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      Clinical performance of custom‐milled polyetherketoneketone (PEKK) posts and cores: A 12‐month follow‐up randomized controlled pilot study

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          Abstract

          Objectives

          Comparing the survival rate and the cumulative success rates of custom‐milled polyetherketone ketone posts and cores (MPP) with prefabricated fiber posts (PFP) in restoring compromised endodontically treated premolars.

          Material and Methods

          This was a randomized, double‐blind, parallel, two‐arm controlled pilot study. A total of 24 patients (12 males, 12 females), each had a compromised lower premolar, needed a root canal treatment and to be restored with post and core. Patients were randomly allocated into two groups, MPP‐group: restored with MPP, and PFP‐group: restored with PFP and composite cores. After that, premolars were restored with single porcelain fused to metal (PFM) crowns. Clinical and radiographic follow‐ups were conducted after 3, 6, and 12 months. The Kaplan–Meier, log‐Rank, and χ 2 tests were used to investigate differences between the two groups at the 0.05 significance level.

          Results

          The survival rate after 12 months in the MPP and PFP groups was 66.7% and 100%, respectively. Meanwhile, the cumulative success rates were 63.6% and 100% in the same order. The log‐rank test showed a significant difference between the two groups ( p = .031). The difference in cumulative success rates was also significant, as the χ 2 test revealed ( p = .011).

          Conclusion

          The PFP group showed a higher success rate than the MPP group and according to the failure types, PEKK posts seem to be inferior to PFP in terms of the mechanical properties and bonding to resin mechanism. Trial registration: ISRCTN, ISRCTN13456471. October, 14, 2019. ( https://doi.org/10.1186/ISRCTN13456471ISRCTN13456471).

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          Most cited references44

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          Reprint of criteria for the clinical evaluation of dental restorative materials. 1971.

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            A randomized controlled trial of endodontically treated and restored premolars.

            This in vivo study examined the contribution of remaining coronal dentin and placement of a prefabricated (LP) or customized fiber post (ES) to the six-year survival of endodontically treated premolars. A sample of 345 patients provided 6 groups of 60 premolars each in need of endodontic treatment. Groups were classified according to the number of remaining coronal walls before abutment build-up. Within each group, teeth were allocated to one of three subgroups: (A) no post retention; (B) LP; or (C) ES (N = 20). All teeth were protected with a crown. Cox regression analysis revealed that fiber post retention significantly improved tooth survival (p < 0.001). Failure risk was lower in teeth restored with prefabricated (p = 0.001) than with customized posts (p = 0.009). Teeth with one (p = 0.004), two (p < 0.001), and three coronal walls (p < 0.001) had significantly lower failure risks than those without ferrule. Similar failure risks existed for teeth without coronal walls, regardless of the presence/absence of ferrule (p = 0.151). Regardless of the restorative procedure, the preservation of at least one coronal wall significantly reduced failure risk (ClinicalTrials.gov number CT01532947).
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              Post-endodontic restorations with adhesively luted fiber-reinforced composite post systems: a review.

              To review the literature on adhesive luting of fiber-reinforced composite posts (FRC) to provide evidence for the clinical procedure of restoring endodontically treated teeth using FRC posts. Data focusing on bonding behavior between root canal dentin, luting agent, and FRC post in vitro as well as in vivo performance of teeth restored with FRC posts were reported. These data were identified by searches of "PubMed", "Scopus", and "Cochrane Library" databases with the terms "post-endodontic restoration", "fiber post", "adhesive luting", "root canal dentin", "clinical study", and "pre-treatment fiber post". Papers published up to September 2007 were selected, and most relevant references were chosen. Cross-referencing of significant papers identified additional relevant articles. FRC posts seem to have become increasingly popular for the restoration of endodontically treated teeth. Compared to metal posts, FRC posts revealed reduced fracture resistance in vitro, along with a usually restorable failure mode. Bonding behavior among FRC post, luting agents, and root canal dentin demonstrated varying results. Bond strengths between FRC posts and resin cements can be enhanced by using various pre-treatment procedures; however, bonding to root canal dentin still seems to be challenging. Most clinical studies investigating survival rates of teeth restored with FRC posts revealed promising results, but risk factors (e.g., the loss of coronal tooth structure) have not been studied intensively. In addition, randomized controlled clinical long term trials are scarce.
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                Author and article information

                Contributors
                naif.ghanem@tishreen.edu.sy
                Journal
                Clin Exp Dent Res
                Clin Exp Dent Res
                10.1002/(ISSN)2057-4347
                CRE2
                Clinical and Experimental Dental Research
                John Wiley and Sons Inc. (Hoboken )
                2057-4347
                03 March 2024
                April 2024
                : 10
                : 2 ( doiID: 10.1002/cre2.v10.2 )
                : e854
                Affiliations
                [ 1 ] Department of Fixed Prosthodontics, Faculty of Dentistry Tishreen University Latakia Syria
                [ 2 ] Department of Pediatric Dentistry, Faculty of Dentistry Tishreen University Latakia Syria
                [ 3 ] Department of Orthodontics, Faculty of Dentistry Tishreen University Latakia Syria
                Author notes
                [*] [* ] Correspondence Naif Ghanem, Department of Fixed Prosthodontics, Faculty of Dentistry, Tishreen University, Latakia, Syria.

                Email: naif.ghanem@ 123456tishreen.edu.sy

                Author information
                http://orcid.org/0000-0003-3403-958X
                http://orcid.org/0000-0001-6959-7552
                Article
                CRE2854
                10.1002/cre2.854
                10909799
                38433309
                196ff642-6701-4b96-aa99-6490f3915bb8
                © 2024 The Authors. Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 12 December 2023
                : 10 October 2023
                : 26 January 2024
                Page count
                Figures: 4, Tables: 3, Pages: 10, Words: 5499
                Funding
                Funded by: None
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                April 2024
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.3.8 mode:remove_FC converted:03.03.2024

                custom‐milled post and core,polyetherketone ketone,prefabricated fiber posts,survival rate

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