUSION: Within the limitations of this study, the adhesive resin luting agent tested appeared to have a significant strengthening effect on the dowel-head retention of the core materials.     

Finite element analysis of stresses in endodontically treated, dowel-restored teeth

STATEMENT OF PROBLEM: Endodontically-treated, dowel-restored teeth may experience fracture, but investigations of variables related to fracture are often inconclusive and occasionally contradictory. PURPOSE: The finite element method was used to analyze the stresses in dowel-restored teeth. The variables studied were material, shape, bonding, modulus of elasticity, diameter, and length of the dowel. MATERIAL AND METHODS: The model of the dowel-restored tooth involved dentin, ligament, cortical and trabecular bone, gingiva, and gutta-percha. The dowels were made of glass fiber, titanium, or zirconia and modeled as an approximation of the brands ParaPost Fiber White, ParaPost XH, and Cerapost, respectively. The dowel was cemented with zinc-phosphate cement or with bonded or nonbonded resin luting agents, and an approximation of the material properties of these 2 materials were used in the modeling. The restoration included a composite resin core and a gold crown. Other variables included taper versus parallel-sided posts, modulus of elasticity, diameter, and length of post. The model was axisymmetrical in 3 dimensions. A load of 100 N was applied to the crown at an angle of 45 degrees, and tensile, shear, and von Mises stresses were calculated. RESULTS: The generated stresses decreased with respect to the dowel material in the following order: glass fiber, titanium, and zirconia. Stresses were in general higher with tapered than with parallel-sided dowels. Stresses were reduced by bonding and with an increasing modulus of elasticity, increasing diameter, and increasing length of the dowel. CONCLUSIONS: Within the limitations of this study, it was found that all investigated dowel-related factors influenced the stress field generated in dowel-restored teeth.     

Tensile bond strength of cast commercially pure titanium dowel and cores cemented with three luting agents

PurposeThe purpose of this study was to compare the tensile strength of commercially pure titanium dowels and cores cemented with zinc phosphate or resin cements.MethodsTwenty-one extracted human canines were endodontically treated. The root preparations were accomplished using Largo reamers (10 mm in depth and 1.7 mm in diameter). Acrylic resin patterns for the dowel and cores were made, and specimens were cast in commercially pure titanium (n = 7) and divided in three groups: TZ–CP Ti dowels luted with zinc phosphate luting agent, TP–CP Ti dowels luted with Panavia F and TR–CP Ti dowels luted with RelyX U100. Tensile strengths were measured in a universal testing machine at a crosshead speed of 0.5 mm/min. The results (N) were statistically analyzed by ANOVA and Tukey tests (α = 0.01).ResultsThe ANOVA indicated that there were significant differences among the groups tested. A Tukey multiple comparison procedure was performed and revealed statistically significant higher retention values for the dowel luted with RelyX U100 when compared with zinc phosphate or Panavia F.ConclusionCast commercially pure titanium dowels and cores fixed with RelyX U100 cement presented superior bond strength retention when compared to zinc phosphate and Panavia F.     

In vitro evaluation of shear bond strengths of resin to densely-sintered high-purity zirconium-oxide ceramic after long-term storage and thermal cycling

STATEMENT OF PROBLEM: The few available studies on the resin bond to zirconium-oxide ceramic recommend airborne-particle abrasion and modified resin luting agents containing adhesive monomers for superior and long-term durable bond strengths. It is unknown whether this regimen can also be successfully applied to the intaglio surface of a commercial zirconia-based all-ceramic system. PURPOSE: The purpose of this study was to evaluate and compare bond strengths of different bonding/silane coupling agents and resin luting agents to zirconia ceramic before and after artificial aging. MATERIAL AND METHODS: Composite cylinders (2.9 mm x 3.0 mm) were bonded to airborne-particle-abraded intaglio surfaces of Procera AllZirkon specimens (n=80) with either Panavia F (PAN) or Rely X ARC (REL) resin luting agents after pretreatment with Clearfil SE Bond/ Porcelain Bond Activator (Group SE). In another group, Rely X ARC was used with its bonding/silane coupling agent (Single Bond/Ceramic Primer, Group SB). PAN without any bonding/silane agent (Group NO) was the control. Subgroups of 10 specimens were stored in distilled water for either 3 or 180 days before shear bond strength was tested. One hundred eighty-day-old specimens were repeatedly thermal cycled for 12,000 cycles between 5 and 60 degrees C with a 15-second dwell time. Data were analyzed with 1- and 2-way analysis of variance and the Tukey multiple comparisons test (alpha=.05). Failure modes were examined under original magnification x25. RESULTS: After 3 days, SE-REL (25.15 +/- 3.48 MPa) and SE-PAN (20.14 +/- 2.59 MPa) groups had significantly superior mean shear bond strengths (P=.0007) compared with either NO-PAN (17.36 +/- 3.05 MPa) or SB-REL (16.90 +/- 7.22 MPa). SE-PAN, NO-PAN, and SB-REL groups were not significantly different. Artificial aging significantly reduced bond strengths. After 180-day storage, SE-PAN (16.85 +/- 3.72 MPa), and SE-REL (15.45 +/- 3.79 MPa) groups demonstrated significantly higher shear bond strengths than NO-PAN (9.45 +/- 5.06 MPa) or SB-REL (1.08 +/- 1.85 MPa) groups. The modes of failure varied among 3-day groups but were 100% adhesive at the ceramic surfaces after artificial aging. CONCLUSION: Artificial aging significantly reduced bond strength. A bonding/silane coupling agent containing an adhesive phosphate monomer can achieve superior long-term shear bond strength to airborne-particle- abraded Procera AllZirkon restorations with either one of the 2 resin luting agents tested.     

Comparative evaluation of fracture resistance of structurally compromised canals restored with different dowel methods

Purpose: The objective of this in vitro study was to evaluate and compare the fracture resistance and fracture mode of endodontically treated teeth with wide root canals restored with various dowel methods. Materials and Methods: Fifty human uniradicular mandibular premolar teeth were decoronated and endodontically treated. The canals were widened with diamond points. The specimens were divided into five groups on the basis of type of dowel method used: conventional custom‐made cast metal dowel; single glass fiber‐reinforced resin dowel; glass fiber‐reinforced resin dowel with accessory fiber dowels; relined glass fiber‐reinforced resin dowel; and dowels formed with the help of polyethylene fiber ribbon‐reinforced resin composite. Specimens were restored with indirect composite crowns, and 150,000 cycles of cyclic loading were applied. The specimens were loaded to test the fracture resistance and fracture mode (repairable and nonrepairable). Results: The cast metal dowel groups had the highest fracture resistance but showed nonrepairable fracture in 90% of specimens. Conclusions: Cast metal dowels had the highest fracture resistance but led to nonrepairable fracture while restoring the wide root canals under cyclic loading. Specimens restored with fiber dowels, accessory dowels, relined dowels, and ribbon‐reinforced resin provided adequate fracture resistance with increased incidence of repairable fractures.     

A Review of Failure Modes in Teeth Restored with Adhesively Luted Endodontic Dowels

Purpose: Previous clinical studies indicated loss of retention between dowel and tooth was a major cause of failure for passive endodontic dowels. Advances in luting cement technology may have improved the retention of dowels. The purpose of this systematic review was to determine the clinical failure modes for dowel/core/crown restorations luted using resin‐based cements that are either self‐etching or used in conjunction with a bonding agent. Materials and Methods: PubMed was searched for English language, peer‐reviewed clinical research following restorations for 2 years or longer. For inclusion, a study group must have followed more than 50 permanent teeth restored using a dowel luted with resin cement and a bonding agent. Furthermore, more than 80% of the restorations must have received a nonresin crown. Results: Fifteen studies met the inclusion criteria and reported a total of 187 failures from 3046 restorations. The commonly reported causes of failure were dowel debonding (37% of all failures and primary cause in 8 of the 17 reporting study groups) and endodontic lesions (37% of all failures and primary cause in 6 of the 11 reporting study groups). Conclusions: Loss of retention remains a major mode of failure even for passive, nonmetal dowels luted by resin cements with a bonding agent. The exact nature and underlying causes of debonding have not been adequately investigated.     

An in vitro comparison of tensile bond strengths of noble and base metal alloys to enamel

STATEMENT OF PURPOSE: Many different surface treatments have been used to increase the bond strength of noble and base metal alloys to enamel, but only a few have been studied. PURPOSE: The purpose of this in vitro study was to compare the tensile bond strength of a tin-plated noble alloy, an Alloy Primer-treated noble alloy, and an airborne particle-abraded base metal alloy, all bonded to enamel with a phosphate-methacrylate resin luting agent. MATERIAL AND METHODS: Seventy noncarious molar teeth were extracted, cleaned, and embedded in autopolymerizing acrylic resin with the buccal surface of the teeth exposed. Seventy wax patterns (4-mm diameter x 2-mm thickness) were waxed, invested, and cast-50 with a noble alloy (Argedent 52) and 20 with a base metal alloy (Argeloy N.P.). Twenty of the noble alloy specimens were tin-plated (TP), 20 noble alloy specimens were treated with Alloy Primer (AP), and 20 base metal alloy specimens were airborne particle abraded (AA). All specimens were luted with a phosphate-methacrylate resin luting agent (Panavia F) and stored in 100% humidity at 37 degrees C, half for 24 hours and half for 7 days. Ten noble alloy specimens were tin-plated and stored in water for 48 hours (aged) before cementation and then stored in water for 24 hours after cementation. These specimens were used to test whether there is an advantage to aging the tin-plated surface in water before cementation. All specimens were thermocycled (5 degrees to 55 degrees C) for 500 cycles and then tested for tensile bond strength (TBS), measured in MPa, with a universal testing machine at a crosshead speed of 0.5mm/min. Various castings (n=6 per test group) were randomly selected from each group and inspected under a scanning electronic microscope to determine mode of failure. The mean values and standard deviations of all specimens were calculated for each group. A 2-way analysis of variance (ANOVA) was performed, and multiple pairwise comparisons were then completed with post hoc Tukey test (alpha=.05). RESULTS: The TBS of the tin-plated noble alloy specimens bonded to enamel (24 hours: 9.33 +/- 1.31 MPa; 7 days: 11.65 +/- 1.55 MPa) was significantly greater than the Alloy Primer noble alloy specimens (24 hours: 6.11 +/- 1.01 MPa; 7 days: 5.45 +/- 1.22 MPa) (P <.001). The Alloy Primer noble alloy group showed the lowest TBS compared with the tin-plated noble alloy and airborne particle-abraded base metal alloy group (24 hours: 10.61 +/- 1.41 MPa; 7 days: 6.94 +/- 1.40 MPa). The tin-plated noble alloy specimens showed greater TBS after storage for 7 days in distilled water compared with storage for 24 hours (24 hours: 9.33 +/- 1.31 MPa; 7 days: 11.65 +/- 1.55 MPa). Aging the tin-plated noble alloy for 48 hours in 37 degrees C (9.17 +/- 1.68 MPa) prior to cementation did not increase the TBS to enamel. The airborne particle-abraded base metal alloy showed significantly lower TBS at the 7-day storage time compared to the 24-hour storage time (24 hours: 10.61 +/- 1.41 MPa; 7 days: 6.94 +/- 1.40 MPa) (P <.001). SEM examination of the debonded metal and enamel surfaces showed mixed (adhesive and cohesive) failures for all groups. CONCLUSION: Tin-plating a noble alloy produced the highest bond strength to enamel. Storing the tin-plated noble alloy in 37 degrees C distilled water for 48 hours before cementation did not result in a change in TBS. Using an Alloy Primer with a noble alloy resulted in statistically significant lower TBS than tin-plating.     

In vitro evaluation of long-term bonding of Procera AllCeram alumina restorations with a modified resin luting agent

STATEMENT OF PROBLEM: Bonded densely sintered aluminum oxide ceramic restorations such as Procera AllCeram laminates rely on a strong and long-term durable resin bond. Air particle abrasion and a phosphate-modified resin luting agent have the potential to provide such bonds to aluminum oxide ceramics, but their efficacy on the Procera AllCeram intaglio surface is unknown. The inherent microroughness of this surface may influence bond strengths, because micromechanical interlocking is a main contributor for adhesion of resins to ceramic materials. PURPOSE: This study evaluated the bond strength of a phosphate-modified resin luting agent with and without silanization to an air particle-abraded Procera AllCeram intaglio surface compared with a conventional resin-bonding system before and after artificial aging. MATERIAL AND METHODS: Sixty square (10 x 10 x 2 mm) specimens of Procera AllCeram alumina ceramic with the Procera intaglio surface were air particle abraded with aluminum oxide. Composite cylinders (2.9 mm in diameter and 3.0 mm in width) were fabricated with Z-250 composite and bonded to the ceramic specimens with either Panavia 21 TC or Rely X ARC (control) and their corresponding bonding/silane coupling agents. In addition, Panavia was used without silanization as suggested in similar studies. Subgroups of 10 specimens were stored in distilled water for either 3 or 180 days before shear bond strength was tested with a universal testing machine (MPa) until fracture. The 180-day specimens were subjected to thermocycling at 2000 cycles every 30 days (12,000 cycles total). Data were analyzed with 1-way analysis of variance and Tukey's multiple comparison (alpha=.05). Failure modes were examined with a light microscope (original magnification x 25). RESULTS: Differences between short-term and long-term groups were highly significant (P=.000). Bond strength with Rely X ARC and its silane coupling agent (22.75 +/- 4 MPa) decreased significantly (P=.000) after artificial aging (3.32 +/- 3.62 MPa). Panavia 21 after silanization revealed significantly different (P=.003) early (21.42 +/- 4.3 MPa) and late (16.09 +/- 2.37 MPa) bond strengths but achieved the highest bond strength after artificial aging. Bond strengths of Panavia without silanization both early (8.06 +/- 2.1 MPa) and late (6.91 +/- 2.49 MPa) were not significantly different. Failure modes were mainly adhesive at the ceramic surface for all groups. CONCLUSION: Panavia 21 in combination with its corresponding bonding/silane coupling agent can achieve an acceptable resin bond to the air particle-abraded intaglio surface of Procera AllCeram restorations after artificial aging, which had mixed effects on the other investigated groups. The conventional resin luting agent revealed the most dramatic decrease in bond strength.     

Bonding to densely sintered alumina surfaces: effect of sandblasting and silica coating on shear bond strength of luting cements

PURPOSE: An important determinant of the clinical success of ceramic restorations is the bond strength of the luting agent to the seating surface and the prepared tooth structures. Manufacturers of ceramic systems frequently specify both the luting agent and preluting treatment of the seating surface of the crown. Procera AllCeram is an all-ceramic crown comprising a porcelain-veneered coping of densely sintered, high-purity aluminum oxide. This study evaluated the shear bond strength of 4 luting agents: zinc-phosphate, glass-ionomer, resin-modified glass-ionomer, and resin cement (dual cured) to Procera aluminum oxide coping material. The luting agents were subjected to different surface treatments: untreated, sandblasted, or silica coated by the Rocatec system. MATERIALS AND METHODS: Cylindric and cubic specimens of the coping material were luted together, and the shear force necessary to separate the cylinder from the cube was measured with a universal testing machine. The surfaces of the specimens were also analyzed. RESULTS: No significant differences were recorded for the shear bond strengths of the luting agents to the untreated aluminum oxide. Glass-ionomer and the resin-modified glass-ionomer cements had the highest values (4.2 +/- 2.5 MPa and 4.3 +/- 1.9 MPa, respectively), and the lowest were 3.3 +/- 2.3 MPa for the resin cement and 3.2 +/- 1.0 MPa for the zinc-phosphate cement. Similar results were recorded for the sandblasted aluminum oxide surfaces, except with the glass-ionomer, which was significantly higher (12.9 +/- 2.4 MPa). For all 4 luting agents, the highest shear bond strength values were recorded for the silica-coated specimens; the highest was for the resin cement, at 36.2 +/- 7.8 MPa. CONCLUSION: The bond strengths between resin cement and aluminum oxide specimens treated by the Rocatec system were significantly higher than those of the other materials and surface treatments evaluated.     

Bonding between resin luting cement and glass infiltrated alumina-reinforced ceramics with silane coupling agent

The purpose of this study was to evaluate the shear bond strengths of three dual-cured resin luting cements (Linkmax HV, Panavia Fluoro Cement, and RelyX ARC) to glass-infiltrated alumina-reinforced ceramic material and the effect of four silane coupling agents (Clearfil Porcelain Bond, GC Ceramic Primer, Porcelain LinerM, and Tokuso Ceramic Primer) on the bond strength. The two type-shaped of In-Ceram alumina ceramic glass-infiltrated specimens were untreated or treated with one of the four ceramic primers and then cemented together with one of the three dual-cured resin luting cements. Half of the specimens were stored in water at 37 degrees C for 24 h and the other half thermocycled 20,000 times before shear bond strength testing. Surface treatment by all silane coupling agents improved the shear bond strength compared with non-treatment. The specimens treated with Clearfil Porcelain Bond showed significantly greater shear bond strength than any of the other three silane coupling agents regardless of resin luting cements and thermocycling except for the use of Panavia Fluoro Cement at 20,000 thermocycles. When the alumina-reinforced ceramic material was treated with any silane coupling agent except GC Ceramic Primer and cemented with Linkmax HV, no significant differences in bond strength were noted between after water storage and after 20,000 thermocycles. After 20,000 thermocycles, all specimens except for the combined use of Clearfil Porcelain Bond or GC Ceramic Primer and Linkmax HV and GC Ceramic Primer and Panavia Fluoro Cement showed adhesive failures at the ceramic-resin luting cement interface.     

Fatigue resistance of endodontically treated teeth restored with three dowel-and-core systems

STATEMENT OF PROBLEM: The successful restoration of endodontically treated teeth is enhanced by a crown design employing the ferrule effect. However, it is unclear which dowel-and-core system most effectively supports successful treatment. PURPOSE: The purpose of this study was to compare the load fatigue resistance of 3 dowel-and-core systems. MATERIAL AND METHODS: Fifteen endodontically treated maxillary central incisors were sectioned perpendicular to the long axis at a point 1.5 mm incisal to the cemento-enamel junction (CEJ). At the level of the CEJ, specimens were then prepared for crowns with 1-mm complete shoulder finish lines and 1.5 mm of axial wall height. The prepared teeth were divided into 3 groups (n=5) and restored with 1 of the following dowel-and-core combinations: Group CG, cast gold dowels and cores; Group TA, titanium alloy dowels (ParaPost XH) with composite cores; or Group FR, fiber-reinforced resin dowels (ParaPost FiberWhite) with composite cores. A dentin bonding agent (OptiBond Solo) was placed prior to the composite cores. Dowel-and-core castings and titanium alloy dowels were cemented with zinc phosphate cement. The fiber-reinforced dowels were cemented with a resin cement (ParaPost Cement). The crowns for all specimens were cast with an incisal notch for applying the fatigue load. The independent variable measured was the number of load fatigue cycles required to cause luting cement failure. The data were subjected to 1-way analysis of variance and the Student-Newman-Keuls test for 3 subsets (alpha=.05). RESULTS: The mean value+/-standard deviation for the cycles to failure for each group was: Group CG: 11,897+/-4080 load cycles, Group TA: 24,384+/-8231 load cycles, and Group FR: 50,696+/-7063 load cycles. Significant differences were found between all groups ( P<.05). CONCLUSIONS: Fiber-reinforced resin dowels and bonded composite cores under fatigue loading provided significantly stronger crown retention than cast gold dowels and cores and titanium alloy dowels with composite cores under fatigue loading.     

Evaluation of load at fracture of Procera AllCeram copings using different luting cements.

PURPOSE: The current study investigated the effect of different luting agents on the fracture resistance of Procera AllCeram copings. METHODS: Six master dies were duplicated from the prepared maxillary first premolar tooth using nonprecious metal alloy (Wiron 99). Thirty copings (Procera AllCeram) of 0.6-mm thickness were manufactured. Three types of luting media were used: zinc phosphate cement (Elite), glass ionomer cement (Fuji I), and dual-cured composite resin cement (Panavia F). Ten copings were cemented with each type. Two master dies were used for each group, and each of them was used to lute five copings. All groups were cemented according to manufacturer's instructions and received a static load of 5 kg during cementation. After 24 hours of distilled water storage at 37 degrees C, the copings were vertically compressed using a universal testing machine at a crosshead speed of 1 mm/min. RESULTS: ANOVA revealed significant differences in the load at fracture among the three groups (p < 0.001). The fracture strength results showed that the mean fracture strength of zinc phosphate cement (Elite), glass ionomer cement (Fuji I), and resin luting cement (Panavia F) were 1091.9 N, 784.8 N, and 1953.5 N, respectively. CONCLUSION: Different luting agents have an influence on the fracture resistance of Procera AllCeram copings.     

Shear strength of resin developed by four bonding agents used with cast metal restorations.

The evolution of the acid etch technique has made possible a more conservative approach to the fabrication of cast metal restorations. The resin bonding technique, however, places a greater burden for success on the selection of a bonding agent. This study examined the shear bond strength durability of cast metal restorations bonded to tooth structure with one of four metal adhesive bonding agents. Results indicated stronger bonds for restorations cemented with Panavia EX bonding agent than with any of the other bonding agents tested, both with and without exposure to thermal stress. Although it was one of the easier materials with which to work, Panavia EX bonding agent requires the additional step of applying an agent to prevent oxygen contact in the setting process.     

Effect of dentin bonding and ferrule preparation on the fracture strength of crowned teeth restored with dowels and amalgam cores

STATEMENT OF PROBLEM: It is necessary to obtain an adequate bond at the core/dentin junction where the majority of failures occur. The effect of recently developed dentin bonding agents on the fracture resistance of endodontically treated teeth at the amalgam core/dentin junction is unclear. PURPOSE: The purpose of this study was to evaluate the effects of 2 dentin bonding agents and a ferrule preparation on the fracture resistance of crowned mandibular premolars incorporating prefabricated dowel and silver amalgam cores. MATERIAL AND METHODS: Sixty extracted mandibular second premolars were divided into 6 groups of 10 each. The coronal portion of each tooth was removed at the cemento-enamel junction (CEJ) in the first 3 groups. In the other groups, teeth were sectioned 1 mm above the CEJ to create a ferrule. After root canal preparations, prefabricated dowels (ParaPost) were placed. The first group served as a control and was tested without application of bonding agents and without incorporation of a ferrule design. In the second and third groups, respectively, an autopolymerizing adhesive (Superbond D-Liner) and a dual-polymerizing adhesive (Panavia F) were applied to tooth surfaces before restorative procedures. For the fourth (ferrule) group, no bonding agent was applied, but a 1-mm ferrule preparation was used. In the fifth (ferrule+D-Liner) and sixth (ferrule+Panavia F) groups, respectively, autopolymerizing and dual-polymerizing bonding agents were used in conjunction with the ferrule preparation. After amalgam core fabrication, Ni-Cr full cast crowns for each group were prepared and cemented. All specimens were stored in water for 1 week and thermal cycled 1000 times between 5 degrees and 55 degrees C. A compressive shear load was applied at an angle of 135 degrees to the crown, and the maximum load at fracture (N) was recorded. The data were analyzed with 1-way ANOVA and Tukey Honestly Significant Difference tests (alpha=.05). RESULTS: Significantly higher fracture strength values were demonstrated for the ferrule+Panavia F (652.5 N), ferrule+D-liner (649.1 N) and ferrule (592.4 N) groups, respectively, than for the other groups. The next highest fracture strength values were found for the D-Liner (485.0 N) and Panavia F (486.3 N) groups. The control group (376.6 N) demonstrated the lowest fracture strength in all test groups (P<.001). CONCLUSION: A ferrule preparation or a bonding agent designed for silver amalgam core-dentin bonding can each increase the fracture strength for teeth receiving cast crowns after endodontic therapy and dowel and amalgam core restorations.     

The Retention of Cast Metal Dowels Fabricated by Direct and Indirect Techniques

Purpose: To explore the effect of fabrication technique, cement type, and cementation procedure on retention of cast metal dowels.
Methods and Materials: Eighty intact single-rooted teeth were selected. The clinical crown was removed at the cementoenamel junction level. Each root was prepared to receive a cast metal dowel of 10-mm length and 1.45 mm in diameter. The 80 specimens were divided into two major groups of 40 based on fabrication technique (direct and indirect). Each group was further divided into four subgroups of ten based on the cement type (zinc phosphate and glass ionomer), and cementation procedure (with and without lentulo spiral). The dowels were subjected to a constantly increasing tensile force, in a universal Instron testing machine, at crosshead speed of 5 mm/min until failure.
Results: The most significant factor to affect retention was the cementation procedure, as cementation with lentulo spiral produced greater retention than cementation without the use of lentulo spiral ( p < 0.05); however, there seems to be a close interaction between fabrication technique, cement type, and cementation procedure ( p = 0.051). The least retentive group was the one fabricated by direct technique, cemented with zinc phosphate without the use of lentulo spiral.
Conclusion: Fabrication technique does not affect retention of cast dowels, except when zinc phosphate was the luting agent and placed in the canal space without using a lentulo spiral. The cementation procedure had a significant effect on retention; thus, it is recommended that cementation should be done using the lentulo spiral.     

Effect of surface treatment of titanium posts on the tensile bond strength.

OBJECTIVES: Retention of composite resins to metal can be improved when metal surfaces are conditioned. The purpose of this investigation was to investigate the effect of two conditioning treatments on the tensile bond strength of four resin-based luting cements and zinc phosphate cement to titanium posts. METHODS: The effect on tensile bond strength of (1) air-particle abrasion (50 microm Al2O3) and (2) silica coating (30 microm SiO(x)) and silanization of tapered titanium posts prior to luting with any of the four resin composite luting cements (Compolute) Aplicap, Flexi-Flow cemTM, Panavia 21 EX, Twinlook) were evaluated. The posts luted with zinc phosphate cement (Tenet) were considered as the control group. Following endodontic preparation of 100 intact anterior human teeth with hand instruments, the post spaces were prepared using the opening drills of the corresponding size of the posts. All posts were cemented into the roots according to the manufacturer's instructions of each cement. The specimens were first stored in water at 37 degrees C for 24 h and then subjected to thermocycling (5000 cycles, 5-55 degrees C, 30 s). The tensile strength values were measured on a universal testing machine at a cross-head speed of 0.5 mm/min. Data were analyzed statistically using ANOVA and corrected with Scheffé-test due to the significance levels (P<0.05). RESULTS AND SIGNIFICANCE: The composite resin luting cements did not show significant differences (P<0.05) showing values between (352+/-76N-475+/-104N) when the posts were air-abraded. After silica coating and silanization, significantly higher (P<0.05) tensile strengths were obtained for Compolute Aplicap (600+/-123N) than those of the other luting cements (Flexi-Flow cemTM: 191+/-62N; Panavia 21 EX: 375+/-77; Twinlook: 430+/-78N). No significant differences (P>0.05) were found between the tensile strength of the posts luted with zinc phosphate (414+/-102N) and the resin composite cements. Silica coating and silanization revealed the highest tensile bond strength in posts luted with Compolute Aplicap but it was not effective for the other experimental groups. Zinc phosphate cement exhibited tensile bond strength as good as resin composite cements.