Post-Retained Single Crowns versus Fixed Dental Prostheses: A 7-Year Prospective Clinical Study

Biomechanical integrity of endodontically treated teeth (ETT) is often compromised. Degree of hard tissue loss and type of final prosthetic restoration should be carefully considered when making a treatment plan. The objective of this prospective clinical trial was to assess the influence of the type of prosthetic restoration as well as the degree of hard tissue loss on 7-y clinical performance of ETT restored with fiber posts. Two groups (n = 60) were defined depending on the type of prosthetic restoration needed: 1) single unit porcelain-fused-to-metal (PFM) crowns (SCs) and 2) 3- to 4-unit PFM fixed dental prostheses (FDPs), with 1 healthy and 1 endodontically treated and fiber post-restored abutment. Within each group, samples were divided into 2 subgroups (n = 30) according to the amount of residual coronal tissues after abutment buildup and final preparation: A) >50% of coronal residual structure or B) equal to or <50% of coronal residual structure. The clinical outcome was assessed based on clinical and intraoral radiographic examinations at the recalls after 6, 12, 24, 36, 48, and 84 mo. Data were analyzed by Kaplan-Meier log-rank test and Cox regression analysis (P < 0.05). The overall 7-y survival rate of ETT restored with fiber post and either SCs or FDPs was 69.2%. The highest 84-mo survival rate was recorded in group 1A (90%), whereas teeth in group 2B exhibited the lowest performance (56.7% survival rate). The log-rank test detected statistically significant differences in survival rates among the groups (P = 0.048). Cox regression analysis revealed that the amount of residual coronal structure (P = 0.041; hazard ratio [HR], 2.026; 95% confidence interval [CI] for HR, 1.031–3.982) and the interaction between the type of prosthetic restoration and the amount of residual coronal structure (P = 0.024; HR, 1.372; 95% CI for HR, 1.042–1.806) were statistically significant factors for survival (ClinicalTrials.gov NCT01532947)

Comparison of the fracture resistance of endodontically treated teeth restored with prefabricated posts and composite resin cores with different post lenghts

OBJECTIVE: This study evaluated the fracture strengths of endodontically treated teeth restored with prefabricated posts with different post lengths. MATERIAL AND METHODS: Thirty freshly extracted canines were endodontically treated. They were randomly divided into groups of 10 teeth and prepared according to 3 experimental protocols, as follows; Group 1/3 PP: teeth restored with prefabricated post and composite resin core (Z250) with post length of 5.0mm; Group 1/2 PP and Group 2/3 PP: teeth restored with prefabricated post and composite resin core (Z250) with different combinations of post length of 7.5mm and 10mm, respectively. All teeth were restored with full metal crowns. The fracture resistance (N) was measured in a universal testing machine (crosshead speed 0.5mm/min) at 45 degrees to the tooth long axis until failure. Data were analyzed by one-way analysis of variance (alpha=.05). RESULTS: The one-way analysis of variance demonstrated no significant difference among the different post lengths (P>;.05) (Groups 1/3 PP = 405.4 N, 1/2 PP = 395.6 N, 2/3 PP = 393.8 N). Failures occurred mainly due to core fracture. CONCLUSIONS: The results of this study showed that an increased post length in teeth restored with prefabricated posts did not significantly increase the fracture resistance of endodontically treated teeth

Success and survival of post-restorations: six-year results of a prospective observational practice-based clinical study.

AIM This prospective, noninterventional, multi-centre, practice-based study aimed to evaluate the longevity of endodontically treated teeth (ETT) restored with posts and to analyse factors influencing the success and survival of endodontic posts. METHODOLOGY Eight general dental practitioners each placed up to 27 endodontic posts without any restriction to size and material. Teeth were restricted to incisors, canines and premolars. Multi-level Cox proportional hazards models were used to evaluate the association between clinical factors and time until failure. RESULTS A total of 195 endodontic posts were followed-up for up to 6.5 years in 195 patients. Of these, 140 posts were judged as successful [mean success time: 59 (55-63) months]; the mean annual failure rate was 8.6%. This decreased to 4.4% when excluding recementations. 152 posts survived [mean survival time: 64 (60-67) months]. Recemented restorations had an eight times higher failure rate compared with new restorations. Furthermore, restorations with glass fibre post had a significantly lower success rate compared with titanium posts. CONCLUSION Relatively low success and survival rates occurred for restorations with posts after root canal treatment in a private practice setting after a follow-up of up to 6.5 years. Recemented crowns had a high risk of failure