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      Root canal adaptation and intra-tubular penetration of three fiber-post cementation systems

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          Abstract

          Background

          To measure the penetration of three bonding systems for the luting of fiber glass posts in endodontically treated teeth, using confocal laser scanning microscopy (CLSM).

          Material and Methods

          A total of 30 maxillary incisors were shaped with the Mtwo system and filled with gutta-percha and Top Seal cement. The sample was divided into three groups (ni=10) according to the bonding system used to cement the posts: Group 1 (Prime&Bond NT and Rebilda DC with a total-etch technique); Group 2 (Futurabond DC and Rebilda DC with a dentin self-etch technique); and Group 3 (BisCem self-adhesive cement). Rhodamine B was added to the bonding systems to allow visualization by CLSM. Three 1-mm thick cross-sections were obtained of each root at a distance of 2, 5 and 8 mm from the coronal limit of the root. The specific software of the CLSM system was used to measure the percentage of the root canal perimeter showing penetration of the bonding system in the dentinal tubules, together with the maximum depth of penetration. Comparison between groups were made by Kruskal Wallis test, and comparison two by two groups with Mann-Whitney U-test.

          Results

          Depth of penetration of the resin tags, were distributed from greater to lesser depth as follows: BisCem > Prime&Bond NT > Futurabond DC. BisCem showed significantly greater penetration in the middle and apical thirds than the rest of the systems (906.14±67.42 and 699.27±76.26 µm, respectively). The percentage perimeter exhibiting penetration in the coronal third was significantly greater with BisCem versus Futurabond DC (56.08±7.24 and 44.38±5.23%, respectively). No significant differences were recorded in the middle and apical thirds among the three systems.

          Conclusions

          BisCem resulted in greater depth of intratubular penetration at all studied levels. The percentage perimeter of the canal showing penetration was similar for all the bonding systems.

          Key words:Fiber post luting, sealer adaptation, confocal laser scanning microscope.

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          Most cited references29

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          Current perspectives on post systems: a literature review.

          This literature review summarizes the most recent and reliable evidence on post systems. A search was limited to review articles published over the last 10 years in dental journals with an impact factor. Papers cited in the initially retrieved review articles were also included if significant. Preservation of tooth tissue, presence of a ferrule effect, and adhesion are regarded as the most effective conditions for long-term success of post-endodontic restorations. Adhesively luted fibre-reinforced composite post restorations have demonstrated satisfactory survival rates over relatively long follow-up periods. The clinical effectiveness of such restorations has been mainly ascribed to the more biomimetic behaviour of fibre-reinforced composite posts that reduces the risk of vertical root fractures. The most common type of failure when using fibre posts is post debonding and it is generally agreed that achieving stable adhesion to intraradicular dentine is more challenging than to coronal dentine. Several factors related to endodontic treatment, root canal shape, post space preparation, post translucency, adhesive cement handling and curing may have an influence on the outcome of the luting procedure. The most reliable results in fibre post cementation are obtained by etch-and-rinse adhesives in combination with dual-cure resin cements. The use of self-adhesive resin cements has also been proposed. Simplification is an obvious advantage of these new materials. However, the durability of their bond still needs to be verified with long-term clinical studies. Several techniques for pre-treating the fibre-reinforced composite post surface have been tested with the aim of improving the bond strength at the post-core and post-cement interfaces. Silicoating followed by silanization currently appears to be the most effective and convenient method for this purpose. In conclusion, the available evidence validates the use of fibre posts as an alternative to metal posts and preferably to other tooth-coloured posts, such as zirconia dowels, in the restoration of endodontically treated teeth. Longer term clinical trials are expected to further strengthen this evidence. © 2011 Australian Dental Association.
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            Limited decalcification/diffusion of self-adhesive cements into dentin.

            Resin cement diffusion into dentin may differ as a function of the pre-treatment regimen. Since self-adhesive cements do not require substrate pre-treatment for luting, penetration of and interaction with the underlying dentin are questioned. We hypothesized that differences in the resin cement diffusion into dentin may exist among current commercial adhesive cements. Composite cylinders were luted on mid-coronal dentinal surfaces by an etch-and-rinse cement (Calibra), a self-etching system (Panavia F 2.0), and 4 self-adhesive cements (Multilink Sprint, Rely X Unicem, G-Cem, Bis-Cem). Dentin/cement interfacial characteristics were analyzed by a staining technique (Masson's trichrome) and by scanning electron microscopy. Conventional acid etching resulted in partially infiltrated adhesive interfaces differing from those achieved with the application of self-etching primer. No hybrid layer and/or resin tag formation was detectable at the interfaces bonded with self-adhesive cements. Limited decalcification/infiltration was observed for self-adhesive cements into the underlying dentin. Self-adhesive cements were not able to demineralize/dissolve the smear layer completely.
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              Chemical analysis and bonding reaction of RelyX Unicem and Bifix composites--a comparative study.

              The chemical and physical properties of the dual curing luting composites RelyX Unicem (3M ESPE) and Bifix (VOCO) were analyzed with regard to their elemental composition, surface morphology and polymerization reaction. The bonding of both materials to hydroxyapatite (HAp) was studied. The main components were analyzed by XPS and EDX. The minor components were identified with ICP-OES. Moreover, the morphology was examined by SEM and the polymerization reaction products were investigated using GPC. XPS was also applied to study the bonding mechanisms to HAp. The inorganic product particles consist of an Al-Si-Na-glass network, which incorporates radiopaque strontium and barium for Bifix and strontium and lanthanum for RelyX Unicem. RelyX Unicem contains about 10% fluoride and 2% Ca(OH)(2), whereas Bifix comprises 2% fluoride. After polymerization, reaction products of 10(5)-10(6)g/mol were identified with RelyX Unicem. Both products contain mono- and oligomeric compounds. The reaction with HAp generates calcium atoms with a reduced binding energy. They act as an electron acceptor and show chemical interaction between the composite and HAp. With RelyX Unicem 86% of the calcium atoms reacted, compared to 65% with Bifix. The intense chemical interaction of RelyX Unicem with HAp seems to be relevant to clinical aspects and explains the mechanical product properties. After setting, a polymer was found with RelyX Unicem but only monomeric/oligomeric products were identified at the surface of Bifix.
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                Author and article information

                Journal
                J Clin Exp Dent
                J Clin Exp Dent
                Medicina Oral S.L.
                Journal of Clinical and Experimental Dentistry
                Medicina Oral S.L.
                1989-5488
                1 December 2018
                December 2018
                : 10
                : 12
                : e1198-e1204
                Affiliations
                [1 ]MD, DDS, PhD. Department of Stomatology. Universitat de València (Spain). C. Gascó Oliag, 1. 46010 Valencia (Spain)
                [2 ]DDS. Department of Stomatology. Universitat de València (Spain). C. Gascó Oliag, 1. 46010 Valencia (Spain)
                [3 ]Department of Dental Materials and Fixed Prosthodontics. University of Siena (Italy). Policlinico Le Scotte, Viale Bracci. 53100 Siena (Italy)
                Author notes
                Clínica Odontológica. Universitat de València C. Gascó Oliag, 1, 46010 Valencia (Spain) , E-mail: llena@ 123456uv.es

                Conflict of interest statement: The authors have declared that no conflict of interest exist.

                Article
                55208
                10.4317/jced.55208
                6343976
                6d3060ff-3e16-4f35-b813-935eba755da8
                Copyright: © 2018 Medicina Oral S.L.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 15 November 2018
                : 9 August 2018
                Categories
                Research
                Operative Dentistry and Endodontics

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