Key factors in achieving firm adhesion in post–core restorations

SummaryAdhesive post–core restorations using a combination of fiber reinforced posts (FRPs) and resin composites have become the preferred choice worldwide in restoring pulpless teeth. The success of this method, especially because of the low incidence of root fracture, has been shown in many clinical studies in several countries. However, the method has also shown a tendency for the FRP to come detached from its post-space, and this potential flaw raises questions about the long-term durable prognoses of such restorations. The adhesive characteristics of post–core materials to root canal dentin have been widely investigated as part of the attempt to find a solution to the problem. Comprehensive understanding of the way that root canal dentin behaves in the post-space may be the key to achieving their better adhesion. Clinicians have to contend with the high stresses produced in the post-space because of its extremely high C-factor. When using light-cured and even dual-cured materials, ensuring deep and complete light penetration is essential to obtain even bonding strength throughout the post-space. Chemically cured adhesive materials, where the progress of curing is relatively slow and there is less stress caused by polymerization shrinkage, should be positively considered for the root canal bonding. In every case, careful attention needs to be paid to the negative effects that endodontic irrigation solutions, such as sodium hypochlorite and EDTA, have on root canal adhesion. Even after better adhesion of the FRP to root canal dentin has been achieved—and proved by high-quality long-term clinical studies, the concept of cusp-coverage in pulpless molars may need to be reconsidered based on a good conservative policy of minimal intervention