Fracture resistance of endodontically-treated maxillary premolars restored with different type of posts and direct composite reconstructions: A systematic review and meta-analysis of in vitro studies

Romeo Patini, Flavia Iaculli, Carlo Rengo, Vincenzo Lodato, Gianrico Spagnuolo, Sandro Rengo

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Objective: To conduct a systematic review and meta-analysis to assess if the presence of an endodontic post may increase the fracture resistance of endodontically-treated maxillary premolars directly restored with composite. Methods: A comprehensive systematic literature search according to the PRISMA statement was conducted to assess in vitro studies including endodontically-treated maxillary premolars, restored with different type of posts supporting direct composite reconstructions. Two groups of meta-analyses were performed using fixed effects model and additional Trial Sequential Analysis (TSA) was carried out. Moreover, risk of bias was conducted and quality of evidence for any performed meta-analysis was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: Twenty-four articles met the inclusion criteria and 13 studies also underwent quantitative evaluation. Fracture resistance of endodontically-treated premolars restored with fiber posts was significantly less than sound teeth (p value: < 0.00001), however endodontically-treated premolars with a fiber post provided an increase in fracture resistance when compared to equivalent teeth restored without post (p value: 0.003). TSA revealed high power of both meta-analyses. Moderate risk of bias was reported in 23/24 studies; only 1 study showed high risk of bias. GRADE system showed moderate strength of evidence due to the presence of a study with high risk of bias and to wide confidence intervals. Significance: Within the limitation of the present systematic review and meta-analysis, it can be concluded that endodontically-treated maxillary premolars restored with a fiber post and direct composite restoration demonstrated increased fracture resistance when compared to equivalent teeth without post.
Lingua originaleEnglish
pagine (da-a)e455-e484
RivistaDental Materials
Volume37
DOI
Stato di pubblicazionePubblicato - 2021

Keywords

  • Direct composite restoration
  • Endodontically-treated teeth
  • Fiber post
  • Fracture resistance
  • Maxillary premolars
  • Metal post
  • Tooth, Nonvital
  • Composite Resins
  • Dental Stress Analysis
  • Humans
  • Post and Core Technique
  • Tooth Fractures
  • Bicuspid

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