Long-term Survival of Adhesively Luted Post-endodontic Restorations

The objective of this prospective clinical study was to investigate survival for endodontically treated teeth restored with adhesively luted prefabricated dentinlike or rigid posts. Data were recorded for glass-fiber posts (GFPs) and compared with historical controls evaluating glass-fiber (GFP I) and titanium posts (TPs) for 128 patients. Three groups were defined based on the type of post system used: group 1, GFP I (n = 41); group 2, GFP II (n = 41); and group 3, TP (n = 46). Posts were adhesively luted with self-adhesive resin, adhesive composite core buildups were performed, and all teeth were restored with full-coverage restorations. The primary end point was restoration survival at recall. Outcome was assessed after 6, 12, 24 and up to 178 months clinically and radiographically. Data were analyzed by the Kaplan-Meier log-rank test and Cox regression analysis. After up to 178 months of observation, 26 restorations failed (GFP I: 10, GFP II: 9, and TP: 7) and 49 (GFP I: 18, GFP II: 12, and TP: 19) were in situ. Cumulative survival probabilities were 57.1% for the GFP I, 56.5% for the GFP II, and 71.8% for the TP groups. In bivariate Cox regression, the factors tooth type and grade of abrasion were significantly assfociated with failure. In multivariate Cox regression, none of the investigated factors were significantly associated with failure. The post system had no significant impact on tooth survival (P > .05). Comparing GFPs and TPs, the post system had no impact on tooth survival up to 15 years. This study indicates that the effect size of post material on survival is low.