Short fiber-reinforced composite resins as post-and-core materials for endodontically treated teeth: A systematic review and meta-analysis of in vitro studies

• Published in: The Journal of prosthetic dentistry 2023-11
• Main Authors: Fousekis, Ektoras, Lolis, Andreas, Marinakis, Emmanouil, Oikonomou, Elissaios, Foros, Petros, Koletsi, Despina, Eliades, George
• Format: Article
• Language: English
• Subjects: core build-up; fiber reinforced composite; post; post-core restorations; SFRCs
• ISSN: 0022-3913; 1097-6841
• DOI: 10.1016/j.prosdent.2023.09.026

As the use of traditional posts has been associated with complications and failure outcomes, the introduction of novel materials and minimally invasive dentistry has shifted toward the use of composite resin post-and-core restorations for endodontically treated teeth. As a further process, to improve stress absorption environment in restored teeth, the invention of short fiber-reinforced composite resins (SFRCs) as post-and-core restorations has recently emerged. However, evidence regarding its performance is still scarce, and a synthesis of existing data is lacking. The purpose of this systematic review and meta-analysis was to assess the performance of SFRC post-and-core restorations, regarding fracture resistance and failure mode and considering both cyclic and static loading. An electronic search in 5 databases was conducted up to August 2022, and the protocol of the study was registered a priori. The search terms included “fiber reinforced composite,” “core build-up,” and “post.” Studies were considered if they compared SFRC restorations with other types of conventional posts and teeth restored using bulk fill composite resin. The internal validity of the studies was assessed by using a custom-made risk of bias tool. A total of 1271 records were identified, of which 13 were considered for full-text assessment. Eight were ultimately included, all being in vitro studies, and 7 of them were deemed eligible for quantitative syntheses. The results varied considerably across studies with divergent fracture resistance values and percentages of catastrophic failure being reported. Standard depth (6 mm) SFRCs presented fewer repetitions until fracture on average, compared with the individually made FRCs (3 studies: mean difference (MD): -4062; 95% CI: -6148, -1975; P