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A structured literature review aimed to elucidate test parameters for in vitro testing of post-endodontic restorations. The literature was digitally searched using MEDLINE, EMBASE, MedPilot and an additional hand search was performed. Two independent researchers assessed the articles in relation to the defined inclusion and exclusion criteria. The literature search revealed 125 abstracts. Sixty-nine studies were included. Fifty-seven per cent of the studies investigated maxillary incisors only. The restorative stage as complex of tooth, post, core, and crown and post-and-core restored specimens without crowns were used most frequently. Fifty-nine per cent of the studies used static loading. Only 15% of the studies performed thermocycling and mechanical loading (TCML). However, the number of thermo- and load cycles varied. The cross-head speed of linear loading after TCML ranged from 0.01 to 150 mm min(-1). The reviewed studies were heterogeneous in test design regarding the used test parameters. A methodological standardization of in vitro testing of post-endodontic restorations is recommended.

Irrigation after post space preparation and its effects on the bond strength of different adhesive strategies are still an issue of interest. The aim of the present study was to investigate the effects of various irrigation protocols (IPs) on the push-out bond strengths of fiber posts. One-hundred and fifty extracted human anterior teeth were divided into three groups (n = 50 each) and endodontically treated. The post space was irrigated before post placement using the following five IPs in each group: IP1 (control): 5 ml of distilled water; IP2: 5.25% sodium hypochlorite (NaOCl) applied with passive ultrasonic irrigation (PUI); IP3: 1% NaOCl applied with PUI; IP4: 18% ethylenediaminetetracetic acid (EDTA) followed by 5.25% NaOCl; and IP5: 2% chlorhexidine (CHX). Fiber posts placement in each group was performed using three different adhesive strategies. A self-etch adhesive system revealed higher bond strength (16.2 ± 6.9 MPa) compared with an etch-and-rinse adhesive (8.5 ± 4.2 MPa) and a self-adhesive resin cement (9.2 ± 4.7 MPa). The use of 18% EDTA/5.25% NaOCl increased the bond strength of the self-adhesive resin cement. Conversely, this IP decreased the bond strength for the etch-and-rinse adhesive system, whilst 1% NaOCl enhanced the bond strength for the same system. Consequently, each adhesive strategy may need to be adapted to a specific IP.

When using self-adhesively luted prefabricated posts, resin composite core build-up, and 2-mm ferrule to reconstruct severely damaged endodontically treated teeth, tooth survival is not influenced by post rigidity. Survival decreased rapidly after 8 years of observation in both groups.