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Performance of Post-retained Single Crowns: A Systematic Review of Related Risk Factors

      Highlights

      • Restoration of endodontically treated teeth should focus on the maintenance of coronal structure.
      • In general, posts with high values of elastic modulus present better performance.
      • Considering teeth with remaining coronal walls, both posts may be indicated.

      Abstract

      Introduction

      Numerous factors may influence the survival/success of post-retained restorations of endodontically treated teeth (ETT). The aim of this review was to assess the influence of the number of remaining coronal walls, the use or disuse of posts, and their type on the clinical performance of these restorations.

      Methods

      Randomized controlled trials and controlled clinical trials for ETT restored with a combination of post/crown or no post/crown were searched for in MEDLINE, Embase, and the Cochrane Library. Two authors independently reviewed all identified titles and abstracts for eligibility. Tables were generated to summarize the included studies, and reports of randomized trials were assessed for bias using the Cochrane risk of bias tool.

      Results

      Nine articles were identified as meeting the inclusion criteria. Teeth without ferrule presented the highest values of variation of success/survival (0%–97%), whereas teeth with remaining coronal walls (1, 2, 3, or 4 walls with ferrule) presented lower variation. The use of posts with a high elastic modulus success/survival ranged between 71.8% and 100%, whereas posts with a low elastic modulus ranged between 28.5% and 100%. The survival of crowns without posts varied between 0% and 100%. The poor performance of posts with a low elastic modulus and without posts was associated with the absence of ferrule and the preservation of only 1 coronal wall.

      Conclusions

      The restoration of ETT should focus on the maintenance of the coronal structure. Until more studies with longer follow-up periods are available, posts with a high elastic modulus appear to present with better performance when restoring ETT with no ferrule.

      Key Words

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      References

        • Baba N.Z.
        • Goodacre C.J.
        • Daher T.
        Restoration of endodontically treated teeth: the seven keys to success.
        Gen Dent. 2009; 57: 596-603
        • Soares C.J.
        • Valdivia A.D.
        • da Silva G.R.
        • et al.
        Longitudinal clinical evaluation of post systems: a literature review.
        Braz Dent J. 2012; 23: 135-740
        • Torbjorner A.
        • Fransson B.
        A literature review on the prosthetic treatment of structurally compromised teeth.
        Int J Prosthodont. 2004; 17: 369-376
        • Ferrari M.
        • Cagidiaco M.C.
        • Grandini S.
        • et al.
        Post placement affects survival of endodontically treated premolars.
        J Dent Res. 2007; 86: 729-734
        • Ferrari M.
        • Vichi A.
        • Fadda G.M.
        • et al.
        A randomized controlled trial of endodontically treated and restored premolars.
        J Dent Res. 2012; 91: 72S-78S
        • Fokkinga W.A.
        • Kreulen C.M.
        • Bronkhorst E.M.
        • et al.
        Up to 17-year controlled clinical study on post-and-cores and covering crowns.
        J Dent. 2007; 35: 778-786
        • Anusavice K.J.
        Standardizing failure, success, and survival decisions in clinical studies of ceramic and metal-ceramic fixed dental prostheses.
        Dent Mater. 2012; 28: 102-111
        • Higgins J.P.
        • Green S.
        Cochrane Handbook for Systematic Reviews of Interventions, version 5.1.0.
        The Cochrane Collaboration, London2011
        • Moher D.
        • Liberati A.
        • Tetzlaff J.
        • et al.
        Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.
        BMJ. 2009; 339: b2535
        • Sampson M.
        • McGowan J.
        • Cogo E.
        • et al.
        An evidence-based practice guideline for the peer review of electronic search strategies.
        J Clin Epidemiol. 2009; 62: 944-952
        • Balshem H.
        • Helfand M.
        • Schunemann H.J.
        • et al.
        GRADE guidelines: 3. Rating the quality of evidence.
        J Clin Epidemiol. 2011; 64: 401-406
        • Ellner S.
        • Bergendal T.
        • Bergman B.
        Four post-and-core combinations as abutments for fixed single crowns: a prospective up to 10-year study.
        Int J Prosthodont. 2003; 16: 249-254
        • Gbadebo O.S.
        • Ajayi D.M.
        • Oyekunle O.O.
        • et al.
        Randomized clinical study comparing metallic and glass fiber post in restoration of endodontically treated teeth.
        Indian J Dent Res. 2014; 25: 58-63
        • King P.A.
        • Setchell D.J.
        • Rees J.S.
        Clinical evaluation of a carbon fibre reinforced carbon endodontic post.
        J Oral Rehabil. 2003; 30: 785-789
        • Monticelli F.
        • Grandini S.
        • Goracci C.
        • et al.
        Clinical behavior of translucent-fiber posts: a 2-year prospective study.
        Int J Prosthodont. 2003; 16: 593-596
        • Sarkis-Onofre R.
        • Jacinto R.C.
        • Boscato N.
        • et al.
        Cast metal vs. glass fibre posts: a randomized controlled trial with up to 3 years of follow up.
        J Dent. 2014; 42: 582-587
        • Zicari F.
        • Van Meerbeek B.
        • Debels E.
        • et al.
        An up to 3-year controlled clinical trial comparing the outcome of glass fiber posts and composite cores with gold alloy-based posts and cores for the restoration of endodontically treated teeth.
        Int J Prosthodont. 2011; 24: 363-372
        • Bitter K.
        • Noetzel J.
        • Stamm O.
        • et al.
        Randomized clinical trial comparing the effects of post placement on failure rate of postendodontic restorations: preliminary results of a mean period of 32 months.
        J Endod. 2009; 35: 1477-1482
        • Fokkinga W.A.
        • Kreulen C.M.
        • Bronkhorst E.M.
        • et al.
        Composite resin core-crown reconstructions: an up to 17-year follow-up of a controlled clinical trial.
        Int J Prosthodont. 2008; 21: 109-115
        • Mancebo J.C.
        • Jimenez-Castellanos E.
        • Canadas D.
        Effect of tooth type and ferrule on the survival of pulpless teeth restored with fiber posts: a 3-year clinical study.
        Am J Dent. 2010; 23: 351-356
        • Mannocci F.
        • Bertelli E.
        • Sherriff M.
        • et al.
        Three-year clinical comparison of survival of endodontically treated teeth restored with either full cast coverage or with direct composite restoration.
        J Prosthet Dent. 2002; 88: 297-301
        • Mannocci F.
        • Bertelli E.
        • Watson T.F.
        • et al.
        Resin-dentin interfaces of endodontically-treated restored teeth.
        Am J Dent. 2003; 16: 28-32
        • Naumann M.
        • Sterzenbac G.
        • Alexandra F.
        • et al.
        Randomized controlled clinical pilot trial of titanium vs. glass fiber prefabricated posts: preliminary results after up to 3 years.
        Int J Prosthodont. 2007; 20: 499-503
        • Otto T.
        Computer-aided direct all-ceramic crowns: preliminary 1-year results of a prospective clinical study.
        Int J Periodontics Restorative Dent. 2004; 24: 446-455
        • Salvi G.E.
        • Siegrist Guldener B.E.
        • Amstad T.
        • et al.
        Clinical evaluation of root filled teeth restored with or without post-and-core systems in a specialist practice setting.
        Int Endod J. 2007; 40: 209-215
        • Schmitter M.
        • Hamadi K.
        • Rammelsberg P.
        Survival of two post systems–five-year results of a randomized clinical trial.
        Quintessence Int. 2011; 42: 843-850
        • Sterzenbach G.
        • Franke A.
        • Naumann M.
        Rigid versus flexible dentine-like endodontic posts–clinical testing of a biomechanical concept: seven-year results of a randomized controlled clinical pilot trial on endodontically treated abutment teeth with severe hard tissue loss.
        J Endod. 2012; 38: 1557-1563
        • Stober T.
        • Rammelsberg P.
        The failure rate of adhesively retained composite core build-ups in comparison with metal-added glass ionomer core build-ups.
        J Dent. 2005; 33: 27-32
        • Zhou X.W.
        • LX-Ya Z.J.
        A 2-year follow-up of endodontically treated teeth restored with either tapered or parallel-sided glass-fiber posts.
        Chin J Tissue Eng Res. 2013; 17: 21-64
        • Chang Z.M.
        Glass fiber post versus metal post in the restoration of endodontically treated teeth.
        Zhongguo Zuzhi Gongcheng Yanjiu. 2013; 17: 5309-5315
        • Sorensen J.A.
        • Engelman M.J.
        Ferrule design and fracture resistance of endodontically treated teeth.
        J Prosthet Dent. 1990; 63: 529-536
        • Skupien J.A.
        • Luz M.S.
        • Pereira-Cenci T.
        Ferrule effect: a meta-analysis.
        J Dent Res. 2016; 28: 258-264
        • Eraslan O.
        • Aykent F.
        • Yucel M.T.
        • et al.
        The finite element analysis of the effect of ferrule height on stress distribution at post-and-core-restored all-ceramic anterior crowns.
        Clin Oral Investig. 2009; 13: 223-227
        • Pierrisnard L.
        • Bohin F.
        • Renault P.
        • et al.
        Corono-radicular reconstruction of pulpless teeth: a mechanical study using finite element analysis.
        J Prosthet Dent. 2002; 88: 442-448
        • Figueiredo F.E.
        • Martins-Filho P.R.
        • Faria E.S.
        Do metal post-retained restorations result in more root fractures than fiber post-retained restorations? A systematic review and meta-analysis.
        J Endod. 2015; 41: 309-316