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Direct restoration of endodontically treated maxillary central incisors: post or no post at all?

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Abstract

Objectives

The aim of this ex-vivo study was to evaluate the impact of cavity size and glass-fiber post (GFP) placement on the load capability of endodontically treated maxillary incisors directly restored with resin composite.

Materials and methods

Ninety-six extracted human maxillary central incisors were endodontically treated and distributed to four groups (n = 24): access cavity (A), access cavity and uni-proximal class III cavity (U), access cavity and bi-proximal class III cavity (B), and decoronated tooth (D). Specimens were restored with resin composite, and 12 specimen of each group received an adhesively placed glass-fiber post (P). Prior to linear loading, specimens were exposed to thermo-mechanical loading (TCML). Statistical analysis was performed using log-rank test after TCML, Kruskall-Wallis and Mann-Whitney U test to compare load capabilities (Fmax).

Results

Significantly more failures occurred in group D for specimens without GFP during TCML (p = 0.001). Fmax (mean (SD) in N was (A) 513 (124), (AP) 554 (201), (U) 438 (171), (UP) 537 (232) (B) 483 (219), (BP) 536 (281), D 143 (181), and DP 500 (331), and differed significantly among groups (p = 0.003). Pair-wise comparison revealed lower Fmax values for group D compared to all other groups (p < 0.034) except group DP.

Conclusions

Endodontically treated maxillary central incisors with cavity sizes up to bi-proximal class III may be successfully directly restored with resin composite. Post placement shows no additional effect except for decoronated endodontically treated incisors.

Clinical relevance

Endodontically treated incisors with access cavities to class III cavities can be successfully restored with resin composite. Post placement for decoronated ETT is recommended.

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References

  1. Bolla M, Muller-Bolla M, Borg C, Lupi-Pegurier L, Laplanche O, Leforestier E (2016) WITHDRAWN: root canal posts for the restoration of root filled teeth. Cochrane Database Syst Rev 11:CD004623. https://doi.org/10.1002/14651858.CD004623.pub3

    Article  PubMed  Google Scholar 

  2. Sequeira-Byron P, Fedorowicz Z, Carter B, Nasser M, Alrowaili EF (2015) Single crowns versus conventional fillings for the restoration of root-filled teeth. Cochrane Database Syst Rev 9. CD009109, https://doi.org/10.1002/14651858.CD009109.pub3

  3. Dietschi D, Duc O, Krejci I, Sadan A (2008) 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). Quintessence Int 39(2):117–129

    PubMed  Google Scholar 

  4. Fokkinga WA, Kreulen CM, Bronkhorst EM, Creugers NH (2007) Up to 17-year controlled clinical study on post-and-cores and covering crowns. J Dent 35(10):778–786. https://doi.org/10.1016/j.jdent.2007.07.006

    Article  PubMed  Google Scholar 

  5. Mangold JT, Kern M (2011) Influence of glass-fiber posts on the fracture resistance and failure pattern of endodontically treated premolars with varying substance loss: an in vitro study. J Prosthet Dent 105(6):387–393. https://doi.org/10.1016/S0022-3913(11)60080-2

    Article  PubMed  Google Scholar 

  6. Koelpin M, Sterzenbach G, Naumann M (2014) Composite filling or single crown? The clinical dilemma of how to restore endodontically treated teeth. Quintessence Int 45(6):457–466. https://doi.org/10.3290/j.qi.a31802

    Article  Google Scholar 

  7. Torbjorner A, Karlsson S, Odman PA (1995) Survival rate and failure characteristics for two post designs. J Prosthet Dent 73(5):439–444

    Article  PubMed  Google Scholar 

  8. Naumann M, Koelpin M, Beuer F, Meyer-Lueckel H (2012) 10-year survival evaluation for glass-fiber-supported postendodontic restoration: a prospective observational clinical study. J Endod 38(4):432–435. https://doi.org/10.1016/j.joen.2012.01.003

    Article  PubMed  Google Scholar 

  9. Magne P, Tan DT (2008) Incisor compliance following operative procedures: a rapid 3-D finite element analysis using micro-CT data. J Adhes Dent 10(1):49–56

    PubMed  Google Scholar 

  10. D’Arcangelo C, De Angelis F, Vadini M, D'Amario M, Caputi S (2010) Fracture resistance and deflection of pulpless anterior teeth restored with composite or porcelain veneers. J Endod 36(1):153–156. https://doi.org/10.1016/j.joen.2009.09.036

    Article  PubMed  Google Scholar 

  11. D'Arcangelo C, De Angelis F, Vadini M, Zazzeroni S, Ciampoli C, D'Amario M (2008) In vitro fracture resistance and deflection of pulpless teeth restored with fiber posts and prepared for veneers. J Endod 34(7):838–841. https://doi.org/10.1016/j.joen.2008.03.026

    Article  PubMed  Google Scholar 

  12. Heydecke G, Butz F, Strub JR (2001) Fracture strength and survival rate of endodontically treated maxillary incisors with approximal cavities after restoration with different post and core systems: an in-vitro study. J Dent 29(6):427–433

    Article  PubMed  Google Scholar 

  13. Vadini M, De Angelis F, D’Amario M, Marzo G, Baldi M, D’Arcangelo C (2012) Conservative restorations of endodontically compromised anterior teeth in paediatric patients: physical and mechanical considerations. Eur J Paediatr Dent 13(3 Suppl):263–267

    PubMed  Google Scholar 

  14. Abduljawad M, Samran A, Kadour J, Karzoun W, Kern M (2016) Effect of fiber posts on the fracture resistance of maxillary central incisors with class III restorations: an in vitro study. J Prosthet Dent. https://doi.org/10.1016/j.prosdent.2016.09.013

  15. Abduljawad M, Samran A, Kadour J, Al-Afandi M, Ghazal M, Kern M (2016) Effect of fiber posts on the fracture resistance of endodontically treated anterior teeth with cervical cavities: an in vitro study. J Prosthet Dent 116(1):80–84. https://doi.org/10.1016/j.prosdent.2015.12.011

    Article  PubMed  Google Scholar 

  16. Bijelic J, Garoushi S, Vallittu PK, Lassila LV (2013) Short fiber reinforced composite in restoring severely damaged incisors. Acta Odontol Scand 71(5):1221–1231. https://doi.org/10.3109/00016357.2012.757640

    Article  PubMed  Google Scholar 

  17. Naumann M, Preuss A, Frankenberger R (2006) Load capability of excessively flared teeth restored with fiber-reinforced composite posts and all-ceramic crowns. Oper Dent 31(6):699–704. https://doi.org/10.2341/05-142

    Article  PubMed  Google Scholar 

  18. Ramirez-Sebastia A, Bortolotto T, Cattani-Lorente M, Giner L, Roig M, Krejci I (2014) Adhesive restoration of anterior endodontically treated teeth: influence of post length on fracture strength. Clin Oral Investig 18(2):545–554. https://doi.org/10.1007/s00784-013-0978-3

    Article  PubMed  Google Scholar 

  19. Valdivia AD, Raposo LH, Simamoto-Junior PC, Novais VR, Soares CJ (2012) The effect of fiber post presence and restorative technique on the biomechanical behavior of endodontically treated maxillary incisors: an in vitro study. J Prosthet Dent 108(3):147–157. https://doi.org/10.1016/S0022-3913(12)60138-3

    Article  PubMed  Google Scholar 

  20. Naumann M, Sterzenbach G, Rosentritt M, Beuer F, Frankenberger R (2008) Is adhesive cementation of endodontic posts necessary? J Endod 34(8):1006–1010. https://doi.org/10.1016/j.joen.2008.05.010

    Article  PubMed  Google Scholar 

  21. Iqbal MK, Johansson AA, Akeel RF, Bergenholtz A, Omar R (2003) A retrospective analysis of factors associated with the periapical status of restored, endodontically treated teeth. Int J Prosthodont 16(1):31–38

    PubMed  Google Scholar 

  22. Schwartz RS, Robbins JW (2004) Post placement and restoration of endodontically treated teeth: a literature review. J Endod 30(5):289–301. https://doi.org/10.1097/00004770-200405000-00001

    Article  PubMed  Google Scholar 

  23. Naumann M, Neuhaus KW, Kolpin M, Seemann R (2016) Why, when, and how general practitioners restore endodontically treated teeth: a representative survey in Germany. Clin Oral Investig 20(2):253–259. https://doi.org/10.1007/s00784-015-1505-5

    Article  PubMed  Google Scholar 

  24. Ferrari M, Vichi A, Fadda GM, Cagidiaco MC, Tay FR, Breschi L, Polimeni A, Goracci C (2012) A randomized controlled trial of endodontically treated and restored premolars. J Dent Res 91(7 Suppl):72S–78S. https://doi.org/10.1177/0022034512447949

    Article  PubMed  Google Scholar 

  25. Sterzenbach G, Franke A, Naumann M (2012) 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 38(12):1557–1563. https://doi.org/10.1016/j.joen.2012.08.015

    Article  PubMed  Google Scholar 

  26. Zicari F, Coutinho E, Scotti R, Van Meerbeek B, Naert I (2013) Mechanical properties and micro-morphology of fiber posts. Dent Mater 29(4):e45–e52. https://doi.org/10.1016/j.dental.2012.11.001

    Article  PubMed  Google Scholar 

  27. Tay FR, Pashley DH (2007) Monoblocks in root canals: a hypothetical or a tangible goal. J Endod 33(4):391–398. https://doi.org/10.1016/j.joen.2006.10.009

    Article  PubMed  PubMed Central  Google Scholar 

  28. Ferrari M, Cagidiaco MC, Grandini S, De Sanctis M, Goracci C (2007) Post placement affects survival of endodontically treated premolars. J Dent Res 86(8):729–734

    Article  PubMed  Google Scholar 

  29. Scotti N, Eruli C, Comba A, Paolino DS, Alovisi M, Pasqualini D, Berutti E (2015) Longevity of class 2 direct restorations in root-filled teeth: a retrospective clinical study. J Dent 43(5):499–505. https://doi.org/10.1016/j.jdent.2015.02.006

    Article  PubMed  Google Scholar 

  30. Sterzenbach G, Kalberlah S, Beuer F, Frankenberger R, Naumann M (2011) In-vitro simulation of tooth mobility for static and dynamic load tests: a pilot study. Acta Odontol Scand 69(5):316–318. https://doi.org/10.3109/00016357.2011.563244

    Article  PubMed  Google Scholar 

  31. Roulet JF, Van Meerbeek B (2007) Editorial: statistics: a nuisance, a tool, or a must? J Adhes Dent 9(3):287–288

    Google Scholar 

  32. Torbjorner A, Fransson B (2004) Biomechanical aspects of prosthetic treatment of structurally compromised teeth. Int J Prosthodont 17(2):135–141

    PubMed  Google Scholar 

  33. Naumann M, Blankenstein F, Kiessling S, Dietrich T (2005) Risk factors for failure of glass fiber-reinforced composite post restorations: a prospective observational clinical study. Eur J Oral Sci 113(6):519–524. https://doi.org/10.1111/j.1600-0722.2005.00257.x

    Article  PubMed  Google Scholar 

  34. Mancebo JC, Jimenez-Castellanos E, Canadas D (2010) Effect of tooth type and ferrule on the survival of pulpless teeth restored with fiber posts: a 3-year clinical study. Am J Dent 23(6):351–356

    PubMed  Google Scholar 

  35. Schmitter M, Hamadi K, Rammelsberg P (2011) Survival of two post systems—five-year results of a randomized clinical trial. Quintessence Int 42(10):843–850

    PubMed  Google Scholar 

  36. DeLong R, Douglas WH (1983) Development of an artificial oral environment for the testing of dental restoratives: bi-axial force and movement control. J Dent Res 62(1):32–36. https://doi.org/10.1177/00220345830620010801

    Article  PubMed  Google Scholar 

  37. Naumann M, Preuss A, Rosentritt M (2006) Effect of incomplete crown ferrules on load capacity of endodontically treated maxillary incisors restored with fiber posts, composite build-ups, and all-ceramic crowns: an in vitro evaluation after chewing simulation. Acta Odontol Scand 64(1):31–36. https://doi.org/10.1080/00016350500331120

    Article  PubMed  Google Scholar 

  38. Naumann M (2007) Rekonstruktion endodontisch behandelter Zähne - glasfaserverstärkte Aufbaustifte in vivo und in vitro. Med. Habilitationsschrift. Medizinische Fakultät Charité-Universitätsmedizin Berlin, Berlin

  39. Sterzenbach G, Rosentritt M, Frankenberger R, Paris S, Naumann M (2012) Loading standardization of postendodontic restorations in vitro: impact of restorative stage, static loading, and dynamic loading. Oper Dent 37(1):71–79. https://doi.org/10.2341/10-355-L

    Article  PubMed  Google Scholar 

  40. Rosentritt M, Behr M, van der Zel JM, Feilzer AJ (2009) Approach for valuating the influence of laboratory simulation. Dent Mater 25(3):348–352. https://doi.org/10.1016/j.dental.2008.08.009

    Article  PubMed  Google Scholar 

  41. Chun YH, Raffelt C, Pfeiffer H, Bizhang M, Saul G, Blunck U, Roulet JF (2010) Restoring strength of incisors with veneers and full ceramic crowns. J Adhes Dent 12(1):45–54. https://doi.org/10.3290/j.jad.a17533

    Article  PubMed  Google Scholar 

  42. Naumann M, Sterzenbach G, Proschel P (2005) Evaluation of load testing of postendodontic restorations in vitro: linear compressive loading, gradual cycling loading and chewing simulation. J Biomed Mater Res B Appl Biomater 74(2):829–834. https://doi.org/10.1002/jbm.b.30321

    Article  PubMed  Google Scholar 

  43. Peroz I, Blankenstein F, Lange KP, Naumann M (2005) Restoring endodontically treated teeth with posts and cores--a review. Quintessence Int 36(9):737–746

    PubMed  Google Scholar 

  44. Preuss A, Rosentritt M, Frankenberger R, Beuer F, Naumann M (2008) Influence of type of luting cement used with all-ceramic crowns on load capability of post-restored endodontically treated maxillary central incisors. Clin Oral Investig 12(2):151–156. https://doi.org/10.1007/s00784-007-0164-6

    Article  PubMed  Google Scholar 

  45. Helkimo E, Carlsson GE, Helkimo M (1977) Bite force and state of dentition. Acta Odontol Scand 35(6):297–303

    Article  PubMed  Google Scholar 

  46. Juloski J, Radovic I, Goracci C, Vulicevic ZR, Ferrari M (2012) Ferrule effect: a literature review. J Endod 38(1):11–19. https://doi.org/10.1016/j.joen.2011.09.024

    Article  PubMed  Google Scholar 

  47. Creugers NH, Mentink AG, Fokkinga WA, Kreulen CM (2005) 5-year follow-up of a prospective clinical study on various types of core restorations. Int J Prosthodont 18(1):34–39

    PubMed  Google Scholar 

  48. Kishen A (2015) Biomechanics of fractures in endodontically treated teeth. Endod Top 33(1):3–13. https://doi.org/10.1111/etp.12089

    Article  Google Scholar 

  49. Heintze SD, Rousson V, Hickel R (2015) Clinical effectiveness of direct anterior restorations—a meta-analysis. Dent Mater 31(5):481–495. https://doi.org/10.1016/j.dental.2015.01.015

    Article  PubMed  Google Scholar 

  50. Vaderhobli RM (2011) Advances in dental materials. Dent Clin N Am 55(3):619–625, x. https://doi.org/10.1016/j.cden.2011.02.015

    Article  PubMed  Google Scholar 

  51. Kishen A, Asundi A (2002) Photomechanical investigations on post endodontically rehabilitated teeth. J Biomed Opt 7(2):262–270. https://doi.org/10.1117/1.1463046

    Article  PubMed  Google Scholar 

  52. Coelho CS, Biffi JC, Silva GR, Abrahao A, Campos RE, Soares CJ (2009) Finite element analysis of weakened roots restored with composite resin and posts. Dent Mater J 28(6):671–678

    Article  PubMed  Google Scholar 

  53. Salameh Z, Sorrentino R, Ounsi HF, Sadig W, Atiyeh F, Ferrari M (2008) The effect of different full-coverage crown systems on fracture resistance and failure pattern of endodontically treated maxillary incisors restored with and without glass fiber posts. J Endod 34(7):842–846. https://doi.org/10.1016/j.joen.2008.03.025

    Article  PubMed  Google Scholar 

  54. Barfeie A, Thomas MB, Watts A, Rees J (2015) Failure mechanisms of fibre posts: a literature review. Eur J Prosthodont Restor Dent 23(3):P115–P127

    PubMed  Google Scholar 

  55. Naumann M, Sterzenbach G, Dietrich T, Bitter K, Frankenberger R, von Stein-Lausnitz M (2017) Dentin-like versus rigid endodontic post: 11-year randomized controlled pilot trial on no-wall to 2-wall defects. J Endod 43(11):1770–1775. https://doi.org/10.1016/j.joen.2017.06.030

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors thank Dr. René Tunjan a lot for his very kind introduction into the embedding procedure.

Funding

The study is funded in part by the German Society of Prosthodontics and Biomaterials (DGPro e.V., Hannover, Germany) and Dentsply DeTrey, Konstanz, Germany.

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Authors and Affiliations

  1. Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197, Berlin, Germany

    Manja von Stein-Lausnitz, M. Bruhnke, G. Sterzenbach & M. Naumann

  2. Department of Prosthetic Dentistry, Regensburg University Medical Center, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany

    M. Rosentritt

  3. Department of Operative and Preventive Dentistry, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197, Berlin, Germany

    K. Bitter

  4. Department of Operative Dentistry and Endodontics, University of Marburg, Georg-Voigt-Str. 3, 35039, Marburg, Germany

    R. Frankenberger

Authors
  1. Manja von Stein-Lausnitz
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  2. M. Bruhnke
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  3. M. Rosentritt
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  4. G. Sterzenbach
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  5. K. Bitter
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  6. R. Frankenberger
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  7. M. Naumann
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Correspondence to Manja von Stein-Lausnitz.

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von Stein-Lausnitz, M., Bruhnke, M., Rosentritt, M. et al. Direct restoration of endodontically treated maxillary central incisors: post or no post at all?. Clin Oral Invest 23, 381–389 (2019). https://doi.org/10.1007/s00784-018-2446-6

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  • DOI: https://doi.org/10.1007/s00784-018-2446-6

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