Eur J Oral Sci 2008; 116: 557563 Printed in Singapore.

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2008 The Authors. Journal compilation 2008 Eur J Oral Sci

European Journal of Oral Sciences

Evaluation of the adhesion of ber posts cemented using different adhesive approaches
Radovic I, Mazzitelli C, Chie N, Ferrari M. Evaluation of the adhesion of ber posts cemented using dierent adhesive approaches. Eur J Oral Sci 2008; 116: 557563. 2008 The Authors. Journal compilation 2008 Eur J Oral Sci The aim of this study was to investigate the adhesion of ber posts cemented with luting agents that utilize three currently available adhesive approaches: etch-and-rinse, self-etch, and self-adhesive. Forty-two intact single-rooted human premolars were used in the study. Teeth were divided into six groups. In each group, a dierent resin cement with its adhesive system (if needed) and a ber post were used. The groups were classied, according to the adhesive approach, into the following three categories. (i) Etch-and-rinse groups: Calibra resin cement/XPBond adhesive + self-curing activator (SCA)/RadiX Fiber Post (Dentsply Caulk), FluoroCore 2 core build-up material/XPBond + SCA/RadiX Fiber Post (Dentsply Caulk), and MultiCore Flow luting and core build-up material/Excite DSC adhesive/FRC Postec Plus ber post (Ivoclar Vivadent). (ii) Self-etch group: Panavia F 2.0/ED primer (Kuraray)/RadiX Fiber Post (Dentsply Caulk). (iii) Self-adhesive groups: experimental self-adhesive cement/RadiX Fiber Post (Dentsply Caulk), and RelyX Unicem/RelyX Fiber Post (3M ESPE). The adhesion between the post and the root canal walls was assessed using the thin-slice push-out test. In the test arrangement used, the self-etching approach may oer less favourable adhesion to root canal dentin in comparison with etch-and-rinse and selfadhesive approaches.

Ivana Radovic1,2, Claudia Mazzitelli2, Nicoletta Chieffi2, Marco Ferrari2

Clinic for Paediatric and Preventive Dentistry, Faculty of Dentistry, University of Belgrade, Belgrade, Serbia; 2Department of Dental Materials and Restorative Dentistry, University of Siena, Policlinico Le Scotte, Viale Bracci, Siena, Italy
1

Dr Ivana Radovic, Clinic for Paediatric and Preventive Dentistry, Faculty of Dentistry, University of Belgrade, Dr Subotica 11, 11000 Belgrade, Serbia Telefax: +381112685361 E-mail: ivana.radovic@gmail.com Key words: dentin-bonding agents; post-andcore technique; resin cements Accepted for publication September 2008

Reconstructing endodontically treated teeth with ber post-and-core systems has been widely investigated (1, 2). This treatment option may oer advantages over conventional cast posts or prefabricated metallic posts (39). Notwithstanding the satisfactory clinical performance of ber post-and-core systems (10), debonding of the post was observed as the main failure mode (1115). The success of ber post-and-core restorative procedures depends, in part, on the cementation technique used to create a link between the post and root canal dentin. Contemporary resin cements may be divided into three subgroups according to the adhesive approach used to prepare the tooth prior to cementation. The rst group utilizes etch-and-rinse adhesive systems. In the second group, enamel and dentin are prepared using selfetching primers. The third, and most recently introduced group of resin cements, is represented by self-adhesive cements. In the majority of clinical investigations, ber posts were cemented using etch-and-rinse adhesives in combination with self-cured (13, 1518) and dual-cured (1214, 1922) resin cements. It was reported that the level of experience of the operator does not inuence the retention of ber posts cemented using etch-and-rinse adhesive under laboratory conditions (23). Nevertheless, scientists and manufacturers have been continuously challenged by a general trend to simplify the clinical procedures. The

simpler, self-etching adhesive approach oers a shorter adhesive application time and a reduced number of clinical steps. It is considered to be less technique-sensitive because the clinical assessment of optimal dentin wetness after rinsing the phosphoric acid is avoided (24). However, the most simple, one-step self-etching adhesives are also associated with permeability and phase separation that may aect bond durability (25). The adhesion of ber posts luted using self-etching adhesives has been assessed only in laboratory studies, most commonly by comparing them with the performance of etch-and-rinse adhesives. The ndings on the performance of self-etching adhesives in ber post cementation are not consistent. It was reported that microleakage at the cementroot dentin interface was signicantly higher when self-etching primer was used for ber post cementation, in comparison with etch-andrinse adhesive (26). Likewise, the resinroot dentin interdiusion zone was less pronounced with the selfetching approach than with the etch-and-rinse adhesive approach (27). However, no dierences between selfetching and etch-and-rinse approaches were found when representative materials were investigated using the microtensile bond strength test (28) and the push-out strength test (29, 30). Self-adhesive cements represent the least investigated group of resin cements. Their in vitro performance in

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Radovic et al. needle and rinsed o after 15 s with water using an endodontic syringe. Excess water was removed with a gentle air blast. Paper points were used to remove residual moisture without desiccating the etched dentin surface. XPBond adhesive was mixed with SCA (1:1), applied to the post space with a microbrush for 20 s, gently air dried, and then excess was removed using paper points. Calibra cement components were mixed 1:1, and then mixed cement was spread on the surface of the post and in the post preparation using a lentulo spiral. The post was seated immediately and light-curing was performed through the post for 40 seconds using a conventional quartztungsten halogen light (600 mW cm)2 output; VIP; Bisco, Schaumburg, IL, USA). (ii) FluoroCore 2 core build-up material, XPBond adhesive/SCA, RadiX Fiber Post (Dentsply Caulk). The RadiX Fiber Post was cleaned with alcohol and air dried. Caulk 34% Tooth Conditioner Gel and XPBond adhesive with SCA were applied as in group (i). FluoroCore 2 base and catalyst were mixed at a ratio of 1:1 for 30 s. The mixture was applied on the post and the post was seated immediately. The material was allowed to autocure for 7 min. Light curing was performed through the post as in group (i). (iii) MultiCore Flow luting/core build-up material, Excite DSC adhesive, and the FRC Postec Plus ber post (Ivoclar Vivadent, Schaan, Liechtenstein). The FRC Postec Plus post was cleaned with phosphoric acid gel (Total Etch) for 60 s, rinsed, and dried. Monobond S was applied on the post and dried after 60 s. Total Etch was applied to the post space through a needle and rinsed o after 15 s with water using an endodontic syringe. Excess water was removed as in group (i). Excite DSC adhesive was activated, applied to the post space with a proprietary microbrush for 10 s, and then gently air dried. Excess adhesive was removed using paper points. MultiCore Flow components were mixed and applied to the post. The post was seated immediately and light curing was performed through the post as in group (i).

ber post cementation was investigated using the pushout strength test (3135), and the results are contradictory. In comparison with the etch-and-rinse approach, both lower (31, 32, 35) and higher (34) push-out strengths of self-adhesive cement were reported. Compared with the self-etching approach, inferior (32), comparable (31), and superior (33) behaviour of the selfadhesive approach was reported, even though the same self-adhesive cement was investigated in all the studies. In the only clinical study available, no failures were recorded after 2 yr of follow-up of restorations retained by ber posts cemented with self-adhesive cement (36). Self-etching and self-adhesive approaches oer simplicity and chair-time reduction, which may be benecial in the clinical setting. However, information on which ber post cementation technique might be most favourable is currently lacking in the literature. Therefore, the aim of this study was to investigate the adhesion of ber posts cemented to intraradicular dentin with luting agents that utilize three currently available adhesive approaches: etch-and-rinse, self-etch, and self-adhesive. The working hypothesis was that the simpler, self-etching, and selfadhesive approaches are equally as eective as the clinically proven etch-and-rinse approach. The null hypothesis tested is that there are no dierences in the retention of ber posts cemented with dierent luting agents.

Material and methods

Specimen preparation Forty-two intact human premolars with a single root canal, extracted for orthodontic reasons, were selected for use in the study. The teeth were hand-scaled and stored in 1% chloramine T at 4C for no more than 6 months until use. The crown of each tooth was removed 1 mm above the cementoenamel junction, using a slow-speed diamond saw (Isomet; Buehler, Lake Blu, IL, USA) under copious water-cooling. The roots were endodontically instrumented at a working length of 1 mm from the apex using a #35 master apical le (Maillefer, Ballaigues, Switzerland), Gates-Glidden drills #2 to #4 (Maillefer), and 2.5% sodium hypochlorite irrigation. For canal obturation, thermoplasticized, injectable gutta-percha (Obtura; Texceed Corp., Costa Mesa, CA, USA) and a resin sealer (AH Plus Jet; Dentsply DeTrey, Konstanz, Germany) were employed. Teeth were randomly divided into six groups. In each group, a dierent resin cement with its adhesive system (if needed) and a ber post were used. The groups were classied, according to the adhesive approach, into three categories: etch-and rinse, self-etch, and self-adhesive. In each roottreated tooth, a 9-mm-deep post space was prepared using low-speed drills provided by the post manufacturer. The materials were handled in strict accordance with the manufacturers instructions.

Self-etch group
(i) Panavia F 2.0, ED primer (Kuraray, Osaka, Japan) and RadiX Fiber Post (Dentsply Caulk). The RadiX Fiber Post was cleaned with alcohol and air dried. The ED primer II was mixed at a ratio of 1:1, applied to the post space with a microbrush for 30 s, gently air dried, and then excess was removed using paper points. Panavia F 2.0 paste A and paste B were mixed for 20 s and applied to the post. The post was seated immediately and light curing was performed through the post as in group (i) of the etch-and-rinse groups.

Self-adhesive groups
(i) Experimental self-adhesive cement and the RadiX Fiber Post (Dentsply Caulk). The RadiX Fiber Post was cleaned with alcohol and air dried. Experimental cement was applied directly to the post space through an endodontic application tip that is attached to the double syringe. The post was seated immediately and the cement was allowed to autocure for 5 min. Light curing was then performed through the post as in group (i) of the etch-and-rinse groups. (ii) RelyX Unicem and RelyX Fiber Post (3M ESPE, Seefeld, Germany). The RelyX Fiber Post was cleaned with alcohol and air dried. After mixing the capsule, RelyX Unicem cement was applied directly to the post space through a disposable

Etch-and-rinse groups
(i) Calibra resin cement, XPBond adhesive/self-curing activator (SCA), RadiX Fiber Post (Dentsply Caulk, Milford, DE, USA). The RadiX Fiber Post was cleaned with alcohol, airdried, and treated with Calibra Silane. Caulk 34% Tooth Conditioner Gel was applied to the post space through a

Adhesion of ber posts application tip that is attached to the capsule. The post was seated immediately and the cement was allowed to autocure for 5 min. Light curing was then performed through the post as in group (i) of the etch-and-rinse groups. The composition and batch numbers of all materials used in this study are reported in Table 1. Following placement of the ber post, in each group, excess luting agent was removed prior to light curing. The exposed dentin along the coronary part of the root and the coronal part of the luting agent/ber post were completely covered with glass ionomer cement (Fuji II; GC Corp., Tokyo, Japan). After storage in water for 24 h at 37C (ISO Standard Dental materialsTesting of adhesion to tooth structure; ISO/TS 11405:2003), the roots were processed for evaluation of the push-out strength.

559

(i) Adhesive failure between dentin and the luting agent. (ii) Adhesive failure between the luting agent and the post. (iii) Cohesive failure within the luting agent. (iv) Cohesive failure within the post. (v) Mixed failure. One slice representative of each failure mode was processed for scanning electron microscopy (SEM) evaluation in order to obtain SEM images of the failure patterns. The slices were rinsed in 96% alcohol solution for 1 min and air dried. 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). Statistical analysis

Push-out strength evaluation In order to assess the adhesion of ber posts, the thin-slice push-out test was used (37). The portion of each root that contained the bonded ber post was sectioned into ve or six 1-mm-thick serial slices using the Isomet saw (Buehler) under water cooling (Fig. 1). Seven bonded roots from each group resulted in 3542 slices per group for push-out strength evaluation. None of the slices failed during sectioning, and all fabricated slices were used for the evaluation of push-out strength. The number of slices in each experimental group of at least 35 was determined from a preliminary power analysis that was conducted in order to assure power of at least 90% for nding the statistically signicant dierences given the standard value of type I errors (0.05) and assuming the dierence of 4 MPa as relevant for this investigation. The within-group standard deviation that was used in the calculations was assumed to be 4 MPa, based on the previous investigations of push-out strength (38). The sample size and power calculations were handled by sigmastat (Systat Software, San Jose, CA, USA). The thickness of each slice was individually measured using a digital calliper and then each slice was rmly xed with cyanoacrylate glue to a loading xture. A compressive load was applied on the apical aspect of the slice via a universal testing machine (Triax Controls, Milano, Italy) that was equipped with a 1-mm-diameter cylindrical plunger. The plunger was positioned so that it only contacted the bonded post on loading, introducing shear stresses along the bonded interfaces. The loading force was extended in an apical-coronal direction, in order to move the post towards the larger part of the root slice. Loading was performed at a speed of 0.5 mm min)1 until failure, as manifested by the extrusion of the post segment from the root slice. This was further conrmed by the appearance of a sharp drop along the load/time curve recorded by the testing machine. The push-out strength (MPa) was computed by dividing the load at debonding (N) by the area (A) of the bonded interface. The latter was calculated through the formula: A pR rh2 R r2 0:5 where 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 calliper with 0.01-mm accuracy. The failure mode of each debonded specimen after the push-out test was assessed using a stereomicroscope (Nikon SMZ645, Tokyo, Japan) at 40 magnication and classied according to the following criteria.

To start with, regression analysis was conducted in each group to check if the root of origin was a signicant factor responsible for dierences in the push-out strengths of root slices. The regression analysis revealed that in none of the groups was the root of origin signicant. Therefore, the slices were considered as independent statistical units within each group. The normal distribution of the push-out strength data was rst checked and veried using the KolmogorovSmirnov test. A one-way analysis of variance (anova) was subsequently performed to assess the signicance of the dierences in push-out strength between the luting agents. As variances were homogeneous (Levenes test), one-way anova was followed by the Tukey test for post hoc comparisons. The level of signicance was set at the 0.05 probability level in all analyses, and calculations were handled using the spss 15.0 software (SPSS, Chicago, IL, USA).

Results
The type of luting agent signicantly inuenced the measured push-out strengths (P < 0.001). The results of push-out strength testing are summarized in Table 2. Multiple comparisons revealed that the push-out strengths of Calibra (etch-and-rinse approach) and RelyX Unicem (self-adhesive approach) were comparable and signicantly higher than the push-out strengths of FluoroCore 2 (etch-and-rinse approach) and Panavia F 2.0 (self-etch approach). The push-out strengths in groups where posts were cemented with MultiCore Flow (etch-and-rinse approach) and Experimental self-adhesive cements were comparable with the push-out strengths in all the other groups (Table 3). The distribution of failure modes is reported in Table 2. In the majority of groups the most frequent type of failure was adhesive between dentin and cement (Fig. 2A), followed by adhesive failures between post and cement, and mixed failures (Fig. 2B). No cohesive failures within the post were observed in this study.

Discussion
The thin-slice push-out strength test is considered to be a valid method for evaluating ber post adhesion to root

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Table 1 Composition and batch numbers of the materials used in the study
Composition 34% phosphoric acid

Radovic et al.

Material (manufacturer), batch number

Caulk 34% Tooth Conditioner Gel (Dentsply Caulk), 0704001801 XPBond adhesive (Dentsply Caulk), 0702001786

Self-cure activator (Dentsply Caulk), 070119 Calibra Esthetic Resin Cement (Dentsply Caulk), 070525, 0705291 Calibra silane coupling agent (Dentsply Caulk), 070511 FluoroCore 2 (Dentsply Caulk) 0705041

RadiX Fiber Post (Dentsply Caulk), 8626460 Total Etch (Ivoclar Vivadent), J25470 Excite DSC adhesive (Ivoclar Vivadent), J23127

MultiCore Flow (Ivoclar Vivadent), H20666

Monobond S (Ivoclar Vivadent), H34023 FRC Postec Fiber Post (Ivoclar Vivadent), K13203

ED primer (Kuraray), 00238B, 00116B

Panavia F 2.0 (Kuraray), 00249A, 00058D

Experimental self-adhesive cement (Dentsply Caulk), HL6-91-1T RelyX Fiber Post (3M ESPE), 050230703 RelyX Unicem cement (3M ESPE), 288418

Carboxylic acid-modied dimethacrylate (TCB resin), phosphoric acid-modied acrylate resin (PENTA), urethane dimethacrylate (UDMA), triethyleneglycol dimethacrylate (TEGDMA), 2-hydroxyethylmethacrylate (HEMA), butylated benzenediol (stabilizer), ethyl-4-dimethylaminobenzoate, camphorquinone, functionalized amorphous silica, tertiary butanol Urethane dimethacrylate (UDMA); 2-hydroxyethylmethacrylate (HEMA); catalyst; photoinitiators; stabilizers; acetone; water Base: dimethacrylate resins; camphorquinone (CQ) photoinitiator; stabilizers; glass llers; fumed silica; titanium dioxide; pigments Catalyst: dimethacrylate resins; catalyst; stabilizers; glass llers; fumed silica Acetone; ethyl alcohol; organo silane Base: urethane dimethacrylate; di- and tri-functional methacrylates; barium boron Catalyst: uoroaluminosilicate glass; camphorquinone (CQ) photoinitiator; photoaccelerators; silicon dioxide; benzoyl peroxide Zirconium-enriched glass bers (60%), epoxy resin matrix (40%) 37% phosphoric acid gel HEMA, dimethacrylates, phosphonic acid acrylate, highly dispersed silicon dioxide, initiators and stabilizers in an alcohol solution. The Excite DSC Brush is coated with initiators Bis-GMA, urethane dimethacrylate and triethylene glycol dimethacrylate; barium glass, ytterbiumtriuoride, Ba-Al-uorosilicate glass and highly dispersed silicon dioxide; catalysts, stabilizers, and pigments 1% 3-methacryloxypropyltrimethoxysilane (3-MPS), ethanol/water-based solvent Glass bers. Matrix: urethane dimethacrylate, triethylene glycol dimethacrylate. Additional contents: ytterbium triuoride, highly dispersed silicon dioxide Liquid A: HEMA, 10-methacryloyloxydecyl dihydrogen phosphate (MDP), N-methacryloyl 5-aminosalicylic acid (5-NMSA), dimethacrylate, sodium aromatic sulphinate, water, accelerator Liquid B: 5-NMSA, accelerator, water, sodium benzene sulphinate Base: Hydrophobic aromatic and aliphatic dimethacrylate, sodium aromatic sulphinate, N,N-diethanol-p-toluidine, functionalized sodium uoride, silanized barium glass sodium benzene sulphinate Catalyst: MDP, hydrophobic aromatic and aliphatic dimethacrylate, photoinitiator, dibenzoyl peroxide, hydrophilic dimethacrylate, silanized silica Information not available Glass bers (6070% by weight) embedded in epoxy-resin matrix containing zirconia ller Powder: glass llers, silica, calcium hydroxide, self-curing initiators, pigments, light-curing initiators, substituted pyrimidine, peroxy compound Liquid: methacrylated phosphoric esters, dimethacrylates, acetate, stabilizers, self-curing initiators, light-curing initiators

Adhesion of ber posts

561

Fig. 1. Schematic drawing of the specimen preparation for push-out strength testing. Each root was sectioned into 1-mmthick slices. The apical surface of each root slice was marked (M) in order to ensure that the loading force would be applied in the apical-coronal direction, in order to move the post towards the larger part of the slice. C, luting agent; D, root dentin; P, ber post.

canal walls (39). It has been shown to be more reliable than the microtensile technique for measuring the adhesion of ber posts (37). The thin-slice push-

out strength test is not dicult to use, and it allows fabrication of several specimens out of one root, as well as testing for regional dierences between root sections (39). However, the manner in which the ber post in a 1-mm-thick root slice is exposed to dislodging forces during push-out testing cannot be directly compared with functional forces that the post needs to withstand during clinical service. It is also possible that the sectioning process may induce artefacts that could inuence test results. This may partly serve as an explanation for the relatively high coecient of variation that was observed in some groups. In each group, resin cement/adhesive was used with the manufacturer recommended ber post. The only exception was made in the case of Panavia F 2.0, as no specic ber post is recommended by the manufacturer (Kuraray). This experimental set-up has limitations, as it was previously reported that push-out strength may be inuenced by a type of ber post to a greater extent than by a luting agent (30). Nevertheless, it was assumed that combining all the ber post system components (resin cement, adhesive, and ber post) from the same manufacturer would prevent possible incompatibility between the materials and allow assessment of the full potential of each system under laboratory conditions. Signicant dierences were found between experimental groups, which led to the rejection of the null hypothesis. Both self-adhesive groups were comparable with Calibra and MultiCore Flow etch-and-rinse groups. This nding is in contrast with some previous

Table 2 Push-out strengths and the percentage of slices that failed in the respective failure mode for each luting agent
Push-out strength Adhesive approach Etch-and-rinse Luting agent Calibra FluoroCore 2 MultiCore Flow Panavia F 2.0 Experimental RelyX Unicem Mean (SD) 12.70 8.07 11.14 8.68 10.61 12.52 (4.33) (4.76) (3.88) (5.29) (5.01) (5.47) A B AB B AB A Med. 13.64 7.93 12.62 8.41 9.69 11.33 25% 10.12 4.70 8.39 3.67 5.40 8.88 75% 16.39 12.17 13.88 12.42 15.38 15.63 AD 50 49 32 47 56 62 Failure modes (%) AP 38 30 50 20 25 5 CC 0 0 0 18 0 0 M 12 21 18 15 19 33

Self-etch Self-adhesive

Dierent letters indicate statistically signicant dierences (one-way analysis of variance and Tukey test, P < 0.05). SD, standard deviation; Med., median value; 25%, lower quartile; 75%, upper quartile; AD, adhesive failure between dentin and the luting agent; AP, adhesive failure between the luting agent and the post; CC, cohesive failure within the luting agent; M, mixed failure.

Table 3 The resultant P-values of post-hoc comparisons between the groups (one-way analysis of variance and Tukey test)
Calibra Calibra FluoroCore 2 MultiCore Flow Panavia F 2.0 Experimental RelyX Unicem 0.001 0.745 0.009 0.491 1.000 FluoroCore 2 0.001 0.050 0.994 0.213 0.001 MultiCore Flow 0.745 0.050 0.254 0.997 0.820 Panavia F 2.0 0.009 0.994 0.254 0.578 0.012 Experimental 0.491 0.213 0.997 0.578 0.574 RelyX Unicem 1.000 0.001 0.820 0.012 0.574

Signicant P-values are in italics (P < 0.05).

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Radovic et al.
A

Fig. 2. Scanning electron microscopy (SEM) micrographs of failed slices. (A) The slice that failed adhesively between root dentin and the luting agent. (B) The slice representative of mixed failure. Remnants of the luting agent are visible (asterisk).

investigations (31, 32, 35). The favourable push-out strength of RelyX Unicem may be partly explained by the fact that in the present investigation it was used with the RelyX Fiber Post. According to the manufacturers claims, this postcement system oers both chemical compatibility and strong micromechanical postcement interlocking. In previous investigations, RelyX Unicem was used with the FRC Postec post (31, 32), the Aestheti Plus post (RTD, St Egreve, France) (35), and the C-Post (RTD) (35), which may account for the discrepancy in the results. In the study by de Durao Mauricio et al. (32), the vast majority of testing failures was found between post and cement, and no failures were observed between dentin and cement, which may imply unsatisfactory RelyX Unicem/FRC Postec coupling. On the contrary, in the present study the majority of failures were located between dentin and cement (Table 3). Furthermore, after the initial 5-min period of self-curing, RelyX Unicem was light-cured in the present study, whereas in the previous investigations it was used only in the selfcure mode (32, 35). It was reported that light curing signicantly increased the bond strength of RelyX Unicem to various types of ceramics (40, 41). Taking into account the low degree of conversion of this cement when it is self-cured (42), it might be advisable to use it in dual-cure mode. Retention of quartz ber posts cemented with the dualcure resin cement RelyX ARC in combination with an etch-and-rinse adhesive was comparable with the retention obtained using RelyX Unicem (43) and these ndings are in accordance with the present investigation. The push-out strength of Panavia F was signicantly lower

than that of RelyX Unicem, and this result is consistent with previous reports (33, 34). It is interesting to note that cohesive failures within the luting agent were only seen in the Panavia F 2.0 group. This may be the result of the unfavourable cohesive strength of this cement. MultiCore Flow is formulated to be used both as the cement and as core material. Its push-out strength in the present investigation was comparable with that of Calibra. Bearing in mind the favourable adhesion of this material to silanized FRC Postec post (44), its clinical use could oer advantages. Besides the procedure being easier and faster, it also results in fewer interfaces between dierent types of materials and therefore in less potentially critical areas where failure could occur. Although FluoroCore 2 is a core build-up material, it was included in this investigation following the suggestion of the manufacturer, in order to explore its potential use in luting ber posts. However, its push-out strength was signicantly lower in comparison with Calibra (Table 3), even though both materials were used with the same adhesive (XPBond). It may be speculated that the application mode and higher viscosity of FluoroCore 2 in comparison with Calibra precluded its close adaptation to root canal walls, as FluoroCore 2 was applied to the post only, whereas Calibra was rst introduced into the post space on a lentulo spiral. This study assessed the push-out strengths of ber posts after 24 h of water storage. It is possible that a longer storage time and/or thermal cycling would give dierent results. Within the limitations of the present investigation, it may be concluded that the 24-h push-out strength of ber posts was signicantly inuenced by luting agents. The study ndings do not indicate with certainty that any one of the three investigated adhesive approaches is better than the others. Nevertheless, in the test arrangement used, the self-etching approach may oer less favourable adhesion to root canal dentin in comparison with etch-and-rinse or self-adhesive approaches.
Acknowledgements The authors thank Dentsply Caulk for the generous donation of the materials used in the study. Special thanks go to Architect Milan Stefanovic for graphic support.

References
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