Use of anatomic post and core for reconstructing an endodontically treated tooth: a case report

A clinical case is presented in which a new type of fiber post was used in combination with the proprietary dual-curing resin cement to bond in a wide, nonrounded root canal. The anatomic post was inserted and the relining resin photopolymerized. The anatomic post was then removed and a luting procedure was performed, as for any other translucent post. The clinical procedure was simple, and a superior fit to the root canal walls was achieved, thus reducing the amount of cement needed. The luting procedure described can be proposed as a clinical technique for routine use when the prepared root canal is too wide or not perfectly round.     

EFFECT OF RELINING ON FIBER POST RETENTION TO ROOT CANAL

One of the clinically relevant problems dentists face when restoring endodontically treated teeth is the mismatch between fiber post and post space diameters, which results in an excessively thick resin cement layer. Fiber post relining appears as a solution for this problem.

Objectives:

The aim of this study was to evaluate the effect of fiber post relining with composite resin on push-out bond strength.

Material and Methods:

Twenty bovine incisors were selected to assess post retention. The crowns were removed below the cementoenamel junction and the root canals were treated endodontically and flared with diamond burs. The roots were allocated into two groups (n=10): G1: fiber posts without relining and G2: fiber posts relined with composite resin. The posts were cemented with a dual-cured resin cement and the specimens were sectioned transversally. Three 1.5-mm thick slabs were obtained per root and identified as cervical, medium and apical thirds. The push-out test was performed at a crosshead speed of 0.5 mm/min until post dislodgement occurred. The failure mode of fractured specimens was analyzed under scanning electron microscopy. Data were analyzed by split-plot ANOVA and post-hoc Tukey''s test at a pre-set alpha of 0.05.

Results:

Relined fiber posts presented higher retention values than non-relined post in all thirds. No statistically significant differences (p>0.05) were found among thirds for relined posts. All failures occurred at the interface between resin cement and root dentin.

Conclusions:

Relining with composite resin seems to be an effective method to improve the retention of fiber posts to flared root canals.     

Efficacy of a self-curing adhesive-resin cement system on luting glass-fiber posts into root canals: an SEM investigation

PURPOSE: The aim of this study was to evaluate the efficacy of a new bonding-luting system in resin tag, adhesive lateral branch, and hybrid layer formation when used in combination with an experimental fiber post. MATERIALS AND METHODS: Thirty anterior teeth extracted for periodontal reasons were selected for this study. They were endodontically treated and randomly divided into three groups of 10 samples each: group 1 = Excite light-cured bonding agent in combination with Variolink II resin cement; group 2 = Excite dual-cured bonding agent self-activated by an experimental microbrush in combination with MultiLink resin cement; and group 3 = one-step bonding system in combination with Dual Link resin cement. In groups 1 and 3, the primer-adhesive solution was light cured before placing the resin cement and the post, whereas in group 2 the adhesive/luting materials were not light cured. Twenty FRC Postec translucent posts (groups 1 and 2) and 10 EndoAesthetic translucent fiber posts (group 3) were used. One week later, the root samples were processed for scanning electron microscopic (SEM) observations. RESULTS: Microscopic examinations of restored interfaces from group 2 revealed a resin-dentin interdiffusion zone higher than that seen in samples from groups 1 and 3 (P < .05). At the apical and middle thirds, the samples from group 2 showed significantly more resin tags than the other two groups. CONCLUSION: The dual-cure self-activating system showed a more uniform resin tag and resin-dentin interdiffusion zone formation along root canal walls than light-curing systems.     

Comparison between two clinical procedures for bonding fiber posts into a root canal: a microscopic investigation

The purpose of this study was to evaluate the influence of two brushes used as carriers of a primer-adhesive solution as to the formation of resin tags, adhesive lateral branches, and a hybrid layer when used to bond translucent fiber posts. Twenty endodontically treated teeth, extracted for periodontal reasons, were used. The samples were randomly divided into two groups of 10 samples each (Group 1: Microbrush + Scotchbond 1 + Rely X ARC resin cement; Group 2: small plastic brush + Scotchbond 1 + Rely X ARC resin cement). The adhesive system and resin cement were used strictly following manufacturers' instructions. The priming-adhesive solution of the one-bottle system was light-cured before placing the resin cement and the post. Twenty translucent fiber posts were used. After luting procedures, root samples were processed for SEM observations. The adhesive system showed a resin dentin interdiffusion zone (RDIZ), resin tag, and adhesive lateral branch formation. Microscopic examination of restored interfaces of group 1 showed a higher percentage (p < 0.05) of RDIZ than those found in samples of group 2. In group 1 samples, RDIZ morphology was well detectable and uniform in all thirds of the root canals. In group 2, RDIZ was not visible in the apical third. No statistically significant differences were found among the two groups coronally and at the middle third, but the apical third of group 1 showed significantly more resin tag formation than group 2. The characteristic reverse cone shape of resin tags was always noted in the coronal and middle third of the root canals of both groups and in the apical third of group 1. In the apical third of group 2 root canals, the resin tags showed a less uniform morphology and a shorter length than those found in the other observed thirds.     

A one step procedure for luting glass fibre posts: an SEM evaluation

AIM: To evaluate the ability of two luting procedures for bonding translucent fibre posts to form resin tags, adhesive lateral branches, and resin dentine interdiffusion zones (RDIZ). METHODOLOGY: Forty root filled teeth, extracted for periodontal reasons, were selected for the study. The teeth were randomly divided into four groups of 10 each. Group 1: One Step, light-cured (LC) 20 s + dual link resin cement (LC 20 s); group 2: One Step, not light-cured (NLC) + dual link resin cement (LC 30 s); group 3: One Step (NLC) + dual link resin cement (LC 60 s); group 4: One Step (NLC) + dual link resin cement (LC 90 sec). Forty translucent fibre posts (DT posts, RTD) were inserted. Then, root specimens were processed for scanning electron microscope (SEM) observations to assess the continuity of the RDIZ, the presence or absence of gaps and the density and morphology of resin tags using a four-step scale method. RESULTS: With all luting procedures the formation of a RDIZ occurred. However, the microscopic examination of adhesive interfaces revealed that the percentage of RDIZ was significantly higher in group 1 than in the other three groups (P < 0.05). Group 4 had a higher percentage of RDIZ than group 3, which in turn exhibited a greater percentage than group 2, but these differences were not statistically significant (P > 0.05). Resin tag formation was evident in all the groups. The characteristic reverse cone shape of resin tags was always noted in the coronal and middle third of all groups, and in the apical third of group 1. In the apical third a shorter length and a less uniform appearance of resin tags were noted in groups 2, 3 and 4. CONCLUSIONS: In this laboratory study, when bonding a translucent fibre post into a root canal, the luting procedure including light curing of the adhesive solution before the placement of the cement was more satisfactory, from a SEM standpoint, than the procedure involving the simultaneous curing of adhesive and cement (one step procedure).     

Evaluation of early resin luting cement damage induced by voids around a circular fiber post in a root canal treated premolar by integrating micro-CT,finite element analysis and fatigue testing

Objective

This study utilizes micro-CT image combined with finite element (FE) analysis and in vitro fatigue testing to investigate the mechanical behavior associating with early resin luting cement damage induced by voids around a circular fiber post in a root canal treated premolar.

Morphological study of fiber-reinforced post-bonding system-root dentin interface by evaluation of two bonding systems

Morphological study of fiber post/bonding system/root dentin interface by evaluation of two bonding systems. OBJECTIVES: The aim of the study was to analyze the interfaces, and thus the seal, between root dentin and bonded fiber-reinforced posts. The interfaces were obtained by applying two enamel-dentin adhesive systems, a one-bottle system used after application of phosphoric acid and a self-etch system, both used with an adhesive cement. The interface was evaluated by SEM observation of the continuity of the hybrid layer and the morphology of the resin tags, in terms of length, density and presence of side branches, at the interface between the fiber-reinforced post, the bonding system and the root dentin. METHODS: Twenty-six anterior single-rooted teeth extracted for periodontal reasons were treated endodontically and then randomly separated into two groups of 13 teeth each: group 1: Excite DSC (Ivoclar Vivadent, Liechtenstein); group 2: AdheSE DC (Ivoclar Vivadent, Schaan, Liechtenstein). After preparation of the root canal and application of the adhesive, each specimen received a Postec translucent FRC post (Ivoclar Vivadent, Schaan, Liechtenstein) that was cemented in with Variolink II dual-curing luting composite (Ivoclar Vivadent, Schaan, Liechtenstein). The specimens were then prepared for SEM observation of the continuity of the hybrid layer and scoring of the morphology of the resin tags in each third of the root (at 1, 4.5 and 8mm from the coronal surface). RESULTS: There was no significant difference (at p<0.05) between the two groups in terms of continuity of the hybrid layer or morphology of the resin tags. The hybrid layer was present, unbroken and uniform in both the group where adhesive was used with a phosphoric acid total etch and the self-etch system group. Whatever the bonding system, the resin tags had side branches, and greater length and density in the cervical third than in the middle or apical thirds. Bubbles were found in the cement layer in most of the specimens. CONCLUSIONS: The one-bottle and self-etch bonding systems gave similar results in terms of interface morphology when a translucent fiber-reinforced post was cemented into the endodontically prepared roots.     

The effect of resin cement film thickness on the pullout strength of a fiber-reinforced post system

STATEMENT OF PROBLEM: Debonding is a common cause of failure encountered with fiber posts and usually occurs along the post space-dentin adhesive interface. The ideal thickness of the resin cement needed to improve retentive bond strength is unknown. PURPOSE: The purpose of this study was to evaluate the effect of 4 different post-space diameters and related resin cement film thicknesses on the bond strength between fiber posts and root dentin. MATERIAL AND METHODS: Eighty human maxillary central incisors with similar root lengths were selected, sectioned at the cemento-enamel junction, and the roots were treated endodontically. The roots were divided into 4 groups (n=20), and the post spaces were prepared to a depth of 8 mm using 1 of 4 different drills with a different diameter: Torpan drill ISO 90 for the control group (D90); and Torpan Drill ISO 100 (D100), Torpan Drill ISO 120 (D120), or Enapost Drill ISO 140 (D140) for the 3 test groups. Quartz fiber posts (Endo Lightpost), 0.9 mm in apical diameter, were luted (Panavia 21) in each specimen after dentin bonding procedures. The specimens were then subjected to a pullout test using a universal testing machine at a crosshead speed of 1.0 mm/min, and the maximum force required to dislodge each post was recorded (N). Data were analyzed using 1-way ANOVA and Tukey multiple comparisons tests (a=.05). RESULTS: The mean bond strength values (SD) in N for the experimental groups D100 (181.7 (55.3)) and D120 (210.7 (55.0)) were higher (P=.036 and <.001, respectively) than that obtained for the D90 control group (138.5 (49.2)). The lowest mean value was recorded for the D140 group (91.1 (36.0)). All experimental groups showed significantly different results, when compared to the control group. A multiple comparison between experimental groups showed significant differences (P<.001). Only the comparison between D100 versus D120 was not significant. CONCLUSIONS: Data suggest that the resin cement film thickness influences the pullout strengths of fiber-reinforced posts. For the selected quartz fiber-reinforced post and resin luting cement, the highest bond strength values were not obtained when the thinnest cement layer was tested (D90) but when oversized post spaces were used (D100-D120). However, when the cement film thickness was too great (D140), the dislocation resistance of fiber-reinforced posts was significantly decreased.     

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.     

五种纤维桩/Panavia F粘接剂/牙本质之间微观机械固位研究

目的通过微拉伸实验和粘接界面的扫描电镜观测,研究五种纤维桩的桩核材料/粘结剂/牙本质之间的微观机械固位强度与形态。方法五种纤维桩：NTI-Kahla Fiber,Twin Luscent Anchors,Tenax Fiber White,PD Tapered Crown Post和Ouya FiberⅠ型。每组10支纤维桩,使用Panavia F粘结至经过常规根管充填和桩核修复根管预备后的下颌前磨牙根管内,其中5个样本扫描电镜下观测纤维桩/粘结剂/牙本质之间结合界面形态,另5个样本进行微拉伸实验,并进行断面观测。结果扫描电镜观测到五种纤维桩的桩核材料/粘结剂/牙本质之间存在相似的微观嵌合形态,微拉伸实验中断裂主要发生在纤维桩材料/粘接剂界面,微拉伸强度值NTI-Kahla Fiber为14.33±5.74Mpa,Twin Luscent Anchors为13.48±8.22Mpa,Tenax Fiber White为13.21±7.54Mpa,PD TaperedCrown Post为12.95±6.57Mpa,Ouya FiberⅠ为13.59±6.31Mpa,各组间无统计差异（P〉0.05）。结论Panavia F树脂粘接剂可以建立与牙本质及纤维桩材料之间的良好连接,五种纤维桩与Panavia F粘结剂及牙本质之间的微观机械固位形态与强度相近。微拉伸断裂模式提示在纤维桩修复中,纤维桩/粘接剂界面是修复体粘接的主要薄弱环节。     

Effectiveness of bonding fiber posts to root canals and composite core build-ups

This study investigated the effects of fiber posts, silanization, and luting agents on the interfacial strength to root dentin and composite cores. Root canals of 120 crownless human teeth were instrumented. Three different posts (opaque and translucent), with and without silane treatment, were bonded using etch-and-rinse, self-etch, and self-adhesive luting agents. The restored roots were built up with dual-curing composite. After storage in water for 24 h at 37°C, 2-mm-thick slices were cut from each sample: one from the composite core and one from the restored root. Interfacial push-out bond strengths of the posts were determined in a universal testing machine. Failure modes were analyzed using scanning electron microscopy. The post type and the luting agent had significant effects on both the post-to-dentin and post-to-core strengths. Silanization did not significantly influence post-to-dentin strengths, but enhanced post-to-core strengths. With etch-and-rinse luting agents, debonding occurred predominantly between the post and the cement, while the self-etch and self-adhesive luting agents showed more failures on root dentin. No failures occurred between the composite core and the cement. The combination of translucent posts and etch-and-rinse dual-curing luting agents can positively influence the retention of fiber posts in root canals. Silanization seems to be less relevant for intra-root canal bonding, but may have beneficial effects on post-to-core strengths.     

桩核黏接界面物理构象的实验研究

目的本实验用激光共聚焦显微镜观测根管内壁牙本质-黏接剂-桩黏接界面的物理构象,了解微观的结构和形态与宏观的固位力之间的关系。方法将18颗人上前牙于釉牙骨质界冠方2mm处截断,根充1周后用预成桩配套钻制备根管。确保预备的根管位于中央包埋牙根。包埋后将钛合金和玻璃纤维两种预成桩分别用磷酸锌水门汀(ZPC)、玻璃离子水门汀(GIC)、树脂类黏接剂黏接于根管内。用LSCM共聚焦显微镜观察截断面的牙本质-黏接剂-桩之间的界面,用随机软件测量黏接层的厚度。结果不同的黏接剂的黏接层厚度没有显著差异;牙根不同部位的黏接层厚度有显著差异,即根尖部<根中部<根颈部;纤维桩的黏接层厚度大于钛桩。结论不同黏接剂的黏接层厚度没有显著差异,不同部位及不同桩的黏接层厚度有显著差异。Parapost Cement黏接层均匀、连续、无孔隙,优于其他两种黏接剂。     

Bond strength between root dentin and three glass-fiber post systems

STATEMENT OF PROBLEM: Glass-fiber posts were introduced for use after endodontic therapy instead of metal alloy and ceramic posts. There are several new types of glass-fiber post systems available, but little is known about how well these posts bond to the root surface. PURPOSE: The purpose of this in vitro study was to compare the bond strengths of 3 different types of glass-fiber post systems-opaque, translucent, and electrical glass-in 3 different locations of prepared post spaces. MATERIAL AND METHODS: Sixty human intact single-rooted extracted teeth were used. The root canals were prepared using a step-back technique and obturated with gutta-percha using lateral condensation. The roots were divided into 3 experimental groups and further divided into 2 subgroups according to testing time (n=10). Roots were restored with 1 of the following post systems according to the manufacturer's instructions: opaque glass-fiber posts (Snowpost), translucent glass-fiber posts (FiberMaster), and electrical glass-fiber posts (Everstick). A self-etching primer (Clearfil Liner Bond) was applied to the walls of the post spaces, allowed to etch for 30 seconds, and gently air dried. A dual-polymerized bonding agent (Clearfil Liner Bond, Bond A and B) was then applied to the same walls. A dual-polymerizing resin luting agent (Panavia F) was mixed for 20 seconds and then placed in the post spaces using a lentulo spiral instrument. The roots were placed in light-protected cylinders; then the light source was placed directly on the flat cervical tooth surfaces and the cement was polymerized. Specimens were stored in light-proof boxes for 24 hours or 1 week after the polymerization procedure. Each root was cut horizontally, and six 1-mm-thick root segments (2 apical, 2 middle, and 2 cervical) were prepared.Using a push-out test, the bond strength between post and dentin was measured after 24 hours or 1 week using a universal testing machine. Statistical analysis was performed with 3-way ANOVA followed by independent t tests (alpha=.05) to detect differences between groups defined by the specific interacting variables. The different combinations of posts and luting material from the cervical segments were analyzed with SEM. RESULTS: The 3-way ANOVA indicated that push-out test values varied significantly according to the post system used (opaque, electrical, and translucent) (P<.01); the root segments (cervical, middle, and apical) (P<.01), however, did not vary statistically according to the time of testing (24 hours and 1 week). Opaque and electrical glass-fiber posts showed higher bond strength values than translucent posts (P<.01). Push-out bond strength values of cervical segments were significantly higher than the middle and apical segments in translucent and electrical glass-fiber post groups (P<.01). In the opaque glass-fiber post group, there were no significant differences between cervical and middle segments. In SEM analysis, a distinct hybrid zone with long, numerous resin tags located between luting material and dentin was exhibited in all post systems. CONCLUSION: The opaque and electrical glass-fiber posts exhibited similar bond strengths, and translucent posts exhibited the lowest bond strength. The highest bond strength was observed in the cervical third of the post spaces for translucent and electrical glass-fiber post groups.     

Effect of thermal cycling on the bond strength of self-adhesive cements to fiber posts

The aim of this study was to assess the push-out bond strengths of self-adhesive resin cements to epoxy resin-based fiber posts after challenging by thermocycling. Thirty-six single-rooted premolars were endodontically treated, and the post-spaces were drilled to receive RelyX Fiber posts #1. Three self-adhesive resin cements (RelyX Unicem, G-Cem, and Breeze) were used for luting fiber posts. The bonded specimens were either stored for 1 month in a moist field (37°C) or submitted to thermocycling (5,000 times) prior to push-out test. The maximum force required to dislodge the post via an apical-coronal direction was recorded (megapascal). The data were statistically analyzed with two-way ANOVA and Tukey tests (p < 0.05). The factors "luting cement" and "thermocycling" significantly influenced bond strengths. The initial push-out values of RelyX Unicem and Breeze were higher than those of G-Cem. After thermocycling, the bond strength of G-Cem increased and no differences were found between groups. RelyX Unicem and Breeze bond strengths were not affected by the thermal challenge. Thermal cycling and cement type differently influence the bond strengths of self-adhesive resin cements. Self-adhesive cements can represent an option for luting fiber posts into root canal.     

Effect of endodontic sealer and resin luting strategies on pull-out bond strength of glass fiber posts to dentin

The aim of this study was to evaluate the influence of eugenol-containing endodontic sealers and luting strategy on the pull-out bond strength of glass fiber posts to dentin. Sixty-four bovine incisors were randomly assigned into two groups of 32 specimens each for obturation procedure with gutta-percha only, or with Pulp Canal Sealer EWT Subsequently, the roots were prepared for the fiber post Reforpost and all specimens of each endodontic sealing procedure were allocated to four groups (n = 8), according to the strategies for post cementation: A) Single Bond 2 and RelyX ARC; B) All Bond 2 and C&B cement; C) All Bond 2 and RelyX ARC; D) Single Bond 2 and C&B Cement. The posts were cemented immediately after the endodontic treatment. The pull-out test was performed at a cross-head speed of 0.5 mm/min in a universal testing machine (EMIC). Data (Kgf) were submitted to a two-way ANOVA and Tukey test (p < or = 0.05). The eugenol-based sealer did not influence the pull-out bond strength of fiber posts regardless of the luting strategy. RelyX ARC showed higher bond strength than C&B Cement when used with Single Bond 2 adhesive system, when the eugenol-based sealer was present. All Bond 2, when associated to all cements studied, promoted similar bond strength, regardless of the eugenol-containing endodontic sealer In conclusion, eugenol-containing sealer did not influence the pull-out bond strength values of the resin luting systems for glass fiber post cementation. The bond system and resin cement association from the same manufacturer had similar bond strength values for dentin.     

Fracture resistance of teeth restored with two different post-and-core designs cemented with two different cements: an in vitro study. Part I.

OBJECTIVE: The purpose of this in vitro study was to investigate fracture resistance in teeth restored with cast post and cores with and without ferrule and using two different luting cements. METHOD AND MATERIALS: Forty intact maxillary premolars were endodontically treated after their crowns were removed at 2.00 mm from the cementoenamel junction. Specimens were embedded in acrylic resin blocks in aluminum cylinders, 4.00 mm apical to the cementoenamel junction. Twenty specimens were ferruled, and half of the posts and cores were cemented with zinc-phosphate cement, while the other half was cemented with resin cement. The same procedures were followed for the nonferruled group. Loads were applied at an angle of 45 degrees and measured with a universal testing machine. ANOVA and Tukey test were used for statistical analyses; a significance level was established at 5%. RESULTS: Ferruled specimens showed greater resistance than nonferruled ones, regardless of the cement used. There was no statistical difference between the group of specimens cemented with resin cement and without ferrule and the ferruled groups. The non-ferruled group with zinc-phosphate cement showed the poorest results. CONCLUSION: A 2.00-mm cervical ferrule is important for fracture resistance of restored teeth, and resin cement has a better performance.     

In vitro evaluation of the fracture resistance of anterior endodontically treated teeth restored with glass fiber and zircon posts

STATEMENT OF PROBLEM: The published information is equivocal regarding the fracture resistance of endodontically treated teeth restored with fiber posts. Additionally, little is known about the biomechanical performance of glass fiber and zircon posts. PURPOSE: This in vitro study investigated the fracture resistance of anterior endodontically treated teeth prepared with a 2-mm ferrule, restored with glass fiber and zircon posts and composite resin cores or cast posts and cores. MATERIAL AND METHODS: Twelve matched pairs of teeth were obtained from 4 cadavers, and all were endodontically treated and prepared with a standardized 2-mm ferrule. According to a random number table, the 2 teeth from each matched pair were randomly divided into 2 groups. The test group consisted of 12 specimens restored with a glass fiber and zircon post (Fibio) and composite resin (Durafil) core. Twelve matching specimens restored with a nickel-chromium (NiCr) cast post and core served as the control. Specimens in both groups were cemented with resin cement (Panavia F). After cementation of cast NiCr complete crowns with zinc polycarboxylate cement (ShangChi), the specimens were loaded with an incremental static force at an angle of 135 degrees to the long axis of the root until failure occurred. A paired sample t test was used to compare the fracture resistance (N) of teeth restored with the 2 post-and-core systems (alpha=.05). RESULTS: The mean failure load of paired differences between the 2 groups was -261.3+/-237.3 N. The test group exhibited significantly lower failure loads than the control group (P=.004). All specimens displayed root fractures, most of which were oblique, with cracks initiating from the palatal cervical margin and propagating in a labial-apical direction. CONCLUSION: Within the limitations of this study, the teeth restored with glass fiber and zircon posts demonstrated significantly lower failure loads than those with cast NiCr post and cores. All specimens failed via root fractures.     

Influence of fatigue loading on four post-and-core systems in maxillary premolars.

OBJECTIVE: Clinical studies show a high failure incidence after years of service of endodontically treated premolars, when restored with post-core crowns, especially those with short posts or deficient ferrules. The reason for this can be a deterioration of the luting cement around the post by fatigue from functional loading. In particular, the anatomy of premolars may frequently be incompatible with the application of long endodontic posts. The aim of this study was to evaluate the influence of fatigue loading on the quality of the cement layer between posts with restricted lengths and the root canal wall in premolars. As the stiffness of posts may affect the outcome, post-and-core systems with varying post stiffness were selected. METHOD AND MATERIALS: Four types of post-and-core systems were selected for this study: three prefabricated post systems combined with a resin composite core material and one cast post and core. The three prefabricated posts were titanium posts (Tenax), quartz-fiber posts (Aestheti-Post), and quartz-coated-carbon-fiber posts (Aestheti-Plus). The post-and-core restorations were made on single-rooted, human, maxillary premolars from which the coronal sections were removed at the level of the proximal cementoenamel junction. Following endodontic treatment, a cast post and core (post length 6 mm) was prepared for each tooth individually (direct method) and cemented into the root canal with chemical cure Panavia 21 TC. The prefabricated posts were directly cemented in the root canal and then, after applying a dual-cure adhesive (Clearfil Photobond), built up with a core build-up composite (Clearfil Photocore). For each group (n = 8), half of the specimens were exposed to fatigue loading (10(6) load cycles) almost perpendicular to the axial axis (85 degrees), while the other half was used as the control. Three parallel, transverse root sections of 1.5-mm thickness, were cut from each specimen. These sections were examined by scanning electron microscopy (SEM) to evaluate the cement integrity, while the retention strength of the cemented post sections was determined with a push-out test. RESULTS: Fatigue loading did not cause separation of the buildups from the roots or affect the push-out strength. On a univariate level, only SEM evaluation showed significant differences between the types of post, fatigue loading, and between the levels of root sections. The cement integrity with the titanium post was significantly less than with the other three systems, which did not differ among themselves. The differences could not be explained by differences in stiffness between the posts. CONCLUSION: A composite core build-up material bonded to the dentin and supported by quartz-fiber posts or quartz-coated-carbon-fiber posts, cemented with adhesive cement like Panavia 21 TC, may be a viable alternative for the conventional cast core.     

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目的观察光照对纤维桩周围双固化树脂粘接效果的影响。方法选用2011年5—11月佛山市向阳口腔医院就诊患者拔除的新鲜完整单根管牙40颗,随机等分为非光照组和光照组。两组牙齿均在截去牙冠后行根管预备,充填,然后植入纤维桩,并使用Bisco全酸蚀粘接系统对纤维桩进行粘接,非光照组仅进行化学固化,光照组在化学固化的基础上再使用QHL75光固化灯照射40s。分别测量两组牙齿根尖段、根中段和根管口段的显微硬度和粘接强度。结果显微硬度:光照组牙齿根管口段的显微硬度明显高于根中段和根尖段及非光照组各段(P<0.05),而光照组根中段和根尖段间差异无统计学意义(P>0.05)。粘接强度:光照组牙齿根管口段的粘接强度高于根中段和根尖段及非光照组各段,差异有统计学意义(P<0.05),且根中段和根尖段的粘接强度差异也有统计学意义(P<0.05)。结论光照有助于加强Bisco全酸蚀粘接剂的聚合程度,从而有助于纤维桩固位。     

Effect of Post Length and Type of Luting Agent on the Dislodging Time of Metallic Prefabricated Posts by Using Ultrasonic Vibration

IntroductionThe purpose of this study was to determine and compare the times needed to dislodge prefabricated titanium posts of different luting lengths with various cements.MethodsEighty-one intact extracted, single-canal human teeth were selected and endodontically treated. Specimens were randomly divided into 9 groups, which were arranged according to the post space length (5, 7, and 9 mm) and cement type (zinc phosphate, glass ionomer, and resin cement). Titanium posts were cemented into the post spaces, and after 1 week of storage they were subjected to ultrasonic vibration. The dislodging times were recorded and analyzed by using the Kruskal-Wallis and Mann-Whitney tests (P < .05).ResultsA significant difference was observed between the dislodging times on the basis of post length and luting agent (P < .001). There were also significant differences between different cements luted with the same length posts (P < .001). Significant differences were observed between the 5-mm posts and both the 7- and 9-mm posts for each cement, but the differences between the 7-mm and 9-mm posts were not significant (P < .05).ConclusionsChanges in the cement type and post length alter the time required to dislodge a post with an ultrasonic device.