Fracture Resistance of Titanium and Fiber Dental Posts: A Systematic Review and Meta‐Analysis

Abstract

Purpose The fracture resistance of dental post systems is influenced by the material of the post. The purpose of this systematic review and meta‐analysis was to assess if there is a difference in fracture resistance between prefabricated dental titanium posts and fiber posts. Methods An online electronic search was performed using the PubMed, Scopus, and Web of Science databases for in vitro studies published from 2010 to 2020 in English. The retrieved eligible studies that compared the fracture resistance of titanium and fiber posts on human teeth were selected. The pooled standardized mean difference (SMD) with a 95% confidence interval was calculated. In addition, the trial sequential analysis (TSA) was performed to test if the available studies are sufficient to make conclusive evidence. Results Of the 1165 retrieved studies, 17 studies were included in the qualitative analysis, while 16 studies were included in the quantitative analysis. Because of the high heterogeneity among studies, data from 10 studies were pooled and submitted to TSA. A total of 852 teeth were evaluated for fracture of the posts in 27 independent comparison groups. The pooled effect of the residual studies revealed no significant difference between titanium and fiber posts (SMD = –0.12; 95% CI = –0.30, 0.06; p = 0.20). Results of the TSA revealed no conclusive evidence. Conclusions The results of the current evidence revealed no significant difference between fiber and titanium posts. The evidence is insufficient, and more standardized in vitro studies are required.

The influence of horizontal glass fiber posts on fracture strength and fracture pattern of endodontically treated teeth: A systematic review and meta‐analysis of in vitro studies

“…An assessment of the risk of bias was undertaken as described by Uzunoglu-Özyürek et al and Alhajj et al 15,16 In each included study, the following parameters were evaluated: randomization of teeth, the presence of control, standardization of teeth dimensions, reporting of age, description of sample size calculation, the use of materials according to the manufacturer's instructions, samples prepared by a single operator, and blinding of the observer during fracture test. The presence of each parameter was recorded as "yes," whereas absence was recorded as "no."…”

Restorative Modalities for Structurally Compromised Teeth with Thin-walled Roots: A Literature Review

“…9,41 In comparison with fiber posts, a systematic review concluded that titanium and fiber posts show similar fracture resistance. 10 Glass fiber resin post systems that are formed from unidirectional glass fibers embedded in a resin matrix are reported to lower the risk of fractures of restored roots. 42 Elasticity of dentin is 20 Gpa, and glass fiber posts with a 40 Gpa modulus of elasticity would be an ideal post material.…”

“…Considering the mode of fracture, based on the articles included in this study and a systematic review, in comparison to metal posts, fiber posts have considerably demonstrated less severe root fractures. 10…”

“…They have nearly the same modulus of elasticity (stiffness) as dentin and when bonded in canal with resin cement, it is assumed that forces would be distributed more evenly through the root walls, resulting in fewer root fractures. 10 Since restoring teeth with insufficient and weakened canal wall is a clinical challenge, the aim of this paper is to review various studies that utilized different materials and techniques for restoration of ETT.…”

“…They have nearly the same modulus of elasticity (stiffness) as dentin and when bonded in canal with resin cement, it is assumed that forces would be distributed more evenly through the root walls, resulting in fewer root fractures. 10…”