Steel or fibre posts for restoration of endodontically handled tooth?


Intra-radicular posts have been used within the restoration of endodontically handled tooth for a whole bunch of years. Posts will be broadly categorized as metallic and non-metallic. Metallic posts could also be solid from noble or base metallic alloys or prefabricated from gold alloys, stainless-steel, and titanium alloys. carbon fibre, polyethylene, zirconia ceramic, and glass fibre have all getting used to make non-metallic posts.

The purpose of this overview was to evaluate the comparative efficacy of fibre and metallic posts used for the restoration of endodontically handled tooth.

Strategies

A protocol was registered on the PROSPERO database. Searches have been performed within the Cochrane Central, Medline/PubMed and Scopus databases. Randomised managed trials (RCTs) assessing the comparative efficacy of fibre posts and metallic posts for the restoration of endodontically handled tooth have been thought of. The first end result was tooth fracture with publish or core fracture, debonding of the publish, and secondary caries as secondary outcomes.

Two reviewers independently chosen research extracted information and assessed threat of bias utilizing the Cochrane threat of bias device (RoB 2.0). Danger ratios (RR) and 95% confidence intervals have been used as abstract statistics for binary outcomes and customary pairwise meta-analysis undertaken together with a community meta-analysis (NMA). Posts have been ranked in line with their efficacy utilizing the Floor Below the Cumulative Rating (SUCRA) system.

Outcomes

  • 25 RCTs have been included.
  • 7 RCTs have been thought of to be at low threat of bias, 2 at excessive threat with 16 research of some concern.
  • 12 RCTs evaluating 9 interventions have been included within the NMA for the relative threat of stopping fracture of the tooth as in contrast with no publish. In contrast with no posts fibre posts considerably prevented tooth fracture, RR= 0.15 (95percentCI: 0.06 to 0.33). SUCRA scores for various publish sorts are proven within the desk beneath.
Relative Danger (95% CI) SUCRA Rank (Rating)
Prefabricated carbon fibre (PCF) 0.06 (0.00 to 0.54) 1 (86.7)
Customized glass fibre (CGF) 0.15 (0.04 to 0.52) 2 (75.4)
Prefabricated glass fibre (PGF) 0.22 (0.07 to 0.62) 3 (64.9)
Customized gold alloy (CGA) 0.26 (0.03 to 1.96) 4 (60.0)
Prefabricated gold alloy (PGA) 0.22 (0.00 to eight.30) 5 (55.4)
Customized Co-Cr (CCC) 0.59 (0.05 to five.86) 6 (35.1)
Prefabricated titanium (PT) 0.58 (0.11 to 2.97) 7 (34.1)
Customized titanium (CT) 1.18 (0.23 to five.95) 8 (19.0)
  • 6 RCTs evaluating 6 interventions have been included within the NMA for the relative threat of stopping publish or core fracture in contrast with no posts with no statistically important variations discovered.
  • 15 RCTs evaluating 12 interventions have been included in a NMA of the relative threat of stopping debonding or lack of retention of a publish as in contrast with no publish. In contrast with no publish Fibre posts, RR = 0.39 (5percentCI: 0.27 to 0.56) and metallic posts, RR = 0.24 (95percentCI:0.12 to 0.46) considerably forestall debonding or lack of retention of a publish or core.
  • 9 RCTs evaluating 8 interventions have been included within the NMA of the relative threat of secondary caries as in contrast with no publish with no important variations have been recognized.

Conclusions

The authors concluded: –

Using a fibre publish when indicated ends in lowered threat of tooth fracture as in contrast with no publish. Prefabricated carbon fibre posts, prefabricated glass fibre posts, and customized glass fibre posts reveal a decrease threat of tooth fracture. General, the usage of prefabricated glass fibre posts had a decrease threat of tooth fracture, debonding, and secondary caries. Nonetheless, extra trials with longer follow-up intervals are advisable to boost the understanding of proof.

Feedback

A protocol for the overview was registered with the PROSPERO database and searches performed in 3 main databases with solely RCTs being included. An earlier overview by Martins et al (Dental Elf – 13th Aug 2021) evaluating fibre and metallic posts discovered no variations between them when it comes to failure charges. The Martin overview included 10 research of which 6 have been assessed as RCTs in contrast with the present overview which incorporates 25 RCTs. The findings of this overview counsel higher outcomes with fibre posts nonetheless, solely 7 of the included trials have been thought of to be at low threat of bias. Future RCTs needs to be nicely performed and reported following SPIRIT and CONSORT steering and use a standard end result set (COMET).

Hyperlinks

Main Paper  

Giok KC, Veettil SK, Menon RK. Comparative effectiveness of fiber and metallic posts within the restoration of endodontically handled tooth: A scientific overview with community meta-analysis. J Prosthet Dent. 2023 Oct 10:S0022-3913(23)00569-3. doi: 10.1016/j.prosdent.2023.08.022. Epub forward of print. PMID: 37827970.

Assessment protocol on PROSPERO

 

Different references

Dental Elf – 13th Aug 2021

Fibre or metallic posts for restoring endodontically handled tooth?

Dental Elf – Fibre publish blogs

 

 



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