Biomechanical aspects of prosthetic treatment of structurally compromised teeth

Fracture resistance of compromised endodontically treated teeth restored with bonded post and cores: An in vitro study

“…2 However, the real challenge is restoring endodontically treated teeth with inadequate remaining tooth structure. 3 Procedures to address the lack of remaining structure include orthodontic extrusion and surgical crown lengthening. However, they may compromise the crown/root ratio, resulting in reduced static load failure of the teeth 4 or unfavorable esthetic outcomes.…”

Rethinking ferrule – a new approach to an old dilemma

“…Lateral forces have a greater potential to damage the tooth-restoration interface when compared to vertical loads. 41 Literature reviews by Torbjorner and Fransson 44,45 concluded that favourable occlusal prosthesis design is probably more important for survival of structurally compromised endodontic treated teeth than is the type of post used, as non-desirable forces introduced by way of an interference on the restoration are a risk for fatigue fracture of teeth.…”

“…The profession lacks long-term clinical results with a high level of evidence pertaining to survival data for various post systems. 45 have conical roots, therefore although by performing crown lengthening, an added dentine height results, a decrease in dentine width at the margin is inevitable after the tooth is further prepared for a new margin. This is possibly the cause for their poorer fracture resistance results.…”

“…[52][53][54] This is thought to possibly be due to fl uid leakage through the apical foramina and lateral canals. 45 Furthermore, bonding to radicular dentine has been shown to be less reliable than bonding to coronal dentine. 55,56 This places further speculation on the ability of bonded posts to reinforce teeth enough to protect against fracture.…”

“…80 A thin layer of resin cement used to bond a post to the radicular dentine may be the key to the dentine reinforcement rather than the type of post/core material used per se. 45 Some investigators 81 have suggested based on in vitro studies that prefabricated posts bonded with resin cement and composite resin cores fail to demonstrate a difference between restored endodontic treated teeth with or without remaining coronal tooth structure between the core and the preparation margin. The ability of the bonded post to negate the need for the commonly accepted ferrule, as well as the effect of bonded materials in variable dentine thicknesses, needs further investigation.…”