journal of dentistry 35 (2007) 778786

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journal homepage: www.intl.elsevierhealth.com/journals/jden

Up to 17-year controlled clinical study on post-and-cores

and covering crowns
Wietske A. Fokkinga a,*, Cees M. Kreulen a, Ewald M. Bronkhorst b, Nico H.J. Creugers a
a

Department of Oral Function and Prosthetic Dentistry, College of Dental Science, Radboud University Nijmegen Medical Centre,
P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
b
Department of Preventive and Restorative Dentistry, College of Dental Science, Radboud University Nijmegen Medical Centre,
P.O. Box 9101, 6500 HB Nijmegen, The Netherlands

article info

abstract

Article history:

Objective: The aim of this long-term follow-up was to collect up to 17-year survival data of

Received 12 February 2007

different metal post-and-core restorations with a covering crown.

Received in revised form

Methods: At initiation of the study, a controlled clinical trial, single tooth was provided with

29 June 2007

an artificial covering crown, by 18 operators. Restorations under investigation were the post-

Accepted 10 July 2007

and-core restorations: cast post-and-core restorations, prefabricated metal post and resin
composite core restorations, and post-free all-composite core restorations. Before treatment allocation, the recipient tooth was categorized according to the expected dentin height

Keywords:

after tooth preparation. A tooth was assessed to have substantial dentin height (Trial 1) or

Core restoration

minimal dentin height (Trial 2). The study sample consisted of 257 patients that received

Composite core

307 core restorations. The performance of the restorations was based on data collected from

Crown

the files of the current dentists monitoring the oral health of the patients. The survival

Clinical trial

probability was analyzed at different levels: on the restoration level (SR), and on the level of

Kaplan Meier

the tooth carrying the restoration (ST). Kaplan Meier analyses were used to compare survival

Long-term follow-up

probabilities.

Metal post

Results: Type of post-and-core restoration showed no influence on the survival prob-

Post-and-core

ability (at both levels) in both trials (P-value > 0.05). The 17-year survival rates at restoration

Remaining dentin

level varied from 71% to 80%, and at tooth level from 83% to 92%.

Survival

Conclusions: The results of this study showed no difference in survival probabilities among
different core restorations under a covering crown of endodontically treated teeth. The
preservation of substantial remaining coronal tooth structure seems to be critical to the
long-term survival of endodontically treated crowned teeth.
# 2007 Elsevier Ltd. All rights reserved.

1.

Introduction

The traditional way to restore an endodontically treated tooth

is a cast (metal) post-and-core and an artificial covering crown.
Since their introduction in the 1970s, prefabricated metal
posts and composite (as a core material) have been used on a

large scale as an alternative method to build-up endodontically treated teeth.13

Long-term clinical studies with a follow-up 5-year on
metal post-and-core restored teeth are scarce. Reported
survival rates vary from 50% to 99% in retrospective studies
with a follow-up period of around 10 years,46 and 89% to 94%

* Corresponding author. Tel.: +31 24 3614004; fax: +31 24 3541971.

E-mail address: w.fokkinga@dent.umcn.nl (W.A. Fokkinga).
0300-5712/$ see front matter # 2007 Elsevier Ltd. All rights reserved.
doi:10.1016/j.jdent.2007.07.006

journal of dentistry 35 (2007) 778786

in prospective studies with a follow-up period of 710 years.7,8

Data based on long-term clinical studies are essential for the
general practitioner for clinical decision making. Preferred
information is derived from prospective comparative clinical
studies, the most decisive are randomized controlled clinical
trials. In the comparison of various clinical studies on postand-core restored teeth, two structured literature reviews
showed a lack of well-designed randomized controlled clinical
trials.9,10
Crown coverage has been argued as an important factor in
the survival of endodontically treated teeth. Some authors
suggest that the survival probability of endodontically treated
teeth is positively influenced by crown placement.11,12
Another aspect related with tooth longevity after endodontic
treatment is the remaining tooth-crown material (dentin
height).1315 A greater amount of remaining dentin might
increase survival probability. It has been suggested that
sufficient ferrule (2 mm) of the covering crown makes the
type of build-up restoration trivial in the longevity of
endodontically treated teeth.13 In a literature review on the
ferrule-effect it was concluded that a ferrule of 1.5 mm is
desirable, but should not be provided at the expense of the
remaining tooth/root structure.16
The aim of present long-term clinical follow-up was to
collect up to 17-year survival data of different post-and-core
restorations with a covering crown. The hypothesis to be
tested is that there is no difference in long-term survival
probability between different types of core restorations, with
or without posts. It is also hypothesized that the amount of
remaining dentin has no influence on the survival probability.

2.

Materials and methods

2.1.

Trial design

The present study was a follow-up of two clinical trials on

various types of core restorations that were made between
January 1988 and June 1991. The design of the trials, the
patients involved, and the materials used have been described
in detail in previous reports.1719 For convenience of the reader
the main conditions will be described briefly.
The trials were organized in a multi-practice setting.
Eighteen operators were involved, 17 dentists practicing in
their own clinic in the Nijmegen area and one dentist at the
university clinic of the College of Dental Science of the
Radboud University Nijmegen Medical Centre. The study
protocol was screened and approved on its ethical acceptability by the Committee on Experimental Research on Man of
the Radboud University Nijmegen. The ethical committee
approved an addendum for the present follow-up as well.
Restorations under investigation were the core build-up
restorations according to: cast post-and-core restorations
(CPC, control), prefabricated metal post and direct resin
composite core restorations (M/C), and post-free all-composite
core restorations (C). All teeth were provided with a metal or
metalceramic crown (+C).
Before treatment allocation, the recipient tooth was
categorized by the operator according to the expected dentin
height after tooth preparation. A tooth was predicted to have

779

remaining substantial dentin height (Trial 1) or minimal

dentin height (Trial 2) after preparation. Substantial dentin
height was defined as: >75% of the circumferential dentin
wall has minimal 1 mm thickness and at least a height of
1 mm above gingival level; less than 25% of the circumference
has less than 1 mm above the gingiva, but a ferrule of 12 mm
could be achieved. Minimal dentin height was defined as:
<75% of the circumferential dentin wall has at least 1 mm
above gingival level; more than 25% of the circumference has
less than 1 mm above the gingiva, or no ferrule of 12 mm
could be achieved.
In Trial 1 the three types of core restorations were made. In
Trial 2 only the types with a post were made (CPC + C, M/C + C).
Within each trial, the type of core restoration to be made was
assigned by balanced randomization. Table 1 describes the
materials and the distributions of the post-and-core restorations per trial.

2.2.

Study sample

The study sample consisted of 257 adult patients (159 female,

98 male, aged 1771 years at intake (mean age 36 years)). They
received 307 core restorations, 204 in the upper jaw, 103 in the
lower jaw. All reconstructed teeth were single restorations
(abutment teeth for fixed partial dentures or removable partial
dentures were excluded). The majority of the patients (211)
received one core restoration, 46 patients received more than
one, but with a maximum of four core restorations.

2.3.

Evaluation

Survival data up to 17 years were collected. Due to a 3-year

intake period at baseline and the data collection period
(started 15 years after the first clinical treatments, and taking
also about 3 years) the available data varied from 15 to 17
years. The performance of the restorations was evaluated
based on data collected from the files of the current dentists
monitoring the oral health of the patients. To check whether
patient records of the dental practices provided valid data, a
convenient sample of 56 reconstructed teeth (18% of all 307
teeth) was clinically examined and cross-checked with the
patient records. The data appeared to be reliable and therefore
no further checks were done.
A restoration was recorded as having survived if the
restoration was still present in its original form at the moment
of evaluation. The survival probability was analyzed at
different levels: on the restoration level (SR), and on the level
of the tooth carrying the restoration (ST).
Endpoints for the survival level SR were intervention due to
caries at the margins of the restoration, re-cementation or
replacement of the post-and-core and crown, and loss or
extraction of the tooth (due to peri-apical problems, caries,
fracture of the root/tooth, trauma, combination of problems,
or unknown reason). Re-cementations of the crown only,
inclusion of the tooth into an abutment for a bridge,
endodontic revisions, and extractions due to periodontal
problems were accounted as censored data for this survival
level, because the restoration is not present in its original form
anymore. Maintenance treatments (e.g. polishing and finishing or adding composite after chipping of small fragments of

780

journal of dentistry 35 (2007) 778786

Table 1 Details of the investigated restorations

Abbreviation

Restoration

Specifications

No.

No. per tooth typea and per trial

Trial 1

CPC + C

M/C + C

C+C

Cast post-and-core restoration

with covering crown

Prefab metal post and composite

core restoration with covering crown

Post-free composite core

restoration with covering crown

Post: Cendres et Metaux

prefabricated cast-on post
Core: palladium alloy

118

Post: Radix or RS prefabricated

post (Maillefer)
Core: Clearfil Core resin
composite (Kuraray)

150

Post: none

39

Core: Clearfil Core resin

composite (Kuraray)

Trial 2

I/C: 24

I/C: 16

P: 21
M: 19

P: 24
M: 14

I/C: 26

I/C: 19

P: 29

P: 17

M: 38

M: 21

I/C: 10

P: 8
M: 21
Total Trial 1: 196

Total Trial 2: 111

Trial 1: comparing CPC + C, M/C + C and C + C under the condition substantial dentin height; Trial 2: comparing only CPC + C and M/C + C
under the condition minimal dentin height.
a
I/C: incisor or canine, P: premolar, M: molar.

porcelain of the crown) and apical surgeries were not regarded

to affect the survival of the restoration. The survival level ST
reflects the survival of the tooth. Endpoints for ST were loss or
extraction of the tooth, except for extraction due to periodontal problems. Extraction due to periodontal problems was
censored at the date of extraction.
Missing data were censored upon the last date that
information was available about the restoration respectively
to the tooth. If the exact date of the last evaluation could not be

retrieved, then the 1st of July of the year in which the last
check-up was recorded was taken as the evaluation date.
Where only month and year were known, the 15th day of the
particular month was taken as the evaluation date.

2.4.

Statistics

Kaplan Meier analyses with log-rank tests were used to test

the variable type of post-and-core restoration for its

Fig. 1 A schematic representation of the interventions of the post-and-core and crowns.

journal of dentistry 35 (2007) 778786

Fig. 2 Restoration survival probability (SR) as a function of

time in Trial 1 (under the condition substantial dentin
height). Vertical lines in survival curves indicate points of
censoring. Kaplan Meier analysis, P > 0.05.

781

Fig. 3 Restoration survival probability (SR) as a function of

time in Trial 2 (under the condition minimal dentin
height). Vertical lines in survival curves indicate points of
censoring. Kaplan Meier analysis, P > 0.05.

influence on the survival probability, with a cut-off value of

P = 0.05. Kaplan Meier analyses were also used for the
comparison of substantial and minimal dentin height.
The analyses were performed with SPSS version 14.0 (SPSS
Inc., Chicago, IL, USA).

3.

Results

At 5 years, data of 89% of the teeth were available, at 10 years

81%, and at 15 year 68%. At 17 years, data of 28% of all teeth were
available. Fig. 1 shows the interventions of the reconstructed
teeth during this follow-up. Characteristics of all failures are
presented in Appendix A. Numbers included in SR and ST may
differ, because it is possible that a restoration was registered as
a failure, while the carrying tooth was registered as non-failure.
Meanwhile the same tooth can be registered as a failure after a
longer follow-up than the failure of the restoration.
The survival curves of the different types of restorations in
SR (restoration survival) of Trials 1 and 2 are presented in
Figs. 2 and 3. Type of post-and-core restoration showed to
have no influence on the survival probability in both trials
(P > 0.05) (Table 2). The 17-year survival rates at restoration
level varied from 71% to 80%, and at tooth level from 83% to
92%. The comparison of substantial and minimal dentin
height showed a significant difference for M/C + C-restorations on restoration level (SR) (Table 3; Fig. 4), but not for the
other comparisons.
Nine teeth received apical surgery (three between 1 and 3
years after baseline, four between 5 and 10 years, and two in

Fig. 4 Restoration survival probability (SR) as a function of

time comparing substantial and minimal dentin
height for only M/C + C (prefab metal post and composite
core + crown). Vertical lines in survival curves indicate
points of censoring. Kaplan Meier analysis, P = 0.03.

782

journal of dentistry 35 (2007) 778786

Table 2 Survival analyses of Trial 1 and 2 with Kaplan Meier log rank tests (up to 17 years)
Trial

Survival levela

Variables

Survival probability

95% Confidence interval survival probability

Trial 1

SR

CPC + C
M/C + C
C+C
CPC + C
M/C + C
C+C

0.85
0.84
0.88
0.92
0.92
0.83

0.730.97
0.740.94
0.761.00
0.841.00
0.860.98
0.651.00

0.94

CPC + C
M/C + C
CPC + C
M/C + C

0.84
0.71
0.92
0.83

0.720.96
0.590.83
0.831.00
0.730.93

0.14

ST

Trial 2

SR
ST

P-value

0.75

0.20

Trial 1: comparing CPC + C, M/C + C and C + C under the condition substantial dentin height; Trial 2: comparing only CPC + C and M/C + C
under the condition minimal dentin height.
a
SR: restoration survival, ST: tooth survival.

the period of 1316 years follow-up). Five of them did not

receive additional treatment until 1516 years (then the data
were censored); one survived 17 years without any additional
treatment; one became an abutment tooth for a bridge 6 years
after the apical treatment; one was eventually extracted at
16.7 years; one (apical treatment at 2.3 years) needed recementation of the covering crown but survived the complete
follow-up period.
Maintenance treatment (finishing, polishing or adding
composite after chipping of small fragments of porcelain of
the crown) was performed in six cases (three between 2 and 5
years after baseline, two between 5 and 7 years, and one at 15.5
years follow-up). Four of these teeth had been followed-up
more than 15 years without any additional intervention. In the
two other cases after maintenance treatments (after approximately 2.5 years) the crown was replaced at, respectively, 5.2
and 12.2 years.

4.

Discussion

The present study compared long-term survival probabilities

of cast post-and-core restorations with direct post-and-core
and post-free core restorations under conventional crowns.
Despite some flaws in the design of the study, we consider the
present report to provide valuable data, because of the long

period of follow-up and the large number of teeth and

restorations involved. Another long-term prospective study
(up to 10 years) with a similar aim included a limited number
of restorations,10 while other long-term studies on post-andcore reconstructed teeth are retrospective.68,2024 To our
knowledge, data from randomized clinical trials are lacking.
The number of operators, in this study, is relatively
high and a limited number of operators would have been
desirable. By the involvement of general dental practices, the
number of subjects per operator is limited and a longer
intake period would have been necessary to reach the same
numbers of teeth included in the study. Further, it was
thought that the multi-practice setting contributed to the
external validity; the results represent daily dental life,
opposite from a study performed in a purely academic
setting.
The disadvantage of the general practice setting appeared
sometimes to be the lack of compliance of the operators
regarding the treatment assignment. As an alternative to the
intention to treat principle, it was decided that the post-andcore restoration as was made at baseline was registered as
such, in contrast to the assignment following the protocol. As
a result numbers of the investigated core restorations in this
analysis slightly differ from the data of the 5-year report. In the
5-year report 314 teeth were included,18 whereas the present
follow-up assessed the survival probability of 307 teeth.

Table 3 Comparison of substantial with minimal dentin height with Kaplan Meier log-rank tests (up to 17 years)
Survival levela

Dentin height

Survival probabilityb

CPC + C

SR

Substantial
Minimal

0.85
0.84

0.87

CPC + C

ST

Substantial
Minimal

0.92
0.92

0.81

M/C + C

SR

Substantial
Minimal

0.84
0.71

0.03

M/C + C

ST

Substantial
Minimal

0.92
0.83

0.15

Variable

a
b

SR: restoration survival, ST: tooth survival.

For the confidence intervals of the survival probability see Table 2.

P-value

journal of dentistry 35 (2007) 778786

After 5 years of study, the patients were not regularly

recalled by the research group. To register restoration
endpoints, history information of the teeth after 17 years
was needed to be able to calculate restoration-survival. It is
common experience that patients cannot recall exact
interventions during follow-up studies, therefore information was retrieved from the patient records. Since the
objective to register data in patient records in general
practices will differ from research objectives, a check for
validity was included. The convenient sample that was used
was considered to be not selective and provided reliable
information. Patient retrieval itself appeared to be very
difficult. About two third of the patients were treated in
general dental practices and we lost track of some patients
due to moving, changing of dentist, or change of practice
owner. Support of local administration was required to
retrieve patients.
For survival analyses, multivariate analyses (Cox Regression) were intended to check for possible influence of covariables (patients age, gender and tooth type). However, proportional hazard models (log-time versus log-hazard)
revealed that in a few plots the proportional hazard assumption was not met, thus the Cox Regression model could not be
used. As a consequence, this report only presents the results
from the univariate Kaplan Meier analyses. Since some
patients received more than one restoration, the condition
stating that all measurements are independent is violated.
Therefore, results of the Cox-model (with co-variables that did
not violate the proportional hazard assumption) were checked
with an extended Cox-model, containing a gamma frailty
term.25 This last model was implemented using the statistical
software R. For both survival levels the extended Cox model
confirmed that correction for clustering did not make any
difference. Therefore, the survival analyses are not sensitive
to the violation of the assumption of all observations being
independent.
The overall survival rates found in present study are within
the range (7894%) reported in the dental literature.610,12,26 A
10-year prospective clinical trial, showed 94% survival rate of
metal post-and-cores with a crown.10 From Fig. 2 it can be seen
that the survival rate at 10 years in the present study is
comparable with that study (94%). A retrospective study on
the longevity of full crowns with or without posts showed an
overall survival rate of 78% after 18 years.26
Failure modes in the present report are similar to other
clinical studies on post-and-core reconstructed teeth.7
10,21,22,24,27,28
It is hardly possible to relate any of the
extractions, as a result from caries, a periodontal or an
endodontic problem, to malfunctioning of the post-and-core
or crown. Registering all extractions as failures (except due to
evident periodontal problems), leaves the presented survival
probability ST to represent the worst-case-scenario regarding survival at tooth level related to the post-and-core and
crown constructions.
Furthermore, the indication of failure during the trial by the
general dentists might play an important role as well. For
example, if a tooth had a peri-apical problem it is reasonable to
state that some dentists decided to extract the tooth, while
other dentists would have decided to do an apical surgery or
revision of the endodontic treatment.

783

Another discussion point associated with the failure mode

is that the most serious complication of a post-and-core
reconstructed tooth is root fracture.28 In this study, only seven
cases were reported to be fractured of the tooth and/or root
and consequently extraction was performed by the dentist.
This number is low, and cases were evenly divided over
groups. Therefore, it was not possible to analyze the failure
mode related to restoration type or remaining dentin.
Obviously, the risk of root fractures is not as high as expected
from in vitro research,29 although rigid metal posts were
placed.
From a clinical point of view, it is interesting to consider
whether a post is necessary. From the literature, it was
suggested that The need to reappraise the utilization of posts
in the restoration of endodontically treated teeth cannot be
overstated.30 The result of present report showed no
difference in the survival probability between restorations
with and without posts in teeth with substantial dentin
height left (Trial 1). On this basis it cannot be recommended
to routinely use a post preceding a crown in an endodontically
treated tooth. This supports the finding from an in vitro
study13 and a long-term retrospective study on full crowns
with or without posts.26
The comparison of substantial and minimal dentin
height is relevant from a clinical point of view. In the 5-year
report of these clinical trials it was concluded that the survival
probability of post-and-core reconstructed teeth with substantial dentin height (Trial 1) was significantly higher than
that of teeth with minimal dentin height (Trial 2). Reported
5-year survival rates were 98% versus 93%.19 In the present 17year follow-up a significant influence of the amount of
remaining dentin was found for the restoration-survival of
the prefabricated metal post group. This suggests that the
survival of prefabricated metal posts is influenced by the
remaining amount of dentin, surprisingly this is not the case
for cast post-and-cores. No difference in restoration-survival
was found between these two types of post-and-cores for
teeth with minimal dentin height. Thus, one should be
careful to conclude that in the situation of a tooth with
minimal dentin height always a cast post-and-core is
preferred.

5.

Conclusions

This study showed no difference in survival probability among

different core-restorations under a covering crown of endodontically treated teeth. The results do not reject the hypothesis. Consequently, this long-term follow-up suggest that in an
endodontically treated tooth with substantial remaining dentin
a post in a core does not perform better than a post-free core.
The preservation of substantial remaining coronal tooth
structure seems to be critical for the long-term survival of
endodontically treated crowned teeth.

Acknowledgements
The initial organizer of these clinical trials, Arno
Mentink, is greatly acknowledged. Many thanks to all

784

journal of dentistry 35 (2007) 778786

operators and patients involved in this study. Gratitude

is also owed to the dentists providing the information

of the patient files from which the data could be

extracted.

Appendix A
Characteristics1 of interventions at the level of the restoration survival (SR):
S.n.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57

Lifetime
(years)

Tooth

Restoration
type

Restoration
survival (SR)

0.83
1.49
1.84
2.03
2.07
2.19
2.59
3.21
3.74
3.95
4.15
4.72
4.99
5.29
5.48
5.66
6.10
6.75
6.94
7.38
7.75
7.81
8.22
8.23
8.70
8.91
8.95
9.20
9.40
9.70
9.86
10.83
10.84
11.03
11.26
11.52
11.84
12.14
12.23
12.81
13.03
13.30
13.34
13.36
13.56
13.64
13.67
13.92
14.17
14.33
14.56
14.71
14.77
14.87
15.00
15.21
15.40

26
22
47
25
13
46
15
37
46
23
14
47
16
11
16
41
43
36
24
34
35
45
26
23
25
16
11
22
11
46
23
35
16
45
47
16
22
46
21
12
25
21
16
46
36
25
47
15
26
46
14
46
15
24
16
34
26

CPC + C
M/C + C
M/C + C
CPC + C
M/C + C
C+C
M/C + C
C+C
CPC + C
CPC + C
CPC + C
M/C + C
M/C + C
M/C + C
M/C + C
CPC + C
M/C + C
M/C + C
M/C + C
M/C + C
M/C + C
M/C + C
CPC + C
CPC + C
C+C
CPC + C
C+C
CPC + C
C+C
M/C + C
M/C + C
M/C + C
CPC + C
M/C + C
M/C + C
M/C + C
M/C + C
M/C + C
CPC + C
M/C + C
CPC + C
M/C + C
M/C + C
CPC + C
C+C
M/C + C
CPC + C
M/C + C
CPC + C
CPC + C
CPC + C
M/C + C
CPC + C
M/C + C
M/C + C
M/C + C
M/C + C

Failure
Failure
Failure
Failure
Failure
Censored
Failure
Failure
Failure
Failure
Failure
Failure
Failure
Failure
Failure
Failure
Failure
Failure
Failure
Failure
Censored
Failure
Censored
Failure
Failure
Failure
Failure
Failure
Censored
Failure
Failure
Failure
Censored
Censored
Failure
Censored
Censored
Failure
Failure
Failure
Failure
Failure
Censored
Censored
Failure
Failure
Censored
Failure
Failure
Censored
Failure
Censored
Failure
Failure
Failure
Failure
Censored

Description of intervention
(treatment)
Extraction (fracture)
Dislodgement of post-and-core and
Extraction (peri-apical/fracture)
Dislodgement of post-and-core and
Dislodgement of post-and-core and
Extraction (periodontal)
Dislodgement of post-and-core and
Extraction (peri-apical)
Extraction (fracture)
Dislodgement of post-and-core and
Extraction (peri-apical)
Extraction (fracture)
Dislodgement of post-and-core and
Crown replacement
Extraction (peri-apical)
Dislodgement of post-and-core and
Caries at crown margin
Caries at crown margin
Post and crown replacement
Caries at crown margin
Extraction (periodontal)
Extraction (peri-apical)
Extraction (periodontal)
Dislodgement of post-and-core and
Extraction (unknown reason)
Crown replacement
Crown replacement
Dislodgement of post-and-core and
Extraction (periodontal)
Extraction (caries)
Dislodgement of post-and-core and
Caries at crown margin
Extraction (periodontal)
Crown placement/bridge
Extraction (peri-apical)
Revision of endodontic treatment
Extraction (periodontal)
Extraction (caries/periodontal)
Crown replacement
Crown replacement
Dislodgement of post-and-core and
Crown replacement
Dislodgement of crown
Revision of endodontic treatment
Extraction (fracture)
Dislodgement of post-and-core and
Crown placement/bridge
Extraction (fracture)
Extraction (peri-apical)
Extraction (periodontal)
Dislodgement of post-and-core and
Extraction (periodontal)
Crown replacement
Caries at crown margin
Crown replacement
Extraction (unknown reason)
Revision of endodontic treatment

crown
crown
crown
crown

crown

crown

crown

crown

crown

crown

crown

crown

crown

Triala
1
2
2
2
2
1
2
1
1
2
1
2
2
1
1
2
1
1
2
2
1
2
2
2
1
2
1
2
1
1
2
2
2
1
1
1
2
2
1
1
1
2
1
1
1
2
1
1
2
1
1
1
1
1
1
2
1

785

journal of dentistry 35 (2007) 778786

Appendix A (Continued )
S.n.
58
59
60

Lifetime
(years)

Tooth

Restoration
type

Restoration
survival (SR)

15.45
15.59
15.83

45
46
15

M/C + C
C+C
CPC + C

Failure
Censored
Censored

Description of intervention
(treatment)
Extraction (unknown reason)
Surgical removal of distal root
Extraction (periodontal)

Triala
1
1
2

CPC + C: cast post-and-core + crown; M/C + C: direct prefabricated metal post + composite core + crown; C + C: post-free all-composite
core + crown.
a
Trial 1: comparing CPC + C, M/C + C and C + C under the condition substantial dentin height; Trial 2: comparing only CPC + C and M/C + C
under the condition minimal dentin height.

Characteristics of interventions at the level of the tooth survival (ST):

S.n.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36

Lifetime
(years)

Tooth

Restoration
type

Tooth survival
(ST)

0.83
1.84
2.19
3.21
3.74
4.15
4.72
5.48
7.75
7.81
8.22
8.70
9.40
9.65
9.70
9.79
10.63
10.66
10.84
11.26
11.84
12.14
12.29
12.36
13.40
13.56
13.92
14.17
14.33
14.71
14.95
15.21
15.29
15.45
15.83
16.66

26
47
46
37
46
14
47
16
35
45
26
25
11
22
46
41
34
36
16
47
22
46
16
35
23
36
15
26
46
46
25
34
14
45
15
46

CPC + C
M/C + C
C+C
C+C
CPC + C
CPC + C
M/C + C
M/C + C
M/C + C
M/C + C
CPC + C
C+C
C+C
CPC + C
M/C + C
CPC + C
M/C + C
M/C + C
CPC + C
M/C + C
M/C + C
M/C + C
CPC + C
M/C + C
CPC + C
C+C
M/C + C
CPC + C
CPC + C
M/C + C
M/C + C
M/C + C
CPC + C
M/C + C
CPC + C
C+C

Failure
Failure
Censored
Failure
Failure
Failure
Failure
Failure
Censored
Failure
Censored
Failure
Censored
Censored
Failure
Censored
Failure
Failure
Censored
Failure
Censored
Failure
Failure
Failure
Failure
Failure
Failure
Failure
Censored
Censored
Failure
Failure
Failure
Failure
Censored
Failure

Description of intervention
(treatment)
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction
Extraction

(fracture)
(peri-apical/fracture)
(periodontal)
(peri-apical)
(fracture)
(peri-apical)
(fracture)
(peri-apical)
(periodontal)
(peri-apical)
(periodontal)
(unknown reason)
(periodontal)
(periodontal)
(caries)
(periodontal)
(caries)
(caries)
(periodontal)
(peri-apical)
(periodontal)
(caries/periodontal)
(peri-apical)
(caries)
(caries)
(fracture)
(fracture)
(peri-apical)
(periodontal)
(periodontal)
(fracture)
(unknown reason)
(caries)
(unknown reason)
(periodontal)
(fracture)

Triala
1
2
1
1
1
1
2
1
1
2
2
1
1
2
1
2
2
1
2
1
2
2
2
2
2
1
1
2
1
1
2
2
1
1
2
1

CPC + C: cast post-and-core + crown; M/C + C: direct prefabricated metal post + composite core + crown; C + C: post-free all-composite
core + crown.
a
Trial 1: comparing CPC + C, M/C + C and C + C under the condition substantial dentin height; Trial 2: comparing only CPC + C and M/C + C
under the condition minimal dentin height.

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