玻璃纤维桩用于含阻塞根管磨牙残冠修复的疗效观察

目的：观察玻璃纤维桩用于含阻塞根管磨牙残冠修复的临床疗效。方法：对25个含有阻塞根管的磨牙残冠采用玻璃纤维桩-树脂核-全冠修复,进行6～24个月的随访,观察其疗效。结果：在25个经治磨牙中,3个出现根尖炎症,1个出现桩松动,21个修复效果满意。结论：只要适应症选择合适,采用玻璃纤维桩修复含阻塞根管的磨牙残冠同样可取得好的临床疗效。     

玻璃纤维桩用于前牙残根、残冠修复的临床观察

目的研究玻璃纤维桩在前牙残根、残冠修复中的临床应用效果。方法临床选择69例患者,共136颗患牙,均为上下前牙残根或残冠,备牙后龈上剩余牙体组织小于3 mm的10颗,备牙后龈上剩余牙体组织3 mm以上者126颗,经过完善的根管治疗,采用玻璃纤维桩制作桩核,Procera氧化锆全冠修复。对修复效果进行随访评价。结果随访12~48个月,未发现根折;131个修复体边缘密合,未见松动,无脱落无继发龋损,牙周健康;有4颗牙发生纤维桩核松动脱落,有1颗纤维桩折断。成功率为96.32%。所有患者对修复体美学效果均感满意。结论对前牙残根残冠使用玻璃纤维桩Procera氧化锆全冠修复美学效果良好,不易造成根折,可以获得较高的成功率,达到满意的修复效果。     

玻璃纤维桩联合双固化桩核材料修复残根残冠

目的 探讨玻璃纤维桩联合双固化桩核材料修复残根残冠的临床效果.方法 88例96颗已行根管治疗的残根残冠,利用玻璃纤维桩与双固化桩核材料制作桩核,再行钛合金烤瓷冠修复.治疗完成后12、 24个月复诊,观察修复效果.结果 12个月后, 2例3颗患牙失访, 1例1颗磨牙作为活动义齿基牙Ⅱ度松动,其余93颗患牙无不适,桩核冠稳固无松动. 24个月后,又有3例3颗患牙失访, 4例4颗磨牙作为活动义齿基牙Ⅱ度松动,其余86颗患牙均修复成功.结论 玻璃纤维桩联合双固化桩核材料制作桩核操作简单方便,强度高,色泽好,可满足临床需要.     

玻璃纤维桩在下切牙残根残冠修复中的临床应用

目的探讨玻璃纤维桩在下切牙残根残冠修复治疗中的临床效果。方法临床选择28例下切牙残根残冠的患者,36颗患牙,经完善的根管治疗后,根据牙根的情况,选择玻璃纤维桩的直径和长度,再以烤瓷冠修复,并经过6个月至2年临床疗效的追踪观察。结果36颗患牙有34颗无异常,2颗有不同程度的脱落和龈炎,修复成功率为94.45%,修复效果满意。结论玻璃纤维桩在下切牙残根残冠的修复治疗中,能达到良好的修复效果。     

纤维桩核冠修复牙体严重缺损的临床效果观察

目的观察纤维桩树脂核全冠修复牙体严重缺损和薄弱根管的临床修复效果。方法选择牙体大面积缺损和薄弱根管患者165例219个患牙为研究对象。患牙经根管治疗后行纤维桩树脂核全冠修复,修复完成后6个月、1年、2年进行临床复查,其中牙体缺损达龈下行牙龈切除术或冠延长术的患牙,增加修复后1个月和3个月临床复查,评价其临床修复效果。结果165例的219个患牙中,有4例出现纤维桩与根管壁完整脱落,均未见根折、根裂,重新粘固后未见异常。其余215个患牙修复体未出现脱落,冠边缘密合,牙周正常,219个患牙均未出现基牙松动。结论应用纤维桩树脂核全冠修复牙体严重缺损和薄弱根管可以达到满意的临床修复效果。     

玻璃纤维增强型复合树脂桩核修复牙体缺损的临床应用

目的:探讨利用玻璃纤维增强型复合树脂桩核修复牙体严重缺损的可行性。方法:选择59例87颗牙体严重缺损的患牙,利用玻璃纤维作为增强材料,制作复合树脂桩核,然后以金属烤瓷全冠修复牙体缺损;患者在治疗完成后3、6和12个月复诊,观察修复效果。结果:1年中有2例3颗患牙失访,在57例84颗复查的患牙中,83颗患牙修复体稳固无松动,咬合功能恢复良好;仅有1颗患牙的修复体松动,但桩核稳固未松动,重新修复后效果良好;所有的修复患牙均未发生牙折,临床修复效果满意。结论:玻璃纤维增强型复合树脂桩核的强度高,色泽好,操作方便,可作为根管桩核材料在临床应用。     

玻璃纤维桩在前牙残冠残根修复中的临床应用

目的：评价玻璃纤维桩在前牙残冠残根修复中的临床应用效果。方法：选择前牙残冠残根病例63例,78个牙,经完善的根管治疗后,制作玻璃纤维桩树脂核恢复基牙外形,然后进行全冠修复。结果：经6～24个月随访,通过临床及X线检查76个牙获得随访,1个牙桩折,1个桩松动脱落,2个冠边缘密合性差,72个修复体的固位、边缘密合度、牙周状况均良好。结论：玻璃纤维桩具有良好的生物相容性、抗折性、抗疲劳性、美观、易操作,是前牙残冠残根保存修复的理想选择。     

一体化氧化锆桩核修复牙本质肩领不完整前牙牙体缺损临床效果评价

目的 评价一体化氧化锆桩核修复牙本质肩领不完整前牙牙体缺损的临床效果。方法 选择2010年1月至2011年12月在广东省中山市人民医院口腔医疗中心修复科就诊的上前牙牙体大面积缺损牙本质肩领不完整患者40例（40颗患牙）。经完善根管治疗后随机分为A、B两组,每组20例（20颗患牙）。A组采用一体化氧化锆桩核+氧化锆全瓷冠进行修复,B组采用铸造钴铬桩核+钴铬烤瓷全冠进行修复。经过2年的临床追踪随访,观察其临床效果。结果 随访期内,40例患者均能如期复诊。A组所有患者对修复美观效果均示满意;有1例右上中切牙在18个月时出现根折,其余病例均无桩核松动、脱落、折断,无根折,无明显牙龈炎,X线片未见继发性根尖周炎。B组中有9例患者对修复美观效果表示满意,11例患者认为美观效果一般;有2例分别是右上侧切牙在6个月及左上中切牙在15个月时发生根折,1例左上中切牙在24个月时因桩核松动而脱落,3例患牙在12个月和18个月时出现牙龈炎。结论 一体化氧化锆桩核修复牙本质肩领不完整前牙牙体缺损时可获得满意的美观效果及生物相容性,近期临床效果满意。     

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目的评价一体化氧化锆桩核修复牙本质肩领不完整前牙牙体缺损的临床效果。方法选择2010年1月至2011年12月在广东省中山市人民医院口腔医疗中心修复科就诊的上前牙牙体大面积缺损牙本质肩领不完整患者40例（40颗患牙）。经完善根管治疗后随机分为A、B两组,每组20例（20颗患牙）。A组采用一体化氧化锆桩核＋氧化锆全瓷冠进行修复,B组采用铸造钴铬桩核＋钴铬烤瓷全冠进行修复。经过2年的临床追踪随访,观察其临床效果。结果随访期内,40例患者均能如期复诊。A组所有患者对修复美观效果均示满意;有1例右上中切牙在18个月时出现根折,其余病例均无桩核松动、脱落、折断,无根折,无明显牙龈炎,x线片未见继发性根尖周炎。B组中有9例患者对修复美观效果表示满意,11例患者认为美观效果一般;有2例分别是右上侧切牙在6个月及左上中切牙在15个月时发生根折,1例左上中切牙在24个月时因桩核松动而脱落,3例患牙在12个月和18个月时出现牙龈炎。结论一体化氧化锆桩核修复牙本质肩领不完整前牙牙体缺损时可获得满意的美观效果及生物相容性,近期临床效果满意。     

玻璃纤维桩在老年人残根残冠修复治疗中的临床研究

目的：探讨玻璃纤维桩在老年人残根、残冠修复治疗中的临床效果。方法：临床选择53例残根残冠的老年患者，68颗患牙。经完善的根管治疗后，采用玻璃纤维制作复合树脂桩核，再以烤瓷冠修复，并经过0．5—2．0年临床疗效的追踪观察。结果：68颗患牙66颗无异常，1颗基牙牙龈炎，1颗纤维桩脱落，修复成功率为97．06％，修复效果满意。结论：玻璃纤维桩在老年患者残根残冠的修复治疗中，能达到良好的修复效果。     

玻璃纤维桩和复合树脂直接修复儿童冠折上前牙的临床评价

目的：应用玻璃纤维桩和复合树脂直接修复儿童冠折上前牙,随访2年并评价其临床效果。方法：对37例45颗儿童冠折上前牙行完善的根管治疗后,应用玻璃纤维桩与复合树脂直接进行修复,定期复查,评价其临床效果。结果：随访期内未见纤维桩折断、根折、及根尖周病变,仅1颗出现桩的脱粘结导致桩和树脂脱落。树脂的边缘渗漏、继发龋、表面着色、树脂折裂或部分脱落偶有发生,经处理均达病人满意。结论：对于根管治疗后儿童冠折前牙,应用玻璃纤维桩和复合树脂直接进行修复是成功而有效的过渡性治疗方法,可在短期内最大限度保存牙体组织,降低根折风险。     

Risk factors for failure of glass fiber-reinforced composite post restorations: a prospective observational clinical study

Glass fiber-reinforced endodontic posts are considered to have favorable mechanical properties for the reconstruction of endodontically treated teeth. The aim of the present investigation was to evaluate the survival of two tapered and one parallel-sided glass fiber-reinforced endodontic post systems in teeth with different stages of hard tissue loss and to identify risk factors for restoration failure. One-hundred and forty-nine glass fiber-reinforced endodontic posts in 122 patients were followed-up for 5-56 months [mean +/- standard deviation (SD): 39 +/- 11 months]. Glass fiber-reinforced endodontic posts were adhesively luted and the core was built with a composite resin. Cox proportional hazards models were used to evaluate the association of clinical variables and failure rate. Higher failure rates were found for restorations of anterior teeth compared with posterior teeth [Hazard-Ratios (HR): 3.1; 95% confidence interval (CI): 1.3-7.4], for restorations in teeth with no proximal contacts compared with at least one proximal contact (HR: 3.0; 95% CI: 1.0-9.0), and for teeth restored with single crowns compared with fixed bridges (HR: 4.3; 95% CI: 1.1-16.2). Tooth type, type of final restoration and the presence of adjacent teeth were found to be significant predictors of failure rates in endodontically treated teeth restored with glass fiber-reinforced endodontic posts.     

Clinical evaluation of the use of fiber posts and direct resin restorations for endodontically treated teeth

PURPOSE: Restoration of root-treated teeth is routinely performed in clinical practice with a choice of therapeutic options, considering many factors to provide optimal mechanical properties, esthetics, and longevity. The aim of the present work was to present a preliminary clinical report on the use of fiber posts and direct resin composites for restoring root-treated teeth. MATERIALS AND METHODS: Thirty-eight anterior and 62 posterior endodontically treated teeth were selected from 3 private prosthodontic offices. The protocol used included endodontic treatment, with translucent fiber posts (DT post) bonded to the post-space using a '1-bottle' adhesive (One-Step, Bisco) and a dual-cure resin cement (DuoLink, Bisco). Direct resin restorations were performed using a micro-hybrid resin composite (Gradia Direct, GC) and a layering technique. Both opaque dentin and enamel and translucent enamel shades were used. RESULTS: Patients were recalled after 6, 12, 24, and 30 months, and the restorations assessed according to predetermined clinical and radiographic criteria. These clinician-mediated evaluation methods confirmed the good clinical performance of the restorations. CONCLUSION: Restoration of endodontically treated teeth with fiber posts and direct resin composites is a treatment option, that in the short term conserves remaining tooth structure and results in good patient compliance.     

An up to 3-Year Controlled Clinical Trial Comparing the Outcome of Glass Fiber Posts and Composite Cores with Gold Alloy-Based Posts and Cores for the Restoration of Endodontically Treated Teeth

Purpose: This controlled clinical trial aimed to compare the 3-year outcomes of glass fiber posts and composite cores with gold alloy-based posts and cores for the restoration of endodontically treated teeth. Materials and Methods: One hundred forty-four patients in need of 205 restorations on endodontically treated teeth were selected and followed for 7 to 37 months (mean: 21 ± 9 months). The teeth were primarily stratified based on the remaining tissue available to restore the tooth core with or without a post. Then, randomization allocated the teeth to either test group 1 (prefabricated glass fiber posts), test group 2 (custom-made glass fiber posts), or test group 3 (composite cores without posts). The control group consisted of gold alloy-based posts and cores. All posts/cores were covered with all-ceramic single crowns. Failures were either absolute, such as root fractures or irreparable fractures of the post/core, or relative, such as loss of post retention or reparable fractures of the core. Success and survival probability lifetime curves, corrected for clustering, were drawn for the entire data set. Results: The recall rate at 3 years was 97.1%. Absolute failures consisted of two root fractures and one endodontic failure, while relative failures included three instances of retention loss of the post/core and one post fracture. Because of the low number of events, no statistical tests were performed. The success and survival probabilities over all groups together at 3 years amounted to 91.7% and 97.2%, respectively. Conclusions: After being followed for up to 3 years, both cast gold and composite post and core systems performed well clinically. Longer follow-up times are needed to detect possible significant differences. Int J Prosthodont 2011;24:363-372.     

Longitudinal clinical evaluation of post systems: a literature review

In this survey, retrospective and prospective clinical studies dealing with cast-post-and core and fiber posts were reviewed regarding the rate of survival of restorations and the most prevalent failures. Electronic searches of the literature were performed in MEDLINE by crossing the key words: "Fiber post and clinical study", "Fiber post and clinical evaluation", "Cast post-and-core and clinical study", and "Root post and retrospective survival study". The cut-off dates were December 1990 through the end of December 2010. Review of literature showed that several interrelated biological, mechanical, and aesthetic factors are involved in the survival rate of restorative procedures in endodontically treated teeth, and post selection should fulfill and optimize these factors. Data based on long-term clinical studies are essential for the general practitioner when making clinical decisions. An adequate selection of teeth and post system must be made, and a minimal amount of existing tooth substance should be removed. A ferrule must be present for safe indication of the fiber posts. Fiber glass posts have demonstrated good survival in clinical studies, with similar performance to cast-post-and cores. Metallic posts have good clinical survival, but the associated failures are mostly irreversible, unlike what happens with the glass fiber posts.     

Three-year follow up of customized glass fiber esthetic posts

Customized glass fiber posts that is well adjusted into the root canal and have mechanical properties similar to those of dentin may be a suitable treatment for severely compromised endodontically treated teeth. This article reports a 3-year follow up of severely damaged endodontically treated teeth restored with unidirectional fiber glass customized post and core system instead of a conventional fiber post. The fabrication of this glass fiber customized post is a simple technique, providing an increased volume of fibers into the root canal, and an adequate polymerization of the post-core system. Over a three-year period, the treatments demonstrated good clinical and radiographic characteristics, with no fracture or loss of the post and/or crown. This technique can be considered effective, less invasive, and suitable for restore endodontically treated teeth.     

Fracture resistance of composite resin cores with or without prefabricated posts over different substrates

The fracture resistance of endodontically treated teeth has been an obstacle to the durability of the remaining teeth and restorations. The aim of this study was to evaluate the fracture resistance of endodontically treated bovine and human teeth that were restored with either prefabricated metal posts, glass fiber posts, or composite resin cores. Statistical analysis revealed significant difference between different substrates, but there was no statistically significant difference between different types of intraradicular posts or in the interaction between substrate and post types. The intraradicular posts do not increase the fracture resistance of endodontically treated teeth. The metal posts presented more unfavorable fracture modes when compared to glass fiber posts and composite resin cores.     

The fracture behavior of premolar teeth with class II cavities restored by both direct composite restorations and endodontic post systems

PURPOSE: The aim of the study was to evaluate the influence of different posts on the fracture load and fracture mode of endodontically treated premolars with class II cavities and direct composite restorations in an ex vivo setting. METHODS: Forty-eight single-rooted human premolars were endodontically treated and prepared with standardized MO (mesio-occlusal) cavities. Eight teeth each received either no posts or were restored with titanium screws (BKS), glass fiber posts (DentinPost), or quartz fiber posts (DT Light SL). Sixteen teeth were restored with zirconium dioxide posts (CeraPost). BKS-screws and eight zirconium dioxide posts were cemented conventionally with glass ionomer cement; Panavia F resin cement was used for all others. The specimens were restored with direct composite restorations. Eight sound premolars served as the controls. After thermomechanical fatigue testing, the samples were loaded until fracture occurred at an angle of 45 degrees . All specimens were evaluated for fracture lines. RESULTS: The sound teeth showed the significant highest fracture load (792.50+/-210.01 N). The group restored with quartz fiber posts differed not significantly from the control. In the groups with fiber posts and titanium screws significant higher fracture load values occurred as in the group with direct composite restorations without posts. The groups with fiber posts did not show a more favorable fracture mode than the other groups. CLINICAL SIGNIFICANCE: The use of an intraradicular post in premolars with class II cavities can significantly increase the resistance towards extra-axial forces.     

Three-year clinical comparison of survival of endodontically treated teeth restored with either full cast coverage or with direct composite restoration

STATEMENT OF PROBLEM: Little information exists regarding the outcome of crown build-ups on endodontically treated teeth restored with metal-ceramic crowns or with only a direct-placed composite. PURPOSE: The aim of this study was to evaluate the clinical success rate of endodontically treated premolars restored with fiber posts and direct composite restorations and compare that treatment with a similar treatment of full-coverage with metal-ceramic crowns. MATERIAL AND METHODS: Subjects included in this study had one maxillary or mandibular premolar for which endodontic treatment and crown build up was indicated and met specific inclusion/exclusion criteria. Only premolars with Class II carious lesions and preserved cusp structure were included. Subjects were randomly assigned to 1 of the following 2 experimental groups: (1) teeth endodontically treated and restored with adhesive techniques and composite or (2) teeth endodontically treated, restored with adhesive techniques and composite, and then restored with full-coverage metal-ceramic crowns. Sixty teeth were included in the first group and 57 in the second. All restorations were performed by one operator. Causes of failure were categorized as root fracture, post fracture, post decementation, clinical and/or radiographic evidence of marginal gap between tooth and restoration, and clinical and/or radiographic evidence of secondary caries contiguous with restoration margins. Subjects were examined for the listed clinical and radiographic causes of failure by 2 calibrated examiners at intervals of 1, 2, and 3 years. Exact 95% confidence intervals for the difference between the 2 experimental groups were calculated. RESULTS: At the 1-year recall, no failures were reported. The only failure modes observed at 2 and 3 years were decementations of posts and clinical and/or radiographic evidence of marginal gap between tooth and restoration. There was no difference in the failure frequencies of the 2 groups (95% confidence interval, -17.5 to 12.6). There was no difference between the number of failures caused by post decementations and the presence of marginal gaps observed in the 2 groups (95% confidence intervals, -9.7 to 16.2 and -17.8 to 9.27). CONCLUSION: Within the limitations of this study, the results upheld the research hypothesis that the clinical success rates of endodontically treated premolars restored with fiber posts and direct composite restorations after 3 years of service were equivalent to a similar treatment of full coverage with metal-ceramic crowns.     

玻璃纤维桩在磨牙残冠桩核冠修复中的临床应用

目的探讨玻璃纤维桩在磨牙残冠修复治疗中的临床效果。方法选择35例患者的44颗磨牙残冠为研究对象。44颗磨牙残冠经完善的根管治疗后,选择玻璃纤维制桩的数目和长度,再烤瓷冠修复,并经过6个月～2年临床疗效的追踪观察。结果44颗患牙有42颗无异常,2颗因纤维桩脱落和基牙牙龈炎而失败,修复成功率为95.45%,修复效果满意。结论玻璃纤维桩在磨牙残冠的修复治疗中,能达到良好的修复效果。