Split Post-and-core for Grossly Destroyed Multirooted Molars: A Systematic Review of Case Reports and Case Series
Year: 2026
Type: review
Study design: Systematic Review
Abstract: A BSTRACT Background: Restoration of extensively damaged multirooted molars often requires custom post-and-core designs when canal divergence precludes a single path of insertion. Evidence is largely case-based, limiting quantitative synthesis. Methodology: A systematic review of literature identified nine single-patient case reports (2012–2024). Data on tooth, design, materials, workflow, luting, and outcomes were extracted. Synthesis without meta-analysis was used with descriptive statistics and exact binomial 95% confidence intervals (CIs) for feature frequencies. Reporting adequacy was appraised using the Joanna Briggs Institute Case Report Checklist. Results: Split (multisection) designs predominated (8/9; 88.9%, 95% CI: 51.8–99.7); lock-and-key variants were reported in 3/9 studies (33.3%), 95% CI: 7.5–70.1. Cast-metal post-and-cores were the most common (8/9; 88.9%, 95% CI: 51.8–99.7); computer-aided design (CAD)-Computer-aided manufacturing (CAM) Polyetheretherketone (PEEK) appeared in 1/9 (11.1%), 95% CI: 0.3–48.2. An impression/workflow description was provided in 6/9 (66.7%), 95% CI: 29.9–92.5. Luting mentions included glass ionomer (7/9; 77.8%, 95% CI: 40.0–97.2) and resin cement (3/9; 33.3%, 95% CI: 7.5–70.1). Conclusion: Case-report evidence indicates clinicians favor split, cast-metal reconstructions for complex molars, reserving lock-and-key when divergence complicates seating. CAD-CAM/PEEK solutions are feasible but under-represented.
Institution: Dr D Y Patil Dental College & Hospital
Language: English
Subfield: General Dentistry
Field: Dentistry
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7204489957