Different Post Placement Strategies for the Restoration of Endodontically Treated Maxillary Premolars with Two Roots: Single Post vs Double Post
Valentina Spicciarelli, Crystal Marruganti, Marco Martignoni, Ludovica Andreatti, Tiziana Doldo, Marco Ferrari, Simone Grandini
Citation Information :
Spicciarelli V, Marruganti C, Martignoni M, Andreatti L, Doldo T, Ferrari M, Grandini S. Different Post Placement Strategies for the Restoration of Endodontically Treated Maxillary Premolars with Two Roots: Single Post vs Double Post. J Contemp Dent Pract 2020; 21 (12):1374-1378.
Aim and objective: The present study compared the fracture strength and failure pattern of endodontically treated, bi-rooted, maxillary premolars with different number of coronal walls and postendodontic restoration (one vs double post). Materials and methods: 105 premolars were divided into 3 groups according to the number of residual walls: control group (intact teeth; n = 15), group 1 (3 residual walls; n = 45), group 2 (2 residual walls; n = 45). Each test group was then divided into 3 subgroups (n = 15 each) according to postendodontic restoration: no post (A), 1 post (B) or 2 posts (C). A load was applied parallel to the longitudinal axis of the teeth, thus simulating physiological occlusion. ANOVA and Tukey's tests were used to detect fracture strength differences among groups, while Chi-square test was used to check differences in fracture pattern. Results: No significant differences were observed between control group (intact teeth) and groups A1 (p = 0.999), B1 (p = 0.997) and C1 (p = 1.000); statistically significant differences were detected between control group and groups A2 (p < 0.001), B2 (p < 0.001) and C2 (p < 0.05). Different post placement techniques were non-significantly associated with fracture pattern in both groups 1 (p = 0.666) and 2 (p = 0.143) while, irrespective of the number of posts, the presence of the post was significantly associated with the fracture pattern in teeth with two residual walls. The double-post technique did not further improve the fracture resistance of hardly damaged endodontically treated maxillary bi-rooted premolars compared to single-post technique. Therefore, the insertion of a single post in the palatal canal could be a safer and more conservative choice. Clinical significance: The double-post technique did not further improve the fracture resistance of severely structurally compromised endodontically treated maxillary premolars with two roots compared to the single-post technique. Therefore, the safer and less invasive treatment is the placement of a single post in the palatal canal.
Dentin collagen cross-linked of root filled and normal teeth. J Endod 1988;14:195–199.
Collagen degradation in endodontically treated teeth after clinical function. J Dent Res 2004;83(5):414–419. DOI: 10.1177/154405910408300512.
Vertical root fractures in endodontically-treated teeth: a retrospective analysis of possible risk factors. J Invest Clin Dent 2017;00:e12273.
Post placement and restoration of endodontically treated teeth: a literature review. J Endod 2004;30(5):289–301. DOI: 10.1097/00004770-200405000-00001.
Comparative assessment of the incidence of vertical root fractures between conventional versus surgical endodontic retreatment. Clin Oral Investig 2014;18(8):2015–2021. DOI: 10.1007/s00784-013-1182-1.
Root fractures due to corrosion diagnostic aspects. Scand J Dent Res 1970;78(5):397–403. DOI: 10.1111/j.1600-0722.1970.tb02088.x.
Effect of residual coronal structure on resistance of teeth restored with posts. G Ital Endod 2012;26:13–21.
Clinical evaluation of the use of fiber posts and direct resin restorations for endodontically treated teeth. Int J Prosthodont 2005;18:399–404.
Effect of ferrule location with varying heights on fracture resistance and failure mode of restored endodontically treated maxillary incisors. J Prosthodont 2019;28(6):677–683. DOI: 10.1111/jopr.13090.
Are posts necessary for the restoration of root filled teeth with limited tissue loss? A structured review of laboratory and clinical studies. Int Endod J 2016;49(9):827–835. DOI: 10.1111/iej.12538.
A comparative evaluation of fracture resistance of endodontically treated teeth restored with different post core systems: an in-vitro study. J Adv Prosthodont 2011;3(2):90–95. DOI: 10.4047/jap.2011.3.2.90.
The effect of fiber post location on fracture resistance of endodontically treated maxillary premolars. Dent Med Probl 2018;55(3):275–279. DOI: 10.17219/dmp/94656.
Effect of remaining tooth structure on the fracture resistance of endodontically-treated maxillary premolars: an in vitro study. J Prosthet Dent 2016;115(3):290–295. DOI: 10.1016/j.prosdent.2015.08.013.
The effect of marginal ridge thickness on the fracture resistance of endodontically-treated, composite restored maxillary premolars. Oper Dent 2007;32(3):285–290. DOI: 10.2341/06-83.
Fracture resistance of weakened teeth restored with condensable resin with and without cusp coverage. J Appl Oral Sci 2009;17(3):161–165. DOI: 10.1590/S1678-77572009000300006.
Influence of cavity type and size of composite restorations on cuspal flexure. Med Oral Patol Oral Cir Bucal 2006;11:536–540.
In vitro measurement of cuspal strain and displacement in composite restored teeth. J Dent 1997;25(3-4):331–337. DOI: 10.1016/S0300-5712(96)00047-4.
Cuspal flexure of teeth with composite restorations subjected to occlusal loading. J Adhes Dent 2007;9:11–15.
Influence of clenching intensity on bite force balance, occlusal contact area, and average bite pressure. J Dent Res 1999;78(7):1336–1344. DOI: 10.1177/00220345990780070801.
Maximal bite force with centric and eccentric load. J Oral Rehabil 1982;9(5):445–450. DOI: 10.1111/j.1365-2842.1982.tb01034.x.
Influence of restorative technique on the biomechanical behavior of endodontically treated maxillary premolars. part II: strain measurement and stress distribution. J Prosthet Dent 2008;99(2):114–122. DOI: 10.1016/S0022-3913(08)60027-X.
The influence of restorative material and glass fiber posts on fracture strength of endodontically treated premolars after extensive structure loss. Niger J Clin Pract 2019;22(6):782–789. DOI: 10.4103/njcp.njcp_11_19.
Fracture resistance of endodontically treated teeth restored with 2 different fiber-reinforced composite and 2 conventional composite resin core buildup materials: an in vitro study. J Endod 2017;43(9):1499–1504. DOI: 10.1016/j.joen.2017.03.031.
The effect of the different restorations on fracture resistance of root-filled premolars. BMC Oral Health 2018;18(1):196. DOI: 10.1186/s12903-018-0663-7.
Effect of fiber posts on the fracture resistance of maxillary central incisors with class III restorations: an in vitro study. J Prosthet Dent 2017;118(1):55–60. DOI: 10.1016/j.prosdent.2016.09.013.
Residual thickness of root in first maxillary premolars with post space preparation. J Endod 1999;25(7):502–505. DOI: 10.1016/S0099-2399(99)80291-X.
Furcation groove of buccal root of maxillary first premolars--a morphometric study. J Endod 2000;26(6):359–363. DOI: 10.1097/00004770-200006000-00012.
The dentine-rot complex: anatomical and biologic considerations in restoring endodontically treated teeth. J Prosthet Dent 1992;67(4):458–467. DOI: 10.1016/0022-3913(92)90073-J.
Cohen's Pathways of the Pulp. 10th ed., St. Louis, MO: Mosby Elsevier; 2011. 148–233.