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Background: The reduced fracture resistance in endodontically treated teeth requires the use of radicular posts, with their advantages and disadvantages. Aim: To evaluate the clinical performance of teeth restored with or without radicular posts at 6 and 12 months. Materials and methods: The study included 22 patients who received endodontic therapy on premolars with a loss of one or two proximal walls. The premolars were divided into groups according to the restoration method: metal post group (MP), fiber post group (FP), and no post group (NP). For the NP group, a dentinal core of fiber-reinforced composite was used. The McNemar test, marginal homogeneity test and Kruskal-Wallis test were used in the statistical analysis. At the 6 and 12 month recall, both the direct composite restorations and the integrity of the post systems were assessed. Results: At 6-month recall assessment, there was no statistically significant difference in the categories of ‘appropriate colour’, ‘secondary caries’ and ‘obturation integrity’. That was not the case with ‘marginal discoloration’, ‘marginal adaptation’, ‘proximal contact’ and ‘surface smoothness’. The recall at 12 months showed a continuation of this tendency, with significant decrease in the category of ‘adequate colour’. Assessment of post longevity at the two recalls did not show any significant changes. The teeth restored without a post showed survival rates comparable to that of teeth restored with a post for the 12-month period of observation. Conclusions: There were no failures of the different posts used. The observed changes were attributed to the progressive deterioration of the composite restorations.

Introduction: The advent of Cone Beam Computed Tomography (CBCT) in endodontics has enhanced the diagnosis of periapical radiolucencies and the assessment of endodontically treated teeth.&nbsp; Aim: The purpose of this study was to assess the prevalence of periapical radiolucencies in a Bulgarian subpopulation and the quality of previous endodontic treatment using CBCT scans. Materials and methods: This study included 2795 roots from 160 Large FOV CBCT which were evaluated by two independent examiners using two scoring systems: CBCT-PAI and PESS.&nbsp; Results: The inter-examiner agreement spanned from strong to almost perfect (0.892 and 0.983). The prevalence of periapical lesions according to the two scoring systems was 23.1% and 12.9 %, respectively. The prevalence of endodontically treated teeth was high (34.1%). Sixty-five percent of them presented with signs of periapical radiolucencies, while only 1.4% of all non-treated roots had a periapical lesion. A significant association between periapical disease, poor quality of the root canal filling and inadequate coronal seal was found (p<0.001).&nbsp; Conclusions: The prevalence of periapical disease in endodontically-treated teeth in the Bulgarian subpopulation was high. Poor qual-ity of the root canal filling and inadequate coronal seal were assessed as prognostic determinants of treatment failure. CBCT techniques can augment conventional diagnostic techniques in the field of endodontics.&nbsp;

Abstract. Endodontically treated teeth (ETT) are more susceptible to fracture during mastication. The aim of our study was to investigate the fracture resistance of premolars, restored with different techniques. Eighteen human premolars, extracted for orthodontic or periodontal reasons, were used. Mesio-occlusal cavities were prepared on all of them. They were divided into 3 groups according to the restoration method: with a cemented fiber post (FP), with a cemented metal post (MP) and without a post, but restored with a fiber reinforced composite core (FRC). After thermocycling, their fracture resistance was evaluated in a standard testing machine. The results were analyzed with one-way ANOVA and Tukey Honestly Significant Difference (HSD) tests (p<0.05). The fracture modes were also determined. The MP group showed the lowest fracture resistance rates and the highest number of unrestorable root fractures. In conclusion, teeth restored with FRC cores or FP show better survival rates than those restored with metal posts.

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