Restoration of Endodontically Treated Anterior Teeth with Cast Metallic Post or Prefabricated Fibre Post Placement: 2 Case Reports and Critical Literature Review

Open access


With a wide variety of post systems and materials available for the restoration of lost tooth structure of endodontically treated teeth, the clinical decision of which to use constitutes a challenge to dental practitioners. Cast metal post and cores are widely used for restoring endodontically treated teeth with extensive loss of coronal tooth structure and to retain metal-ceramic crowns. When dental aesthetics is of primary concern, the selection of the underlying restorative material becomes an important factor to consider. The fibre-reinforced posts combined with all-ceramic crowns offer a highly aesthetic outcome in anterior region restorations, but longterm evaluation is necessary in order to assess their clinical performance and longevity.

The purpose of this paper was to present and compare 2 restorative options with regard to materials (cast metallic post and core versus prefabricated fibre post and composite resin core) for the prosthetic rehabilitation of cases with inadequate aesthetic appearance or fractured maxillary anterior teeth. Furthermore, the article reviews the main indications, advantages, and disadvantages from the use of the 2 post types combined with the final restorations, in order to allow the dental practitioner make the selection of appropriate restorative materials.

1. Morgano SM, Brackett SE. Foundation restorations in fixed prosthodontics: Current knowledge and future needs. J Prosthet Dent, 1999; 82:643-657.

2. Bateman G, Ricketts DNJ, Saunders WP. Fibre-based post systems: a review. Br Dent J, 2003; 195:43-48.

3. Aquilino SA, Caplan DJ. Relationship between crown placement and the survival of endodontically treated teeth. J Prosthet Dent, 2002; 87:256-263.

4. Cagidiaco M, Goracci C, Garcia-Godoy F, Ferrari M. Clinical studies of fiber posts: A literature review. Int J Prosthodont, 2008; 21:328-336.

5. Grandini S, Goracci C, Tay FR, Grandini R, Ferrari M. Clinical evaluation of the use of fiber posts and direct resin restorations for endodontically treated teeth. Int J Prosthodont, 2005; 18:399-404.

6. Monticelli F, Grandini S, Goracci C, Ferrari M. Clinical behavior of translucent fiber posts: A 2-year prospective study. Int J Prosthodont, 2003; 16:592-596.

7. Qing H, Zhu Z, Chao Y, Zhang W. In vitro evaluation of the fracture resistance of anterior endodontically treted teeth restored with glass fiber and zircon posts. J Prosthet Dent, 2007; 97:93-98.

8. Cormier CJ, Burns DR, Moon P. In vitro comparison of the fracture resistance and failure mode of fiber, ceramic, and conventional post systems at various stages of restoration. J Prosthodont, 2001; 10:26-36.

9. Hudis SI, Goldstein GR. Restoration of endodontically treated teeth: a review of literature. J Prosthet Dent, 1986; 55:33-38.

10. Creugers NH, Mentink AG, Kayser AF. An analysis of durability data on post and core restorations. J Dent, 1993; 21:281-284.

11. Heydecke G, Peters MC. The restoration of endodontically treated, single-rooted teeth with cast or direct posts and cores. A systematic review. J Prosthet Dent, 2002; 87:380-386.

12. Robbin SJW. Guidelines for the restoration of endodontically treated teeth. J Am Dent Assoc, 1990; 120:558-566.

13. Akkayan B, Gulmer T. Resistance to fracture of endodontically treated teeth restored with different post systems. J Prosthet Dent, 2002; 87:431-437.

14. Smith CT, Schuman NJ, Wasson W. Biomechanical criteria for evaluating prefabricated post-and-core systems. A guide for the restorative dentist. Quintessence Int, 1998; 29:305-312.

15. Silvers JE, Johnson WT. Restoration of endodontically treated teeth. Dent Clin North Am, 1992; 36:631-638.

16. Reeh ES, Douglas WH. Stiffness of endodontically-treated teeth related to restoration technique. J Dent Res, 1989; 68:1540-1544.

17. Sorensen JA, Engelman MJ. Ferrule design and fracture resistance of endodontically treated teeth. J Prosthet Dent, 1990; 63:529-536.

18. Caputo AA, Standlee. Pins and posts - why, when and how. Dent Clin North Am, 1976; 20:299-311.

19. Trope M, Maltz DO, Tronstad L. Resistance to fracture of restored endodontically treated teeth. Endod Dent Traumatol, 1985; 1:108-111.

20. Sorensen JA, Engelmen MJ. Effect of post adaptation on fracture resistance of endodontically-treated teeth. J Prosthet Dent, 1990; 64:419-424.

21. Tjan AH, Whang SB. Resistance to root fracture of dowel channels with various thickness of buccal dentin walls. J Prosthet Dent, 1985; 53:496-500.

22. Cooney JP, Caputo AA, Trabert KC. Retention and stress distribution of tapered-end endodontic posts. J Prosthet Dent, 1986; 55:504-506.

23. Stockton LW. Factors affecting retention of post systems: A literature review. J Prosthet Dent, 1999; 81:380-385.

24. Freedman GA. Esthetic post-and-core treatment. Dent Clin North Am, 2001; 45:103-116.

25. Sidoli GE, King PA, Setchell DJ. An in vitro evaluation of a carbon fiber-based post and core system. J Prosthet Dent, 1997; 78:5-9.

26. Espevik S. Corrosion of base metal alloys in vitro. Acta Odontol Scand, 1978; 36:113-116.

27. Standlee JP, Caputo AA, Holcomb J, Standlee JP. The retentive and stress-distributing properties of a threaded endodontic dowel. J Prosthet Dent, 1980; 44:398-403.

28. Burns DA, Krause WR, Douglas HB, Burns DR. Stress distribution surrounding endodontic posts. J Prosthet Dent, 1990; 64:412-418.

29. Ross RS, Nicholls JI, Harrington GW. A comparison of strains generated during placement of five endodontic posts. J Endodont, 1991; 17:450-456.

30. Sirimai S, Riis DN, Morgano SM. An in vitro study of the fracture resistance and incidence of vertical root fracture of pulpless teeth restored with six post-and-core systems. J Prosthet Dent, 1999; 81:262-269.

31. Larson TD, Jensen JR. Microleakage of composite resin and amalgam core material under complete cast crowns. J Prosthet Dent, 1980; 44:40-44.

32. Bergman B, Lundquist P, Sjogren U, et al. Restorative and endodontic results after treatment with cast posts and cores. J Prosthet Dent, 1989; 61:10-15.

33. Balkenhol M, Wostmann B, Rein C, Ferger P. Survival time of cast post and cores: a 10-year retrospective study. J Dent, 2007; 35:50-58.

34. Kantor ME, Pines MS. A comparative study of restorative techniques for pulpless teeth. J Prosthet Dent, 1977; 38:405-412.

35. Davies SJ, Gray RJM, Qualtrough AJE. Management of tooth surface loss. Br Dent J, 2002; 192:11-23.

36. Edmunds DH, Dummer PMH. Root canal retained restorations: General considerations and custom-made cast posts and cores. Dent Update, 1990; June:183-188.

37. Smith CT, Schuman NJ, Wasson W. Biomechanical criteria for evaluating prefabricated post-and-core systems: A guide for the restorative dentist. Quintessence Int, 1998; 29:305-312.

38. Cheung W. A review of the management of endodontically treated teeth. Post, core and the final restoration. J Am Dent Assoc, 2005; 136:611-619.

39. Meyenberg K. Dental esthetics - A European perspective. J Esthet Dent, 1994; 6:274281.

40. Koutayas SO, Kern M. All-ceramic posts and cores: The state of the art. Quintessence Int, 1999; 30:383-392.

41. Ferrari M, Vichi A, Mannocci F, Mason PN. Retrospective study of clinical performance of fiber posts. Am J Dent, 2000; 13:9B-14B.

42. Fragou T, Tortopidis D, Kontonasaki E, Evangelinaki E, Ioannidis K, Petridis H, Koidis P. The effect of ferrule on the fracture mode of endodontically treated canines restored with fibre posts and metal-ceramic or all-ceramic crowns. J Dent, 2012; 40:276-285.

43. Newman MP, Yaman P, Dennison J, Rafter M, Billy E. Fracture resistance of endodontically treated anterior teeth restored with four post-and-core systems J Prosthet Dent, 2003; 89:360-367.

44. Pontius O, Hutter JW. Survival rate and fracture strength of incisors restored with different post and core systems and endodontically treated incisors without coronoradicular reinforcrment. J Endod, 2002; 28:710-715.

45. Evangelinaki E, Tortopidis D, Kontonasaki E, Fragou T, Gogos C, Koidis P. Effect of a crown ferrule on the fracture strength of endodontically treated canines restored with fiber posts and metal-ceramic or all-ceramic crowns. Int J Prosthodont, 2013; 26:384-387.

46. Ferracane JL. Using posterior composites appropriately. J Am Dent Assoc, 1992; 123:53-58.

47. Ferracane JL, Condon JR. Post-cure heat treatments for composites: properties and fractography. Dent Mater, 1992; 8:290-295.

48. Mccullock AJ, Smith BGN. In vitro studies of cuspal movement produced by adhesive restorative materials. Br Dent J, 1986; 61:405-409.

49. Bitter K, Kielbassa AM. Post-endodontic restorations with adhesively luted fiber-reinforced composite post systems: A review. Am J Dent, 2007; 20:353-360.

50. Piovesan EM, Demarco FF, Cenci MS, Pereira-Cenci T. Survival rates of endodontically treated teeth restored with fiber-reinforced custom posts and cores: A 97-month study. Int J Prosthodont, 2007; 20:633-639.

Balkan Journal of Dental Medicine

Successor of the Balkan Journal of Stomatology

Journal Information


All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 479 479 63
PDF Downloads 173 173 26