An Umbrella Review of Systematic Reviews and Meta-Analyses Evaluating the Success Rate of Prosthetic Restorations on Endodontically Treated Teeth

Abstract

Statement of the Problem. Various direct and prosthetic restorations are clinically used to restore endodontically treated teeth. However, determining the most successful and reliable treatment to restore endodontically treated teeth is affected by numerous elements and still unclear for most clinicians. Therefore, this umbrella review study assessed the systematic/meta-analytic reviews (S/M-R) regarding the success rate of prosthetic restorations in endodontically treated teeth. Materials and Methods. The electronic search was conducted in the MEDLINE/PubMed, Cochrane, and Google Scholar databases until November 2020, regardless of language limitations. The inclusion criterion was as follows: S/M-R regarding prosthetic restorations in endodontically treated teeth. Three qualified researchers evaluated the inclusion criteria and bias risk. The fourth investigator was referred to when facing any doubtfulness. Results. From 43 achieved S/M-R, 14 studies were selected for this inquiry. Primary extracted information included success rate, survival rate, and postendodontic failure rate. Five S/M-R had a moderate risk of bias, and nine S/M-R had a low risk of bias and were considered strong clinical evidence in this examination. According to the low-risk reports, the success rate of fiber posts was higher than that of metal posts; the rate of root fracture in metallic and fiber posts was alike; the failure rate for fiber posts was comparable to fixed partial dentures or single crowns; the construction of endocrowns was likely to perform better than intracanal posts, composite resin, or inlay/onlay restorations. Conclusion. It appears that with practice and experience, deciding which type of restoration to choose changes. In dental restorations associated with root canal therapy, the single crowns are likely to be a proper option. Nevertheless, due to the heterogeneity of the studies, more clinical assessments are required to achieve more specific findings in this field.

The importance of crown protection of endodontically treated teeth

“…This can be achieved with the help of industrial post or cast post 46 . In this way, the efficiency of force transmission to the root of the tooth is improved, which is reflected in studies that point out that there is no significant difference in the degree of survival of implants and endodontically treated teeth reinforced with crowns and posts 47 . Although there are reports that posts can improve the fracture resistance of endodontically treated teeth, the post preparation itself weakens the root of the tooth 48 , so it is important that posts are used only when retention cannot be established by any other means 5 .…”

“…Ovo se može ostvariti uz pomoć industrijskih kočića ili livenih nadogradnji 46 . Na ovaj način poboljšava se efikasnost prenosa sila na koren zuba, što se pominje u studijama koje ističu da ne postoji značajna razlika u stepenu opstanka implantata i endodontski lečenih zuba ojačanih krunama i kočićima 47 . Iako postoje navodi o tome da kočići mogu poboljšati otpornost endodontski lečenih zuba na frakturu, sama preparacija za kočić oslabljuje koren zuba 48 , tako da je važno da se kočići koriste samo onda kada nije moguće uspostaviti retenciju na neki drugi način 5 .…”

Application of discipline integration in the practical teaching of endodontic‒restorative sequential treatment

“…Usually, a crown is associated with improved long-term survival of a root canal-treated tooth. A systematic review by Stavropoulou showed that teeth restored with crowns after RCT exhibited an acceptable long-term survival of 10 years [15]. Therefore, it is frequently a sequence from endodontics to prosthodontics.…”

Future Trends in Endodontics: How Could Materials Increase the Long-Term Outcome of Root Canal Therapies?

“…In fact, the most significant reasons for primary root canal treatment (RCT) failure are their persistence and their secondary contamination of the root canal system, which could cause recurrent disease with the exacerbation of symptoms [ 4 ]. Nevertheless, the recurrent infection-related aspects are not the unique cause of long-term failure, since the mechanical fracture of endodontically treated teeth can occur [ 5 , 6 ]. As thoroughly demonstrated, the post-endodontic restoration of teeth with crowns or cast restorations does not influence treatment success based on periapical healing as long as there is no sign of coronal leakage; however, it can influence the survival rate of teeth over time, reducing the mechanical failure rate [ 7 , 8 ].…”