Dental post placement is much less common today than it was in the past due to our ability to bond to tooth structure. However, the dental post still has its place and are IMHO not in use as often as they should be.
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Reading the conclusions of the lit review below will tell you when to use a dental post and what dental post may be best. There is no clear answer though. Clinicans Research findings state one should use a post when the tooth has a root canal and has one of any of the following conditions.
Lit review Schwartz JOE Remember The primary purpose of a post is to retain a core in a tooth with extensive loss of coronal tooth structure. However, preparation of a post space adds a certain degree of risk to a restorative procedure. The placement of posts also may increase the chances of root fracture and treatment failure, especially if an oversized post channel is prepared. For these reasons, posts should only be used when other options are not available to retain a core. The need for a post varies greatly between the anterior and posterior teeth.
Lit review of fracture resisitance AL-Omiri Adhesively luted resin/fiber posts with composite cores appear to be the best currently available option in terms of tooth fracture and biomechanical behaviour. Yet Sarkis-Onofre JOE finds metal posts better IF no ferrule.
Lit review Ferrule effect Juloski JOE 1.5mm to 2mm
Lit Review Balevi EBD Tooth fracture metal vs fiber unsure
Lit review from J Prosthetics opens with Most endodontically treated teeth require a post-and-core build-up for restoring the teeth to optimum health and function. I struck the stupid stuff
Cast post higher fracture resistance than fiber Meta-analysis (so maybe in heavy grinder with minimal coronal tooth structure cast better)
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Overall metal and fiber about = in fracture resistance but cast metal and glass fiber are better than prefab metal and carbon fiber Meta-analysis Figueiredo JOE
Composite vs. Fiber post oct 11 = fiber post better
Oval posts in oval canals better adapted than round? NO
Effects of post, core, crown type, and ferrule Nov 10 Fiber posts best anterior and use cast post and core with metal crown.
Cast metal core vs. resin luted core Resin core better (not sure how this impacts posts per se)
Metal posts vs. fiber post in anterior teeth (lab only) Feb 11 Metal better especially under ceramic crown This is consistent with other findings in that metal is less likely to fail but if does more permanent failure ie tooth fracture versus post coming debonded with resin.
Metal post seals anteriors better Sept 12although may be true check #5 in 1st lit review. So resin may leak more but metal will have catastrophic failure
Glass fiber=Ti with self-adhesive luting prefab
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