Rigid vs. flexible endodontic posts: 5-year results of a RCT

Objective: to compare the clinical survival rate of ‘rigid' titanium and more ‘flexible' glass fiber reinforced endodontic posts. All posts were adhesively placed with a self-adhesive resin cement.

Methods: 98 patients with a treatment need of postendodontic restoration were assessed for eligibility. 91 patients met the selection criteria, were randomized and allocated to two intervention groups. 45 patients were treated using titanium posts, and 46 patients received glass fiber posts. All posts had a diameter of 1.4mm and a length of 13mm, were cemented with self-adhesive universal resin cement and composite core build-ups were placed. A circumferential ferrule of 2mm was prepared in all cases, if necessary by means of surgical crown lengthening. Patients were observed at 3, 6, 12 month after post placement, and annually thereafter for a total of 5 years.

Results: Half of all restored teeth received single cast crowns, while in 23% fixed partial dentures and in 11% combined fixed-removable partial dentures were placed. 10% of all restored teeth were molars. One patient was excluded from the analysis since no final restoration was placed. One tooth was extracted due to changes of prosthetic treatment planning. One tooth was extracted for periodontal reasons. One patient was lost to follow-up. One abutment tooth for a cantilever bridge fractured where a glass fiber post was inserted. An intention-to-treat analysis revealed no statistically significant differences between groups (p=0.553, Fisher's Exact test).

Conclusion: Adhesively luted titanium and glass fiber reinforced endodontic posts may have similarly low failure rates over 5 years of clinical service if a 2mm ferrule is provided.