Is a fiber post better than a metal post for the restoration of endodontically treated teeth? A systematic review and meta-analysis

Martins, Marielle Dias; Junqueira, Rafael Binato; Carvalho, Rodrigo Furtado de; Lacerda, Mariane Floriano Lopes Santos; Faé, Daniele Sorgatto; Lemos, Caa

doi:10.1016/j.jdent.2021.103750

Cited by 37 publications

(34 citation statements)

References 31 publications

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“…Cast metal alloy posts and zirconia posts-which have much higher elastic moduli than dentin-generate concentrated stress at the root, which may result in the fracture of the root, while the posts remain intact [62,63]. Fiber-reinforced composite (FRC) posts exhibit more balanced stress distribution, and while the risk of root fracture is lower, the posts are more easily fractured [64]. Nevertheless, because of their excellent mechanical behavior, FRC posts have become the most commonly used material for post-and-core restoration, although there are still some disadvantages.…”

Section: Post-and-corementioning

confidence: 99%

PEEK in Fixed Dental Prostheses: Application and Adhesion Improvement

et al. 2022

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Polyetheretherketone (PEEK) has been widely applied in fixed dental prostheses, comprising crowns, fixed partial dentures, and post-and-core. PEEK’s excellent mechanical properties facilitate better stress distribution than conventional materials, protecting the abutment teeth. However, the stiffness of PEEK is not sufficient, which can be improved via fiber reinforcement. PEEK is biocompatible. It is nonmutagenic, noncytotoxic, and nonallergenic. However, the chemical stability of PEEK is a double-edged sword. On the one hand, PEEK is nondegradable and intraoral corrosion is minimized. On the other hand, the inert surface makes adhesive bonding difficult. Numerous strategies for improving the adhesive properties of PEEK have been explored, including acid etching, plasma treatment, airborne particle abrasion, laser treatment, and adhesive systems.

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Section: Post-and-corementioning

confidence: 99%

PEEK in Fixed Dental Prostheses: Application and Adhesion Improvement

et al. 2022

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“…In teeth with round root canals, the use of prefabricated, conically shaped and adhesively luted root canal posts, ideally without further post space preparation, is recommended (Figure 8). Up to now, there is no clinical evidence that the post material's rigidity affects the survival of root filled teeth or the occurrence of root fractures (Figueiredo et al, 2015;Martins et al, 2021). Outcome data for post-retained restorations varies with respect to F I G U R E 8 Zirconia crown (Lava; 3M ESPE AG) replacement following root canal retreatment 21 (a-c) preoperative buccal views and long-cone periapical radiograph (d-f) removal of cast post and root canal retreatment (h-j) internal bleaching followed by fibre post, composite core placement and thereafter, crown preparation (k) completed crown cementation (l) radiographic follow-up at 3 years.…”

Section: Postsmentioning

confidence: 99%

Present status and future directions: The restoration of root filled teeth

et al. 2022

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This narrative review will focus on a number of contemporary considerations relating to the restoration of root filled teeth and future directions for research. Clinicians are now more than ever, aware of the interdependence of the endodontic and restorative aspects of managing root filled teeth, and how these aspects of treatment are fundamental to obtaining the best long-term survival. To obtain the optimal outcomes for patients, clinicians carrying out endodontic treatment should have a vested interest in the restorative phase of the treatment process, as well as an appreciation for the structural and biomechanical effects of endodontic-restorative procedures on restoration and tooth longevity. Furthermore, the currently available research, largely lacks appreciation of occlusal factors in the longevity of root filled teeth, despite surrogate outcomes demonstrating the considerable influence this variable has.Controversies regarding the clinical relevance of minimally invasive endodontic and restorative concepts are largely unanswered with respect to clinical data, and it is therefore, all too easy to dismiss these ideas due to the lack of scientific evidence.However, conceptually, minimally invasive endodontic-restorative philosophies appear to be valid, and therefore, in the pursuit of improved clinical outcomes, it is important that the efficacies of these treatment protocols are determined. Alongside an increased awareness of the preservation of tooth structure, developments in adhesive bonding, ceramic materials and the inevitable integration of digital dentistry, there is also a need to evaluate the efficacy of new treatment philosophies and techniques with well-designed prospective clinical studies.

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“…The restoration of immature incisors with the use of flowable fiber-reinforced post-core composites displayed promising performance in a matter of fatigue-resistance and survival [ 8 ]. Martins et al [ 9 ] systematically reviewed ten studies regarding the evidences about the failure rates of endodontically treated teeth restored with intraradicular metal posts or fiber posts and found out no difference for failure rates between metal posts and fiber posts [ 9 ]. Various posts have been used to rehabilitate structurally compromised immature teeth.…”

Section: Introductionmentioning

confidence: 99%

Fracture Resistance and Stress Distribution Pattern of Different Posts-Core Systems in Immature Teeth: An In Vitro Study and 3D Finite Element Analysis

Khadar

Sapkale

Patil

et al. 2022

International Journal of Dentistry

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Introduction. Restoration of immature teeth with open apices and thin dentinal walls with conventional post systems remains a challenge. The purpose of this study was to evaluate the fracture resistance of simulated immature teeth restored with different intraradicular posts and assess their stress distribution pattern using 3D Finite Element Analysis (FEA). Methods. Fracture strength testing using universal testing machine was carried out in simulated immature teeth restored with different intraradicular posts grouped as follows: Group A: teeth not restored with posts served as control group; Group B: Cast metal post (CMP); Group C: Customized Composite Post (CCP); Group D: Fiber post (FP). Four 3D FEA models of the above groups were created using CATIATM software and analyzed for stress distribution using ANSYSTM. The results of fracture strength testing and FEA were correlated. Multiple group comparisons were analyzed by one-way ANOVA followed by Tukey HSD post hoc test. Results. The CMP exhibited highest fracture resistance (336.43 N) but resulted in root fractures. The CCP exhibited lower fracture resistance (240.90 N) and favorable stress distribution as compared to CMP. The FP and control group exhibited lower fracture resistance values of 182.69 N and 130.46 N, respectively. The results of 3D FEA demonstrated higher stress concentration in model comprising metallic post and core. Conclusions. Teeth restored with cast metal posts and cores exhibited maximum fracture resistance followed by the customized composite posts, the fiber posts, and the control group. The cast metal posts indicated higher von Mises stresses concentrated in the radicular region; however, the customized composite posts, the fiber posts, and the control group demonstrated stress concentration in the coronal region.

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Is a fiber post better than a metal post for the restoration of endodontically treated teeth? A systematic review and meta-analysis

Cited by 37 publications

References 31 publications

PEEK in Fixed Dental Prostheses: Application and Adhesion Improvement

PEEK in Fixed Dental Prostheses: Application and Adhesion Improvement

Present status and future directions: The restoration of root filled teeth

Fracture Resistance and Stress Distribution Pattern of Different Posts-Core Systems in Immature Teeth: An In Vitro Study and 3D Finite Element Analysis

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