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.

Statement of Problem. Very little is known about the resistance to fracture of endodontically treated teeth restored with newly developed esthetic post systems. Purpose. This in vitro study compared the effect of 1 titanium and 3 esthetic post systems on the fracture resistance and fracture patterns of crowned, endodontically treated teeth. Material and Methods. A total of 40 recently extracted human maxillary canines with their crowns removed were endodontically treated. Four groups of 10 specimens were formed. Teeth were restored with titanium, quartz fiber, glass fiber, and zirconia posts and numbered as groups 1, 2, 3, and 4, respectively. All posts were cemented with Single Bond dental adhesive system and dual-polymerizing RelyX ARC adhesive resin cement. All teeth were restored with composite cores, and metal crowns were fabricated and cemented with glass ionomer cement. Each specimen was embedded in acrylic resin and then secured in a universal load-testing machine. A compressive load was applied at a 130-degree angle to the long axis of the tooth until fracture, at a crosshead speed of 1 mm/min. One-way analysis of variance and a Tukey test were used to determine the significance of the failure loads between groups ( P 2 test was conducted for evaluation of the mode of failure ( P Results. The mean failure loads (kg) were 66.95, 91.20, 75.90, and 78.91 for groups 1 to 4, respectively. Teeth restored with quartz fiber posts (group 2) exhibited significantly higher resistance to fracture ( P P >.05). Fractures that would allow repair of the tooth were observed in groups 2 and 3, whereas unrestorable, catastropic fractures were observed in groups 1 and 4 ( P Conclusion. Within the limitations of this study, significantly higher failure loads were recorded for root canal treated teeth restored with quartz fiber posts. Fractures that would allow repeated repair were observed in teeth restored with quartz fiber and glass fiber posts. J Prosthet Dent 2002; 87:431-7.

Resistance to fracture of endodontically treated teeth restored with different post systems.

Finite element analysis of a glass fibre reinforced composite endodontic post

http://www.fibrebond.biz/pdfs/mechanicalpropertiesofposts.pdf

Flexural properties of fiber reinforced root canal posts.

OBJECTIVE: The restoration of endodontically treated teeth has long been guided by empirical rather than biomechanical concepts. Part I of this literature review presented up-to-date knowledge about changes in tissue structure and properties following endodontic therapy, as well as the behavior of restored teeth in monotonic mechanical tests or finite element analysis. The aim of the second part is to review current knowledge about the various interfaces of restored, nonvital teeth and their behavior in fatigue and clinical studies. REVIEW METHOD: The basic search process included a systematic review of articles contained in the PubMed/Medline database, dating between 1990 and 2005, using single or combined key words to obtain the most comprehensive list of references; a perusal of the references of the references completed the review. RELEVANT INFORMATION AND CONCLUSIONS: Nonvital teeth restored with composite resin or composite resin combined with fiber posts resisted fatigue tests and currently represent the best treatment option. In comparison to rigid metal and/or ceramic posts, when composite resin or composite resin/fiber posts fail, the occurrence of interfacial defects or severe tooth breakdown is less likely. Adhesion into the root, however, remains a challenge because of the unfavorable ovoid canal configuration, as well as critical dentin microstructure in the deepest parts of the canal. Thus, specific combinations of adhesives and cements are recommended. The clinical performance of post-and-core restorations proved satisfactory overall, in particular with a contemporary restorative approach using composite resin and fiber posts. However, the clinical literature does not clearly isolate or identify exact parameters critical to success. This, in turn, emphasizes the importance and relevance of in vitro studies to further improve the quality and long-term stability of prosthetic foundations.

Biomechanical considerations for the restoration of endodontically treated teeth: a systematic review of the literature, Part II (Evaluation of fatigue behavior, interfaces, and in vivo studies).

Statement of problem. The Composipost dowel is made of stretched, aligned carbon fibers embedded in an epoxy-resin matrix. It is widely used in Europe and Canada for the restoration of endodontically treated teeth and was introduced in the United States 2 years ago as the C-Post dowel. Purpose. This retrospective study evaluated treatment outcome of the Composipost system after 2 to 3 years. Material and methods. A total of 236 patients treated during a 1-year period by seven Swedish dental practitioners were included. Of those, 146 patients consented and data were collected from the dental records of the remaining patients. Thus, the material comprised 236 teeth restored with carbon fiberreinforced epoxy resin post, 130 maxillary and 106 mandibular teeth, with a mean restoration time of 32 months (range 27 to 41). Periodontal conditions, radiographic signs, and prosthodontic results were recorded. Results. Five teeth (2%) had been extracted for reasons unrelated to the Composipost system. Periodontal conditions such as plaque accumulation, gingival health, bleeding on probing, and pocket depth around the teeth with Composipost dowels were similar to the control teeth. No dislodgment or root or post fractures were observed clinically or on radiographs. Radiographic examination of bone height measured from the apex to the bone margin mesially and distally showed differences on the mesial side but not on the distal surface ( p Conclusions. Promising results after 2 to 3 years of clinical service indicate that this system can be a viable alternative to conventional post-and-core systems. (J Prosthet Dent 1998;80:151-7.)

Madeleine Pamenius

Papers

A retrospective study of 236 patients with teeth restored by carbon fiber-reinforced epoxy resin posts

Optical methods for complete stress determination — An experimental alternative to finite-element analysis