Saker Samah, Özcan Mutlu
Assistant Professor, Department of Conservative Dentistry and Fixed Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
Professor, University of Zürich, Dental Materials Unit, Center for Dental and Oral Medicine, Clinic for Fixed and Removable Prosthodontics and Dental Materials Science, Zürich, Switzerland.
J Prosthet Dent. 2015 Dec;114(6):856-61. doi: 10.1016/j.prosdent.2015.06.015. Epub 2015 Sep 16.
The prognosis of a fixed dental prosthesis cemented to endodontically treated teeth is primarily determined by the presence of a ferrule on the tooth. Adhesion of the post in the root canal, conditioning methods for the canal and the amount of coronal structure could also be decisive on survival of reconstructions cemented on endodontically treated teeth.
The purpose of this in vitro study was to test the effect of remaining coronal structure on the retention of airborne-particle abraded fiber-reinforced composite resin posts built up with composite resin cores after the treatment of root canal dentin with different conditioning protocols.
One hundred and fifty extracted human teeth with single root canal space were endodontically treated and divided into 3 groups as follows: group CEJ: the teeth were sectioned at the level of cementoenamel junction (CEJ); group CEJ1: the teeth were sectioned 1 mm above the CEJ; group CEJ2: the teeth were sectioned 2 mm above the CEJ. Each group was further divided into 5 subgroups (n=10 per group) according to the root canal treatments as follows: group C: no conditioning (control); group PH: conditioning with 37% phosphoric acid gel for 15 seconds; group E: conditioning with 17% ethylenediaminetetraacetic acid (EDTA) for 60 seconds; group CHX: conditioning with 2% chlorhexidine (CHX) for 60 seconds; group Q: conditioning with combination of 2% CHX with 17% EDTA and a surfactant solution for 60 seconds. Glass fiber-reinforced composite resin posts were airborne-particle abraded and luted to the root canal dentin with a self-adhesive resin cement (RelyX Unicem). The retentive force was tested by applying a tensile load parallel to the long axis of these posts at a crosshead speed of 2 mm/min. Two-way ANOVA and the Tukey HSD post hoc test were used to analyze the data.
The highest retention (N) was obtained with the CHX-EDTA conditioned group (374.7 ±29.8) followed by 17% EDTA (367.9 ±33.3) conditioning when 2 mm remaining coronal structure was available. Conditioning with the CHX-EDTA showed comparable retention values to 17% EDTA conditioned groups when 0 or 1 mm coronal structure was present that differed significantly compared to 37% PH and 2% CHX conditioning (P<.05).
Conditioning root canal either with CHX-EDTA or 17% EDTA delivered superior retention values for fiber-reinforced composite resin posts with composite resin cores that were luted with self-adhesive resin cement to endodontically treated teeth with 2 mm remaining coronal structure.
粘结在经过根管治疗的牙齿上的固定义齿的预后主要取决于牙齿上是否存在箍套。桩在根管内的粘结、根管的预处理方法以及冠部结构的量也可能对粘结在经过根管治疗的牙齿上的修复体的存留起决定性作用。
本体外研究的目的是测试不同预处理方案处理根管牙本质后,剩余冠部结构对用复合树脂核构建的空气颗粒磨损纤维增强复合树脂桩的固位力的影响。
选取150颗单根管的离体人牙,进行根管治疗后分为3组:CEJ组:在牙骨质釉质界(CEJ)水平截断牙齿;CEJ1组:在CEJ上方1mm处截断牙齿;CEJ2组:在CEJ上方2mm处截断牙齿。每组再根据根管治疗方法进一步分为5个亚组(每组n = 10):C组:不进行预处理(对照组);PH组:用37%磷酸凝胶预处理15秒;E组:用17%乙二胺四乙酸(EDTA)预处理60秒;CHX组:用2%氯己定(CHX)预处理60秒;Q组:用2% CHX与17% EDTA及一种表面活性剂溶液联合预处理60秒。玻璃纤维增强复合树脂桩经空气颗粒磨损后,用自粘结树脂水门汀(RelyX Unicem)粘结到根管牙本质上。通过以2mm/min的十字头速度在平行于桩长轴的方向施加拉伸载荷来测试固位力。采用双向方差分析和Tukey HSD事后检验分析数据。
当剩余2mm冠部结构时,CHX - EDTA预处理组获得的固位力最高(N)(374.7±29.8),其次是17% EDTA预处理组(367.9±33.3)。当存在0或1mm冠部结构时,CHX - EDTA预处理组的固位力值与17% EDTA预处理组相当,与37%磷酸和2% CHX预处理组相比有显著差异(P <.05)。
对于用自粘结树脂水门汀粘结到剩余2mm冠部结构的经过根管治疗的牙齿上的、带有复合树脂核的纤维增强复合树脂桩,用CHX - EDTA或17% EDTA预处理根管可提供更高的固位力值。