ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Fiber Posts Do Not Provide Greater Fracture Resistance for Endodontically Treated Molar Teeth Compared to No Post
Clinical Question Do fiber posts give greater fracture resistance for endodontically treated molar teeth compared to no post?
Clinical Bottom Line Fiber posts do not provide greater fracture resistance for endodontically treated molar teeth compared to no post (restored with resin composite and zirconia-ceramic crown). Instead they optimize the fracture pattern while the remaining number of residual walls dictates fracture resistance. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 16861075Salameh/2006No human subjects. 90 mandibular molar teeth extracted for periodontal reasons. Subgroups included those with fiber posts and those without. The teeth had zirconia-ceramic crowns. In vitro study of extracted teeth.
Key resultsLow p value (P<0.001). Steadily increased fracture resistance with decreased number of residual cavity walls. Decreased fracture resistance with the insertion of fiber posts.
Evidence Search Limits: Randomized Controlled Trial Search & Tooth, Nonvital"[Mesh] Search & Post and Core Technique &;[Mesh];Molar&;[Mesh]
Comments on
The Evidence
This in vitro study affords relatively weak evidence. Due to the lack of human subjects, follow-up and fracture resistance cannot be measured over time. The article does not state whether treatment provider and evaluator were blinded and calibrated. External validity is questionable due to lack of clarity concerning how pressure was applied to the teeth and if it was performed in a wet or dry setting.
Applicability Although the in vitro studies provide weak evidence, the knowledge can be applied to patients receiving root canal therapy on molar teeth.
Specialty/Discipline (Endodontics) (General Dentistry)
Keywords Root canal, post and core, molar, tooth (nonvital), fracture
ID# 467
Date of submission: 01/06/2010spacer
E-mail hogans@uthscsa.edu
Author Jeff Shao
Co-author(s) Steven Hogan, Paul McLornan
Co-author(s) e-mail
Faculty mentor/Co-author S. Thomas Deahl, II, DMD, PhD
Faculty mentor/Co-author e-mail deahl@uthsca.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
post a comment
by Dr. Rick Schwartz (San Antonio, TX) on 12/19/2013
When considering a question like this, you have to look at the whole body of literature. One study is not meaningful. The literature is very one sided on this question. The 13 references below conclude fiber posts do, in fact, make teeth stronger. Two of the articles were written subsequently by Salameh. Schmitter et. al., PMID: 16554204 and Rosentritt et.al., PMID: 15210029; Salameh et. al., PMID: 17804327; Carvalho et. al., PMID: 15876327; Goncalves et. al., PMID: 17098497; Hayashi et. al., 2006, PMID: 16171857; D’Arcangelo et. al., 2008 PMID: 1857099; Salameh et. al., 2008 PMID: 18570992; Naumann et. al., 2007 PMID: 16464492; Nam et. al., 2010 PMID: 20113794; Bitter et. al., 2010 PMID: 20536574; Schmoldt et. al., 2011 PMID: 21924188. Tanalp et. al., 2012 PMID: 22151797.
by Stephen Siedow (San Antonio, Texas) on 04/06/2012
I completed a PubMed search on this topic on April 6th, 2012. The publications listed in the CAT are the most up-to-date and highest level of evidence related to this clinical question.
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