VOLUME 36 • NUMBER 9 • OCTOBER 2005 737 QUINTESSENCE INTERNATIONAL The prognosis of endodontically treated teeth depends not only on the treatment itself, but also on sealing the canal and mini- mizing the leakage of oral fluids and bacteria into periradicular areas by prompt placement of coronal restorations. 1 This treatment includes the decision of whether or not posts should be used. After many years of scientif- ic work involving post material, post geome- try, post length, core material, and other con- siderations, the indication for posts is re- emerging as a topic of discussion. A change of paradigm has occurred based on the advantages of adhesive restorations, which seem to make post insertion unnecessary. In addition to this development, evidence- based treatment is becoming increasingly important in dentistry. Treatment decisions and strategies should be based on the best and most-up-to-date factual evidence avail- able. Evidence-based dentistry is influencing Restoring endodontically treated teeth with posts and cores—A review Ingrid Peroz, Dr Med Dent 1 /Felix Blankenstein, Dr Med Dent 1 / Klaus-Peter Lange, Prof Dr Med Dent 2 /Michael Naumann, Dr Med Dent 3 Objective: The prognosis of endodontically treated teeth depends not only on the suc- cess of the endodontic treatment, but also on the type of reconstruction. These considera- tions include the decision of whether or not to use posts. Methods and materials: A liter- ature review has been performed to create guidelines for the reconstruction of endodonti- cally treated teeth by posts and cores. Results: Posts should only be used for the reten- tion of core material in cases where little dental substance remains, ie, one or no cavity walls. A ferrule of 2 mm has to be provided, by surgical means if necessary. The post length is limited by the necessary apical seal of 4 to 6 mm. In cases of short posts, adhe- sive fixation is preferred. Ceramic posts show a higher risk of fracture than fiber posts which are retrievable. Composites have proven to be a good core material. Posts should be inserted if endodontically treated teeth are used as abutments for removable partial dentures. Conclusion: These guidelines are based mainly on in vitro studies with an evi- dence level of II a or II b, as there is a lack of randomized clinical studies available. The remaining tooth structure is an important factor influencing the indication of posts and cores, yet it is not sufficiently recognized in clinical studies and in vitro. Therefore, further prospective clinical studies are needed. (Quintessence Int 2005;36:737–746) Key words: endodontically treated teeth, post and core, reconstruction, review 1 Associate Professor, Humboldt University of Berlin, Dental School, Department of Prosthetic Dentistry and Oral Gerontology, Berlin, Germany. 2« Professor, Humboldt University of Berlin, Dental School, «Department of Prosthetic Dentistry and Oral Gerontology, «Berlin, Germany. 3« Assistant Professor, Humboldt University of Berlin, Dental «School, Department of Prosthetic Dentistry and Oral «Gerontology, Berlin, Germany. Reprint requests: Dr Ingrid Peroz, Zentrum für Zahnmedizin, Abteilung für Zahnärztliche Prothetik und Alterszahn- medizin, Augustenburger Platz 1, 13353 Berlin, Germany. E-mail: ingrid.peroz@charite.de