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Post-endodontic restorations with adhesively luted fiber-reinforced composite post systems: a review.

PURPOSE
To review the literature on adhesive luting of fiber-reinforced composite posts (FRC) to provide evidence for the clinical procedure of restoring endodontically treated teeth using FRC posts.


METHODS
Data focusing on bonding behavior between root canal dentin, luting agent, and FRC post in vitro as well as in vivo performance of teeth restored with FRC posts were reported. These data were identified by searches of "PubMed", "Scopus", and "Cochrane Library" databases with the terms "post-endodontic restoration", "fiber post", "adhesive luting", "root canal dentin", "clinical study", and "pre-treatment fiber post". Papers published up to September 2007 were selected, and most relevant references were chosen. Cross-referencing of significant papers identified additional relevant articles.


RESULTS
FRC posts seem to have become increasingly popular for the restoration of endodontically treated teeth. Compared to metal posts, FRC posts revealed reduced fracture resistance in vitro, along with a usually restorable failure mode. Bonding behavior among FRC post, luting agents, and root canal dentin demonstrated varying results. Bond strengths between FRC posts and resin cements can be enhanced by using various pre-treatment procedures; however, bonding to root canal dentin still seems to be challenging. Most clinical studies investigating survival rates of teeth restored with FRC posts revealed promising results, but risk factors (e.g., the loss of coronal tooth structure) have not been studied intensively. In addition, randomized controlled clinical long term trials are scarce.