A randomized controlled trial of endodontically treated and restored premolars.
This in vivo study examined the contribution of remaining coronal dentin and placement of a prefabricated (LP) or customized fiber post (ES) to the six-year survival of endodontically treated premolars. A sample of 345 patients provided 6 groups of 60 premolars each in need of endodontic treatment. Groups were classified according to the number of remaining coronal walls before abutment build-up. Within each group, teeth were allocated to one of three subgroups: (A) no post retention; (B) LP; or (C) ES (N = 20). All teeth were protected with a crown. Cox regression analysis revealed that fiber post retention significantly improved tooth survival (p < 0.001). Failure risk was lower in teeth restored with prefabricated (p = 0.001) than with customized posts (p = 0.009). Teeth with one (p = 0.004), two (p < 0.001), and three coronal walls (p < 0.001) had significantly lower failure risks than those without ferrule. Similar failure risks existed for teeth without coronal walls, regardless of the presence/absence of ferrule (p = 0.151). Regardless of the restorative procedure, the preservation of at least one coronal wall significantly reduced failure risk (ClinicalTrials.gov number CT01532947).
Department of Dental Materials and Fixed Prosthodontics of the University of Siena, Tuscan School of Dental Medicine, University of Firenze and Siena, Policlinico Le Scotte, viale Bracci, Siena 53100, Italy. ferrarm@gmail.com
M
M
Ferrari
A
A
Vichi
G M
GM
Fadda
M C
MC
Cagidiaco
F R
FR
Tay
L
L
Breschi
A
A
Polimeni
C
C
Goracci
D001641:Bicuspid / Q000473:pathology*; D003442:Crowns; D000044:Dental Abutments; D001840:Dental Bonding; D017267:Dental Prosthesis Design; D017268:Dental Prosthesis Retention; D019232:Dental Restoration Failure; D003804:Dentin / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D011176:Post and Core Technique / Q000295:instrumentation; D011446:Prospective Studies; D012390:Root Canal Therapy; D014082:Tooth Fractures / Q000209:etiology; D014092:Tooth Root / Q000293:injuries; D019553:Tooth, Nonvital / Q000628:therapy*; D016896:Treatment Outcome