• Restorative Dentistry and Endodontics
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• v.48 no.4
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• pp.34.1-34.12
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• 2023

This systematic review aimed to investigate whether minimally invasive root canal preparation ensures higher fracture resistance compared to conventional root canal preparation in endodontically treated teeth (ETT). A comprehensive search strategy was conducted on the "PubMed, Web of Science, and Scopus" databases, alongside reference and hand searches, with language restrictions applied. Two independent reviews selected pertinent laboratory studies that explored the effect of minimally invasive root canal preparation on fracture resistance, in comparison to larger preparation counterparts. The quality of the studies was assessed, and the risk of bias was categorized as low, moderate, or high. The electronic search yielded a total of 1,767 articles. After applying eligibility criteria, 8 studies were included. Given the low methodological quality of these studies and the large variability of fracture resistance values, the impact of reduced apical size and/or taper on the fracture resistance of the ETT can be considered uncertain. This systematic review could not reveal sufficient evidence regarding the effect of minimally invasive preparation on increasing fracture resistance of ETT, primarily due to the inherent limitations of the studies and the moderate risk of bias.

• Restorative Dentistry and Endodontics
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• v.34 no.5
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• pp.383-389
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• 2009

The purpose of this study was to investigate the fracture resistance of crown-root fractured teeth repaired with dual-cured composite resin and horizontal posts. 48 extracted human premolars were assigned to control group and three experimental groups. Complete crown-root fractures were experimentally induced in all control and experimental teeth. In the control group. the teeth (n=12) were bonded with resin cement and endodontically treated. Thereafter, the access cavities were sealed with dual-cured composite resin. In composite resin core-post group (n=12), the teeth were endodontically treated and access cavities were sealed with dual-cured composite resin. In addition, the fractured segments in this group were fixed using horizontal posts. In composite resin core group (n=12), the teeth were endodontically treated and the access cavities were filled with dual-cured composite resin without horizontal posts. In bonded amalgam group (n = 12), the teeth were endodontically treated and the access cavities were sealed with bonded amalgam. Experimental complete crown-root fractures were induced again on repaired control and experimental teeth. The ratio of fracture resistance to original fracture resistance was analyzed with Kruskal-Wallis test. The results showed that teeth in control and composite resin core-post group showed significantly higher resistance to re-fracture than those in amalgam core group (p < 0.05). The resistance to refracture was high in the order of composite resin - post group, control group, composite resin group and bonded amalgam group. Within the scope of this study, the use of horizontal post could be beneficial in increasing the fracture resistance of previously fractured teeth.

• The Journal of Advanced Prosthodontics
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• v.9 no.3
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• pp.232-237
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• 2017

Dentists often place post and core buildups on endodontically treated abutments for crown and bridge restorations. This article analyzes the bio-mechanical purposes, advantages and disadvantages of placing a core or a post and core in an endodontically treated tooth and reviews literature on post and core biomechanics. The author assesses the scientific rationale of the claim that the main purpose of a post is to retain a core, or the claim that posts weaken teeth. More likely, the main function of a post is to help prevent the abutment, on which a crown is cemented, from fracturing such that the abutment separates from the tooth root, at a fracture plane that is located approximately and theoretically at the level of the crown (or ferrule) margin. A post essentially improves the ferrule effect that is provided by the partial fixed denture prosthesis. This paper also explores the difference between bio-mechanical failures of crowns caused by lack of retention or excess taper, versus failures due to a sub-optimal ferrule effect in crown and bridge prostheses.

• Imaging Science in Dentistry
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• v.43 no.3
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• pp.171-177
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• 2013

Purpose: The purpose of this study was to compare the efficacy of two imaging modes in a cone beam computed tomography (CBCT) system in detecting root fracture in endodontically-treated teeth with fiber posts or screw posts by selecting two fields of view. Materials and Methods: In this study, 78 endodontically-treated single canal premolars were included. A post space was created in all of them. Then the teeth were randomly set in one of 6 artificial dental arches. In 39 of the 78 teeth set in the 6 dental arches, a root fracture was intentionally created. Next, a fiber post and a screw post were cemented into 26 teeth having equal the root fractures. High resolution (HiRes) and standard zoom images were provided by a CBCT device. Upon considering the reconstructed images, two observers in agreement with each other confirmed the presence or absence of root fracture. A McNemar test was used for comparing the results of the two modes. Results: The frequency of making a correct diagnosis using the HiRes zoom imaging mode was 71.8% and in standard zoom was 59%. The overall sensitivity and specificity in diagnosing root fracture in the HiRes mode were 71.79% and 46.15% and in the standard zoom modes were 58.97% and 33.33%, respectively. Conclusion: There were no significant differences between the diagnostic values of the two imaging modes used in the diagnosis of root fracture or in the presence of root canal restorations. In both modes, the most true-positive results were reported in the post space group.

• Restorative Dentistry and Endodontics
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• v.18 no.2
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• pp.463-468
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• 1993

The purpose of this study was to evaluate the effects of Vitapex on the periapical lesions. Thirteen single-rooted teeth from ten patients who visited the SNU hospital were endodontically treated with Vitapex and Gutta percha cone, and radiographically and clinically evaluated for a period of 1 to 6 months. The results were as follows : 1. The loss of clinical symtoms was observed in all 13 teeth. 2. The reduction of size of periapical lesions in radiographs was observed in 10 teeth. The periapical lesions of remaining 3 teeth also look better in the radiographs. 3. All 13 teeth showed the reduction of radiolucency. 4. The gradual resorption of Vitapex over the root apex was observed.

• The Journal of Advanced Prosthodontics
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• v.9 no.5
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• pp.328-334
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• 2017

PURPOSE. This study evaluated fracture resistance with regard to ferrule lengths and post reinforcement on endodontically treated mandibular premolars incorporating a prefabricated post and resin core. MATERIALS AND METHODS. One hundred extracted mandibular premolars were randomly divided into 5 groups (n=20): intact teeth (NR); endodontically treated teeth (ETT) without post (NP); ETT restored with a prefabricated post with ferrule lengths of either 0 mm (F0), 1 mm (F1), or 2 mm (F2). Prepared teeth were restored with metal crowns. A thermal cycling test was performed for 1,000 cycles. Loading was applied at an angle of 135 degrees to the axis of the tooth using a universal testing machine with a crosshead speed of 2.54 mm/min. Fracture loads were analyzed by one-way ANOVA and Tukey HSD test using a statistical program (${\alpha}=.05$). RESULTS. There were statistical differences in fracture loads among groups (P<.001). The fracture load of F2 ($237.7{\pm}83.4$) was significantly higher than those of NP ($155.6{\pm}74.3N$), F0 ($98.8{\pm}43.3N$), and F1 ($152.8{\pm}78.5N$) (P=.011, P<.001, and P=.008, respectively). CONCLUSION. Fracture resistance of ETT depends on the length of the ferrule, as shown by the significantly increased fracture resistance in the 2 mm ferrule group (F2) compared to the groups with shorter ferrule lengths (F0, F1) and without post (NP).

• The Journal of Korean Academy of Prosthodontics
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• v.36 no.2
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• pp.366-378
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• 1998

Post and core is used to restore endodontically treated teeth, and it is a very important part which supplies retention and support to the prosthesis. But occasionally, caries occured due to the microleakage at the post and core and tooth interface, the failure of prosthesis has happened. In this study, the microleakage of cast gold post and core, amalgam core, and composite resin core was investigated and compared. The coronal part of the extracted upper anterior teeth were removed and endodontically treated with conventional method. The teeth were divided into three groups. In group 1, cast gold post and core was cemented with resin cement and in group 2, ready-made post was cemented with resin cement and amalgam core was built. In group 3, ready-made post was cemented with resin cement and composite resin core was built. All specimens were thermocycled between $5^{\circ}C\;and\;55^{\circ}C$ with dwell time of 15 seconds, and immersed in 0.5% aqueous solution of basic fuchsin dye for 24 hours. After embedded in the epoxy resin, the specimens were sectioned longitudinally and observed with stereomicroscope with the magnification of 25. From the findings of this study, the following conclusions were obtained. 1. There was microleakage at the core/tooth interface of all specimens. 2. The microleakage of gold post and core was significantly less than those of the other two groups. 3. There was no significant difference between the microleakage of amalgam core and that of composite resin core.

• Restorative Dentistry and Endodontics
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• v.16 no.1
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• pp.133-150
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• 1991

To study the mechanical behavior depended on the restoration method and alveolar bone height at endodontically treated teeth. a finite element model was made which was applied by four types of restoration methods and alveolar bone height on upper central incisor and then 1 Kg force was applied on each model as follows; 1) $45^{\circ}$ diagonal load on incisal edge. 2) $26^{\circ}$ diagonal load on lingual surface. and 3) horizontal load on labial surface. The author analyzed the displacement and stress of teeth and their supporting tissue by finite element method according to three type of loading conditions. The results were as follows : 1. The displacement by restoration method and the stress in dentin was found greater in restoration without a post than in that with a post. 2. The displacement and stress was found about the same when compared : A) in Resin model and PFM model applied by restoration method without a post and B) in PRC model and CPC model applied by restoration method with a post. 3. The lower alveolar bone height was. the greater was the displacement and stress. 4. The lower alveolar bone height was. the greater slightly was the stress of restoration without a post than in that with a post. 5. The stress in loading condition was the greatest in P1 in dentin and post. and was greatest in P3 in alveolar hone. 6. In the restoration method without a post. stress concentration in labial dentin was distributed to a figure of long belt in adjacent part to periodontal ligament. while in restoration method with a post. it was distributed in adjacent part to post side. And in all types of restoration method stress concentration in alveolar bone was distributed along the compact bone of labial and lingual surface.

• Restorative Dentistry and Endodontics
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• v.45 no.4
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• pp.49.1-49.11
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• 2020

Objectives: The aim of this study was to perform a clinical and radiographic analysis of endodontically treated teeth (ETT) restored with cast metal posts (CMPs) or prefabricated glass fiber posts (GFPs) and crowns. Materials and Methods: Fifty ETT were restored with 25 CMPs and 25 GFPs at a private dental clinic between 2001 and 2016. The restorations consisted of 12 all-ceramic crowns, 31 metal-ceramic crowns, and 7 composite resin crowns. Demographic data, type of teeth, type of post-and-core system, time of placement, crown restorations, the number of proximal contacts, the type of antagonist, and reports of any complications after post-and-core placement were recorded for each patient. Assessments were performed at baseline (radiographic) and follow-up (radiographic and clinical). Data were analyzed by the McNemar test, the Pearson χ² test, and Kaplan-Meier survival curves (α = 0.05). The mean follow-up was 67.6 months. Results: No significant difference was observed for any of the radiographic parameters when the baseline and final radiographs were compared. In the clinical evaluation, anatomical form (p = 0.009) and occlusion (p = 0.001) showed significant differences according to the type of crown restoration; specifically, metal-ceramic and all-ceramic crowns outperformed composite resin crowns. Conclusions: CMPs and GFPs showed favorable results for restoring ETT after 6 years of follow-up. All-ceramic and metal-ceramic crowns showed higher survival rates and better clinical outcomes.

• The Journal of Advanced Prosthodontics
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• v.6 no.3
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• pp.200-206
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• 2014

PURPOSE. This in vitro study investigated the fracture resistance of endodontically treated premolars restored using silorane-or methacrylate-based composite along with or without fiber or nano-ionomer base. MATERIALS AND METHODS. Ninety-six intact maxillary premolars were randomly divided into eight groups (n = 12). G1 (negative control) was the intact teeth. In Groups 2-8, root canal treatment with mesio-occlusodistal preparation was performed. G2 (positive control) was kept unrestored. The other groups were restored using composite resin as follows: G3, methacrylate-based composite (Z250); G4, methacrylate composite (Z250) with polyethylene fiber; G5 and G6, silorane-based composite (Filtek P90) without and with the fiber, respectively; G7 and G8, methacrylate-and silorane-based composite with nano-ionomer base, respectively. After aging period and thermocycling for 1000 cycles, fracture strength was tested and fracture patterns were inspected. The results were analyzed using ANOVA and Tukey HSD tests (${\alpha}$=0.05). RESULTS. Mean fracture resistance for the eight groups (in Newton) were G1: $1200{\pm}169^a$, G2: $360{\pm}93^b$, G3: $632{\pm}196^c$, G4: $692{\pm}195^c$, G5: $917{\pm}159^d$, G6: $1013{\pm}125^{ad}$, G7: $959{\pm}148^d$, G8: $947{\pm}105^d$ (different superscript letters revealed significant difference among groups). Most of the fractures in all the groups were restorable, except Group 3. CONCLUSION. Silorane-based composite revealed significantly higher strength of the restored premolars compared to that of methacrylate one. Fiber insertion demonstrated no additional effect on the strength of both composite restorations; however, it increased the prevalence of restorable fracture of methacrylate-based composite restored teeth. Using nano-ionomer base under methacrylate-based composite had a positive effect on fracture resistance and pattern. Only fiber-reinforced silorane composite restoration resulted in a strength similar to that of the intact teeth.