Restorative strategies for weakened roots: Systematic review and Meta-analysis of in vitro studies

Abstract

Objective: This study evaluated fracture resistance values and failure mode of weakened roots restored with cast post and core, fiber post and anatomical posts. Materials and methods: In vitrostudies, published in English, Portuguese and Spanish, that evaluated weakened roots restored with at least two of mentioned strategies were searched for in three databases MEDLINE, PubMed and Scopus until June 2017; there was no restriction regarding the publication year. Fracture resistance values were obtained, and the following comparisons: cast post and core vs. fiber post and vs. anatomical post and fiber post vs. anatomical post were performed. Meta-analyses were conducted using the random effects model to calculate the combined effect of the difference between the averages. Six articles were included in the study. Results: There was no significant difference between the fracture resistance values, but more catastrophic failures were observed on cast post and core, and the included studies presented a low risk of bias for the most domains. Conclusion: It was concluded that weakened roots restored with the searched strategies seem to have similar fracture strength, but fiber and anatomic post decreases the possibility of catastrophic failure.KeywordsReview; Root; Dental restoration.

Effect of fiber-reinforced direct restorative materials on the fracture resistance of endodontically treated mandibular molars restored with a conservative endodontic cavity design

“…No studies have detected an increase in the fracture strength of post endodontic restoration as a result of intraradicular post placement [ 71 , 72 ]. Intraradicular post placement may weaken the root during post–space preparation and may also lead to procedural errors, such as strip perforation [ 73 ].…”

Clinical longevity of metallic versus fiberglass intraradicular posts: a systematic review

“…Being restored with an intraradicular post, whether metallic or fiberglass, does not mean that the restoration and/or the tooth are reinforced [19,20]. Recent studies [21][22][23][24] have defended the efficiency of restorations without the presence of intraradicular posts. Sáry et al [23] pointed out that restorations can be reinforced with fiberglass or polyethylene strips, an alternative to increase the longevity of extensive restorations.…”

“…The reinforcement is under a layer of resin composite, absorbing masticatory tensions, without compromising aesthetics and eliminating the need for intraradicular posts. They are called biomimetic restorations because they use materials with a modulus of elasticity similar to the tooth structure, mimicking their substrates and preserving their structure as much as possible [21][22][23][24].…”

Fiberglass versus cast metal posts: a practical review based on mechanical properties

“…Corrêa et al [57] evaluated fracture strength values and failure modes of weakened roots restored with cast posts and cores, fiber posts, and anatomical posts. They obtained fracture strength values and made the following comparisons: cast post and core vs. fiber post, cast post and core vs. anatomical post, and fiber post vs. anatomical post.…”