Influence of coronal restorations on the fracture resistance of root canal‐treated premolar and molar teeth: A retrospective study

Abstract

To evaluate the influence of coronal restorations on the fracture resistance of endodontically treated teeth, 676 root canal-filled and restored posterior teeth were evaluated after a mean period of 9.7 (± 2.8; minimum: 5) years. A total of 86.2% of the endodontically treated and restored teeth survived the mean observation period of 9.7 years without fracture. The overall survival period was 13.6 (± 0.2) years. All teeth with gold partial crowns survived without fractures (n = 24). Teeth with crowns and adhesively sealed access cavities showed a mean survival period of 15.3 (± 0.4) years, with crown and bridge restorations 14.0 (± 0.3), with individual metal posts 13.9 (± 0.2), with composite fillings 13.4 (± 0.5), with prefabricated metal posts 12.7 (± 0.6), with amalgam fillings 11.8 (± 0.6) and with glass ionomer cements (GIC) 6.6 (± 0.5) years. Teeth with one or two surfaces restored by amalgam, composite or GIC showed a significantly lower fracture rate than teeth with three and more restored surfaces (P < 0.05). The mean fracture rate of teeth restored with GIC was significantly higher when compared with all other groups (P < 0.001). In general, endodontically treated teeth restored with prosthetic restorations demonstrated a significantly lower mean fracture rate than teeth restored with fillings. Cavities with up to three surfaces may well be successfully restored adhesively with composite filling material.

A 20‐year historical prospective cohort study of root canal treatments. A Multilevel analysis

“…The need for long-term clinical studies on teeth following root canal treatment is essential (Tickle et al 2008, Fonzar et al 2009, Ng et al 2011a,b, Bergenholtz & Kvist 2013, Dammaschke et al 2013, Skupien et al 2013, Landys Bor en et al 2015, Bergenholtz 2016. Such studies overcome gaps in knowledge and increase the evidence on tooth survival and health of periapical tissues.…”

Stability of endodontically treated teeth with differently invasive restorations: Adhesive vs. non-adhesive cusp stabilization

“…During and especially after completed endodontic treatment, the situation considerably changes due to the weakening effect of endodontic access preparation and the often large amount of tissue having been lost by extensive caries excavation [6][7][8][9][10][11][12]. It is proven that the biomechanical stability of posterior teeth after access cavity and even further preparation is dramatically decreased with a high risk of vertical root fracture [13][14][15][16][17][18].…”

Direct Restoration of Endodontically Treated Teeth: a Brief Summary of Materials and Techniques

“…Direct restoration with composite resin provides more resistance against tooth fracture than amalgam, as well as providing intra-coronal reinforcement [18]. The results of a retrospective study confirm that cavities with up to three surfaces can be restored successfully with composite restoration using adhesive techniques [46]. However, the major shortcomings of composite resins, such as fracture within the body, margins of restoration, and polymerization shrinkage, remain a concern for clinicians [44,47].…”