Resin adhesives in  Endodontics    INDIAN DENTAL ACADEMYLeader in Continuing Dental Education    www.indiandentalacademy.c...
Contents   Introduction   Adhesion   Challenges in bonding to dentin   Coronal vs radicular dentin   Resin based root...
Introduction   Improvement in esthetic materials &    techniques   Acid etch technique & composites present    two major...
Adhesion   Process of solid &/or liquid interaction of    one material with another at a single    interface   Classifie...
Factors for achieving adhesive                  bond   Wetting   Interpenetration   Micromechanical interlocking   Che...
Challenges in bonding to dentin   Dentin as substrate,      composition      tubular structure      intrinsically hydrate...
   Smear layer   Moist vs dry dentin    surfaces            www.indiandentalacademy.com
Coronal vs radicular dentin   Root dentin is less permeable than coronal    dentin           www.indiandentalacademy.com
Resin sealers   Epoxy based resin sealers          AH 26 , toxicity due to release of    formaldehyde          AH Plus, p...
Methacrylate based root canal                sealers   Application of adhesive dentistry concepts to    endodontics      ...
Fiberfill ( Pentron, Wallingford)   Designed for use with GP in single cone    technique   Consists of,      primer A & ...
EndoREZ ( Ultradent)   New dual cure sealer   The only self-priming, hydrophilic sealer    available   UDMA resin-based...
   EndoREZ Points are    standard ISO-sized    gutta percha points    overlayed with a thin    resin coating.   The resi...
Newer systemsEach system component is resin based resulting in a solid resin monoblock in the root that effectively seals ...
Epiphany (Pentron)The Epiphany Soft Resin Endodontic Obturation System consists of,*self-etching primer*dual-cure resin s...
RealSeal (sybronEndo)   System consists of     primer     polyester based sealer                                         ...
Resilon   It is a thermoplastic synthetic    polymer-based RC filling material   Polyester, difunctional    methacrylate...
   Shipper et al 2004, evaluated coronal    leakage using E. faecalis & S. mutans   Trope et al 2004, root filled teeth ...
Factors influencing adhesion in root               canal   Smear layer removal with 17% EDTA &    5.25% NaOCl   Mitzi D....
   Mitzi et al , reduction in bond strength with    RC prep           - H2O2           - polyethlene glycol   C – factor...
Post endodontic restoration     www.indiandentalacademy.com
Resin based post systems   Carbon, glass, quarts or silica fibers embedded    in resin matrix   Advantage of flexing sli...
Carbon fiber posts• Carbopost unidirectional, longitudinal fiberreinforced composite posts, made of T700carbon fibers (60%...
Quartz fiber post   Aestheti-post, white    quartz fibers    surrounding carbon    fibers   Aesthetic-plus, all    quart...
Quartz fiber post   Light Post (Bisco) unidirectional,    quartz fibres, instead of carbon    fibres    The ratio of the...
   Lucent anchor post (Dentatus) is a fiber-glass,    clear resin post used with Luxacore (zenith), an    auto mixed self...
www.indiandentalacademy.com
Glass fiber post   SNOWPOST posts are made of 60% in volume of    zircon-rich glass fiber embedded in an epoxy resin    m...
Resin luting cements  www.indiandentalacademy.com
3M RelyX ARC Adhesive Resin Cement   methacrylate resin-based dual cure luting    material designed to be used with the 3...
Step 1 -Etching:   • Apply 3M Scotchbond Etchant to the canal - wait 15 seconds.   • Rinse for 10 seconds.   • Dry for 2 s...
Calibra , Dentsply   Prime & Bond NT Dual Cure is the    bonding agent component of the system.   Calibra is both light ...
PANAVIA 21        Self-Curing Adhesive Bond System   Paste/paste formulation    ED Primer for effective    one-step cond...
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 ...
Rehablitation of weakened roots      www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
Core material   Popular core materials   Bondability to posts & to remaining tooth    structure – increased retension  ...
   Disadvantages       - polymerization shrinkage       - water sorption       - adhesion to deep dentin       - techniqu...
Restoration of access cavity    Bonding to metal     ceramic & all-     ceramic restorations1.   Surface treatment2.   Si...
www.indiandentalacademy.com
   Bonding to metal restoration     * mechanical adhesion- surface treatment    * chemical adhesion – oxide layer, tin or...
Material incompatibility   Eugenol   Selfetching systems vs self-cure & dual    cure composites          - residual acid...
Conclusion   Future directions should focus on materials that       penetrate patent d.tubules       bond to both org & i...
References   Post and core systems, refinements to tooth    preparation and cementation                    - BDJ, vol .19...
   Geometric factors affecting dentin bonding in root canals: A    theoretical modeling approach                         ...
   Restorative dentistry                       -DCNA,vol.46 – 2002   Adhesion of a new methacrylate resin-based sealer o...
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Resin adhesives in endodontics / /certified fixed orthodontic courses by Indian dental academy

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

  1. 1. Resin adhesives in Endodontics INDIAN DENTAL ACADEMYLeader in Continuing Dental Education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. 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 www.indiandentalacademy.com
  3. 3. 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 www.indiandentalacademy.com
  4. 4. 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 www.indiandentalacademy.com
  5. 5. Factors for achieving adhesive bond Wetting Interpenetration Micromechanical interlocking Chemical bonding www.indiandentalacademy.com
  6. 6. Challenges in bonding to dentin Dentin as substrate, composition tubular structure intrinsically hydrated www.indiandentalacademy.com
  7. 7.  Smear layer Moist vs dry dentin surfaces www.indiandentalacademy.com
  8. 8. Coronal vs radicular dentin Root dentin is less permeable than coronal dentin www.indiandentalacademy.com
  9. 9. 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 www.indiandentalacademy.com
  10. 10. 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 www.indiandentalacademy.com
  11. 11. 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 www.indiandentalacademy.com
  12. 12. 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 www.indiandentalacademy.com
  13. 13.  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. www.indiandentalacademy.com
  14. 14. Newer systemsEach system component is resin based resulting in a solid resin monoblock in the root that effectively seals to the dentinal walls www.indiandentalacademy.com
  15. 15. Epiphany (Pentron)The Epiphany Soft Resin Endodontic Obturation System consists of,*self-etching primer*dual-cure resin sealer www.indiandentalacademy.com
  16. 16. RealSeal (sybronEndo) System consists of primer polyester based sealer Shortcut to real seal.lnk www.indiandentalacademy.com
  17. 17. 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 www.indiandentalacademy.com
  18. 18.  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 www.indiandentalacademy.com
  19. 19. 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 www.indiandentalacademy.com
  20. 20.  Mitzi et al , reduction in bond strength with RC prep - H2O2 - polyethlene glycol C – factor in root canal- 20 -100 www.indiandentalacademy.com
  21. 21. Post endodontic restoration www.indiandentalacademy.com
  22. 22. 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 www.indiandentalacademy.com
  23. 23. Carbon fiber posts• Carbopost unidirectional, longitudinal fiberreinforced composite posts, made of T700carbon fibers (60% by volume) embedded in anepoxy resin matrix (40% by volume).• radiopacity- barium filler in the resin matrix.• factory silanated, allowing the use of resinbonding cements and core composite, andgiving a homogeneous all-composite corono-radicular restoration. www.indiandentalacademy.com
  24. 24. Quartz fiber post Aestheti-post, white quartz fibers surrounding carbon fibers Aesthetic-plus, all quartz fibers, used with One step + Post cement Hi-X www.indiandentalacademy.com
  25. 25. 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. www.indiandentalacademy.com
  26. 26.  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 www.indiandentalacademy.com
  27. 27. www.indiandentalacademy.com
  28. 28. 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   www.indiandentalacademy.com
  29. 29. Resin luting cements www.indiandentalacademy.com
  30. 30. 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 www.indiandentalacademy.com
  31. 31. 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 remainingwww.indiandentalacademy.com
  32. 32. 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 www.indiandentalacademy.com
  33. 33. 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 www.indiandentalacademy.com
  34. 34. RelyX Unicem Self-Adhesive Universal Resin Cement 3M ESPE RelyX Unicem Self-Adhesive Universal Resin Cement www.indiandentalacademy.com
  35. 35. 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 www.indiandentalacademy.com
  36. 36. Rehablitation of weakened roots www.indiandentalacademy.com
  37. 37. www.indiandentalacademy.com
  38. 38. www.indiandentalacademy.com
  39. 39. www.indiandentalacademy.com
  40. 40. 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 www.indiandentalacademy.com
  41. 41.  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) www.indiandentalacademy.com
  42. 42. Restoration of access cavity Bonding to metal ceramic & all- ceramic restorations1. Surface treatment2. Silanation3. Bonding www.indiandentalacademy.com
  43. 43. www.indiandentalacademy.com
  44. 44.  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 www.indiandentalacademy.com
  45. 45. Material incompatibility Eugenol Selfetching systems vs self-cure & dual cure composites - residual acid - emulsion polymerization www.indiandentalacademy.com
  46. 46. 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 www.indiandentalacademy.com
  47. 47. 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 www.indiandentalacademy.com
  48. 48.  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 www.indiandentalacademy.com
  49. 49.  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 www.indiandentalacademy.com

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