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      Resistencia de unión del sistema de postes REBILDA® con la dentina intrarradicular Translated title: Resistance to Dislodgement of REBILDA® Post System to Intraradicular Dentin

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          Abstract

          ResumenActualmente existe controversia en la literatura acerca de la efectividad clínica y adhesiva con respecto a los sistemas adhesivos de refuerzo radicular. Así, el objetivo de este estudio fue evaluar la resistencia de unión mediante la prueba de Push-Out entre el sistema de postes Rebilda® y la dentina intraradicular. Para esto, se utilizaron 28 dientes unirradiculares, que fueron cortados y padronizados en 16 mm. Los segmentos radiculares fueron sometidos a confección de tratamiento endodóntico; posteriormente, se dividieron aleatoriamente en dos grupos, Grupo 1 (n=14): Rebilda® DC+Futurabond DC; Grupo 2 (n=14): RelyX ARC+Adper Scothbond Multipropósito Plus. Seguidamente, diez especímenes de cada grupo se cortaron para ser sometidos al Test de Push-Out. Los restantes 4 especímenes de cada grupo se prepararon para Microscopia Electronica de Barrido con el fin de evaluar la formación de prolongaciones resinosas en la interface poste-cemento-dentina. El grupo 2 obtuvo mejores resultados al compararlo al Grupo 1 en cuanto a resistencia de unión y en formación de prolongaciones resinosas, pero no hubo diferencia estadísticamente significativa (p>0.05). Se concluyó que el Sistema de Postes REBILDA® promueve una adecuada resistencia de unión a dentina intrarradicular.

          Translated abstract

          AbstractCurrently there is controversy in the literature about clinical and adhesive effectiveness with respect to adhesive systems aimed to root reinforcement. Thus, the objective of this study was to evaluate the Push-Out bond strength between the Rebilda® post system and the intraradicular dentine. Thus, 28 unirradicular teeth were used, cut and standardized in 16 mm. The root segments were submitted to endodontic treatment; and then randomly divided into two groups, Group 1 (n = 14): Rebilda® DC + Futurabond DC; Group 2 (n = 14): RelyX ARC + Adper Scothbond Multipurpose Plus. Ten specimens from each group were submitted to the Push-Out Test. The remaining 4 specimens from each group were prepared for Scanning Electron Microscopy (SEM) in order to evaluate the formation of resinous extensions at the post-cement-dentin interface. Group 2 showed better results when compared to Group 1 regarding bond strength and in formation of resinous extensions or tags, but there was no statistically significant difference (p>0.05). It was concluded that the REBILDA® Post System promotes adequate bond strength to intraradicular dentin.

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          Most cited references28

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          The promotion of adhesion by the infiltration of monomers into tooth substrates.

          The effectiveness of 4-methacryloxyethyl trimellitate anhydride (4-META) on the adhesion of an acrylic rod with etched dentine and enamel was studied. Etching of tooth substrates with a 10% citric acid-3% ferric chloride solution prior to the adhesion proved effective. Monomers with both hydrophobic and hydrophilic groups like 4-META promoted the infiltration of monomers into the hard tissue. The infiltrated monomers polymerized in situ and good adhesion with the tooth substrates took place. The tensile adhesive strength was 18 MPa on the etched dentine. Scanning electron microscopic studies suggested that the monomers possess affinity with the hard tissue. The good adhesion was not provided by the interlocking at the tubules as had been considered previously.
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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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              The structure of dentine in the apical region of human teeth.

              To study the structure of the apical region of human teeth with emphasis on dentinal tubules and their branches. This descriptive histological study employed demineralized stained sections for light microscopy, demineralized unstained sections for scanning electron microscopy, and undemineralized, acid-etched specimens for confocal tandem scanning microscopy. The apical portion of human teeth showed marked variations in structure, including accessory root canals, areas of resorption and repaired resorptions, occasional attached, embedded and free pulp stones, varied amounts of irregular secondary dentine, and even cementum-like tissue lining the apical root canal wall. The apex often deviated from the long axis of the root canal. Primary dentinal tubules were irregular in direction and density. Some areas were devoid of tubules. The irregular and variable structure of the apical region of human teeth represent special challenges during endodontic therapy. Obturation techniques based on the penetration of adhesives into dentinal tubules are unlikely to be successful and adhesive techniques must depend on impregnation of a hybrid layer.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                odovtos
                Odovtos International Journal of Dental Sciences
                Odovtos
                Facultad de Odontología. Universidad Nacional (San José, San José, Costa Rica )
                1659-1046
                2215-3411
                August 2017
                : 19
                : 2
                : 47-59
                Affiliations
                [2] orgnameUniversidad de Costa Rica orgdiv1Facultad de Odontología Costa Rica
                [1] orgnameUniversidad de Costa Rica Costa Rica
                Article
                S2215-34112017000200047
                10.15517/ijds.v19i2.28742
                b35e99e6-fcfc-43f6-9f13-58ee05eb64af

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

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                Figures: 0, Tables: 0, Equations: 0, References: 31, Pages: 13
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                SciELO Costa Rica


                Dentina intra-radicular,Resistencia de unión,Cemento resinoso,Microscopía electrónica de barrido,Intraradicular dentin,Push-out bond strength,Resin cement,Scanning electron microscope

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