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Adhesive Cementation of Endo Posts

Adhesive Cementation of Endo Posts. Posts & Cements. Ricardo Carvalho, DDS, PhD R&D, Bisco Inc. Darkening of tooth structure. Metal. > Probability of root fracture. 2 appointments (cast). No adhesion. Carbon Fiber Posts. Modulus of Elasticity similar to tooth structure

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Adhesive Cementation of Endo Posts

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  1. Adhesive Cementation of Endo Posts Posts & Cements Ricardo Carvalho, DDS, PhD R&D, Bisco Inc.

  2. Darkening of tooth structure Metal > Probability of root fracture 2 appointments (cast) No adhesion

  3. Carbon Fiber Posts Modulus of Elasticity similar to tooth structure Bonding capability

  4. Aesthetic Resistant Adhesive

  5. Data from fiber rods before shaping to post

  6. Adhesive cementation of posts requires adequate bonding between : ? Post - Cement ? Cement - Adhesive ? Adhesive - Dentin

  7. Adhesive cementation of posts requires adequate bonding between : Post - Cement

  8. FRCPs present surface irregularities that provide sites for micromechanical retention

  9. Silanation does not seem to be clinically relevant for improved retention… Bitter et al., Effect of silanization on bond strengths of fiber posts to various resin cements. Quintessence Int 2007 38:121-128 Wrbas K-T et al., Effect of adhesive resin cements and post surface silanization on the bond strengths of adhesively inserted fiber posts. JOE 2007 33:840-843. Application of the adhesive appears to be more relevant...

  10. Push-out bond strength (MPa)

  11. Materials and Methods: Cury, A.H.

  12. Measuring: Cury, A.H.

  13. Cement A

  14. Adhesive cementation of posts requires adequate bonding between : Adhesive - Dentin Adhesive - Cement

  15. The bonding of the cement to the post is generally better than the bonding of the cement to dentin.

  16. Choice of Adhesive

  17. Easy to use and apply in the canal Ability to cure in the canal (apex) Compatible with self- dual-cure cements Bond stability over time

  18. Factors to consider: Cleaning Moisture control Application and light-curing of adhesive Light-curing of cement Curing mode of cement NaOCl Moisture Adhesive X + + c + + a e ± ± ± ± - - - d - f - b -

  19. Cleaning: Avoid using NaOCl or H2O2...

  20. Moisture Control Application of Adhesive Moisture Adhesive a b

  21. A A

  22. Factors to Consider: Light-curing of adhesive Light-curing of cement Curing mode of cement Light-curing reaches only 2-3 mm cervical + + c + + e ± ± ± ± Middle and apical thirds only self-curing Acidic, simplified adhesives.... On hydrated dentin......PROBLEM!!!! - - - d - f - -

  23. Degree of Conversion (%) vs. Curing Mode Pegoraro & Carvalho, 2008

  24. Degree of Conversion (%) vs. Curing Mode Pegoraro & Carvalho, 2008

  25. Degree of Conversion (%) vs. Curing Mode Pegoraro & Carvalho, 2008

  26. Degree of Conversion (%) vs. Curing Mode Pegoraro & Carvalho, 2008

  27. JOE, Nov, 2005 Shrinkage stresses due to cement curing are the highest ever calculated ... Capable of challenging the adhesive interfaces... ... Causing rupture of the weakest bonds

  28. JOE, Nov, 2005

  29. Push-out strength of luted posts

  30. Failure occurs at the cement – dentin interface Bonfante et al., Dent Mater 2008 Undercured cement absorbs water and is prone to degradation...

  31. Bond integrity at post/cement/adhesive/dentin is generally accomplished at the cervical cuff only... Frictional retention is more clinically relevant What to use to lute posts ???

  32. Effect of hygroscopic expansion on the push-out resistance of FRCP cemented with GICs. Cury A, Goracci C, Navarro MFL, Carvalho RM, Sadek FT, Tay FR, Ferrari M JOE, jan, 2006

  33. If adhesives are to be included.... Use 3-step etch and rinse or 2-step self-etch

  34. Self-adhesive cements are an excellent option to lute posts! Do not require adhesive, improved properties over traditional cements and are dual- self-cured. No adhesive / no incompatibility

  35. Cury et al., 2007

  36. Thank you

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