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Surface Treatments For Improving Bond Strength To Prefabricated Fiber Posts: A Literature Review

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Operative Dentistry, 2008, 33-3, 346-355

Literature Review

Surface Treatments for


Improving Bond Strength to
Prefabricated Fiber Posts:

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A Literature Review
F Monticelli •R Osorio • FT Sadek
I Radovic • M Toledano • M Ferrari

Clinical Relevance
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 mecha-
nism.

Francesca Monticelli, DDS, MSc, PhD, vice dean and professor, SUMMARY
Department of Surgery, Faculty of Health and Sport Sciences, This literature review summarizes the research
University of Zaragoza, Huesca, Spain
on fiber post surface treatments and provides
Raquel Osorio, DDS, PhD, professor, Department of Dental information related to their benefit in enhancing
Materials, Colegio Maxímo, University of Granada, Granada, bond strength to composites, based on the results
Spain
of original scientific full papers from peer-
Fernanda Tranchesi Sadek, DDS, MSc, PhD, post-doctoral reviewed journals listed in Pub Med. The search
researcher, Department of Dental Materials, Universidade de
was conducted using the terms “fiber post,” “sur-
São Paulo (USP), SP, Brazil
face treatment,” “surface conditioning,” “etch-
Ivana Radovic, DDS, MSc, clinical assistant, Clinic of Pediatric ing” and “sandblasting.” A consistent number of
and Preventive Dentistry, Faculty of Dentistry, University of
in vitro studies that investigated the surface
Belgrade, Serbia and PhD student, Department of Restorative
Dentistry and Dental Materials, Policlinico Le Scotte, treatment of fiber posts in an attempt to improve
University of Siena, Siena, Italy bond strength have been published to date. Their
Manuel Toledano, MD, DDS, PhD, professor, Department of
results have been summarized in the following
Dental Materials, Colegio Maxímo, University of Granada, categories: chemical treatments and micro-
Granada, Spain mechanical treatments of fiber post surfaces (or
*Marco Ferrari, MD, DDS, PhD, dean and professor, Department a combination of both principles). The majority
of Restorative Dentistry and Dental Materials, Policlinico Le of available literature data is based on studies
Scotte, University of Siena, Siena, Italy that investigated different “chairside” post
*Reprint request: Policlinico Le Scotte, Viale Bracci, 53100, superficial treatments. According to the in vitro
Siena, Italy; e-mail: md3972@mclink.it results, surface conditioning improves fiber post
DOI: 10.2341/07-86 bonding properties, and the bond strength of pre-
Monticelli & Others: Fiber Post Surface Conditioning: A Review 347

treated fiber posts to restorative materials is sat- This literature review summarizes the results of the
isfactory. Long-term clinical studies are needed research conducted on fiber post surface treatments
prior to making a general recommendation for and provides information on their benefit for improving
their use. bonding to resin composites based on the results of orig-
inal scientific full-papers from peer-reviewed journals
INTRODUCTION listed in Pub Med. This search was conducted using the
Fiber posts are widely used to restore endodontically- terms “fiber post,” “surface treatment,” “surface condi-
treated teeth that have insufficient coronal tooth struc- tioning,” “etching” and “sandblasting.”
ture to retain a core for the definitive restoration.1
Many in vitro studies have investigated factors that LITERATURE DATA
may affect the retention of a post. These factors may Silanization and/or adhesive application is undoubted-
include design, length, diameter and surface treat- ly the most thoroughly investigated fiber post-surface
ments.2-5 treatment in the current literature. The vast majority

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The retention of fiber post and composite restorations of articles published in Medline-cited journals investi-
depends on the quality of the bond established at dif- gated the effectiveness of these chairside procedures for
ferent interfaces. Several investigations have been con- improving bond strength. Limited information is avail-
ducted to evaluate the interface with dentin, both at the able on chemo-mechanical surface treatments used in
coronal and radicular levels.6-8 the attempt to enhance/modify the surface area avail-
able for bonding. All published articles are based on in
Since the introduction of fiber posts, a continuous vitro investigations. The selected investigations have
effort has been made to improve bonding inside the root been primarily performed using microtensile and push-
canal: despite the development of novel adhesive sys- out bond strength tests in combination with microscop-
tems, radicular dentin still offers less favorable condi- ic analysis. Few investigations include aging proce-
tions for bonding than coronal dentin.9-10 dures in their experimental design, such as thermo-
Chersoni and others11 recently reported that the bond- cycling and/or water storage (Table 1).
ing efficacy of simplified hydrophilic adhesives to auto- 1. Chemical Bonding to Fiber Posts
cured composites/cements is hampered by the intrinsic
permeability of these adhesives to water still present in Several studies suggest using silane coupling agents in
pulpless teeth. coating applications to promote adhesion between inor-
ganic surfaces and polymeric molecules.18-20
The most frequent cause of adhesive failure is debond-
ing of a post restoration at the resin cement/dentin Organosilanes have the formula R’-Si-(OR)3, with an
interface.12-14 organic functional group (R’) and three alkoxy groups
Although adhesion in the root canal represents the
weakest point of the restoration, the post/composite
adhesion needs to be considered. Immediately after
fiber post cementation and core build-up, the restora-
tion has to resist the stresses transmitted during core
trimming to adapt the provisional crown.15 At the coro-
nal level, the amount of residual tooth structure still
offers more favorable conditions for ensuring strong
adhesion and retention.16-17
At the post-core interfacial level, only the chemical
interaction between the fiber post surface and the com-
posite may ensure the bond of the core material around
the post.
In an attempt to maximize resin bonding to fiber
posts, several surface treatments have been recently
suggested. These procedures fall into three categories:
1) treatments that result in chemical bonding between
a composite and post (coating with priming solutions);
2) treatments that intend to roughen the surface (sand-
blasting and etching) or 3) combine micromechanical Figure 1. Representative drawing of the coupling reaction at the fiber
and chemical components either by using the two above post-composite interface. Organosilanes with chemical formula R’-Si-
mentioned methods or a unique system (such as Co-Jet ). (OR)3 have an organic functional group (R’) and three alkoxy groups
(R): the reaction begins with hydrolysis of the alkoxide groups (R) into
silanols (SiOH) that condense, forming siloxane bonds.
348 Operative Dentistry

Table 1: In Vitro Studies on Superficial Treatments of the Fiber Post Surface


Selection Criteria Authors Superficial Treatment Experimental Design
Aksornmuang and Adhesive application; silanization Microtensile bond strength test;
Chemical Bonding
others, 200427 SEM analysis
Aksornmuang and Adhesive application; silanization Microtensile bond strength test;
others, 200628 SEM analysis
Bitter and others, Silanization Push-out bond strength test
200726
Ferrari and others, Adhesive application; silanization Microtensile bond strength test;
200645 SEM analysis
Goracci and others, Silanization Microtensile bond strength test;
200515 SEM analysis
Dietschi and Adhesive application Fatigue test;

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others, 200644 SEM and Confocal microscopy analysis
Perdigão and Silanization Push-out bond strength test
others, 200629
Micro-mechanical Bitter and others, Co-Jet Silanization Push-out bond strength test;
200625 SEM analysis
and Chemical
Bonding Balbosh and Kern, Sandblasting; Adhesive application Thermocycling; Fatigue cycling;
20061 Pull-out test
D’Arcangelo and Hydrofluoric acid; Sandblasting; Push-out bond strength test;
others, 200761 Silanization SEM analysis
Asmussen and Grinding; Sandblasting; Co-Jet; Contact angle measurment
others, 200565 Alloy primer application
Monticelli and Hydrogen peroxide; Sodium ethoxide; Microtensile bond strength test;
others, 200676 Potassium permanganate; Silanization SEM analysis
Monticelli and Sodium ethoxide; Silane/Adhesive Microtensile bond strength test;
others, 200649 application SEM analysis
Monticelli and Hydrogen peroxide; Silanization Microtensile bond strength test;
others, 200640 SEM analysis
Monticelli and Hydrogen peroxide; Water storage; theromocycling;
others, 200683 Silane/Adhesive application Microtensile bond strength test;
SEM analysis
Monticelli and Hydrogen peroxide; Silanization Microtensile bond strength test;
others, 200680 SEM analysis
Sahafi and Sandblasting; Hydrofluoric acid; Water storage; Shear bond strength test
others, 200331 Alloy Primer application; Co-Jet
Sahafi and Sandblasting; Co-Jet; Silanization Water storage; Pull-out test
others, 200458
Sahafi and Sandblasting; Hydrofluoric acid; Water storage; Diametral tensile strength
others, 200464 Silanization
Radovic and Sandblasting; Adhesive application; Microtensile bond strength test;
others, 200766 Silanization SEM analysis
Valandro and Hydrofluoric acid; phosphoric acid; Microtensile bond strength test;
others, 200660 Co-Jet; Silanization SEM analysis
Vano and Hydrofluoric acid; Hydrogen peroxide; Microtensile bond strength test;
others, 200663 Silanization SEM analysis

(R): the chemical reaction begins with hydrolysis of the According to some authors,25 silane treatment did not
alkoxide groups (R) into silanols (SiOH) that may con- enhance the retention of glass fiber posts luted with six
dense, forming siloxane bonds (Figure 1).20-21 different resinous cements. Even if the effects of
Silane has been proven to increase ceramic-composite silanization proved to be significant with regard to bond
bond strength during luting procedures or when repair- strengths to FRC posts, the clinical relevance of the dif-
ing chipped ceramic restorations.22-24 Treating the post ferences has been considered to be of minor impor-
surface with a silane-coupling agent may be advisable tance.26
for enhancing adhesion. However, opinion differs about Goracci and others recently reported an improvement
the efficiency of post silanization. in bond strength between silanized fiber posts and flow-
able composites used as core materials.15 Similarly,
Monticelli & Others: Fiber Post Surface Conditioning: A Review 349

Aksornmuang and others and Perdigão and others con- The selection of a warm air stream (38°C) for air-dry-
firmed the benefit of silane application for enhancing ing the fiber post surface seemed to be a clinically-fea-
the microtensile bond strength of a dual-cure resin core sible chairside procedure used to overcome some of the
material to translucent fiber posts.27-29 problems related to silane composition and/or applica-
These results rely on silanes’ capability to increase tion.18,37,43
surface wettability, creating a chemical bridge with OH- Some results recently achieved on ceramics confirmed
covered substrates, such as glass. However, the interfa- this aspect, particularly for the two-component systems
cial strength is still relatively low when compared to the that have proved to be more sensitive to heating.38,43
values achieved with dental substrates.15,30-31 Some authors and manufacturers have proposed adhe-
One possible reason is the absence of a chemical union sive systems as a possible alternative to silane in fiber-
between resin composites (methacrylate-based) and the post couplings.44 The possible benefit of silanization and
matrix of fiber posts, which are often made of epoxy the consecutive application of a bonding agent have
recently been evaluated with controversial results.

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resin. Epoxy polymers exhibit a high degree of conver-
sion and highly cross-linked structures.32 Ferrari and others45 reported no substantial improve-
ment in bond strength by the separate application of
Amino-silane coupling agents are generally used as silane and a different formulation of dentin adhesives
adhesion promoters in the presence of epoxy resin poly- on methacrylate-based quartz fiber posts. One possible
mers.33 On the other hand, MPS (methacryloxypropy- explanation is the formation of a thick multi-phase cou-
ltrimethoxysilane) silanes are commonly applied in den- pling layer in which flaws may easily be produced dur-
tistry.21,24 Since MPS silane does not bond well with the ing each separate phase of the application. Some
epoxy matrix, bond strength between the epoxy resin recently marketed coupling agents rely on the possibil-
phase of the fiber post and the methacrylate-based resin ity of combining a silane/primer solution (Clearfil
composite should not be enhanced. A chemical bond Porcelain Bond Activator, Kuraray) and a bonding
through silane may be achieved only between the resin agent (Clearfil SE Bond, Kuraray or alternative adhe-
composite and the exposed glass fibers of the post. sives from the same manufacturer). In these two-com-
This lack of compatibility between the fiber post mate- ponent systems for “on-demand” hydrolysis, the silane
rial and silane blends may have some influence on the is rapidly hydrolyzed when mixed with the acidic phos-
way silane molecules can absorb, condense or interact phate monomers present in the water-containing
with a substrate.34-35 dentin adhesives. This results in a condensation reac-
Moreover, silane coupling is a technique-sensitive tion that enables the trialkoxy silane to perform more
step. Among factors influencing its efficacy, the compo- efficiently than completely pre-hydrolyzed solutions.46
sition (pH, solvent content, molecule size) and applica- This approach has been shown to improve bond
tion mode are primarily involved. Solvent evaporation strength to ceramics.47-48 Satisfactory results have been
plays an important role: while small amounts of solvent reported on both the zirconia and epoxy resin-based
may be beneficial to promoting silane wetting, incom- translucent fiber posts.27-28,50 These combined
plete removal may compromise coupling.36 silane/bonding agents may have an advantage in bond-
ing to the post surface, because of the simultaneous for-
To optimize the mechanism of chemical interaction mation of siloxane bonds and the polymerization of
between silane and an inorganic surface, the reaction functional groups in the resin.
may be catalyzed by acid treatment or heating.18,37 Heat
treatment of silanated glass is routinely performed in A possible limitation of this technique is represented
the glass industry to maximize bond strength.38 Silane by the selection of bonding agent. Several newly mar-
has been proven to increase ceramic-composite bond keted adhesive systems include large amounts of water
strength during luting procedures, when repairing and other organic solvents, acidic monomers or 2-
chipped ceramic restorations22,24,38 or when bonding hydroxyethylmethacrylate.50 As a consequence of their
ceramics to resin composite.37,39 composition, simplified one-step self-etch adhesives are
considered prone to phase separation of the hydropho-
A similar approach was recently proposed in an bic monomers when the volatile solvent/water ratio is
attempt to improve silane coupling to translucent fiber reduced during evaporation, creating a non-uniform
posts.40 In that study, single-phase pre-activated solu- interface. This aspect may expedite degradation of the
tions (Monobond-S, Ivoclar-Vivadent and Porcelain post/composite interface, rendering its potential use
Silane, BJM Lab), based on different silane molecules with silane coupling agents as questionable.
(3-MPS and GPS, respectively) and a two-component Conversely, the inclusion of a separate hydrophobic
system (Porcelain Liner M, Sun Medical) in which resin coating in the two-step adhesives (Clearfil SE
hydrolysis occurs when mixing the silane coupler (γ- Bond or Clearfil Protect Bond, Kuraray) that were
MPTS) with the acidic monomer (4-META) just before applied after the silane/adhesive primer solution con-
its application, were tested.41-42 tributes to the creation of a more reliable seal of the
350 Operative Dentistry

post surface. Nevertheless, chemical adhesion


alone may not guarantee a strong, durable fiber
post-to-composite bond.
2. Chemical and Micro-mechanical Bonding
to Fiber Posts
Surface treatments are common methods for
improving the general adhesion properties of a
material by facilitating chemical and microme-
chanical retention between the different con-
stituents. In adhesive dentistry, surface condition-
ing techniques have been developed for natural
substrates (enamel, dentin)51-53 and restorative
materials.

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The concept of conditioning artificial substrates
to improve bond strength is exemplified by the
etching of Maryland bridges54-55 and feldspathic
porcelain restorations.24,56-57 Based on this principle,
different conditioning procedures, initially pro-
posed for ceramics, have also been tested on fiber
posts.
Hydrofluoric Acid
Etching with hydrofluoric acid is intended to cre-
ate a roughening of the surface, which allows for
micromechanical interlocking with the resinous
restoration.
Hydrofluoric acid has recently been proposed for
etching glass fiber posts (Figure 2A).58-61 The effect
Figure 2: A) Representative SEM micrographs of the fiber post surface after HF
of the acid has been proven to be time-dependent
etching. Denuded quartz fibers are evident on the post surface, due to deep epoxy
and influenced by the post composition (type of resin dissolution (1000x). B) Morphological aspect of the fiber post surface before
matrix and/or fibers). This technique produced treatment: no fibers are exposed on the outer surface. which appears embedded in
substantial damage to the glass fibers and affected the epoxy resin matrix (1000x bar 10 µm). C) SEM images of the fiber post surface
the integrity of the post.60 after sandblasting (1000x bar 10 µm) and D) after etching with 10% hydrogen per-
oxide for 20 minutes. Exposure of the quartz fibers could be seen as a result of the
The glass fibers appeared weaker than quartz partial dissolution of the surface epoxy resin. Fibers were not damaged by the etch-
fibers. This is due to the extremely corrosive effect ing treatment (1000x bar 10 µm). E) SEM image of the experimental zirconium oxide
of hydrofluoric acid on the glass phase of a ceram- industrial coating: particles are detectable on the post surface, thus covering the
ic matrix.24,62 These findings were confirmed by fibers and the resinous matrix (1200x bar 10 µm).
Vano and others63 when hydrofluoric acid was used
ratory use in 1989. This system relies on the use of alu-
to condition the methacrylate-based fiber posts: despite
minum oxide particles modified by silica. As a result, a
the improvement in post-to-composite bond strength, a
silicate layer is welded onto the post surface by high
remarkable surface alteration, ranging from micro-
spot heat produced by blasting pressure in a process
cracks to longitudinal fractures of the fiber layer, was
called tribochemical coating. These procedures are fol-
detected. As a consequence, it is not possible to suggest
lowed by silanization of the pre-treated fiber post sur-
general guidelines for using hydrofluoric acid in the
face, thus combining chemical and micromechanical
surface etching of aesthetic fiber posts.
retention.
Sandblasting and Silica Coating
Several studies investigated the bonding of resinous
Non-treated fiber posts have a relatively smooth sur- materials to different types of posts, evaluating the
face area that limits mechanical interlocking between effect of the surface treatments. Air abrasion with sili-
the post surface and resin cement, and purely adhesive ca-coated aluminum oxide particles creates a layer of
failure modes are commonly recorded at the post/com- silica on the surface of the post due to the high velocity
posite interfaces (Figure 2B). Sandblasting with alumi- impact of the silica on the substrate, allowing for the
na particles results in an increased roughness of the penetration of particles of about 15 microns.60 This
surface and surface area. The Co-Jet system (Co-Jet, treatment improved the bond strength between quartz
3M ESPE, St Paul, MN, USA) for intraoral use is a FRC posts and resin cements when compared with
modification of the Rocatec system introduced for labo- phosphoric acid or hydrofluoric acid etching.60
Monticelli & Others: Fiber Post Surface Conditioning: A Review 351

Sahafi and others tested the efficacy of blasting the resin phase of fiber posts may be beneficial in improv-
surface of zirconia and fiber posts with silica oxide (Co- ing their adhesion to methacrylate-based resin compos-
Jet System).31,64 Despite the satisfactory bond strengths ites.
achieved, the treatment was considered too aggressive For industrial applications, such as epoxy resin-based
for fiber posts, with the risk of significantly modifying circuit boards, many chemical techniques have been
their shape and, consequently, their fit within the root introduced to strengthen adhesion between the compo-
canals.64 The application time, size of the particles of nents of the fiber-reinforced resin composites.70-72 In
alumina and pressure may have influenced the results. particular, potassium permanganate is usually applied
On the other hand, this treatment appeared to be ben- for conditioning epoxy resin surfaces for the metal plat-
eficial when performed on zirconia posts. ing of printed circuits boards.73-75
Bitter and others26 reported that, depending of the This treatment, commonly defined as desmearing, is
luting materials used, some influence was exerted by a process designed to remove the smeared epoxy resin
the CoJet treatment of the bond strength of fiber posts

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byproducts from copper surfaces, thus providing supe-
to resinous cements. rior topography for increased adhesion of direct metal-
More promising results were recently achieved by lization or electroless copper.
Balbosh and Kern1 and Asmussen and others.65 Epoxy This procedure, consisting of the subsequent applica-
resin-based fiber posts were air-born particle abraded tion of three chemical solutions (swelling, etching and
with 50 micron alumina particles at 2.5-bar pressure neutralizing), was tested on translucent fiber posts,
for five seconds and a distance of 30 mm. This regimen achieving noteworthy results.76
did not produce visible changes to the form of the post.
Nevertheless, this regimen resulted in increased sur- With a similar purpose, hydrogen peroxide and sodi-
face area and mechanical interlocking with the resin um ethoxide are commonly employed in immunological
cement. Similarly, Radovic and others66 reported a sig- electron microscopy to partially dissolve the resin sur-
nificant increase in surface retention when Rocatec-Pre face of epoxy resin-embedded tissue sections and
aluminum oxide particles were used to treat FRC posts: expose tissue epitopes for immunolabeling enhance-
the mechanical action of blasting probably determined ment. The etching effect of these chemicals depends on
removal of the superficial layer of the resinous matrix, the capacity to partially dissolve the resin matrix,
creating micro-retentive spaces on the post surface breaking epoxy resin bonds through a mechanism of
(Figure 2C). substrate oxidation.68,77-79
However, the main problem related to these tech- A similar approach has been proposed in dentistry for
niques is represented by the lack of selectivity: both the the surface pre-treatment of fiber posts to increase
matrix and the fibers of the post are affected by this their responsiveness to silanization. It has achieved
treatment, sometimes resulting in damage to the post satisfactory results for both chemicals tested.49,80 The
structure. surface conditioning treatment consisted of immersion
of the fiber posts into the solutions for a relatively short
Alternative Etching Techniques time (10-20 minutes), thus allowing for modification of
To achieve optimal properties in fiber-reinforced com- the post surface morphology (Figure 2D).
posite materials, adhesion between the fibers and the By removing a surface layer of the epoxy resin, a
composite is usually optimized through selective super- greater surface area of exposed quartz fibers is avail-
ficial preparations.67 These treatments allow for modifi- able for silanization. The spaces between these fibers
cation and improvement of the properties of the inter- provide additional sites for micromechanical retention
face between the resinous matrix and the fibers. of the resin composites. This retention concept is remi-
It was of interest to verify whether, and to what niscent of the creation of hybrid layers in dentin,81 as
extent, the adhesive potential of the fiber post could be the interface is contributed to by both quartz fibers
improved as a result of these treatments. Different from the fiber post and the methacrylate resin matrix.
chemicals and laboratory and industrial techniques In particular, H2O2 etching (10% H2O2 for 20 minutes)
have been evaluated in an attempt to find a possible provided an easy, clinically feasible method for enhanc-
application in dentistry. ing the interfacial strength between fiber posts and
As previously reported, the absence of chemical inter- resin composites without the need to employ extremely
action between the methacrylate-based resin composite corrosive liquids in a clinical setting.80
and epoxy resin matrix of the fiber posts24 represents
FUTURE DIRECTIONS
the primary cause of weakness in post-to-composite
bonds. Surface post treatments represent one important fac-
tor when dealing with epoxy resin-based fiber posts.
Different solutions and solvents are known to be effec- Clinicians should be aware of the specific indications
tive on epoxy resin.68-69 Surface pre-treatment of the for treatment that they can perform.
352 Operative Dentistry

However, chairside post pre-treatments are still con- 2. Stockton LW (1999) Factors affecting retention of post sys-
sidered a technique-sensitive step. In an attempt to tems: A literature review Journal of Prosthetic Dentistry
simplify clinical procedures, instituting industrial 81(4) 380-385.
conditioning of the fiber post surface may be of some 3. Nergiz I, Schmage P, Ozcan M & Platzer U (2002) Effect of
help. length and diameter of tapered posts on the retention
Journal of Oral Rehabilitation 29(1) 28-34.
For this purpose, pre-coated epoxy resin-based fiber
4. Cohen BI, Pagnillo MK, Newman I, Musikant BL & Deutsch
posts have been recently proposed. Although only pre- AS (1998) Retention of three endodontic posts cemented with
liminary in vitro bond strength tests have been per- five dental cements Journal of Prosthetic Dentistry 79(5) 520-525.
formed (Radovic, unpublished results), the zirconium 5. Cohen BI, Musikant BL & Deutsch AS (1992) Comparison of
oxide post surface coating provided by the manufac- retentive properties of four post systems Journal of Prosthetic
turer has offered sufficient interfacial strength with Dentistry 68(2) 264-268.
composites (Figure 2E). 6. Ferrari M, Vichi A & Grandini S (2001) Efficacy of different

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Silica-containing films are assumed to provide excel- adhesive techniques on bonding to root canal walls: An SEM
lent surface properties, thanks to the stability of their investigation Dental Materials 17(5) 422-429.
bonds and their ability to form highly hydrophobic 7. Ngoh EC, Pashley DH, Loushine RJ, Weller N & Kimbrough
substrates.81-82 Moreover, the epoxy resin matrix of the F (2001) Effects of eugenol on resin bond strengths to root
post is not directly involved in the adhesion mecha- canal dentin Journal of Endodontics 27(6) 411-414.
nism, avoiding the risk of incompatibility with 8. Ari H, Yasar E & Belli S (2003) Effects of NaOCl on bond
methacrylate-based restorative materials.80 Further strength of resin cement to root canal dentin Journal of
investigations are needed to evaluate the long-term Endodontics 29(4) 248-251.
durability of these bonds through accelerated aging 9. Ferrari M, Grandini S, Simonetti M, Monticelli F & Goracci
conditions.83,64 C (2002) Influence of a microbrush on bonding fiber posts into
root canals under clinical conditions Oral Surgery, Oral
From a manufacturing perspective, alternative Medicine, Oral Pathology, Oral Radiology and Endodontics
strategies, based on the combination of micromechan- 94(5) 627-631.
ical and chemical conditioning of the post surface, are 10. O’Keefe KL & Powers JM (2001) Adhesion of resin composite
advisable to improve retention, thus achieving more core materials to dentin International Journal of
reliable adhesion. The use of plasma technology may Prosthodontics 14(5) 451-456.
be an example: this technique has a wide range of 11. Chersoni S, Acquaviva GL, Prati C, Ferrari M, Grandini S,
applications and provides several types of surface Pashley DH & Tay FR (2005) In vivo fluid movement through
treatments when materials have to be combined or dentin adhesives in endodontically treated teeth Journal of
when surfaces need special modifications.84-86 Some Dental Research 84(3) 223-227.
application fields are represented by etching (micro- 12. Ferrari M, Vichi A, Mannocci F & Mason PN (2000)
sandblasting by ion bombardment) and surface coat- Retrospective study of clinical performance of fiber posts The
ing through plasma polymerization. The potential for American Journal of Dentistry 13(Spec No) 9B-13B.
this technique in fiber post pre-coating should be 13. Ferrari M, Vichi A & García-Godoy F (2000) Clinical evalua-
assessed. tion of fiber-reinforced epoxy resin posts and cast post and
cores The American Journal of Dentistry 13(Spec No) 15B-
CONCLUSIONS 18B.

The trend in clinical practice is towards fiber posts, and 14. Malferrari S, Monaco C & Scotti R (2003) Clinical evaluation
of teeth restored with quartz fiber-reinforced epoxy resin
the literature generally encourages their application. posts International Journal of Prosthodontics 16(1) 39-44.
Most in vitro and in vivo studies agree that the failure
mode of fiber posts is more favorable than with metal 15. Goracci C, Raffaelli O, Monticelli F, Balleri P, Bertelli E &
Ferrari M (2005) The adhesion between fiber posts and com-
posts, and the level of success seen in short-term pub- posite resin cores: Microtensile bond strength with and with-
lished clinical studies is being confirmed by ongoing out post silanization Dental Materials 21(5) 437-444.
long-term evaluations. If certain basic principles are
16. Castellucci A & Becciani R (2004) [Ricostruzione post-
followed, it is possible to achieve high levels of clinical endodontica dei denti compromessi. Aspetti biomeccanici]
success with most of the current fiber posts on the mar- Dental Cadmos 2 2-21.
ket today. 17. Schwartz RS & Robbins JW (2004) Post placement and
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