http://www.endoexperience.com/filecabinet/Endo%20Related%20Restorative%20Dentistry/Post%20and%20Cores/scwartz%20post%20review%20article.pdf

Post placement and restoration of endodontically treated teeth: a literature review.

https://www.endoexperience.com/documents/FractureRotaryNiTiInstrumentFractureanditsConsequencesParashos2006.pdf

Rotary NiTi instrument fracture and its consequences.

Statement of Problem. Crowns have been considered the restoration of choice for endodontically treated teeth, but their selection has been based primarily on anecdotal evidence. Purpose. This study tested the hypothesis that crown placement (coronal coverage) is associated with improved survival of endodontically treated teeth when preaccess, endodontic, and restorative factors are controlled. Material and Methods. A University of Iowa College of Dentistry treatment database was used to identify permanent teeth that had undergone initial obturation between July 1, 1985, and December 31, 1987. Study patients were restricted to persons with at least 1 dental visit in each 2-year interval from 1985 to 1996; a simple random sample of 280 patients (n = 400 teeth) was selected. Dental charts, radiographs, and computerized databases were examined to ascertain variables of interest and to verify study inclusion criteria. Kaplan-Meier survival estimates were generated for the 203 teeth that satisfied study inclusion criteria. Multivariate Cox proportional hazards regression models were developed, with standard errors adjusted to account for clustering of teeth within patients. Results. When tooth type and radiographic evidence of caries at access were controlled, the final Cox model showed that endodontically treated teeth not crowned after obturation were lost at a 6.0 times greater rate than teeth crowned after obturation (95% confidence interval: 3.2 to 11.3). Conclusion. Within the limitations of this study, a strong association between crown placement and the survival of endodontically treated teeth was observed. These results may impact treatment planning if long-term tooth retention is the primary goal. (J Prosthet Dent 2002;87:256-63.)

http://www.endoexperience.com/documents/SurvivalofEndodonticTxTeethWithoutCrowns.pdf

Relationship between crown placement and the survival of endodontically treated teeth

This literature review summarizes the most recent and reliable evidence on post systems. A search was limited to review articles published over the last 10 years in dental journals with an impact factor. Papers cited in the initially retrieved review articles were also included if significant. Preservation of tooth tissue, presence of a ferrule effect, and adhesion are regarded as the most effective conditions for long-term success of post-endodontic restorations. Adhesively luted fibre-reinforced composite post restorations have demonstrated satisfactory survival rates over relatively long follow-up periods. The clinical effectiveness of such restorations has been mainly ascribed to the more biomimetic behaviour of fibre-reinforced composite posts that reduces the risk of vertical root fractures. The most common type of failure when using fibre posts is post debonding and it is generally agreed that achieving stable adhesion to intraradicular dentine is more challenging than to coronal dentine. Several factors related to endodontic treatment, root canal shape, post space preparation, post translucency, adhesive cement handling and curing may have an influence on the outcome of the luting procedure. The most reliable results in fibre post cementation are obtained by etch-and-rinse adhesives in combination with dual-cure resin cements. The use of self-adhesive resin cements has also been proposed. Simplification is an obvious advantage of these new materials. However, the durability of their bond still needs to be verified with long-term clinical studies. Several techniques for pre-treating the fibre-reinforced composite post surface have been tested with the aim of improving the bond strength at the post-core and post-cement interfaces. Silicoating followed by silanization currently appears to be the most effective and convenient method for this purpose. In conclusion, the available evidence validates the use of fibre posts as an alternative to metal posts and preferably to other tooth-coloured posts, such as zirconia dowels, in the restoration of endodontically treated teeth. Longer term clinical trials are expected to further strengthen this evidence.

https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1834-7819.2010.01298.x

Current perspectives on post systems: a literature review

The restoration of endodontically treated teeth has been the focus of considerable controversy and empiricism. Time-tested methods have been highly successful in some respects, but failures are still apparent. The inherent causes of failure are rarely evaluated and the limitations of specific restorative systems are seldom identified. Regardless of the system, there should be a thorough understanding of the anatomy and biology of the dentin and root supporting the restoration on the part of the practitioner, because both endodontic and restorative procedures alter the hard tissues.

The dentin-root complex: anatomic and biologic considerations in restoring endodontically treated teeth.

Much confusion exists in the dental community regarding the restoration of endodontically treated teeth; few review articles present succinct guidelines for the restoration of these teeth. This article reviews the literature and presents guidelines for restoration of endodontically treated teeth.

Guidelines for the Restoration of Endodontically Treated Teeth

The restoration of endodontically treated teeth is a topic that is extensively studied and yet remains controversial from many perspectives. This article reviews the major pertinent literature on this topic, with an emphasis on major decision-making elements in post placement and restoration of endodontically treated teeth. Recommendations are made for treatment planning, materials, and clinical practices from restorative and endodontic perspectives. There are few subjects in dentistry that have been studied more than the restoration of endodontically treated teeth. Yet, many practical questions and controversies remain in this clinically important element of the treatment plan. Unfortunately, the diversity of published opinions is confusing and may lead to less than optimal treatment selections. Fortunately, there are a number of areas in which the preponderance of research supports specific clinical procedures. The purpose of this review is to organize this topic into its component parts and provide evidence-based principles that are sound from a restorative as well as an endodontic perspective. The article focuses primarily on recent publications, although some of the classic literature also is discussed. With one exception, all the references cited are full-text articles from refereed journals.

http://endoexperience.com/filecabinet/endo related restorative dentistry/post and cores/scwartz post review article.pdf

REVIEW ARTICLE Post Placement and Restoration of Endodontically Treated Teeth: A Literature Review

Tensile bond strength of dental adhesives to dentin and enamel.

Background The authors compared the clinical performance of complex amalgam restorations, replacing at least one cusp—retained either mechanically with self-threading pins or bonded—with a filled, 4-methacryloxyethyl trimellitate anhydride, or 4-META, –based resin designed for amalgam bonding. Methods The authors placed 60 amalgam restorations (28 pin-retained and 32 bonded), each restoration replacing at least one cusp. They used self-threading stainless steel pins in the pin-retained group and a filled, 4-META–based bonding resin in the bonded group. For both groups, the authors left in place any retention form remaining after removal of an old restoration but did not enhance it. Results At four years, six restorations had failed. At five years, of the 40 restorations available for evaluation, three had failed, for a total of nine failed restorations; seven of those were pin-retained and two were bonded. Using the Fisher exact test to compare the groups at five years, the authors found no significant difference in failure rate, marginal adaptation, marginal discoloration, secondary caries, tooth sensitivity or tooth vitality. Conclusions At five years, there was no difference in the performance of pin-retained amalgam restorations and bonded amalgam restorations. This study will be continued for at least a sixth year. Clinical Implications Bonding with a filled, 4-META–based bonding resin appears to be a satisfactory method of retaining large amalgam restorations replacing cusps.

James W. Robbins

Papers

Post placement and restoration of endodontically treated teeth: a literature review.

Guidelines for the Restoration of Endodontically Treated Teeth

REVIEW ARTICLE Post Placement and Restoration of Endodontically Treated Teeth: A Literature Review

Tensile bond strength of dental adhesives to dentin and enamel.

The performance of bonded vs. pin-retained complex amalgam restorations: A five-year clinical evaluation