ABSTRACT
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.