Bitter Kerstin, Gläser Christin, Neumann Konrad, Blunck Uwe, Frankenberger Roland
Department for Operative and Preventive Dentistry, University School of Dental Medicine, CharitéCentrum 3, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Department of Medical Informatics Biometry and Epidemiology, CharitéCentrum 4, Charité - Universitätsmedizin Berlin, Berlin, Germany.
PLoS One. 2014 Feb 28;9(2):e86294. doi: 10.1371/journal.pone.0086294. eCollection 2014.
Restoration of endodontically treated teeth using fiber posts in a one-stage procedure gains more popularity and aims to create a secondary monoblock. Data of detailed analyses of so called "post-and-core-systems" with respect to morphological characteristics of the resin-dentin interface in combination with bond strength measurements of fiber posts luted with these materials are scarce. The present study aimed to analyze four different post-and-core-systems with two different adhesive approaches (self-etch and etch-and-rinse).
Human anterior teeth (n = 80) were endodontically treated and post space preparations and post placement were performed using the following systems: Rebilda Post/Rebilda DC/Futurabond DC (Voco) (RB), Luxapost/Luxacore Z/Luxabond Prebond and Luxabond A+B (DMG) (LC), X Post/Core X Flow/XP Bond and Self Cure Activator (Dentsply DeTrey) (CX), FRC Postec/MultiCore Flow/AdheSE DC (Ivoclar Vivadent) (MC). Adhesive systems and core materials of 10 specimens per group were labeled using fluorescent dyes and resin-dentin interfaces were analyzed using Confocal Laser Scanning Microscopy (CLSM). Bond strengths were evaluated using a push-out test. Data were analyzed using repeated measurement ANOVA and following post-hoc test.
CLSM analyses revealed significant differences between groups with respect to the factors hybrid layer thickness (p<0.0005) and number of resin tags (p = 0.02; ANOVA). Bond strength was significantly affected by core material (p = 0.001), location inside the root canal (p<0.0005) and incorporation of fluorescent dyes (p = 0.036; ANOVA). CX [7.7 (4.4) MPa] demonstrated significantly lower bond strength compared to LC [14.2 (8.7) MPa] and RB [13.3 (3.7) MPa] (p<0.05; Tukey HSD) but did not differ significantly from MC [11.5 (3.5) MPa].
It can be concluded that bond strengths inside the root canal were not affected by the adhesive approach of the post-and-core-system. All systems demonstrated homogenous hybrid layer formation and penetration into the dentinal tubules in spite of the complicating conditions for adhesion inside the root canal.
采用纤维桩一步法修复经根管治疗的牙齿越来越普遍，旨在形成一个二次整体结构。关于所谓“桩核系统”在树脂 - 牙本质界面形态特征方面的详细分析数据，以及结合用这些材料粘结的纤维桩的粘结强度测量数据较为匮乏。本研究旨在分析四种不同的桩核系统及两种不同的粘结方法（自酸蚀和酸蚀冲洗）。
选取80颗人上前牙进行根管治疗，使用以下系统进行桩道预备和桩置入：Rebilda桩/Rebilda DC/Futurabond DC（Voco）（RB）、Luxapost/Luxacore Z/Luxabond Prebond和Luxabond A + B（DMG）（LC）、X桩/Core X Flow/XP Bond和自凝活化剂（登士柏德特雷）（CX）、FRC Postec/MultiCore Flow/AdheSE DC（义获嘉伟瓦登特）（MC）。每组10个样本的粘结系统和核材料用荧光染料标记，使用共聚焦激光扫描显微镜（CLSM）分析树脂 - 牙本质界面。采用推出试验评估粘结强度。数据采用重复测量方差分析及后续的事后检验进行分析。
CLSM分析显示，各组在混合层厚度（p < 0.0005）和树脂突数量（p = 0.02；方差分析）方面存在显著差异。粘结强度受核材料（p = 0.001）、根管内位置（p < 0.0005）和荧光染料掺入情况（p = 0.036；方差分析）的显著影响。与LC [14.2（8.7）MPa]和RB [13.3（3.7）MPa]相比，CX [7.7（4.4）MPa]的粘结强度显著较低（p < 0.05；Tukey HSD），但与MC [11.5（3.5）MPa]无显著差异。
可以得出结论，根管内的粘结强度不受桩核系统粘结方法影响。尽管根管内粘结条件复杂，但所有系统均显示出均匀的混合层形成并渗透到牙本质小管中。
