Long-term bond strength of fiber posts cement to dentin with self-adhesive or conventional resin cements

The aim of this study was to evaluate the immediate and the long-term push-out bond strength of glass fiber posts (GFP) cemented with conventional or self-adhesive dual-curing resin cements, at different root depths. Prior to cementation, the GFP (Reforpost #3, Angelus) were etched with 37% phosphoric acid for 30 s followed by silane for 1 min. Thirty canine roots were divided into two groups (n = 15) according to resin cement type: ARC – dual resin cement (RelyX ARC/3M ESPE) combined with an three-step etch-and-rinse adhesive (Adper Scotch Bond Multi-Purpose Plus 3M/ESPE) or U200 – self-adhesive resin cement (RelyX U200/3M ESPE). The manufacturer’s instructions were followed. After 48 h, the roots were cross-sectioned at three different depths, resulting in serial slices corresponding to the cervical, middle, and apical root thirds. Slices were randomly divided into two groups, according to the period of water storage prior to push-out bond strength analysis: 48 h or 180 days. The data (MPa) were analyzed using three-way ANOVA for randomized blocks (p < 0.05), which showed no significant interaction between the three factors (p = 0.716). The main study factors were also proven not significant (cement: p = 0.711; time: 0.288; root third: p = 0.646). In conclusion, root depth, cement type (self-adhesive or conventional), and storage in water for 180 days did not influence the bond strength of GFP to intracanal dentin.     

Bonding ability of self-adhesive resin-cements after dentin biomodification with hyaluronic acid

Purpose: The present study evaluated the influence of the hyaluronic acid (HA) on the bonding ability of self-adhesive resin cements to dentin regarding the bond strength. Eighty bovine incisors were ground flat to obtain a 2-mm thick slices which received conical preparations. The specimens were randomly distributed into 4 groups (n = 15) according to the dentin pretreatment (1 – control: untreated dentin; 2 – application of HA) and the evaluation time (1 – control: immediate evaluation; 2 – hydrolytic degradation: 6 months of storage in water at 37 °C). Preparations received the application of a self-adhesive resin cement (RelyX U200 or MaxCem Elite). Push-out bond strength test was conducted (0.5 mm/min). The bond strength data was submitted to two-way ANOVA/Tukey’s test (α = 0.05). For U200, no significance was observed when comparing the immediate (24 h) and 6 months means for the control groups (unexposed specimens). Previous application of HA to dentin significantly reduced the bond strength of U200 to dentin in both evaluation times (p < 0.05). HA had no significant influence on the push-out bond strength means for the cement MAX in both evaluation times (p > 0.05). The type 1 failure mode (adhesive mode) occurred in 100% of the specimens, irrespective of the dentin treatment or evaluation times. Pretreatment of dentin with HA produces a material-dependent influence on the push-out bond strength. The bonding ability of RelyX U200 is negatively influenced by the pretreatment of dentin with HA, whereas the biomodification of dentin with this bioactive agent causes no impact for the cement MaxCem Elite.     

Influence of surface energy parameters of dental self-adhesive resin cements on bond strength to dentin

The purpose of this study was to determine the surface energy parameters of dental self-adhesive resin cements (SRCs) and to measure their bond strength to dentin. Six dental SRCs (RelyX Unicem Clicker, RU; Maxcem Elite, ME; BisCem, BC; Clearfil SA Luting, SA; Multilink Speed, MS; seT PP, SP) and one resin-modified glass ionomer cement (RelyX Luting 2, RL; control) were tested. Smear layer-covered bovine dentin was used as bonding substrate. Using the dynamic sessile drop method, surface energy, surface energy components, degree of hydrophobicity/hydrophilicity (expressed as ΔG _sws using thermodynamic notation), and apparent surface energies for each material were calculated. The luting cements were bonded to the dentin and stored in water at 37?°C for 24?h prior to shear bond strength test (n?=?10). Pearson correlation analysis was applied to detect possible correlations between surface energy parameters and measured shear bond strength (α?=?0.05). RU, SA, and MS produced negative ΔG _sws values (hydrophobic), whereas ME, BC, SP, and RL yielded positive ones (hydrophilic). RU had the highest value among all six SRCs tested, the value for MS being statistically equivalent (p?=?0.785). The base component, ΔG _sws, and surface energy determined with water showed significant negative linear correlations with dentin bond strength (r/p?=??0.801/0.030, ?0.900/0.006, and ?0.892/0.007, respectively). These results suggest that bonding to smear layer-covered bovine dentin was governed by the base component and the hydrophobicity/hydrophilicity of the SRCs.     

Shear Bond Strength of Indirect Composites Luted with Three New Self-Adhesive Resin Cements to Dentin

The aim of this study was to evaluate the shear bond strengths of indirect composites (those cured outside the mouth) luted by three different, recently developed, self-adhesive resin cements to dentin. Seventy caries-free mandibular third molar teeth embedded in acrylic resin and with exposed dentin surfaces were used. Teeth were randomly divided into seven groups. The following application protocols were carried out: a) Group 1 (control group)—direct composite resin restoration (Alert) with total-etch adhesive system (Bond 1 primer/adhesive); b) Group 2—indirect composite restoration (Estenia) luted by a resin cement (Cement-It) combined with the same total-etch adhesive; c) Group 3—direct composite resin restoration with self-etch adhesive system (Nano-Bond); d) Group 4—indirect composite restoration luted by the resin cement combined with the same self-etch adhesive; e) Groups 5–7—indirect composite restoration luted with self-adhesive resin cements (RelyX Unicem®, Maxcem®, and Embrace WetBond®, respectively) onto untreated dentin surfaces. Shear bond strengths of the groups were performed with a universal testing device. Results were statistically analysed by student-t and one way ANOVA tests. The fractured surfaces were also examined by SEM. The indirect composite restorations luted with the self-adhesive resin cements (Groups 5–7) showed successful results compared with the other groups (p < 0.05). Group 4 showed the weakest bond strength (p > 0.05). Open dentin tubules were observed on the total-etch adhesive applied surfaces whereas a smear rich layer was found by SEM on the self-etch adhesive applied surfaces. The new universal self-adhesive resins may be considered an alternative for luting the indirect composite restorations onto the untreated dentin surfaces.     

Inorganic characterizations and filler particles morphology of self-adhesive cements

This study evaluated the thermal and morphological filler characteristics of self-adhesive resin cements. The cements (Embrace WetBond, MaxCem Elite, Bifix SE, G-Cem, and RelyX U200) were manipulated according to the manufacturers׳ instructions. Thermogravimetric analysis and differential thermal analysis were performed to obtain the glass transition temperature (T_g) and weight loss. Specimens were also obtained to characterize the zeta potential, the mean particle size and distribution, and the polydispersity by dynamic light scattering. An elemental analysis of the fillers was also conducted using X-ray spectroscopy analysis and micromorphology under SEM. MaxCem Elite contained the least organic matrix, followed by G-Cem, Bifix SE, RelyX U200, and Embrace WetBond. Bifix SE presented the highest T_g and G-Cem the lowest. Bifix SE presented the broadest filler size distribution, exhibiting lower zeta potentials and mobility. G-Cem was found to be a highly filler loaded cement with the lowest effective diameter, highest zeta potential and mobility. RelyX U200 presented chromium in the composition and G-Cem presented fluorine. Differences in the nature and chemistry of inorganic fractions seemed to dictate the morphology of the filler content and also the thermal behavior of the materials tested and, may consequently influence the clinical performance of self-adhesive resin cements.     

Adhesion of conventional and self-adhesive resin cements to indirect resin composite using different surface conditioning methods

This study evaluated the adhesion of conventional and self-adhesive resin cements to indirect resin composite (IRC) using different surface conditioning methods. Cylindrical IRC specimens (N = 192) were randomly assigned to four surface conditioning methods (n = 8 per group): (a) Control group, (b) Hydrofluoric acid, (c) Tribochemical silica-coating, and (d) 50 μm Al₂O₃ air-abrasion. Specimen surfaces were finished using silicon carbide papers up to 600 grit under water irrigation, rinsed and dried. Direct composite blocks were bonded to IRC specimens using three conventional resin cements (Multilink, Panavia F2.0, and Resicem) and three self-adhesive resin cements (RelyX U100, Gcem, Speed Cem). Specimens were subjected to shear bond strength test in a Universal Testing Machine (0.5 mm/min). Failure types were categorized as mixed, adhesive and cohesive. Data were analyzed using 2-way ANOVA and Tukey’s tests. Two-parameter Weibull modulus, scale (m) and shape (0) were calculated. The bond strength results (MPa) were significantly affected by the surface conditioning method (p < 0.0001) and cement type (p < 0.001). For Panavia F2.0, Resicem, air-abrasion with 50 μm Al₂O₃ significantly increased the results (22.6 ± 6.5, 26.2 ± 6.5, respectively) compared to other conditioning methods (13.6 ± 1.4–21.9 ± 3.1) but for Multilink, hydrofluoric acid etching (20.5 ± 3.5) showed significantly higher results (p < 0.01). For the self-adhesive resin cements, air-abrasion with 50 μm Al₂O₃ significantly increased the results compared to other conditioning methods, except for RelyX U100 (p < 0.05). After air-abrasion with Al₂O₃, Gcem, (11.64), RelyX U100 (9.05), and SpeedCem (8.29) presented higher Weilbul moduli. Exclusively cohesive failure in the IRC was observed with RelyX U100 and Speedcem after Al₂O₃ air-abrasion.     

Effect of cyclic loading and resin cement type used for luting fiber posts on bond strength at different root levels of crown-restored human teeth

Objective: This study aimed to evaluate the bond strength (BS) of glass fiber posts (GFP) at different root levels when luted with conventional or self-adhesive cements in crown-restored human premolars subjected, or not, to cyclic mechanical loading.

Materials and Methods: Sixty lower premolar roots were endodontically treated and prepared for a GFP system. Half of the roots (n = 30) had their posts cemented with a self-adhesive resin cement, while the remaining roots followed a three-step conditioning method: acid etch, bonding agent, and a conventional resin cement. Metal crowns were luted onto the post-core preparations and the specimens were embedded to simulate the periodontium. Half of the specimens from each group (n = 15) were submitted to cyclic loading simulations (130 N; 2.0 Hz) and then sections were obtained from each root for the pushout BS test.

Results: Independently of the cyclic loading and the root level tested, the conventional resin cement provided significantly higher values of BS (p = 0.002). For either cement or either root level, cyclic loading caused a significant decrease in BS values (p = 0.023). The Tukey test indicated that, regardless of the resin cement used or the cyclic loading, BS was highest at the middle and cervical thirds of the root (p = 0.026), and their values did not differ between themselves.

Conclusions: When used for luting GFP, self-adhesive resin cement resulted in lower pushout BS than the conventional counterpart, with cyclic loading causing a decrease in BS of the GFP to dentin for both resin cements.     

Bond strength evaluation of composite resin bonded to glass ionomer cements after different periods of setting

This study investigated the time elapsed after setting of glass ionomer cements on the bond strength to composite resin restorations. Bovine incisors received cavity preparations on the buccal surface (6 mm×6 mm×2 mm) and the specimens were tested according to cement type (conventional and resin-modified) and time elapsed before performing the restorations: GC10m: conventional glass ionomer cement and 10 min time elapsed after setting; GC24h: conventional cement and 24 h after setting; GC7d: conventional cement and 7 days after setting; GRM10m: resin-modified glass ionomer cement and 10 min after setting; GRM24h: resin-modified cement and 24 h after setting; and GRM7d: resin-modified cement and 7 days after setting. Specimens were subjected to micro-shear testing and the data were analyzed by Analysis of Variance and Tukey′s test (p=0.05). Bond strength of restorations performed on conventional cement after 10 min of time elapsed presented the lowest mean values and differed statistically from values at 24 h and 7 days. Resin-modified cement after 24 h presented the highest mean values and differed statistically from values at 10 min and 7 days. The time elapsed after setting of glass ionomer cement may interfere in the bond strength to composite restorations.     

Effect of dentinal surface preparation on the bonding of self-adhesive luting cements

The purpose of the present study was to evaluate the bond strength and the interaction morphology of self-adhesive resin luting cements (SLCs) to dentin prepared with different methods. Four SLCs were used: RelyX U100^®, RelyX U200^®, Clearfil SA Luting^®, and SmartCem2^®. A flat dentin surface of 40 human molars was exposed and each tooth was sectioned in four tooth-quarters, which were distributed into four groups according to the SLC used to cement indirect resin composite restorations. The tooth-quarters of each group were then distributed in four subgroups according to the method used for dentin preparation: flat-ended cylindrical fine-grit diamond, flat-ended cylindrical median-grit diamond, flat-ended cylindrical plain-cut tungsten carbide, or abraded with #600-grit SiC paper (control). The restored tooth-quarters were sectioned to obtain beams (0.8?mm²) and submitted to the microtensile bond strength test (n?=?10). The results were analyzed using two-way ANOVA/Tukey (α?=?0.05). Forty-four additional teeth were used for micromorphological investigation of the SLC/dentin interface and of the topographic aspect of the dentin surfaces after application of the SLCs. Only the bond strength of RelyX U200 was significantly influenced by the surface preparation. No interference was identified on the micromorphological aspect of the bonding interfaces. The topographic investigation of the dentinal surfaces showed that the SLCs were not able to effectively remove the smear layer and etch the underlying dentin, irrespective of the preparation method. So, the interference of the dentin preparation on the bond strength of SLCs is material dependent, but don’t influence the micromorphologic aspect of the interaction zone.     

Evaluation of different desensitizing agents effect on shear bond strength of adhesive resin cement to dentin

Desensitizing agents can inhibit the bonding strength between dentin and adhesive resin cement. This study evaluated the effects of different desensitizing agents on the shear bond strength of adhesive resin cement to dentin. Sixty freshly extracted and caries free teeth were classified into five experimental groups, randomly (n?=?12). Each group was treated with a different desensitizing agent (Teethmate, Shield Force Plus, Admira Protect and Ultra-Ez) respectively, except for an untreated control group. After desensitizing agents and adhesive resin cement were applied to each dentin surface, all specimens were stored in incubator at 37?°C for 24?h. The shear bond strength was tested with a Universal testing machine at a 0.5?mm/min crosshead speed. Data were analysed by using a statistical software (SPSS 22). The results of the measurements were analysed by Kruskal Wallis test with Bonferroni correction and multiple comparisons were made by Wilcoxon test (p???.01). Specimens were examined by a scanning electron microscope, additionally. The Shield Force Plus showed significantly the highest shear bond strength compared with other groups (p?<?.01). Ultra-Ez showed the lowest shear bond strength (p?>?.01). There was no significant difference among Teethmate and Admira Protect groups (p?>?.01). Desensitizing agents containing resin monomers increased the bonding strength, however desensitizers containing calcium phosphate, potassium nitrate and fluoride did not effect the bonding strength of resin cement to dentin.     

Effect of adhesive air-drying time on bond strength to dentin: A systematic review and meta-analysis

ObjectiveThe objective of this review was to evaluate the effect of air-drying time on the adhesion (bond) strength of adhesives to dentin in previously published studies and to conduct a meta-analysis to quantify the differences in the bond strength obtained after the different air-drying times.MethodsAn electronic search was performed using the Medline, Cochrane library, and Scopus databases. The included studies were laboratory studies that investigated the effect of adhesive air-drying time on adhesion (bond) strength of resin-based adhesives to coronal dentin. Studies which evaluated the effect of adhesives air-drying time on physical and mechanical properties of adhesives, interfacial properties, bond strength to root dentin, enamel, or bond strength of indirect composite restoration or orthodontic bracket, were excluded. The methodological quality of included studies was assessed. Meta-analysis was performed using Comprehensive Meta-Analysis software, version 2.0 (Biostat, Englewood, NJ, USA). The results of the meta-analysis were subjected to a further one-way analysis of variance, followed by the Tukey post hoc multiple comparison using R-software, version 3.4.3 (R Foundation for Statistical Computing, Vienna, Austria).ResultsThirteen studies fulfilled the inclusion criteria of this review, while only five studies were included in meta-analysis. The effect of adhesive air-drying time on the bond strength was significant in eight studies (61.5%), material-dependent in four studies (30.8%), and not significant in one study (7.7%). Eight studies (61.54%) presented a medium-risk of bias, three studies (23.08%) presented a low-risk of bias, and two studies (15.38%) presented a high-risk of bias. The analysis of micro-tensile bond strength (μTBS) of adhesives showed statistically significant difference between different air-drying times (p<0.05). The highest mean μTBS values were: 52.9 ± 11.38 MPa (obtained after air-drying of adhesives for 30 s), followed by 48.26 ± 9.77 MPa (15 s), and 37.76 ± 1.45 (25 s), while the lowest mean μTBS was 33.98 ± 2.30 MPa and 35.79 ± 6.63 MPa (5 s) obtained after 10 s and 5 s respectively.ConclusionThe air-drying time of adhesives is crucial to the adhesion strength to coronal dentin. Adhesive air-drying for shorter durations (5–10 s) may be insufficient to obtain adequately durable bonding to dentin, instead, Air-drying should be performed for longer durations (15–30 s), considering the pressure and distance of air-drying source.     

Influence of glass fiber post translucency on microhardness and dentin bond strength of resin cement at different root levels

The aims of this study were (a) to evaluate the influence of glass fiber post translucency on the hardness of a light-cure resin cement within the root canal; (b) to assess dentin bond strength at different root levels. Fifty human canine roots were randomly divided into five groups. Translucent posts (Exacto, Angelus; White Post DC, FGM; FRC Postec Plus, Ivoclar Vivadent) were used in three groups, opaque posts (Exacto Opaco, Angelus) were used in one group and no posts were used in the last group. The posts were cemented using a light-cure resin cement (Variolink N Base, Ivoclar Vivadent). The roots were cross-sectioned into slices (two from the cervical, two from the middle, and two from the apical thirds) which were then submitted to microhardness and push-out tests. Two-way analysis of variance and Tukey test were performed. Cement microhardness was significantly higher in the translucent post groups when compared to opaque posts and no post. At the apical third, the White Post DC and FRC Postec groups showed higher microhardness values than those in the Exacto Translucido group. The type of glass fiber post did not significantly influence bond strength values. White Post DC and FRC Postec Plus provided higher resin cement microhardness values, especially at the most apical thirds. Bond strength was not dependent on the type of post used. Failure mode analysis suggested superior cement curing when the translucent posts were used.     

Adhesion of resin cements to contaminated zirconia resin cements on zirconia: effect saliva-contamination and surface conditioning

This study evaluated the adhesion of resin cements to zirconia after saliva contamination using resin cements with different chemistries. Zirconia discs (N?=?240, n?=?10 per group) were randomly divided into three groups: (a) C: No contamination (Control), (b) S: Contamination with saliva, (c) S?+?AA: Contamination with saliva followed by air-abrasion (CoJet). While half of the specimens were not conditioned, the other half were conditioned with 37.5% H₃PO₄ for 60?s. After rinsing, all specimen surfaces were silanized (Monobond Plus). Resin cements based on either methacrylate (Variolink II–VL) or MDP monomer (Panavia 21-PN) were polymerized on the substrates. The specimens were randomly divided into two further groups to be tested either after (a) 24?h dry storage at 37?°C or (b) thermocycling (×5000, 5–55?°C). Microshear bond (MSB) tests were conducted in a Universal Testing Machine and failure types were analyzed. Data were analyzed using Univariate analysis and Tukey’s tests (alpha = 0.05). While saliva contamination, 37.5% H₃PO₄ application (p?<?.001) and aging (p?<?.05) significantly affected the bond results, cement type did not show significant difference after aging (p?>?.05). Adhesive strength of PN (1.2–4.4?MPa) on saliva contaminated and etched zirconia was more stable than that of VL (0–2.8?MPa). After aging, bond strength results decreased the most with VL (3–100%) compared to PN (32–71%) but the decrease was less in the air-abraded groups after aging (VL: 3%; PN: 32%). Exclusively adhesive failures were experienced in all groups.     

Influence of desensitizing procedures on adhesion of resin cements to dentin

This study evaluated the effect of two desensitizer agents with different contents and Nd:YAG laser irradiation on the shear bond strength (SBS) of adhesive resin cements to dentin. New treatment options of Nd:YAG laser irradiation and tetracalcium phosphate-containing agent applications were compared with routinely used glutaraldehyde-containing agents. One hundred and twenty human, caries-free premolars were embedded in acrylic resin blocks 2 mm below the cementoenamel junction. Buccal surfaces of the teeth were ground to expose dentin. The specimens were randomly assigned into three different surface treatments (desensitizing agents, Nd:YAG laser) and the control, then into three different adhesive resin cement applications (n = 10). Resin cements (Panavia SA cement (PA), Panavia SA cement with Clearfil Universal Bond (PACU), and Multilink N (MN)) were applied to the conditioned teeth surfaces using Teflon tubes. The specimens were thermocycled (5000 cycles, 5–55 ± 1 °C, dwell time 30 s). The SBS test was performed in all groups. The results were submitted to two-way ANOVA and Tukey HSD tests (p < .05). Further, SEM analysis was performed on the dentin surfaces. SBS values were significantly difference among the surface treatment groups and also among adhesive resin cement groups (p < .05). The specimen cemented with PA showed lower SBS values than PACU- and MN-applied specimens. The highest SBS value was obtained in the Nd:YAG laser group which was cemented with PACU cement. The lowest SBS value was obtained in the control group which was cemented with PA cement. In addition, SEM evaluation revealed that desensitizing agents and Nd:YAG laser occluded dentin tubules.     

Bond Strength and Interfacial Ultramorphology of Current Adhesive Systems

This study evaluated the bond strength and ultramorphology of the resin-dentin interfaces produced by current dental adhesive systems. Nine dentin bonding agents were investigated. Restored teeth were vertically, serially sectioned to obtain bonded slices for interfacial TEM analysis or to produce bonded beams for the microtensile bond strength test. The one-step self-etching adhesives (Futurabond® NR and Hybrid Bond®) showed lower bond strength values than the three-step etch-&-rinse adhesive system All-Bond 3. Most bonding agents presented statistically similar mean bond strength values, which ranged from 41.3 ± 17.9 to 35.0 ± 5.3 MPa. The thickness of the hybrid layer varied according to the type of adhesive system used. While the etch and rinse adhesives with alcohol as organic solvent showed bond strength means higher than 40 MPa, the self-etching systems showed bond strength lower than 40 MPa. Resin-dentin interdifusion zone and resin tags were noted in all bonded interfaces.     

Effects of mixing techniques and dentin moisture conditions on push-out bond strength of ProRoot MTA and Biodentine

Objective: To evaluate the influence of manual and mechanical mixing techniques as well as the effects of moisture on the push-out bond strength of ProRoot MTA (Dentsply Tulsa Dental, Tulsa, OK, USA) and Biodentine (Septodont, Saint Maur des Fosses, France) to radicular dentin.

Material and methods: Two hundred and forty dentin discs were assigned into three groups with respect to the moisture condition tested: (1) dry, (2) paper points, (3) wet. The discs were further divided into four subgroups according to the calcium silicate cements (CSCs) and mixing techniques used: (1) ProRoot MTA mixed manually, (2) ProRoot MTA mixed mechanically, (3) Biodentine mixed manually, and (4) Biodentine mixed mechanically. Bond strengths of the cements to root canal dentin were measured using a push-out test setup. The data were statistically analyzed using three-way ANOVA and Bonferroni post hoc test p = 0.05.

Results: The data indicated that the push-out bond strength values were significantly affected by CSCs, mixing techniques, and moisture conditions (p < 0.001). Dry conditions caused a significant decrease in bond strength values for both CSCs (p < 0.001). The mean bond strength of Biodentine was significantly higher than that of ProRoot MTA, regardless of the mixing techniques and moisture conditions (p < 0.001). Mechanical mixing favored bond strength values statistically compared to manual mixing (p < .001).

Conclusion: The mixing techniques and moisture conditions have an effect on the push-out bond strengths of ProRoot MTA and Biodentine. Dry samples and manual mixing of cements deteriorate the push-out bond strengths values.     

Impact of conditioning regimens and time on adhesion of a fiber post to root dentin using two resin cements

The aim of this study was to evaluate the influence of irrigation protocols on the bond strength of a glass fiber post bonded to dentin using two resin cements. In 200 root-filled teeth, post space was prepared and divided into five groups (n?=?40) based on the irrigation protocol: group 1 (3% sodium hypochlorite), group 2 (3% sodium hypochlorite – 17% Ethylene diamine tetraacetic acid), group 3 (a mixture of sodium hypochlorite and etidronic acid), group 4 (sodium hypochlorite – QMix), and group 5 (distilled water). Samples were subdivided into two subgroups (n?= 10) and fiber posts were cemented using subgroup A (Self-adhesive dual-cure resin cement; SEA) or B (dual-cure resin cement following an etch-and-rinse protocol, ER). Push-out bond strength was performed after 24 h and four months (n?= 10) and failure modes were categorized. Statistical analysis of data was carried out by appropriate analyses (p < 0.05). The irrigation protocol and the resin cement had a significant impact on push-out bond strength. Subgroup A group showed lower bond strength than B at both time periods when 3% NaOCl–17% EDTA and 1:1 mixture of 6% NaOCl + 18%EA protocols were used. Three percent NaOCl used in combination with 17% EDTA or QMix significantly decreased the push-out bond strength of ER at the end of four months (p < 0.05). In conclusion, dual-cure resin cements bonded with etch-and-rinse protocol showed highest bond strength when a mixture of NaOCl and etidronic acid was used as root canal irrigant. These values were differentially influenced by time.     

Micro-computerized tomography analysis of cement voids and pull-out strength of glass fiber posts luted with self-adhesive and glass-ionomer cements in the root canal

This study evaluated the pull-out strength of different glass fiber posts and measured volume of cement and voids in the cement in the root canal utilizing micro-computerized tomography (micro-CT) analysis after they were cemented with two different luting cements. Canine teeth (N = 40) were endodontically treated and randomly divided into four groups depending on the fiber post and the cement type (n = 10 per group) as follows: Group RU: (RelyX + RelyX U200), Group PU: (PINpost + RelyX U200), Group RF: (RelyX + FujiCEM 2), Group PF: (PINpost + FujiCEM 2). Each tooth was scanned using micro-CT and the percentage of cement and void volume at the coronal, middle, and apical levels was calculated. Pull-out tests were performed by applying tensile load parallel to the long axis of the posts (0.5 mm/min). Data were analyzed using, ANOVA, Kruskal–Wallis, and Mann–Whitney U tests (α = 0.05). Regardless of cement type, the percentage (%) of cement volume in the RelyX post groups (RU:31–36; RF:29–40) was significantly higher than that in the PINpost groups (PU:19–23; PF:18–22) (p < 0.05). The percentage of void volume at the PINpost groups (PU:6–11; PF:8–13) was significantly lower than that in the RelyX groups (RU:2; RF:3) (p < 0.05). No significant differences were observed in pull-out strength (N) between the four experimental groups (RU:358.8 ± 56.2; RF:299 ± 64.8; PU:311.9 ± 61.3; PF:293.1 ± 91.3) (p > 0.05). The micro-CT analysis demonstrated that the percentage of cement and void volumes vary depending on the type of fiber post and cement used. No correlation between cement, void volume, and pull-out strength was observed.     

Effect of different mechanical cleansing protocols of dentin for recementation procedures on micro-shear bond strength of conventional and self-adhesive resin cements

Service life of debonded indirect dental restorations could be prolonged by recementation. This process requires removal of cement remnants from dentin. This study evaluated the effect of different mechanical cleansing protocols of dentin for recementation procedures on micro-shear bond strength (μSBS) of conventional and self-adhesive resin cements. The labial surfaces mandibular incisors (N=200) were ground with a low speed saw to expose the coronal dentin. The teeth were randomly divided into two subgroups (n: 100 per group) and received either (a) conventional (Panavia F 2.0, Kuraray, PAN) or (b) self-adhesive (Clearfil SA, Kuraray, CSA) resin cement. Resin cements were condensed into polyethylene molds incrementally and photo polymerized using an LED polymerization unit. Specimens were stored in distilled water at 37 °C for 24 h and subjected to μSBS (0.5 mm/min). Resin cement remnants on bonded dentin surfaces were removed using by (a) composite finishing bur (cb), (b) tungsten carbide bur (ob), (c) ultrasonic scaler tip (sc) or (d) pumice-water slurry (pw). Non-cleaned teeth acted as the control group (cn) (n: 20 per subgroup). After cleaning, the same cement type was rebonded simulating clinical recementation. Failure types were analyzed using optical microscope and Scanning Electron Microscope (SEM). Data (MPa) were analyzed using Wilcoxon Signed Ranks, Mann-Whitney U and Bonferroni tests (α=0.05). Overall, CSA (6.42±2.96) showed significantly lower results than that of PAN cement (7.88±3.49) (p<0.05). All cleansing protocols (4.29±2.17 to 5.82±2.5) showed significantly lower results than that of the control group (9.84±4.88) for PAN cement. For CSA cement, all cleansing protocols presented non-significant results (4.25±2.74 to 6.44±2.4 MPa) compared to control group (p>0.05) expect cb method (3.42±1.47) (p<0.05). Remnants of cements were detected on dentin surfaces in all groups at varying degrees. SEM showed that while using pumice-water slurry was the least effective for PAN, tungsten carbide bur was the most effective for both cements. All other methods showed similar cleansing efficacy. None of the cleansing protocols yielded to complete removal of resin cement rest on dentin upon recementation for both cements tested.     

The effect of intracanal placement of various medicaments on the bond strength of three calcium silicate-based cements to root canal dentin

This study aimed to evaluate the effect of intracanal placement of various medicaments on the bond strength of ProRooT MTA, Biodentine, and Endosequence root repair material (ERRM) putty. Ninety extracted human mandibular premolar teeth were decoronated and instrumented using Protaper Next rotary system and #1 to #6 Peeso reamers. The prepared teeth were randomly divided into six groups according to the intracanal medicaments: Group 1: double antibiotic paste (DAP) consisting of metronidazole and ciprofloxacin; Group 2: Triple antibiotic paste (TAP) with cefaclor; Group 3: TAPwith clindamycin; Group 4: amoxicillin and clavulanic acid (Augmentin®); Group 5: calcium hydroxide (CH); Group 6: control (no medicament) (n = 15). Parallel transverse sections were obtained in the coronal to the apical direction (4 slices/ tooth) and were divided into three subgroups according to the cements: Group A: ProRoot MTA; Group B: Biodentine; Group C: ERRM (n = 20 slices/subgroup). A push-out test was used to measure bond strength. Data were analyzed using two-way analysis of variance and Tukey’s post hoc test. The bond strength was significantly lower for DAP and TAPs than for Augmentin®, CH, or the control (p < 0.05). Biodentine and ERRM had significantly higher bond strength values than ProRooT MTA (p < 0.05) regardless of the intracanal medicaments tested, while no significant difference existed between Biodentine and ERRM (p > 0.05). While the application of DAP or TAPs decreased the bond strength, application of CH or Augmentin® did not. ERRM and Biodentine had higher bond strength values than ProRoot MTA.