Direct Application of Fiber-Reinforced Composite Resins in Post-Endodontic Restorations: A Case Series

INTRODUCTION

The restoration of endodontically treated teeth significantly impacts their long-term prognosis and is crucial during treatment planning.⁸ Due to factors like past restorations, access preparation, trauma, and caries, these teeth often experience considerable loss of coronal and radicular structure, impairing their ability to withstand stresses. To address this, posts are recommended for teeth with compromised structure, historically constructed from metal but prone to issues like root fractures and corrosion.

In response, carbon fiber posts were introduced in 1990, offering anisotropic behavior and reduced risk of fracture and decementation. This innovation aims to mimic tooth tissues' physical properties, with recent advancements including quartz and glass fiber posts encased in resin for aesthetic appeal. Dentistry now prioritizes restoring endodontically treated teeth with materials similar to dentin, free from metal and with uniform qualities.⁵

Glass fiber reinforced posts enhance light transmission and avoid corrosive reactions seen with metal posts, also facilitating easier removal during retreatment if necessary.⁴ These case report presents a detailed procedure for restoring damaged permanent mandibular molar and pre molar using glass fiber reinforced intracanal posts, showcasing their benefits and clinical relevance.⁹

CASE REPORT 1

A 35-year-old female patient came with a chief complaint of broken tooth in lower left back region reported to the department of Conservative Dentistry and Endodontics and to get the teeth treated. On clinical examination grossly decayed 35 with previously initiated root canal treatment was seen. Tooth vitality was carried by using electronic pulp vitality tester and the teeth was found to be non vital. Clinical photographs were taken before initiating the procedure. The tooth was cleaned and prepared for endodontic treatment followed by fibre post and core with crown.

Pre-operative radiographs were evaluated. Root canal treatment was initiated and intra canal medicament was placed for 1 week and recalled for completion of root canal treatment. Post space preparation was done using peeso reamers. Impression of upper and lower arches was made using putty wash technique. Cast was poured using dental stone.

Postoperative clinical photographs were recorded and postoperative instructions were given. Patient was recalled after 1 week for evaluation.

CASE REPORT 2

A 28-year-old male patient came to the department with the chief complaint of dislodged crown since 1 month. No history of sensitivity or pain. Non relevant medical history. No periapical radiolucency was seen under radiograph. On clinical examination rct treated 47 with dislodged post endo and crown was seen. Diagnosis made was rct treated tooth with dislodged crown. Preoperative image was taken. Post space preparation was done and fibre post was placed in the distal root of the mandibular molar.

Post space was prepared with peeso reamer and post try in was done. Fibre post was placed and core build up was done.

DISCUSSION

Adults may bite with a maximum force of 90 KGF(Kilogram- Force) and chew with a force ranging from 7 to 15 KGF.² To withstand these stresses over time, a clinically effective restored tooth must mimic dentin and distribute stress properly along the root.3 Fiber posts with an elastic modulus similar to dentin result in less stress transfer, creating a more resilient post-core system.

Reports suggest that the elasticity of fiber-reinforced composite posts (FRCP) closely resembles dentin. Dentinal bonding creates a monoblock dentin-post-core system, enhancing stress distribution along the root under load.¹

In these case reports, glass fibers were incorporated into the post system, initially developed for tooth-colored fillings and core build up with crown. The unidirectional R-glass composition significantly increases flexural strength, making it preferable for badly mutilated posterior teeth due to its excellent retention and stress distribution properties.

Glass fiber posts offer advantages such as greater flexural strength, ease of handling, suitability for high-stress regions, aesthetic acceptability, and compatibility with various composites.⁷ Their modulus of elasticity closely matches dentin, reducing the risk of irreparable root fractures.

Resin adhesive cement is used for cementing glass fiber posts, forming a strong bond between the post, core, and remaining tooth structure. This adhesive integration creates a monobloc repair, efficiently transferring and dispersing functional stresses throughout the tooth.¹⁰

CONCLUSION

The utilization of customized unidirectional glass fiber posts, tailored to match the internal architecture of the root canal in this case, showcased favorable clinical and radiographic outcomes. These posts exhibit excellent light conductivity, biocompatibility, ease of handling, and equivalent elasticity modulus to dentin. Additionally, they possess robust flexural and fatigue strength, along with exceptional cosmetic properties. This procedure is well-suited for restoring endodontically treated teeth, offering efficiency, minimal invasiveness, and suitability for the task at hand.

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