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  1. Alarami N, Sulaiman E, Al-Haddad A
    Am J Dent, 2017 Aug;30(4):197-200.
    PMID: 29178701
    PURPOSE: To evaluate fracture resistance and failure mode of endodontically-treated mandibular molars restored with different intra-radicular techniques.

    METHODS: 75 human mandibular molars were randomly divided into five equal groups. Teeth were standardized, endodontically-treated and restored according the assigned group as follows: amalgam core only, prefabricated titanium post in the distal canal and amalgam core, composite core only; fiber post in the distal canal and composite core. One group of untreated sound teeth was used as a control. Non-precious metal crowns were fabricated and cemented on the prepared specimens with Rely X U200 resin cement. All specimens were subjected to a compressive load at crosshead speed 0.5 mm/minute, 25° to the long axis of the tooth. Failure loads and modes were recorded.

    RESULTS: Mean failure loads among the groups were significantly different (P= 0.035). Post-hoc multiple pair-wise comparisons revealed the amalgam core and composite core groups produced significantly lower fracture resistance than the control group (P= 0.041 and P= 0.025, respectively) and no significant differences among the different intra-radicular techniques (P> 0.05). The composite core with fiber post and amalgam core with titanium posts showed the highest percentage of favorable failures (67%) and non-favorable failures (87%) respectively.

    CLINICAL SIGNIFICANCE: The composite core with fiber post is the most appropriate intraradicular restoration in cases of severely compromised molars.

  2. Sulaiman E, Alarami N, Wong YI, Lee WH, Al-Haddad A
    Dent Med Probl, 2018 10 18;55(3):275-279.
    PMID: 30328305 DOI: 10.17219/dmp/94656
    BACKGROUND: There is no sufficient literature on the effect of post location on endodontically treated premolar teeth with 2 roots.

    OBJECTIVES: The aim of the study was to evaluate the effect of fiber post location on fracture resistance and failure mode of endodontically treated premolars with 2 roots.

    MATERIAL AND METHODS: Fifty extracted maxillary first premolars with 2 roots were divided randomly into 5 groups. Group 1 was comprised of sound teeth, which received only metal crowns (control). Teeth from groups 2, 3, 4, and 5 were decoronated 2 mm above the cementoenamel junction (CEJ) and were endodontically treated. No post was placed in group 2 teeth. Teeth from groups 3, 4 and 5 were given a fiber post placed in the buccal canal, palatal canal, and both buccal and palatal canals, respectively. All teeth in groups 2, 3, 4, and 5 were built up with composite and full coverage metal crowns. A compressive static load was applied at an angle of 25° to the crowns with a crosshead speed of 0.5 mm/min, until fracture.

    RESULTS: One-way analysis of variance (ANOVA) showed significant differences among the groups (p = 0.002). A post hoc test showed significantly lower fracture resistance of group 4 compared to group 5 (p = 0.011). Furthermore, group 2 had significantly less fracture resistance compared to group 1 (p = 0.021) and group 5 (p = 0.002). According to Fisher's exact test, different post locations are non-significantly associated with fracture mode (p = 0.256).

    CONCLUSIONS: Fiber post location has a significant effect on fracture resistance of severely damaged, endodontically treated maxillary premolars with 2 roots. However, post placement in the palatal root is preferred, as it maintains the restorability of the tooth.

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