Systematic review fracture resistance of endodontically treated posterior teeth restored with fiber reinforced composites- a systematic review

Abstract

Background Large cavity designs and access cavities impair endodontically treated tooth fracture resistance. As the tooth’s strength is known to reduce significantly after the root canal treatment, occlusal loading as a result of functions such as chewing, biting and certain parafunctional tendencies makes the endodontically treated tooth vulnerable to fracture. Hence, after endodontic treatment, it is vital to give adequate and appropriate restorative material to avoid tooth fractures. Accordingly, the choice of such restorative material should be dictated by the property of fracture resistance. Objective The goal of this study was to conduct a systematic review and critical analysis of available data from in vitro studies examining the fracture resistance of endodontically treated posterior teeth restored with fiber-reinforced composites. Methodology The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRIS-MA) Statement was used to guide the reporting of this systematic review A comprehensive literature search was performed using MEDLINE (via PubMed), Scopus, ScienceDirect, Google Scholar, and LILACS. A manual search of the reference lists of the articles was also performed. The databases provided a total of 796 studies from the electronic systematic search. The databases provided a total of 796 studies from the electronic systematic search. Two reviewers scrutinized the papers for eligibility based on inclusion/exclusion criteria and extracted data. The studies were assessed for their potential risk of bias. Based on modified JBI & CRIS (checklist for reporting in vitro studies) guidelines, along with the methodology and treatment objective, we have formulated 13 parameters specifically to assess the risk of bias. A total of 18 studies met the inclusion criteria and were included for qualitative analysis. Considering the high heterogeneity of the studies included, a meta-analysis could not be performed. Results The majority of the included studies had a moderate or high risk of bias. When compared to traditional hybrid composites, fiber-reinforced composites showed increased fracture resistance of endodontically treated teeth in the majority of investigations. On the other hand, limited evidence was found for the bulk fill composites. Moreover, moderate evidence was found for the fracture resistance of inlays and fiber posts with fiber-reinforced composites for core build-up in endodontically treated teeth. No evidence could be found comparing the fracture resistance of endo crowns and fiber-reinforced composites in endodontically treated teeth. Conclusion According to the research, using fiber-reinforced composites instead of conventional hybrid composites improves the fracture resistance of endodontically treated teeth. However, there was a high risk of bias in the research considered. No judgments could be reached about the superiority of one material over another based-on comparisons between other core restorations.

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

“…In the current literature, for endodontically treated teeth, fiber-reinforced resin composite materials are currently the recommended option [ 66 ]. In this study, the fracture strength of the fiber-reinforced groups was significantly higher than that of the bulk-fill resin composite groups ( p < 0.05).…”

Mechanical Performance of Extensive Restorations Made with Short Fiber-Reinforced Composites without Coverage: A Systematic Review of In Vitro Studies

“…After 36 days, the material’s water absorption was the second best (0.5 wt%), while other regular bulk-fill composite materials had much higher values (Estelite Bulk Fill Flow 1.1 wt%) [ 46 ]. Regarding fracture patterns, SFRCs show a promising performance in stopping and deflecting crack formation [ 48 , 49 , 50 ]. As it is the fracture pattern that will determine the restorability of teeth in case of a fracture, it is of high importance.…”

Evaluation of Students' Proficiency in Removing Gutta-Percha Prior to Fiber Post Placement: A Retrospective Study

“…Restoring endodontically treated teeth with short roots, such as the mandibular anterior, might be challenging. In such a case, the minimum apical seal could be compromised to increase the post length and enhance retention and resistance [17]. However, the apical seal must be considered even in these cases to avoid microleakage and failure of the endodontic treatment [18].…”