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
  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
  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
  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
  5. 5. Factors for achieving adhesive bond Wetting Interpenetration Micromechanical interlocking Chemical bonding
  6. 6. Challenges in bonding to dentin Dentin as substrate, composition tubular structure intrinsically hydrated
  7. 7.  Smear layer Moist vs dry dentin surfaces
  8. 8. Coronal vs radicular dentin Root dentin is less permeable than coronal dentin
  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
  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
  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
  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
  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.
  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
  15. 15. Epiphany (Pentron)The Epiphany Soft Resin Endodontic Obturation System consists of,*self-etching primer*dual-cure resin sealer
  16. 16. RealSeal (sybronEndo) System consists of primer polyester based sealer Shortcut to real seal.lnk
  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
  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
  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
  20. 20.  Mitzi et al , reduction in bond strength with RC prep - H2O2 - polyethlene glycol C – factor in root canal- 20 -100
  21. 21. Post endodontic restoration
  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
  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.
  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
  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.
  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
  27. 27.
  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
  29. 29. Resin luting cements
  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
  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
  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
  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
  34. 34. RelyX Unicem Self-Adhesive Universal Resin Cement 3M ESPE RelyX Unicem Self-Adhesive Universal Resin Cement
  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
  36. 36. Rehablitation of weakened roots
  37. 37.
  38. 38.
  39. 39.
  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
  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)
  42. 42. Restoration of access cavity Bonding to metal ceramic & all- ceramic restorations1. Surface treatment2. Silanation3. Bonding
  43. 43.
  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
  45. 45. Material incompatibility Eugenol Selfetching systems vs self-cure & dual cure composites - residual acid - emulsion polymerization
  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
  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
  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
  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