Recent CommentsUse Glass Ionomer to Cement Posts and Seal up Endo Access?
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Print This PostDr. F. asks:
My endodontist has told me that composite leaks badly and that many of the endo cases that he does are due to composites that leak. He advised me to use glass ionomer to cement posts and to seal up endo access, like over orifices. I have had terrible experiences using glass ionomer with cores for crowns. They break or fall out. So, what about using glass ionomer to seal up the access and cover it with a composite core? Will the glass ionomer eliminate the microleakage? The composite core should give me retention and strength. Thoughts?
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6 Responses to “ Use Glass Ionomer to Cement Posts and Seal up Endo Access? ”
Both GIC and copmosite are fairly reasonable materials as far as core materials go.
But it is dependant on many factors :
1. are good isolation and moisture control being used , eg rubber dam ?
2. what family o GICs are being used ? ie resin modified etc ?
A ferfectly good core to use is the Nayaar Core where by amalgam is used in the orifices of the root canal entrances after the Gutta percha is drilled out and then condensed
hello
i just ask you to send me qeustions about implants and about materials in dentistry so i can know myself in these topics ,by the way thanx for your emails.
dana
I have not placed a post in about 14 years…. “crown down” leakage mostly comes from leaky crowns. Besides having castings with supragingival margins, I have found that placing a zinc phosphate base into the chamber, then using Clearfil Protect Bond and Clearfil Photo Core to build up the prep so that a uniform casting will go over top. Posts are simply not necessary.
If little coronal tooth structure exists, a post or posts are necessary. Why take a chance with the retention of a bonded resin core which is primarily bonded into dentin. Over time, leakage resulting from the hydrolysis of the hybrid layer from occlusal stress, torque stress, and hot/cold cycles will eventually result in bond failure. I’ve successfully resurrected teeth that almost needed extraction due to so little coronal tooth structure, some docs might think I was too heroic. I use active threaded posts usually 3 medium, the system is similar to the Dentatus brand. I open up about 4mm of canal space (measured from the pulpal floor) with 2 and 3 peesos. Of course it’s then rinsed and dried, even using coarse paper points. I then lute with pure glass ionomer non-resin reinforced. RRGI are not necessary in the canal space. The consistency is slightly runny but not too runny, like warm pancake syrup. I use a perio probe to carefully place 2 dabs of cement into the dried canal, so it’s about half filled, I then take the post in the provided wrench and dip the threads into the cement slightly. I carefully place it in and bottom out, then I turn it out about 1/8 turn so the threads are not fully engaged, which can lead to root fracture. If there is much coronal tooth loss, I will usually place a second post in a second canal. In premolars, they’re side by side, but in molars, they form “teepee”. I wait about 4 mins, while I place 0015 tofflemire and large wedges to hold the tofflemire in place. When the cement gets firm, I remove the excess around the posts with an endo explorer so more resin core build up can bond. Sometimes I use a medium needle finishing bur to clean up around the post. I then air abrade the posts with 50 micron AlOx. Etch, Optibond FL primer, them adhesive, air dried/thinned for 10 secs. Cure, then I place Absolute Dentin (Parkell). Cure and prep away. It is amazingly strong and predictable. Remember, the posts are not 100% engaged to reduce and stress along the root structure. In the anterior, I use air abraded parallel post with the same cementing and bonded core technique. BTW, after endo is finished, I use plain polycarboxylate are the access seal. I have my assistant mix it up normally and I spread it around the internal axial walls with a MicroBrush. Then I hace her add more powder to be real thick like PlayDoh and I quickly take it and smoosh it in there. It’ll set within 30 secs. Why the two viscosities? The initial is “wet” enough to bond to the tooth, while the thick mix is for resistance against wear. Sometimes, I feel that if a patient does not return at all, which is rare, or is gone for up to a year or so and decides to return, it nice to see that the coronal access of polycarboxylate was durable and held the tooth together, and most of all no leakage had occurred. I almost always put a small cotton pellet before the polycarboxylate is placed, but if little to no coronal tooth is left, I place UltraSeal opaque white sealant directly over canals, and plug up the rest with the two viscosity technique using polycarboxylate directly above the sealant and no cotton is used. I can send photos in an email if anyone wants to see how I did these.
In my opinion, as long as you obtain a clean and dry field, use any current bonding agent according to manufacturors instructions, AND, if using a light cured core material, use small incremental build up technique, there is no better seal obtained with composite bonding. Glass ionomers have weaker bond strength leak more than a PROPERLY bonded composite.
if subgingival, use amalgum if supra. use GIC OR COMPOSITE IF THE SEALER WASN’T CONTAIN EUGENOL??WHAT IS YOUR OPENIONS ?!!!