Journal of Dental Medicine

Background and Aim: The structural rehabilitation of a pulpless tooth is critically important to ensure a successful restorative outcome following endodontic treatment. A post and core is often indicated for the retention and reinforcement of the final restoration. But, the clinical situation is significantly challenging if the root exhibits immature development or there is a thin root wall that can compromise the prognosis for a long- term successful treatment. The purpose of this in vitro study was to evaluate different methods of intraradicular reinforcement in structurally compromised roots.

Materials and Methods: In this experimental study, seventy two extracted intact maxillary central incisors with similar size, shape and root anatomy were selected. After root canal therapy in 60 teeth, an acrylic laboratory bur was used to thin the cervical area and simulate the thin dentinal walls of immature teeth. The preparation was performed through the palatal access and extended 5mm apical to CEJ. The remaining 12 teeth remained unprepared to serve as positive control group. Cases were randomly divided into six groups of 12 teeth each and restored as follows. In the 12 cervically unprepared teeth (positive controls) the composite resin with dentin bonding agent (DBA) was placed in access cavity and cured for 120 seconds. This technique was also applied to other groups when the access was restored with composite. In the second group, the access cavity was restored with composite only to the level of CEJ. In the third group the cervically prepared teeth were reinforced with cement resin (Enforce) and a prefabricated post was placed in 5mm apical to the CEJ. In the fourth group, the cervically prepared teeth were reinforced with composite resin and DBA by a clear plastic post. In the fifth group the cervically prepared teeth were reinforced with composite resin and dba and a cast post. In the sixth group the cervically prepared teeth were restored with composite resin and dba with a prefabricated post. All of the specimens were mounted by rubberized technique and tested in the Instron universal testing machine. The fracture loads in samples were analyzed with ANOVA and Duncan tests with p<0.05 as the limit of significance.

Results: Significant differences in fracture resistance were observed between the first and second groups compared with others. The highest fracture resistance values were recorded for first group while the lowest were registered for the second group. Fracture resistance of the third, fourth and fifth groups had no significant statistical differences with others and fracture resistance of sixth group was the highest with significant difference (P<0.05).

Conclusion: From this study, it may be concluded that the use of a dba and a composite resin in thin-walled roots reinforces the immature teeth and facilitates the use of post.

Background and Aim: As composite-dentin bond strength is affected by cavity preparation and the bond strength of composite resin to new and used bur prepared dentin has not yet been evaluated, this study evaluated the effects of cutting dentin with different cutting efficacy (new and used) of burs on composite-dentin shear bond strength using self-etching primer bonding system and total etching bonding system.

Materials and Methods: Sixty caries free human 3rd molar were sectioned in occlosal surface to expose dentin, then polished with silicon carbide paper and randomly divided into four groups. Each group was prepared in a depth of 0.5mm of dentin, using new diamond bur, or used diamond bur. To change into a used bur, each new rough diamond bur had to work on bovine enamel for 30 minutes, under a load of 150g. Then, each group was bonded, using a total etch adhesive (single Bond) or a self etch adhesive (clearfil SE Bond) So there were 4 groups : 1-SE Bond, New bur 2-SE Bond , used bur 3-Single Bond , New bur 4-Single Bond, used bur. Similar composite capsules(Filtek Z250) were bonded to dentin surface and cured. specimens were stored in physiologic saline for 48h at 37⁰ c , then put under shearing load to define composite - dentin shear bond strength. Results were interpreted via statistical analysis (T-test & two - way variance).

Results: Shear bond strength of each group was as follows: 1-(27.3Mpa), 2-(33.5Mpa), 3-(16.9Mpa) 4-(19.3Mpa). Statistical analysis proved that shear bond strength of used diamond bur prepared groups (2,4) was more than new diamond bur prepared ones (1,3). This statistical difference, specially, was seen between SE Bond groups (1,2) but not between single Bond groups (3,4). Also, shear bond strength of (SE Bond) bonded groups (1,2) were more significantly than (single Bond) bonded ones (3,4).

Conclusion: This study show that Bur cutting efficiency influences composite - dentin shear bond strength especially when the adhesive is SE Bond (used bur> new bur) Also type of adhesive affects on composite - dentin shear bond strength. (SE Bond > Single Bond).