Statement of problem Developments in ceramic core materials such as lithium disilicate, aluminum oxide, and zirconium oxide have allowed more widespread application of all-ceramic restorations over the past 10 years. With a plethora of ceramic materials and systems currently available for use, an overview of the scientific literature on the efficacy of this treatment therapy is indicated. Purpose This article reviews the current literature covering all-ceramic materials and systems, with respect to survival, material properties, marginal and internal fit, cementation and bonding, and color and esthetics, and provides clinical recommendations for their use. Material and methods A comprehensive review of the literature was completed seeking evidence for the treatment of teeth with all-ceramic restorations. A search of English language peer-reviewed literature was undertaken using MEDLINE and PubMed with a focus on evidence-based research articles published between 1996 and 2006. A hand search of relevant dental journals was also completed. Randomized controlled trials, nonrandomized controlled studies, longitudinal experimental clinical studies, longitudinal prospective studies, and longitudinal retrospective studies were reviewed. The last search was conducted on June 12, 2007. Data supporting the clinical application of all-ceramic materials and systems was sought. Results The literature demonstrates that multiple all-ceramic materials and systems are currently available for clinical use, and there is not a single universal material or system for all clinical situations. The successful application is dependent upon the clinician to match the materials, manufacturing techniques, and cementation or bonding procedures, with the individual clinical situation. Conclusions Within the scope of this systematic review, there is no evidence to support the universal application of a single ceramic material and system for all clinical situations. Additional longitudinal clinical studies are required to advance the development of ceramic materials and systems.

Current ceramic materials and systems with clinical recommendations: A systematic review

http://www.endoexperience.com/filecabinet/Endo%20Related%20Restorative%20Dentistry/Post%20and%20Cores/scwartz%20post%20review%20article.pdf

Post placement and restoration of endodontically treated teeth: a literature review.

Aggressiveness of contemporary self-etching systems. I: Depth of penetration beyond dentin smear layers.

Fundamentals of Materials Science

Aim of the study was to compare the trimming and non-trimming variants of the microtensile technique with the 'micro' push-out test in the ability to measure accurately the bond strength of fiber posts luted inside root canals. In 15 endodontically treated teeth (Group A), fiber posts were cemented with Excite DSC in combination with Variolink II (Ivoclar-Vivadent). In 15 roots RelyX Unicem (3M-ESPE) was used for fiber post luting (Group B). Within each group, the bond strength of cemented fiber posts was assessed with the trimming and non-trimming microtensile technique, as well as with the push-out test. The great number of premature failures (16.9% in Group A, 27.5% in Group B) and the finding of high standard deviation values make questionable the reliability of the trimming microtensile technique. With the non-trimming microtensile technique, only five sticks were obtained from a total of six roots. The remaining specimens failed prematurely during the cutting phase. With the push-out test no premature failure occurred, the variability of the data distribution was acceptable, and regional differences in bond strength among root levels could be assessed. Relatively low values of bond strength were, in general, recorded for luted fiber posts. In conclusion, when measuring the bond strength of luted fiber posts, the push-out test appears to be more dependable than the microtensile technique.

The adhesion between fiber posts and root canal walls: comparison between microtensile and push-out bond strength measurements.

PURPOSE This retrospective study evaluated treatment outcome of cast post and core and Composipost systems after 4 yrs of clinical service. MATERIALS AND METHODS 200 patients were included in the study. They were divided in two groups of 100 endodontically treated teeth restored with a post. Group 1: Composipost systems were luted into root canal following the manufacturer's instructions. Group 2: Cast post and cores were cemented into root canal preparations with a traditional technique. The patients were recalled after 6 months, 1, 2 and 4 yrs and clinical and radiographic examinations were completed. Endodontic and prosthodontic results were recorded. RESULTS Group 1: 95% of the teeth restored with Composiposts showed clinical success; 3% of these samples were excluded for noncompliance and 2% showed endodontic failure. Group 2: Clinical success was found with 84% of teeth restored with cast post and core. 2% of these samples were excluded for noncompliance, 9% showed root fracture, 2% dislodgment of crown and 3% endodontic failure. Statistical evaluation showed significant differences between Groups 1 and 2 (P < 0.001). The results of this retrospective study indicated that the Composipost system was superior to the conventional cast post and core system after 4 yrs of clinical service.

Clinical evaluation of fiber-reinforced epoxy resin posts and cast post and cores.

Purpose To evaluate in vitro the dentin morphology in root canals in terms of tubule orientation, density and increase in surface area after etching. Materials and methods Thirty anterior teeth were divided in 3 groups at random: the samples of Group 1 were used to study tubular morphology in SEM. Groups 2 and 3 samples were etched with 32% phosphoric acid. The teeth in Group 2 were examined by SEM without further treatment. The samples in Group 3 were treated with a bonding system and fiber posts were luted into the canal. These teeth were then processed for evaluation of hybrid layer formation and resin tags in dentin tubules. The observations were made according to location in the root dentin, tubule density was estimated, and the increase in area available for bonding after etching was calculated. Results The observations revealed variability in tubule density and orientation within different areas of any one sample. Statistically significant differences in the density of tubules were found depending on location. The dentin surface area available for bonding increased by 202% after etching in the cervical third, 156% in the middle third, and 113% in the apical third of the root dentin. Group 3 samples showed that the thickness of the hybrid layer depended on the density of tubules. In the sectors with a low density of tubules, the hybrid layer was significantly thinner than in areas with a higher density of tubules. The increase in dentin surface area might be responsible for the enhanced bond strength after acid etching, but not all areas exhibited equal responses to etching.

Bonding to root canal: structural characteristics of the substrate.

Purpose To evaluate the clinical performance of C-Posts, AEstheti Posts and AEstheti Plus Posts after a period of clinical service ranging from 1-6 yrs Materials and methods 1,304 posts were included in the study: 840 Composiposts, 215 AEstheti posts and 249 AEstheti Plus posts were placed into endodontically treated teeth Four combinations of bonding/luting materials were used The patients were recalled every 6 months and clinical and radiographic examinations were completed Endodontic and prosthodontic results were recorded Actuarial Life Table statistical analysis and Mantel-Haenszel comparison of survival curve have been performed at 95% level of confidence Results The 32% failure rate was due to two reasons: 25 posts debonded during removal of temporary restorations, and 16 teeth showed periapical lesions at the radiographic examination No statistical significant differences were found among the four groups The results of this retrospective study indicate that fiber posts in combination with bonding/luting materials can be routinely used

Alessandro Vichi

Papers

Clinical evaluation of fiber-reinforced epoxy resin posts and cast post and cores.

Bonding to root canal: structural characteristics of the substrate.

Retrospective study of the clinical performance of fiber posts.

Color and opacity variations in three different resin-based composite products after water aging.

Color related to ceramic and zirconia restorations: A review