Adhesive dentistry and endodontics: materials, clinical strategies and procedures for restoration of access cavities: a review

By Schwartz RS, Fransman R.

Date: 01/2006
Journal: JOE

Purpose:  to address in detail the important issues when restoring access cavities through natural tooth structure and restorative materials  by focusing on those aspects of adhesive dentistry that are important and unique to endodontics

Summary: 

•Prevent contamination of the root canal system and Restore access cavities immediately

•When immediate restoration is not possible, then tooth must be temporized

•If a cotton pellet is to be placed then an orifice barrier is needed (Fig1)

Orifice barrier such as composite  or  GIC is preferred; but MTA , Cavit, and  IRM may also be used

•All of the temporary materials are adequate if placed in a thickness of 3 mm or greater

•The 4th generation (3 steps: etch, primer, adhesive) adhesive systems are preferred because they provide a better bond than the adhesives that require fewer steps

• “Self etching” adhesives should not be used with self-cure or dual-cure restorative composites (low bond strength); b/c self etching includes eugenol in the hybrid layer

•When restoring access cavities, the best esthetics and highest initial strength is obtained with an incremental fill technique with composite resin.

•A more efficient technique which provides acceptable esthetics is to bulk fill with a glass ionomer material to within 2 to 3mm of the cavo-surface margin, followed by two increments of light-cure composite

• If retention of a crown or bridge abutment is a concern after root canal treatment, post placement increases retention to greater than the original •Bonding to Metal-Ceramic and All-Ceramic Restorations (Fig 8-9)