Posts to Refit Telescopic Crowns After Fracture – a Retrospective Analysis

Objectives: Fracture of teeth under telescopic crown (TC) retained dentures (TCD) is a common cause of failure. Due to extra axial forces when TCD is removed and inserted incorrectly or a long denture saddle does not fit the edentulous jaw areas, risk for tooth fracture increases because of the rigid connection to the TCD. In these cases, it is established clinical practice to refit the existing TC with post and core (PC). Though, many authors reported bad survival for PC under TCD they did not distinguish between PC that were already in situ at the time of fitting TCD (PC1) and PC to refit TC after fracture (PC2). Therefore, this retrospective survival analysis aimed to compare the survival of PC1 and PC2 and to investigate possibly influencing parameters.
Methods: In the observation period (2004-2022) 253 patients were treated with overall 406 PC in combination with TCD (132 PC1 and 274 PC2). The patient files were analysed for the parameters: Jaw, type of tooth, luting material, PC material, bone attachment and cause of failure. The statistical analysis was conducted using Kaplan-Meier and Cox regression analysis.
Results: The average survival time for PC1 was 11.91 years and 7.63 years for PC2, resulting in a highly significant difference between the two investigation groups (p<0.001). Furthermore, the bone attachment had a significant influence on survival (p=0.002). Tooth fracture was the most common cause of failure leading to inevitable tooth extraction.
Conclusions: PC2 is an acceptable treatment, since it is sometimes the last option to refit TC after fracture. Nevertheless, clinicians should weigh the effort-benefit ratio of PC2 treatment in each case. If the abutment tooth is dispensable for the stability of TCD, the dentist should discuss with the patient to extract the tooth because of the bad survival probability.