Contemporary Concepts of Adhesive Cementation of Glass-Fiber Posts: A Narrative Review.

(1) Background: Cementation of glass fiber posts to root canals has been associated with various failures, especially debonding. This narrative review aims to present the contemporary concepts concerning the adhesive cementation of glass fiber post and to discuss the optimal management of these factors. (2) Methods: Electronic search was performed in MEDLINE/Pub Med and Google Scholar using selected keywords examining the parameters post length, surface treatment of glass fiber posts, post space preparation and dentin pretreatment, resin cement selection, adhesive systems and hybrid layer formation, and clinical techniques. (3) Results: The search led to the selection of 44 articles. Epoxy resin-based endodontic sealers are recommended and the use of temporary cement in the root canal should be avoided. The minimum length of a glass fiber post adhesively cemented to a root canal is 5 mm. Irrigating the root canals with chlorhexidine, MTAD, or EDTA (alone or in combination with NaOCl) after post space preparation seems to enhance the bond strength. Silane application on the surface of the post seems to be beneficial. Concerning resin cements and adhesive systems, the results were rather inconclusive. Finally, resin cement should be applied inside the root canal with an elongation tip and photoactivation should be delayed. (4) Conclusions: Contemporary concepts of adhesive cementation of glass fiber posts can indeed improve the bond between glass fiber posts, resin cement, and root canal dentin, however, evidence coming from long-term randomized prospective clinical trials is needed in order to obtain safer conclusions.

Evaluation of the Fracture Resistance of Different Designs of All-Resin Post and Core Systems: An In Vitro Study.

Introduction There is a growing demand for post and core systems that offer both ease of use and efficiency. Recently introduced dual-cure build-up and post cement materials exhibit properties similar to dentin. The objective of this laboratory experiment is to compare the fracture resistance among three distinct post and core systems and identify the locations of failures within each group. Material and methods This in vitro experimental study involved 30 epoxy resin-based blocks (Endo Training Bloc J, Dentsply Sirona, Ballaigues, Switzerland) divided into three groups: The first group was a post space preparation and restoration with a fiber post (RelyX™ Fiber Post, 3M ESPE, Saint Paul, Minnesota, United States) 1.6 mm in diameter and 10 mm in length (Group A) where core build-up and cementation were performed using a dual-cure build-up and cement for endodontic post resin material (Core X Flow, Dentsply DeTrey, Konstanz, Germany). The second group was a post space preparation and restoration using a dual-cure build-up and cement for endodontic post resin material, 10 mm in length filled with resin but without fiber post placement (Group B). The third group was where post space and core were filled and restored with a dual-cure build-up and cement for endodontic post resin material, 5 mm in length and without fiber post placement (Group C). Subsequently, samples were mounted and tested using a universal testing machine (Instron, Canton, Massachusetts, United States), and the fracture site was located. Results Significant differences were identified among the three groups, indicating the impact of both post length and type on fracture resistance (p-value <0.05). Group B exhibited the highest mean compressive strength resistance and maximum load at 899.3330 (N), followed by Group C at 848.9690 (N) and Group A at 751.9620 (N). The predominant failures in the samples were core fractures or debonding of the core material. Conclusion All-resin posts demonstrated high fracture resistance, unlike fiber posts which displayed inferior fracture resistance.

How long must a post be? A retrospective survival analysis on a large cohort with long follow-ups.

OBJECTIVES: Post and core (PC) is frequently used, but clinical evidence concerning how long a post must be is scarce. Recommendations in dental literature range from half of the root which should be incorporated, to post space preparations conducted as deep as possible increasing the risk for root perforation thus tooth loss. Therefore, the aim of this retrospective survival analysis is to evaluate the post length as well as the post-clinical crown ratio on a large patient cohort with long follow-ups. MATERIALS AND METHODS: Overall 1026 PC in 731 patients could be included in this study (2004-2023). The files were analysed due to the parameters post length and post-clinical crown ratio on X-Ray. Furthermore, the influence of the type of covering prosthetic restoration, location, type of tooth, luting material, PC material, bone attachment and therapist was evaluated. The statistical analysis was assessed using Kaplan-Meier (univariate influences) and Cox regression (multifactorial influences). RESULTS: Survival until extraction as well as decementation was significantly influenced by bone attachment and covering prosthetic restoration. Posts reaching the middle third of the root showed highly significant (p < 0.001) better survival probabilities than those reaching the coronal or apical third. Regarding the post-clinical crown ratio, no significant difference was found for post = crown/post > crown, whereas post

Current Insights on Fiber Posts: A Narrative Review of Laboratory and Clinical Studies.

PURPOSE: The aim of this study was to review the literature related to the clinical performance and laboratory findings regarding fiber posts, as well as the cementation technique employed with their use. MATERIALS AND METHODS: A literature search was performed using an electronic database, PubMed/Medline, between 2010 and 2023. The terms used were "intra coronal post, fiber post, post cementation, and post length". Titles and abstracts were initially screened, and a full-text assessment was conducted for those that fulfilled the inclusion criteria. The reference list of the collected papers was also screened for further relevant citations. RESULTS: In this work, 135 potentially eligible studies were analyzed. Titles and abstracts of 90 studies followed the inclusion criteria and were selected for a full-text assessment, resulting in 50 studies selected. Moreover, additional studies from relevant citations were included, totaling 57 studies. CONCLUSION: According to the laboratory and clinical studies revised, the survival rate between fiber and prefabricated and cast metal posts was similar, and failures were mainly related to the loss of retention. The intra-canal post length of less than two-thirds of the root length presented successful results when ferrule was present. Furthermore, the ferrule increased the longevity of teeth restored with fiber posts. Additionally, the use of a surface treatment protocol for fiber posts and the adhesive cementation technique both contributed to the clinical success and longevity of the intra-canal post.

Influence of the Fiber Post Length on the Fracture Strength of Endodontically Treated Teeth.

Background and Objectives: Although fiber posts are widely used in the restoration of endodontically treated teeth (ETT), their ideal cementation depth into the root canal is still debated in literature. The aim of the present study was to evaluate whether the different intra-radicular insertion lengths of the fiber posts influence the fracture strength of ETT. Materials and Methods: A total of 10 permanent human lower incisors with straight roots of similar length and volume extracted for periodontal reason were sectioned 2 mm above the cement-enamel junction (CEJ) to a total length of 18 mm and endodontically treated in the same manner, then randomly divided into two groups of five each (Groups 1 and 2, n = 5). Two sound incisors, with no endodontic treatment, were used as the control group (Group 3, n = 2). After one week of storage in a humid environment, spaces for fiber post no. 1 (Reforpost, Angelus, Londrina, PR, Brazil) were prepared in the first two groups at a depth of 5 mm (Group 1) and 7 mm (Group 2), and the fiber posts were adhesively cemented using self-adhesive resin cement (Maxcem Elite, Kerr GmbH, Herzogenrath, Germany). After 7 days, the samples were vertically positioned and fixed in a self-curing transparent acrylic resin, up to 2 mm below the CEJ level, and mechanically tested in compression after another week of storage using a displacement-controlled testing machine up to each sample's fracture. The force-displacement curves were recorded for each sample, the means were calculated for each group and a statistical comparative analysis between groups was conducted. Results: Although no statistically significant differences between groups were observed, the highest mean fracture force (N) was recorded in Group 2 (1099.41 ± 481.89) in comparison to Group 1 (985.09 ± 330.28), even when compared to the sound, non-treated teeth (1045.69 ± 146.19). Conclusions: Within the limitations of this in vitro study, teeth where fiber posts were placed deeper into the root canal (7 mm) recorded slightly higher fracture forces in comparison with shorter lengths (5 mm). However, similar biomechanical performances obtained in the mechanical tests showed no statistical differences between the 7 mm and the 5 mm inserted posts.

Radiographic Analysis of Posts Performed by Undergraduate Dental Students: A Cross-Sectional Study.

INTRODUCTION: Post and core restorations for endodontically treated teeth must meet certain prosthetic criteria to ensure the success of the final restoration. The aim of this study is to evaluate the quality of posts performed by dental students at King Abdulaziz University Dental Hospital (KAUDH), Jeddah, Saudi Arabia, utilizing periapical radiographs and whether the prosthetic criteria were strictly met by students. MATERIALS AND METHODS: This cross-sectional study included 661 digital periapical radiographs of posts performed by 6th-year dental students from September 2018 to April 2019. The assessment included the following factors: patient's age, patient's gender, tooth type, and arch. Post-related factors including post type, shape, diameter, length, and status of the remaining gutta percha were also evaluated. Statistical analysis was performed using SPSS. Descriptive statistics were generated, and the association between different variables was determined using chi-square test at p<0.05. RESULTS: Posts were used to restore maxillary teeth (67%), and were particularly placed in premolars (44%). The majority of used posts were prefabricated tapered fiber posts (90%). The results were as follows: post diameter equal to one-third of root diameter, 50% met criterion; post length equal to two-thirds of root length, 33%; post length equal to or more than crown height, 93%; absence of space between gutta percha (GP) and post, 74%; and length of the remaining GP equal to 3-5 mm, 68%. Overall, 11% of the posts met all the ideal prosthetics criteria. CONCLUSION: Most qualities of post and core restorations that were radiographically assessed were found to be acceptable and within the recommended prosthodontic criteria.

In vitro fracture resistance of zirconia, glass-fiber, and cast metal posts with different lengths.

AIM: Post-and-core restorations require sufficient length of the post for retention of the prosthesis and root strength. The effect of different lengths of prefabricated zirconia posts (ZPs) on the fracture strength of endodontically treated teeth needs evaluation. Hence, the aim of this study was to evaluate the in vitro fracture resistance of endodontically treated incisors restored with ZP, glass-fiber (GFP), and cast posts (CP) of different lengths. SETTINGS AND DESIGN: Comparative in-vitro study. MATERIALS AND METHODS: Sixty extracted incisors were endodontically treated, tooth preparations were carried out, and the impression of the coronal portion of each prepared tooth was made using polyvinyl siloxane impression material loaded in copper tubes. The coronal portion of each tooth was removed, maintaining a 2 mm ferrule. The teeth were restored with one of the three posts: CPs, GFP, or ZPs, with intraradicular lengths of either 6 or 8 mm (n = 10). The CP and core patterns were fabricated using post space impressions and core buildup and cast using Nickel-Chromium alloy. After composite resin core buildup of GFP and ZPs treated teeth using the previously made copper tube impressions, the teeth were loaded to fracture in an oblique direction in the universal testing machine. STATISTICAL ANALYSIS USED: Data were analyzed using two-way ANOVA and Tukey-Kramer tests (α = 0.05). RESULTS: The highest and lowest values of fracture resistance were reported with ZP8 and GFP6 groups, respectively. There was no significant difference in fracture resistance between the posts of length 6 mm and 8 mm in CP, GFP, and ZP groups. There was no significant difference (P = 0.953) in fracture resistance between CP (284.8 N) and ZP (258.31 N) groups, while the GFP group (160.61 N) had a significantly lower value of fracture resistance than the CP and ZP groups. Two-way ANOVA test for fracture resistance of the post systems and post lengths showed that there was no significant correlation between the post systems and post length on the fracture resistance. There was a greater percentage of favorable fractures in GFP and ZP groups (65% each), than the CP group (20%). CONCLUSION: For the post systems tested, extending the post length does not significantly increase the fracture resistance of the restored teeth. The ZP represents a viable alternative to the cast metal post during the esthetic restoration of endodontically treated anterior teeth.

A comparative evaluation of fracture resistance of endodontically treated premolar teeth reinforced with different prefabricated and custom-made fiber-reinforced post system with two different post lengths: An in vitro study.

AIMS: The aim of this study is to determine the mean failure load for each postsystem and the relationship between post lengths with the mean failure loads. MATERIALS AND METHODS: Ninety single-rooted decoronated mandibular premolar teeth were endodontically treated and randomly assigned to three groups with respect to their post length (2/3rd and ½ of the root length). The first two groups were randomly divided into four subgroups, restored with the following postsystem: polyethylene-woven fiber posts, glass fiber tape, prefabricated carbon, and glass fiber posts. A composite core with no post served as control. All posts were cemented using dual-cure resin cement, and the same was used for core buildup. The standard cores were formed in each group. All the specimens were tested in a universal testing machine, and the load was calculated. RESULTS: One-way analysis of variance (ANOVA) showed that prefabricated glass fiber post had significantly highest fracture resistance when compared to other prefabricated and custom fiber-reinforced composite posts. Two-way ANOVA demonstrated no significant difference among the post lengths. CONCLUSION: The results of this study showed that glass fiber posts showed higher fracture load, but post length did not significantly increase the fracture resistance of endodontically treated teeth.

Effect of fiber post length and abutment height on fracture resistance of endodontically treated premolars prepared for zirconia crowns.

The purpose of this study was to compare the fracture resistance, mode of fracture, and stress distribution of endodontically treated teeth prepared with three different fiber post lengths and two different abutment heights, using both experimental and finite element (FE) approaches. Forty-eight human maxillary premolars with two roots were selected and endodontically treated. The teeth were randomly distributed into six equally sized groups (n = 8) with different combinations of post lengths (7.5, 11, and 15 mm) and abutment heights (3 and 5 mm). All the teeth restored with glass fiber post (Rely X Fiber Post, 3M ESPE, USA) and a full zirconia crown. All the specimens were thermocycled and then loaded to failure at an oblique angle of 135°. Statistical analysis was performed for the effects of post length and abutment height on failure loads using ANOVA and Tukey's honestly significant difference test. In addition, corresponding FE models of a premolar restored with a glass fiber post were developed to examine mechanical responses. The factor of post length (P < 0.01) had a significant effect on failure load. The abutment height (P > 0.05) did not have a significant effect on failure load. The highest mean fracture resistance was recorded for the 15 mm post length and 5 mm abutment height test group, which was significantly more resistant to fracture than the 7.5 mm post and 5 mm abutment height group (P < 0.05). The FE analysis showed the peak compression and tension stress values of 7.5 mm post length were higher than that of 11 and 15 mm post length. The stress value of remaining tooth decreased as the post length was increased. Within the limitations of this experimental and FE analysis study, increasing the post length inside the root of endodontically treated premolar teeth restored with glass-fiber posts increase the fracture resistance to non-axial forces. Failure mode is more favorable with reduced abutment heights.

Influence of glass fibre post length and remaining dentine thickness on the fracture resistance of root filled teeth.

AIM: To evaluate, ex vivo, the influence of glass fibre post length and remaining thickness of dentine on the fracture resistance of bovine roots, after thermomechanical ageing. METHODOLOGY: Ninety bovine roots of the same size were root filled and randomly distributed into nine groups (n = 10), according to the root weakening protocol (NW - nonweakened; MW - medium weakened; HW - highly weakened) and post length (7 mm; 9 mm and 12 mm). The weakening of roots was performed using diamond burs, resulting in different thicknesses of remaining dentine. The post spaces were prepared, and in the weakened roots, the glass fibre posts were customized with composite resin, to create posts matching the canal size. Chemically activated resin cement was used to lute the posts. After luting, full crowns made of composite resin were attached to a silicon matrix. To reproduce physiological mobility, the roots were covered with polyether and embedded in polyurethane. The thermomechanical cycling was performed (1 200 000 cycles; 88N; 3,8 Hz; 5 ± 1 °C to 55 ± 1 °C). Then, the specimens were subjected to compressive force in a universal testing machine (1 mm min-1 ; 100 kgf) to analyse the fracture resistance. The specimens were analysed through a stereomicroscope to classify the failure mode (repairable/catastrophic). The values were subjected to statistical analysis (two-way anova and Tukey's test at 5%). The frequencies of failure mode were compared using chi-square test. RESULTS: The association between length and dentine thickness was significant (P > 0.05). The difference was between NW and HW roots for posts of 12 mm in length. There was an association between failure mode and the length and remaining dentine thickness. CONCLUSIONS: Reduced dentine thickness in roots with longer posts had lower fracture resistance values, as catastrophic failure was more predominant.

Factors affecting the length of fiber post and core structure: a literature review / 口腔疾病防治

@#An id eal balance between the post length within root and the coronal extension should exist. Some theories advocated the use of the longest post as possible as the apical seal is not disturbed. Others advocated that the post should be longer than the crown or that the post should be a certain fraction of the length of the root. The conventional post length has been equal to 2/3-3/4 of the root length from half a century ago. Most of these theories have emphasized the post length in order to achieve sufficient retention and rigidity for coronal restoration. However, dental materials are evolving.With the use of fiber post and resin cement, stress distribution and post retention are improved over conventional metal post and zinc phosphate or glass-ionomer cement. Therefore, with improved bonding strength of fiber post, the post length within root should be minimized to maintain sufficient coronal rigidity. Factors affecting fracture resistance balance of a post-and-core system include the amount of Ferrule height (FH), Post length in root (PLIR), Post length in bone (PLIB), Abutment height (AH), Core length (CL) and Post length out of bone (PLOB). In view of the factors mentioned above, this paper investigated the mechanical factorsin a post-and-core system with literature review.

Comparison of fracture sites and post lengths in longitudinal root fractures.

INTRODUCTION: Comparing the epidemiology of fractures originating in the cervical and apical regions may help to understand the causes and risk of a vertical root fracture. We aimed to determine the frequency of vertical root fractures in different fracture sites and how the fracture site relates to fracture direction and post length. METHODS: Teeth diagnosed with a vertical root fracture were retrospectively surveyed for age and sex of the patient, type of tooth, a fracture region in the longitudinal axial direction, site of the fracture, and presence of a post. The fracture region in the longitudinal axial direction was classified as an incomplete fracture, complete fracture, and uncertain. Incomplete fractures were further classified into a fracture originating in the cervical region, a fracture originating in the midregion, and a fracture originating in the apical region. Posts were evaluated by loss of post and length of post. RESULTS: Fractures originating in the cervical and apical region occurred around the same frequency, whereas fractures originating in the midregion were extremely scarce. Of the fractures originating in the cervical region, 36.2% were in a mesial and/or distal site and 57.4% in a buccal and/or lingual site. Of the fractures originating in the apical region, 90.8% were in the buccal and/or lingual site. The number of cases of fractures originating in the apical region decreased with increased post length. CONCLUSIONS: Sites of fracture and post length differed greatly between fractures originating in the cervical region and the apical region, suggesting that risk factors for fractures originating in the cervical and apical regions are different.

Effect of ferrule height and glass fibre post length on fracture resistance and failure mode of endodontically treated teeth.

The purpose of this study was to evaluate the combined effect of ferrule height and post length on fracture resistance and failure mode of endodontically treated teeth restored with glass fibre posts, composite resin cores and crowns. Ninety human maxillary central incisors were endodontically treated and divided into three groups (n = 30) according to the ferrule heights: 4, 2 and 0 mm, respectively. Post spaces in each group were prepared at 2/3, 1/2 and 1/3 of the root length (n = 10). The specimens were received fibre posts, composite resin core build up and cast metal crowns. After thermocycling, compressive static load was applied at an angle of 135° to the crowns. Two-way analysis of variance showed significant differences in the failure load in the ferrule height groups, no significant differences in post length groups and no significant interaction between ferrule heights and post lengths. More restorable failure modes were observed.

Effects of Fiber Length and Content of Glass Fiber Posts on the Fracture Resistance of Teeth / 天津医药

Objective To explore the influence of different lengths and contents of glass-fiber post on the fracture resistance of teeth, and to investigate the optimal length and content of glass-fiber post used for restorative treatment. Meth-ods Forty-two intact single canal mandibular premolars were collected from orthodontic patients and were divided into three experimental groups (A, B and C). All the teeth were endodontically treated after cut off the crowns from the 2 mm above cemento-enamel junction. The post lengths were10 mm in A group, 8 mm in B group, and 6 mm in C group.There were two subgroups for each experimental group (A1, A2, B1, B2, C1, C2 ), 7 teeth for each subgroup.The 42%glass fiber post was used in A1, B1 and C1 groups. The 75%glass fiber post was used in A2, B2 and C2 groups. All of groups were restored with resin cores and metal crowns. The fracture resistance was measured with universal testing machine and recorded the root frac-ture pressure data and the mode of all the teeth. Results The fracture resistance was significantly higher in group A than that of group B and group C (P<0.05), and the fracture resistance was significantly higher in group B than that of group C (P<0.05). The fracture resistance was significantly higher for 75%glass fiber post than that of 42%glass fiber post (P<0.05). Conclusion Within a certain range, the longer the length of glass fiber post, the greater the tooth fracture resistance. The fracture resistance of fiber content is better for 75%glass fiber post than that of 42%glass fiber post.

Evaluation of different post lengths' effect on fracture resistance of a glass fiber post system.

OBJECTIVES: The purpose of this in vitro study was to evaluate the influence of different post lengths upon root fracture resistance. METHODS: 78 maxillary central teeth with similar dimensions were mounted in acrylic blocks with artificial silicone periodontal ligaments. Combinations of post lengths of 6 mm (shorter than 1/1 clinical crown length), 9 mm (1/1 clinical crown length), and 12 mm (longer than 1/1 clinical crown length) made up 6 different groups consisting of 13 teeth each. The glass fiber posts (Snowpost) were cemented with Super-Bond C&B and Panavia F luting cement. Composite-resin cores were made with Clearfil PhotoCore. The specimens were tested in a universal test machine. The testing machine applied controlled loads to the core, 2 mm from its incisal edge, on the palatal side at an angle 135 degrees to the long axis of the root. The testing machine was set at a crosshead speed of 5mm per minute. All samples were loaded until failure. RESULTS: There was no statistically significant difference between cements (P>.05). Posts shorter than clinical crown length, demonstrated root fracture under significantly lower loading forces (P<.05). CONCLUSION: Usage of posts shorter than clinical crowns should be avoided to eliminate clinical failure.