Retention of different all ceramic endocrown materials cemented with two different adhesive techniques

Area of Science:

• Dental Materials Science
• Prosthodontics
• Biomaterials Engineering

Background:

• All-ceramic endocrowns are increasingly used for restoring endodontically treated posterior teeth.
• Material selection and adhesive luting cement choice significantly impact restoration retention.
• Understanding the retentive force of different ceramic materials and adhesive systems is crucial for clinical success.

Purpose of the Study:

• To evaluate the influence of two adhesive techniques on the retentive force of four all-ceramic endocrown endocrowns.
• To compare the retentive strength of hybrid ceramic (Vita Enamic), resin nano-ceramic (Lava Ultimate), zirconia-reinforced lithium disilicate (Celtra Duo), and zirconia (Lava Zirconia) endocrowns.
• To assess the effect of total-etch (RelyX ARC) versus self-adhesive (RelyX UniCem) resin cements on endocrown retention.

Main Methods:

• Forty endodontically treated maxillary molars were restored with four types of all-ceramic endocrowns.
• Restorations were cemented using either a total-etch or a self-adhesive resin luting cement.
• Pull-out testing was performed using a universal testing machine to measure retentive force and calculate dislodgement stress.

Main Results:

• Vita Enamic, Lava Ultimate, and Celtra Duo exhibited significantly higher mean dislodgement stresses (up to 64.3 MPa) compared to Lava Zirconia.
• No significant difference in retention was found between Vita Enamic, Lava Ultimate, and Celtra Duo.
• The total-etch cement (RelyX ARC, mean=60.09 MPa) demonstrated significantly higher retentive force than the self-adhesive cement (RelyX UniCem, mean=49.73 MPa).

Conclusions:

• The retention of Vita Enamic, Lava Ultimate, and Celtra Duo endocrowns is significantly superior to Lava Zirconia.
• Total-etch adhesive resin cements provide better retention for all-ceramic endocrowns compared to self-adhesive resin luting cements.
• Material choice and adhesive technique are critical factors influencing the retentive stability of endocrown restorations.