Crown vs. Composite for Post-retained Restorations: up to 59-month Trial

Objectives: This randomized clinical trial compared the survival of composite resin restorations and metal-ceramic crowns on endodontically treated teeth that received a glass fiber post.
Methods: Forty-seven patients (age 42.5±11.5) with fifty-seven endodontically treated teeth severely damaged but with at least one entire wall were randomly allocated into two groups according to the type of coronal restoration: metal-ceramic crown or composite resin (Z250). A glass fiber post (White Post DC #1) was previously cemented in all teeth with regular (RelyX ARC) or self-adhesive (RelyX U100) resin cement. Descriptive analysis through FDI clinical criteria was performed and the longevity of restorations and teeth were analyzed using Kaplan-Meier statistics and log-rank tests.
Results: The recall rate was 100% for a time up to 59 months. From 30 composite restorations and 27 metal-ceramic crowns, one tooth was extracted after 11 months due to root fracture (composite group). Eight composite restorations and one crown had reparable failures, all due to secondary caries or restoration fracture. The general annual failure rate (AFR) was 0.92% after 50 months for success of the restorations, with 1.83% for the composite group and 0.26% for the metal-ceramic crown group. The log-rank test showed no difference for survival according to the type of restoration (p=0.344). However, for success rates, metal-ceramic crowns demonstrated better performance (p=0.022).
Conclusions: Indirect restorations provided higher acceptable clinical performance and lower need for reintervention after the follow-up time. Still, both types of restorations presented good survival rates. (NCT01461239)