Purpose Restoration of endodontically treated teeth using fiber posts in a one-stage procedure gains more popularity and aims to create a secondary monoblock. Data of detailed analyses of so called “post-and-core-systems” with respect to morphological characteristics of the resin-dentin interface in combination with bond strength measurements of fiber posts luted with these materials are scarce. The present study aimed to analyze four different post-and-core-systems with two different adhesive approaches (self-etch and etch-and-rinse). Materials and Methods Human anterior teeth (n = 80) were endodontically treated and post space preparations and post placement were performed using the following systems: Rebilda Post/Rebilda DC/Futurabond DC (Voco) (RB), Luxapost/Luxacore Z/Luxabond Prebond and Luxabond A+B (DMG) (LC), X Post/Core X Flow/XP Bond and Self Cure Activator (Dentsply DeTrey) (CX), FRC Postec/MultiCore Flow/AdheSE DC (Ivoclar Vivadent) (MC). Adhesive systems and core materials of 10 specimens per group were labeled using fluorescent dyes and resin-dentin interfaces were analyzed using Confocal Laser Scanning Microscopy (CLSM). Bond strengths were evaluated using a push-out test. Data were analyzed using repeated measurement ANOVA and following post-hoc test. Results CLSM analyses revealed significant differences between groups with respect to the factors hybrid layer thickness (p<0.0005) and number of resin tags (p = 0.02; ANOVA). Bond strength was significantly affected by core material (p = 0.001), location inside the root canal (p<0.0005) and incorporation of fluorescent dyes (p = 0.036; ANOVA). CX [7.7 (4.4) MPa] demonstrated significantly lower bond strength compared to LC [14.2 (8.7) MPa] and RB [13.3 (3.7) MPa] (p<0.05; Tukey HSD) but did not differ significantly from MC [11.5 (3.5) MPa]. Conclusion It can be concluded that bond strengths inside the root canal were not affected by the adhesive approach of the post-and-core-system. All systems demonstrated homogenous hybrid layer formation and penetration into the dentinal tubules in spite of the complicating conditions for adhesion inside the root canal.
References
[1]
Bitter K, Noetzel J, Stamm O, Vaudt J, Meyer-Lueckel H, et al. (2009) Randomized clinical trial comparing the effects of post placement on failure rate of postendodontic restorations: preliminary results of a mean period of 32 months. J Endod 35: 1477–1482.
[2]
Cagidiaco MC, Goracci C, Garcia-Godoy F, Ferrari M (2008) Clinical studies of fiber posts: a literature review. Int J Prosthodont 21: 328–336.
[3]
Sterzenbach G, Franke A, Naumann M (2012) Rigid versus Flexible Dentine-like Endodontic Posts-Clinical Testing of a Biomechanical Concept: Seven-year Results of a Randomized Controlled Clinical Pilot Trial on Endodontically Treated Abutment Teeth with Severe Hard Tissue Loss. Journal of Endodontics 38: 1557–1563.
[4]
Naumann M, Koelpin M, Beuer F, Meyer-Lueckel H (2012) 10-year survival evaluation for glass-fiber-supported postendodontic restoration: a prospective observational clinical study. Journal of Endodontics 38: 432–435.
[5]
Mj？r IA, Smith MR, Ferrari M, Mannocci F (2001) The structure of dentine in the apical region of human teeth. Int Endod J 34: 346–353. doi: 10.1046/j.1365-2591.2001.00393.x
Tay FR, Pashley DH (2007) Monoblocks in root canals: a hypothetical or a tangible goal. J Endod 33: 391–398.
[8]
Arrais CA, Miyake K, Rueggeberg FA, Pashley DH, Giannini M (2009) Micromorphology of resin/dentin interfaces using 4th and 5th generation dual-curing adhesive/cement systems: a confocal laser scanning microscope analysis. J Adhes Dent 11: 15–26. doi: 10.1002/lsm.20945
[9]
Bitter K, Paris S, Martus P, Schartner R, Kielbassa AM (2004) A Confocal Laser Scanning Microscope investigation of different dental adhesives bonded to root canal dentine. International Endodontic Journal 37: 840–848. doi: 10.1111/j.1365-2591.2004.00888.x
[10]
Bitter K, Paris S, Mueller J, Neumann K, Kielbassa AM (2009) Correlation of scanning electron and confocal laser scanning microscopic analyses for visualization of dentin/adhesive interfaces in the root canal. J Adhes Dent 11: 7–14.
[11]
Bitter K, Paris S, Pfuertner C, Neumann K, Kielbassa AM (2009) Morphological and bond strength evaluation of different resin cements to root dentin. Eur J Oral Sci 117: 326–333. doi: 10.1111/j.1600-0722.2009.00623.x
[12]
Ferrari M, Carvalho CA, Goracci C, Antoniolli F, Mazzoni A, et al. (2009) Influence of luting material filler content on post cementation. J Dent Res 88: 951–956. doi: 10.1177/0022034509342851
[13]
Mazzoni A, Marchesi G, Cadenaro M, Mazzotti G, Di Lenarda R, et al. (2009) Push-out stress for fibre posts luted using different adhesive strategies. Eur J Oral Sci 117: 447–453. doi: 10.1111/j.1600-0722.2009.00656.x
[14]
Zicari F, Couthino E, De Munck J, Poitevin A, Scotti R, et al. (2008) Bonding effectiveness and sealing ability of fiber-post bonding. Dent Mater 24: 967–977. doi: 10.1016/j.dental.2007.11.011
[15]
Radovic I, Mazzitelli C, Chieffi N, Ferrari M (2008) Evaluation of the adhesion of fiber posts cemented using different adhesive approaches. Eur J Oral Sci 116: 557–563. doi: 10.1111/j.1600-0722.2008.00577.x
Sterzenbach G, Karajouli G, Naumann M, Peroz I, Bitter K (2012) Fiber post placement with core build-up materials or resin cements-An evaluation of different adhesive approaches. Acta Odontologica Scandinavica 70: 368–376. doi: 10.3109/00016357.2011.603702
[18]
Bitter K, Meyer-Lueckel H, Priehn K, Kanjuparambil JP, Neumann K, et al. (2006) Effects of luting agent and thermocycling on bond strengths to root canal dentine. Int Endod J 39: 809–818. doi: 10.1111/j.1365-2591.2006.01155.x
[19]
Bitter K, Noetzel J, Volk C, Neumann K, Kielbassa AM (2008) Bond strength of fiber posts after the application of erbium:yttrium-aluminum-garnet laser treatment and gaseous ozone to the root canal. J Endod 34: 306–309.
[20]
Bitter K, Perdigao J, Exner M, Neumann K, Kielbassa A, et al. (2012) Reliability of fiber post bonding to root canal dentin after simulated clinical function in vitro. Operative Dentistry 37: 397–405. doi: 10.2341/11-066-l
[21]
Kenshima S, Francci C, Reis A, Loguercio AD, Filho LE (2006) Conditioning effect on dentin, resin tags and hybrid layer of different acidity self-etch adhesives applied to thick and thin smear layer. Journal of Dentistry 34: 775–783. doi: 10.1016/j.jdent.2006.03.001
[22]
Van Meerbeek B, Yoshihara K, Yoshida Y, Mine A, De Munck J, et al. (2011) State of the art of self-etch adhesives. Dental Materials 27: 17–28. doi: 10.1016/j.dental.2010.10.023
[23]
Van Landuyt KL, Snauwaert J, De Munck J, Peumans M, Yoshida Y, et al. (2007) Systematic review of the chemical composition of contemporary dental adhesives. Biomaterials 28: 3757–3785. doi: 10.1016/j.biomaterials.2007.04.044
[24]
Lohbauer U, Nikolaenko SA, Petschelt A, Frankenberger R (2008) Resin tags do not contribute to dentin adhesion in self-etching adhesives. Journal of Adhesive Dentistry 10: 97–103.
[25]
Watson TF (1997) Fact and artefact in confocal microscopy. Adv Dent Res 11: 433–440. doi: 10.1177/08959374970110040901
[26]
D'Alpino PH, Pereira JC, Svizero NR, Rueggeberg FA, Pashley DH (2006) Use of fluorescent compounds in assessing bonded resin-based restorations: a literature review. J Dent 34: 623–634. doi: 10.1016/j.jdent.2005.12.004
[27]
Czonstkowsky M, Wilson EG, Holstein FA (1990) The smear layer in endodontics. Dental Clinics of North America 34: 13–25.
[28]
Fawzi EM, Elkassas DW, Ghoneim AG (2010) Bonding strategies to pulp chamber dentin treated with different endodontic irrigants: microshear bond strength testing and SEM analysis. Journal of Adhesive Dentistry 12: 63–70.
[29]
Gu XH, Mao CY, Liang C, Wang HM, Kern M (2009) Does endodontic post space irrigation affect smear layer removal and bonding effectiveness? European Journal of Oral Sciences 117: 597–603. doi: 10.1111/j.1600-0722.2009.00661.x
[30]
Santos JN, Carrilho MR, De Goes MF, Zaia AA, Gomes BP, et al. (2006) Effect of chemical irrigants on the bond strength of a self-etching adhesive to pulp chamber dentin. Journal of Endodontics 32: 1088–1090.
[31]
Zhang L, Huang L, Xiong Y, Fang M, Chen JH, et al. (2008) Effect of post-space treatment on retention of fiber posts in different root regions using two self-etching systems. European Journal of Oral Sciences 116: 280–286. doi: 10.1111/j.1600-0722.2008.00536.x
[32]
Bitter K, Eirich W, Neumann K, Weiger R, Krastl G (2012) Effect of cleaning method, luting agent and preparation procedure on the retention of fibre posts. Int Endod J 45: 1116–1126. doi: 10.1111/j.1365-2591.2012.02081.x
[33]
Perdigao J, Gomes G, Augusto V (2007) The effect of dowel space on the bond strengths of fiber posts. J Prosthodont 16: 154–164. doi: 10.1111/j.1532-849x.2006.00166.x
[34]
Sattabanasuk V, Vachiramon V, Qian F, Armstrong SR (2007) Resin-dentin bond strength as related to different surface preparation methods. Journal of Dentistry 35: 467–475. doi: 10.1016/j.jdent.2007.01.002
[35]
Malyk Y, Kaaden C, Hickel R, Ilie N (2010) Analysis of resin tags formation in root canal dentine: a cross sectional study. International Endodontic Journal 43: 47–56. doi: 10.1111/j.1365-2591.2009.01631.x
[36]
Arrais CA, Giannini M, Rueggeberg FA, Pashley DH (2007) Microtensile bond strength of dual-polymerizing cementing systems to dentin using different polymerizing modes. Journal of Prosthetic Dentistry 97: 99–106. doi: 10.1016/j.prosdent.2006.12.007
[37]
Arrais CA, Giannini M, Rueggeberg FA (2009) Effect of sodium sulfinate salts on the polymerization characteristics of dual-cured resin cement systems exposed to attenuated light-activation. Journal of Dentistry 37: 219–227. doi: 10.1016/j.jdent.2008.11.016
[38]
Goracci C, Corciolani G, Vichi A, Ferrari M (2008) Light-transmitting ability of marketed fiber posts. J Dent Res 87: 1122–1126. doi: 10.1177/154405910808701208
[39]
Ferrari M, Mannocci F (2000) A ‘one-bottle’ adhesive system for bonding a fibre post into a root canal: an SEM evaluation of the post-resin interface. Int Endod J 33: 397–400. doi: 10.1046/j.1365-2591.2000.00310.x
[40]
Ferrari M, Mannocci F, Vichi A, Cagidiaco MC, Mj？r IA (2000) Bonding to root canal: structural characteristics of the substrate. Am J Dent 13: 255–260. doi: 10.1016/s0109-5641(00)00059-2
[41]
Soares CJ, Santana FR, Castro CG, Santos-Filho PC, Soares PV, et al. (2008) Finite element analysis and bond strength of a glass post to intraradicular dentin: comparison between microtensile and push-out tests. Dent Mater 24: 1405–1411. doi: 10.1016/j.dental.2008.03.004
[42]
D'Alpino PH, Pereira JC, Svizero NR, Rueggeberg FA, Pashley DH (2006) Factors affecting use of fluorescent agents in identification of resin based polymers. J Adhes Dent 8: 285–292. doi: 10.1016/j.jdent.2005.12.004
[43]
Rodig T, Nusime AK, Konietschke F, Attin T (2010) Effects of different luting agents on bond strengths of fiber-reinforced composite posts to root canal dentin. J Adhes Dent 12: 197–205.
[44]
Schmage P, Cakir FY, Nergiz I, Pfeiffer P (2009) Effect of surface conditioning on the retentive bond strengths of fiberreinforced composite posts. Journal of Prosthetic Dentistry 102: 368–377. doi: 10.1016/s0022-3913(09)60196-7
[45]
Sarkis-Onofre R, Skupien J, Cenci M, de Moraes R, Pereira-Cenci T (2013) The Role of Resin Cement on Bond Strength of Glass-fiber Posts (GFPs) Luted Into Root Canals: A Systematic Review and Meta-analysis of In Vitro Studies. Oper Dent doi: 10.2341/13-070-lit
[46]
Kurtz JS, Perdigao J, Geraldeli S, Hodges JS, Bowles WR (2003) Bond strengths of tooth-colored posts, effect of sealer, dentin adhesive, and root region. American Journal of Dentistry 16 Spec No: 31A–36A.
[47]
Goracci C, Grandini S, Bossu M, Bertelli E, Ferrari M (2007) Laboratory assessment of the retentive potential of adhesive posts: a review. J Dent 35: 827–835. doi: 10.1016/j.jdent.2007.07.009
[48]
Watzke R, Blunck U, Frankenberger R, Naumann M (2008) Interface homogeneity of adhesively luted glass fiber posts. Dent Mater 24: 1512–1517. doi: 10.1016/j.dental.2008.03.022
[49]
Alster D, Feilzer AJ, De Gee AJ, Mol A, Davidson CL (1992) The dependence of shrinkage stress reduction on porosity concentration in thin resin layers. Journal of Dental Research 71: 1619–1622. doi: 10.1177/00220345920710091401
[50]
Boschian Pest L, Cavalli G, Bertani P, Gagliani M (2002) Adhesive post-endodontic restoration with fiber posts: push-out tests and SEM observations. Dent Mater 18: 596–602. doi: 10.1016/s0109-5641(02)00003-9
