A comparative evaluation of the fracture resistance of endodontically treated teeth with compromised intra radicular tooth structure using three different post system

Intra-radicular loss of tooth structure in endodontically treated teeth poses a challenge. Available methods for treatment are cast post-core, intra-radicular resin reinforcement using composite resin followed by placement of prefabricated metal/fibre post (glass or carbon).This study is an attempt to investigate the validity of treatment of such teeth using above methods and evaluate which post system is best suited for rehabilitation. Thirtysix endodontically treated anterior teeth were prepared by uniformly removing intra-radicular tooth structure from buccal, lingual, mesial & distal surfaces such that only 0.75mm-1mm remained. Twelve teeth were subsequently restored with cast metal post & core, 12 with intra-radicular resin reinforcement followed by prefabricated titanium post (Luminex post system) & 12 with intra-radicular resin reinforcement followed by glass fibre post (Luscent Anchor post system). Statistical analysis used was t-test. There was no statistically significant difference between the 3 post systems, but it was observed that cast post & cores caused more apical & oblique fractures, rendering the teeth unrestorable. Teeth restored with intra-radicular resin reinforcement & placement of titanium or glass fibre post failed with root fractures limited to the coronal aspect along with dislodgement of post. Intra-radicular resin reinforcement offers advantages like preventing the metal display of the post through the thin dentinal wall, reinforcement of the thin walled teeth & comparable fracture resistance to cast post and core.