Stewardson D. Non metal post systems. Dent Update. 2001; 28:326-336
Ring ME. The Eighteenth Century in Dentistry, An Illustrated History, 2nd edn. New York: Abradale Press/Harry N Abrams; 1992
Lewis R, Smith BG. A clinical survey of failed post retained crowns. Br Dent J. 1988; 165:95-97
Sorensen JA, Martinoff JT. Clinically significant factors in dowel design. J Prosthet Dent. 1984; 52:28-35
Valderhaug J, Jokstad A, Ambjornsen E, Norheim PW. Assessment of the periapical and clinical status of crowned teeth over 25 years. J Dent. 1997; 25:97-105
Rollings S, Stevenson B, Ricketts D. Posts – When it all goes wrong! Part1: Case assessment and management options. Dent Update. 2013; 40:82-91
Tickotsky N, Petel R, Haim Y, Ghrayeb M, Moskovitz M. Post-and-core restoration of severely damaged permanent posterior teeth in young adolescents. Int J Prosthodont. 2017; 30:458-460
Bateman G, Tomson P. Trends in indirect dentistry: 2. Post and core restorations. Dent Update. 2005; 32:190-198
Ng YL, Mann V, Rahbaran S, Lewsey J, Gulabivala K. Outcome of primary root canal treatment: systemic review of the literature – Part 1. Effects of study characteristics on probability of success. Int Endod J. 2007; 40:921-939
Ng Y, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: pericapical health. Int Endod J. 2011; 44:583-609
Tjan AH, Whang S. Resistance to root fracture of dowel channels with various thicknesses of buccal dentin walls. J Prosthet Dent. 1985; 53:496-500
Goodacre CJ, Spolnik KJ. The prosthodontic management of endodontically treated teeth: a literature review. Part III. Tooth preparation considerations. J Prosthodont. 1995; 4:122-128
Stankiewicz N, Wilson P. The ferrule effect. Dent Update. 2008; 35:222-228
Singh SV, Gupta S, Sharma D, Pandit N, Nangom A, Satija H. Stress distribution of posts on the endodontically treated teeth with and without bone height augmentation: a three-dimensional finite element analysis. J Conserv Dent. 2015; 18:196-199
Ichim I, Kuzmanovic DV, Love RM. A Finite element analysis of ferrule design on restoration resistance and distribution of stress within a root. Int Endod J. 2006; 39:443-452
Convissar R. Principles and Practice of Laser Dentistry, 1st edn. London: Elsevier; 2011
Ng CC, Al-Bayat MI, Dumbrigue HB, Griggs JA, Wakefield CW. Effect of no ferrule on failure of teeth restored with bonded post and cores. Gen Dent. 2004; 52:143-146
King PA, Setchell DJ. An in vitro evaluation of a prototype CFRC prefabricated post developed for the restoration of pulpless teeth. J Oral Rehabil. 1990; 17:599-609
Bonchev A, Radeva E, Tsvetanova N. Fibre reinforced composite posts – a review of the literature. Int J Sci Res. 2017; 6:1887-1893
Mentink AG, Creugers NH, Meeuwissen R, Leempoel PJ, Kayser AF. Clinical performance of different post and core systems – results of a pilot study. J Oral Rehabil. 1993; 20:577-584
Standlee JP, Caputo AA, Hanson EC. Retention of endodontic dowels: effect of cement, dowel length, diameter, and design. J Prosthet Dent. 1978; 39:400-405
Schwartz R, Robbins J. Post placement and restoration of endodontically treated teeth: a literature review. J Endod. 2004; 30:289-301
The restoration of structurally compromised endodontically treated teeth: principles and indications of post and core restorations Reem Ahmed Raj Dubal Dental Update 2024 47:8, 707-709.
Authors
ReemAhmed
BDS, MFDS RCS
Dental Core Trainee, Department of Restorative Dentistry, St George's Hospital, Blackshaw Road, London, SW17 0QT, UK
The use of posts to retain indirect restorations in structurally compromised teeth is a technique that has been used for many years. There are many factors that need to be considered prior to the provision of post- and core-retained crowns to reduce the risk of failure. This includes case selection and an understanding of the cumulative prognostic endodontic, periodontal and prosthodontic factors. Many clinicians are hesitant to use post- and core-retained restorations, due to an uncertainty of whether the treatment modality would work, and with some seeing it as an out-dated clinical technique. The evolution and widespread use of dental implants has also provided an additional fixed tooth replacement option, which may result in a reduced drive to retain structurally compromised teeth. As a result, fewer post-retained restorations are being placed, with the majority of these being old restorations present in the older age demographic. It is important for this treatment modality to remain within a clinician's armamentarium, not only for application when clinically appropriate but, with an ageing population with a heavily restored dentition, clinicians must be able to repair and replace these restorations when necessary.
CPD/Clinical Relevance: A sound understanding of the biological and technical considerations in the provision of post and core restorations will allow clinicians to offer this treatment modality to appropriate patients with greater predictability and reduced failure rates.
Article
Post and core restorations have been used as a treatment modality for structurally compromised teeth since 1728, when Pierre Fauchard described the use of metal screws in the roots of maxillary anterior teeth to retain crowns made from ivory and bone.1,2 Since then, posts and cores have been widely used to provide retention on teeth that would otherwise have had insufficient coronal tissue to retain a crown. There has been much advancement since 1728 in the characteristics and materials of post systems, meaning that clinicians have a plethora of options from which to choose.
Although it has been suggested that there is a high failure rate associated with post- and core-retained crowns, a clinical study by Sorensen and Martinoff demonstrated that, although posts may not reinforce teeth, success with this treatment modality is possible, with success rates of 87.3% and 100% for tapered cast posts and parallel-sided posts, respectively, when the length of the post was greater than the length of the crown.3,4 Furthermore, a study by Valderhaug et al reported that crowned teeth with good quality endodontic treatment and a post and core with optimal morphology had a similar 25-year survival rate to that of crowned teeth with a vital pulp.5 These studies demonstrate that clinical success is significantly reliant on operator skill and appropriate case and material selection. This article reviews some of the factors behind appropriate case and material selection, as well as demonstrating the technique using a clinical case.
Register now to continue reading
Thank you for visiting Dental Update and reading some of our resources. To read more, please register today. You’ll enjoy the following great benefits:
