Intervention Review

Root canal posts for the restoration of root filled teeth

  1. Marc Bolla2,
  2. Michele Muller-Bolla1,*,
  3. Cybele Borg2,
  4. Laurence Lupi-Pegurier1,
  5. Olivier Laplanche3,
  6. Eric Leforestier4

Editorial Group: Cochrane Oral Health Group

Published Online: 24 JAN 2007

Assessed as up-to-date: 31 OCT 2006

DOI: 10.1002/14651858.CD004623.pub2

How to Cite

Bolla M, Muller-Bolla M, Borg C, Lupi-Pegurier L, Laplanche O, Leforestier E. Root canal posts for the restoration of root filled teeth. Cochrane Database of Systematic Reviews 2007, Issue 1. Art. No.: CD004623. DOI: 10.1002/14651858.CD004623.pub2.

Author Information

  1. 1

    Faculté de Chirurgie Dentaire, Sante Publique (Public Health), Nice, France

  2. 2

    Faculté de Chirurgie Dentaire, Biomatériaux Dentaires (Biomaterials), Nice, France

  3. 3

    Faculté de Chirurgie Dentaire, Prothèses (Prosthetics), Nice, France

  4. 4

    Faculté de Chirurgie Dentaire, Odontologie Conservatrice - Endodontie (Conservative Dentistry), Nice, France

*Michele Muller-Bolla, Sante Publique (Public Health), Faculté de Chirurgie Dentaire, 24 Rue des Diables Bleus, Nice, 06357, France. muller@unice.fr.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 24 JAN 2007

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

The foundation for the reconstruction of endodontically-treated teeth can be provided by a metal or a non-metal post and core system but no guidelines exist for choosing one or the other in particular clinical cases.

Objectives

To assess the effectiveness of different post and core systems for the restoration of endodontically-treated teeth. The primary objective of this review was to compare the clinical failure rates of the different types of posts.

Search methods

We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2005, Issue 3), MEDLINE (from 1966 to September 2005), Scopus (from January 1985 to December 2004) and EMBASE (until December 2004). We looked through reference lists of articles and dental conference proceedings. We contacted researchers in the field and manufacturers.

Selection criteria

Randomised or quasi-randomised clinical trials (RCTs) comparing failures on endodontically-treated permanent teeth with different types of post. The outcomes were loss of retention, post fracture and root fracture.

Data collection and analysis

Two review authors independently assessed the quality of trials and extracted data. Study authors were contacted for additional information.

Main results

Two trials involving 317 participants were included but only one of them, involving 200 participants, compared metal to non-metal posts. The other answered to the secondary objective. The risk of failure was greater with metal-cast posts (9/98) compared to carbon fibre posts (0/97) (risk ratio (RR) = 0.05 (95% confidence interval (CI) 0.00 to 0.90)) but the study was at high risk of bias. Thus fewer failures occurred when using non-metal posts but the evidence is unreliable.

Authors' conclusions

Our systematic review could not specify which type of post and core system should be used when two or three dentine walls remain. More RCTs are needed to confirm whether fibre-reinforced post and core systems are superior and to clarify the influence of the remaining tooth structure on the treatment outcome of the different post and core systems available. Well-defined inclusion criteria focusing on the number of dentine walls (two or three) should be used.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Root canal posts for the restoration of root filled teeth

There is weak evidence from one trial of 200 people that carbon fibre posts have fewer failures after 4 years than metal-cast posts. More research is needed.
Root canal posts are placed in teeth that have lost an extensive amount of tooth structure because of decay, failed fillings (restorations) or tooth fractures. Post and core systems can be metal or non-metal and provide a way to securely anchor the filling material core to the tooth. The core is retained by the post and the tooth can then be restored with a crown. The post is inserted into the root canal of an endodontically-treated tooth. Thus it provides retention for the final restoration. In one study, non-metal posts induced fewer failures. Thus more research is necessary to indicate which system should be used for different clinical cases.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

用來復形根管治療後牙齒的根管柱釘

根管治療後的牙齒的重建基礎可以用金屬或非金屬的柱釘和柱心系統,但有關特定的臨床狀況下該使用何種系統,並無任何準則。

目標

評估不同的柱釘和柱心系統用來復形根管治療後牙齒的效用.這篇文獻回顧主要目的在比較不同種類鑄釘的臨床失敗率.

搜尋策略

我們由網路搜尋了Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2005, Issue 3), MEDLINE (從1966 年到2005年九月), Scopus (從1985年一月到2004年十二月)和 EMBASE (2004年十二月以前).我們從文章中的參考書目和牙科研討會議記錄等尋找相關研究.我們也和在這個領域中的研究者及製造商聯絡來搜尋.

選擇標準

隨機或類隨機(quasirandomised)臨床試驗比較根管治療後的牙齒用不同種類的柱釘治療的失敗率.評估項目包括釘子鬆動,釘子斷裂及牙根斷裂.

資料收集與分析

二位文獻回顧作者(Michele MullerBolla (MMB)和 Cybele Borg (CB))各自獨立評估實驗設計的品質並選擇可用的結果.聯絡實驗的作者以獲得更多的資訊.

主要結論

此文獻回顧包含二個實驗,共有317位受測者,然而只有其中一個實驗的200位受測者是比較金屬和非金屬的柱釘.另一個實驗則可作為本研究次要目標的答案.失敗的比率在金屬鑄造的柱釘(9/98)比碳纖維柱釘(0/97)來的高(風險率(RR) = 0.05 (95%信賴區間 0.00 to 0.90)),但實驗設計是很有可能存在偏差.因此當使用非金屬的柱釘發生較少的失敗,但所得的證據是不足以採信的.

作者結論

我們的系統性回顧並不能確定的指出當牙齒剩下二面或三面牙本質牆壁時該使用那種柱釘及柱心系統.需要有更多的隨機對照試驗來確定究竟強化纖維的柱釘和柱心系統是不是較好的,並釐清剩餘牙齒結構對於使用不同柱釘及柱心系統治療效果的影響.實驗應該使用定義完整的選擇條件(inclusion criteria)著重於牙本質牆壁的數目(二面或三面)

翻譯人

本摘要由臺灣大學附設醫院鄭偉立翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

由一個200位受測者的實驗中所得到結果顯示:薄弱的證據顯示在治療4年後碳纖維柱釘比金屬鑄造釘失敗較少發生.因此需要更多的研究來得到結論.牙根柱釘用於牙齒因為蛀牙,填補物失敗或牙齒斷裂等所造成牙齒結構大範圍的缺損.柱釘及柱心系統可以是金屬或非金屬作成,用來提供固定填補柱心材料在牙齒上的方式.柱心被柱釘固定住,這樣一來牙齒就可以裝上牙套.柱釘是插入根管治療完牙齒的牙髓腔中,因此它提供最後復形物所需的附著力.在一個實驗中,非金屬的柱釘導致失敗較少.然而需要更多的研究來指出在不同的臨床病例時應該使用那種系統。