Purpose:This article presents a review of the literature on biomechanical factors
affecting the treatment outcome of prosthetic treatment of structurally compromised
dentitions, with the main emphasis on often-compromised endodontically treated
teeth. Materials and Methods:Articles cited in a MEDLINE/PubMed search were
reviewed with a focus on factors influencing the risk for fatigue failures. Results:
Technical failures in connection with fixed prosthodontics are often caused by fatigue
fractures. The abutments, cement, and reconstruction are all subjected to stress
caused by occlusal forces, and fatigue fracture may occur at the weakest point or
where the maximum stress occurs. The weakest point is frequently in connection with
endodontically treated teeth restored with posts and cores. Conclusion:The literature
points to nonaxial forces as a risk for fatigue fracture of teeth, cement, and restorative
material. Favorable occlusal prosthesis design is probably more important for survival
of structurally compromised endodontically treated teeth than is the type of post used.
Int J Prosthodont 2004;17:369–376.