JOURNAL OF ENDODONTICS Printed in U.S.A.

Copyright © 2002 by The American Association of Endodontists VOL. 28, NO. 9, SEPTEMBER 2002

SCIENTIFIC ARTICLES

Evaluation of Two Post Core Systems Using Two

Different Methods (Fracture Strength Test and a
Finite Elemental Stress Analysis)
Gürcan Eskitaşcıoğlu, DDS, PhD, Sema Belli, DDS, PhD, and Mustafa Kalkan, DDS, PhD

The aim of this study was to compare a fiber com- have resulted in an increased demand for clinically convenient post
posite laminate (FCL) post core and a conventional core systems to help restore lost tooth structure. In the past, it was
cast post core system by using two different meth- thought that posts reinforced endodontically treated teeth, how-
ods. The first method was a conventional fracture ever, recent research has shown the opposite. Today, the main
reason for using posts is recognized to be a connection of the
strength test, and the second was a finite elemen-
replacement for the missing coronal portion of the tooth to the
tal stress-analysis method (FEM). For the conven- remaining root structure, thereby providing retention for the crown
tional fracture strength test, 20 extracted, human (2). Several post core systems have been described in the literature.
upper, central incisors were used. The teeth were Previously, posts were cast in a precious alloy, or prefabricated
decoronated, treated endodontically, and restored posts made of stainless steel, titanium, or precious alloy were used.
with two post core systems. After embedding the The construction of post core castings is relatively more time
samples in resin blocks, a loading force was ap- consuming and demands extra clinic and laboratory time (3).
plied to the teeth at a crosshead speed of 5 mm/ Prefabricated posts allow fast, cheap, and easy techniques (4), but
min at an angle of 45 degrees to the long axis of the they do not take into account the individual shape of the root canal
tooth. The data were recorded, and the results and their adaptation is not always ideal (5).
The post core systems include components of different rigidity.
were compared by using the Mann-Whitney U test.
Because the more rigid component is able to resist forces without
There was no statistically significant difference be-
distortion, stress is expected to be transferred to the less rigid
tween the two post systems (p > 0.05). substrate. The difference between the elastic modulus of dentin and
For FEM analysis, a pseudo three-dimensional post material may, therefore, be a source of stress for the root
model of a maxillary central incisor, theoretically re- structures. Recently, the preference of dentists has changed from
stored with either a cast post or an FCL, was used. very rigid materials to materials that closely resemble dentin to
The analysis was performed by using the structural create a mechanically homogenous unit. Research for new, less
analysis program (SAP90). FEM analysis showed that rigid materials resulted in the marketing of new materials, such as
stress was accumulated within the cast post core carbon fiber posts (6), composipost systems, ceramic posts (7), and
system, and transmission of stress to supportive fiber composite laminate (FCL) post cores.
structures and the tooth was low. This is an advan- In this study, the effect of rigidity of post core systems on stress
distribution was investigated by the theoretical technique, finite
tage for tooth and supporting tissues. When the FCL
elemental stress-analysis method (FEM). The physical behaviors
post core system was evaluated by FEM, the results of two post core systems (cast alloy post cores and FCL post cores)
indicated that this system transferred stress to sup- were also evaluated by using a conventional fracture strength test.
portive structures and the tooth while stress accu- By evaluating the mechanical characteristics of restorative mate-
mulation within the post system was low. This is an rials and their supporting structures, clinicians may be aided in post
advantage for the restoration but disadvantage for core material selection.
the supporting tissues.
MATERIALS AND METHODS

Conventional Fracture Test

Endodontically treated teeth with excessive loss of substance have
less mineralized tissue, and thus, in comparison with sound teeth, Twenty, extracted, human maxillary central incisors with sim-
are weak (1). The high success rates for modern-day endodontics ilar root length (approximately 12 mm) and without fracture or

629
630 Eskitaşcıoğlu et al. Journal of Endodontics

cracks were used. The coronal part of the teeth was removed 1-mm
coronal to the labial CEJ. The pulp tissue was removed; the canals
were prepared using the step-down method with sodium hypochlo-
rite irrigation. The canals were filled with gutta-percha and Seal
Apex (Kerr, Italia S.p.A, Salerno, Italia) sealer. The teeth were
then randomly assigned to 2 groups of 10 specimens. The post
preparations were made 24 h later.

Cast Post Core Preparation

Post holes were prepared to a depth of 8 mm by removing

gutta-percha with Gates Glidden drills. The remaining dentin
thickness for each tooth was approximately 2 mm. The post holes
were irrigated with water and dried with paper points. Impressions
were made by using polyvinylsiloxane impression material (Ex-
trude Light, Kerr Manufacturing) that was poured in type IV dental
stone (Fujirock, GC Alsip, IL, U.S.A.) and allowed to set for 24 h.
Two coats of die spacer (PDQ Whip Mix, Louisville, KY) were FIG 1. Schematic representation of the preparation of Ribbond fiber
applied to the dies. Wax-ups of the post and core (Maves #3 Inlay laminate core. (A) Determining the length of Ribbond needed. (B)
Wax, Maves, Cleveland, OH) were fabricated on the dies and were Placement instrument and Ribbond inserted into root canal. (C) A
transferred to the corresponding test specimens. Each waxed spec- second V of ribbon was then placed into the first V at a right angle.
imen was then invested with an induction casting machine (Fornax (D) Ribbond ends protruding from canal. One end is folded over and
35 K, Bego Bremer Goldschageri Wilh. Herbst GmbH & Co., tucked back into the canal.
Bremen, Germany). After the corrected fit had been ascertained,
the surfaces of the cast post cores (NiCr, Remanium CS, Dentau-
rum, Germany) were abraded with airborne particles (25 ␮m
aluminum oxide under 3.0 kg/cm2 of pressure). Zinc phosphate
cement (Postcal, Voco, Cuxhaven, Germany) was mixed according
to the manufacturers recommendations and inserted into the canal
by using a lentulo spiral and applied to the post. The cast post cores
were then seated into the canal space under finger pressure. Once
set, the excess cement was removed with a sharp, hand instrument.

FCL Post Core Preparation

The post holes were prepared as described in group 1. After

rinsing and drying, the root canal spaces were treated with a
self-etching primer from Kuraray and coated with a dual-cure
bonding agent (Liner Bond 2 V, Bond A and B mixture, Kuraray
Co., Ltd., Osaka, Japan). Two-millimeter wide Ribbond (Ribbond
Inc., Seattle, WA) was chosen, and the ribbon lengths were deter-
mined as follows: the depth of each post space (8 mm) was
doubled, and 16 to 20 mm was then added to the measured length
(Fig. 1A). After coating the ribbon pieces with bonding agent and
blotting of the excess, the ribbons were folded in a V shape and the
inside of Vs were coated with a dual-cure resin (Variolink II,
Vivadent, Lichtenstein). The first piece of ribbon was then placed
in the post space in a facial-lingual orientation (Fig. 1B). A second FIG 2. Test apparatus with specimen mounted in universal testing
V of ribbon was then placed into the first V at a right angle (Fig. machine (Instron).
1C). The ribbons were condensed and a small drop of dual-cure
resin was then placed between the ribbon ears, protruding from the
root, shaped into a post, and light cured thoroughly (Fig. 1D). samples were loaded until failure. The loading force (N) required to
All the samples were embedded in individual autopolymerizing cause failure was recorded, and the results for the groups were com-
acrylic-resin blocks by using a mold that provided a flat surface 2 mm pared by Mann-Whitney U test.
below the facial and lingual margins of the crown. A device was made
that allowed loading of the tooth at an angle of 45 degrees to its long
axis (Fig. 2). The roots were stored in water for 24 h before testing. Finite Elemental Stress Analysis
They were then placed into a retention device, mounted in a universal
testing machine (Instron Corp., Canton, MA), and a controlled loading In a finite element analysis, the first step is the specification of
force was applied to the teeth at a crosshead speed of 5 mm/min. All the element nodes. The elements are connected with each other at
Vol. 28, No. 9, September 2002 Evaluation of Two Post Core Systems 631

their nodes. The force-displacement relations written in terms of

the nodal variables help to form the element stiffness matrix. These
element matrices are then combined to give the global stiffness
matrix. Use of the initial and boundary conditions, together with
the given loading characteristics, yields the nodal displacement
patterns. The strain-displacement relations then provide the result-
ant strains. The required normal and shearing stresses are found
through the stress-strain relationship (8). In this study, a pseudo
three-dimensional mathematical model of a maxillary central in-
cisor tooth and its supporting structures was used (Fig. 3). The
geometry used for the tooth model was described by Wheeler (9).
Two models were designed. The first model simulated cast post
core system, and the second simulated the polyethylene woven
fiber post core. Each mathematical model included 1101 elements
and 1137 nodes. All of the materials were treated as homogenous,
isotropic, and linear elastic. Their elastic properties, Young’s mod- FIG 3. Finite element model representing the midfaciopalatinal sec-
ulus (E) and Poisson’s ratio (␮), were determined from the liter- tion of human maxillary central incisor tooth and supporting tissues.
ature (Table 1) (10 –12). The effect of cementum is neglected
because of its low thickness. An average loading force of 200 TABLE 1. The elastic properties of the modeled materials
Newtons was used to simulate biting forces (Fig. 4) (13). An Young’s
evenly distributed dynamic load was applied just above the cin- Poisson’s Ref.
Material Properties Modulus
Ratio No.
gulum location (node 1079). The final element on the X- and (GPa)
Y-axis for each model was assumed to be fixed for boundary Dentine 18.6 0.31 10
conditions. As a Z-axis, a 1-mm section was added and a pseudo Zinc phosphate cement 22.0 0.35 10
third dimension was created. Periodontal ligament 0.0689 0.45 10
The analysis was performed on an IBM compatible computer Gutta/percha 0.00069 0.45 10
running a SAP90 program (Computer Structures Inc. Berkley, Spongiose bone 1.37 0.30 11
CA). The outputs were transferred to SAPLOT program to Compact bone 13.7 0.30 11
display the resulting stress values. This study was calculated by NiCr 200 0.33 12
Ribbond fiber ⫹ bonding 23.6* ⬃0.32 *
considering the pseudo three-dimensional von Mises stress
Agent ⫹ flowable composite
criteria.
* Value determined by the authors.

RESULTS

Conventional Fracture Test Results

Table 2 shows the mean failure loads of the groups. According

to the Mann-Whitney U test, no significant difference was found
among the groups (p ⬎ 0.05). Table 3 shows the failure modes of
the groups. Cast post core restored samples showed 100% post
displacements with 70% root fractures. FCL samples showed 70%
core fractures, 20% root fractures with 10% post displacement.

Finite Element Stress Analysis Results

The results are presented in terms of von Mises stress values. FIG 4. FEM model representation of the post core design and loading
Although the analyses were performed by using a pseudo three- direction (200-N force).
dimensional mathematical model (X, Y, Z direction), the results
were expressed two dimensionally (X,Y) for clarity of the figures.
(approximately 0 –30 MPa) were observed within the FCL post
When all the structures in the models were evaluated mathemati-
core (Fig. 6).
cally, low-stress values occurred with cast post core systems com-
pared with FCL post cores (Figs. 5 and 6). In the cast post system,
the stress was accumulated within the cast post core (maximum DISCUSSION
140 MPa within the post core) (Fig. 5), and transmission of stress
to supportive structures and tooth was low (maximum 70 MPa on All structural analysis and design require a knowledge of the
apical 1⁄3 region) (Fig. 7). When the FCL post core mathematical forces that will be applied and the mechanical properties of the
model was evaluated, stress was accumulated along the cervical 1⁄3 materials that must withstand these forces. Oral rehabilitation is
region of the tooth (maximum 120 MPa) (Fig. 8) and along the inherently difficult, because the functional and parafunctional
buccal bone (maximum 150 MPa) (Fig. 6). Minimum stress values forces that occur within the mouth result in extremely complex
632 Eskitaşcıoğlu et al. Journal of Endodontics

TABLE 2. The mean failure loads of the groups

Groups N Mean ⫾ SD (MPa)

FCL Post Core 10 328 ⫾ 74
Cast Core 10 370 ⫾ 172

TABLE 3. The failure modes of the groups

Core Root Post Displacement of

Groups
Fracture Fracture Fracture the Post
FCL 7 2 — 1
Cast Core — 7 — 10

FIG 7. Distribution of stress within the root restored with cast post
core system.

FIG 5. Von Mises stress distribution pattern of tooth restored with

cast post core system.

FIG 8. Distribution of stress within the root restored with FCL post
core system.

concerned are not available for comparison, the likelihood of a

failure is decided by accepting the fact that a higher von Mises
stress value is a strong indication of a greater possibility of failure.
In this study, when von Mises stress values were evaluated, it
was observed that stress was accumulated along the cast post core
system. This is an advantage for the tooth structure and supporting
tissues but may be a disadvantage for the apical 1⁄3 of the tooth and
coronal region. When the stress values were evaluated for the FCL
FIG 6. Von Mises stress distribution pattern of tooth restored with
post core, it was observed that stress was accumulated along the
FCL post core system.
cervical region of the tooth and along the buccal bone. But there
was minimum stress along the FCL core structure. However, the
structural responses by the oral tissues. Determination of resulting stress accumulation around the cervical region and supporting
stresses can be accomplished only with appropriate stress-analysis tissues was approximately twice compared with the cast post core
techniques and sufficient information of the characteristics of the systems.
oral tissues and restorative materials. The objective of seeking this Ko et al. (15) indicated that posts changed dentin stress sub-
knowledge is to predict the clinical performance of restorative stantially under compression in vertical loading. Confirming their
modalities and to provide guidelines for their use (14). In this results, the posts affected the dentin stress distribution in this study.
study, using theoretical (FEM) and experimental techniques (con- These results may be helpful for post core material choice in the
ventional fracture test), the mechanical performance of two differ- clinic. For example, due to the results of this study, it seems that
ent post core systems was evaluated. Such a comparison may be a FCL post core has advantages for the restoration of teeth with
useful to the clinician in selecting a design to provide the best apical resection. In the cases, where the supporting tissues must be
prognosis for longevity. protected (cases with periodontal problem), cast post core systems
The FEM results are presented in terms of the von Mises stress have an advantage. But FEM results should be evaluated as qual-
values. Because the tensile strength values of all of the materials itative, because the results are theoretical. It is hoped that this
Vol. 28, No. 9, September 2002 Evaluation of Two Post Core Systems 633

valuable theoretical tool will find more fields of application in The authors thank Dr. Yi Zhang (Medical College of Georgia, Augusta) for
measuring the elastic modulus of Ribbond fiber impregnated with bonding
biomechanics. agent and flowable composite, Dr. David H. Pashley for the opportunity to
When the fracture strength test results were evaluated, 10 post work in his laboratory and for his suggestions. The authors also acknowledge
core displacements were observed in the cast post core group. Dr. Shigeru Uno (Hokkaido University, Faculty of Dentistry) for his special help
and Dr. David Rudo (Ribbond Inc., Seattle, WA) for supplying material.
Although the FEM analysis indicated that stress was distributed
along the cast post cores, seven cervical root fractures were ob- Dr. Eskitaşcioğlu is associate professor and chair, Department of Prosth-
odontics, Dr. Belli is associate professor and chair, Department of Endodon-
served at the end of the fracture strength test. We noticed that there tics, and Dr. Kalkan is research assistant, Department of Prosthodontics,
were also displacements in the cast post core group. The displace- Faculty of Dentistry, Selcuk University, Konya, TÜRKİYE. Address requests for
ment of the posts might have caused cervical root fracture. Based reprints to Dr. Sema Belli, Department of Endodontics, Faculty of Dentistry,
Selcuk University, 42079, Campus, Konya, TÜRKİYE.
on this failure mode, adhesive bonding of the cast post cores may
prevent displacement of the posts and may prevent cervical root
fracture.
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