Randomized Clinical Trial Comparing the Effects of Post Placement on Failure Rate of Postendodontic Restorations: Preliminary Results of a Mean Period of 32 Months

Introduction: The aim of this randomized clinical trial was to assess whether the placement of a fiber post (DT Light Post) (DT) and the amount of residual coronal dentin affect the time to failure of single-unit postendodontic restorations. Methods: Ninety patients providing 120 teeth were selected. Three groups (n = 40) were defined on the basis of the amount of residual coronal dentin: 2-walls group, 2 or more coronal walls; 1-wall group, 1 coronal wall; no-wall group, no wall exceeding 2 mm above the gingival level. Within each group teeth were randomized and allocated to 2 intervention groups (n = 20), including subgroups no post (no root canal retention) and subgroups post (placement of DT). Results: After a mean observation period of 32.4 (13.7) months in subgroups no post, the failure rates were 10%, whereas in subgroups post, failure rates of 7% were observed (P = .318). In no-wall group post placement significantly affected the time to failure of total restorations (P = .029, log-rank test). Teeth without post retention revealed a significantly higher failure rate (31%) compared with teeth restored with post retention (7%). Conclusions: Within the observation time of the present study, fiber post placement was efficacious to reduce failures of postendodontic restorations only with teeth that exhibited no coronal walls. Post insertion for teeth showing a minor substance loss should be critically reconsidered. (J Endod 2009;35:1477-1482)