THE EFFECT OF SURFACE TREATMENT ON FIBER REINFORCED POSTS

Presented by Dr. Amit PG 1st year

The prognosis of endodontically treated teeth depends not only on the success of the endodontic treatment but also on the type of reconstruction

INTRODUCTION

Endodontically treated teeth may be damaged by

decay, excessive wear, previous restorations,

LEADS TO

lack of coronal tooth structure.

Therefore , Require the placement of a post to ensure adequate retention core

CAST METAL POSTS VS FIBER REINFORCED POST

Why do we need various surface treatments??

Fogel via fluid filtration microleakage test evaluated found that none of the post systems tested were capable of consistently achieving a fluid-tight seal.
Similar results were reported by Tjan et al, who used second generation dental adhesives and found that all teeth showed leakage.

In vitro and in vivo studies indicate that failure of glass fiber reinforced post-and-core restorations often occurs because of debonding at the post-resin interface and/or resin- dentin interface as a result of bond deficiencies.

What can we do about the failures??

Authors have investigated different procedures for improving the interfacial bond strength between posts and resin-based materials .

Pretreatment procedures
Treatments Acid etching, Silanization airborne- that combine both and/or particle micromechan abrasion, and adhesive ical and a silica application chemical coating; component

These procedures may be divided into 3 categories:

PRETREATMENT PROCEDURES

Silanization and/or adhesive application

SILANE INCREASES SURFACE WETTABILITY

BOND FORMATION WITH OH CONTAINING GROUPS AS GLASS OR QUARTZ FIBERS

ENHANCING ADHESION OF FIBRE POST TO COMPOSITE RESIN

INCREASED BOND STRENGH

Solvent evaporation plays an important role since an incomplete removal may compromise coupling

To optimize the chemical interaction between silane and inorganic surfaces, the reaction may be catalyzed by acid treatment or heating.

The chemical bond may be achieved only between the composite resin and the exposed glass fibers of the post. Bond strength between the epoxy resin-based fiber posts and the methacrylate based resin are not fully enhanced by silanization

ACID ETCHING , SANDBLASTING AND SILICA COATING

CERAMIC ETCHING WITH HF

Nontreated fiber posts have a relatively smooth surface which CREATES ROUGH SURFACE limits mechanical interlocking with resin cements and purely MICROMECHANICAL INTERLOCKING adhesive WITH RESINOUS CEMENTfailure modes are commonly recorded at the DAMAGES GLASS FIBERS, post/composite interfaces
MICROCRACKS, CORROSIVE EFFECTS

RELIES ON USE OF ALUMINIUM OXIDE PARTICLES MODIFIED BY SILICA. SILICATE LAYER WELDED ON TO THE TREATED SURFACE BY HIGH SPOT HEAT PRODUCED BY BLASTING PRESSURE IN A PROCESS CALLED TRIBOCHEMICAL COATING. FOLLOWED BY SILANIZATION OF PRETREATED LAYER; COMBINING CHEMICAL AND MICROMECHANICAL RETENTION. BLASTING REMOVES SUPERFICIAL LAYER OF RESINOUS MATRIX CREATING MICRORETENTIVE SPACES ON POST SURFACE

AIR ABRASION

USING SILICA COATED ALUMINIUM OXIDE PARTICLES; CREATES A SILICA LAYER ON THE POST SURFACE. PENETRATES 15 MICRONS EFFICIENT WHEN COMPARED TO ACID ETCHING, BUT MAY MODIFY THEIR SHAPE AND FIT INTO ROOT CANALS

BALBOSH AND ASUMUSSEN ET AL REGIMEN

THIS REGIMEN DID NOT PRODUCE VISIBLE CHANGES OF THE EPOXY BASED FIBRE POSTS SHAPE OF THE POST AND RESULTED IN INCREASED SURFACE ABRADED WITH 50 MICRONS ALUMINA PARTICLES,2.5 BAR AREA AND MECHANICAL INTERLOCKING WITH THE RESIN

PRESSURE,5 SEC, AT 30MM DISTANCE

MAIN PROBLEM WITH CONDITIONING TECHNIQUES ---LACK OF SENSITIVITY

BOTH THE MATRIX AS WELL AS THE FIBERS OF THE POST AFFECTED BY TREATMENT RESULTING IN DAMAGE OF THE POSTS INNER STRUCTURE.
ALTERNATIVE ETCHING TECHNIQUES :
SWELLING CONDITIONING OF EPOXY RESINSETCHING WITH KMNO4 DESMEARING. FOR METAL PLATING. NEUTRALIZING
FIBER

POSTS IMMERSED INTO SOLUTION(H2O2) 10-15 MIN. SURFACE LAYER MORE SPACES FOR SILANIZATION.

REMOVING

REVIEW OF LITERATURE

 Main

aim of the study was to evaluate the effects of sandblasting combined with silanization as a surface treatment on the bond strength between fiber posts and resin cement. Both sandblasting and silanization can improve the bonding of fiber posts to resin cement. The effect of sandblasting is predominant.This study suggested that fiber posts should be pretreated with sandblasting or combined with silanization before clinical use.
COMBINATION OF SANDBLASTING AND SILANIZATION ON THE BOND STRENGTH BETWEEN FIBER POST AND RESIN CEMENT. WANG YJ, ZHANG L, CHIEFFI N, CHEN JH, FERRARI M INTERNATIONAL DENTISTRY SA VOL. 8, NO. 6

Investigated the effects of pretreatment (silanization) on bond strengths between three different types of fibre posts and 4 resin cements.Concluded that fibre post revealed a significant influence on the bond strengths, whereas the effects of silanization appeared to be clinically negligible EFFECTS OF SILANIZATION ON BOND STRENGTHS OF FIBRE POSTS TO VARIOUS
RESIN CEMENTS. Bitter K, Noetzel J, Neumann K, Keilbassa AM , Quintessence Int 2007;38:121-128

Evaluated the effect of post-silanization heat treatment of a silane agent and rinsing with hot water of silanized CAD/CAM feldspathic ceramic surfaces on the microtensile bond strength between resin cement and the ceramic, before and after mechanical cycling. They concluded that oven drying at 77C improved the bond strength between the resin cement and feldspathic ceramic, but hot water rinsing reduced the bond strength and should not be recommended.
Effect of Post-silanization Heat Treatments of Silanized Feldspathic Ceramic on Adhesion to Resin Cement. Corazza, Cavalcanti PH, Queiroz SCM J Adhes Dent - 2013

Evaluated the effect of post silanization on the microtensile bond strength (MTBS) of translucent fiber posts to seven flowable composite resins used as core material. The different resin composite materials and the post silanization procedures had a significant effect on MTBS. The application of a silane coupling agent increased MTBS of flowable composite resins to translucent posts.
Post silanization improves bond strength of translucent posts to flowable composite resins. Albaladejo A, Osorio R et al. Journal of Biomedical Materials Research Part B Applied Biomaterials 2007; 82(2):320-4.

This study evaluated the effect of three post surface treatments on quartz-fiber post (a) retention and (b) morphology. Different treatments were performed for the other posts: silanization; etching by hydrofluoric acid 9.5%; sandblasting with 50 m Al2O3. Retentive post bond strengths were significantly enhanced with any tested post surface pretreatment. The increase in retentive strength was more remarkable in sandblasted and etched posts. Significant changes of post surfaces were SEM observed after different conditioning treatments.
Effect of Surface Treatments on Tensile Bond Strength and on Morphology of Quartz-fiber Posts. Arcangelo C, Amario M et al. 2007

Evaluated the tensile bond strengths and the effect of silanization of fiber posts inserted with different adhesive systems. Concluded that Silanization had no significant effect. Tensile bond strengths were significantly influenced by the type of resin cement. Silanization of fiber post surfaces seemed to have no clinical relevance.
Effect of Adhesive Resin Cements and Post Surface Silanization on the Bond Strengths of Adhesively Inserted Fiber Posts. Wrbas KT, Altenburger MJ et al. Journal of Endodontics 2007;33(7):840-843.

Main aim was to investigate the effects of pretreatment (silanization) on bond strengths between 3 different types of fiber posts and 4 resin cements, respectively. Bond strengths were significantly affected by the resin cement, the pretreatment , and the type of post, but not by thermocycling. The IPN post demonstrated significantly higher bond strengths compared to the other posts. Silanization significantly increased bond strengths compared to those of the control groups.The type of fiber post revealed a significant influence on bond strengths, whereas the effects of silanization appeared to be clinically negligible.
Effect of silanization on bond strengths of fiber posts to various resin cements.Bitter K, Noetzel J et al. Quintessence Int 2007 Feb;38(2):121-8.

The bond strength of composite resin cores to the smooth surface of prefabricated zirconia-based ceramic posts is problematic because it might not be sufficient to ensure stability of the post-and-core system. It is also not clear whether any alteration of the post surface to provide additional mechanical or chemical retention would compromise flexural strength of the posts.CONCLUDED - The use of a tribochemical silica coating process and silanization on zirconia-based ceramic posts increased both the bond strength to composite resin as well as the fracture strength of posts.

Effect of silica coating and silanization on flexural and composite-resin bond strengths of zirconia posts: An in vitro study Xible AA, Tavarez RRJ et al. 2007

Several surface treatments have been proposed for improving the bonding of resin cements or core materials to FRC (fiber-reinforced composite) posts. The possibility of combining chemical and micromechanical retention on post surface provides the most promising adhesion mechanism.This literature review summarizes the research on fiber post surface treatments and provides information related to their benefit in enhancing bond strength to composites, based on the results of original scientific full papers from peer-reviewed journals listed in Pub Med. According to the in vitro results, surface conditioning improves fiber post bonding properties, and the bond strength of pre-treated fiber posts to restorative materials is satisfactory. Long-term clinical studies are needed prior to making a general recommendation for their use.
Surface Treatments for Improving Bond Strength to Prefabricated Fiber Posts: A Literature Review. Monticelli F , Osorio R et al. 2008

Several post surface treatments with or without the application of a bonding agent have been recommended to improve the bond strength of resin cements to posts. A regimen that produces the maximum bond strength of glass fiber-reinforced composite resin posts has not been verified.The purpose of this study was to evaluate the influence of post surface conditioning methods and artificial aging on the retention and microleakage of adhesively luted glass fiber-reinforced composite resin posts. Treating the surface of the posts with phosphoric acid for 15 seconds before cementation produced no significant improvement in post retention. Airborne-particle abrasion of the surface of the post significantly improved post retention
Effects of endodontic post surface treatment, dentin conditioning, and artificial aging on the retention of glass fiber-reinforced composite resin posts. Albashaireh ZS, Ghazal M, Kern M. The Journal of Prosthetic Dentistry Volume 103, Issue 1, January 2010, Pages 3139

The purpose of this study was to evaluate the effect of 2 chemical solvents, hydrogen peroxide and methylene chloride, on the shear bond strength of quartz and glass fiber posts to a composite resin. There were significant differences between the shear bond strength for LP and CB. There was no significant difference between the S and M groups. The SEM observations demonstrated that the fiber post surfaces were modified after chemical surface treatment techniques. The surface treatment of quartz and glass fiber posts with hydrogen peroxide significantly enhanced the shear bond strength of the composite resin tested due to its ability to dissolve the epoxy resin matrix used in each post Effects of chemical surface treatments of quartz and glass fber posts on the
retention of a composite resin Yenisey M and Kulunk S , (J Prosthet Dent 2008;99:38-45)

CONCLUSION

 Advances

in the surface treatments of the fibre posts representing on of the most important factor which has improved the success of the esthetic post systems over the last two decades. term clinical studies supporting the benefits of one technique over the other in the future is requested.

Long