Statement Of Problem: Prefabricated dowels do not always provide intraradicular sealing in the root canal dentin, and the lack of sealing predisposes the dowel to adhesive failure and debonding. It is unclear if fiber-reinforced composite resin dowels provide better sealing.

Purpose: The purpose of this in vitro study was to evaluate the intraradicular sealing and morphological fit of prefabricated dowels and fiber-reinforced composite resin dowels in root canal dentin. The thickness of the resin cement layer and push-out bond strength were determined to assess their effects on the sealing of the dowels.

Material And Methods: A total of 50 permanent maxillary central incisors were endodontically treated and divided into 2 subgroups (n=25). In one group, prefabricated dowels were cemented; in the second group, fiber-reinforced composite resin dowels were placed. The thickness of the resin cement layer was assessed in 3 different locations: coronal, middle, and apical of the root canal dentin with fluorescence confocal laser microscopy. The push-out bond strength was then determined, and intraradicular sealing observed by using scanning electron microscopy.

Results: Fiber-reinforced composite resin dowels showed a closer intraradicular fit and seal in the root canal dentin, and the morphology of the apical portion of the fiber-reinforced composite resin dowels showed a sealing area with the gutta percha in the apical portion. The mean thickness of the resin cement layer was significantly reduced for the fiber-reinforced composite resin dowels compared with the prefabricated dowels (P<.05) in the cervical area (197.0 μm versus 311.0 μm) and in the apical portion of the root canal (57.3 μm versus 131.6 μm). The mean push-out strength was higher for the fiber-reinforced composite resin dowels (22.98 N/mm) than that for the prefabricated dowels (16.49 N/mm) (P<.05).

Conclusions: The morphological fit of fiber-reinforced composite resin dowels provides better intraradicular sealing in the cervical and apical portions, reducing the resin cement thickness. The increased push-out strength can therefore be assumed to result from increased frictional retention compared with prefabricated dowels.

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http://dx.doi.org/10.1016/j.prosdent.2021.06.005DOI Listing

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