The application of fiber core posts in restoring badly destroyed primary incisors

Early childhood caries (ECC) represents a challenge to pediatric dentists especially, when teeth are badly destroyed. ECC involves the upper anterior teeth early in life and by the time the dentist sees the child, most of the coronal structure is lost. Dentally, this is a very devastating situation for both the den-tist and parents, as in many cases, extraction of these teeth is the only option.

With the introduction of new adhesive systems and restorative materials, a new approach for treating these teeth is explained and documented by clinical cases, where fiber core posts are introduced into the root canals of primary incisors for a distance of 2 to 3 mm. It is retained in place by flowable composite, then the coronal part is reconstructed by a strip crown to restore the crown form.After a follow up period of one year, only 2 teeth out of 30 had to be extracted. The failure was attributed to failure in pulpal ther-apy rather than failure in the restorations, which were totally intact. A laboratory testing of the fracture load resistance of the restored teeth proved that this technique significantly improved the fracture load resistance of composite celluloid crowns, making it a valuable procedure to consider when the coronal tooth structure is not enough to support and retain a composite celluloid strip crown.

1. Davies GN. Early childhood caries. A synopsis. Community Dent Oral Epidemiol 26 (1 suppl): 106-16, 1998.

2. Croll TP. Primary incisor restoration using resin-veneered stain-less steel crowns. J Dent Child 65: 89-95, 1998.

3. Carranza F, Garcia-Godoy F. Esthetic restoration of primary incisors. Am J Dent 12: 55-8, 1999.

4. Citron CI. Esthetics in pediatric dentistry. N Y State Dent J 61: 30- 3, 1995.

5. Drummond BK. Restoration of primary anterior teeth with com-posite crowns. N Z Dent J 89: 92-5, 1993.

6. Pollard MA, Curzon JA, Fenlon WL. Restoration of decayed pri-mary incisors using strip crowns. Dent Update 18: 150-2, 1991.

7. Croll TP. Bonded composite resin crowns for primary incisors: technique update. Quintessence Int 21: 153-7, 1990.

8. Lambrechts F, Willems G, Vanherle G, Braem M. Esthetic limits of light cured composite resin in anterior teeth. Int Dent J 40: 149- 58, 1990.

9. Rosen M, Melman GE, Cohen J. Changes in light cured compos-ite resin material used to restore primary anterior teeth: an eigh-teen month in vivo study. J Dent Assoc S Afr 45: 251-5, 1990.

10. Croll TP, Helpin ML. Preformed resin veneered stainless steel crowns for restoration of primary incisors. Quintessence Int 27: 309- 13, 1996.

11. Baker LH, Moon F, Mourino AP. Retention of esthetic veneers on primary stainless steel crowns. J Dent Child 63: 185-9, 1996.

12. Wiedenfeld KR, Draughn RA, Welford JB. An esthetic tech-nique for veneering anterior stainless steel crowns with compos-ite resin. J Dent Child 61: 321-6, 1994.

13. Ellis RK, Donly KJ,Wild TW. Indirect resin crowns as an esthetic approach to treating ectodermal dysplasia: a case report. Quin-tessence Int 23: 727-9, 1992.

14. Rifkin A. Composite post crowns in anterior primary teeth. J Dent Assoc S Afr 38: 225-7, 1983.

15. Judd PL, Kenny DJ, Johnston DH, Yakobi R. Composite resin short post technique for primary anterior teeth. J Am Dent Assoc 120: 553-5, 1990.

16. Cohen BI, Pagnillo MK, Deutsch AS, Musikant BL. Fracture strength of three core restorative materials supported with or without a prefabricated split-shank post. J Prosthet Dent 78: 560-5, 1997.

17. Cohen BI, Pagnillo MK, Newman I, Musikant BL, Deutsch AS. Cyclic fatigue testing of five endodontic post designs supported by four core materials. J Prosthet Dent 78: 458-64, 1997.

18. Cohen BI, Pagnillo MK, Condos S, Deutsch AS. Four different core materials measured for fracture strength in combination with five different designs of endodontic posts. J Prosthet Dent 76: 487-95, 1996.

19. Cohen BI, Condos S, Musikanti BL, Deutsch AS. Pilot study comparing the photoelastic stress distribution for four endodon-tic post systems. J Oral Rehabil 23: 679-85, 1996.

20. Cohen BI, Musikanti BL, Deutsch AS. Clinical usage of the Flexi-Flange post system. Dental News 2: 33-6, 1995.

21. Cohen BI, Musikanti BL, Deutsch AS. The Flexi-Flange post sys-tem and its clinical use. Compend Contin Educ Dent 15: 1124-8, 1994.

22. Cohen BI, Deutsch AS, Musikanti BL. Cyclic fatigue testing of six endodontic post systems. J Prosthet Dent 2: 28-32, 1993.

23. Sidoli GE, King PA, Setchell DJ.An in vitro evaluation of a carbon fiber-based post and core system. J Prosthet Dent 78: 5-9, 1997.

24. Cohen BI, Pagnillo MK, Musikant BL, Deutsch AS, Cofrancesco G. Pilot study of the effects of three bonding systems on the tor-sional resistance of a titanium-reinforced composite core. J Pros-thet Dent 82: 277-80, 1999.

25. Braem MJ, Lambrechts P, Gladys S, Vanherle G. In vitro fatigue behavior of restorative composites and glass ionomers. Dent Mater 11: 137-41, 1995.