PubMed · 8032446
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D L Baird. 1994. Options for full coverage ceramic restorations.. https://pubmed.ncbi.nlm.nih.gov/8032446/
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Underdimensioning may adversely affect the clinical use of a crown or bridge. Insufficient dimensions may be due to inadequate modelling or deficiencies caused by the casting process. The dimensions of cast objects are measured mechanically using a calliper. This method has often proved to be insufficient in detecting areas of too small dimensions. This paper presents a non-destructive method of inspecting dental castings using radiography. The occlusal thickness of a random sample of 150 crowns made during regular clinical treatment in our department was inspected mechanically and radiographically. We found that 19% of the crowns were only 0.1 mm thick or less at the thinnest spot, 18% were between 0.1 and 0.2 mm and 9% were between 0.2 and 0.3 mm. In comparison to mechanical examination, radiographic inspection usually showed smaller values.
Thirty-six maxillary central incisors were endodontically treated and restored with a post and core and cast crown. Three different post and core systems were evaluated. Restored teeth were fatigue-loaded until preliminary failure of the casting occurred as detected by a strain gauge bonded across the lingual margin of the cast crown. After preliminary failure, fatigue loading was continued for 100,000 load cycles with the crown margin exposed to basic fuschin dye. Teeth were then immersed in dye for 24 h, sectioned, and evaluated for leakage. There was no significant difference in the number of load cycles required to cause preliminary failure among the three post and core systems. Leakage occurred in all three groups, with no significant difference between groups. The occurrence of preliminary failure is clinically undetectable, yet it allows leakage between the restoration and tooth that may extend down the prepared post space.
In this era of fiscal and professional accountability, variations in the utilization of posts to improve the retention of crowns or other restorations on endodontically treated teeth are no longer acceptable. This practice ignores not only the potential for root perforations during post space preparations, but also the adhesive properties of modern resin-based materials. Since the retention of restorations hinges on many other factors, the placement of posts does not necessarily assure service quality and may even lead to deleterious changes. The need to reappraise the utilization of posts in the restoration of endodontically treated teeth cannot be overstated.