The Open Dentistry Journal




ISSN: 1874-2106 ― Volume 13, 2019

Effects of Internal Bleaching on the Adhesion of Glass-Fiber Posts



Paulo E. de Oliveira Moreira1, Lucianne S. Pamplona1, Gláucia C. R. Nascimento1, Renata A. Esteves2, Oscar F. Pessoa3, Cecy M. Silva1, *
1 Department of Dentistry, School of Dentistry of Federal University of Pará, Belém, Pará, Brazil
2 Department of Prosthodontics, School of Dentistry of Federal University of Pará, Belém, Pará, Brazil
3 Department of Endodontics, School of Dentistry of Federal University of Pará, Belém, Pará, Brazil

Abstract

Objective: We evaluated the effects of internal bleaching on the adhesion of glass-fiber posts (GFPs) luted with different resin cements. Methods: Forty extracted human single-root teeth were endodontically treated and divided into four groups (n=10): G1- conventional resin cement (CRC); G2- self-adhesive resin cement (SARC); G3- bleaching + CRC; and G4- bleaching + SARC. Specimens were sectioned transversally into three slices to perform the push-out test at the coronal, middle and apical regions of the root canals. Data were analyzed using analysis of variance and Tukey's test (p<0.05).Results:The push-out bond strength of GFPs luted with SARC after bleaching (G4) was significantly lower than that of the other groups (p<0.001). We found no statistically significant differences in push-out bond strength among the other groups. Significance: Internal bleaching reduced the adhesion of GFPs luted with SARC. The adhesion of GFPs luted with CRC was not decreased after bleaching.

Keywords:: Dental bleaching, dental bonding, dentin-bonding agents, hydrogen peroxide, resin cements, tooth bleaching.


Article Information


Identifiers and Pagination:

Year: 2015
Volume: 9
First Page: 375
Last Page: 379
Publisher Id: TODENTJ-9-375
DOI: 10.2174/1874210601509010375

Article History:

Received Date: 25/8/2015
Revision Received Date: 11/9/2015
Acceptance Date: 29/9/2015
Electronic publication date: 10/12/2015
Collection year: 2015

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* Address correspondence to this author at the School of Dentistry, Federal University of Para, Rua dos Mundurucus, 822 / 903, 66025-660, Jurunas, Belem, Pará, Brazil; Tel: +55 9191144905; E-mail: cecymsilva@gmail.com




INTRODUCTION

Fiber posts are non-metallic alternatives that increase the optical effect of the restoration, providing better aesthetics [1Beriat NC, Ertan AA, Yilmaz Z, Gulay G, Sahin C. Effects of different luting cements and light curing units on the sealing ability and bond strength of fiber posts Dent Mater J 2012; 31(4): 575-82.
[http://dx.doi.org/10.4012/dmj.2011-209] [PMID: 22864210]
, 2Demiryürek EO, Külünk S, Saraç D, Yüksel G, Bulucu B. Effect of different surface treatments on the push-out bond strength of fiber post to root canal dentin Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108(2): e74-80.
[http://dx.doi.org/10.1016/j.tripleo.2009.03.047] [PMID: 19615650]
]. As advantages have mechanical characteristics approaching to dentin, furthermore, the fiber posts have biocompatibility, mechanical strength and resistance to corrosion [2Demiryürek EO, Külünk S, Saraç D, Yüksel G, Bulucu B. Effect of different surface treatments on the push-out bond strength of fiber post to root canal dentin Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108(2): e74-80.
[http://dx.doi.org/10.1016/j.tripleo.2009.03.047] [PMID: 19615650]
, 3Perdigão J, Geraldeli S, Lee IK. Push-out bond strengths of tooth-colored posts bonded with different adhesive systems Am J Dent 2004; 17(6): 422-6.
[PMID: 15724754]
]. The use of this material reduces the probability of root fracture and reduces the time required to complete the restoration eliminating the laboratory procedures [4Calixto LR, Bandéca MC, Clavijo V, Andrade MF, Vaz LG, Campos EA. Effect of resin cement system and root region on the push-out bond strength of a translucent fiber post Oper Dent 2012; 37(1): 80-6.
[http://dx.doi.org/10.2341/11-035-L] [PMID: 21942240]
, 5Borges MG, Faria-e-Silva AL, Santos-Filho PC, Silva FP, Martins LR, Menezes MdeS. Does the moment of fiber post cutting influence on the retention to root dentin? Braz Dent J 2015; 26(2): 141-5. [Epub ahead of print].
[http://dx.doi.org/10.1590/0103-6440201300242] [PMID: 25831104]
]. The retention of glass-fiber posts (GFPs) in the root canal depends on the quality of the hybrid layer [6Mendonça AA, Garcez RM, Oliveira AS, Moreira AG, Moraes RR. Adhesion strategy and early bond strengths of glass-fiber post luted into root canals Braz Oral Res 2012; 26: 485-7.
[http://dx.doi.org/10.1590/S1806-83242012005000017] [PMID: 22892880]
].

Certain endodontically treated teeth might require internal bleaching before coronal reconstruction to obtain satisfactory aesthetic results. However, the application of hydrogen peroxide to tooth structures has been shown to decrease the microhardness [7de Oliveira DP, Teixeira EC, Ferraz CC, Teixeira FB. Effect of intracoronal bleaching agents on dentin microhardness J Endod 2007; 33(4): 460-2.
[http://dx.doi.org/10.1016/j.joen.2006.08.008] [PMID: 17368339]
], and modulus of elasticity [8Chng HK, Yap AU, Wattanapayungkul P, Sim CP. Effect of traditional and alternative intracoronal bleaching agents on microhardness of human dentine J Oral Rehabil 2004; 31(8): 811-6.
[http://dx.doi.org/10.1111/j.1365-2842.2004.01298.x] [PMID: 15265219]
], produce morphological alterations in the dental surface [9Sulieman M, Addy M, Macdonald E, Rees JS. A safety study in vitro for the effects of an in-office bleaching system on the integrity of enamel and dentine J Dent 2004; 32(7): 581-90.
[http://dx.doi.org/10.1016/j.jdent.2004.06.003] [PMID: 15386865]
], affect the intertubular and peritubular dentin [10Kawamoto K, Tsujimoto Y. Effects of the hydroxyl radical and hydrogen peroxide on tooth bleaching J Endod 2004; 30(1): 45-50.
[http://dx.doi.org/10.1097/00004770-200401000-00010] [PMID: 14760908]
] and cause structural alterations to the hydroxyapatite due to ionic bonds that weaken its structure [11Attin T, Müller T, Patyk A, Lennon AM. Influence of different bleaching systems on fracture toughness and hardness of enamel Oper Dent 2004; 29(2): 188-95.
[PMID: 15088731]
].

Several studies have investigated the relationship between the bonding effectiveness of GFPs and resin cement types [3Perdigão J, Geraldeli S, Lee IK. Push-out bond strengths of tooth-colored posts bonded with different adhesive systems Am J Dent 2004; 17(6): 422-6.
[PMID: 15724754]
, 12Cantoro A, Goracci C, Vichi A, Mazzoni A, Fadda GM, Ferrari M. Retentive strength and sealing ability of new self-adhesive resin cements in fiber post luting Dent Mater 2011; 27(10): e197-204.
[http://dx.doi.org/10.1016/j.dental.2011.07.003] [PMID: 21820728]
-15Kahnamouei M-A, Mohammadi N, Navimipour E-J, Shakerifar M. Push-out bond strength of quartz fibre posts to root canal dentin using total-etch and self-adhesive resin cements Med Oral Patol Oral Cir Bucal 2012; 17(2): e337-44.
[http://dx.doi.org/10.4317/medoral.17429] [PMID: 22143695]
] and application modalities [1Beriat NC, Ertan AA, Yilmaz Z, Gulay G, Sahin C. Effects of different luting cements and light curing units on the sealing ability and bond strength of fiber posts Dent Mater J 2012; 31(4): 575-82.
[http://dx.doi.org/10.4012/dmj.2011-209] [PMID: 22864210]
, 16Gomes GM, Gomes OM, Reis A, Gomes JC, Loguercio AD, Calixto AL. Effect of operator experience on the outcome of fiber post cementation with different resin cements Oper Dent 2013; 38(5): 555-64.
[http://dx.doi.org/10.2341/11-494-L] [PMID: 23216469]
-19Lee B-S, Lin Y-C, Chen S-F, Chen S-Y, Cahng C-C. Influence of calcium hydroxide dressing and acid etching on the push-out bond strengths of three luting resins to root canal dentin Clin Oral Investig 2013. [Epub ahead of print].
[PMID: 23686133]
]. However, to date, no information is available on the combined effects of bleaching agents on the adhesion of GFPs luted with resin cements.

The present study evaluated the influence of internal bleaching with 35% hydrogen peroxide on the adhesion of GFPs luted with two different resin cements (conventional versus self-adhesive). The null hypothesis was that 35% hydrogen peroxide would not affect the adhesion of GFPs cemented with the various luting agents.

MATERIALS AND METHODS

Human Tooth Specimens

Following approval of our investigation by the local ethics committee, informed consent was obtained from all of the subjects. Forty extracted single-rooted human teeth with intact crowns and similar root sizes and lengths were selected for this study. Radiographs were obtained to ensure the presence of straight single main root canals and completely formed apices in all of the teeth. After the teeth were cleaned of adhering tissue remnants from their surfaces, they were rinsed and stored in distilled water until use. The specimens were randomly assigned to one of the four groups (n=10) characterized by resin cement (conventional or self-adhesive) and bleaching procedure (Table 1).

Table 1

Distribution of the groups according to treatment received before bonding and luting agent tested.




Table 2

Luting agents used and their application modes according to the manufacturer’s instructions.




Table 3

Push-out bond strength in megapascals (MPa) (Mean, SD and CI 95%) for the groups evaluated in different regions.




Endodontic Treatment

The coronal access opening was prepared using a diamond burr under high-speed water spray cooling. The working length of the tooth was established 1 mm from the root apex. All of the canals were instrumented by the step-back technique using K-files. All of the enlargement procedures were followed by irrigation with 2.5% sodium hypochlorite solution. The prepared root canals were filled with gutta-percha cones (Kerr/Sybron, Corp, Romulus, MI, USA) using the lateral condensation technique and resin sealer

(Sealer-26, Dentsply Ind. Com. Ltda, Petrópolis, RJ, Brazil). Gutta-percha excess was removed 2 mm below the cementoenamel junction (CEJ) after obturation was completed.

Bleaching Procedure

The bleached teeth received 2-mm-thick cervical seals of glass ionomer cement (Vitro Fil, DFL, Rio de Janeiro, RJ, Brazil) at the CEJ. The teeth were stored at 37°C for 45m to ensure the complete setting of the glass ionomer cement. The “walking bleach” technique was performed. A 35% hydrogen peroxide gel (Whiteness HP, FGM, Joinville, SC, Brazil) was applied to the buccal surface and in the pulp chamber. A tiny cotton pellet was placed into the gel and the teeth were sealed with provisional restorations. This procedure was repeated three times with a five-day bleaching interval. Between sessions, the teeth were stored in 100% relative humidity at 37°C. After the bleaching treatment, we applied a cotton pellet with a calcium hydroxide powder paste and distilled water into the pulp chamber; the pulp chamber was then temporarily sealed. The teeth were stored in distilled water at 37°C for 14d [20Martins JD, Bastos LC, Gaglianone LA, Azevedo JF, Bezerra RB, Morais PM. Different alternatives to teeth whitening darkened treated endodontically J Med Biol Sci 2009; 8: 213-8., 21Oliveira DP, Gomes BP, Zaia AA, Souza-Filho FJ, Ferraz CC. In vitro assessment of a gel base containing 2% chlorhexidine as a sodium perborate’s vehicle for intracoronal bleaching of discolored teeth J Endod 2006; 32(7): 672-4.
[http://dx.doi.org/10.1016/j.joen.2006.01.004] [PMID: 16793478]
].

The crowns were removed using a low-speed diamond disc under water cooling. Each root canal was enlarged with a low-speed drill provided by the manufacturer of the post system (White Post DC, size 2, FGM, Joinville, SC, Brazil). The post space preparation was 8-mm deep, leaving at least 4-mm of gutta-percha inside the canal to guarantee an apical seal. The posts were cleaned with 70% alcohol and received a layer of silane (3M ESPE); the excess silane was removed with compressed air applied for 5s. The GFPs were cemented according to the guidelines of the manufacturer of the resin cement (Table 2). After cementation, the roots were maintained in 100% relative humidity at 37°C for 24h before testing.

Push-out Bond Strength Test

The post of each root containing the fiber post was sectioned transversally into three slices with a water-cooled low-speed diamond saw (Micromet, Remet, Bologna, Italy); the first section was made 1-mm away from the CEJ. Each slice was approximately 2.5-mm thick. The first slice represented the coronal region, the second slice the middle region and the third slice the apical region of the post space preparation.

Each post was carried with a cylindrical plunger (2-mm diameter) connected to a universal testing machine (DL 2000, Emic, São José dos Pinhais, São Paulo, Brazil). The plunger tip was sized and positioned such that it was in contact with only the fiber post. A load was applied on the apical aspect of the root slice in the apical-coronal direction. The load was applied at a speed of 0.5 mm/min until failure, defined as the extrusion of the post segment from the root slice [22Borges MG, Faria-e-Silva AL, Santos-Filho PC, Silva FP, Martins LR, Menezes MdeS. Does the moment of fiber post cutting influence on the retention to root dentin? Braz Dent J 2015; 26(2): 141-5.
[http://dx.doi.org/10.1590/0103-6440201300242] [PMID: 25831104]
, 23Costa CL, Xavier OS, Filho SH. Bond strenght on root dentin in fiber post cementation Rev Bras Odontol 2009; 66: 117-21.].

The maximum failure load was recorded in newtons (N) and converted into megapascals (MPa) by dividing the applied load by the bonded area (SL). The bonded area represents the lateral surface of a truncated cone and was therefore calculated with the following formula: SL=π(R+r) (h2+[R–r]2)0.5, where π=3.14, R=coronal post radius, r =apical post radius, and h =root slice thickness.

Statistical Analysis

Statistical analyses of the data were performed using a statistical software package (SPSS, version 16.0, SPSS Corp., Chicago, IL, USA). The Shapiro-Wilk and Levene tests were used to verify normality and homogeneity. Analysis of Variance (ANOVA) was used to analyze the data, followed by Tukey’s multiple comparison test. For all analyses, the level of significance was 5%.

RESULTS

The descriptive statistics for the push-out bond strength and the results of Tukey test for multiple comparisons between groups are presented in Table 3. The push-out bond strength of GFPs luted with self-adhesive cement after bleaching (G4) was significantly lower than that of the other groups in the cervical and middle slices (p<0.001). The location within the root region appeared to influence bond strength, as significant differences were observed in the conventional cement group (G1) between the cervical and middle slices (p<0.001) and between the cervical and apical slices (p<0.001). In this group, the cervical slices had greater push-out bond strength. We found no statistically significant differences in bond strength between the root regions of the other groups (p>0.05).

DISCUSSION

To our knowledge, this was the first study to assess the impact of internal bleaching on the push-out bond strength of GFPs luted with two types of resin luting agent. The null hypothesis was partially rejected because GFPs luted with self-adhesive resin cement had the lowest push-out bond strength values.

This result could be due to alterations in the organic substance of dentin after bleaching. The residual oxygen from the bleaching agent might interfere with resin attachment and inhibit resin polymerization, thus increasing the porosity of the resin material and producing poorly formed and undefined interfaces [24Uysal T, Er O, Sagsen B, Ustdal A, Akdogan G. Can intracoronally bleached teeth be bonded safely? Am J Orthod Dentofacial Orthop 2009; 136(5): 689-94.
[http://dx.doi.org/10.1016/j.ajodo.2007.11.033] [PMID: 19892286]
]. Hydrogen peroxide was also shown to oxidize organic dentin compounds and modify their mineral components [25Ubaldini AL, Baesso ML, Medina Neto A, Sato F, Bento AC, Pascotto RC. Hydrogen peroxide diffusion dynamics in dental tissues J Dent Res 2013; 92(7): 661-5.
[http://dx.doi.org/10.1177/0022034513488893] [PMID: 23632810]
]. Hydrogen peroxide generates free radicals that combine with hydroxyapatite and produce a structure known as apatite peroxide that degrades calcium and phosphate, the two primary mineral components of dental hydroxyapatite [26Zhao H, Li X, Wang J, Qu S, Weng J, Zhang X. Characterization of peroxide ions in hydroxyapatite lattice J Biomed Mater Res 2000; 52(1): 157-63.
[http://dx.doi.org/10.1002/1097-4636(200010)52:1<157::AID-JBM20>3.0.CO;2-U] [PMID: 10906687]
].

Some studies have reported that bleaching results in the removal of calcium, phosphate and other ions from dental structures [27Attin T, Schmidlin PR, Wegehaupt F, Wiegand A. Influence of study design on the impact of bleaching agents on dental enamel microhardness: a review Dent Mater 2009; 25(2): 143-57.
[http://dx.doi.org/10.1016/j.dental.2008.05.010] [PMID: 18635255]
-30Faria-e-Silva AL, Menezes MdeS, Silva FP, Reis GR, Moraes RR. Intra-radicular dentin treatments and retention of fiber posts with self-adhesive resin cements Braz Oral Res 2013; 27(1): 14-9.
[http://dx.doi.org/10.1590/S1806-83242013000100003] [PMID: 23306622]
]. During the bonding process of self-adhesive resin cement, the calcium present in the dentin hydroxyapatite acts as an electron acceptor, promoting chemical union between the acidic resin monomers and the hard dental tissues [31Stape TH, Menezes MS, Barreto BC, Aguiar FH, Martins LR, Quagliatto PS. Influence of matrix metalloproteinase synthetic inhibitors on dentin microtensile bond strength of resin cements Oper Dent 2012; 37(4): 386-96.
[http://dx.doi.org/10.2341/11-256-L] [PMID: 22335305]
]. The calcium ions are responsible for the neutralization of the phosphoric acidic components. Therefore, greater losses of calcium ions probably result in greater amounts of unreacted monomers and therefore in the higher sorption and greater solubility of the self-adhesive resin cement. Sorption and solubility can influence the strength of the resin cement [32Marghalani HY. Sorption and solubility characteristics of self-adhesive resin cements Dent Mater 2012; 28(10): e187-98.
[http://dx.doi.org/10.1016/j.dental.2012.04.037] [PMID: 22607764]
]. Moreover, the self-adhesive cement had higher hydrophilicity than more hydrophobic conventional composite cements [33Lührs AK, De Munck J, Geurtsen W, Van Meerbeek B. Does inhibition of proteolytic activity improve adhesive luting? Eur J Oral Sci 2013; 121(2): 121-31.
[http://dx.doi.org/10.1111/eos.12018] [PMID: 23489902]
].

Bleaching procedures have been shown to increase metalloproteinase-mediated collagen degradation in dentin [34Toledano M, Yamauti M, Osorio E, Osorio R. Bleaching agents increase metalloproteinases-mediated collagen degradation in dentin J Endod 2011; 37(12): 1668-72.
[http://dx.doi.org/10.1016/j.joen.2011.08.003] [PMID: 22099902]
]. Metalloproteinases (MMPs) produce collagen degradation at the dentin-resin bonded interfaces, jeopardizing the efficacy of bonded restorations [34Toledano M, Yamauti M, Osorio E, Osorio R. Bleaching agents increase metalloproteinases-mediated collagen degradation in dentin J Endod 2011; 37(12): 1668-72.
[http://dx.doi.org/10.1016/j.joen.2011.08.003] [PMID: 22099902]
]. In addition, dentin demineralization by acidic monomers could release sequestered growth factors that could then diffuse through the dentinal tubules along with unpolymerized acidic monomers, stimulating the expression of MMP by odontoblasts [35Sung EC, Chan SM, Mito R, Caputo AA. Effect of carbamide peroxide bleaching on the shear bond strength of composite to dental bonding agent enhanced enamel J Prosthet Dent 1999; 82(5): 595-9.
[http://dx.doi.org/10.1016/S0022-3913(99)70060-0] [PMID: 10559733]
] and possibly contributing to bond degradation [31Stape TH, Menezes MS, Barreto BC, Aguiar FH, Martins LR, Quagliatto PS. Influence of matrix metalloproteinase synthetic inhibitors on dentin microtensile bond strength of resin cements Oper Dent 2012; 37(4): 386-96.
[http://dx.doi.org/10.2341/11-256-L] [PMID: 22335305]
]. These related adverse effects, the relatively high viscosity of self-adhesive resin cement and the low demineralizing capacity of the cement contribute to low monomer infiltration into dentin, thus reducing micromechanical retention [36Shinohara MS, Peris AR, Pimenta LA, Ambrosano GM. Shear bond strength evaluation of composite resin on enamel and dentin after nonvital bleaching J Esthet Restor Dent 2005; 17(1): 22-9.
[http://dx.doi.org/10.1111/j.1708-8240.2005.tb00078.x] [PMID: 15934682]
]

In contrast, we found no significant decrease in the push-out bond strength of GFPs luted with conventional resin cement after bleaching [37Borges AB, Rodrigues JR, Borges AL, Marsilio AL. The influence of bleaching agents on enamel bond strength of a composite resin according to the storage time Rev Odontol UNESP 2007; 36: 77-83., 38AlEisa K, Al-Dwairi ZN, Lynch E, Lynch CD. In vitro evaluation of the effect of different endodontic sealers on retentive strength of fiber posts Oper Dent 2013; 38(5): 539-44.
[http://dx.doi.org/10.2341/12-414-L] [PMID: 23557444]
]. These results could be explained by differences in the compositions of the luting agents. These luting agents had distinct viscosities and different bonding mechanisms [39Macedo VC, Souza NA, Faria e Silva AL, et al. Pullout bond strength of fiber posts luted to different depths and submitted to artificial aging Oper Dent 2013; 38(4): E1-6.
[http://dx.doi.org/10.2341/12-321-L] [PMID: 23391034]
]. For example, the Scotchbond Multipurpose is an alcohol-based adhesive, and studies have concluded that alcohol-based adhesives could increase the bond strength for bleached teeth [38AlEisa K, Al-Dwairi ZN, Lynch E, Lynch CD. In vitro evaluation of the effect of different endodontic sealers on retentive strength of fiber posts Oper Dent 2013; 38(5): 539-44.
[http://dx.doi.org/10.2341/12-414-L] [PMID: 23557444]
, 39Macedo VC, Souza NA, Faria e Silva AL, et al. Pullout bond strength of fiber posts luted to different depths and submitted to artificial aging Oper Dent 2013; 38(4): E1-6.
[http://dx.doi.org/10.2341/12-321-L] [PMID: 23391034]
]. Alcohol-based dental bonding agents can also reduce or eliminate the detrimental effects of residual oxygen on the bonding process. The high volatility, the solvent and hydrophobic nature of these bonding agents and the rapid evaporation of the agents into the environment facilitates the removal of residual oxygen from the tubules, thus contributing to increased bond strength between the adhesive composite and the teeth [37Borges AB, Rodrigues JR, Borges AL, Marsilio AL. The influence of bleaching agents on enamel bond strength of a composite resin according to the storage time Rev Odontol UNESP 2007; 36: 77-83.].

Despite the fact that the teeth were unbleached, our results are in agreement with those of previous studies that reported that self-adhesive cement and conventional resin cement had similar push-out bond strengths [12Cantoro A, Goracci C, Vichi A, Mazzoni A, Fadda GM, Ferrari M. Retentive strength and sealing ability of new self-adhesive resin cements in fiber post luting Dent Mater 2011; 27(10): e197-204.
[http://dx.doi.org/10.1016/j.dental.2011.07.003] [PMID: 21820728]
, 14Dimitrouli M, Geurtsen W, Lührs AK. Comparison of the push-out strength of two fiber post systems dependent on different types of resin cements Clin Oral Investig 2012; 16(3): 899-908.
[http://dx.doi.org/10.1007/s00784-011-0571-6] [PMID: 21647589]
, 16Gomes GM, Gomes OM, Reis A, Gomes JC, Loguercio AD, Calixto AL. Effect of operator experience on the outcome of fiber post cementation with different resin cements Oper Dent 2013; 38(5): 555-64.
[http://dx.doi.org/10.2341/11-494-L] [PMID: 23216469]
]. However, the push-out bond strength values obtained for resin cements in the literature have been quite controversial. Some studies have found that self-adhesive resin cement has greater push-out bond strengths than other types of resin cements [15Kahnamouei M-A, Mohammadi N, Navimipour E-J, Shakerifar M. Push-out bond strength of quartz fibre posts to root canal dentin using total-etch and self-adhesive resin cements Med Oral Patol Oral Cir Bucal 2012; 17(2): e337-44.
[http://dx.doi.org/10.4317/medoral.17429] [PMID: 22143695]
, 19Lee B-S, Lin Y-C, Chen S-F, Chen S-Y, Cahng C-C. Influence of calcium hydroxide dressing and acid etching on the push-out bond strengths of three luting resins to root canal dentin Clin Oral Investig 2013. [Epub ahead of print].
[PMID: 23686133]
, 13Soares CJ, Pereira JC, Valdivia AD, Novais VR, Meneses MS. Influence of resin cement and post configuration on bond strength to root dentine Int Endod J 2012; 45(2): 136-45.
[http://dx.doi.org/10.1111/j.1365-2591.2011.01953.x] [PMID: 21995296]
]. Other investigations have reported greater bond strength for conventional resin cements [17Özcan E, Çetin AR, Çapar ID, Tunçdemir AR, Aydinbelge HA. Influence of eugenol on the push-out bond strengths of fiber posts cemented with different types of resin luting agents Odontology 2013; 101(2): 204-9.
[http://dx.doi.org/10.1007/s10266-012-0082-1] [PMID: 23011473]
, 18Özcan E, Çetin AR, Tunçdemir AR, Ülker M. The effect of luting cement thicknesses on the push-out bond strength of the fiber posts Acta Odontol Scand 2013; 71(3-4): 703-9.
[http://dx.doi.org/10.3109/00016357.2012.715194] [PMID: 23039068]
, 30Faria-e-Silva AL, Menezes MdeS, Silva FP, Reis GR, Moraes RR. Intra-radicular dentin treatments and retention of fiber posts with self-adhesive resin cements Braz Oral Res 2013; 27(1): 14-9.
[http://dx.doi.org/10.1590/S1806-83242013000100003] [PMID: 23306622]
]. One possible explanation for these results is the different protocols and variables adopted in other investigations. In addition, the size and shape of the root canals and the texture and properties of the inner surfaces of the root canals may have differed among the teeth used [38AlEisa K, Al-Dwairi ZN, Lynch E, Lynch CD. In vitro evaluation of the effect of different endodontic sealers on retentive strength of fiber posts Oper Dent 2013; 38(5): 539-44.
[http://dx.doi.org/10.2341/12-414-L] [PMID: 23557444]
]. This variability, however, also occurs in clinical situations [38AlEisa K, Al-Dwairi ZN, Lynch E, Lynch CD. In vitro evaluation of the effect of different endodontic sealers on retentive strength of fiber posts Oper Dent 2013; 38(5): 539-44.
[http://dx.doi.org/10.2341/12-414-L] [PMID: 23557444]
].

Significant differences in push-out bond strength were observed between the root sections only for GFPs cemented with conventional cement in unbleached teeth; coronal sections, in particular, demonstrated greater bond strength. This observation might be due to the fact that this adhesive requires more complex procedures, resulting in compromised moisture control in the apical third [4Calixto LR, Bandéca MC, Clavijo V, Andrade MF, Vaz LG, Campos EA. Effect of resin cement system and root region on the push-out bond strength of a translucent fiber post Oper Dent 2012; 37(1): 80-6.
[http://dx.doi.org/10.2341/11-035-L] [PMID: 21942240]
]. Some studies have demonstrated that the bond strengths of conventional resin cements in root canals are greater in cervical areas and lower toward the apical third [1Beriat NC, Ertan AA, Yilmaz Z, Gulay G, Sahin C. Effects of different luting cements and light curing units on the sealing ability and bond strength of fiber posts Dent Mater J 2012; 31(4): 575-82.
[http://dx.doi.org/10.4012/dmj.2011-209] [PMID: 22864210]
, 4Calixto LR, Bandéca MC, Clavijo V, Andrade MF, Vaz LG, Campos EA. Effect of resin cement system and root region on the push-out bond strength of a translucent fiber post Oper Dent 2012; 37(1): 80-6.
[http://dx.doi.org/10.2341/11-035-L] [PMID: 21942240]
, 13Soares CJ, Pereira JC, Valdivia AD, Novais VR, Meneses MS. Influence of resin cement and post configuration on bond strength to root dentine Int Endod J 2012; 45(2): 136-45.
[http://dx.doi.org/10.1111/j.1365-2591.2011.01953.x] [PMID: 21995296]
, 29Lehmann N, Debret R, Roméas A, et al. Self-etching increases matrix metalloproteinase expression in the dentin-pulp complex J Dent Res 2009; 88(1): 77-82.
[http://dx.doi.org/10.1177/0022034508327925] [PMID: 19131322]
]. However, no differences were found between the slices in the other groups.

The preliminary findings of this in vitro report could be confirmed with in situ evaluations.

CONCLUSION

Internal bleaching with 35% hydrogen peroxide reduced the adhesion of GFPs luted with self-adhering resin cement. The adhesion of GFPs luted with conventional resin cement was not decreased after bleaching.

CONFLICT OF INTEREST

The authors confirm that this article content has no conflict of interest.

ACKNOWLEDGEMENTS

Declared none.

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