Summary
Conventional perspectives at the placement of dental posts, in the past considered only for protecting a core, are evolving. Preservation of dentin all the way through dental procedures, together with get right of entry to opening, canal shaping, root preparation for posts, and recovery, is an important for the longevity and good fortune of restorations. Extra removing of dentin, particularly for straight-line get right of entry to, weakens the enamel construction and will increase the danger of failure. Medical research display that keeping up coronal dentin is necessary for supporting the core buildup and making sure the survival of endodontically handled tooth.
The usage of parallel-sided posts, which incessantly require casting off sound dentin, is being reconsidered in prefer of tapered quartz fiber posts that agree to the herbal form of the canal and scale back rigidity. Those fiber posts be offering a number of benefits, akin to nearer modulus of elasticity to dentin, upper flexural power, and resistance to cyclic fatigue, in comparison to conventional steel or zirconia posts. Moreover, they don’t corrode or reason discoloration. The evolution in fabrics and strategies, together with using fiber posts, objectives to make stronger enamel construction, decrease the danger of catastrophic disasters, and beef up the medical results for sufferers.
Creation
“Conventional pondering {that a} put up is best positioned to retain a core and serves no different goal might not be legitimate.” (1) The preservation of dentin all the way through get right of entry to opening, shaping the canal, getting ready the basis for placement of a put up, and all the way through recovery with an on lay or complete protection preparation is significant to the medical longevity and good fortune of the general recovery. (2) It’s now effectively identified that extra removing of dentinal toughen, now not best within the root, but additionally coronally, adjustments the flexural habits and resistance to failure, and that over flaring the canal for immediately line get right of entry to to the canals weakens the dentinal advanced. (3-6)
Coronal Dentin and Core Buildup Beef up
Dentin coronally should be maintained, now not best to provide toughen to the core buildup, (7,8) however as effectively, as a result of medical and in vitro research toughen the truth that survival of endodontically handled tooth restored with posts is without delay proportional to the residual coronal dentin that is still. (9,10)
Put up Preparation Issues
Put up preparation of the basis canal area should now not take away further dentin, as this contributes to a discounted fracture toughness. (Fig. 1) Ree et al. state that “no further dentin will have to be got rid of past what’s vital to finish the endodontic remedy”. (11) If this idea is to be adhered to clinically, then after all using parallel sided posts should be eradicated from our medical protocol, as those posts most often require removing of sound apical radicular dentin, developing sharper inner line angles, leading to a weakened root and the next root fracture chance (Fig 2). (12) As effectively, the parallel put up does now not supplement the tapered form of the ready canal, leading to extra luting composite within the coronal side of the canal, which is able to lower bonding efficacy and reduce dislocation resistance (Fig. 3). (13)
Minimizing Dentin Elimination
If we adhere to the concept that of minimum dentin removing within the root, and if we acknowledge that the majority root canals are ovoid in form, then an entirely other remedy way than what we’ve got been taught up to now is indicated. Boksman et al. have beneficial using a tapered grasp quartz fiber put up (MacroLock™ Put up Phantasm X-RO with further Fibercones.
Medical Benefits of Fiber Posts
positioned into the irregularity (lateral areas) of the canal (Figs. 4 & 5). (14) This method is very similar to the use of a grasp gutta percha level with accent gutta percha issues, which is well-understood. Using this way supplies a number of medical benefits (15-19) together with extra anti-rotational resistance, diminished quantity of composite or cement lateral to the put up to lower the C and S Issue constraints (volumetric shrinkage), higher adhesion to the basis canal partitions leading to diminished microleakage and extending resistance to dislodgement, in addition to diminished chance for lateral perforation. The mix of a put up, or a couple of posts, that transmit mild successfully, with enough prolonged mild curing time/output, ends up in higher composite polymerization.
The oblique forged gold/steel/zirconia put up and core has been in large part changed with a one appointment recovery of an instantaneous put up and core. Fiber posts such because the Extremely dent Unicore Fiber Put up, the quartz fiber posts manufactured by way of RTD (St. Egreve, France), the Macro-Lock X-RO, and the DT Gentle-Put up (Bisco Canada, Richmond, BC) have many bodily traits that cause them to extra fascinating clinically, somewhat than steel and zirconia posts:
Benefits of Fiber Posts Over Steel and Zirconia Posts
1. The elastic modulus (or a subject matter’s stiffness) of fiber posts extra intently approximates that of dentin (18.6 Gigapascals-GPa) permitting some slight flex in serve as, dissipating rigidity, and decreasing the possibility of wear and tear to the basis. (20,21) Chrome steel has an elastic modulus of about 200GPa, titanium alloy 110GPa and Zirconia 300GPa. (22) The stiffness of steel and zirconia posts creates extra inner rigidity, zones of hysteria and shear all the way through serve as and parafunction, (23) which can lead to unrestorable catastrophic root fractures.
2. Fiber posts have a top flexural power, and in a learn about by way of Stewardson, “the flexural power of fiber bolstered composite endodontic put up fabrics exceed the yield power of gold and stainless-steel and two of the FRC (fiber bolstered composite) posts had been related to the yield power of titanium”. (24) It should be famous right here that now not all fiber posts are created equivalent. There are variations in fracture load, flexural power, fiber diameter, fiber/matrix ratio, form of fiber (with quartz fiber posts having upper failure resistance), mild transmission, form, put up floor adhesion, high quality of fiber, structural defects/voids, and production high quality, which all impact the medical end result and longevity.
The clinician should make an educated selection for opting for a fiber put up – on the lookout for the most efficient attributes above – so as to choose the put up with awesome homes in response to unbiased analysis. The dental practitioner should additionally take note of the most efficient adhesive combos and strategies as there are some incompatibilities between dual-cure core fabrics and simplified acidic adhesives because of residual acidity. There’s a variation in the result of the clinical literature when comparing fiber posts, now not best on account of the variations within the posts themselves, but additionally on account of the cementing/bonding/adhesive methods used. Thus far, a couple of articles within the clinical literature toughen the observation that “best particular combos of dentin adhesives and luting cements turn out environment friendly, with overall etch adhesives mixed with dual-cure cement (composite) showing to be your best option”. (30,31)
3. Fiber posts aren’t matter to galvanic or corrosion job. The corrosion of base metals predisposes to a top proportion of disasters with forged posts which is able to additionally create a adverse esthetic end result of a dismal root and darkening of the gingival collar (Fig. 6A). (32, 33) Milnar and others have printed very good papers appearing that using a gentle transmitting put up can do away with this not unusual esthetic problem, permitting now not best mild transmission down the canal getting rid of the darkish gingival color, but additionally the advent of excellent medical esthetics with translucent ceramics over a composite core (Fig. 6B). (34-36)
4. Clinically, closely restored tooth might hang as much as standard occlusal serve as however many fail in cyclic fatigue-repeated purposeful rigidity and torque. 21 Fiber than steel posts, and the quartz fiber put up is located to be greater than two times as fatigue resistant as the immaculate and titanium alloy posts. (37) All through repeated fatigue loading, the flexural power of steel posts can lower by way of 40%, while there may be just a 14% lower in a fiber composite put up. (38)
5. Endodontic procedures do fail, both because of erroneous method, the shortcoming to get right of entry to or totally debride a canal, micro-leakage/ bacterial contamination publicity to endotoxins after endodontic remedy is carried out, however sooner than a last recovery is positioned (all endodontic procedures will have to be adopted by way of fast recovery), (39,40) or because of failure and microleakage of the coronal recovery. It’s been estimated that 25% of retreatments contain the presence of a put up. Fiber posts are atraumatically got rid of in a question of a couple of mins with to be had proprietary removing drill methods. (41-43)
The Idea of the Circumferential Ferrule
No dialogue of the recovery of a badly damaged down endodontically handled enamel could be entire with out discussing the concept that of the circumferential ferrule, which is explained as “a steel band or ring that encircles the enamel in an effort to supply retention and resistance shape, in addition to give protection to the enamel from fracture”. (44) Many of the printed articles, in response to in vivo and in vitro knowledge, counsel {that a} 2mm ferrule is absolute best for bettering resistance to fracture with vital decreases when the ferrule is 1mm or nonexistent. (45-47)
On the other hand, it isn’t best the peak of the remainder dentin this is essential for developing the ferrule, however simply as essential is the width of the remainder dentin and the collection of partitions. As proven in Figures 7 and eight, there’s a drastic distinction in results when getting ready a ferrule in a modestly flared canal as opposed to a large flare.
As will also be noticed, when a large flare exists, the preparation of a ferrule in truth gets rid of the dentinal lateral partitions making a stand-alone core that necessarily has no ferrule in any respect. You will need to word right here that tumbler ionomer cements and resin changed glass ionomers lack the bodily homes to serve as as a core subject matter. (48,49) Jotkowitz et al. of their article on “Rethinking the Ferrule”, supplies one of the crucial absolute best regression analyses and medical pointers within the literature, comparing the results of the peak, collection of partitions closing, thickness of the partitions, and whether or not a mesial/distal or buccal/lingual wall is closing in dating to the purposeful stresses concerned. (50)
A easy instance will be the distinction of shedding a lingual wall on an higher central – even though 3 partitions stay – which will also be catastrophic because of the torque positioned at the lingual in serve as, versus shedding an interproximal wall which has little weakening impact when lingual rigidity is implemented.
Their conclusion is that no ferrule equals un-restorable. “Medical protocols will have to function well-defined inclusion standards, together with delineation of the collection of residual coronal partitions, for a clearer evaluation of the affect of the remainder enamel construction on remedy results”. (51) Because the collection of closing partitions lower, the fracture resistance decreases when no put up is used, however the fracture resistance is higher considerably when fiber posts are positioned – apart from when there is not any wall left. (52) “The good fortune fee for all posts decreases vastly within the absence a residual coronal wall.” (51)
Definitions and Fresh Analysis on Reinforcement
The literal definitions of reinforcement from more than a few assets contains:
- A tool designed to supply further power.
- To improve by way of including additional toughen.
- To support.
- To improve with some added piece, toughen or subject matter.
- To make a construction more potent.
A lot of the dental literature and texts from the Seventies to the early Nineties point out {that a} put up is positioned when there may be inadequate construction left to retain a core/crown, and that steel posts don’t make stronger the basis. (53-56) Retrospectively taking a look at analysis on endodontically handled tooth using steel posts no doubt toughen this discovering. (57,58) On the other hand, newer analysis articles and publications are making a frame of labor that fiber posts do certainly make the basis extra proof against fracture and might improve the basis. What follows is just a partial checklist with brief summaries of one of the most newer related research supporting the perception of reinforcement by way of the use of fiber posts:
Fracture Resistance Research
D’Arcangelo et al. (59) studied the fracture resistance and deflection of tooth restored with a fiber put up and ready for veneers. Seventy-five human maxillary central incisors with identical anatomic crowns had been incorporated: no preparation, veneer preparation, endodontic get right of entry to full of composite, endodontic get right of entry to with composite and veneer preparation, and fiber put up placement (RTD Endo Gentle Put up) adopted by way of veneer preparation. All specimens had been thermo cycled and submitted to fracture power exams by way of the use of a displacement size machine. Preparation for veneers higher the deflection values of the specimens, however the fiber bolstered put up recovery with veneer arrangements didn’t display statistically vital variations from the intact unprepared incisor.
Premolars and Composite Recovery Research
When investigating the fracture resistance and failure mode of premolars restored with composite resin and more than a few prefabricated posts Hajizadeh et al. (1) applied 60 extracted tooth with 4 subgroups: no hollow space preparation, endodontics with an MOD and no put up, endodontics with a DT Gentle Put up (RTD) and MOD, and the remaining team with endodontics, Filpost (Filhol Dental, Gloucestershire, UK) and an MOD composite recovery. The tooth restored with the DT Gentle Put up and composite had been as sturdy because the keep an eye on (the unprepared enamel) and more potent than the ones tooth restored with composite by myself with no put up, and the ones restored with a Titanium put up and composite. Within the DT Gentle Put up team, 86% of the fractures had been “restorable”, which was once a lot upper than any of the opposite 3 teams. In line with the authors, “There may be rising proof that fiber posts give you the further good thing about higher fracture resistance.”
Fiber Posts Below Zirconia-Ceramic Crowns
The impact of striking fiber posts underneath zirconiaceramic crowns was once studied by way of Salameh et al. (60) 90 mandibular 2d molars had been divided into 3 check teams representing more than a few extents of coronal injury, endodontically accessed and obturated with heat vertical condensation. Part of the specimens had been restored with composite, the opposite part with a translucent FRC put up (Depend-X Fiber Put up 3M/Espe) with a composite core. The insertion of the fiber put up advanced the toughen underneath the zirconia crowns, which ended in upper fracture rather a lot and beneficial failure kind in comparison to a composite core build-up.
Esthetic Put up Analysis
Maccari et al. (61) applied thirty unmarried rooted endodontically-treated tooth to guage the fracture resistance of various prefabricated esthetic posts. Incorporated within the learn about had been Aestheti Put up (RTD), FibreKor Put up (Jeneric Pentron, Wallingford, CT) and CosmoPost (a ceramic put up machine) (Ivoclar Vivadent, Schaan, Liechtenstein). They summarized that the imply fracture resistance of the glass fiber prefabricated esthetic posts proved the next fracture resistance than the ceramic put up which was once not up to one part of the fiber posts.
Maxillary Incisors and Fiber Posts
The fracture resistance and failure trend of endodontically handled maxillary incisors restored with composite resin, with and with out fiber bolstered composite posts underneath several types of complete protection crowns, was once studied by way of Salameh et al. (62) 100 twenty maxillary incisors had been endodontically handled and divided into 4 teams of 30 each and every and extra divided into two sub-groups of recovery without or with a fiber put up (Postec Plus, Ivoclar Vivadent, Schaan, Liechtenstein). Restorations positioned had been PFM, Empress II, SR Adoro crowns and Cercon crowns with all arrangements together with a 2mm ferrule. Fracture exams confirmed that the kind of crown was once now not a significant component affecting the fracture resistance, however the presence of a put up was once.
The authors state that “even supposing prosthodontic textbooks don’t usually suggest the location of fiber posts in endodontically-treated incisors, the result of this learn about point out that using fiber posts in such tooth will increase their resistance to fracture and improves the diagnosis in case of fracture.”
Vertical Loading Stipulations
In a learn about of 80 endodontically handled maxillary premolars handled without or with fiber posts, and MOD hollow space arrangements restored with several types of crowns together with porcelain fused to steel, lithium disilicate, fiber bolstered composite or zirconia crowns, Salemeh et al, (63) loaded the restorations till failure recording the utmost breaking rather a lot. Below vertical loading stipulations, the fracture plenty of tooth restored with fiber posts had been considerably more than the ones with out posts, and the fiber posts considerably contributed to the reinforcement and strengthening of pulpless tooth by way of supporting the remainder enamel construction towards vertical compressive stresses.
Ongoing Analysis and Diversifications in Literature
There are lots of extra research appearing the reinforcement of enamel construction with fiber posts. 64-73 It’s unimaginable to summarize all of them, however it sort of feels evident that our thought of restoring endodontically-treated tooth is consistently advancing as new merchandise and bonding ways evolve. Even if there are permutations within the sorts of fiber posts used within the research, and other cementation and adhesive protocols, there may be compelling proof that fiber posts can make stronger enamel construction. To create stability on this assessment of the literature, it should be stated that there are naturally some printed clinical articles that don’t display a reinforcing impact of fiber posts. (7,74,75)
Along with the normal definition of mechanical reinforcement: restoring a compromised enamel to a fracture power equivalent to or more than its authentic “untreated” fracture resistance, we clinicians in all probability will have to be extra centered at the predictability of results, in particular in worst-case situations. That’s the contribution of the put up as opposed to no put up, or composite best, to the remainder buildings. Essentially the most foremost conclusion rising from the rising frame of in vitro (76-79) (and medical) knowledge is that disasters of fiber posts in situ are much more likely to be described as “non catastrophic” or “repairable” which is most often now not the case with top modulus posts. Moreover, just lately printed medical trials correlate the good fortune fee to the collection of closing dentin partitions.
Components Affecting Fiber Put up Efficiency
Diversifications within the literature on fiber posts are the result of: use of herbal tooth or bovine tooth, in vivo as opposed to in vitro effects, the impact of the periodontal ligament in distributing one of the most stresses, loading method (vertical, horizontal or at an perspective), the sort and high quality of the put up, the popularity of the “secondary smear layer” and the way it impacts adhesion, the kind of radicular dentin this is to be bonded, the adhesive used, the sunshine sporting or transmission capacity of the put up, the kind of composite used to cement the put up, the quantity of composite lateral to the put up, the filler loading of the composite, and the quantity of essential dentin this is got rid of to put the put up.
Adhesive bonding within the root canal has its distinctive demanding situations because of dentinal construction within the canal (coronal dentin bonds higher than apical dentin), the “secondary smear layer” of particles from gutta percha and sealer that compromises the power of simplified methods to in truth bond to the basis floor (ends up in principally frictional resistance), C and S Issue polymerization results, curing to intensity when the use of dual-cured composite (all twin cured composites have the next polymerization proportion when uncovered to enough mild) leading to higher total bodily homes, and subject matter incompatibilities. Fiber put up recovery ways require a meticulous protocol and the clinician is steered to scour the literature, now not just for the most efficient fiber put up to be had but additionally the most efficient ways for placement. Fabrics and strategies for fiber put up recovery of endodontically-treated tooth are steadily evolving with the inevitable end result of higher medical effects for our sufferers. 
Determine 1: Particularly in ovoid canals (that are the norm) put up preparation can needlessly take away dentin and lead to weakening the remainder enamel construction, whilst leaving lateral gutta percha which compromises bonding cementation.
Determine 2: Require extra apical removing of necessary dentinal construction needlessly weakening the basis and developing an apical rigidity level.
Determine 3: The taper of the Macro-Lock put up lets in appreciate for the dentin and guarantees a extra even and minimum quantity of surrounding composite resin, thereby decreasing polymerization contraction forces.
Determine 4: In abnormal or ovoid canals using Fiber cones lateral to the Macro-Lock X RO has many medical benefits expanding longevity
Determine 5: A medical {photograph} appearing the location of Fibercones laterally to the primary Macro-Lock Put up which decreases composite quantity, provides anti-rotational components, and reduces microleakage.
Determine 6A: The typical esthetic failure when the use of steel posts with discolouration of the enamel construction in addition to the gingival collar.
Determine 6B: The results of striking a gentle transmitting fiber put up with a translucent ceramic.
Determine 7: The standard results of making a complete crown with a ferrule in a quite tapered endodontic get right of entry to opening.
Determine 8: When getting ready a ferrule on a enamel with a large flare, the preparation gets rid of all lateral dentin making a stand by myself core which vastly decreases the medical good fortune fee.
AUTHORS
Dr. Len Boksman graduated as a DDS from the College of Dentistry, College of Western Ontario in 1972. After 7 years in non-public apply, he joined the College of Dentistry at Western as an assistant professor of operative dentistry, in a while thereafter achieving the tenured place of Affiliate Professor. He has authored greater than 100 articles and a number of other chapters in textbooks and was once awarded the Ontario Dental Affiliation Award of Advantage in 2005. Dr. Len Boksman graduated has just lately been appointed as adjunct professor within the College of Generation Dental College, Jamaica, the place he donates his time. He will also be contacted at lenpat28@gmail.com.
Dr. Gary Glassman graduated from the College of Toronto, College of Dentistry in 1984 and was once awarded the James B. Willmott Scholarship, the Mosby Scholarship and the George Hare Endodontic Scholarship for skillability in Endodontics. A graduate of the Endodontology Program at Temple College in 1987, he gained the Louis I. Grossman Find out about Membership Award for tutorial and medical skillability in Endodontics. The writer of a lot of publications, Dr. Glassman lectures globally on endodontics, is on workforce on the College of Toronto, College of Dentistry within the graduate division of endodontics, and is Adjunct Professor of Dentistry and Director of Endodontic Programming for the College of Generation, Jamaica. Gary is a fellow of the Royal School of Dentists of Canada, and the endodontic editor for Oral Well being dental magazine. He maintains a personal apply, Endodontic Consultants in Toronto, Ontario, Canada. He will also be reached via his website online www.rootcanals.ca.
Dr. Santos gained his DDS (1986) and MSc in dental clinics (1999) from Federal College of Bahia, and PhD in prosthodontics (2003) from College of São Paulo. Dr. Santos was once appointed as assistant professor, Department of Restorative Dentistry on the College of Western Ontario Schulich College of Drugs and Dentistry in 2006 and in 2011 was once appointed chair of the Department of Restorative. He has a number of publications in global journals and has educated and mentored graduate scholars within the house of biomaterials analysis right through his profession. He will also be reached at by the use of e mail at gildo.santos@ schulich.uwo.ca.
Dr. Manfred Friedman graduated from the College of Witwatersrand and Johannesburg in 1971 after which bought his BChD Honours on the College of Pretoria in 1980. He immigrated to Canada in 1987 the place he took up a full-time place on the College of Western Ontario (UWO) and was once appointed as director of dentistry at The Southwestern Regional Middle for developmentally challenged adults from 1987 to 1994. Dr. Friedman was once additionally the director of the undergrad endo program from 1997 to 2002. He lately has a full-time apply in London, ON, proscribing his apply to endodontics, and is a significant part-time adjunct professor at Schulich College of Drugs and Dentistry at UWO, the place he directs the endodontic lab direction in addition to acts as medical trainer.
Dr. Friedman has given a lot of classes on endodontics since becoming a member of UWO, with specific pursuits in rotary instrumentation, endodontic fabrics, apex locators, and restoring the endodontically handled enamel. He will also be reached at (519) 673- 5293 or at friedmanm@rogers.com. The authors wish to thank Mrs. Laura Delellis for her paintings developing the figures used on this article.
REFERENCES
1 Hajizadeh H, Namzakhah MS, Moghaddas MJ, Ghavamnasiri M. Results of posts at the fracture resistance of load cycled endodontically handled premolars restored with direct composite resin. The Magazine of Fresh Dental Follow 2009; 10(3): 1- 10.
2 Pilo R, Shapenco E, Lewinstein I. Residual dentin thickness in bifurcated maxillary first premolars after root canal and put up area preparation with parallel sided drills. J Prosthet Dent. 2008; 99: 267-273.
3 Trope M, Ray HL Jr. Resistance to fracture of endodontically handled roots. Oral Surg Oral Med Oral Trail. 1992; 73: 99-102.
4 Reeh ES, Messer HH, Douglas WH. Aid in enamel stiffness because of endodontic and restorative procedures. J Endod. 1989; 15: 512-516.
5 Linn J, Messer HH. Impact of restorative procedures at the power of endodontically handled molars. J Endod. 1994; 20: 479- 485.
6 Panitvisai P, Messer HH. Cuspal deflection in molars relating to endodontic and restorative procedures. J Endod. 1995 ; 21: 57- 61.
7 Fokkinga WA, Le Bell AM, Kreulen CM, Lassila LVJ, Vallittu PK, Creugers NHJ. Ex vivo fracture resistance of direct resin composite entire crowns with and with out posts on maxillary premolars. Int Edod. J 2005; 38(4): 230-7.
8 Creugers NH, Mentink AG, Fokkinga WA, Kreulen CM. 5-year observe up of a potential medical learn about on more than a few sorts of core restorations. Int. J Prosthodont 2005; 18(1): 34-9.
9 Ferrari M, Cagidiaco MC, Goracci C, Vichi A, Mason PN, Radovic I, Tay F. Lengthy-term retrospective learn about of the medical efficiency of fiber posts. Am J Dent 2007, 20(5): 287- 91.
10 Oliveira F de C, Denehy GE, Boyer DB. Fracture resistance of endodontically ready tooth the use of more than a few restorative fabrics. J AM Dent Assoc 1987; 115: 57-60.
11 Ree M, Schwartz RS. The endo restorative interface: present ideas. Dent Clin N Am 54 2010: 345-374.
12 Sorensen JA, Mito WT. Rationale and medical method for esthetic recovery of endodontically handled tooth with the CosmoPost and IPS Empress Put up machine. Quintessence Dent Technol 1998; 21: 81-90.
13 Boksman L, Hepburn AB, Kogan E, Friedman M, de Rijk W. Fixing put up endodontic root form and taper permutations with fiber put up ways. OH November 2011: 12-26.
14 Boksman L, Santos G, Friedman M. Put up arrangements: medical answers for long run good fortune. Dentistry These days January 2013: 52-57.
15 Akkayan B, Gaucher H, Atalay S, Alkumru H. Impact of put up geometry at the resistance to fracture of endodontically handled tooth with oval formed root canals. Canadian Magazine of Restorative Dentistry and Prosthodontics Summer time 2010: 20-26.
16 Maceri F, Martignoni M, Vairo G. Optical mechanical design of anatomic put up methods for endodontic recovery. Comput. Strategies Biomech Biomed Engin July 2008;16: 1 (Epub forward of print).
17 Li Q, Xu B, Wang Y, Cai Y. Results of auxiliary fiber posts on endodontically handled tooth with flared canals. Oper Dent. 2011 July-Aug;36(4): 380-9 Epub 2011 Aug 11.
18 Mossavi H, Maleknejad F, Kimyai S. Fracture resistance of endodontically handled tooth restored the use of 3 root-reinforcement strategies. J Contemp Dent Pract Jan 2008 ;9(1): 030-037.
19 Porciani P, Vano M, Radovic I, Goracci C, Garcia- Godoy F, Ferarri M. Fracture resistance of fiber posts: Mixtures of a number of small posts vs. standardized unmarried put up. Am J dent 2008; 21: 373-376.
20 Ferrari M, Scotti R. Fiber posts: traits and medical packages. Masson Publishing 2002, p26.
21 Duret B, Duret F, and Reynaud M. Lengthy-life bodily assets preservation and put up endodontic rehabilitation with the Composipost. Compendium 17:S50- S56, 1996.
22 Goracci C, Ferrari M. Present views on put up methods: a literature overview. Australian Dental Magazine June 2011; 56.
23 Rodrigues-Cervantes PJ, Sancho-bru JL, Barjau- Escribano A, Forner-Navarro L, Perez-Gonzales A, Schenche-Marin FT. Affect of prefabricated put up dimensions on restored maxillary incisors. Magazine of Oral Rehabilitation 2007; 34(2): 141-152.
24 Stewardson DA, Shortall AC, Marquis PM, Lumley PJ. The flexural homes of endodontic put up fabrics. Dent Mat Aug 2010; 26(8): 730-736.
25 Seefeld r. Wenz H-J, Ludwig Okay, Kern M. Resistance to fracture and structural traits of various fiber bolstered put up methods. Dent Mat March 2007; 23(3): 265-271.
26 Freedman G, Jain C. Recovery of the endodontically handled enamel–a purchaser’s information to pins and posts. Dentistry These days July 2008: 108-121.
27 CRA E-newsletter–Posts a shift clear of steel? Would possibly 2004; 28(5): 1-3.
28 Bassi M. Gentle diffusion via double taper quartz-epoxy fiber posts. Complaints from the fifth World Symposium 2001: 21-26
29 Boudrias P, Sakkal S, Petrova Y. Anatomical Put up Design Carried out to Quartz Fiber/Epoxy era: A conservative way. OH Nov 2001: 9-16.
30 Dietschi D, Olivier D, Krejci I, Sadan A. Biomechanical concerns for the recovery of endodontically handled tooth: A scientific overview of the literature, Pat II Analysis of fatigue habits, interfaces, and in vivo research. Quint Int . Feb 2008; 39(2): 117-129.
31 Radovic I, Mazzitelli C, Chieffi N, Ferrari M. Analysis of the adhesion of fiber posts cemented the use of other adhesive approaches. Ecu Magazine of Oral Sciences Dec 2008; 116(6): 557-563.
32 Rosenstiel, Land, Fujimoto. Fresh Fastened Prosthodontics third Version, July 2000 Yearbook Clinical Publications pg. 295.
33 Torbjorner A, Karlsson S, Odman PA. Survial fee and failure traits for 2 put up designs. J Prosthet Dent 1995; 73(5): 439-444.
34 Milnar FJ. Aesthetic Remedy of Darkish Root Syndrome. Dent These days Sept 2010; 29(9): 74-79.
35 Martelli R. Fourth technology intra radicular posts for the cultured recovery of anterior tooth. Pract Periodontics Aesthet Dent. 2000; 12: 579-584.
36 Strassler HE. Restoring endodontically compromised tooth with fiber-reinforced mild transmitting anchors. Fresh Esthetics and Restorative Follow. 1999; 3: 58-60.
37 Wiskott HWA, Meyer M, Perriard J, Scherrer SS. Rotational fatigue resistance of 7 put up varieties anchored in herbal tooth. Dent Mat Nov 2007; 23(11): 1412-1419.
38 Duret B, Duret F, Reynaud M. Lengthy lifestyles bodily assets preservation and put up endodontic rehabilitation with the Composipost. Compendium 1996; 17: S50-S56.
39 Magura ME, Kafrawy AH, Brown CE, Newton CW. Human saliva coronal microleakage in obturated root canals: n in vitro learn about. J Endodon 1991; 17: 324-31.
40 Alves J, Walton R, Drake D. Coronal leakage: endotoxin penetration from blended bacterial communities via obturated, put up ready root canals. J Endodno 1998; 24: 587- 91.
41 Anderson G, Perdigao J, Hodges J, Bowles W. Potency and effectiveness of fiber put up removing the use of 3 ways. Quintessence Int 2007; 38: 663-670.
42 Frazer RQ, Kovarik R, Likelihood KB, Mitchell R. Elimination instances of fiber posts as opposed to titanium posts. Am J Dent 2008; 21: 175-178.
43 Gesi A, Magnolfi S, Goracci C, Ferrari M. Comparability of 2 ways for casting off fiber posts.
44 Yonker CM, Rubinstein S, Nidetz AJ. Restoring endodontically handled tooth. Within Dentistry Sept 2011; 7(8): 56-62.
45 daSilva Nr, Raposo LHA, Versluis A, Fernando-Neto AJ, SoaresCJ. The impact of put up, core, crown kind and ferrule presence at the biomechanical behaviour of endodontically handled bovine anterior tooth. J Prosthet Dent 2010; 104: 306-317.
46 deLima Af, Spazzin AO, Galafassi D, Correr-Sobrinho L, Carlini B Jr. Affect of ferrule preparation without or with glass fiber put up on fracture resistance of endodontically handled tooth. J Appl Oral Sci 2009; 18: 360-363.
47 Hu S, Osada T, Shimizu T, Warita Okay, Kawawa T. Resistance to cyclic fatigue and fracture of structurally compromised root restored with other put up and core restorations. Dent mater J 2005; 24 :225-231.
48 Gateau P, Sabek M, Dailey B. In vitro fatigue resistance of glass ionomer cements utilized in post-and core packages. J Prosthet Dent 2001; 86: 149-55.
49 Mollersten L, Lockowandt P, Linden LA. A comparability of strengths of 5 core and post-and-core methods. Quint Int 2002; 33: 140-9
50 Jotkowitz A, Samet N. Rethinking the ferrule: a brand new option to an outdated catch 22 situation. BDJ 2010; 209: 25-33.
51 Ferrari M, Vichi A, Gadda GM, Cagidiaco MC, Tay FR, Breschi L, Polimeni A, Goracci C. A randomized managed trial of endodontically handled and restored premolars. JDR 2012; 91(7): S72-S78
52 Nam SH, Chang HS, Min KS, Lee Y, Cho HW, Bae JM. Impact of the collection of residual partitions on fracture resistances, failure patterns, and photoelasticity of simulated premolars restored without or with fiber-reinforced composite posts. JOE Feb 2010; 36(2): 297-301.
53 Sorensen JA, Engleman MJ. Impact of put up adaptation on fracture resistance of endodontically handled tooth. J Prosthet Dent 1990; 64: 419-424.
54 Caputo AA, Standlee JP. Pins and posts why, when and the way. Dent Clin North Am.1976;20:299-311.
55 Sorensen JA, Martinoff Jt. Intracoronal reinforcement and coronal protection: a learn about of endodontically handled tooth. J Prosthet Dent 1984; 51: 780-784.
56 Assif D, Gorfil C. Biomechanical concerns inrestoring endodontically handled tooth. J Prosthet Dent 1994; 71: 565-567.
57 Trope M, Maltz DO, Tronstad L. Resistance to fracture of restored endodontically handled tooth. Endod Dent Traumatol 1985; 1: 108-111.
58 Guzy GE, Nichols JI. In vitro comparability of intact endodontically handled tooth with and with out endopost reinforcement. J Porsothet Dent 1979; 42: 39-44.
59 D’Arcangelo C, De Angelis FDe, Vadini M, Zazzeroni S, Ciampoli C, A’Amario M. In vitro fracture resistance and deflection of pulpless tooth restored with fiber posts and ready for veneers. JOE July 2008; 34(&): 838841.
60 Salameh Z, Ounsi F, Aboushelib MN, Sadig W, Ferrari M. Fracture resistance and failure patterns of endodontically handled mandibular molars with and with out glas fiber put up together with a zirconiaceramic crown. Magazine of Dentistry 2008; 36(7): 513-519.
61 Maccari PC, Conceicao EN, Nunes MF. Fracture resistance of endodontically handled tooth restored with 3 other prefabricated esthetic posts. J Esthet Resor Dent 2003; 15: 25-31.
62 Salameh Z, Sorrentino R, Ounsi HF, Sadig W, Atiyeh F, Ferrari M. The impact of various complete protection crown methods on fracture resistance and failure trend of endodontically handled maxillary incisors restored with and with out glass fiber posts.
63 Salameh Z, Sorrentino R, Ounsi HF, Goracci C, Tashkandi E, Tay FR, Ferrari M. Impact of various all ceramic crown machine on fracture resistance and failure trend of endodontically handled maxillary premolars restored with and with out glass fiber July 2007; 33(7): 848-851.
64 Schmitter M, Huy C, Ohlmann B, Gabbert O, Gilde H, Rammelsberg P. Fracture resistance of higher and decrease incisors restored with glass fiber bolstered posts. J Endod April 2006; 32(4): 328-30.
65 Carvalho CA, Valera MC, Oliveira LD, Camargo CHR. Structural resistance in immature tooth the use of root reinforcements in vitro Dent Traumatol June 2005; 21(3): 155- 159.
66 Rosentritt M, Sikora M, Behr M, Handel G. In vitro fracture resistance and marginal adaptation of steel and enamel colored put up methods. J Oral Rehabil July 2004; 31(7): 675-81.
67 Goncalves LA, Vansan LP, Paulino SM, Neto MDS. Fracture resistance of weakened roots restored with a transilluminating put up and adhesive restorative fabrics. J Prosthet Dent Nov 2006;96 (5): 339 – 344.
68 Naumann M, Preuss A, Frankenberger R. Reinforcement impact of adhesively luted fiber bolstered composite as opposed to titanium posts. Dent Mater Feb 2007; 23(2): 138 – 144.
69 Hayashi M, Takahashi Y, Imazoto S, Shigeyuki E. Fracture resistance of pulpless tooth restored with post-cores and crowns. Dentr Mat 2006; 22: 477-485.
70 Hayashi M, Sugeta A, Takahashi Y, Imazato S, Ebisu S. Static and fatigue fracture resistance of pulp much less tooth restored with put up cores. Demt Mat Sept 2008; 24(9): 1178- 1184.
71 Salameh Z, Ounsi HF, Aboushelib MN, Al-Hamidan R, Sadig W, Ferrari M. Impact of various onlay methods on fracture resistance and failure trend of endodontically handled mandibular molars restored with and with out glass fiber posts. Am J Dent 2010; 23(2): 81-86.
72 Ferrari M, Cagidiaco MC, Grandini M, De Sanctis M, Gorraci C. Put up placement impacts survival of endodontically handled premolars. J Dent Res 2007; 86(8): 729-734.
73 Nothdurft FP, Seidel E, Gebhart F, Naumann M, Motter PJ, Pospiech PR. The fracture habits of premolar tooth with elegance II cavities restored by way of each direct composite restorations and endodontic put up methods. Magazine of Dentistry June 2008; 36(6): 444- 449.
74 Kreijci I, Duc O, Dietschi D, de Campos E.. Marginal adaptation, retention and fracture resistance of adhesive composite restorations on devitalized tooth with and with out posts. Oper Dent 2003; 28(2): 127-35.
75 Abdul Salam SN, Banerjee A, Mannocci F, Pilecki P, Watson TF. Cyclic loading of endodontically handled tooth restored with glass fibre and titanium alloy posts: fracture resistance and failure modes. Eur J Prosthodont Restor Dent Sept 2006; 14(3): 98-104.
76 Cormier C, Burns D, Moon P. In vitro comparability of the fracture resistance and failure mode of fiber, ceramic, and standard put up methods at more than a few phases of recovery. J Prosthodont 2001; 10: 26 – 36.
77 Fokkinga WA, Creugers NH, Kreulen CM. In vitro failure mode of fiber bolstered put up core methods: A scientific overview. J Dent Res. Vol. 82 IADR Abrstact #2563, 2003
78 Le Bell-Ronnlof AM, Lassial LV, Kangasniemi I, Vallittuu PK. Load-bearing capability of human incisor restored with more than a few fiber bolstered composite posts. Dent Mater. Jun 2001; 27(6): e107 – 15 Epub 2011 Mar 27.
79 Cagadiaco MC, Goracci C, Garcia-Godoy F, Ferarri M. Medical research of fiber posts: a literature overview. Int J Prosthodont. JulAug 2008; 21(4): 328 – 36.
80 Sour Okay, Noetzel J, Stamm O, Vaudt J, Meyer-Lueckel H, Neumann Okay, Kielbassa A. Randomized medical trial evaluating the results of put up placement on failure fee of put up : Initial result of a median length of 32 months. J Endod 2009; 35: 1477 – 82.
81 Naumann M, Koelpin M, Beuer F, Meyer-Lueckel H. Ten-year survival analysis or glass fiber supported put up endodontic recovery: a potential observational medical learn about. J Endod Apr 2012; 38(4): 432-5 Epub 2012 Feb 16.