A review of failure modes in teeth restored with adhesively luted endodontic dowels.
ABSTRACT Previous clinical studies indicated loss of retention between dowel and tooth was a major cause of failure for passive endodontic dowels. Advances in luting cement technology may have improved the retention of dowels. The purpose of this systematic review was to determine the clinical failure modes for dowel/core/crown restorations luted using resin-based cements that are either self-etching or used in conjunction with a bonding agent.
PubMed was searched for English language, peer-reviewed clinical research following restorations for 2 years or longer. For inclusion, a study group must have followed more than 50 permanent teeth restored using a dowel luted with resin cement and a bonding agent. Furthermore, more than 80% of the restorations must have received a nonresin crown.
Fifteen studies met the inclusion criteria and reported a total of 187 failures from 3046 restorations. The commonly reported causes of failure were dowel debonding (37% of all failures and primary cause in 8 of the 17 reporting study groups) and endodontic lesions (37% of all failures and primary cause in 6 of the 11 reporting study groups).
Loss of retention remains a major mode of failure even for passive, nonmetal dowels luted by resin cements with a bonding agent. The exact nature and underlying causes of debonding have not been adequately investigated.
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ABSTRACT: Introduction Luting posts inside the root canal is still a challenge because of the difficulty of bonding adhesive materials in the apical third of roots. This study evaluated the effect of the application mode of 3 simplified etch-and-rinse adhesives on the push-out bond strength (PBS), nanoleakage (NL), and in situ degree of conversion (DC) of fiber posts in the root canal. Methods The roots of human premolars were endodontically prepared and divided into 6 groups according to the combination of the main factors: adhesive (Ambar, FGM, Joinville, SC, Brazil; Adper Single Bond 2, 3MESPE, St Paul, MN; and XP Bond+self-cure activator, DeTrey Dentsply, Konstanz, Germany) and application mode (manual or sonic). The posts were cemented and the PBS tested at 0.5 mm/min. The NL was evaluated by scanning electron microscopy after the immersion of specimens in 50% silver nitrate. Micro-Raman spectroscopy was used to measure the in situ DC. Root third was also considered in the statistical evaluation. Data were analyzed by 3-way repeated measures analysis of variance and Tukey tests (5%). Results Under sonic application, the PBS and the in situ DC increased, whereas NL decreased significantly for all groups in the middle and apical thirds (P < .05). Conclusions The application of simplified adhesives by sonic mode in the root canal is a feasible tool to increase the fiber post bond to root canals.Journal of Endodontics 08/2014; · 2.79 Impact Factor
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ABSTRACT: Objective This randomized controlled trial compared the survival of glass fiber and cast metal dental posts used to restore endodontically treated teeth with no remaining coronal wall. Methods Fifty-four participants (45 women) and 72 teeth were evaluated during a follow-up period of up to 3 years. Teeth were randomly allocated to the glass-fiber and cast-metal post groups. All teeth were restored with single metal-ceramic crowns. Survival probabilities were analyzed using Kaplan–Meier statistics (p ≤ 0.05). Results The 3-year recall rate was 92.3% and the survival rates of glass fiber and cast metal posts were similar (97.1% and 91.9%, respectively; p = 0.682). Four failures were observed: two glass fiber posts in a premolar and anterior tooth debonded, one glass fiber post in a premolar debonded in association with root fracture, and one root fracture occurred in a molar with a cast metal post. Conclusions Glass fiber and cast metal posts showed similar clinical performance in teeth with no remaining coronal wall after 3 years. Clinical Significance: Posts are used to restore most endodontically treated teeth with no remaining coronal wall. This randomized controlled trial, one of few to compare glass fiber and cast metal posts in such teeth, showed that post type did not significantly influence the survival of restorations. These results can help dentists respond to the important question of how best to rehabilitate endodontically treated teeth with no remaining coronal wall.Journal of dentistry 05/2014; · 3.20 Impact Factor
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ABSTRACT: Coronal tooth lesions, such as caries, enamel cracking, and composite resin restoration cavities, have been observed by optical coherence tomography (OCT). This pilot study was performed to verify whether OCT could reveal details of root canals filled with resin core build-up. A dual-cure, one-step, self-etch adhesive system-bonding agent (Clearfil Bond SE ONE, Kuraray Noritake Dental) and dual-cure resin composite core material (Clearfil DC Core Automix ONE, Kuraray Noritake Dental) were used according to the manufacturer's instructions in root canals. OCT was performed at three stages of the core build-up: after the post space preparation, after bonding application, and after resin core fabrication. The cementum was removed in the cementum absent group and the root was left untreated in the cementum present group. Bubbles were observed in the resin cores and gaps formed between the resin core and dentin. In the cementum absent group, the internal structure of the root could be visualized clearly compared with the cementum present group. The root internal structure could be observed by OCT and the image became clearer when cementum was removed.Journal of Biomedical Optics 04/2014; 19(4):46004. · 2.75 Impact Factor