Survival of Fiber-Reinforced Composite Resin Post-Restored vs. Cast Post-and-Core-Restored Teeth: A Retrospective Clinical Study

Objective: The question of whether classic cast post-and-core (CPC) or fiber-reinforced composite resin posts (FRCP) are the best clinical decision has still not been fully solved. Materials and Methods: One hundred and sixty-two teeth were restored with FRCP, and 162 CPC restored teeth were included in this study with a matched-pair design. In a primary analysis, the survival rates after one year (primary endpoint) were compared. The additional analysis included an evaluation of tooth- and construction-specific variables and an illustration of the survival up to 60 months via Kaplan-Meier curves. Results: FRCP showed lower failure risk considering the definitive prosthetic restoration and tooth type compared to CPC restored teeth. In total, 17 failures were observed in the FRCP group and 35 failures in the CPC group. A 60-month survival rate of 79.3% for FRCP and 64.5% for CPC was observed. Teeth serving as abutments for telescopic dentures were more likely to be affected by failure compared to teeth restored with single crowns. Conclusion: Within the limitations of this study, the FRCP showed a lower failure risk compared to the CPC, considering the definitive prosthetic restoration and tooth type within the observation period.

Use of fiberglass CAD-CAM post-and-core for rapid orthodontic extrusion of anterior tooth – Case Report

This report describes the restoration of an anterior fractured tooth with a fiberglass CAD-CAM post-and-core followed by rapid orthodontic extrusion. The post space was prepared, the post-and-core was luted and a interim crown was luted to allow the tooth extrusion through the use of orthodontic buttons and elastic rubber bands. A lithium disilicate glass-ceramic crown was luted and the case was followed up after 6 and 12 months.

A Novel Method for Managing Flared Root Canal with Anatomic Post and Core: A Case Report

The compromised tooth structure after endodontic treatment necessitates the use of post and core for structural durability. Management of the flared root canal is still a tough obstacle for the clinicians. Reinforcing the root canal space with the customised anatomic post thus regains the lost structure within the canal and aids in establishing a great strength and stability to the tooth structure. The report of this case scenario aims on clinical technique of fabricating anatomic post with glass - fibre posts and composite resin on a central and lateral incisor.

Management of a fractured endodontically treated tooth with crown lengthening and glass fibre post: A case report

Purpose: This clinical case discusses the step-by-step implementation of a core and a post system that uses a single resin composite material for cementation of a glass fibre post and core build up of a fracture endodontically treated maxillary left first premolar with gingivectomy as a crown lengthening procedure. Clinical considerations: Several materials and methods has been discussed in the literatures regarding restoration of endodontically treated teeth with minimal tooth structure left which require fibre post and core build up. Gingivectomy as a crown lengthening is also a common procedure that facilitates restorative dentistry. This case presents a restoration of a tooth with a short clinical crown by gingivectomy and post core build up by glass fibre post with a mono-block technique or core-and-post technique with dual cure composite resin as a luting and core build up material. Conclusion:Post and core is needed to restored tooth with little tooth structure remaining.Glass fibre post are prefabricated posts which makes it easy to manipulate and reduces chairs side time among other advantages. Use of single material system for post-and-core reduces the steps of manipulation and chair side time compared to conventional techniques. Clinical significance: More measures are required when different materials are used for post-cementation and core build-up, increasing the chair time and the number of interfaces between the materials. However, these shortcomings can be overcome by the mono-block technique where only one material is used for both cementation and core build up. Update Dent. Coll. j: 2021; 11(2): 38-42

CAD/CAM Milled Glass Fiber Posts: Adaptation and Mechanical Behavior in Flared Root Canals

SUMMARY This study aimed to evaluate the cementation and mechanical behavior of flared root canals restored with CAD/CAM milled glass fiber post-and-core systems. Sixty-six endodontically treated human canines with a flared root canal were divided into three different groups according to the type of post: GPF received prefabricated posts; GREL received relined glass fiber posts, and GMILLED received CAD/CAM milled glass fiber posts. Cementation was performed with self-adhesive resin cement. The samples were submitted to x-ray microcomputed tomography analysis for the analysis of voids and gaps. The roots were sectioned and submitted to the push-out bond strength test. The load-to-fracture was evaluated in post-and-core systems. GMILLED presented lower void and lower gap volumes when compared to GPF and GREL. On the load-to-fracture test, GREL presented statistically significant higher values than GMILLED. GPF values had no statistically significant difference from the two other groups. On the push-out bond strength test, GPF presented statistically significant lower values when compared to GREL and GMILLED. The most common failure pattern was between dentin and cement in all groups. CAD/CAM milled glass fiber post-and-core systems presented an enhanced adaptation of glass fiber posts to flared root canal systems. Their results were comparable to relined posts in bond strength, while load-to-fracture-results for GMILLED were lower than those for GPF.

Alternative conservative approach for tooth build-up in patients with special healthcare needs

Purpose: The success of an artificial crown mainly depends on the biomechanical factors such as bonding capacity of cement between the crown and abutment tooth, and root strength of the abutment tooth. In this case series, we aim to provide insight on the potential use of the cast metal post and cost for patients with intellectual disabilities and severely compromised tooth structure. Material and methods: The first patient was a 41-year old male with the chief complaint of a dislodged porcelain fused metal (PFM) crown of tooth #20 (mandibular left second bicuspid). The patient was informed about the advantages, disadvantages, and risks of each option. After further consideration and discussion with the parents and the patient, we decided to rebuild the coronal tooth structure with the cast metal post and core and prosthetic restoration with the same crown. Patient satisfaction was measured on the visual analog scale as 10/10. The second case involves a 26-year old female, who presented with a chief complaint of chronic lingering pain on tooth #9. The tooth structure was extensively damaged and un-supportive of the ferrule, therefore, it was decided to build a metal post and core instead of a fiber post. The prosthetic restoration was made with a monolithic zirconia crown and the patient was followed up twice in 6 months and graded the satisfaction as 10/10 on a visual analog scale. Results: The most common type of posts used in dentistry has been cast post and cores in the last decade which generally includes an additional laboratory stage where a custom post is prepared according to the impression taken from the prepared post space. Conclusions: Both the presented cases explain an interesting advantage of restoring a root canal treated tooth with a metal post and core system which implies that in a prefabricated post and core restored tooth failure, a metal post, and core can potentially be the treatment of choice instead of extracting the tooth. Keywords: post and core; special needs; cast metal post.

Alternative Conservative Approach for Tooth Build-Up in Patients with Special Healthcare Needs

Purpose: The success of an artificial crown mainly depends on the biomechanical factors such as bonding capacity of cement between the crown and abutment tooth, and root strength of the abutment tooth. In this case series, we aim to provide insight on the potential use of the cast metal post and cost for patients with intellectual disabilities and severely compromised tooth structure. Material and Methods: The first patient was a 41-year old male with the chief complaint of a dislodged porcelain fused metal (PFM) crown of tooth #20 (mandibular left second bicuspid). The patient was informed about the advantages, disadvantages, and risks of each option. After further consideration and discussion with the parents and the patient, we decided to rebuild the coronal tooth structure with the cast metal post and core and prosthetic restoration with the same crown. Patient satisfaction was measured on the visual analog scale as 10/10. The second case involves a 26-year old female, who presented with a chief complaint of chronic lingering pain on tooth #9. The tooth structure was extensively damaged and un-supportive of the ferrule, therefore, it was decided to build a metal post and core instead of a fiber post. The prosthetic restoration was made with a monolithic zirconia crown and the patient was followed up twice in 6 months and graded the satisfaction as 10/10 on a visual analog scale. Results: The most common type of posts used in dentistry has been cast post and cores in the last decade which generally includes an additional laboratory stage where a custom post is prepared according to the impression taken from the prepared post space. Conclusions: Both the presented cases explain an interesting advantage of restoring a root canal treated tooth with a metal post and core system which implies that in a prefabricated post and core restored tooth failure, a metal post, and core can potentially be the treatment of choice instead of extracting the tooth.

Aesthetic Rehabilitation of Anterior Incisor: Post and core treatment –A Case Report

This case report describes the post and core treatment of a maxillary central incisor. An 18-year-old female patient reported to the Department of Conservative Dentistry and Endodontics with the chief complaint of pain in upper front tooth region. On clinical examination, there was Ellis class III fracture resulting in loss of significant tooth structure necessitating post and core treatment. Treatment was initiated with removal of carious region, canal was located, working length was established followed by chemo mechanical preparation and obturation. Post space preparation was done in the canal followed by post cementation and core build up. Keywords: Post, core, ceramic, crown lengthening.