Post-endodontic Restoration Research Articles

Stronger than Ever: Multifilament Fiberglass Posts Boost Maxillary Premolar Fracture Resistance.

This paper investigates the influence of cavity configuration and post-endodontic restoration on the fracture resistance, failure mode and stress distribution of premolars by using a method of fracture failure test and finite elements analysis (FEA) coupled to Weibull analysis (WA). One hundred premolars were divided into one control group (Gcontr) (n = 10) and three experimental groups, according to the post-endodontic restoration (n = 30), G1, restored using composite, G2, restored using single fiber post and G3, restored using multifilament fiberglass posts (m-FGP) without post-space preparation. Each experimental group was divided into three subgroups according to the type of coronal cavity configuration (n = 10): G1O, G2O, and G3O with occlusal (O) cavity configuration; G1MO, G2MO, and G3MO with mesio-occlusal (MO); and G1MOD, G2MOD, and G3MOD with mesio-occluso-distal (MOD). After thermomechanical aging, all the specimens were tested under compression load, and failure mode was determined. FEA and WA supplemented destructive tests. Data were statistically analyzed. Irrespective of residual tooth substance, G1 and G2 exhibited lower fracture resistance than Gcontr (p < 0.05), whereas G3 showed no difference compared to Gcontr (p > 0.05). Regarding the type of restoration, no difference was highlighted between G1O and G2O, G1MO and G2MO, or G1MOD and G2MOD (p > 0.05), whereas G3O, G3MO, and G3MOD exhibit higher fracture resistance (p < 0.05) than G1O and G2O, G1MO and G2MO, and G1MOD and G2MOD, respectively. Regarding cavity configuration: in G1 and G2, G1O and G2O exhibited higher fracture resistance than G1MOD and G2MOD, respectively (p < 0.05). In G3, there was no difference among G3O, G3MO and G3MOD (p > 0.05). No difference was found among the different groups and subgroups regarding the failure mode. After aging, premolars restored with multifilament fiberglass posts demonstrated fracture resistance values comparable to those of an intact tooth, irrespective of the different type of cavity configuration.

Comparative Evaluation of the Bonding Efficacy of Multimode Adhesive, Two-Step Self-Etch Adhesive, and a Total-Etch System to Pulpal Floor Dentin - An In vitro Study.

Postendodontic restoration with composite resins has gained popularity due to the development of more reliable adhesives with simplified bonding procedures and less technique sensitivity. Pulpal floor dentin is a complex biological structure and a more challenging bonding substrate. Hence, appropriate selection of the bonding agent for these regions of the tooth is important. To compare the shear bond strength of a new generation of dental adhesives referred to as multimode adhesives, two-step self-etch adhesive, and a total-etch system to pulpal floor dentin. Sixty human mandibular molars were sectioned with a slow speed diamond disc to expose the pulp chamber and divided into four groups of 15 teeth each, based on the bonding agent used. Group A: Single bond universal (self-etch); Group B: Single Bond Universal (etch-and-rinse), Group C: Clearfil SE Bond, Group D: Adper Single Bond 2. Using a split Teflon mold, composite cylinders were built on the prepared dentinal surfaces. The shear bond strength was then evaluated with the universal testing machine. Two step self-etch adhesives recorded higher shear bond strength than total-etch and multimode/universal adhesives applied in both self-etch and etch-and-rinse techniques. The self-etching/priming system bonded more strongly to the pulpal floor dentin than multimode adhesive and total-etch system.

Evaluation of Fracture Resistance of Root Canal Treated Teeth Restored with Different Types of Post-Endodontic Restorations: An In Vitro Study

Background Clinicians often face issues in restoring teeth with extensive root canals using various restorative methods. For clinical success these methods of restoration must be evaluated.Methods A randomized controlled trial was conducted on sixty extracted intact maxillary premolars. The prmolars were collected and equally divided into six groups. Except for G1 all the other groups were treated endodontically G2 MOD preparation without restoration G3 MOD preparation with resin composite restoration G4 MOD preparation with resin composite restoration amp restored with porcelain fused metal crown G5 MOD preparation restored with glass fiber horizontal post and resin composite and G6 MOD preparation restored with Polyethylene fiber mesh. The specimens were loaded in a micro universal testing machine until the fracture occurred. Failure loads were then statistically analyzed. The mode of failure was determined by visual inspection.Results Composite resin restorations reinforced with a fiberglass horizontal post and polyethylene mesh significantly increased fracture resistance of endodontically treated premolar teeth with MOD cavity. Conclusion Fiberglass horizontal post can be used as an alternative for post endodontic restoration in endodontically treated teeth with MOD cavities.

A Comparative Evaluation of Fracture Resistance in Endodontically Treated Teeth Reinforced by Novel Hybrid Post and with Various Pre-Fabricated Post Techniques: An In-Vitro Study

Introduction: Teeth with a final post-endodontic restoration cannot support significant structural loss brought on by fracture, caries, big pre-existing restorations, or aggressive cavity preparation. Post and core restoration allows for the restoration of such teeth. Reduced dentine size, moisture, and compromise on supporting structures such the oblique bridge, marginal ridges, and pulp chamber roof result in a reduction in their resistance because of structural loss. Under such circumstances, choosing a good post-endodontic restorative material can be difficult. Materials and Methods: In terms of post-treatment procedures, 40 single-rooted decoronated mandibular premolar teeth were endodontically treated and randomly divided into four groups. As a control, the first group had a composite core but no post; groups two and three had prefabricated metal threaded posts; group four had prefabricated hybrid posts. The posts were affixed using dual-cure resin cement, and the core build-up material was nano composite. Each group's core structure was standardised, and metal crowns of the same size were used to reinforce it. A universal testing machine was used to test every specimen, and the fracture load was tabulated. Statistical analysis used: one way ANOVA analysis Results: The highest failure load was found with prefabricated hybrid post. This group had significantly higher load compared to other post groups. Followed by prefabricated fibre post and prefabricated metal threaded post. Conclusions: Fracture resistance of endodontically treated teeth reinforced with hybrid post showed significant values when compared to that of prefabricated glass fiber posts, prefabricated threaded post and control teeth.

Preference for Postendodontic Restoration for Fractured Anterior Teeth: A Questionnairebased Cross-sectional Study among Dentists in Maharashtra, India

Introduction: One of the common dilemmas faced by today’s clinicians is the management of structurally and aesthetically compromised endodontically treated teeth due to various treatment options available. There is no one factor which is the sole determinant for treatment planning. And there are various parameters contributing to the long-term success of a postendodontic restoration, especially in a fractured anterior tooth. Aim: This study is aimed to investigate the preference for postendodontic restoration for fractured anterior teeth with respect to the tooth structure and aesthetics. Materials and Methods: This cross-sectional study was conducted in the Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, Nagpur, Maharashtra, India, from August 2021 to December 2021 among 150 clinicians in Maharashtra. A validated questionnaire containing 17 close-ended questions was given to the participants which ascertained their treatment choices, the importance of preserving the tooth structure, aesthetics and the consideration given to the physical properties while choosing the material and planning the treatment. Data obtained from the survey were statistically analysed by the Chi-square test. Results: The mean age of the participants was 30.25±9.08 years. Among the 150 participants, postgraduates were 60 (40%) followed by general dentists 38 (25.3%), endodontists 36 (24%) and other specialists 16 (10.7%). Out of total, 82 (54.7%) preferred composites when more than 50% of the tooth structure remained. Crowns increased the longevity of the tooth according to 50 (83.3%) postgraduates. Among them, 28 (77.8%) endodontists opted for IPS Emax crowns over zirconia veneer for better aesthetics, 71 (47.3%) preferred glass fibre posts and 113 (75.3%) preferred ideal ferrule for better fracture resistance. Reattachment of the fragment was also a preferred option in all groups. Conclusion: A 77.8% of the endodontists preferred IPS Emax crowns while 71.1% of the general dentists preferred zirconia veneers. Good awareness was seen among endodontists regarding method, patient preferences and aesthetics, very good awareness in materials and excellent awareness in treatment choices. More awareness is needed among general dentists, postgraduates, and other specialists in terms of treatment methods.

Comparative Evaluation of Two Different Fiber-Reinforced Composite Materials in Class 1 Post-Endodontic Restorations in Molars-A Randomized Clinical Study.

This study aimed to evaluate and compare two different fiber-reinforced composite materials in class I post-endodontic restoration in molars. A total of 50 patients were randomly assigned into two groups (n = 25 for each group); group A: everX Posterior (packable composite) with a top layer of solareX (nano-hybrid composite) and group B: everX Flow (flowable composite) with a top layer of G-aenial universal injectable (flowable composite). Patients were evaluated immediately after the procedure (baseline), at 6 months, and at 1 year time intervals based on the modified USPHS criteria. The statistical analysis using a chi-square test showed no statistically significant difference in the clinical performance of group A and group B. Clinical performance of the combination of everX Flow with overlying G-aenial universal injectable composite proved to be comparable with everX Posterior with overlying solareX composite as post-endodontic restorations in class I lesions in permanent molars.

Clinical aspects of tooth autotransplantation and post-endodontic restoration of autrotransplanted tooth: case-based literature review

Introduction. Tooth autotransplantation allows to maintain a vital status of periodontal ligament, which supports the preservation of the alveolar bone volume, better conservation of the interdental papilla and the possibility of dental movement through orthodontic forces. It has been shown that longevity and prognosis of autotransplanted teeth are comparable with those of dental implants.&#x0D; Objective. To discuss major practically-oriented aspects regarding tooth autotransplantation operation including further post-endodontic restoration based on presented clinical case.&#x0D; Materials and Methods. A bibliographic search was conducted in April 2022 by the using MESH terms equivalent to the keywords “tooth” and “autotransplantation” within the Cochrane Library and PubMed database with the aim to identify publications related with practical aspects of tooth autotransplantation presented in clinical case. Data extraction during content-analysis of selected publications was provided selectively in terms to represent the most practically valuable information regarding tooth autotransplantation operation, principles of tooth autotransplantation surgery and further post-endodontic restoration of autotransplanted tooth taking into account aspects highlighted in present clinical case.&#x0D; Results. Due to the provided literature review it was highlighted that success rate of tooth autotransplantation is highly inţuenced by such factors as the stage of root development, morphology of the tooth, selected surgical procedure, time of extraoral exposure of donor tooth, shape of the recipient socket, vascularity of the recipient site, and the vitality of the periodontal ligament cells, impact of which was considered during presented clinical case.&#x0D; Conclusions. Present clinical case report with accompanied literature review arguments the clinical perspective of tooth autotransplantation procedure as valuable treatment option, and highlights major practically-oriented aspects regarding tooth autotransplantation operation including further post-endodontic restoration of donor tooth. Synergy of tooth autotransplantation and post-endodontic restoration protocols in the hands of an experienced doctor who is ready to carefully follow the scientiŢc evidence-based protocol associated with successful outcome of provided treatment.

A study to evaluate the preferences of dentists for the materials chosen to restore endodontically treated teeth and the influence of both clinical experience and level of specialization on the dentist's choice of posts

Background: In endodontics, dentist's choice for using posts/materials relevant to posts used to restore endodontic-treated teeth is influenced by clinical experience, whether concerning the length of practice time and level of specialization. Objective: Traditional restorative approaches are being modified as newer materials become available and patient preferences shift. The purpose of the study was to see if dentists' preferences for using posts and other materials associated to post used to restore endodontically treated teeth are influenced by practical experience, whether measured by the length of clinical practice time or level of specialty. Methodology: A cross-sectional study was conducted with dentists (n = 100) working in Karnataka utilizing a questionnaire. Data on sociodemographics, clinical experience, postgraduate training, and postendodontic restoration characteristics (posts/types of cement and rubber dam application) were obtained. The samples only included general and specialist dentists. A descriptive analysis was performed on the data. The Chi-square test and Fisher's exact test investigated the relationships. Results: The most chosen materials were metal posts (60%) and resin cement (70%). There was a statistically significant association between clinical practice duration and postuse type (P = 0.017). In addition, there was a highly significant relationship (P = 0.001) between clinical practice time, level of specialty, and the use of rubber dams. Conclusions: Dentists favored metal posts for post endodontic restorations, while resin-based cement was the preferred luting cement for the posts' cementation. Additional training and more clinical practice time were factors in several dental postselection decisions.

Bond Strength Evaluation between Different Glass Fiber Post Systems to Restore Weakened Roots

A new bundled glass fiber-reinforced resin post was developed to be used in post-endodontic restoration. We evaluated the bond strength of a single prefabricated glass fiber post (GFP) and a bundled glass fiber-reinforced resin post (GT), used alone or combined, to restore weakened roots. Fifty bovine incisors roots were weakened with a diamond bur, except for those from the control group. The root canals were endodontically treated (Pro Taper Next system, gutta-percha, and endodontic cement), and the roots were divided into five groups (n = 10): Reb—single prefabricated GFP (Rebilda Post—Voco); GT—bundled glass fiber-reinforced resin post (Rebilda Post GT—Voco); RebGT—association between the prefabricated GFP (Reb) and the bundled one (GT); CP—prefabricated GFP customized with composite resin; and Cont—singular post in a non-weakened root (Control). All posts were cemented using a universal adhesive system (Futurabond U) and dual-cure resin cement (Rebilda DC—Voco). Afterwards, two slices were obtained from each root third (cervical, middle, and apical) and submitted to a push-out bond strength test. Data were analyzed regarding the post system used and the root thirds by two-way ANOVA, followed by Tukey’s test (p &lt; 0.05). There were higher bond strength means for the RebGT and CP groups, presenting values similar to the control. The Reb and GT groups showed lower values. The adhesion to deeper thirds of the root canal remains a challenge for adhesive dentistry and is not related to the design of the post. Additionally, the rehabilitation of teeth with weakened roots requires the customization of the glass fiber post with composite resin or the association between prefabricated options with multiple posts.

Impact of laser disinfection and passive ultrasonic irrigation on postoperative pain in single visit root canal therapy

Introduction: Postoperative endodontic pain is common. 3 to 58% of patients had post-op pain. Canal microbes are tough to eliminate. No irrigant meets all the perfect irrigant characteristics. Methods: In Kanpur, India, 46 participants were enrolled in this randomised clinical trial from January to June 2022. Department of Conservative Dentistry and Endodontics conducted the study. Local anaesthetic (1:2,000 lignocaine with adrenaline) was followed by rubber dam isolation and access cavity preparation. Teeth were cleaned and shaped. Patients were divided into two groups using a coin flip. Group A employed a 2 W 810 nm diode laser for laser disinfection. In Group B, sodium hypochlorite (NaOCl) was ultrasonically agitated. After a final treatment with saline, composite resin was used for obturation and post-endodontic restoration. A blinded assessor rated post-endodontic treatment after 6 hours, 24 hours, 48 hours, and 7 days. SPSS 20.0 was used to gather and analyse the data after utilising Pearson's Chi-square test with 5% significance. Results: 25 men and 19 women among 44 patients. 10 patients were 40-60, 28 were 30-40, and 12 were 18-29. No statistically significant difference was seen between PUI and laser disinfection in single visit root canal therapy (p=0.086).

Influence of Access Cavity Design on the Fracture Strength of Endodontically Treated Teeth Restored Using Short Fiber-Reinforced Composite and High Strength Posterior Glass Ionomer Cement.

Aim: This in vitro study aimed to determine the influence of access cavity design and residual tooth structure and to compare the fracture resistance of the teeth post endodontically restored with short fiber-reinforced composite (GC everX Posterior; GC, India) and conventional posterior high-strength GIC (Glass Ionomer Cement) (GC Gold Label IX; GC, India).Methods: Ninety extracted human mandibular molars were classified into five groups, i.e., one control group (n = 10) and four test groups based on the access cavity design (n = 20): Traditional access cavity (TAC), Conservative access cavity (CAC), Ninja access cavity (NAC), and Truss access cavity (TRAC). Then 80 teeth in test groups were endodontically treated and further subdivided (n = 10) based on post-endodontic restorative materials, i.e., short fiber-reinforced composite (SFC) and Type 9 GIC. Samples were then subjected to fracture resistance under a universal testing machine and fracture loads were compared statistically.Results: The fracture resistance of various access cavity designs (TAC, CAC, NAC, and TRAC) varied significantly (P < .05). Regardless of access cavity design, teeth restored with SFC had higher fracture resistance than teeth restored with high strength posterior GIC (P = .001).Conclusion: Using newer access cavity designs like (CAC, NAC, and TRAC) and reinforcing the teeth with a post-endodontic restoration such as SFC, fracture resistance of endodontically treated teeth can be improved notably.

Impact of access cavity cleaning on the seal of postendodontic composite restorations in vitro.

The aim of the study was to investigate the influence of cavity cleaning and conditioning on marginal integrity of directly placed post-endodontic composite class-I-restorations in vitro. A total of 168 fully intact teeth without caries or fillings received pre-endodontic composite restorations (class-II) after their extraction. Occlusal endodontic access-cavities were prepared, and root canals were instrumented and filled with gutta-percha and an epoxy resin-based sealer. Prior to post-endodontic class-I-restoration, access cavities were completely contaminated with sealer, cleaned with alcohol and pre-treated as follows: cleaner only (alcohol), glycine-polishing, Al2 O3 sandblasting, carbide bur (immediate as well as delayed restoration). A positive control (not contaminated with sealer and adhesive used) and negative control (cleaner used but no adhesive) were established. Half of the teeth from each group were subjected to thermocycling and mechanical loading (TCML). Marginal integrity of post-endodontic restoration was evaluated in oro-vestibular or mesio-distal sections after AgNO3 dye penetration (DP) by standardized photomacroscopic imaging and expressed in per cent of margin length along all segments and separately for enamel, dentine and composite, respectively. Results were analysed non-parametrically (α = .05). No restorations or teeth fractured or debonded completely. Without TCML, the median DP of all segments was significantly higher for the negative control compared with all other groups in oro-vestibular cutting direction (53%; p = .002) and in mesio-distal cutting direction (51%; p ≤ .041). The other groups without TCML revealed 16%-24% DP (oro-vestibular) and 12%-24% DP (mesio-distal). With TCML, the median DP in oro-vestibular cutting direction for all segments ranged between 48% and 62% for all groups, a significant difference was only observed between glycine-polishing and carbide bur (p = .041). In mesio-distal cutting direction, the median DP in negative control was 69% with TCML and significantly higher compared with all other groups (p = .002). For all other groups, the median DP of all segments ranged between 28% and 40% with TCML without significant differences. Error rates method (k = 7) revealed a significant influence of TCML in general on penetration of all segments in both oro-vestibular and mesio-distal cutting directions. Additional access cavity pre-treatment after alcohol cleaning did not improve the marginal integrity of post-endodontic composite restorations. Thorough cleaning of the access cavity with alcohol seems to assure an acceptable marginal integrity to the tooth and restorative composite.

Recent trends in post endodontic restorations: A comprehensive case series

Root canal treatment is said to be completely successful when the tooth is restored and comes back to normal function. A more complex restoration is required after endodontic treatment when compared to normal tooth restoration, because of factors such as extensive caries, post-treatment root canal dentin and even the economics condition of the patient. With the availability of newer high strength materials like lithium disilicate dentists are now able to offer better esthetics and high strength restoration which withstands heavy occlusal forces with even thin layers. Thus, the aim of this case series is to summarize the recent advances of post endodontic restorations, various new materials their indications depending on the remaining tooth structure and the teeth that needs to be restored.

Retrieval of File from Canal Apical Third: A Report of Two Cases

Background: Procedural mishaps can occur during any step of root canal during cleaning and shaping, and might affect the prognosis of treatment. Among these separation of instruments in the canal is one of the most troublesome incidents in endodontic therapy especially if the fragments cannot be removed. Several techniques have been employed to facilitate the removal of the fragments; however, they are technique sensitive, expensive and require great expertise. Aim: This paper aims to suggest combination of techniques for retrieval of file from apical or beyond the apical third of canal. Materials and Methods: A 30year old patient presented with pain in upper anterior tooth. Clinical examination revealed a temporary restoration in 21 with no soft tissue abnormality. A radio-visio-graph indicated 22 associated with periapical radiolucency and a separated file extending 3mm beyond the radiographic apex in the periapical area. Retrieval of the separated instrument was planned using braiding technique followed by obturation and post endo restoration. Second case report includes a female 43 years old with pain in upper lateral incisor. IOPA radiograph revealed a separated instrument in the apical third of root canal. Retreatment was planned by first bypassing the fractured file and then using ultrasonics to loosen the fragment followed by obturation and post endodontic restoration. Conclusion: Combining different techniques during file retrieval can retrieve file with minimal dentinal destruction. Keywords: braiding, bypass, file retrieval, H file, K file, instrument separation, ultrasonics.

Preference for Using Posts to Restore Endodontically Treated Teeth among Dentists in College of Dentistry/ Hawler Medical University

Objective: Traditional restorative approaches are being modified as newer materials become available and patient preferences shift. The purpose of the study was to see if dentists' preferences for using posts and other materials associated to post used to restore endodontically treated teeth are influenced by practical experience, whether measured by the length of clinical practice time or level of specialty. &#x0D; Methods: A cross-sectional study was conducted with dentists (n = 108) working at Hawler Medical University/College of Dentistry utilizing a questionnaire. Data on sociodemographics, clinical experience, postgraduate training, and post-endodontic restoration characteristics (posts/types of cement, rubber dam application) were obtained. The samples only included general and specialist dentists. A descriptive analysis was performed on the data. The Chi-square test and Fisher's exact test investigated the relationships. &#x0D; Results: The most chosen materials were metal posts (53.7 %) and resin cement (50 %). There was a statistically significant association between clinical practice duration and post-use type (P = 0.017). In addition, there was a highly significant relationship (P = 0.001) between clinical practice time, level of specialty, and the use of rubber dams. &#x0D; Conclusions: Dentists favored metal posts for post endodontic restorations, while resin-based cement was the preferred luting cement for the posts' cementation. Additional training and more clinical practice time were factors in several dental post-selection decisions.

Coronal restoration of endodontically treated posterior teeth

There is still no consensus on the restoration of endodontically treated posterior teeth in the most appropriate way. With the development of adhesive materials with improved properties and a shift in approach towards minimally invasive dentistry, there is a paradigm change in the restorative modalities of root-filled teeth. Conventionally endodontically treated teeth were restored with post and core followed by a crown, but conservative restorative options have gained popularity with the advancements in adhesive techniques. Many studies have been done, but there is a need to re-explore the scholarly literature with the changing trend. This review article provides a brief overview of the literature on the survival of endodontically treated posterior teeth in relation to the type of post endodontic restoration. A literature search of papers related to the survival of endodontically treated teeth and type of post endodontic restorations published till July 2021 was undertaken in PubMed, MEDLINE, SCOPUS, Web of Science and Science direct. A few of the keywords searched were: post endodontic restorations, survival, clinical performance, root canal treated teeth, endodontically treated teeth, success, resin composite, crown, cuspal coverage restoration.

Present status and future directions: vertical root fractures in root filled teeth.

Vertical root fracture (VRF) is a common reason for the extraction of root filled teeth. The accurate diagnosis of VRF may be challenging due to the absence of clinical signs, whilst conventional radiographic assessment is often inconclusive. However, an understanding of the aetiology of VRFs, and more importantly, the key predisposing factors, is crucial in identifying teeth that may be susceptible. Thorough clinical examination with magnification and co‐axial lighting is essential in identifying VRFs, and although CBCT is unable to reliably detect VRFs per se, the pattern of bone loss typically associated with VRF can be fully appreciated, and therefore, increases the probability of correct diagnosis and management. The prevalence of VRFs in root filled teeth is significantly greater than in teeth with vital pulps, demonstrating that the combination of loss of structural integrity, presence of pre‐existing fractures and biochemical effects of loss of vitality is highly relevant. Careful assessment of the occlusal scheme, presence of deflective contacts and identification of parafunctional habits are imperative in both preventing and managing VRFs. Furthermore, anatomical factors such as root canal morphology may predispose certain teeth to VRF. The influence of access cavity design and root canal instrumentation protocols should be considered although the impact of these on the fracture resistance of root filled teeth is not clearly validated. The post‐endodontic restoration of root filled teeth should be expedient and considerate to the residual tooth structure. Posts should be placed ‘passively’ and excessive ‘post‐space’ preparation should be avoided. This narrative review aims to present the aetiology, potential predisposing factors, histopathology, diagnosis and management of VRF and present perspectives for future research. Currently, there are limited options other than extraction for the management of VRF, although root resection may be considered in multi‐rooted teeth. Innovative techniques to ‘repair’ VRFs using both orthograde and surgical approaches require further research and validation. The prevention of VRFs is critical; identifying susceptible teeth, utilizing conservative endodontic procedures, together with expedient and appropriate post‐endodontic restorative procedures is paramount to reducing the incidence of terminal VRFs.

Direct postendodontic restoration of teeth with the use of core resins and fiber posts morphological aspects. (In Vitro study)

Relevance. It is known that endodontically treated teeth have a lower survival rate compared to vital teeth. This is due both to changes in the hard tissues of the tooth, and to the use of inadequate technologies for their restoration. Therefore, the methods of restoration of such teeth are very relevant. But their application should be conditioned by their scientific substantiation using fundamental research methods, which determined the relevance of this study.Material and methods. The study of the structural and functional characteristics of the restoration was carried out by scanning electron microscopy in the area of the restoration border, the border of the material-pin insert, the ledge area and the surface of the restoration material. For this purpose, 60 periodontal removed teeth with an IROPZ index of 0.8 or more were used, of which 120 restoration samples were made from the standard form of the composite and 120 restorations from the core-composite using a fiber-optic pin in both groups.Results and discussion. In the course of the study, it was found that the data obtained in the study of the morphology of the restoration in group No. 1 indicate insufficient adaptive properties of the traditional form of the composite (porosity, cohesive fractures, violation of the marginal fit); The results of SEM testify to the advantages of the core-composite, which has a homogeneous, micro-rough, adhesive surface free from technical impurities, suitable for the use of all currently used methods of fixing an orthopedic structure.

Long-term Survival of Adhesively Luted Post-endodontic Restorations

IntroductionThe objective of this prospective clinical study was to investigate survival for endodontically treated teeth restored with adhesively luted prefabricated dentinlike or rigid posts. MethodsData were recorded for glass-fiber posts (GFPs) and compared with historical controls evaluating glass-fiber (GFP I) and titanium posts (TPs) for 128 patients. Three groups were defined based on the type of post system used: group 1, GFP I (n = 41); group 2, GFP II (n = 41); and group 3, TP (n = 46). Posts were adhesively luted with self-adhesive resin, adhesive composite core buildups were performed, and all teeth were restored with full-coverage restorations. The primary end point was restoration survival at recall. Outcome was assessed after 6, 12, 24 and up to 178 months clinically and radiographically. Data were analyzed by the Kaplan-Meier log-rank test and Cox regression analysis. ResultsAfter up to 178 months of observation, 26 restorations failed (GFP I: 10, GFP II: 9, and TP: 7) and 49 (GFP I: 18, GFP II: 12, and TP: 19) were in situ. Cumulative survival probabilities were 57.1% for the GFP I, 56.5% for the GFP II, and 71.8% for the TP groups. In bivariate Cox regression, the factors tooth type and grade of abrasion were significantly assfociated with failure. In multivariate Cox regression, none of the investigated factors were significantly associated with failure. The post system had no significant impact on tooth survival (P > .05). ConclusionsComparing GFPs and TPs, the post system had no impact on tooth survival up to 15 years. This study indicates that the effect size of post material on survival is low.

Patterns of Post-Endodontic Restoration: A Nationwide Survey of Dentists in Turkey.

Developments in materials and techniques, geographical locations, age, specialty, and affiliations of dental practitioners affect the preference of post-endodontic restoration. Thus, this survey aimed to evaluate the trends of dentists in Turkey in terms of post-endodontic restorations. An anonymous survey containing 10 questions regarding demographics, post-endodontic restoration patterns, and factors affecting restoration selection was electronically delivered to the dentists registered in the database of the Turkish Dental Association. The data were analyzed using by a chi-square test and ordinal logistic regression analysis. A total of 1093 surveys from 20,564 participants were collected with a response rate of 5.3%. Half of the participants (52%) preferred composite resins for post-endodontic restorations. Usage of posts was less prevalent amongst prosthodontists and dentists with clinical experience of more than 20 years compared to endodontists (p < 0.001) and dentists with clinical experience of less than 5 years (p = 0.004). More than half of the participants (56%) utilized fiber posts. Composite resins and fiber posts were the most common preferences in post-endodontic restoration. Endodontists had a higher tendency to use posts than prosthodontists and general dental practitioners.