Factors affecting the cement-post interface.

ABSTRACT

OBJECTIVES: To evaluate the effect of different factors on the push-out bond strength of glass fiber posts luted in simulated (standard) root canals using different composite cements. METHODS: Three types of glass-fiber root-canal posts with a different matrix, namely an epoxy resin (RelyX post, 3M ESPE), a proprietary composite resin (FRC-Plus post, Ivoclar-Vivadent), and a methacrylate resin (GC post, GC), and three types of composite cements, namely an etch-and-rinse Bis-GMA-based (Variolink II, Ivoclar-Vivadent), a self-etch 10-MDP-based (Clearfil Esthetic Cement, Kuraray) and a self-adhesive (RelyX Unicem, 3M ESPE) cement, were tested. Posts were either left untreated (control), were treated with silane, or coated with silicated alumina particles (Cojet system, 3M ESPE). Posts were inserted up to 9-mm depth into composite CAD-CAM blocks (Paradigm, 3M ESPE) in order to solely test the strength of the cement-post interface, while excluding interference of the cement-dentin interface. After 1-week storage at 37 °C, three sections (coronal, middle, apical) of 2-mm thickness were subjected to a push-out bond-strength test. RESULTS: All three variables, namely the type of post, the composite cement and the post-surface pre-treatment, were found to significantly affect the push-out bond strength (p<0.001). Regarding the type of post, a significantly lower push-out bond strength was recorded for the FRC-Plus post (Ivoclar-Vivadent); regarding the composite cement, a significantly higher push-out bond strength was recorded for the self-adhesive cement Unicem (3M ESPE); and regarding the post-surface treatment, a significantly higher push-out bond strength was recorded when the post-surface was beforehand subjected to a Cojet (3M ESPE) combined sandblasting/silicatization surface pre-treatment. Many interactions between these three variables were found to be significant as well (p<0.001). Finally, the push-out bond strength was found to significantly reduce with depth from coronal to apical. SIGNIFICANCE: Laboratory testing revealed that different variables like the type of post, the composite cement and the post-surface pre-treatment may influence the cement-post interface, making clear guidelines for routine clinical practice hard to define. Further long-term durability testing may help to clarify, and should therefore be encouraged.