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10 March 2020

Do post-and-core restorations work better on anterior or posterior teeth?

Edoardo Mancuso

The restoration of endodontically treated teeth with post and core restorations has been extensively studied in the last 20 years. Yet, the association between tooth type, location in the dental arch and selection of a post-and-core system for endodontically treated teeth is still unclear.
In the scientific literature has been accepted that non-vital teeth are to be considered vulnerable and more susceptible to fracture than vital teeth because they are generally associated with a substantial loss of coronal and radicular tooth structure, which may causes a significant reduction in their capacity to withstand functional loads.
Furthermore different retrospective studies have reported a relationship between successful post-and-core restorations and factors such as the number of proximal contacts, occlusal contacts and type of definitive restoration.

As regard to the position of the tooth in the dental arch, Dr. Garcia and hers team recently published a systematic review on the Journal of Prosthetic Dentistry to assess the available evidence on the failure rates of anterior and posterior teeth treated with post-and-core restorations

Materials, methods and results
In this study, from the 2526 studies identified in the meta-analysis, 6 studies had been assessed to evaluate eligibility.
Based on these studies, no statistically significant difference between the groups was identified.
Some of the studies examined in this review, showed a greater number of failures in anterior than posterior teeth. This occurrence might be explained, according to the authors, with the higher incidence of horizontal forces responsible for tensile and shear stresses that occurs in anterior teeth, which, along with the premolars, are more subjected to lateral forces. In molars, contrariwise, vertical compression forces are the more frequent. 

The review concludes assessing that the failure rates in anterior and posterior teeth treated with post-and-core restorations are similar.
Anyhow all the studies included in this systematic review and meta-analysis, despite the location of the treated teeth with post-and-core restoration, emphasized the importance of a conservative preparation during endodontic treatment and the importance of a ferule and the preservation of coronal tooth structure have been emphasized to increase survival rates of both posterior and anterior teeth.

For additional informations: Do anterior and posterior teeth treated with post-and-core restorations have similar failure rates? A systematic review and meta-analysis.

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