Clinical performance and failure modes of pulpless teeth restored with posts: a systematic review

Abstract

The aim of this systematic review was to compare the clinical performance and failure modes of teeth restored with intra-radicular retainers. A search was performed on PubMed/Medline, Central and ClinicalTrials databases for randomized clinical trials comparing clinical behavior and failures of at least two types of retainers. From 341 detected papers, 16 were selected for full-text analysis, of which 9 met the eligibility criteria. A manual search added 2 more studies, totalizing 11 studies that were included in this review. Evaluated retainers were fiber (prefabricated and customized) and metal (prefabricated and cast) posts, and follow-up ranged from 6 months to 10 years. Most studies showed good clinical behavior for evaluated intra-radicular retainers. Reported survival rates varied from 71 to 100% for fiber posts and 50 to 97.1% for metal posts. Studies found no difference in the survival among different metal posts and most studies found no difference between fiber and metal posts. Two studies also showed that remaining dentine height, number of walls and ferrule increased the longevity of the restored teeth. Failures of fiber posts were mainly due to post loss of retention, while metal post failures were mostly related to root fracture, post fracture and crown and/or post loss of retention. In conclusion, metal and fiber posts present similar clinical behavior at short to medium term follow-up. Remaining dental structure and ferrule increase the survival of restored pulpless teeth. Studies with longer follow-up are needed.

Multi-Fiber-Reinforced Composites for the Coronoradicular Reconstruction of Premolar Teeth: A Finite Element Analysis

“…Moreover, MIC and sFRC present a greater elastic modulus than that of dentin, which also increases the risk of tooth fracture [ 9 ]. Clearly, important tissue removal and differential mechanical behavior weaken the root and lead to low tooth survival [ 10 – 14 ]. Furthermore, reconstructed premolars have a lower survival rate due to smaller crowns and lateral occlusal forces [ 15 ].…”

In Vitro Fracture Strength of Teeth Restored with Lithium Disilicate Onlays with and without Fiber Post Build-Up

“…A recent meta-analysis found that the absence of coronal structure and ferrule might increase the risk of failure of post and core restorations [ 18 ]. Another systematic review reached the same conclusion [ 19 ]. However, even if these principles have always been valid for restorations delivered with traditional, non-adhesive cements, are they still needed when adhesive luting procedures are applied?…”

Current options concerning the endodontically-treated teeth restoration with the adhesive approach

“…A systematic review in 2017 on ETT failure modes revealed that metal posts are associated with higher risks of root fracture, while glass-fiber posts are associated with higher risks of post/crown/core loss of retention. 72 In conclusion, recent studies do not agree on the clinical benefit of using pre-fabricated glass-fiber posts rather than cast post-and-core. More clinical studies should be carried out in order to provide more data for a meta-analysis.…”