A survey of failed post-retained restorations

Survival of endodontically treated, post-restored teeth depends on a multitude of factors, all of which are practically impossible to include in a randomized, controlled clinical study. The purpose of this survey was to characterize and analyze reported failures of post-retained restorations to identify factors critical to failure and to type of failure. A questionnaire was mailed to private practitioners in Denmark with a request to complete the questionnaire whenever a patient presented with a failed post-retained restoration. Information was gathered on factors related to the patient, the tooth, the restorative materials, and the techniques. Two-hundred and sixty questionnaires were collected from 171 practitioners over a 3-year period. Functioning time until failure varied between 3 months and 38 years. Mean survival time until failure was 11 years. Of the failed restorations, 61% had functioned for 10 years or less. Fracture of the tooth was the most common type of failure reported, followed by loosening of the post and fracture of the post. Tapered posts implied an increased risk of tooth fracture compared to loosening or fracture of the post, and the relative risk of tooth fracture increased with the functioning time until failure. Fracture of the post was more common among male than female patients. On the basis of this survey of failed post-retained restorations, it was concluded that tapered posts were associated with a higher risk of tooth fracture than were parallel-sided posts

Evaluation of fracture resistance of endodontically treated teeth restored with prefabricated posts and composites with varying quantities of remaining coronal tooth structure Avaliação da resistência à fratura de dentes tratados endodonticamente restaurados com pinos pré-fabricados e resinas compostas variando o remanescente dentário coronal

OBJECTIVES: The aim of this study was to evaluate the influence of remaining coronal tooth structure on endodontically treated teeth restored with prefabricated posts and two different composites for core build-up: dual-cured resin (Enforce Core) and light-cured resin (Z-250). METHODS: Fourty freshly extracted canines were endodontically treated and divided into four groups: Group I - teeth with 3mm remaining coronal structure, restored with Enforce Core; Group II - teeth with 3mm remaining coronal structure, restored with Z-250; Group III - teeth with no remaining coronal structure, restored with Enforce; Group IV - teeth with no remaining coronal structure, restored with Z-250. After restoration, the teeth were embedded in acrylic resin and the fracture resistance was measured on a universal testing machine at 45 degrees to the long axis of the tooth until failure. RESULTS: Data were analyzed by two-way analysis of variance, which showed significant differences between groups (p=0.00). The Tukey test did not show significant differences between specimens with and without remaining coronal structure. Conversely, significant difference was observed between groups with different core build-up. The highest values of fracture resistance were found in the group restored with light-cured resin. SIGNIFICANCE: The remaining coronal tooth structure did not influence the resistance of endodontically treated teeth; however, the change of core build-up was able to modify this resistence.<br>O objetivo desta pesquisa foi avaliar a influência do remanescente dentário coronal de dentes tratados endodonticamente, restaurados com pinos pré-fabricados e duas resinas como núcleos de preenchimento, uma de presa dual (Enforce Core) e outra fotopolimerizável (Z-250). Foram utilizados 40 caninos superiores humanos extraídos, divididos em quatro grupos de 10 espécimes: Grupo l - com remanescente dentário coronal de 3mm e restaurados com Enforce Core; Grupo ll - com remanescente dentário coronal de 3mm e restaurado com Z-250; Grupo III - sem remanescente dentário coronal e restaurado com Enforce Core; Grupo IV - sem remanescente dentário coronal e restaurado com Z-250. Após restaurados, os dentes foram levados a uma Máquina de Ensaio Universal e submetidos a uma força de compressão à 45º até que ocorresse fratura da restauração. A análise dos resultados (ANOVA, p>0,05) mostrou não haver diferença estatisticamente significativa entre os dentes com e sem remanescente dentário coronal. Com relação ao material utilizado para o preenchimento coronário, constatou-se diferença significativa, sendo que os valores mais elevados de resistência à fratura foram encontrados no grupo restaurado com a resina fotopolimerizável

Can a single composite resin serve all purposes?

Contains fulltext : 47640.pdf (publisher's version ) (Closed access)The consensus view less than a decade ago was that direct posterior composites should be restricted to small restorations, preferably in premolar teeth with little, if any, occlusal function. Major advances in adhesive systems, materials and restorative techniques have combined to allow us to question this view and our increased clinical evidence base makes it appropriate to reconsider this viewpoint