Eur J Oral Sci 2013; 121: 5056 DOI: 10.1111/eos.12005 Printed in Singapore.

All rights reserved

2012 Eur J Oral Sci

European Journal of Oral Sciences

Jelena Juloski1,2, Giovanni M. Fadda1, Ivana Radovic2, Nicoletta Chief1, Zoran R. Vulicevic2, Juan M. Aragoneses3, Marco Ferrari1
1

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

Juloski J, Fadda GM, Radovic I, Chie N, Vulicevic ZR, Aragoneses JM, Ferrari M. Push-out bond strength of an experimental self-adhesive resin cement. Eur J Oral Sci 2013; 121: 5056. 2012 Eur J Oral Sci The adhesion of ber posts luted with simplied 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 ber 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), signicantly higher push-out bond-strength values were measured (15.87 4.68 MPa) compared with the other groups.

Department of Dental Materials and Fixed Prosthodontics of Siena, Tuscan School of Dental Medicine, University of Florence and Siena, Siena, Italy; 2Clinic for Pediatric and Preventive Dentistry, Faculty of Dentistry, University of Belgrade, Belgrade, Serbia; 3 School of Biomedical Sciences, European University of Madrid, Madrid, Spain

Jelena Juloski, Department of Dental Materials and Fixed Prosthodontics of Siena, Policlinico Le Scotte, Viale Bracci, 53100 Siena, Italy Telefax: +390577233117 E-mail: jelenajuloski@gmail.com Key words: adhesion; ber post; push-out bond strength; self-adhesive cement Accepted for publication October 2012

Endodontically treated teeth that have suered considerable loss of coronal tooth structure are routinely restored with ber posts (13). Resin-based luting agents and the use of dierent adhesive strategies are recommended for bonding the posts to root canal dentin (48). However, good and stable adhesion is to some extent unpredictable as a result of several negative factors, such as surfaces covered with debris and pulp remnants, the presence of a thick smear layer, residual irrigants and medicaments, irregular histology of deep radicular dentin, as well as limited control of application steps in deeper parts of the root canal (911). In order to overcome the complexity and the sensitivity related to the etch-and-rinse adhesive technique (12), materials that oer simpler, less time-consuming, and less-sensitive procedures have been investigated. As a result, resin cements that utilize self-etch adhesives, and, more recently, self-adhesive cements that do not require any pretreatment of the bonding surface, have been introduced to dental practice. The adhesion of ber posts luted with these simplied adhesive systems has been a matter of great interest over the past years (5, 6, 1319). However, controversial results regarding their post retentive potential have been reported. In some investigations, self-adhesive cements and those that utilize self-etch adhesives achieved inferior bond strength compared with

cements that rely on etch-and-rinse adhesive systems (13, 19). In other studies, self-adhesive cements performed better (16, 20), as well as worse (14), than did luting agents applied with self-etch and etch-and-rinse adhesives. On the other hand, comparable bond strengths were also measured for cements with dierent adhesive approaches (6, 13, 16). Therefore, the available data in the literature do not favor any of the three adhesive approaches with absolute certainty. Nevertheless, self-adhesive luting agents have rapidly gained popularity because the main advantage of these materials is the simplicity of application. A variety of self-adhesive cements with dierent compositions and mechanisms of adhesion are currently available (21, 22). New experimental self-adhesive cement (EXP) has been recently developed. According to the manufacturer, phosphoric acid ester is the functional monomer that achieves demineralization and bonding to the tooth surface. A new initiator system is applied to improve the initial bonding and it is claimed that favorable bonding is achieved either by light-curing or by self-curing mode. However, no scientic information is so far available regarding its adhesive potential when used for ber post luting. Therefore, the aim of this study was to assess, by means of the push-out test, the post retentive potential of experimental self-adhesive resin cement when used

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alone and in combination with a self-etch adhesive system. The experimental material was compared with a marketed self-adhesive cement, as well as with a cement that utilizes a self-etch adhesive, both produced by the same manufacturer. The tested null hypothesis was that no signicant dierences in terms of bond strength emerged among the materials under test.

Material and methods

Specimen preparation Twenty-four intact single-rooted and single-canal human premolars, extracted for orthodontic reasons, were selected for the study after obtaining informed consent from the donors. Teeth were stored in 0.5% chloramine-T solution at 4C and used within 1 month. The crowns were removed 1 mm above the cementoenamel junction (CEJ) using a water-cooled low-speed diamond saw (Isomet; Buehler, Lake Blu, IL, USA). The roots were endodontically treated using ProTaper Universal nickel-titanium rotary instruments (Dentsply Maillefer, Ballaigues, Switzerland), successively from size S1 to size F2 (apical diameter, 0.25 mm; taper, 0.08). During preparation the canals were irrigated with 5% sodium hypochlorite (NICLOR 5; Ogna, Maggio, Italy) at each change of instrument. The canals were obturated with ` ne Whaledent, Langenau, gutta-percha points (Roeko; Colte Germany) and canal resin sealer AH Plus Jet (Dentsply DeTrey, Konstanz, Germany) following the lateral condensation technique. The lled roots were sealed with glass-ionomer cement (Fuji II; GC, Tokyo, Japan), and stored in water for 48 h to allow the sealer to set.

After removing the temporary coronal seal, a post space of 8 mm in depth was prepared in each root with the corresponding low-speed drills provided by the post manufacturer. Translucent methacrylate-based glass-ber posts (GC Fiber Posts, diameter 1.6 mm; GC) were selected for the study. Following the manufacturers instructions the post surface was treated with a silanisation agent (Ceramic Bond; Voco, Cuxhaven, Germany) before luting. The specimens were randomly divided into four groups of six specimens each, and the groups were classied according to the luting material, as follows: (i) Group 1: EXP alone (experimental self-adhesive luting cement GAM-200; GC). (ii) Group 2: EXP used with self-etch adhesive (GAM200 used with Gradia Core Self-Etching Bond; GC). (iii) Group 3: marketed dual-cured cement used with selfetch adhesive (Gradia Core cement used with Gradia Core Self-Etching Bond; GC). (iv) Group 4: marketed self-adhesive cement (G-CEM Automix; GC). The materials were used according to the manufacturers instructions. Application mode, chemical composition, and batch numbers of the materials are reported in Table 1. Light curing was performed using a conventional quartztungstenhalogen light (600 mW cm2 output; VIP; Bisco, Schaumburg, IL, USA) by placing the light tip on the coronal end of the post. The exposed dentin along the coronal part of the root of all prepared specimens was sealed with owable composite (OptiBond FL adhesive/ Premise owable; Kerr, Orange, CA, USA). All the postcemented roots were placed in water at room temperature for 24 h until further use.

Table 1 Application mode, chemical composition, and batch numbers of the materials used in the study
Material (batch number) GC Fiber Post (071550801) Manufacturer GC Composition Glass bers (77 vol%) and methacrylate resin matrix (23 vol%) Phosphoric acid ester, trimethoxysilane, and acetone UDMA, dimethacrylates, uoroaminosilicate glass, phosphoricacid ester monomer, silicon dioxide, initiators, stabilizers, and pigment Distilled water, ethanol, 4-methacryloxyethyltrimellitate anhydride, dimethacrylates, silicon dioxide, and initiator UDMA, dimethacrylates, uoroaminosilicate glass, silicon dioxide, initiator, inhibitor, pigment UDMA, dimethacrylates, uoroaminosilicateglass, phosphoric acid ester monomer, silicon dioxide, initiators/stabilizers, and pigment Coat the post with Ceramic Bond and allow to dry for 60 s Dispense into the post space. Seat the post. Light cure for 20 s Application mode

Ceramic Bond (0945405)

Voco

GAM-200 (1109281-1109272)

GC

Gradia Core Self-Etching Bond (1009011)

GC

Gradia Core dual-cured luting cement (1009031)

GC

Mix Liquid A and Liquid B for 5 s. Apply to the post space and wait for 30 s. Dry with medium air pressure for 10 s. Light cure for 10 s Dispense into the post space. Seat the post. Light cure for 20 s

GC G-CEM Automix (1105271)

GC

Dispense into the post space. Seat the post. Light cure for 20 s

UDMA, urethane dimethacrylate.

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Juloski et al. Each slice was mounted on a metallic stub, sputter coated with gold (Polaron Range SC7620; Quorum Technology, Newhaven, UK), and observed under a scanning electron microscope (JSM 6060 LV; JEOL, Tokyo, Japan) at dierent magnications. Statistical analysis A preliminary linear regression analysis was conducted in each group to check if the root of origin was a signicant factor for dierences in push-out strengths of root slices. The results revealed that in none of the groups did the root of origin signicantly inuence the measured bond strength. Therefore, the slices were considered as independent statistical units within each experimental group. As push-out strength data were not normally distributed (Normality test failed, P < 0.05), the KruskalWallis analysis of variance was applied. Dunns multiple range test was used for post hoc comparison among the groups. The chi-square test was used to investigate whether the failure mode distribution diered signicantly among the groups. The level of signicance was set at P < 0.05. In post hoc comparisons of failure modes the Bonferroni correction was applied. Calculations were performed using the SigmaPlot 11.0 software (Systat Software, San Jose, CA, USA).

Push-out test The roots were transversely sectioned into six, 1-mm-thick slices with the Isomet saw under water cooling. The rst section was made at a distance of 1 mm from the CEJ. None of the slices failed during the cutting procedure, and the sectioning resulted in 36 slices per group. All slices obtained were used for the statistical evaluation of pushout bond strength. The test was performed using a universal testing machine (Triax Digital 50; Controls, Milan, Italy) operating at a crosshead speed of 0.5 mm min1. Each slice was positioned on the loading machine with the apical aspect facing the plunger, in order to assure application of the loading force in the apicalcoronal direction, so as to move the post toward the larger part of the slice. In consideration of the tapered design of the post, two different sizes of cylindrical plungers were used for the testing. The plunger was positioned so that it only contacted the post on loading, introducing shear stresses along the bonded interfaces. Bond failure was manifested by the extrusion of the post segment from the root slice. To express the bond strength in MPa, the failure load, recorded in N, was divided by the area of the bonded interface in square millimetre. The area of the bonded interface was calculated as the lateral surface area of a truncated cone using the formula: A pR rh2 R r2 1=2, where A represents the area of the bonded interface, R represents the coronal post radius, r represents the apical post radius, and h is the thickness of the slice (in mm). The diameters of the post and the thickness of the slice were individually measured using a digital caliper (Orteam, Milan, Italy) with 0.01 mm accuracy. All debonded specimens were analyzed using a stereomicroscope (Nikon SMZ645; Nikon, Tokyo, Japan) at 409 magnication, and failures were classied as follows: adhesive between the cement and the dentin (AD); adhesive between the cement and the post (AP); cohesive within the cement (CC); fracture of the specimen (cohesive within the post and the dentin) (FR); and mixed failure (M). Scanning electron microscopy An additional tooth in each group was prepared in the same way as described previously and each tooth provided one, 1-mm-thick slice that was processed for scanning electron microscopy observation of the adhesive interface. The coronal aspect of each slice was polished under water irrigation using a series of silicon carbide papers of 6001,200 grit, and subsequently treated with silica-free 32% phosphoric acid gel (Uni-Etch; Bisco) for 60 s. The slices were rinsed with water and subsequently in 96% alcohol solution for 1 min and then air dried.

Results
Descriptive statistics of the post push-out strengths are reported in Table 2. Statistically signicant dierences in push-out bond strength were observed among the groups. Experimental self-adhesive cement in combination with self-etch adhesive (Group 2) achieved the highest bond strength (15.87 4.68 MPa). The values recorded in the other groups were signicantly lower and did not dier from each other. Table 3 illustrates the distribution of failure modes in the experimental groups. The chi-square test results showed that the failure modes distribution diered signicantly among the groups. Specically, post hoc analyses revealed that Groups 1 and 4 diered signicantly from Groups 2 and 3. In Groups 1 and 4 the most frequent type of failure was adhesive between dentin and cement, followed by cohesive failures within the cement. Conversely, failures in the other two groups occurred either at the cementdentin or cementpost

Table 2 Descriptive statistics of the post push-out bond strength

Group Group Group Group Group 1 2 3 4 Statistical signicance (P < 0.05) B A B B Mean (SD) 7.48 15.87 8.77 6.79 (4.35) (4.68) (4.58) (3.68) Median value 6.58 16.64 7.86 5.80 25% 4.20 12.19 5.61 3.70 75% 8.93 18.96 9.71 9.69

Values are given as MPa. Dierent letters indicate statistically signicant dierences among the groups (KruskalWallis analysis of variance followed by Dunns multiple range test, P < 0.05). 25%, lower quartile; 75%, upper quartile; SD, standard deviation.

Bond strength of self-adhesive cement

Table 3 Failure mode distribution
Statistical signicance (P < 0.008) B A A B Failure mode (%) AD 61 19 36 72 AP 17 19 20 3 CC 19 9 8 19 FR 0 17 8 0

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Group Group Group Group Group 1 2 3 4

M 3 36 28 6

Dierent letters indicate statistically signicant dierences (chi-square multiple comparisons, P < 0.008). AD, adhesive between the cement and the dentin; AP, adhesive between the cement and the post; CC, cohesive within the cement; FR, fracture of the specimen (cohesive within the post and the dentin); M, mixed.

interface; however, a high percentage of mixed failures and several fractures of the specimens were also reported. The scanning electron microscopy micrographs of the adhesive interface between the resin cement and the root canal dentin for each experimental group are presented in Figs 14.

Discussion
Several bond-strength tests microtensile, post pullout, and post push-out have been developed for the laboratory assessment of retention of adhesive posts

(23). However, the bond strength measured between an adhesively luted ber post and root dentin depended considerably on the testing method used for its assessment (24). The majority of studies recommend the push-out bond-strength test as a method for determining the bond strength of ber posts to dentin (2527). It is considered to be more akin to clinical conditions compared with the pull-out test (28). Moreover, the push-out test has demonstrated a more homogenous stress distribution in nite element analysis (27) and lower data variability (2527) compared with the microtensile test. The microtensile technique had a frequent occurrence of premature failures, while with the push-out test no premature failure occurred (25, 26).

Fig. 1. Scanning electron microscopy images of the specimen from Group 1. (A) Magnication 9450, bar = 50 lm; (B) magnication 91000, bar = 10 lm. c, resin cement; d, root canal dentin.

Fig. 2. Scanning electron microscopy images of the specimen from Group 2. (A) Magnication 9450, bar = 50 lm; (B) magnication 91000, bar = 10 lm; (C) magnication 92000, bar = 10 lm. a, adhesive; c, resin cement; d, root canal dentin; p, post; r, resin tags.

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A B

Fig. 3. Scanning electron microscopy images of the specimen from Group 3. (A) Magnication 9450, bar = 50 lm; (B) magnication 91000, bar = 10 lm. a, adhesive; c, resin cement; d, root canal dentin.

Fig. 4. Scanning electron microscopy images of the specimen from Group 4. (A) Magnication 9450, bar = 50 lm; (B) magnication 91000, bar = 10 lm. c, resin cement; d, root canal dentin.

Therefore, the current study employed the push-out bond strength test to evaluate ber post adhesion to root canal walls. Based on the studys results, the null hypothesis has to be rejected, as signicant dierences in post retention emerged among the tested cements. The highest bond strength was achieved by the experimental self-adhesive cement in combination with self-etch adhesive (15.87 4.68 MPa). Signicantly lower values were measured when the cement was applied without any surface pretreatment (7.48 4.35 MPa). This nding is in contrast with a previous investigation reporting that a modied application procedure of self-adhesive cements, in combination with self-etch adhesives, did not improve the post retention when compared with the conventional use of self-adhesive cements (15). Nevertheless, EXP used alone (7.48 4.35 MPa), marketed self-adhesive cement (6.79 3.68 MPa), and dual-cured cement used with self-etch adhesive (8.77 4.58 MPa) performed similarly in terms of push-out bond strength (Table 2). This observation is in line with the results of several preceding studies that found no dierence in post retention between the cements used in combination with self-etch adhesives and self-adhesive luting agents (6, 13, 19). Conversely, some studies reported better adhesive performance of self-adhesive cements than that of cements used in combination with self-etch adhesives (16, 20), while others showed the opposite results (14). The inconsistency in the ndings may be explained by dierent adhesive systems and cements investigated in the present and the cited studies.

Dual-cured cement, investigated in Group 3, is a material formulated to be used for both post cementation and the core build-up procedure. Several studies investigated its adhesion to ber posts (29, 30), and to intraradicular (3133) and coronal (34, 35) dentin. Good adaptation to the post surface was observed (29), while relatively weak bond strength (29) could be increased by sandblasting or silane application to the post surface (30). Moreover, when the cement was used for ber post luting in combination with dierent adhesives, no signicant dierences in terms of push-out bond strength were reported (31). Also, the microtensile bond strength to root canal dentin was not dependent on post space level or mode of polymerization (32). One study assessed the post-retentive ability of the selfetch adhesive used in combination with two dierent luting/core build-up materials, and the results did not reveal any dierence in bond strength between the luting agents, regardless of the post shape (33). On the other hand, in the present study, signicantly dierent bond strengths were measured in Group 2 and Group 3, which utilized the same adhesive. As the dierence in the chemical composition between EXP and dual-cure cement (Group 3) is in the phosphoric acid ester monomer, it may be assumed that the functional monomer incorporated in EXP positively aects the bonding to root canal dentin. Nevertheless, further investigations on adhesive potential, polymerization kinetics, and mechanical properties of the experimental cement are needed in order to provide a better understanding of its overall performance. However, EXP was developed as

Bond strength of self-adhesive cement

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an improved version of the self-adhesive cement (Group 4) and it is worth mentioning that even though the statistical analysis did not reveal any signicant difference, the bond-strength values of the experimental cement were slightly higher than those of previously marketed self-adhesive cement. Little information currently exists in the literature regarding the performance of the marketed self-adhesive cement when used for ber post luting (17, 18, 36). Lower bond strength was observed compared with the other self-adhesive (17, 36) and multistep (36) resin cements. However, it was also noted that its push-out bond strength increased after thermal challenge (17). Moreover, the microhardness of the cement was higher than that of the other self-adhesive cements and it also showed a signicant increase 7 d after the cementation compared with the initial values (18). Therefore, it would be of interest to assess the performance of the investigated materials after subjecting the specimens to aging methods or to thermomechanical stress, simulating the clinical function. It should also be mentioned that the materials investigated in the present study were light-cured, even though they are dual-cured cements that are expected to cure adequately even in the complete absence of light. Nevertheless, light-curing was recommended for dual-cured resin cements because the degree of conversion (37, 38), the extent of polymerization, and microhardness (39) were higher when light-activation was used instead of self-curing only. It could therefore be assumed that in the self-curing polymerization mode the results of the test could have been dierent. With regard to failure mode distribution, signicant dierences were also observed among the groups (Table 3). When self-adhesive cements (Groups 1 and 4) were used as luting agents the most frequent type of failure was adhesive between dentin and cement (61 and 72%, respectively), which could be related to the weaker bonds achieved in those groups. This nding is consistent with the vast majority of studies reporting adhesive failure as the most frequent type of failure when posts are luted with self-adhesive resins (6, 13, 16). As the bond strength increased in Groups 2 and 3, the percentage of adhesive failures at the cementdentin interface decreased (19 and 36%, respectively). However, the frequency of mixed failures was higher compared with the other two groups (Table 3). In Group 2 it was noted that 17% of specimens failed by cohesive fractures, suggesting that the bond created between the cement and the dentin was higher than the cohesive strength of the dentin or the post. Scanning electron microscopy evaluation revealed the formation of numerous resin tags at the adhesive cementdentin interface in Group 2 (Fig. 2; area c), suggesting good adhesion and supporting the highest push-out data measured in this group. In scanning electron microscopy micrographs of all groups, tight and continuous adaptation of the resin cement to root canal dentin was visible at both low and high magnication (Figs 14). No gaps or discontinuities were observed at the bonding interface in any of the groups.

Finally, the authors are aware that the most valuable evidence on the bonding performance of adhesive materials is generated from long-term clinical trials. However, the ethical and practical need for in vitro tests before starting clinical trials cannot be doubted (40). Therefore, the valid evidence provided by this laboratory study is considered essential before the clinical application of the experimental material. Within the limitation of this study it can be concluded that the post retentive ability of experimental self-adhesive resin cement is comparable with that of a cement which utilizes a self-etch adhesive and a self-adhesive cement marketed by the same manufacturer. When experimental self-adhesive cement was used in combination with a self-etch adhesive system, signicantly higher pushout bond-strength values were measured compared with the other cementation strategies investigated in the study.

References
1. SCHWARTZ RS, ROBBINS JW. Post placement and restoration of endodontically treated teeth: a literature review. Endod J 2004; 30: 289301. 2. GORACCI C, FERRARI M. Current perspectives on post systems: a literature review. Aust Dent J 2011; 56 (Suppl 1): 7783. 3. CAGIDIACO MC, GORACCI C, GARCIA-GODOY F, FERRARI M. Clinical studies of ber posts: a literature review. Int J Prosthodont 2008; 21: 328336. 4. DIETSCHI D, DUC O, KREJCI I, SADAN A. Biomechanical considerations for the restoration of endodontically treated teeth: a systematic review of the literature, Part II (Evaluation of fatigue behavior, interfaces, and in vivo studies). Quintessence Int 2008; 39: 117129. 5. BITTER K, KIELBASSA AM. Post-endodontic restorations with adhesively luted ber-reinforced composite post systems: a review. Am J Dent 2007; 20: 353360. 6. RADOVIC I, MAZZITELLI C, CHIEFFI N, FERRARI M. Evaluation of the adhesion of ber posts cemented using dierent adhesive approaches. Eur J Oral Sci 2008; 116: 557563. 7. MONTICELLI F, FERRARI M, TOLEDANO M. Cement system and surface treatment selection for ber post luting. Med Oral Patol Oral Cir Bucal 2008; 13: E214E221. 8. NAUMANN M, STERZENBACH G, ROSENTRITT M, BEUER F, FRANKENBERGER R. Is adhesive cementation of endodontic posts necessary? Endod J 2008; 34: 10061010. 9. FERRARI M, MANNOCCI F, VICHI A, CAGIDIACO MC, MJOR IA. Bonding to root canal: structural characteristics of the substrate. Am J Dent 2000; 13: 255260. 10. SCHWARTZ RS. Adhesive dentistry and endodontics. Part 2: Bonding in the root canal systemthe promise and the problems: a review. Endod J 2006; 32: 11251134. 11. FERRARI M, VICHI A, FADDA GM, CAGIDIACO MC, TAY FR, BRESCHI L, POLIMENI A, GORACCI C. A randomized controlled trial of endodontically treated and restored premolars. J Dent Res 2012; 91 (Suppl 7): 72S78S. 12. VAN MEERBEEK B, DE MUNCK J, YOSHIDA Y, INOUE S, VARGAS M, VIJAY P, VAN LANDUYT K, LAMBRECHTS P, VANHERLE G. Buonocore memorial lecture. Adhesion to enamel and dentin: current status and future challenges. Oper Dent 2003; 28: 215235. 13. MAZZONI A, MARCHESI G, CADENARO M, MAZZOTTI G, DI LENARDA R, FERRARI M, BRESCHI L. Push-out stress for bre posts luted using dierent adhesive strategies. Eur J Oral Sci 2009; 117: 447453. 14. CALIXTO LR, BANDECA MC, CLAVIJO V, ANDRADE MF, VAZ LG, CAMPOS EA. Eect of resin cement system and root

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Juloski et al.
region on the push-out bond strength of a translucent ber post. Oper Dent 2012; 37: 8086. ERDEMIR U, SAR-SANCAKLI H, YILDIZ E, OZEL S, BATUR B. An in vitro comparison of dierent adhesive strategies on the micro push-out bond strength of a glass ber post. Med Oral Patol Oral Cir Bucal 2011; 16: e626e634. STERZENBACH G, KARAJOULI G, NAUMANN M, PEROZ I, BITTER K. Fiber post placement with core build-up materials or resin cements an evaluation of dierent adhesive approaches. Acta Odontol Scand 2012; 70: 368376. MAZZITELLI C, MONTICELLI F, TOLEDANO M, FERRARI M, OSORIO R. Eect of thermal cycling on the bond strength of selfadhesive cements to ber posts. Clin Oral Investig 2012; 16: 909915. BAENA E, FUENTES M, GARRIDO M, RODRIGUEZ J, CEBALLOS L. Inuence of post-cure time on the microhardness of selfadhesive resin cements inside the root canal. Oper Dent 2012; [Epub ahead of print]. GORACCI C, SADEK FT, FABIANELLI A, TAY FR, FERRARI M. Evaluation of the adhesion of ber posts to intraradicular dentin. Oper Dent 2005; 30: 627635. BITTER K, MEYER-LUECKEL H, PRIEHN K, KANJUPARAMBIL JP, NEUMANN K, KIELBASSA AM. Eects of luting agent and thermocycling on bond strengths to root canal dentine. Int Endod J 2006; 39: 809818. RADOVIC I, MONTICELLI F, GORACCI C, VULICEVIC ZR, FERRARI M. Self-adhesive resin cements: a literature review. J Adhes Dent 2008; 10: 251258. FERRACANE JL, STANSBURY JW, BURKE FJ. Self-adhesive resin cements chemistry, properties and clinical considerations. J Oral Rehabil 2011; 38: 295314. M, BERTELLI E, FERRARI M. GORACCI C, GRANDINI S, BOSSU Laboratory assessment of the retentive potential of adhesive posts: a review. J Dent 2007; 35: 827835. CASTELLAN CS, SANTOS-FILHO PC, SOARES PV, SOARES CJ, CARDOSO PE. Measuring bond strength between ber post and root dentin: a comparison of dierent tests. J Adhes Dent 2010; 12: 477485. GORACCI C, TAVARES AU, FABIANELLI A, MONTICELLI F, RAFFAELLI O, CARDOSO PC, TAY F, FERRARI M. The adhesion between ber posts and root canal walls: comparison between microtensile and push-out bond strength measurements. Eur J Oral Sci 2004; 112: 353361. CEKIC-NAGAS I, ERGUN G, NAGAS E, TEZVERGIL A, VALLITTU PK, LASSILA LV. Comparison between regional micropushout and microtensile bond strength of resin composite to dentin. Acta Odontol Scand 2008; 66: 7381. SOARES CJ, SANTANA FR, CASTRO CG, SANTOS-FILHO PC, SOARES PV, QIAN F, ARMSTRONG SR. Finite element analysis and bond strength of a glass post to intraradicular dentin: comparison between microtensile and push-out tests. Dent Mater 2008; 24: 14051411. SUDSANGIAM S, VAN NOORT R. Do dentin bond strength tests serve a useful purpose? J Adhes Dent 1999; 1: 5767. SADEK FT, MONTICELLI F, GORACCI C, TAY FR, CARDOSO PE, FERRARI M. Bond strength performance of dierent resin composites used as core materials around ber posts. Dent Mater 2007; 23: 9599. RADOVIC I, MONTICELLI F, GORACCI C, CURY AH, CONIGLIO I, VULICEVIC ZR, GARCIA-GODOY F, FERRARI M. The eect of sandblasting on adhesion of a dual-cured resin composite to methacrylic ber posts: microtensile bond strength and SEM evaluation. J Dent 2007; 35: 496502. PUTIGNANO A, PODERI G, CERUTTI A, CURY A, MONTICELLI F, GORACCI C, FERRARI M. An in vitro study on the adhesion of quartz ber posts to radicular dentin. J Adhes Dent 2007; 9: 463467. FOXTON RM, NAKAJIMA M, TAGAMI J, MIURA H. Adhesion to root canal dentine using one and two-step adhesives with dual-cure composite core materials. J Oral Rehabil 2005; 32: 97104. CONIGLIO I, MAGNI E, CANTORO A, GORACCI C, FERRARI M. Push-out bond strength of circular and oval-shaped ber posts. Clin Oral Investig 2011; 15: 667672. ARIYOSHI M, NIKAIDO T, OKADA A, FOXTON RM, TAGAMI J. Dentin bond strengths of three adhesive/composite core systems using dierent curing units. Dent Mater J 2008; 27: 187194. OTO T, YASUDA G, TSUBOTA K, KUROKAWA H, MIYAZAKI M, PLATT JA. Inuence of power density on polymerization behavior and bond strengths of dual-cured resin direct core foundation systems. Oper Dent 2009; 34: 192199. ZICARI F, COUTHINO E, DE MUNCK J, POITEVIN A, SCOTTI R, NAERT I, VAN MEERBEEK B. Bonding eectiveness and sealing ability of ber-post bonding. Dent Mater 2008; 24: 967977. KUMBULOGLU O, LASSILA LV, USER A, VALLITTU PK. A study of the physical and chemical properties of four resin composite luting cements. Int J Prosthodont 2004; 17: 357363. FRASSETTO A, NAVARRA CO, MARCHESI G, TURCO G, DI LENARDA R, BRESCHI L, FERRACANE JL, CADENARO M. Kinetics of polymerization and contraction stress development in self-adhesive resin cements. Dent Mater 2012; 28: 10321039. CADENARO M, NAVARRA CO, ANTONIOLLI F, MAZZONI A, DI LENARDA R, RUEGGEBERG FA, BRESCHI L. The eect of curing mode on extent of polymerization and microhardness of dualcured, self-adhesive resin cements. Am J Dent 2010; 23: 1418. ROULET JF. Editorial: is in vitro research in restorative dentistry useless? J Adhes Dent 2012; 14: 103104.

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33. 34.

21. 22. 23. 24.

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