Influence of coronal restorations on the fracture resistance of root canal-treated premolar and molar teeth: A retrospective study

• Published in: Australian endodontic journal Vol. 39; no. 2; pp. 48 - 56
• Main Authors: Dammaschke, Till, Nykiel, Kathrin, Sagheri, Darius, Schäfer, Edgar
• Format: Journal Article
• Language: English
• Published: Australia Blackwell Publishing Ltd 01.08.2013; Wiley Subscription Services, Inc
• Subjects: Adolescent; Adult; Aged; Bicuspid - physiopathology; Composite Resins - chemistry; coronal restoration; Crowns - classification; Dental Alloys - chemistry; Dental Amalgam - chemistry; Dental Materials - chemistry; Dental Restoration, Permanent - methods; Dentistry; Denture, Partial; Female; Follow-Up Studies; fracture resistance; Glass Ionomer Cements - chemistry; Gold Alloys - chemistry; Humans; Male; Middle Aged; Molar - physiopathology; Post and Core Technique - instrumentation; post-endodontic restoration; Retrospective Studies; Root Canal Filling Materials - therapeutic use; root canal treatment; Survival Analysis; survival rate; Tooth Fractures - physiopathology; Tooth, Nonvital - therapy; Young Adult; coronal restoration; survival rate; post-endodontic restoration; fracture resistance; root canal treatment
• ISSN: 1329-1947; 1747-4477
• DOI: 10.1111/aej.12002

To evaluate the influence of coronal restorations on the fracture resistance of endodontically treated teeth, 676 root canal‐filled and restored posterior teeth were evaluated after a mean period of 9.7 (±2.8; minimum: 5) years. A total of 86.2% of the endodontically treated and restored teeth survived the mean observation period of 9.7 years without fracture. The overall survival period was 13.6 (± 0.2) years. All teeth with gold partial crowns survived without fractures (n = 24). Teeth with crowns and adhesively sealed access cavities showed a mean survival period of 15.3 (± 0.4) years, with crown and bridge restorations 14.0 (± 0.3), with individual metal posts 13.9 (± 0.2), with composite fillings 13.4 (± 0.5), with prefabricated metal posts 12.7 (± 0.6), with amalgam fillings 11.8 (± 0.6) and with glass ionomer cements (GIC) 6.6 (± 0.5) years. Teeth with one or two surfaces restored by amalgam, composite or GIC showed a significantly lower fracture rate than teeth with three and more restored surfaces (P < 0.05). The mean fracture rate of teeth restored with GIC was significantly higher when compared with all other groups (P < 0.001). In general, endodontically treated teeth restored with prosthetic restorations demonstrated a significantly lower mean fracture rate than teeth restored with fillings. Cavities with up to three surfaces may well be successfully restored adhesively with composite filling material.