Evidências científicas na utilização de pinos de fibra de vidro e núcleos metálicos fundidos

Abstract

Traditionally, metals have been used to fabricate dental posts because of their suitable physical properties and possibility of being cast or machined into precise shapes. However, in recent decades, the increasing demand for aesthetics has led to the development of glass fiber posts. Glass fiber posts are considered an alternative to cast metal posts to restore endodontically treated teeth. Considering both types of intracanal posts, this study was divided into four parts. In the first, a narrative literature review of current concepts in the use of glass fiber posts was performed. In general, it may be said that the use of fiber posts is an important clinical option in Dentistry, but clinicians should be aware of the difficulties in achieving good adhesion within the root canal. In the second part, a systematic review evaluated if the use of silane would be beneficial to the bond strength of glass fiber posts. This review showed that although there is little evidence in the literature, silanization might improve the retention of glass fiber posts luted into root canals provided that selective physical/chemical surface treatments are applied to the post before silanization. In the third part, an in vitro study compared how operators (experienced or not) and intracanal impression techniques (direct or indirect) influenced the surface characteristics of the impressions and the quality of cast metal posts. Results showed that both operators and techniques resulted in clinically acceptable posts according to international standards. The fourth part of this study evaluated the accuracy of cast metal posts depending on the tooth position and impression technique performed on a randomised controlled trial. Results showed that cast metal post were shorter than their respectvive impressions for all variables tested, but resulted in clinically acceptable metal posts. However, the direct technique was more time-consuming than the indirect technique, which is especially important in cases of multiple teeth involved and/or reduced interarch space. Thus, it may be concluded that data from the in vitro study corroborated with the RCT, as irrespective of the impression technique, operator level of expertise or the position of the tooth in the arch all cast metal posts were shorter, but clinically acceptable.