Radiographic assessment of the quality of post and core restorations performed by general dental practitioners in Saudi Arabia.

Background: Dentists utilize various techniques and materials for post and core restoration of endodontically treated teeth, which remains a noteworthy health concern and can be addressed through interdisciplinary strategies to enhance outcomes. Therefore, this study aimed to evaluate the technical quality of the residual gutta-percha (GP) and posts by analysing the periapical radiographs of endodontically restored teeth. Methods: A total of 594 periapical digital radiographs were evaluated for tooth type, post material, post shape, design, diameter, length, residual GP, GP length, GP tapering, GP homogeneity, and final restoration. Frequency distribution and cross-tabulation of the variables were performed. Results: Maxillary molars had the highest frequency of restorations, including posts, accounting for 27.4 %, followed by maxillary premolars (25.4 %) and maxillary anterior teeth (19.2 %). The prefabricated metallic posts were most commonly used (81.0 %), among these, 50.4 % were screwed posts. Tapered posts were the most commonly used (65.6 %). The percentage of posts with an acceptable length was 58.2 %. The most commonly used posts exhibited a width of one-third of the root diameter, accounting for 87.0 %. Suitable GP lengths were observed in 61.1 % of the restorations, and 62.8 % demonstrated adequate GP homogeneity. The findings of this study revealed that crown restoration accounted for 42.6 % of the studied sample. Conclusions: The technical quality of the remaining GP after restoration was comparable to that of previous epidemiological investigations. However, the technical quality of the post was deemed suboptimal.

Assessment of CAD/CAM Fabrication Technologies for Post and Core Restorations-A Narrative Review.

The primary objective of this study is to conduct a comprehensive review of the existing literature that discusses research on post and core restorations, covering aspects such as their composition, manufacturing methods, and clinical effectiveness. The methodology employed in this review encompasses the implementation of a well-defined search strategy, the establishment of criteria for inclusion and exclusion, and the selection of relevant studies to summarize their findings. To gather relevant literature published between 1993 and 2023, the research team conducted separate searches on PubMed, Web of Science, and Embase databases. In total, 168 titles were initially retrieved from these electronic databases. By applying the predefined exclusion criteria, the researchers identified 73 articles that specifically address the conventional and computer-aided design/computer-aided manufacturing (CAD/CAM) technologies employed in post and core restorations. These treatments are commonly employed to restore teeth that have received endodontic therapy and subsequently experienced loss of dental structure. The development of computerized technology for the creation of customized posts and cores has emerged as a straightforward and efficient alternative to traditional methods. The review synthesizes papers discussing the techniques and materials involved in CAD/CAM-based construction of post and cores. It explores strategies for restoring endodontically treated teeth, highlighting both direct and indirect approaches. Commonly mentioned materials include zirconia, composite resin, and hybrid ceramics. Despite the limited literature on CAD/CAM post and core procedures, the review emphasizes the necessity of further research to assess long-term outcomes and efficacy. Additionally, it suggests including implications for future research and clinical recommendations to enhance the depth and practical relevance of the review.

Polyetheretherketone (PEEK) Post and Core Restorations: A 3D Accuracy Analysis between Heat-Pressed and CAD-CAM Fabrication Methods.

PURPOSE: The purpose of this study was to evaluate the accuracy of polyetheretherketone (PEEK) based post and core restorations using heat-pressed and computer-aided design and computer-aided manufacturing (CAD-CAM) methods. MATERIALS AND METHODS: Post and core patterns (n = 10) were fabricated using an acrylic pattern resin and each pattern was scanned to generate a resin pattern standard tessellation file (STL-R) to be used as the standard control group for the 3D profilometric analysis. The STL-R files were loaded into a computer-aided manufacturing (CAM) machine and a milling disk made of a modified PEEK-based polymer with 20% ceramic fillers was milled into post and core restorations. Each original post and core resin pattern was sprued, invested and pressed using pellets made of the same PEEK material and a PEEK pressing unit. The resulting post and core restorations from the CAD-CAM and heat-pressed methods were scanned to generate STL-M (milled) and STL-P (heat-pressed) files, respectively. STL-M and STL-P files were digitally aligned and compared to STL-R files using a 3D analysis software. The 3D spatial distribution deviation was exported, and the statistical analysis was performed using the 95% CI deviation distribution from the Gaussian function subtraction. The statistical outcome for each group was merged and a 3D color-coded map was created showing the average deviation (α = 0.05). RESULTS: The heat-pressed post and core restoration showed 79 ±6% of the areas within ±50 µm while the CAD-CAM post-and-core restoration showed 66 ±9%. The CAD-CAM post and core restorations show 6 ±5% of the areas above the ideal for marginal adaptation limit threshold of 200 µm, while only 0.7 ±0.7% was found for the heat-pressed. CONCLUSIONS: The heat-pressed method to manufacture PEEK-based post and core restorations showed higher accuracy than the CAD-CAM method.

Radiographic Evaluation of Post-core Restorations fabricated by Dental Students at Jazan University.

AIM: Post and core procedures are important clinical methods in routine dental practice. The present research aimed to radiographically assess the quality of post seating performed by undergraduate students at the College of Dentistry, Jazan University. MATERIALS AND METHODS: A total of 343 periapical X-rays of cemented posts (170 from males and 173 from females) were assessed. The assessment covered tooth type, arch, gender, type of post, length of post in relation to the crown and root lengths, the presence of any abnormality in post space, status of the remaining gutta-percha (GP), and the presence or absence of spaces between the end of post and GP. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) program (version 21), and associations between variables were determined using chi-squared or Fisher's exact tests. RESULTS: Maxillary teeth were the most frequently restored with posts, and the majority (41%) comprised incisors. Similarly, glass fiber post (69%) and taper-shaped posts (86%) were the most used posts. The majority of posts (81.6%) featured a width one-thirds that of the root. Lengths of posts were twice (58%) or equal to (51%) crown and root length respectively. More than 55% of cases presented 3 to 5 mm of GP at their apical portion, and 29% reached more than 5 mm. Approximately 5 to 8% of assessed cases revealed widening of periodontal ligaments, presence of periapical pathologies, and deviation of posts from the canal wall. Most cases (75%) showed the absence of space between GP and the post end. CONCLUSION: Qualities of assessed post and core restorations conducted by the 6th year dental students were clinically acceptable. CLINICAL SIGNIFICANCE: Periodic evaluation to determine the quality of delivered treatments is a vital cue for health service authorities. This evaluation will improve quality of services and treatments provided by dental students to their patients under the supervision of the faculty. Results obtained will also provide authorities with a clear feedback about academic infrastructure.