Resin adhesives in endodontics / /certified fixed orthodontic courses by Indian dental academy

Resin adhesives in
Endodontics

INDIAN DENTAL ACADEMY
Leader in Continuing Dental Education
www.indiandentalacademy.com


Contents
 Introduction
 Adhesion
 Challenges in bonding to dentin
 Coronal vs radicular dentin
 Resin based root canal sealers
-factors affecting adhesion
 Post endodontic restoration
 Resin based luting cements
 Rehabilitation of endodontically treated tooth
 Restoration of access cavities
 Material incompatibility
 conclusion


Introduction
 Improvement in esthetic materials &
techniques
 Acid etch technique & composites present
two major advances
 Stronger bonds to enamel & more
predictable bonds to dentin
 The tremendous potential of resin based
materials have been tried in endodontics


Adhesion
 Process of solid &/or liquid interaction of
one material with another at a single
interface
 Classified as
*physical bonding
*mechanical bonding
*chemical bonding
*micromechanical bonding

Factors for achieving adhesive
bond
 Wetting

 Interpenetration

 Micromechanical interlocking

 Chemical bonding

Challenges in bonding to dentin
 Dentin as substrate,

composition

tubular structure

intrinsically hydrated


 Smear layer

 Moist vs dry dentin
surfaces


Coronal vs radicular dentin
 Root dentin is less permeable than coronal
dentin


Resin sealers
 Epoxy based resin sealers
AH 26 , toxicity due to release of
formaldehyde
AH Plus, paste-paste system,
increased radiopacity, shoter setting time ,
better flow

 Kwang et al ,AH 26 showed greater bond
strength to dentin & GP

Methacrylate based root canal
sealers
 Application of adhesive dentistry concepts to
endodontics create improved apical &
coronal seal

 Introduction of methacrylate resin based sealers
& dentin adhesives for endodontic use

 Sealers that bond to dentin & used with gutta-
percha


Fiberfill ( Pentron, Wallingford)
 Designed for use with GP in single cone
technique
 Consists of,
primer A & B
methacrylate based sealer
 Economidies et al 2004, compared sealing
ability with CaOH based sealer


EndoREZ ( Ultradent)
 New dual cure sealer
 The only self-priming, hydrophilic sealer
available
 UDMA resin-based root canal sealer with
hydrophilic properties that improve sealing
ability
 radiopaque as gutta percha
 Kardon et al 2003, EndoRez vs AH plus


 EndoREZ Points are
standard ISO-sized
gutta percha points
overlayed with a thin
resin coating.
 The resin coating allows
EndoREZ Points to
bond chemically with
EndoREZ and other
resin-based sealers.

Newer systems

Each system component is resin based
resulting in a solid resin monoblock in the
root that effectively seals to the dentinal
walls


Epiphany (Pentron)
The Epiphany Soft Resin
Endodontic Obturation System
consists of,
*self-etching primer

*dual-cure resin sealer


RealSeal (sybronEndo)
 System consists of
primer
polyester based sealer

Shortcut to real seal.lnk


Resilon
 It is a thermoplastic synthetic
polymer-based RC filling material
 Polyester, difunctional
methacrylate resin, bioactive glass
& radioopaque fillers
 Available as conv/std cones &
pellets
 Lat compaction, warm vertical
condensation or thermoplastic
injection

 Shipper et al 2004, evaluated coronal
leakage using E. faecalis & S. mutans

 Trope et al 2004, root filled teeth with
resilon showed greater fracture resistance

 Shipper et al 2005, resilon group showed
lesser periapical inflamation

Factors influencing adhesion in root
canal
 Smear layer removal with 17% EDTA &
5.25% NaOCl
 Mitzi D. Morris et al, demonstrated
significantly larger reduction in dentin
bond strength
 Completely reversed by application of
10% ascorbic acid or 10% sodium
ascorbate


 Mitzi et al , reduction in bond strength with
RC prep
- H2O2
- polyethlene glycol
 C – factor in root canal- 20 -100


Post endodontic restoration


Resin based post systems
 Carbon, glass, quarts or silica fibers embedded
in resin matrix

 Advantage of flexing slightly

 Modulus of elasticity close to dentin

 Bonded to the root surface with resin cements


Carbon fiber posts
• Carbopost unidirectional, longitudinal fiber
reinforced composite posts, made of T700
carbon fibers (60% by volume) embedded in an
epoxy resin matrix (40% by volume).

• radiopacity- barium filler in the resin matrix.

• factory silanated, allowing the use of resin
bonding cements and core composite, and
giving a homogeneous all-composite corono-
radicular restoration.


Quartz fiber post
 Aestheti-post, white
quartz fibers
surrounding carbon
fibers
 Aesthetic-plus, all
quartz fibers, used
with One step + Post
cement Hi-X


Quartz fiber post
 Light Post (Bisco) unidirectional,
quartz fibres, instead of carbon
fibres
 The ratio of the quartz
fibres/epoxy matrix is
approximately 60/40
 higher flexural strength
 a low modulus of elasticity (close
to that of dentin) to allow the post
to flex along with the restored
tooth.

 Lucent anchor post (Dentatus) is a fiber-glass,
clear resin post used with Luxacore (zenith), an
auto mixed self cured resin cements
 FibreKor post (Jeneric/Pentron) uses glass
fibers bundled in resin matrix, Bond 1 + Build-it,
an automixed dual-cured composite
 ParaPost Fiber White (Coltene/Whaledent)
mono directional fibers in resin matrix


Glass fiber post

 SNOWPOST posts are made of 60% in volume of
zircon-rich glass fiber embedded in an epoxy resin
matrix.

 SNOWLIGHT posts are made of 65% in volume of
zircon-rich glass fiber embedded in a polyester-
metacrylate resin matrix, thus allowing the transmission
of light.
Both are silanated

 unidirectional, longitudinal glass fibers for strength,
embedded in a resin matrix


Resin luting cements


3M RelyX ARC Adhesive Resin Cement

 methacrylate resin-based dual cure luting
material designed to be used with the 3M Single
Bond dental adhesive system.

 two-paste system

 The resin is composed of bisphenol-A-
diglycidylether dimethacrylate (BisGMA) and
triethylene glycol dimethacrylate (TEGDMA)
polymer. Zirconia/silica filler is used

Step 1 -Etching:
• Apply 3M Scotchbond Etchant to the canal - wait 15 seconds.
• Rinse for 10 seconds.
• Dry for 2 seconds. Remove excess moisture with a
paper point.

Step 2 - Adhesive:
• Apply 3M Single Bond Adhesive to the canal.
• Dry for 5 seconds.
• Remove excess (if any) with a dry paper point.

Step 3 - Light-Cure:
• Light-cure for 10 seconds.

Step 4 - Apply Cement:
• Dispense cement onto a mixing pad and mix for 10 seconds.
• Apply cement in and around canal using a periodontal probe.
• Place a thin layer of mixed cement on post.

Step 5 - Seat the Post and Light-Cure:
• Seat the post.
• Remove excess cement while holding post in place.
• Light-cure for 40 seconds from an occlusal direction. The
remaining

Calibra , Dentsply
 Prime & Bond NT Dual Cure is the
bonding agent component of the system.
 Calibra is both light cure and dual cure.
 low film thickness between 12 and 18
microns


PANAVIA 21
Self-Curing Adhesive Bond System

 Paste/paste formulation
 ED Primer for effective
one-step conditioning of
cut enamel and dentin
without having to rinse
 Radiopaque and insoluble


RelyX Unicem
Self-Adhesive Universal Resin Cement

 3M ESPE RelyX Unicem Self-Adhesive
Universal Resin Cement


RelyX luting cement 3M
 RelyX Luting cement is the new name for
Vitremer Luting cement.
 is a hybrid glass ionomer cement
 simple application with no pretreatment or
adhesives required
 Indicated for metal post


Rehablitation of weakened roots


Core material
 Popular core materials
 Bondability to posts & to remaining tooth
structure – increased retension
 Pilo et al showed that composites have fracture
resistance comparable to amalgam and cast
post & core
 High tensile strength & tooth prepation can be
done immediately
 More favourable failure mode
 Used with transluscent restorations


 Disadvantages
- polymerization shrinkage
- water sorption
- adhesion to deep dentin
- technique sensitive
 Composite is not a good choice with minimal
remaining tooth structure, particularly if isolation
is a problem.
 Eg. ParaCore (Coltene), Build-it (Pentron)

Restoration of access cavity
 Bonding to metal
ceramic & all-
ceramic restorations
1. Surface treatment
2. Silanation
3. Bonding


 Bonding to metal restoration

* mechanical adhesion- surface treatment
* chemical adhesion – oxide layer, tin or
chromium plating platting
* metal primers
* silica coating
* silanation has no effect on bonding to metal


Material incompatibility
 Eugenol
 Selfetching systems vs self-cure & dual
cure composites
- residual acid
- emulsion polymerization


Conclusion
 Future directions should focus on materials that
penetrate patent d.tubules
bond to both org & inorg phases of dentin
antimicrobial action
induce cemental regenarative response
strength root system
 Within this frame work resin based materials
hold tremendous potentials and furthur research
is need

References
 Post and core systems, refinements to tooth
preparation and cementation
- BDJ, vol .198,9 – 2004
 Post placement and restoration of endodontically
treated teeth: A literature review
- JOE, vol.30,5 – 2004
 Comparative study of apical sealing ability of a
new resin-based root canal sealer.
- JOE, vol.30,6 – 2004
 Colour atlas of endodontics
- Debra R. Haselton


 Geometric factors affecting dentin bonding in root canals: A
theoretical modeling approach
-JOE, vol.31,8 – 2005

 Adhesive dentistry and endodontics : A review
-JOE, vol.31,3 – 2005

 Weakened anterior roots – intraradicular rehabilitation
-BDJ, vol.198 – 2005

 Esthetic dentistry
-DCNA, vol.34,4 – 1998

 Properties of a new injectable type of root canal filling resin with
adhesiveness to dentin
-JOE,vol.29,1 - 2003


 Restorative dentistry
-DCNA,vol.46 – 2002
 Adhesion of a new methacrylate resin-based sealer of
human dentin
-JOE, vol.30,4 – 2004
 Phillip’s science of dental materials
- Anusavice, 11th ed
 Sturdevant’s Art & science of operative dentistry
- Theodore M Roberson, 4th ed
 Pathways of pulp
- Stephen Cohen 8th & 9th ed


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Resin adhesives in endodontics / /certified fixed orthodontic courses by Indian dental academy