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

Manja von Stein-Lausnitz; M Bruhnke; M Rosentritt; G Sterzenbach; K Bitter; R Frankenberger; M Naumann

doi:10.1007/s00784-018-2446-6

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

Clin Oral Investig. 2019 Jan;23(1):381-389. doi: 10.1007/s00784-018-2446-6. Epub 2018 Apr 30.

Authors

Manja von Stein-Lausnitz¹, M Bruhnke², M Rosentritt³, G Sterzenbach², K Bitter⁴, R Frankenberger⁵, M Naumann²

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@charite.de.
² 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.
³ Department of Prosthetic Dentistry, Regensburg University Medical Center, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
⁴ 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.
⁵ Department of Operative Dentistry and Endodontics, University of Marburg, Georg-Voigt-Str. 3, 35039, Marburg, Germany.

PMID: 29713887
DOI: 10.1007/s00784-018-2446-6

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 (F_max).

Results: Significantly more failures occurred in group D for specimens without GFP during TCML (p = 0.001). F_max (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 F_max 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.

Keywords: Direct restoration; Endodontic post; Glass-fiber post; Postendodontic treatment; Resin composite.

MeSH terms

Composite Resins / chemistry*
Dental Restoration Failure
Dental Restoration, Permanent*
Dental Stress Analysis
Humans
In Vitro Techniques
Incisor*
Maxilla
Post and Core Technique*
Tooth, Nonvital / therapy*

Substances

Composite Resins