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

Ex vivo fracture resistance of direct resin composite complete crowns with and without posts on maxillary premolars.

Contains fulltext : 47466.pdf (publisher's version ) (Closed access)AIM: To investigate ex vivo the fracture resistance and failure mode of direct resin composite complete crowns with and without various root canal posts made on maxillary premolars. METHODOLOGY: The clinical crowns of 40 human extracted single-rooted maxillary premolars were sectioned at the cemento-enamel junction. The canals were prepared with Gates Glidden drills up to size 4. Thirty samples were provided with standardized post spaces in the palatal canal and all roots were embedded in acrylic. Minimal standardized preparations in the canal entrances were made. Groups of 10 samples were treated with (i) prefabricated metal posts, (ii) prefabricated glass fibre posts, (iii) custom-made glass fibre posts, and (iv) no posts (control). Posts were cemented with resin cement and resin composite complete crowns were made. All specimens were thermocycled (6000x, 5-55 degrees C). Static load until fracture was applied using a universal loading device (crosshead speed 5 mm min(-1)) at a loading angle of 30 degrees . Failure modes were categorized as favourable and unfavourable failures. RESULTS: No significant difference was observed between the mean failure loads (group 1: 1386 N, group 2: 1276 N, group 3: 1281 N, and group 4: 1717 N, P > 0.05), nor between frequencies of failure modes (P > 0.05). All failures were fractures of the resin composite crown in combination with tooth material (cohesive failures). CONCLUSIONS: Within the limits of this laboratory investigation it is concluded that severely damaged and root filled maxillary premolars, restored with direct resin composite complete crowns without posts have similar fracture resistances and failure modes compared to those with various posts, which suggest that posts are not necessarily required

Proteomics beyond trypsin

Peptide-centered shotgun analysis of proteins has been the core technology in mass spectrometry based proteomics and has enabled numerous biological discoveries, such as the large-scale charting of protein-protein interaction networks, the quantitative analysis of protein post-translational modifications and even the first drafts of the human proteome. The conversion of proteins into peptides in these so-called bottom-up approaches is nearly uniquely done by using trypsin as a proteolytic reagent. Here, we argue that our view of the proteome still remains incomplete and this is partially due to the nearly exclusive use of trypsin. Newly emerging alternative proteases and/or multi-protease protein digestion aim to increase proteome sequence coverage and improve the identification of post-translational modifications, through the analysis of complementary and often longer peptides, introducing an approach termed middle-down proteomics. Of pivotal importance for this purpose is the identification of proteases beneficial for use in proteomics. Here, we describe some of the shortcomings of the nearly exclusive use of trypsin in proteomics and review the properties of other proteomics-appropriate proteases. We describe favorable protease traits with an emphasis on middle-down proteomics and suggest potential sources for the discovery of new proteases. We also highlight a few examples wherein the use of other proteases than trypsin enabled the generation of more comprehensive data sets leading to previously unexplored knowledge of the proteome