Intracanal Posts Research Articles

In Vitro Fracture Strength of Primary Canine Teeth Reinforced With Prefabricated and Customized Fiber-Reinforced Post Systems.

The demand for esthetics has increased in today's worldand most parents prefer to preserve their children's primary anterior teeth until their natural exfoliation. However, an intracanal post is required to provide retention for reconstruction of severely damaged anterior teeth due to caries or trauma. Various materials and methods may be used for the fabrication of intracanal posts. This study assessed the fracture strength and fracture mode of primary canine teeth reconstructed with prefabricated and customized polyethylene and glass fiber posts. This in vitro study evaluated 60 extracted primary canine teeth in four groups (n = 15). After pulpectomy and post space preparation with 4 mm depth, composite resin post, prefabricated glass fiber post (Whitepost), customized glass fiber post (Interlig), or customized polyethylene fiber post (Ribbond) were placed in the root canals to provide retention, and the tooth crown was restored with bulk-fill composite resin. The fracture strength was then measured in a universal testing machine. The fracture mode was also evaluated visually. The mean fracture strength was 22.45 ± 5.06, 33.10 ± 8.5, 30.20 ± 7.33, and 32.61 ± 5.73 N/mm2 in the composite resin post, Whitepost, Interlig, and Ribbond groups, respectively. The fracture strength was significantly lower in the composite group than in the remaining three groups (p = 0.000). No other significant differences were found (p > 0.05).Also, no significant difference was observed among the study groups in the fracture mode (p = 0.241). The composite resin post yielded a significantly lower fracture strength than the prefabricated and customized glass and polyethylene fiber posts, but the fracture mode was not significantly different among the four groups.

Assessment of Periodontitis Risk Factors in Endodontically Treated Teeth: A Cross-Sectional Study.

The aim of the study was to collect data about the prevalence and risk factors of apical periodontitis in a population of endodontically treated patients. The study group included 151 patients (52 males, 99 females; mean age 48.36 ± 15.708 yrs.) with 391 endodontically treated teeth (mean follow-up of 5.25 ± 1.759 yrs.). According to the initial tooth diagnosis, root-filled teeth were divided into Group A, root-filled teeth treated for pulpitis or for the purpose of prosthetic pulpectomies (vital pulp group), and Group B, root-filled teeth with non-vital pulp (necrotic pulp). Clinical and radiographic evaluation of the root and its periapical area were performed to establish the success/failure of endodontic therapy, the quality of the root canal fillings (length, density, taper), and coronal restoration. The presence of recurrent caries, periodontal pathology, or endo-periodontal lesions were also recorded. Univariate and multivariate analyses were used to determine the risk factors for apical periodontitis and calculate their odds ratios (ORs). For the root-filled vital pulp tooth group, the highest risks for apical periodontitis are associated with inadequate homogeneity (OR 30.938), periodontitis (OR 9.226), and over-filling (OR 8.800). For the root-filled non-vital pulp tooth group, the highest risks are associated with periodontitis (OR 4.235) and age over 60 yrs. (OR 4.875). For the necrotic pulp tooth group, multivariate analysis identified an age > 60 yrs., filled molars, intracanal posts, poor coronal restoration quality, under-filling, and periodontitis as significant combined risk factors. Inadequate root canal filling and periodontitis in both groups were risk factors associated with most cases of apical periodontitis. Other risk factors include age > 60 yrs., poor coronal restoration quality, and the presence of intracanal posts in root-filled teeth with necrotic pulp.

Iatrogenic Root Perforations: Case Report

Root perforation, a connection between the root canal system and tooth surface, is a common cause of endodontic therapy failures. Caused by pathological conditions or operative errors, it can occur during access cavities, root canal preparation, or post-preparation. A 28-year-old patient was diagnosed with a vestibular medium-sized infra-osseous perforation during root post realization. Despite no systemic disorders, the patient showed physiologic movement and was slightly sensitive to pressure. A flap surgical treatment was chosen to remove excess material and enable tissue regeneration. Biodentine® was used to prevent future discolorations. The patient underwent an intrasulcular incision, flap raised, cavity cleaned, disinfected, revised, and sealed using an anterior Schilder plugger. Root perforations are common errors caused by factors like anatomy, caries, pulp calcifications, and intracanal posts. Diagnosis is based on clinical signs, radiographic examinations, and imaging techniques. The prognosis depends on preventing bacterial infection. The ideal reparation material should stimulate bone formation, be biocompatible, maintain sealing, and not disintegrate in tissue fluid. Equivalent materials like Biodentine® offer advantages in protocol, antibacterial power, and bioactive properties. Radicular perforations, a significant dental issue, can be prevented through early management using modern techniques and clinical training, ensuring long-term success in endodontic treatments.

A Successful Reinforcement and Restoration of an Already Damaged Post and Core in a Teeth with an Existing Crown That Has Received Endodontic Treatment: 3 Case Reports

Once correctly indicated, endodontic retreatment requires the preservation of dental components. Effective treatment of teeth with severe damage to the structure of the tooth relies not only on successful endodontic treatment but also on timely postendodontic tooth repair after the same endodontic. Furthermore, for teeth with intracanal posts, the evolution of endodontic procedures and materials has decreased the indication of surgical treatment. Underneath an undamaged crown is a typical clinical occurrence of broken coronal tooth structure. The tooth can be repaired with a post and core if the underlying root is in good condition, and then, the crown is refabricated. This article outlines a method for the aforementioned scenario that makes use of the current unbroken crown. The entire crown was later rescued, and a damaged post and core were also discovered in the canal. The retrieved metallic post was re-cemented in the post space then the undamaged crown was adjusted to fit it, and the opposing arch maintained occlusion. Next, a composite resin that can be dual-cured and built up was poured into the crown, molding it to fit onto the broken tooth. As we know, the core buildup material has a property of dual curing that means it can be self-cured as well as light-cured. Hence, we waited and allowed it to get set by itself chemically. Then, after we carefully removed the crown from over it, a brand-new composite resin core was discovered and adhered to the tooth structure after that we light-cured it for complete the setting process. After that, dual-cured core build-up composite resin was used to re-cement the crown to the core. Even after a year of follow-up, the method of strengthening the tooth’s core and restoring it with the current crown was shown to be effective.

Assessing the Impact of the Metal Artifact Reduction Tool on Detecting Furcation Lesions in Maxillary Molars with Different Intracanal Posts: An Ex Vivo Cone-beam Computed Tomography Study

IntroductionConsidering the potential image compromise and diagnostic challenges posed by metals, this study aimed to assess the efficacy of the metal artifact reduction (MAR) tool in cone-beam computed tomography examinations for detecting furcation lesions in upper molars treated endodontically and restored with different intracanal posts. MethodsThis ex vivo study used 45 endodontically treated maxillary first molars, categorized into the following3 groups (n = 15): control (without intracanal post), metal post, and fiberglass post. Simulations were conducted in the laboratory to replicate alveolar bone, periodontal ligament, and grade I, II, and III furcation lesions. Cone-beam computed tomography scans were obtained with and without the MAR tool, and the furcation lesions were evaluated considering a 5-point Likert scale. Data were analyzed at 5%. ResultsIn the control group, there was no influence of MAR (P > .05); grade II lesions were not diagnosed, and grade III lesions were the most detected (P < .05). In the metal post group with MAR, grade III lesions were diagnosed more frequently than I and II (P < .05) and grade III without MAR (P < .05). In the fiberglass post group, the diagnosis of grade I lesions decreased with MAR (P < .05), and without MAR, grade III was most diagnosed (P < .05); grade III lesions were the most diagnosed (P < .05). ConclusionsThe MAR tool was only effective for diagnosing grade III furcation lesions, regardless of the intracanal material. Its application for grade I and II lesions did not contribute to improved diagnosis. Furthermore, in the fiberglass post group with grade I lesions, the MAR tool negatively affected the detection of the lesions.

Laser-texturing and traditional surface modification to improve the adhesion of glass fiber-reinforced composite posts to resin cements

ObjectivesThe aim of this study was to perform an experimental evaluation of the synergistic effects of laser-texturing and different traditional surface modification approaches to improve the adhesion of glass fiber-reinforced composite (GFRC) posts to resin-matrix cements used in endodontically treated teeth rehabilitation. MethodsOne hundred and ten freshly extracted mandibular single-rooted premolars were endodontically treated and groups of specimens were divided according to the GFRC cementation after different surface treatment, as follow (n = 10): silane-based conditioning (SIL); 9.7 % HF acid-etching (HF); 35 % H2O2 etching (H2O2); grit-blasting (GB); HF plus H2O2 etching (HFH2O2); 6 W Nd:YAG laser-texturing (L6W); 4.5 W Nd:YAG laser-texturing (L4.5W); 3 W Nd:YAG laser-texturing (L3W); 3 W Nd:YAG plus 35 % H2O2 (L3WH2O2); 3 W Nd:YAG plus SIL (L3WSIL); and untreated (C). GFRC posts were cemented into the tooth root canals using a dual-cured resin cement. Then, specimens were cross-sectioned and mechanically assessed by push-out bond strength tests. Specimens were inspected by optical microscopy and scanning electron microscopy (SEM) at magnification from × 30 up to × 2000. The failure mode was recorded by microscopic analyses after the bond strenght tests. ResultsSurface analyses of the GFRC posts showed a rough and retentive morphological aspect with a removal of the outer epoxy matrix layer and exposure of glass fibers after laser-texturing, grit-blasting, or etching under 35 % H2O2. The highest bond strength values at 21.8 MPa was recorded for GFRC posts after laser-texturing on 3W plus silane-based conditioning followed by the group etched with 35 % H2O2 (20.5 MPa). The failure mode was microscopically characterized as cohesive and mixed pathways. The lowest bond strength values around 5 and 9 MPa and adhesive failure were recorded for the untreated GFRC group or specimens etched with HF. ConclusionsThe combination of acidic etching and silane conditioning with laser-texturing at moderate intensity promoted an adequate surface modification of GFRC posts and increased adhesion to a resin-matrix cement. Such combination of physicochemical approaches can enhance the long-term mechanical behavior of the restorative interface at endodontically treated teeth. Clinical relevanceCombining traditional and novel physicochemical approaches can provide promising adhesion pathways for glass fiber-reinforced composite posts to resin-matrix cements. A high mechanical interlocking of the resin-matrix cements and the stable retention of the teeth root intracanal posts can decrease the risks of clinical failures by fracture and detachment of the intraradicular interface.

Restoring an Extremely Destructed Tooth with Flared Root Canal Walls: A Case Report.

Reconstructing severely damaged teeth has always presented a challenge when the remaining crown structure is limited, often requiring retention from the root canal using intracanal posts. However, the real challenge is when the root canal walls are also weak, and there is a high risk of vertical root fracture due to the wedging forces of a rigid post. This case report presents a tooth with extremely flared (0.3mm) root canal walls, successfully restored with a newly introduced polymer made of polyether ether ketone (PEEK), with one-year follow-up. Due to its close elastic modulus to dentin, capacity to bond effectively to tooth structure, shock-absorbing properties, and thereby facilitating favorable stress distribution, utilizing this material for an intracanal post has the potential to mitigate the risk of fractures often associated with cast metal posts. It combines the good fitness of cast posts with the low modulus of elasticity and optical properties of prefabricated fiber posts.

Mechanical Properties and Clinical Success of Intracanal Posts in Primary Maxillary Anterior Teeth: A Systematic Review and Meta-analysis.

Intracanal posts are commonly used to restore lost permanent/primary tooth structure and the smile of the patient. This systematic review aims to evaluate the clinical success of intracanal posts used in primary maxillary anterior teeth and compare their mechanical properties. An extensive literature search was performed using Medline via PubMed, Embase via embase.com, LILACS, CINAHL via EBSCO, Cochrane Oral Health Group Specialized Register, Scopus, and Web of Science until December 2021 and was updated till December 2022. In vivo and in vitro studies in the English language that assessed clinical success and mechanical properties were included. Distiller SR software was used for everything from title screening to data extraction. A total of 30 studies were analyzed, including 11 in vivo and 19 in vitro studies. Four studies were included in a meta-analysis, and all 30 studies qualified for qualitative analysis. The meta-analysis showed that fiber posts are clinically superior to composite resin posts (CRPs) (p = 0.02). No significant difference was observed between the fracture resistance of CRPs and no posts (p = 0.73). Most of the included studies showed a high risk of bias. Conclusive evidence about the effectiveness of various intracanal posts cannot be established. This is due to the limited number of clinical trials and included studies of low to moderate quality with a high risk of bias. To validate the use of posts in primary maxillary anterior teeth, further research, including randomized controlled trials (RCTs) of higher quality, is required. The use of intracanal posts in primary teeth is a commonly used treatment modality among pediatric dentists. However, the quality of the evidence to support its use is low. This systematic review provides a comprehensive summary of the current literature and highlights the need for further research. Results were interpreted with caution, as the evidence supporting the use of intracanal posts in primary teeth is limited. Shanmugam Y, Raghu A, Muthu MS, et al. Mechanical Properties and Clinical Success of Intracanal Posts in Primary Maxillary Anterior Teeth: A Systematic Review and Meta-analysis. Int J Clin Pediatr Dent 2023;16(S-3):S293-S305.

Comparison of shear bond strength of different types of intracanal posts in restoring extensively damaged primary anterior teeth.

Severe caries in early childhood is a concern for both children receiving dental treatment and their parents. This dental disease progresses rapidly and quickly damages the coronal part of the tooth. When there is insufficient coronal structure to support a coronal restoration, using intracanal components following root canal treatment increases tooth resistance and helps provide retention for the coronal restoration. This study compared the shear bond strength of three types of intracanal posts (composite resin post, reverse metal post, and fiber post) in severely damaged primary anterior teeth. This in vitro study was conducted on 30 extracted anterior primary teeth with at least two-thirds of healthy roots and no prior pulp treatment. The teeth were randomly divided into three groups of 10: group 1: composite resin post with 8th generation universal bonding, group 2: reverse metal post with GC restorative glass cement, and group 3: fiber post with GC restorative glass cement. After placing the post, the samples were restored with a height of 3 mm from cementoenamel junction (CEJ) using an Anterior GC Gradia Packable composite resin. All the samples underwent 500 cycles of thermocycling in a hot water bath at 55±2 °C and a cold water bath at 5±2 °C. The shear strength of the samples was then evaluated using an electromechanical universal testing machine at a rate of 1 mm/min and at a location 2 mm coronal to the CEJ in terms of megapascals. The average shear bond strength of composite resin posts with 8th generation bonding application was 8.02220 MPa, reverse metal posts with glass ionomer application was 13.8600 MPa, and fiber posts with glass ionomer application was 9.7400 MPa. Based on these findings, it can be concluded that the highest shear bond strength in this study was related to the reverse metal post, and the lowest shear bond strength was related to the composite resin post. According to the results, reverse metal posts demonstrated better shear bond strength than composite resin posts and fiber posts (P<0.05).

Diagnostic efficacy of cone-beam computed tomography for detection of vertical root fractures in endodontically treated teeth: a systematic review

BackgroundVertical root fractures (VRFs) sometimes occur in endodontically treated teeth. They have a difficult diagnosis and a dismal result. The objective of this review was to evaluate the diagnostic performance of cone-beam computed tomography (CBCT) for detecting VRFs in teeth that had undergone endodontic treatment.MethodsLiterature was reviewed from Web of Science, PubMed, Cochrane Review, SCOPUS, and Embase databases between 2000 and 2022. The searched keywords included "endodontically treated teeth," "cone-beam computed tomography," "CBCT," "tooth fracture," "vertical root fracture," "VRF," "accuracy," "sensitivity," and "specificity." Only articles in the English language were included. The final analysis included 20 papers that satisfied the eligibility requirements.ResultsThe overall mean ± SD values (%) for the diagnostic sensitivity and specificity of CBCT for detection of VRFs in endodontically treated teeth in the presence of root-filling materials without an intracanal post were 71.50 ± 22.19 and 75.64 ± 19.41, respectively. The overall mean (SD) value (%) for the sensitivity of CBCT for the detection of VRFs in the presence of root-filling materials and intracanal posts was 72.76 (18.73), while the mean (SD) specificity was 75.44 (18.26). The accuracy of CBCT (mean ± SD) was 78.47 ± 17.19% and 74.02 ± 10.64%, respectively, for teeth without intracanal posts and those with posts.ConclusionsFurther clinical research is needed to validate the optimum efficiency of CBCT as a diagnostic technique for detecting VRFs in teeth that have had endodontic treatment, given the low sensitivity, significant heterogeneity of studies, and lack of in-vivo studies on the subject.

Comparison of the Pull-Out Resistance of Grossly Decayed Primary Anterior Teeth Restored With Two Different Intracanal Posts: An In Vitro Study

Background Severely damaged primary anterior teeth that require pulp therapy present a high risk of failure due to the loss of tooth substance, resulting from pre-existing decay and endodontic therapy. The ideal post material should have physical and mechanical properties similar to those of dentin. Another concern in restoring endodontically treated primary teeth is the need to find a material that can resorb similar to the natural tooth structure as a part of the exfoliation process, allowing normal eruption of permanent successors. Accordingly, there is no such material other than dentin itself. The introduction of biological dentin posts offers an excellent alternative for restoring such teeth. This study aimed to assess the effect of using dentin posts on the pull-out resistance of endodontically treated primary anterior teeth in comparison to glass fiber posts. Methodology A sample of 30 primary anterior teeth was collected from the outpatient clinic of the Pediatric Dentistry Department, Faculty of Dentistry, Damascus University. A total of 15 freshly extracted permanent teeth with single roots were also collected from the outpatient clinic of the Maxillofacial Surgery Department, Faculty of Dentistry, Damascus University. The roots of the permanent teeth were used to prepare 30 dentin posts using a CAD-CAM machine. After receiving proper endodontic treatment, the primary teeth were divided into two groups (15 teeth in each group). The first group was restored with dentin posts, and the secondwas restored with glass fiber posts, with the posts measuring 3 mm in length for both groups. Pull-out resistance testing was performed using a Testometric machine. Results The arithmetic mean of the forces applied in the glass fiber posts group was 153.2 ± 39.12 N, while the arithmetic mean of the forces applied in the dentin posts group was 156.7 ± 39.78 N. The data were analyzed at a 95% confidence interval using the independent Student's t-test. There were no statistically significant differences in pull-out resistance between the two groups. Conclusions Dentin posts showed a little increase in pull-out resistance than glass fiber posts. Therefore, the use of dentin posts as intracanal retention in primary anterior teeth is a successful alternative for composite posts.

Effect of different intracanal posts and exposure parameters on detection of vertical root fractures by cone-beam computed tomography.

This study evaluated the effect of different amperage values and voxel sizes of two CBCT scanners on VRF detection in the presence of different intracanal posts. After post-space preparation, VRFs were induced in half of the samples of 20 maxillary premolars. Five different intracanal posts were passively placed in each root canal. Samples were scanned using CS 9300 and Cranex3D with two different voxel sizes and amperage setting in each unit. The diagnostic sensitivity, specificity and accuracy were compared using the Mann-Whitney and Kruskal-Wallis tests (α=0.05). Changes in amperage and voxel size did not affect the detection of VRFs (p ⟩ 0.05). The VRF detection accuracy was the highest in fibreglass and the lowest in nickel-chromium group. Changes in amperage and voxel size within assessed values do not seem to influence the detection of VRF whereas different intracanal post-materials have significant effect on VRF detection.

Effect of the Field of View Size on CBCT Artifacts Caused by the Presence of Metal Objects in the Exomass.

Materials and Methods In this in vitro experimental study, titanium implants, teeth with cobalt-chromium (Co-Cr) intracanal posts, and teeth with mesio-occluso-distal (MOD) amalgam restorations were placed in an empty socket of the extracted third molar of a human mandible. These metallic materials were differently arranged in the exomass (zone outside of the FOV). A polypropylene tube containing dipotassium phosphate was placed in the empty socket of the right canine tooth in a dry human mandible. CBCT scans were taken with a NewTom VGI (Verona, Italy) scanner using a 6 × 6 cm and an 8 × 8 cm FOV. The histogram tool of OnDemand software (Cybermed, Seoul, Korea) was used to select circles with a 1.5 mm diameter as the (ROI) at the center of the homogenous solution of dipotassium phosphate tube on the axial plane. The mean gray value (GV) and its standard deviation (SD) in the region of interest (ROI) were calculated (P > 0.05). The data were analyzed by SPSS 26. Results The reduction in the size of the FOV significantly decreased the mean GV (P < 0.001). Metal objects in the exomass significantly decreased the mean GV (P < 0.001), and minimum mean GV and maximum SD were recorded for amalgam, followed by Co-Cr intracanal posts, and titanium implants. The unilateral presence of a metal object was associated with a higher mean GV and lower SD (P < 0.001). Conclusion Using a smaller FOV increases the size of the exomass, which may negatively affect the image quality. Metal objects in the exomass decrease the GV of CBCT scans and adversely affect the image quality.

An Umbrella Review of Systematic Reviews and Meta-Analyses Evaluating the Success Rate of Prosthetic Restorations on Endodontically Treated Teeth.

Materials and Methods The electronic search was conducted in the MEDLINE/PubMed, Cochrane, and Google Scholar databases until November 2020, regardless of language limitations. The inclusion criterion was as follows: S/M-R regarding prosthetic restorations in endodontically treated teeth. Three qualified researchers evaluated the inclusion criteria and bias risk. The fourth investigator was referred to when facing any doubtfulness. Results From 43 achieved S/M-R, 14 studies were selected for this inquiry. Primary extracted information included success rate, survival rate, and postendodontic failure rate. Five S/M-R had a moderate risk of bias, and nine S/M-R had a low risk of bias and were considered strong clinical evidence in this examination. According to the low-risk reports, the success rate of fiber posts was higher than that of metal posts; the rate of root fracture in metallic and fiber posts was alike; the failure rate for fiber posts was comparable to fixed partial dentures or single crowns; the construction of endocrowns was likely to perform better than intracanal posts, composite resin, or inlay/onlay restorations. Conclusion It appears that with practice and experience, deciding which type of restoration to choose changes. In dental restorations associated with root canal therapy, the single crowns are likely to be a proper option. Nevertheless, due to the heterogeneity of the studies, more clinical assessments are required to achieve more specific findings in this field.

Cement selection criteria for different types of intracanal posts

To consciously select an appropriate dental cement for each type of intracanal post. An electronic search was carried out (1970 to 2020) through Medline, PubMed, Scopus, and Google Scholar. The following keywords were searched in title, abstract, or keywords with different combinations: endodontically treated tooth, root canal therapy, dental posts, post and core, prefabricated posts, custom posts, dental cement, resin cements, cement selection, cement, and adhesive resin cement. Evaluating full texts, 146 articles were selected to review the types of posts and cements, selection criteria of appropriate cement for each type of post, and compare the results obtained by different cements. Dental cements affect the survival rate, durability, and success rate of postbased treatments. Considering special characteristics and application of each type of intracanal post, conscious selection of cement is an important determining factor in long-lasting success. Choosing an appropriate cement has a key role in success and durability of dowel posts-based fixed restorations.

Comparison of Fracture Resistance of Primary Incisors Restored with Different Intracanal-Reinforcement Materials.

AimTo evaluate the effects of placing short posts made of different restorative materials on the fracture resistance of root canals in primary incisors of primary teeth.Materials and MethodsThe root canals of 40 extracted primary incisors were prepared and filled with Vitapex and randomly divided into five groups of 8 each. In Groups 1–4, a post space was created and filled with different restorative materials (Tetric® N-Ceram Bulk Fill, AeliteFlo, Filtek Z250 XT, and GC Fuji II LC® capsule), while Group 5 was kept filled with Vitapex as a control. Fracture resistance was measured using a universal testing machine at a 0.5-mm/min crosshead speed. The results were statistically analyzed and compared.ResultsThe highest fracture resistance was recorded for GC Fuji II LC capsules [439.82 N] and control [423.37 N], while the lowest fracture resistance was recorded for Tetric® N Ceram Bulk Fill (239.91 N). A multiple comparison test showed that the Tetric® N-Ceram Bulk Fill had a significantly lower average value than AeliteFlo (P = 0.030), as well as a significantly lower average value than GC Fuji II LC® capsule (P = 0.001), and a significantly lower average value than the control group (P = 0.002). Multiple comparison tests showed no significant difference between Tetric® N-Ceram Bulk Fill and Filtek Z250 XT (P = 0.39).ConclusionThe fracture resistance of primary incisor root canals differs according to the material used for the intracanal posts. Three-millimeter intracanal posts in the primary incisors showed the highest fracture resistance for the teeth restored with GC Fuji II LC capsules and the control.

Treatment Modalities for Rehabilitation of Mutilated Primary Anterior Teeth

Early childhood caries commonly affects the primary maxillary anterior teeth, in which extensive post- endodontic rehabilitation has always been a challenge. This is due to the small size of the crown, relatively large pulp chambers, and the age of the child. The remaining inadequate sound tooth structure renders restorations more prone to fractures. Among the available treatment modalities which include extraction of the grossly destructed tooth structure, use of semipermanent crowns and intracanal posts, the posts can be used effectively, to restore the lost function and anatomy. They also enhance the quality of the final coronal restoration by providing additional support for retention. The available methods for intracanal reinforcement for anterior teeth include the metal posts fabricated using orthodontic wires, short composite posts fabricated directed in the primary root canal, prefabricated glass fiber posts and posts utilising polyethylene fibers (Ribbond). Recently certain advanced techniques such as the biologic dentin and zirconia have also come into use. The various advantages and disadvantages for these have been summarised in this review along with the standardised clinical protocol for their placement in the primary root canals. Various in-vivo and in-vitro studies have concluded that the glass-fiber short intracanal posts provide the most suitable esthetics, strength, elastic modulus, and resilience. However, further qualitative research is required to certify it as a standard treatment modality.

Blooming artifact reduction using different cone-beam computed tomography software to analyze endodontically treated teeth with intracanal posts.

The appearance of high-density root obturating materials, such as gutta-percha and intracanal posts, on cone-beam computed tomography (CBCT) scans is substantially different from that seen in the specimen. This study evaluated the effectiveness of different CBCT software in the reduction of blooming artifacts when examining teeth with intracanal posts. The sample included 42 human single-rooted teeth with two types of posts: G1 - low-fusion alloy posts; G2 - gold alloy posts. CBCT scans were obtained using two scanners, PreXion 3D Elite® and Carestream 9000C 3D®. First, the posts were measured using a digital micrometer (standard reference, control). Post diameters were determined using the Blooming Artifact Reduction (BAR) tool of the e-Vol DX software and of the PreXion3D Image Analysis System. Statistical data were evaluated using the van Der Waerden nonparametric analysis of variance and, after that, normalized data were analyzed using the Tukey test. The level of significance was set at α=5%. There were no significant differences (p>0.05) between the diameters of intracanal posts on the CT scans when the e-Vol DX was used, or when these results were compared with those obtained using a micrometer. There were significant differences in post diameters determined using the PreXion3D Image Analysis System when compared with the e-Vol DX and the micrometer values (p<0.05). The use of the e-Vol DX BAR filter eliminated blooming artifacts. There were no dimensional changes in the CBCT images of the low-fusion and gold alloy intracanal posts using the e-Vol DX BAR filter.

The resin-matrix cement layer thickness resultant from the intracanal fitting of teeth root canal posts: an integrative review.

The aim of this study was to perform an integrative review on the layer thickness and microstructure of resin-matrix cements around custom-made or standard teeth root intracanal posts. An electronic search was conducted on the PubMed using a combination of the following scientific terms: intraradicular post, root intracanal post, resin cement, thickness, adaptation, endodontic post, layer thickness, fit, shape, and endodontic core. The literature selection criteria accepted articles published in the English language, up to May 2021, involving in vitro analyses, meta-analyses, randomized controlled trials, and prospective cohort studies. The search identified 154 studies, of which 24 were considered relevant to this study. The selectedstudies provided important data considering cement layer thickness, tooth preparation, endodontic post, and type of resin-matrix cement. The anatomical variability of root canal systems, such as the oval- orC-shaped, represents a challenge in dental restoration with tooth root intracanal posts. The fitting of intracanal posts to different rootregions is variable resulting in thick and irregular layers of resin-matrix cement. Defects like pores, micro-cracks, and micro-gaps were detected in the resin-matrix cement microstructure and represent spots of stress concentration and fracture. Custom-made tooth rootintracanal posts provide a proper fitting and decrease the layer thickness of resin-matrix cement. In fact, the layer thickness of resin-matrix cements depends on the fitting of endodontic posts to tooth root canals. An increase of resin cementthickness causes the appearance ofdefects like pores, micro-cracks, and micro-gaps that can induce stress concentration and fractures at interfaces. The fitting of the endodonticpost into the teeth root canal determine the layer thickness of the resin-matrix cement to establishan adequate retention.However, the increase in the thickness of the resin-matrix cement layer can lead to a high number of defects like pores or cracks and therefore decrease the strength of the interface.

Microbiological analysis of root canal space prepared for prosthetic intracanal posts

The aim of the study was to microbiologically analyze the root canal space prepared for prosthetic intracanal posts. Thus, a 2% chlorhexidine solution was used after the intraradicular preparation of ten teeth with endodontic treatment performed for prosthetic purposes and pulp vitality history. Two collections were performed for microbiological analysis: one before the use of the studied solution, showing positive microbiological culture in all cases; and another, after application for 3 minutes of 2% chlorhexidine solution. The results showed the effectiveness of the solution in nine of ten cases, presenting negative results in microbial culture.