Department of Prosthodontics, Faculty of Dentistry, University of Jordan, Amman, Jordan.
J Endod. 2010 Sep;36(9):1439-49. doi: 10.1016/j.joen.2010.06.005.
Posts have been used efficiently to retain restorations for badly destructed teeth. This article critically analyzes the concerned topics related to the fracture resistance of teeth restored with dowel-retained restorations.
A systematic review of PubMed/MEDLINE, Cochrane, and Scopus databases was completed (from 1960 to 2010). Single or combined key words were used to obtain the most possible comprehensive list of articles. Checking the references of the relevant obtained sources completed the review along with a manual search to locate related articles on the topic. In vivo and ex vivo (laboratory, computer-based finite element, and photoelastic stress analysis studies) investigations related to the topic were included.
Many factors have been proposed to influence the fracture resistance of post-restored teeth. Recognizing the significance of these factors on the fracture resistance of teeth would aid in choosing the suitable treatment modality for every individual case. Fracture resistance was improved if tooth structure loss was limited, a ferrule was obtained, a post with similar physical properties to natural dentine was used, and adhesive techniques for post luting and coronal restoration were used. Adhesively luted resin/fiber posts with composite cores appear to be the best currently available option in terms of tooth fracture and biomechanical behaviour.
Most guidelines were based mainly on ex vivo studies and to a lesser extent on limited in vivo studies. The lack of long-term controlled randomized clinical studies was the main hindrance to reaching a conclusive and undisputable opinion regarding endodontic posts in terms of tooth fracture and biomechanical behaviour.
桩核技术已被广泛应用于残根、残冠的修复。本文主要对桩核修复后牙体抗折性能的相关问题进行了综述。
通过对 PubMed/MEDLINE、Cochrane、Scopus 数据库进行系统回顾（检索时间为 1960 年至 2010 年），采用单一或联合关键词的方式获取与研究内容相关的文章。同时查阅相关文献的参考文献，并通过手工检索对该主题的相关文章进行补充。本研究纳入了与该主题相关的体内和体外（实验室、计算机有限元、光弹性应力分析研究）研究。
许多因素都被认为会影响桩核修复后牙的抗折性能。了解这些因素对牙体抗折性能的影响，有助于为每一个具体病例选择合适的治疗方案。如果能限制牙体组织的丧失、获得桩核冠、使用与天然牙本质物理性能相似的桩核、使用粘结技术进行桩核粘结和牙冠修复，可以提高牙体的抗折性能。在牙体抗折和生物力学性能方面，黏结性树脂/纤维桩核复合树脂核似乎是目前最好的选择。
大多数指南主要基于体外研究，较少基于有限的体内研究。缺乏长期的、对照的、随机的临床研究，是目前在桩核修复后牙体抗折和生物力学性能方面难以得出明确、无可争议的结论的主要原因。
