The Outcomes of Endodontically Treated Teeth Restored with Custom-Made Cast Post-and-Core Restorations: A Retrospective Cohort Study.

INTRODUCTION: Custom-made cast post-and-core (CMCPC) restorations have long been used to restore structurally deficient endodontically treated teeth (ETT). However, the evidence regarding their impact on the outcomes of ETT is largely inconclusive. This study evaluated the long-term treatment outcome of ETT restored with CMCPC. METHODS: This retrospective cohort study examined the dental records of patients that received CMCPC at a specialty private practice in Toronto, Canada between 1999 and 2021. The proportion of ETT with complete periapical healing and those that survived were estimated, and prognostic factors were investigated using multiple logistic and Cox regression analyses respectively (P < .05). RESULTS: A total of 500 and 1000 teeth met periapical healing and survival criteria, respectively. The periapical healing rate was 88.8% and was associated with the presence of baseline periapical radiolucency [odds ratio = 0.1; 95% confidence interval (CI), 0.05-0.2; P < .001]. The survival after a median follow-up time of 52.9 months (interquartile range: 26.5-99.4) was 90.1% and was associated with <75% of root length in bone [hazard ratio (HR) = 2.6; 95% CI, 1.0-6.6; P = .033], type and quality of final restoration (HR = 2.09; 95% CI, 1.1-3.9; P = .020; HR = 2.3; 95% CI, 1.2-4.5; P = .008, respectively), and the presence of periapical radiolucency at the latest recall (HR = 3.2; 95% CI, 1.7-6.3; P < .001). CONCLUSIONS: The outcome of ETT restored with CMCPC was favorable. CMCPC may be regarded as a viable restorative option for structurally deficient ETT.

The effect of smoking on osseointegrated dental implants. Part I: implant survival.

PURPOSE: Recent studies implicate smoking as a significant factor in the failure of dental implants. The purpose of this long-term retrospective study was to evaluate the survival of Brånemark endosseous dental implants in relation to cigarette smoking. MATERIALS AND METHODS: The sample consisted of 464 consecutively treated completely and partially edentulous patients who had a total of 1852 implants placed between 1979 and 1999, and who were part of a surgical/prosthodontic prospective treatment outcomes study. The effect of cigarette smoking on implant survival in relation to the time of implant failure, gender, age, surgeon, date and site of implant placement, implant length and diameter, prosthesis design, and occlusal loading considerations was assessed in bivariate and multivariate survival analyses. RESULTS: The overall implant failure rate was 7.72%. Patients who were smokers at the time of implant surgery had a significantly higher implant failure rate (23.08%) than nonsmokers (13.33%). Multivariate survival analysis showed early implant failure to be significantly associated with smoking at the time of stage 1 surgery and late implant failure to be significantly associated with a positive smoking history. Short implants and implant placement in the maxilla were additional independent risk factors for implant failure. CONCLUSION: Cigarette smoking should not be an absolute contraindication for implant therapy; however, patients should be informed that they are at a slightly greater risk of implant failure if they smoke during the initial healing phase following implant insertion or if they have a significant smoking history.