根管治療歯における異なるポスト・コアシステムの長期予後に関する前向き研究

Restoration of endodontically treated teeth (ETT) often necessitates the use of post and core systems to ensure functional and structural longevity. However, the long-term performance of various post and core materials remains the subject of clinical interest. Hence the aim of the study was to evaluate and compare the longevity and failure modes of three commonly used post and core systems-fiber-reinforced composite (FRC), prefabricated metal, and custom-cast post systems-in ETT over a 3-year follow-up period.

A total of ninety patients (aged 25-50 years) with single-rooted endodontically treated premolars were recruited and randomly allocated into three groups (n = 30 each): Group A - FRC posts, Group B - prefabricated metal posts, Group C - custom-cast posts. All teeth were restored with full-coverage crowns. Clinical evaluations were conducted at 6-month intervals for 36 months. Survival rates and failure patterns were recorded. Statistical analysis included Kaplan-Meier survival estimates and log-rank tests.

At 36 months, Group A (FRC) exhibited a survival rate of 93.3%, Group B (metal) 86.7%, and Group C (custom-cast) 80.0%. The most frequent failure mode in Group A was debonding (6.7%), in Group B was post loosening (10.0%), and in Group C was root fracture (13.3%). Kaplan-Meier analysis revealed a statistically significant difference in survival among groups (P = 0.041), with Group A outperforming Group C.

FRC posts demonstrated superior longevity and a more favorable failure pattern over prefabricated metal and custom-cast posts in endodontically treated teeth, suggesting their preferable use in clinical practice for long-term success.