17 December 2021

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Endodontically treated teeth: fiber post or not?

Lorenzo Breschi

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The restoration of an endodontically treated tooth (ETT) has been widely discussed in the literature. Most of the available RCTs showed that premolars restored  with a fiber post and a single full crown have a high survival rate and an acceptable clinical behavior. However, the use of lithium disilicate posterior partial restorations (PPR) has recently showed some benefits, such as less invasive tooth preparation, especially at the cervical level, easier cleansing of supragingival margins, and the advantage of an adhesive cementation.
M. Ferrari et al. published an interesting in vivo work where the authors evaluated the clinical performances of lithium disilicate partial crowns used to restore endodontically posterior teeth with or without the employment of a fiber post in molars and premolars.

MATERIAL & METHODS  
The research group selected 120 patients that according to inclusion criteria were divided into two groups (n = 60) to the type of restored tooth: Group 1, premolars and Group 2, molars. The patients of the molars and premolars group were further divided into 2 subgroups (n = 30) according to the presence or absence of a fiber post in the canal.  Clinical and intraoral radiographic examinations were assessed during each recall (6 months and, 1, 2, and 3 years). Kaplan-Meier log-rank test and Cox regression analysis (Pp < 0.05) were applied.

RESULTS
After 3-y follow up, the authors reported a survival rate of ETT restored with or without fiber post on molars of 100%. Teeth with posts had no mechanical complications, whilst only premolars without posts showed 2 mechanical failures due to fracture of the abutment and root after two years. The Cox regression analysis showed that the presence of the post was not a significant factor for survival time. Furthermore, the group of Prof Ferrari found out that tooth type had an influence on survival time. Particularly, failure risk was greater for premolars.      

CONCLUSIONS
From the results obtained in the present clinical study, after 3 years of observation the authors  concluded that the use of the fiber post was not fundamental for the restoration of ETT with PPR, in fact no significant difference was recorded on both premolars and molars groups. In order to provide stronger evidence, longer-term data will be collected through further recalls.  

For additional information:  Posterior partial crowns out of lithium disilicate (LS2) with or without posts: A randomized controlled prospective clinical trial with a 3-year follow up