Fibre-reinforced Cad/CAM Post and Cores: The New "gold Standard" for Anterior Teeth with Extensive Coronal Destruction?-A Fully Digital Chairside Workflow

Overview

Journal Heliyon

Specialty Social Sciences

Date 2023 Aug 23

PMID 37609410

Authors

Jonas Adrian Helmut Vogler

Louise Billen

Kay-Arne Walther

Bernd Wostmann

Affiliations

Soon will be listed here.

Abstract

Objectives: Since one-third of persons suffer a dental trauma, treatment of anterior teeth using post and core (PC) is becoming important. In teeth with extensive destruction, cast PC (CPC) remain the "gold standard", even though they lead to aesthetic impairment and have a mismatching elastic modulus to that of dentin. Prefabricated fibre-reinforced posts have elastic modulus similar to that of dentin but the accuracy of fit and mechanical stability are worse. This study was aimed to evaluate the deviation and mechanical performance of fibre-reinforced CAD/CAM PC (FRPC) fabricated in a fully digital chairside workflow, compared to those of CPC.

Methods: On 30 teeth, a PC preparation was conducted, and a conventional and digital post impression were taken with an intraoral scanner. Fifteen teeth each were treated with CPC and FRPC, respectively. The deviation was evaluated by superimposing the datasets of the digitalised stone models and digital post impressions. Decementation and root fracture during chewing simulation were analysed by microscopy and X-ray. Statistical analysis was performed by pairwise comparison and Kaplan-Meier analysis.

Results: The median deviation for the "coronal", "middle" and "apical" were 14.5, 18.0 and 113.7 μm, respectively. The pairwise comparison for "coronal"/"middle" showed no significance (p = 0.465), whereas that for "coronal"/"apical" and "middle"/"apical" showed highly significant differences (p < 0.001). After chewing simulation, five decementations and two root fractures were detected for CPC. For FRPC, neither decementation nor root fracture were documented.

Significance: Within the limitations of this study, FRPC performed significantly better than CPC.

Citing Articles

Post and Core Treatment to Refit Telescopic Crown-Retained Dentures after Abutment Tooth Fracture: An Evaluation of Therapy by Retrospective Survival Analysis.

Vogler J, Abrahamian W, Reich S, Wostmann B, Rehmann P Dent J (Basel). 2024; 12(7).

PMID: 39057011 PMC: 11275264. DOI: 10.3390/dj12070224.

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