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Al-Dabbagh RA, Sindi MA, Sanari MA, Manna AI, Al-Dabbagh MA. Effect of a circumferential ferrule on the survival and success of endodontically treated teeth restored with fiber posts: A systematic review and meta-analysis. J Prosthet Dent 2024:S0022-3913(23)00809-0. [PMID: 38216376 DOI: 10.1016/j.prosdent.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/29/2023] [Accepted: 12/01/2023] [Indexed: 01/14/2024]
Abstract
STATEMENT OF PROBLEM The success of endodontically treated teeth (ETT) is influenced by factors that include the use of prefabricated glass fiber posts. A consideration for success is the presence of a circumferential ferrule, but systematic reviews and meta-analyses are lacking. PURPOSE The purpose of this systematic review and meta-analysis was to assess the impact of the presence or absence of a circumferential ferrule on the survival and success rates of ETT restored with prefabricated fiber posts. MATERIAL AND METHODS Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search of the major scientific literature databases was conducted. Eligible studies included randomized clinical trials and prospective cohort studies with a minimum 6-month follow-up, focusing on ETT restored with fiber posts either with or without a uniform circumferential ferrule. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated to compare outcomes. The degree of variability among studies was assessed using the chi-squared test (α=.05). RESULTS Of 3731 identified records, 8 were eligible for inclusion. Direct analysis of success rates (2 studies, 123 teeth) showed a significant increase in success when a uniform circumferential ferrule was present (RR=1.28, 95% CI: 1.06, 1.54, P<.05). However, indirect analysis of survival and success rates (8 studies, 407 teeth) indicated no significant differences in outcomes between the ferrule and no ferrule groups (P>.05). CONCLUSIONS The results of this systematic review and meta-analysis determined that a uniform circumferential ferrule had a positive effect on the success rates of ETT restored with prefabricated fiber posts. However, further high-quality studies are required to provide more robust evidence and to allow potential confounding factors to be considered.
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Affiliation(s)
- Raghad A Al-Dabbagh
- Associate Professor and Prosthodontics Consultant, Oral and Maxillofacial Rehabilitation Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Mohammed A Sindi
- Graduate student, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed A Sanari
- Graduate student, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Alaa I Manna
- Assistant Professor and Restorative Dentistry Consultant, Department of Restorative Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mona A Al-Dabbagh
- Pediatric Infectious Diseases and Transplant Infectious Diseases Consultant, King Abdulaziz Medical City, Jeddah, Saudi Arabia; and Clinical Assistant Professor in Pediatric Infectious Diseases, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
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Abdrabuh R, El Meligy O, Farsi N, Bakry AS, Felemban OM. Restoration Integrity in Primary Teeth Prepared Using Erbium/Yttrium-Aluminum-Garnet Laser: A Randomized Split-Mouth Clinical Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1215. [PMID: 37508712 PMCID: PMC10377907 DOI: 10.3390/children10071215] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/06/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023]
Abstract
The most frequently used and universally accepted technique for removing caries is mechanical ablation of decayed tissues by rotating drills. New minimally invasive strategies, such as the use of lasers to perform highly controlled tissue ablation, have been introduced in dental practice. The aim of this study was to assess and compare treatment with a 2940 nm erbium/yttrium-aluminum-garnet (Er:YAG) laser versus a conventional rotary treatment during cavity preparation in children with regard to restoration integrity. In a randomized, controlled, blinded trial using a split-mouth design, 40 (9-12-year-old) children with 80 carious primary molars were included. The cavity in one quadrant was randomized to be treated conventionally using a bur, while the cavity in the other quadrant was prepared using an Er:YAG laser. At the one-year follow-up, clinical examinations were conducted to assess the integrity of the restorations according to the Ryge criteria. The data were analyzed using SPSS version 22 (IBM Inc., Chicago, IL, USA). The average age of the participants was 9.4 ± 1.29 years. Males accounted for 51.4% of the participants. The Ryge criteria showed clinical success of restorations, and there was no discernible difference between the conventional and laser intervention techniques. Over one year, no statistically significant differences in the clinical integrity based on the Ryge criteria were found following class I cavity preparation in primary teeth with either procedure.
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Affiliation(s)
- Raghdah Abdrabuh
- Paediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Omar El Meligy
- Paediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Paediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria 21521, Egypt
| | - Najat Farsi
- Paediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Ahmed Samir Bakry
- Restorative Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria 21521, Egypt
| | - Osama M Felemban
- Paediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah 21589, Saudi Arabia
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Nagarkar S, Loguercio AD, Perdigão J. Evidence-based fact checking for selective procedures in restorative dentistry. Clin Oral Investig 2023; 27:475-488. [PMID: 36607490 DOI: 10.1007/s00784-022-04832-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 12/18/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Similar to other dental specialties, there are many clinical procedures in restorative dentistry that may or may not be supported by good evidence. Thus, the effectiveness of these procedures is uncertain. The aim of this paper is to reduce this knowledge gap by critically inspecting selective procedures in restorative dentistry and exploring if these well-established or widely advocated treatment modalities are necessary for improving treatment outcomes based on the best available evidence. MATERIALS AND METHODS A MEDLINE search was conducted to identify research on selective procedures while focusing on clinical trials and systematic reviews. Due to their practical relevance in the decision-making process, cost-effectiveness analyses were also included. RESULTS Mixed results were identified regarding the included interventions. Some procedures had adequate evidence supporting them while others were mostly based on beliefs. CONCLUSIONS A critical review of the available literature indicates that some common restorative procedures lack adequate support from high-quality research evidence. CLINICAL RELEVANCE This paper attempts to highlight the need to critically examine the scientific validity of traditional knowledge and techniques through the context of current research evidence. This will not only help generate consensus between educators, clinicians, and researchers regarding restorative procedures but will also lead to improved patient care and outcomes.
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Affiliation(s)
- Sanket Nagarkar
- Park Dental Group, Minneapolis, MN, USA.,Department of Restorative Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Alessandro D Loguercio
- School of Dentistry, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - Jorge Perdigão
- Division of Operative Dentistry, Department of Restorative Sciences, University of Minnesota, 515 SE Delaware St, 8-450 Moos Tower, Minneapolis, MN, 55455, USA.
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An Umbrella Review of Systematic Reviews and Meta-Analyses Evaluating the Success Rate of Prosthetic Restorations on Endodontically Treated Teeth. Int J Dent 2022; 2022:4748291. [PMID: 35242190 PMCID: PMC8888057 DOI: 10.1155/2022/4748291] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 01/20/2022] [Accepted: 02/03/2022] [Indexed: 01/08/2023] Open
Abstract
Materials and Methods The electronic search was conducted in the MEDLINE/PubMed, Cochrane, and Google Scholar databases until November 2020, regardless of language limitations. The inclusion criterion was as follows: S/M-R regarding prosthetic restorations in endodontically treated teeth. Three qualified researchers evaluated the inclusion criteria and bias risk. The fourth investigator was referred to when facing any doubtfulness. Results From 43 achieved S/M-R, 14 studies were selected for this inquiry. Primary extracted information included success rate, survival rate, and postendodontic failure rate. Five S/M-R had a moderate risk of bias, and nine S/M-R had a low risk of bias and were considered strong clinical evidence in this examination. According to the low-risk reports, the success rate of fiber posts was higher than that of metal posts; the rate of root fracture in metallic and fiber posts was alike; the failure rate for fiber posts was comparable to fixed partial dentures or single crowns; the construction of endocrowns was likely to perform better than intracanal posts, composite resin, or inlay/onlay restorations. Conclusion It appears that with practice and experience, deciding which type of restoration to choose changes. In dental restorations associated with root canal therapy, the single crowns are likely to be a proper option. Nevertheless, due to the heterogeneity of the studies, more clinical assessments are required to achieve more specific findings in this field.
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Higashi M, Mine A, Matsumoto M, Yumitate M, Hagino R, Ban S, Yamanaka A, Miura J, Minamino T, Van Meerbeek B, Yatani H. Do resin core build-ups obtain the benefits of higher bonding ability from direct or indirect technique? J Prosthodont Res 2021; 65:565-572. [PMID: 34053974 DOI: 10.2186/jpr.jpr_d_20_00275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE This study evaluated the effects of different materials (composite resin system including a photo-cure adhesive (DC) vs. resin cement system including a self-etching primer (PV)) and techniques (direct vs. indirect) for resin core build-up on the bonding performance to root canal dentin. METHODS The human teeth were decoronated and root canal preparation was performed. All specimens were randomly divided into four groups according to the combinations of the methods (Direct or Indirect) and the materials (DC: Clearfil DC Core, Kuraray Noritake Dental or PV: Panavia V5, Kuraray Noritake Dental). Micro-tensile bond strength (μTBS) and push-out tests were performed. Scanning electron microscope observations of the interface were also performed, and microcomputed tomography and optical coherence tomography were applied to evaluate the sealing ability. RESULTS The Indirect group had significantly higher μTBSs than the Direct group in the DC group (P = 0.0076). The PV group had significantly higher bond strengths than the DC group in both the Direct and Indirect groups (P < 0.001). The Direct/PV group demonstrated significantly higher push-out bond strength than the Direct/DC group (P < 0.001). In the Direct/PV group, the formation of resin tags was observed even on the apical side of the canal. Microleakage was more clearly observed in the DC group than in the PV group. CONCLUSIONS PV has a higher bonding ability to root canal dentin than DC. When using DC, the indirect technique exhibited a higher bonding ability than the direct technique.
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Affiliation(s)
- Mami Higashi
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka
| | - Atsushi Mine
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka
| | - Mariko Matsumoto
- Department of Restorative Dentistry, Hokkaido University Graduate School of Dental Medicine, Hokkaido.,BIOMAT & University Hospitals Leuven, Department of Oral Health Sciences, KU Leuven (University of Leuven), Leuven
| | - Masahiro Yumitate
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka
| | - Ryosuke Hagino
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka
| | - Shintaro Ban
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka
| | - Azusa Yamanaka
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka
| | - Jiro Miura
- Division for Interdisciplinary Dentistry, Osaka University Dental Hospital, Osaka
| | - Takuya Minamino
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka
| | - Bart Van Meerbeek
- BIOMAT & University Hospitals Leuven, Department of Oral Health Sciences, KU Leuven (University of Leuven), Leuven
| | - Hirofumi Yatani
- Department of Fixed Prosthodontics, Osaka University Graduate School of Dentistry, Osaka
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Thomas RM, Kelly A, Tagiyeva N, Kanagasingam S. Comparing endocrown restorations on permanent molars and premolars: a systematic review and meta-analysis. Br Dent J 2020:10.1038/s41415-020-2279-y. [PMID: 33184483 DOI: 10.1038/s41415-020-2279-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 05/22/2020] [Indexed: 12/21/2022]
Abstract
Objectives The objective of this systematic review was to evaluate the success of endocrown restorations on molars in comparison with endocrown restorations on premolars.Registration number The methodology for this review is registered with the PROSPERO database (CRD42019149543).Data sources Medline, Embase, Dentistry & Oral Sciences Source and Cochrane CENTRAL were searched through January 2020, supplemented with hand searching of additional relevant journals.Data selection and data extraction Two independent reviewers screened studies against predefined inclusion criteria and extracted data.Data analysis Narrative analysis was carried out and random-effects meta-analysis was performed where possible.Results Out of the selected eight studies, reported success rate of endocrown restoration in molars varied from 72.73% to 99.57% and in premolars ranged from 68.75% to 100%, with a follow-up range of 3-19 years. The pooled odds ratio and 95% confidence intervals for failure rates in molars compared to premolars in four studies selected for meta-analysis were 1.096 (95% CI: 0.280, 4.292).Conclusions These findings showed similar success rates and no difference in the rate of endocrown failures between molars and premolars, thus suggesting that premolars may be considered suitable candidates for endocrowns. However, the findings should be interpreted with caution due to methodological limitations of the included studies. Further better quality and specifically designed controlled trials directly comparing the clinical performance of endocrowns on molars and premolars are required.
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Affiliation(s)
- Rose M Thomas
- Senior Clinical Teacher in Endodontology, School of Dentistry, University of Central Lancashire, Preston, PR1 2HE, UK.
| | - Aengus Kelly
- Clinical Lecturer in Dental Education, Peninsula Dental School, Plymouth University, Plymouth, PL6 8BT, UK
| | - Nara Tagiyeva
- Lecturer in Epidemiology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Shalini Kanagasingam
- Course Lead MSc/MClinDent in Endodontology, Senior Clinical Lecturer, School of Dentistry, University of Central Lancashire, Preston, PR1 2HE, UK
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Khabadze Z, Mordanov O, Taraki F, Magomedov O, Kuznetsova A, Solimanov S, Nazhmudinov S, Bokova R, Adzhieva A, Bakaev Y. Effects of the Ferrule Design on Fracture Resistance to Endodontically-Treated Teeth Restored with Fiber Posts: A Systematic Review. Open Dent J 2019. [DOI: 10.2174/1874210601913010493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The ferrule is considered to be a key element in teeth preparation when restoring using a fiber post. It helps to resist occlusal forces, maintain cement tightness and minimize stress concentration on restoration using posts.
Aim:
The aim of this review is to determine the influence of the ferrule design in endodontically-treated teeth using fiber posts on their fracture resistance.
Materials and Methods:
The electronic databases examined were Medline, Scopus, and PubMed from April 2019 to October 2019. The studies were selected using well-established inclusion criteria.
Results:
In total, 79 articles were identified, 16 of which were selected after considering the titles and abstracts. After reading the full-text articles, the total number of articles included in this review was 7 with a low risk of bias.
Conclusion:
A full ferrule with a maximum height is the best design for resistance to fractures in all groups of teeth, but if it is impossible to provide this condition, the ferrule height from the palatal/lingual wall of the tooth should be increased.
The PROSPERO ID: 153543.
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Chisnoiu A, Picos A, Lascu L, Negucioiu M, Chisnoiu R, Kui A. Dentists' perspectives on the reconstruction possibilities of a non-vital tooth. Med Pharm Rep 2019; 92:387-392. [PMID: 31750440 PMCID: PMC6853044 DOI: 10.15386/mpr-1148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 05/17/2019] [Accepted: 06/09/2019] [Indexed: 11/23/2022] Open
Abstract
Background and aims The decision-making process when restoring a non-vital tooth is influenced by multiple factors. This study aimed to survey the dentists’ preferences regarding cast post-and-core and fiber post techniques for the reconstruction of non-vital teeth and to identify a correlation between reconstruction technique and practitioners characteristics, or dental characteristics. Methods The survey instrument was a questionnaire, which included a general part with questions regarding the practitioner’s profile (gender, age, years of experience, pattern and location of practice, etc.) and the dental characteristics (anterior or posterior position of the tooth on the arch, the amount of dental remaining tissues, etc.) and a technical part, containing more specific questions regarding the manufacture and performance of root-coronal reconstructions. Results Among the surveyed practitioners (n=35), 69.7% use more often cast post-and-core reconstructions (CPR) while 30.3% choose fiber post reconstructions (FPR). No difference in the reconstruction type was observed regarding patient’s age (p=0.23) or gender (p=0.092). The para-function criterion was considered important by 8.23% of the participants. When deciding the type of the root-coronal reconstruction depending on the remaining dentine walls, CPRs are significantly more frequently used in posterior areas (p=0.043) or when para-functional habits exist (p=0.022). Conclusion Cast post-and-core represent the most frequently used type of reconstruction for non-vital teeth. Fiber post reconstructions are indicated in the aesthetic zone and when the amount of healthy remaining dental structure is higher.
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Affiliation(s)
- Andrea Chisnoiu
- Department of Prosthodontics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Alina Picos
- Department of Prosthodontics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Liana Lascu
- Department of Prosthodontics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Marius Negucioiu
- Department of Prosthodontics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Radu Chisnoiu
- Department of Odontology, Endodontics and Oral Pathology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Andreea Kui
- Department of Prosthodontics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Gulabivala K, Ng YL. Value of root-filled teeth in maintaining a functional dentition for life. Br Dent J 2019; 226:769-784. [DOI: 10.1038/s41415-019-0313-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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MARCHIONATTI AME, WANDSCHER VF, RIPPE MP, KAIZER OB, VALANDRO LF. Clinical performance and failure modes of pulpless teeth restored with posts: a systematic review. Braz Oral Res 2017; 31:e64. [DOI: 10.1590/1807-3107bor-2017.vol31.0064] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 06/01/2017] [Indexed: 11/21/2022] Open
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Eliyas S, Jalili J, Martin N. Restoration of the root canal treated tooth. Br Dent J 2016; 218:53-62. [PMID: 25613259 DOI: 10.1038/sj.bdj.2015.27] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2014] [Indexed: 11/09/2022]
Abstract
When considering endodontically treated teeth, the quality of the restoration is important from the outset. It sheds light into possible causes of pulp necrosis or failure of endodontic treatment and influences the outcome of future endodontic treatment. A tooth undergoing endodontic treatment requires an effective coronal seal during and following completion of endodontic treatment. This paper discusses, using the available literature, the maintenance of optimal coronal seal and coronal integrity during and after root canal treatment.
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Affiliation(s)
- S Eliyas
- Glenfield Hospital, University Hospitals of Leicester NHS Trust, Groby Road, Leicester, LE3 9QP
| | - J Jalili
- Charles Clifford Dental Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Wellesley Road, Sheffield, S10 2SZ
| | - N Martin
- Academic Unit of Restorative Dentistry, School of Clinical Dentistry, University of Sheffield
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Sequeira‐Byron P, Fedorowicz Z, Carter B, Nasser M, Alrowaili EF. Single crowns versus conventional fillings for the restoration of root-filled teeth. Cochrane Database Syst Rev 2015; 2015:CD009109. [PMID: 26403154 PMCID: PMC7111426 DOI: 10.1002/14651858.cd009109.pub3] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Endodontic treatment involves removal of the dental pulp and its replacement by a root canal filling. Restoration of root filled teeth can be challenging due to structural differences between vital and non-vital root-filled teeth. Direct restoration involves placement of a restorative material e.g. amalgam or composite, directly into the tooth. Indirect restorations consist of cast metal or ceramic (porcelain) crowns. The choice of restoration depends on the amount of remaining tooth, and may influence durability and cost. The decision to use a post and core in addition to the crown is clinician driven. The comparative clinical performance of crowns or conventional fillings used to restore root-filled teeth is unknown. This review updates the original, which was published in 2012. OBJECTIVES To assess the effects of restoration of endodontically treated teeth (with or without post and core) by crowns versus conventional filling materials. SEARCH METHODS We searched the following databases: the Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE via OVID, EMBASE via OVID, CINAHL via EBSCO, LILACS via BIREME. We also searched the reference lists of articles and ongoing trials registries.There were no restrictions regarding language or date of publication. The search is up-to-date as of 26 March 2015. SELECTION CRITERIA Randomised controlled trials (RCTs) or quasi-randomised controlled trials in participants with permanent teeth that have undergone endodontic treatment. Single full coverage crowns compared with any type of filling materials for direct restoration or indirect partial restorations (e.g. inlays and onlays). Comparisons considered the type of post and core used (cast or prefabricated post), if any. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data from the included trial and assessed its risk of bias. We carried out data analysis using the 'treatment as allocated' patient population, expressing estimates of intervention effect for dichotomous data as risk ratios, with 95% confidence intervals (CI). MAIN RESULTS We included one trial, which was judged to be at high risk of performance, detection and attrition bias. The 117 participants with a root-filled, premolar tooth restored with a carbon fibre post, were randomised to either a full coverage metal-ceramic crown or direct adhesive composite restoration. None experienced a catastrophic failure (i.e. when the restoration cannot be repaired), although only 104 teeth were included in the final, three-year assessment. There was no clear difference between the crown and composite group and the composite only group for non-catastrophic failures of the restoration (1/54 versus 3/53; RR 0.33; 95% CI 0.04 to 3.05) or failures of the post (2/54 versus 1/53; RR 1.96; 95% CI 0.18 to 21.01) at three years. The quality of the evidence for these outcomes is very low. There was no evidence available for any of our secondary outcomes: patient satisfaction and quality of life, incidence or recurrence of caries, periodontal health status, and costs. AUTHORS' CONCLUSIONS There is insufficient evidence to assess the effects of crowns compared to conventional fillings for the restoration of root-filled teeth. Until more evidence becomes available, clinicians should continue to base decisions about how to restore root-filled teeth on their own clinical experience, whilst taking into consideration the individual circumstances and preferences of their patients.
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Affiliation(s)
- Patrick Sequeira‐Byron
- University of BernDepartment of Preventive, Restorative and Pediatric DentistryFreiburgstrasse 7BernBernSwitzerlandCH‐3010
| | | | - Ben Carter
- Cardiff University School of MedicineInstitute of Primary Care & Public Health3rd Floor, Neuadd Meirionnydd, Heath ParkCardiffUKCF14 4YS
| | - Mona Nasser
- Plymouth University Peninsula Schools of Medicine and DentistryPeninsula Dental SchoolThe John Bull Building, Tamar Science Park,PlymouthUKPL6 8BU
| | - Eman F Alrowaili
- Ministry of HealthOral and Dental Health ServicesPO Box 12ManamaBahrain
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SARKIS-ONOFRE R, PEREIRA-CENCI T, OPDAM NJ, DEMARCO FF. Preference for using posts to restore endodontically treated teeth: findings from a survey with dentists. Braz Oral Res 2014; 29:1-6. [DOI: 10.1590/1807-3107bor-2015.vol29.0001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 08/02/2014] [Indexed: 11/21/2022] Open
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14
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A flood tide of systematic reviews on endodontic posts: methodological assessment using of R-AMSTAR. Clin Oral Investig 2013; 17:1287-94. [DOI: 10.1007/s00784-013-0945-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Accepted: 02/05/2013] [Indexed: 01/08/2023]
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15
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Restorative outcomes for endodontically treated teeth in the Practitioners Engaged in Applied Research and Learning network. J Am Dent Assoc 2012; 143:746-55. [PMID: 22751976 DOI: 10.14219/jada.archive.2012.0262] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The authors aimed to determine the outcome of and factors associated with success and failure of restorations in endodontically treated teeth in patients in practices participating in the Practitioners Engaged in Applied Research and Learning (PEARL) Network. METHODS Practitioner-investigators (P-Is) invited the enrollment of all patients seeking care at participating practices who had undergone primary endodontic therapy and restoration in a permanent tooth three to five years earlier. P-Is classified endodontically reated teeth as restorative failures if the restoration was replaced, the restoration needed replacement or the tooth was cracked or fractured. RESULTS P-Is from 64 practices enrolled in the study 1,298 eligible patients who had endodontically treated teeth that had been restored. The mean (standard deviation) time to follow-up was 3.9 (0.6) years. Of the 1,298 enrolled teeth, P-Is classified 181 (13.9 percent; 95 percent confidence interval [CI], 12.1-15.8 percent) as restorative failures: 44 (3.4 percent) due to cracks or fractures, 57 (4.4 percent) due to replacement of the original restoration for reasons other than fracture and 80 (6.2 percent) due to need for a new restoration. When analyzing the results by means of multivariate logistic regression, the authors found a greater risk of restorative failure to be associated with canines or incisors and premolars (P = .04), intracoronal restorations (P < .01), lack of preoperative proximal contacts (P < .01), presence of periodontal connective-tissue attachment loss (P < .01), younger age (P = .01), Hispanic/Latino ethnicity (P = .04) and endodontic therapy not having been performed by a specialist (P = .04). CONCLUSIONS These results suggest that molars (as opposed to other types of teeth), full-coverage restorations, preoperative proximal contacts, good periodontal health, non-Hispanic/Latino ethnicity, endodontic therapy performed by a specialist and older patient age are associated with restorative success for endodontically treated teeth in general practice. CLINICAL IMPLICATIONS These results contribute to the clinical evidence base to help guide practitioners when planning the restoration of endodontically treated teeth.
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Fedorowicz Z, Carter B, de Souza RF, Chaves CDAL, Nasser M, Sequeira-Byron P. Single crowns versus conventional fillings for the restoration of root filled teeth. Cochrane Database Syst Rev 2012:CD009109. [PMID: 22592736 DOI: 10.1002/14651858.cd009109.pub2] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Endodontic treatment, involves removal of the dental pulp and its replacement by a root canal filling. Restoration of root filled teeth can be challenging due to structural differences between vital and non-vital root filled teeth. Direct restoration involves placement of a restorative material e.g. amalgam or composite directly into the tooth. Indirect restorations consist of cast metal or ceramic (porcelain) crowns. The choice of restoration depends on the amount of remaining tooth which may influence long term survival and cost. The comparative in service clinical performance of crowns or conventional fillings used to restore root filled teeth is unclear. OBJECTIVES To assess the effects of restoration of endodontically treated teeth (with or without post and core) by crowns versus conventional filling materials. SEARCH METHODS We searched the following databases: the Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE via OVID, EMBASE via OVID, CINAHL via EBSCO, LILACS via BIREME and the reference lists of articles as well as ongoing trials registries.There were no restrictions regarding language or date of publication. Date of last search was 13 February 2012. SELECTION CRITERIA Randomised controlled trials (RCTs) or quasi-randomised controlled trials in participants with permanent teeth which have undergone endodontic treatment. Single full coverage crowns compared with any type of filling materials for direct restoration, as well as indirect partial restorations (e.g. inlays and onlays). Comparisons considered the type of post and core used (cast or prefabricated post), if any. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trial quality and extracted data. MAIN RESULTS One trial judged to be at high risk of bias due to missing outcome data, was included. 117 participants with a root filled premolar tooth restored with a carbon fibre post, were randomised to either a full coverage metal-ceramic crown or direct adhesive composite restoration. At 3 years there was no reported difference between the non-catastrophic failure rates in both groups. Decementation of the post and marginal gap formation occurred in a small number of teeth. AUTHORS' CONCLUSIONS There is insufficient evidence to support or refute the effectiveness of conventional fillings over crowns for the restoration of root filled teeth. Until more evidence becomes available clinicians should continue to base decisions on how to restore root filled teeth on their own clinical experience, whilst taking into consideration the individual circumstances and preferences of their patients.
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Affiliation(s)
- Zbys Fedorowicz
- UKCC (Bahrain Branch), College of Medicine, AMA International University of Bahrain, Awali,
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Dejak B, Młotkowski A. Finite element analysis of strength and adhesion of cast posts compared to glass fiber-reinforced composite resin posts in anterior teeth. J Prosthet Dent 2011; 105:115-26. [DOI: 10.1016/s0022-3913(11)60011-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ikram OH, Patel S, Sauro S, Mannocci F. Micro-computed tomography of tooth tissue volume changes following endodontic procedures and post space preparation. Int Endod J 2009; 42:1071-6. [DOI: 10.1111/j.1365-2591.2009.01632.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Bitter K, Noetzel J, Stamm O, Vaudt J, Meyer-Lueckel H, Neumann K, Kielbassa AM. 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; 35:1477-82. [PMID: 19840634 DOI: 10.1016/j.joen.2009.07.026] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2009] [Revised: 07/21/2009] [Accepted: 07/27/2009] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The aim of this randomized clinical trial was to assess whether the placement of a fiber post (DT Light Post) (DT) and the amount of residual coronal dentin affect the time to failure of single-unit postendodontic restorations. METHODS Ninety patients providing 120 teeth were selected. Three groups (n = 40) were defined on the basis of the amount of residual coronal dentin: 2-walls group, 2 or more coronal walls; 1-wall group, 1 coronal wall; no-wall group, no wall exceeding 2 mm above the gingival level. Within each group teeth were randomized and allocated to 2 intervention groups (n = 20), including subgroups no post (no root canal retention) and subgroups post (placement of DT). RESULTS After a mean observation period of 32.4 (13.7) months in subgroups no post, the failure rates were 10%, whereas in subgroups post, failure rates of 7% were observed (P = .318). In no-wall group post placement significantly affected the time to failure of total restorations (P = .029, log-rank test). Teeth without post retention revealed a significantly higher failure rate (31%) compared with teeth restored with post retention (7%). CONCLUSIONS Within the observation time of the present study, fiber post placement was efficacious to reduce failures of postendodontic restorations only with teeth that exhibited no coronal walls. Post insertion for teeth showing a minor substance loss should be critically reconsidered.
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Affiliation(s)
- Kerstin Bitter
- Department of Operative Dentistry and Periodontology, University School of Dental Medicine, CharitéCentrum 3, Charité-Universitätsmedizin Berlin, Berlin, Germany.
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Theodosopoulou JN, Chochlidakis KM. A Systematic Review of Dowel (Post) and Core Materials and Systems. J Prosthodont 2009; 18:464-72. [DOI: 10.1111/j.1532-849x.2009.00472.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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AL-Wahadni AM, Hamdan S, Al-Omiri M, Hammad MM, Hatamleh MM. Fracture resistance of teeth restored with different post systems: in vitro study. ACTA ACUST UNITED AC 2008; 106:e77-83. [DOI: 10.1016/j.tripleo.2008.03.038] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2008] [Revised: 02/29/2008] [Accepted: 03/31/2008] [Indexed: 10/21/2022]
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