Fracture resistance of teeth restored with post-retained restorations: an overview.
BACKGROUND
Posts have been used efficiently to retain restorations for badly destructed teeth. This article critically analyzes the concerned topics related to the fracture resistance of teeth restored with dowel-retained restorations.


METHODS
A systematic review of PubMed/MEDLINE, Cochrane, and Scopus databases was completed (from 1960 to 2010). Single or combined key words were used to obtain the most possible comprehensive list of articles. Checking the references of the relevant obtained sources completed the review along with a manual search to locate related articles on the topic. In vivo and ex vivo (laboratory, computer-based finite element, and photoelastic stress analysis studies) investigations related to the topic were included.


RESULTS
Many factors have been proposed to influence the fracture resistance of post-restored teeth. Recognizing the significance of these factors on the fracture resistance of teeth would aid in choosing the suitable treatment modality for every individual case. Fracture resistance was improved if tooth structure loss was limited, a ferrule was obtained, a post with similar physical properties to natural dentine was used, and adhesive techniques for post luting and coronal restoration were used. Adhesively luted resin/fiber posts with composite cores appear to be the best currently available option in terms of tooth fracture and biomechanical behaviour.


CONCLUSIONS
Most guidelines were based mainly on ex vivo studies and to a lesser extent on limited in vivo studies. The lack of long-term controlled randomized clinical studies was the main hindrance to reaching a conclusive and undisputable opinion regarding endodontic posts in terms of tooth fracture and biomechanical behaviour.
Al-Omiri
Mahmoud Khaled
MK
Department of Prosthodontics, Faculty of Dentistry, University of Jordan, Amman, Jordan. alomirim@yahoo.co.uk
Mahmoud
Ahmad Abdelaziz
AA
Rayyan
Mohammad Ramadan
MR
Abu-Hammad
Osama
O
D003738:Dental Cements / Q000627:therapeutic use; D003793:Dental Restoration, Permanent / Q000009:adverse effects* / Q000379:methods; D003799:Dental Stress Analysis; D006801:Humans; D011176:Post and Core Technique / Q000009:adverse effects* / Q000295:instrumentation; D014070:Tooth / Q000473:pathology / Q000601:surgery; D014082:Tooth Fractures / Q000209:etiology* / Q000517:prevention & control; D018677:Tooth Injuries / Q000209:etiology* / Q000517:prevention & control
D003738:Dental Cements