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Effect of three root canal sealers on the retentive strength of endodontic posts luted with a resin cement.

AIM: This investigation examined what effect three different sealers had on retention of endodontic posts (Parapost) luted with a resin cement (Panavia 21 OP). METHODOLOGY: Sixty-four single-rooted teeth were decoronated, filed, cleaned, and shaped with a size 5 Gates-Glidden drill and 0.12 taper G.T. rotary instrumentation (Dentsply/Tulsa Dental). Teeth were then divided into four groups of 16 each. Group 1 was not obturated, and served as a control. The other three groups were obturated with gutta-percha using a different sealer for each group. Group 2 used a eugenol containing sealer (Kerr Pulp Canal Sealer), group 3 a resin sealer (AH-26), and group 4 a calcium hydroxide sealer (Sealapex). After 1 week's storage at 100% humidity, 10-mm deep post spaces were prepared with a size 6 Gates-Glidden drill, and size 5 Paraposts were cemented. Following 48 h of storage, samples were mounted in a PVC pipe with acrylic, and the posts were removed vertically using a universal testing machine at 1 mm min-, with data recorded in kilograms. RESULTS: The mean values of force required to remove the posts were: group 1 = 61.80, SD = 16.21; group 2 = 43.14, SD = 14.66; group 3 = 48.54, SD = 17.84; group 4 = 53.52, SD = 18.77. Using anova and Bonferroni tests, group 1 demonstrated significantly greater mean retention strength values than group 2, but no other significant differences existed between groups. CONCLUSION: The chemical formulation of root canal sealers did not significantly affect the retention of endodontic posts luted with resin cement.

Analysis of Variance↗

Effect of seating force, margin design, and cement on marginal seal and retention of complete metal crowns.

PURPOSE: The purpose of this study was to determine the marginal discrepancy and retention of silver-palladium crowns cemented with zinc phosphate (Phosphacap) and glass-ionomer cement (Fuji Cap 1) using different seating forces on preparations with various margin designs. MATERIALS AND METHODS: Crown preparations with three finish lines--chamfer, shoulder, and shoulder with a 45-degree bevel--were sequentially prepared on a dentoform premolar. A metal die for each of the three finish lines was constructed. Complete metal crowns were fabricated for each metal die using a silver-palladium alloy. Three different seating forces--25, 100, and 300 N--were used to load the crowns until initial set of the cement. The marginal discrepancy was calculated by measuring the change in crown height before and after cementation using a digimatic indicator. Retention was determined by measuring the tensile strength using the Lloyd universal testing machine. RESULTS: The higher seating forces produced better crown seating but had no significant effect on crown retention. The shoulder and shoulder with bevel finish lines provided better crown retention than the chamfer. Glass-ionomer cement provided greater crown retention than zinc phosphate cement. No significant correlation between marginal seating and crown retention was revealed using a Pearson analysis. CONCLUSION: Marginal seal was not influenced by either margin design or type of luting cement, but was improved with higher seating force. Crown retention was affected by the margin finish line and the luting agent.

Analysis of Variance↗

Retentive [correction of Preventive] efficacy of glass ionomer, zinc phosphate and zinc polycarboxylate luting cements in preformed stainless steel crowns: a comparative clinical study.

This study was undertaken to assess the efficacy of three luting cements, namely, glass ionomer, zinc phosphate and zinc polycarboxylate in retainng the preformed stainless steel crowns in-vivo. Twenty subjects, with an indication for restoration of three primary molars with stainless steel crowns, were selected. Sixty teeth were taken up for the study, and twenty crowns were cemented with each of the three luting cements. After an eight month follow up the crowns were assessed for their presence/ absence or "rocking". Statistical analysis was done using Chi-square test. The results have shown no significant difference in retentivity of stainless steel crowns with the use of either of the three luting agents.

Cementation↗

Retention of three endodontic posts cemented with five dental cements.

STATEMENT OF PROBLEM: The retention of a post is believed to be a major factor in restoration survival. Therefore the cement with the greatest in vitro retention property should give the best performance for a restoration. PURPOSE: This study compared retentive values of three posts (Flexi-Post, AccessPost, and ParaPost) cemented with five cements (Flexi-Flow, zinc phosphate, Advance, Duet, and Ketac-Cem) plus a control group that consisted of a Flexi-Post No. 2 dowel without cement. MATERIAL AND METHODS: A total of 160 recently extracted human single-rooted teeth with crowns removed at the cementoenamel junction were divided into 16 groups of 10 samples. Post holes were prepared according to manufacturers' instructions. Posts were then cemented with one of the five cements. Each sample was placed into a specialized jig and on a tensile testing machine with crosshead speed of 0.638 cm/minute, applied until failure. A two-way analysis of variance and Newman-Keuls multiple range comparison tests were performed for all cemented groups. A one-way analysis of variance and a Student-Newman-Keuls multiple range comparison test were performed only for the groups with the Flexi-Post dowel, this included the no cement condition, with significant results if p < 0.05. RESULTS: Flexi-Post dowel with Flexi-Flow Natural cement obtained the highest retentive value (303.91 pounds). ParaPost dowel with Duet cement exhibited the lowest retention value (21.23 pounds). The Flexi-Post dowel demonstrated higher mean retention than AccessPost or ParaPost dowels, AccessPost dowel was higher than ParaPost dowel. Flexi-Flow cement had the highest overall mean retention followed, in decreasing order, by zinc phosphate, Advance, Ketac-Cem, and Duet cements. CONCLUSIONS: Flexi-Post dowel was the most retentive post studied with values ranging from 303.91 pounds with Flexi-Flow Natural cements to 150.93 pounds without cement. Flexi-Flow cements had a higher overall mean retention than other cements studied.

Analysis of Variance↗

Efficacy of threaded hydroxyapatite-coated implants placed in the anterior mandible.

A data subset from an ongoing prospective multicenter clinical study of threaded hydroxyapatite-coated implants was evaluated to assess safety and efficacy of the implants in anterior maxillary regions when used to support fixed prostheses. Observations were recorded before surgery, at first-stage surgery, at second-stage surgery, at loading, and at quarterly post-restoration prophylactic exams and annual comprehensive patient visits. Of 2,062 implants restored in 720 patients in the parent study, a total of 95 implants in 54 patients met the criteria for inclusion into this portion. Implant failure criteria included mobility, radiographic evidence of bone loss greater than one-third the length of the implant or peri-implant radiolucency, fracture, exfoliation, removal for any reason, and patient reported pain upon palpation. Soft tissue indices were monitored as part of the study. Post-restoration implant performance was analyzed using life-table methodology. No failures were observed before prosthodontic rehabilitation. Three implants failed during an observation period of up to 5 years after completion of prosthodontic treatment. The Cutler-Ederer life table success rate after 5 years was 93.4 percent. Results of this investigation suggest that threaded hydroxyapatite-coated implants are safe and effective when placed in anterior maxillary regions to support fixed prostheses.

Adult↗

The effect of cementing agent and technique on the retention of a CeraOne gold cylinder: a pilot study.

Endosseous dental implants are routinely used for the replacement of missing teeth. The CeraOne system uses a gold cylinder that is luted to a metal abutment. This study evaluated two luting agents and two luting techniques on the retention of a CeraOne gold cylinder to a CeraOne titanium abutment. A mechanical testing instrument was used to provide an uniaxial tensile force on the gold cylinder, which was cemented with zinc phosphate or Tempbond NE. The access opening to the gold abutment screw was filled or unfilled. Filling the access opening resulted in significantly higher retentive values (P < 0.01) compared to leaving the access opening unfilled. The gold cylinder was significantly more retentive when cemented with zinc phosphate as compared with Tempbond NE (P < 0.01). A Tukey post hoc test demonstrated that all means were significantly different at the P = 0.01 level. The results suggest that the choice of luting agent and luting technique may affect retention of a CeraOne gold cylinder.

Analysis of Variance↗

In vitro evaluation of the retention of composite fiber and stainless steel posts.

PURPOSE: This study compared the tensile retentive strength of composite fiber-reinforced dowels luted with a resin cement to stainless steel dowels luted with zinc phosphate cement. MATERIALS AND METHODS: The crowns of 40 extracted human mandibular premolars were removed with a separating disc 1-mm coronal to the cementoenamel junction. The teeth were randomly divided into 4 groups (n = 10). A post space was prepared in each specimen to a depth of 9 mm, using the drill supplied by the respective manufacturer. For the stainless steel post group, 1.25-mm-diameter posts were cemented with zinc phosphate cement. For the composite fiber reinforced groups, posts with diameters of 1.00, 1.25, and 1.50 mm were luted with a Bisphenol A-Glycidyl Methacrylate (BIS-GMA) resin bonding system (Jeneric/Pentron, Wallingford, CT) according to manufacturer specifications. The specimens were stored in a sealed container with a moist environment for 24 hours, placed in a fixture in an 801 Materials Test Systems (MTS) machine (MTS Systems Corp, Minneapolis, MN), and loaded in tension at a rate of 5.0 mm/min until failure. Differences among the 4 groups were determined using a one-way analysis of variance and Tukey-B post-hoc tests (alpha = 0.05). RESULTS: The mean loads to failure ranged from 43.9 +/- 10.4 kg for the stainless steel dowel group to 19.9 +/- 5.7 kg for the composite fiber-reinforced 1.00-mm-diameter group. The stainless steel post luted with zinc phosphate cement provided significantly greater tensile resistance than all composite fiber dowel groups. The retention of the 1.00-mm composite fiber-reinforced post was significantly less than the remaining groups. CONCLUSIONS: Under the conditions of this study, the stainless steel dowel luted with zinc phosphate cement provided significantly greater retention.

Analysis of Variance↗

Retention of four endodontic posts cemented with composite resin.

Retention was compared of an active post system (Flexi-Flange), a metal passive prefabicated post system (ParaPost), a passive prefabricated burnout post system (ExactaCast) with and without grooved dentin walls, and a zirconium oxide ceramic post design (Cerapost). The Flexi-Flange with Flexi-Flow Natural cement obtained the highest retentive value of 270.4 lb. The Cerapost cemented with Universal Cement had the lowest retention value of 23.4 lb. The ExactaCast with grooved dentin walls was significantly stronger than the ExactaCast without grooving, the ParaPost, and the Cerapost. The two ExactaCast groups and the ParaPost group had higher retention than the Cerapost group.

Analysis of Variance↗

In vitro assessment of retention of four esthetic dowels to resin core foundation and teeth.

STATEMENT OF PROBLEM: Several new esthetic dowel systems are currently available for the restoration of endodontically treated teeth. These dowel systems enhance the esthetic quality of all-ceramic restorations better than metallic dowel systems. PURPOSE: The purpose of this study was to evaluate the retentive strength of composite and ceramic endodontic dowel systems to the tooth and to the core foundation. MATERIAL AND METHODS: The following dowel systems were tested: resin dowels (Fibrekor [FR]; Luscent [LU]; Twin Luscent Anchor [TLU]); ceramic dowels (Cerapost [CR]; Cosmopost [CO]); and a titanium dowel (ParaPost XH [Ti]). In Part I of the study, core retention was tested by forming Bis-Core resin (n=12) cores around dowels followed by separation using a universal testing machine. In Part II, 60 (n=12) extracted human canines were endodontically treated, and dowel spaces were prepared using the corresponding drill for each dowel system. Nine-millimeter resin and ceramic dowels were cemented with C & B resin luting agent. Additionally, 2 groups (n=12) of Ti dowels cemented with C & B resin luting agent and zinc phosphate luting agent served as control groups. Retention was tested using a universal testing machine to separate the dowels from teeth. One-way analysis of variance and Student Newman-Keuls tests were conducted for statistical analysis (alpha=.05). Surface texture of all dowel systems tested was examined using SEM at original magnification x25 and x250. RESULTS: Core retention of Ti was higher than all esthetic dowels tested (alpha<.05), but FR had higher core retention than the other esthetic dowels tested. Resin dowels had better retention to teeth than ceramic dowels (alpha<.05). CONCLUSION: The esthetic dowel systems were less retentive for the resin core material than the titanium control. Resin dowel systems were more retentive in the root than the ceramic dowels but were similar to the titanium control.

Analysis of Variance↗

Resin bonded attachments for maxillary obturator retention: a clinical report.

This clinical report describes the prosthetic rehabilitation of a maxillary defect with an obturator retained by extracoronal resilient attachments. Resin-bonded cast-metal units were used to retain and stabilize the obturator through abutment contour modification, addition of retentive elements, and primary abutment splinting. The resulting rehabilitation conserved tooth structure and satisfied both esthetic and functional needs.

Adult↗

Retention and failure mode after cyclic loading in two post and core systems.

Retention of a prefabricated post and composite resin core system was compared with that of a cast post and core restoration in anterior maxillary teeth on which root canal preparations, enlarged in the coronal part, were performed. The effect of cyclic loading on restoration retention was also investigated. Retention of restorations not subjected to cyclic loading was not influenced by post type, but loaded prefabricated post restorations showed lower retention than both loaded cast post and core restorations and nonloaded prefabricated post restorations. After dislodgement, the failure mode was also determined. The results of this study suggest that if a canal requires extensive preparation, a well-adapted cast post and core restoration may be more retentive than a prefabricated post restoration that does not match the canal shape.

Composite Resins↗

Does hybridization of intraradicular dentin really improve fiber post retention in endodontically treated teeth?

This study tested the hypothesis that hybridization of intraradicular dentin eliminates interfacial gaps, thereby improving the coronal seal and retention of teeth restored with fiber posts. Post spaces were bonded with two types of fiber posts, using the corresponding etch-and-rinse adhesives and dual-cured resin cements. Longitudinal sections of the interfaces were examined for dentin hybridization in the coronal- and middle-thirds of the root canals. Resin replicas of these sections were evaluated for interfacial gap formation. Although intraradicular dentin hybridization was not compromised irrespective of whether the adhesives were light-cured before cementation, the universal occurrence of interfacial gaps along the hybrid layer surface or the post-cement interface reflects the challenge in bonding to post spaces with low compliance and high C-factors. The clinical success associated with bonded fiber posts is probably due predominantly to frictional retention.

Acid Etching, Dental↗

Effect of preparation convergence on retention and seating discrepancy of complete veneer crowns.

The purpose of this study was to evaluate the retention and marginal seating discrepancy of complete veneer crown cemented with zinc phosphate using various preparation convergence designs. The method employed was that of cementing cast metal crowns onto 46 metal dies fabricated as complete veneer crown preparations with various convergence angles ranging from 0 degrees to 70 degrees and a shoulder finish line. The marginal discrepancy was calculated by measuring the change in crown height before and after cementation using an optical measuring microscope. The force required to remove the crowns from the dies in a vertical direction was determined using an Instron universal testing machine and recorded as retention. The increase in preparation convergence exhibited a wide variation of seating discrepancy between specimens, ranging from 4.58 +/- 1.13 to 73.13 +/- 78.32 microm. Significant tilting of crown was observed as the convergence angle of preparation increased. The retention values ranged from 4.03 +/- 0.61 to 12.12 +/- 0.33 MPa. The Pearson analysis revealed statistically significant correlations between preparation convergence and marginal discrepancy (r = +0.62), and retention (r = -0.91). Complete veneer crown retention and marginal discrepancy were influenced by the preparation convergence design.

Cementation↗

Evaluation of the clinical performance and effectiveness of adhesively-bonded metal crowns on damaged canine teeth of working dogs over a two- to 52-month period.

In this clinical study, 41 metal full crown restorations of canine teeth were placed in 18 working dogs. Twenty-six canine teeth had severe attrition with no involvement of the pulp cavities; 15 fractured canine teeth were endodontically treated. With the exception of one tooth, at least one-third of the coronal part of each canine tooth was available for a supragingivally performed, minimal tooth crown preparation. A dental resin luting cement technique was used to bond the electrolytically etched crown (made from an alloy of cobalt-chrome-molybdenum) to the tooth. The metal crowns were slightly shorter and with a more rounded tip than the original tooth. Posts or post-and-core techniques were not used. Median follow-up period was 30 months (range 2 to 61 months), at which time 36 crowns were found to be intact and functional. Five crowns were lost; three as a result of subsequent injury and fracture of the tooth below the crown; one as a result of use of less than one-third of the coronal portion of the tooth for retention of the crown; and one as a result of an oblique fracture of the root.

Animals↗

Eighteen-month clinical evaluation of two dentin adhesives applied on dry vs moist dentin.

PURPOSE: To evaluate the influence of substrate moisture on the clinical behavior of two dentin adhesives after 18 months. The null hypothesis tested was that drying dentin with air upon rinsing off the acid would not influence the clinical performance of two dentin adhesives as compared to leaving the preparation visibly moist. MATERIALS AND METHODS: Thirty-five patients were enrolled in this study. One hundred twenty-eight restorations divided into 4 groups were inserted and evaluated at baseline: (1) NT/Moist - Prime & Bond NT, an acetone-based adhesive, applied on moist dentin; (2) NT/Dried - Prime & Bond NT applied on dentin dried with air for 3 to 4 s; (3) SB/Moist - Single Bond, an ethanol- and water-based adhesive, applied on moist dentin; (4) SB/Dried - Single Bond applied on dentin dried with air for 3 to 4 s. A microfilled composite resin was used for all restorations. Patients were recalled at 6 and 18 months. RESULTS: At 18 months after initial placement, 110 restorations (86% recall rate) were re-evaluated. Retention rates at 18 months were 92% for NT/Moist, 93% for NT/Dried, 100% for SB/Moist, and 89% for SB/Dried. No statistically significant differences were found among groups for retention rate. Both NT/Moist and SB/Moist resulted in a significant decrease in sensitivity to air from baseline to 18 months. When data were pooled for the variable "substrate moisture", SB resulted in an overall retention rate of 95%, while NT resulted in a retention rate of 92% (statistically similar). The marginal adaptation with SB was significantly worse at 18 months than at baseline. CONCLUSION: The moisture level of the dentin substrate in noncarious cervical lesions does not influence retention of composite restorations, but moist conditions caused less sensitivity to air. When applied as per manufacturers' instructions (moist dentin), both adhesives resulted in Class V retention rates exceeding the ADA 18-month full acceptance guidelines.

Acrylic Resins↗

Clinical evaluation of mandibular overdentures supported by multiple-bar fabrication: a follow-up study of two implant systems.

A retrospective follow-up study was undertaken to assess the clinical condition, complications, and prosthodontic aftercare of two different implant systems over a long period. Thirty-six patients treated with a total of 135 ITI type F endosseous implants, and 37 patients treated with the transmandibular implants and a total of 146 transmandibular posts, were studied during a mean follow-up period of 70 months and 44 months, respectively. The choice of implant type was mainly influenced by a change in financial support by the National Health Insurance Company in The Netherlands in 1987. Cumulative success rates were calculated using the Kaplan-Meier product limit method. In the analysis, the risk for failure of the implants was adjusted for differences in mandibular bone height. There were no differences between the two treatment groups with regard to age, gender, period of edentulousness, and mandibular bone height. During the follow-up period, plaque, bleeding, and hyperplasia scores demonstrated no significant differences between the two groups. The ITI type F group showed significantly more recession, and the transmandibular implant group demonstrated significantly increased Periotest values. After adjusting for differences in bone height, patients treated with ITI type F implants had a lower risk of failure (relative risk, 0.55; 95% confidence interval 0.32 to 0.95). However, neither of the implant systems fulfilled Albrektsson's criteria of success.

Alveolar Bone Loss↗

Effect of hygroscopic expansion on the push-out resistance of glass ionomer-based cements used for the luting of glass fiber posts.

This study examined the contribution of hygroscopic expansion of glass-ionomer (GIC) and resin modified glass-ionomer (RMGIC) luting cements to the push-out resistance of fiber posts. Glass fiber posts were luted to post spaces using different cements. Experimental specimens were stored in water, while control specimens were desiccated and stored in mineral oil to eliminate water from intraradicular dentinal tubules and/or the external environment that could have contributed to hygroscopic expansion of the cements. Thin slice push-out tests revealed no difference in retention strengths of resin composite cements that were stored in water or oil. Conversely, GIC and RMGIC cements exhibited increased retention strengths after water sorption. As unfavorable cavity geometry is taxing to dentin bond integrity in root canals, a strategy that relies on increasing the frictional resistance to post dislodgement via delayed hygroscopic expansion of glass-ionomer based materials may be a more pragmatic approach to fiber post retention.

Acrylic Resins↗