Radiographic analysis of 1000 cast posts in Sergipe state, Brazil

Abstract Introduction Endodontically treated teeth with extensive coronary destruction require posts and cores to enable prosthetic restoration. Despite the increasing use of prefabricated posts, cast metal posts and cores are still widely used. The quality of the latter is important for the longevity of restorative treatment, and failure can occur if the fundamental principles are not followed. Objective To radiographically evaluate the prosthetic principles of 1000 cast metal post-and-core restorations performed in single-rooted teeth and their coherence with the principles used for their confection. Material and method Digital periapical radiographs of 1000 endodontically treated, single-rooted teeth with cast metal posts and cores were selected from the collection of a radiology clinic (Centro de Imagem, Aracaju/SE, Brazil). The images were analyzed using a measurement software (ImageJ, USA) in accordance with the fundamental prosthetic principles: length and diameter of the post, ratio between post and bone crest, contiguity of post to the root canal, gap between post and the remaining root canal filling, amount of remaining root canal filling, and absence of periapical lesion. The data were qualitatively analyzed, classified into ideal and not ideal, and submitted to the chi-square test (α=0.05). Result Only 6.7% of the cast metal posts analyzed were satisfactorily fabricated. Conclusion Many prosthetic criteria are neglected during the manufacturing of cast metal post and cores, resulting in inadequate work that may compromise the longevity of restorative treatments.

摘要
引言：经根管治疗（endodontic treatment）且存在广泛牙冠缺损的患牙，需通过桩核（post and core）修复以实现修复体修复。尽管预制桩（prefabricated post）的应用日益广泛，但铸造金属桩核（cast metal post and core）仍被广泛使用。这类桩核的质量对修复治疗的使用寿命至关重要，若未遵循其基本原则，修复体可能出现失败。
研究目的：通过影像学检查，评估1000颗单根牙铸造金属桩核修复体的修复原则合规情况，并验证其与制作原则的契合度。
材料与方法：从巴西阿拉卡茹市（塞尔希培州）影像中心（Centro de Imagem）的馆藏中，选取1000颗经根管治疗、佩戴铸造金属桩核的单根牙的数字化根尖片（digital periapical radiograph）。采用测量软件ImageJ（美国），依据修复学基本原则对图像进行分析，分析指标包括：桩的长度与直径、桩与骨嵴的比例、桩与根管壁的贴合度、桩与剩余根管充填材料之间的间隙、剩余根管充填材料的量以及是否存在根尖周病变（periapical lesion）。对数据进行定性分析，将其分为理想（合规）与非理想（不合规）两类，并采用卡方检验（chi-square test）进行统计学分析，显著性水平设定为α=0.05。
结果：本研究分析的铸造金属桩核中，仅6.7%的制作质量符合规范要求。
结论：铸造金属桩核的制作过程中，诸多修复学标准被忽视，导致修复体制作不达标，可能会缩短修复治疗的使用寿命。