Influence of luting agent translucency on fiber post retention.

The aim was to assess the influence of cement translucency on the retentive strength of luted fiber posts. Twenty extracted human premolars were randomly divided into four equal groups, based on the combinations of materials to be tested. Two post types of the same size, shape, and chemical composition, but different light-transmission properties [Translucent post (TP) and Opaque post (OP)] were selected. The two post types were luted using the etch-and-rinse, light-curing adhesive in combination with two shades of the same resin cement of markedly different light-transmitting ability [Transparent shade (TS) and Opaque shade (OS)]. Early post retention was assessed using the thin-slice push-out test. Post type did not significantly influence post retention; however, cement translucency emerged as a relevant factor in intraradicular cementation, with the TS achieving higher push-out strengths. The between-factor interaction was also statistically significant; specifically, OP-OS yielded significantly lower retentive strengths than all the other groups. Post translucency did not influence post retention, provided that a highly translucent cement was utilized for luting.

[Hard dental tissue minimal-invasive preparation using contemporary polymer rotating instruments and laser].

Goal of contemporary dentistry is to decrease the patient's discomfort during treatment. Dentists aim to achieve maximum with the newly developed dental materials as well as with new cavity preparation techniques in the shortest time span. Since the development of the first constructed borer (drilling machine) for caries removal, the preparation techniques have considerably changed. The progress of dental materials as well as the cavity preparation techniques has led us to contemporary carbide tungsten and diamond borers that are used with obligatory water cooling. The innovation within this field represents newly developed polymer borers that can detect the difference between carious lesions and healthy tooth structure. In this way the cavity preparation may be performed without damaging dental healthy tissue. This is possible owing to their hardness which is lower than the hardness of intact dentin. Polymer borer preparation is painless with less vibration, while the increase in temperature is negligible. Lasers have been used in clinical dentistry since 1980s so it can be said that they represent a new technology. The function of lasers is based on ablation which requires water. Erbium lasers have shown the highest potential with their ability to produce effective ablation of hard dental tissues. Laser application in dentistry requires special training as well as some protective measures. Laser advantages, compared to traditional preparation techniques, involve the absence of vibration, painless preparation, possibility of preparation without anesthetic and easier patient's adjustment to dental intervention which is of importance, especially in pediatric dentistry.

[The application of air abrasion in dentistry].

One of the main objectives of contemporary dentistry is to preserve healthy tooth structure by applying techniques of noninvasive treatment. Air abrasion is a minimally invasive nonmechanical technique of tooth preparation that uses kinetic energy to remove carious tooth structure. A powerful narrow stream of moving aluminum-oxide particles hit the tooth surface and they abrade it without heat, vibration or noise. Variables that affect speed of cutting include air pressure, particle size, powder flow, tip's size, angle and distance from the tooth. It has been proposed that air abrasion can be used to diagnose early occlusal-surface lesions and treat them with minimal tooth preparation using magnifier. Reported advantages of air abrasion include reduced noise, vibration and sensitivity. Air abrasion cavity preparations have more rounded internal contours than those prepared with straight burs. This may increase the longevity of placed restorations because it reduces the incidence of fractures and a consequence of decreased internal stresses. However, air abrasion cannot be used for all patients, i.e. in cases involving severe dust allergy, asthma, chronic obstructive lung disease, recent extraction or other oral surgery, open wounds, advanced periodontal disease, recent placement of orthodontic appliances and oral abrasions, or subgingival caries removal. Many of these conditions increase the risk of air embolism in the oral soft tissues. Dust control is a challenge, and it necessitates the use of rubber dam, high-volume evacuation, protective masks and safety eyewear for both the patient and the therapist.

Shear bond strength to enamel and flexural strength of different fiber-reinforced composites.

PURPOSE: To assess the shear bond strength to unground human enamel (ESBS) and flexural strength (FS) of different reinforcing fibers used in combination with a flowable composite resin. MATERIALS AND METHODS: For ESBS testing, 90 human molars were selected and randomly divided into 9 groups (n = 10) according to the reinforcing fiber to be tested: 1. RTD Quartz Splint additionally impregnated at chairside with Quartz Splint Resin (RTD); 2. RTD Quartz Splint without additional impregnation; 3. Ribbond-THM (Ribbond) impregnated with OptiBond FL Adhesive; 4: Ribbond Triaxial (Ribbond) impregnated with OptiBond FL Adhesive; 5. Connect (Kerr) impregnated with OptiBond FL Adhesive; 6. Construct (Kerr) impregnated with Opti- Bond FL Adhesive; 7. everStick PERIO (Stick Tech); 8. everStick C&B (Stick Tech); 9. nonreinforced composite Premise flowable (Kerr). Cylinders of flowable composite reinforced with the fibers were bonded to the intact buccal surface of the teeth. After 24 h of storage, shear loading was performed until failure occurred. FS was assessed performing three-point bending test according to ISO Standard 4049/2000. ESBS and FS data were analyzed using one-way ANOVA, followed by Tukey's HSD test for post-hoc comparisons (p < 0.05). RESULTS: For each group, the ESBS and FS, respectively, in MPa were: 1. 17.07 ± 4.52 and 472.69 ± 30.49; 2. 14.98 ± 3.92 and 441.77 ± 61.43; 3. 18.59 ± 5.67 and 186.89 ± 43.89; 4. 16.74 ± 6.27 and 314.41 ± 148.52; 5. 14.38 ± 4.14 and 223.80 ± 77.35; 6. 16.00 ± 5.55 and 287.62 ± 85.91; 7. 16.42 ± 3.67 and 285.35 ± 39.68; 8. 23.24 ± 5.81 and 370.46 ± 29.26; 9. 12.58 ± 4.76 and 87.75 ± 22.87. For most fibers, no significant difference in ESBS was found compared to the control group, except for everStick C&B, which yielded higher ESBS. Nonreinforced composite exhibited the lowest FS, while all fibers positively affected the FS. CONCLUSIONS: Fiber reinforcement of flowable composite does not affect its ESBS. The flexural strength of FRCs is significantly influenced by fiber composition and pattern.

Push-out bond strength of an experimental self-adhesive resin cement.

The adhesion of fiber posts luted with simplified adhesive systems has been a matter of great interest over the past years. The aim of this study was to assess the post retentive potential of experimental self-adhesive resin cement (EXP) when used alone and in combination with a self-etch adhesive. Fiber posts were placed in endodontically treated teeth and divided into four groups (n = 6) according the luting material, as follows: group 1 (EXP alone); group 2 (EXP used with self-etch adhesive); group 3 (marketed dual-cured cement used with self-etch adhesive); and group 4 (marketed self-adhesive cement). The push-out test was used to assess the retentive strength of fiber posts (expressed in MPa), and specimens were analyzed under a stereomicroscope to determine failure mode. The adhesive interface between the cement and root canal dentin for each group was evaluated using scanning electron microscopy. The post retentive potential of group 1 (EXP) (7.48 ± 4.35 MPa) was comparable with that of marketed cements from group 4 (6.79 ± 3.68 MPa) and group 3 (8.77 ± 4.58 MPa). When EXP was used in combination with self-etch adhesive (group 2), significantly higher push-out bond-strength values were measured (15.87 ± 4.68 MPa) compared with the other groups.

Post-retentive ability of new flowable resin composites.

PURPOSE: To investigate the applicability of flowable composites as post luting agents by assessing the push-out strength of posts. METHODS: 36 intact single rooted human premolars were selected. The endodontic treatment was performed and half of the specimens were restored with light transmitting posts (DT Light Post Illusion) and the other half with opaque posts (Tech 21 X-OP). In both groups the following combinations of adhesive/cement were tested: OptiBond Solo Plus/Nexus Third Generation (NX3), XP Bond/SureFil SDR Flow (SDR), and Vertise Flow (VF). Push-out test was used to assess the retentive strength of fiber posts, which was expressed in megapascals (MPa). Specimens were analyzed under a stereomicroscope to determine failure mode (adhesive between luting agent and post, adhesive between luting agent and dentin or mixed failure). Push-out data and failure mode distribution were analyzed by two-way ANOVA and Chi-square test, respectively (P< 0.05). RESULTS: The statistical analysis revealed that only the type of luting material significantly influenced push-out bond strength of the post (P< 0.001). SDR (9.00 +/- 2.17 MPa) performed similarly to the control group NX3 (7.15 +/- 1.74 MPa), while VF (4.81 +/- 1.51 MPa) should significantly lower bond strength. Failure modes differed significantly among groups.

Enamel and dentin bond strength of new simplified adhesive materials with and without preliminary phosphoric acid-etching.

PURPOSE: To assess the influence of preliminary phosphoric acid-etching on shear bond strength (SBS) to enamel and dentin of a self-adhering restorative composite and of a new self-etch adhesive used in combination with the proprietary flowable composite. METHODS: 100 human molars were selected. SBS was assessed on flat buccal enamel surfaces and mid-coronal dentin. Teeth from each group were divided into five subgroups (n=10): (1) FL: etch-and-rinse adhesive OptiBond FL/Premise flowable; (2) XTR: 2-step self-etch adhesive OptiBond XTR/Premise flowable; (3) eXTR: OptiBond XTR on etched substrates/Premise flowable; (4) VF: self-adhering flowable composite Vertise Flow; (5) eVF: Vertise Flow on etched substrates. Specimens were stressed in shear until failure. Failure modes were evaluated under a stereomicroscope. Data were analyzed by two-way ANOVA and Fisher's exact test (P< 0.05). RESULTS: Dental substrate, material and between-factor interaction significantly influenced SBS (MPa). In FL group (16.83 +/- 2.93) significantly higher SBS to enamel than in the other groups (XTR 8.59 +/- 4.39; eXTR 7.04 +/- 3.63; VF 6.61 +/- 2,41; eVF 9.87 +/- 4.24) was measured. On dentin FL (8.15 +/- 3.88) performed similarly to XTR (10.60 +/- 5.0), eXTR (9.60 +/- 4.91) and eVF (5.48 +/- 4.94); VF recorded significantly lower SBS (2.94 +/- 2.79 MPa). Failure modes differed significantly among groups.

Ferrule effect: a literature review.

INTRODUCTION: Preserving intact coronal and radicular tooth structure, especially maintaining cervical tissue to create a ferrule effect, is considered to be crucial for the optimal biomechanical behavior of restored teeth. The ferrule effect has been extensively studied and still remains controversial from many perspectives. The purpose of this study was to summarize the results of research conducted on different issues related to the ferrule effect and published in peer-reviewed journals listed in PubMed. METHODS: The search was conducted using the following key words: "ferrule" and "ferrule effect" alone or in combination with "literature review," "fracture resistance," "fatigue," "finite element analysis," and "clinical trials." RESULTS: The findings from reviewed articles were categorized into three main categories: laboratory studies, computer simulation, and clinical trials. Laboratory studies were further classified into subchapters based on the main aspect investigated in relation to the ferrule effect. CONCLUSIONS: The presence of a 1.5- to 2-mm ferrule has a positive effect on fracture resistance of endodontically treated teeth. If the clinical situation does not permit a circumferential ferrule, an incomplete ferrule is considered a better option than a complete lack of ferrule. Including a ferrule in preparation design could lead to more favorable fracture patters. Providing an adequate ferrule lowers the impact of the post and core system, luting agents, and the final restoration on tooth performance. In teeth with no coronal structure, in order to provide a ferrule, orthodontic extrusion should be considered rather than surgical crown lengthening. If neither of the alternative methods for providing a ferrule can be performed, available evidence suggests that a poor clinical outcome is very likely.

Microtensile vs microshear bond strength of all-in-one adhesives to unground enamel.

PURPOSE: to determine the bond strength to unground enamel of all-in-one adhesives in comparison with an etch-andrinse system and to compare the reliability of microtensile and microshear methods in providing such measurements. MATERIALS AND METHODS: the bonding procedure was performed on enamel of 64 extracted molars. The tested all-inone adhesives were: Bond Force (Tokuyama), AdheSE One (Ivoclar-Vivadent), and Xeno V (Dentsply). Prime&Bond NT (Dentsply) served as control. Microtensile specimens were obtained from 4 teeth per group. Twelve teeth per group were used for microshear testing. Microtensile specimens that failed prior to testing were included in statistical calculations; they were assigned the lowest value measured in the respective group. Failure modes were observed under light microscope and classified (cohesive within substrates, adhesive, mixed). Statistically significant differences in bond strength were assessed among the adhesives within each testing method and between microshear and microtensile data for each adhesive. Failure mode distributions were compared using the chi-square test. RESULTS: all-in-one adhesives had similar microshear and microtensile bond strengths. In both testing methods, the etch-and-rinse system achieved the strongest bond. For all adhesives, significantly higher bond strengths were measured with the microshear test. In microtensile testing, specimens bonded with the etch-and-rinse adhesive exhibited a significantly different distribution of failure modes. The coefficients of variation were extremely high for microtensile bond strength data, particularly of all-in-one adhesives. CONCLUSION: the adhesive potential to intact enamel of recently introduced all-in-one adhesives was inferior to that of an etch-and-rinse system. When testing bond strength to enamel of all-in-one adhesives, microshear testing may be a more accurate method than microtensile.

Light transmission through fiber post: the effect on adhesion, elastic modulus and hardness of dual-cure resin cement.

OBJECTIVES: The aim of this study was to investigate the effect of fiber post light transmitting ability to the continuity of resin cement-root dentin (C-RD) and resin cement-fiber post (C-FP) interface, elastic modulus and hardness of a dual-cure resin cement. METHODS: Spectrophotometric measurements were applied for the determination of light transmission at coronal, middle and apical level as well as at the apical tip through Tech 21 X-OP (TECH) and DT Light Post (DT). Posts were cemented using dual-cured resin cement (Calibra). Roots were sectioned longitudinally through the post. Epoxy resin replicas were made and used to evaluate C-RD and C-FP interface under SEM. Modulus of elasticity (E) and Vicker's hardness (VH) of the cement layer were assessed. RESULTS: No light transmission was detected through TECH. Light transmission through DT decreased from coronal to apical and rose at the apical tip. TECH presented a significantly lower percentage of continuous C-RD and C-FP interface in comparison to DT. Coronal third of C-RD interface in TECH specimens had a significantly higher percentage of continuity than apical third. No regional differences in continuity of C-RD interface were found in DT specimens. E and VH were significantly lower when TECH was used, and decreased from coronal to apical for both posts. SIGNIFICANCE: Cementation of fiber post with no light transmitting ability using a dual-cured resin cement resulted in lower E and VH of the cement layer, and lower percentage of continuous C-RD and C-FP interface in comparison to cementation of light transmitting fiber post.

Self-adhesive resin cements: a literature review.

PURPOSE: To summarize research conducted on self-adhesive cements and provide information on their properties, based on the results of original scientific full-length papers from peer-reviewed journals listed in PubMed. MATERIALS AND METHODS: The search was conducted using the term "self-adhesive cement OR (trade names of currently available products)". RESULTS: Only in vitro studies that investigated two commercially available self-adhesive cements have been published so far. The results were summarized into the following categories: adhesion to tooth substrates (enamel, dentin, root dentin), adhesion to restorative materials (endodontic posts, ceramics, titanium abutments), marginal adaptation, microleakage, mechanical properties, biocompatibility, chemical adhesion and fluoride release, and ratings in clinical use. CONCLUSION: The majority of available literature data is based on studies that investigated one of the self-adhesive cements that are currently available to clinicians. According to the in vitro results, self-adhesive cement adhesion to dentin and various restorative materials is satisfactory and comparable to other multistep resin cements, while adhesion to enamel appears to be a weak link in their bonding properties. Long-term clinical performance of these materials needs to be assessed prior to making a general recommendation for their use.

Accelerated aging of adhesive-mediated fiber post-resin composite bonds: A modeling approach.

OBJECTIVES: Although fiber posts luted in root canals are not directly exposed to oral fluids, water storage is considered as in vitro accelerated aging test for bonded interfaces. The aim of the study was to evaluate the influence of accelerated water aging on fiber post-resin composite adhesion. METHODS: Forty fiber posts (DT Light Post, RTD) were randomly divided into two main groups, according to the surface treatment performed. Group I: XPBond adhesive (Dentsply Caulk); Group II: sandblasting (Rocatec-Pre, 3M ESPE) and XPBond. Dual-cured resin cement (Calibra, Dentsply Caulk) and flowable composite (X-Flow, Dentsply Caulk) were applied on the posts to produce cylindrical specimens. The bond strength at the interface between post and cement/composite was measured with the microtensile test according to the non-trimming technique. Half of the sticks were tested immediately for bond strength, while in the other half testing was performed after 1 month of water storage at 37 degrees C. Post-cement/composite interfaces were evaluated under SEM prior and after water aging. Statistical analysis was performed using the Kruskal-Wallis ANOVA followed by Dunn's multiple range test (p<0.05). RESULTS: Immediate bond strength was higher on sandblasted posts. After water aging the two post surface treatments resulted comparable in bond strength. Resin cement achieved higher bond strength to fiber posts than flowable composite. Water aging significantly reduced bond strength. CONCLUSIONS: Sandblasting followed by adhesive coating may improve immediate post-resin bond strength in comparison to adhesive alone. However, fiber post-resin bond strength mediated by hydrophilic adhesive tends to decrease after water aging.

The effect of sandblasting on adhesion of a dual-cured resin composite to methacrylic fiber posts: microtensile bond strength and SEM evaluation.

OBJECTIVES: To evaluate the influence of different surface treatments on the microtensile bond strength of a dual-cured resin composite to fiber posts. METHODS: Thirty-two glass methacrylate-based fiber posts (GC Corp.) were used in the study. Posts were divided into two groups, according to the surface pretreatment performed. Group 1: sandblasting (Rocatec-Pre, 3M ESPE). Group 2: no pretreatment. In each of the two groups posts received three types of additional "chair-side" treatments. (1) Silane application (Monobond S, Ivoclar Vivadent); (2) adhesive application (Unifil Core self-etching bond, GC); (3) no treatment was performed. A dual-cured resin composite (Unifil Core, GC) was applied on the posts to produce cylindrical specimens. Specimens were cut to obtain microtensile sticks that were loaded in tension at a cross-head speed of 0.5mm/min until failure. The morphology of the post/composite interface and the post surface morphology were evaluated under SEM. Statistical analysis was performed with two-way ANOVA and Tukey test for post hoc comparisons (p<0.05). RESULTS: Post surface pretreatment did not prove to be a significant factor in post-composite bond strength (p=0.08), whereas "chair-side" treatment modalities and the interaction between pretreatment and treatment showed a significant influence on bond strength (p<0.001). When no "chair-side" treatment was performed, bond strength was significantly higher on sandblasted posts. Additional adhesive application resulted in significantly lower bond strength on sandblasted posts. When no pretreatment was performed, silane application resulted in higher bond strength than adhesive application. CONCLUSIONS: Sandblasting may give an increase in microtensile strength to methacrylate-based glass fiber posts, eliminating the need for additional "chair-side" treatments. Reducing the number of clinical steps could contribute to simplify the clinical procedures.

Morphological evaluation of 2- and 1-step self-etching system interfaces with dentin.

This in vitro study evaluated the resin-dentin interface formed by two 2-step and two 1-step self-etching adhesive systems under SEM. Class V cavities (4 x 2.5 x 1.5 mm) were prepared on the buccal surfaces of 25 extracted intact human third molars using a carbide bur in a high-speed handpiece. Four self-etching systems with corresponding resins were used: two 2-step systems, AdheSE (Ivoclar Vivadent) and Contax (DMG Hamburg), one 1-step/2 components system Futurabond NR (Voco) and a 1-step/1 component adhesive G-Bond (GC Corp). An etch and rinse system, PQ Clear (Ultradent), was used as a control. The teeth were thermocycled (500 cycles, 5 degrees /55 degrees C, 30 seconds dwell time), and 2 sections were made longitudinally through the restorations with a low-speed diamond saw, producing approximately 1-mm wide samples. The samples were polished with silicon carbide paper of increasing grit (400-1000), demineralized (6N HCl, 30 seconds), deproteinized (2.5% NaOC1, 10 minutes), left to air dry for 24 hours in a desiccator under low vacuum pressure, gold sputtered and viewed under SEM (JEOL-JSM-6460LV). In the AdheSE, Contax and Futurabond NR specimens, resin tag penetration into the tubules and lateral tags could be seen. G-Bond showed different interface morphology, with a tight, thin continuous junction and almost no resin penetration into tubules. PQ Clear samples exhibited the highest number of resin tags with numerous lateral tags. A clearly defined hybrid layer was seen in the Contax and PQ Clear specimens. Investigated self-etching systems showed similar interfacial morphology with dentin, except for the 1 step/1 component adhesive G-Bond. The degree of demineralization and interaction with dentin correlated with the acidity of the self-etching primers/adhesives. Fewer resin tags were formed with self-etching primers/adhesives than with the etch and rinse system.