Clinical performance of fiber post restorations: 2-year results

Objectives: To evaluate the 2-year outcome of post-retained restorations of endodontically treated teeth. Methods: A consecutive sample of 45 patients was collected and 45 premolars (25 maxillary, 20 mandibular) were restored. RelyX Fiber posts (3M ESPE) were luted with RelyX Unicem (3M ESPE) following manufacturer's instructions. Filtek Flow (3M ESPE) was used to build-up the abutment, that was covered with an all-ceramic crown (Empress II, Ivoclar-Vivadent). Baseline factors such as tooth type and number of residual coronal walls were noted. After 23-25 months patients were recalled and two operators who had been previously calibrated separately performed a clinical and radiographic examination. The following events were considered as failures: post debonding, post fracture, root fracture, failure of the core portion requiring a new coronal restoration, displacement of the crown, endodontic and periradicular conditions requiring endodontic retreatment. Kaplan-Meier plots were constructed. The Cox regression analysis was applied to assess the influence of baseline factors on failure occurrence. Results: One patient could not be re-evaluated. Radiographic signs of periapical pathology were observed in 3 teeth, though symptoms were reported for only 1 of them. The 3 teeth showing periapical lesions also had the post debonded. Overall, 4 teeth with 2 residual coronal walls exhibited post debonding along with marginal leakage. All debonded posts were re-luted and the teeth were thus restored to function. The survival rate of post-retained restorations in this study was similar to the rates reported in previous clinical trials. The Cox regression analysis did not reveal any significant influence of baseline factors on failure occurrence. Conclusions: Restorations of endodontically treated premolars retained by fiber posts luted with a self-adhesive resin cement showed a satisfactory success rate after 2 years of clinical service. All the 4 recorded failures consisted of post debonding, while no irreparable failures such as root fracture occurred.