The influence of customization of glass fiber posts on fracture strength and failure pattern: A systematic review and meta-analysis of preclinical ex-vivo studies.

OBJECTIVE To perform a systematic review of the literature focused to evaluate in vitro function of prefabricated fiber posts with and without customization by additional auxillary fiber posts and composite resin on the fracture strength of wide or enlarged canals and the failure pattern. METHODS Six databases were used as primary search sources (PubMed, Scopus, LILACS, SciELO, Science Direct, and Web of Science) and three databases (Open Grey, Open Thesis, and OATD) were used to partially capture the "grey literature". The research included laboratory studies that used human upper anterior teeth aiming to assess the fracture strength and failure pattern of different glass fiber post customizations by additional auxiliary fiber posts or composite resin. The search had no restriction of year, language, and publication status. The risk of bias of the studies was assessed from the criteria established in systematic reviews of laboratory studies. Standardized mean differences were calculated by comparing the mean fracture strengths of customized and non-customized posts. Pooled estimates were calculated by Glass' delta method using the random-effects model. Subtotal estimates were presented according to each type of relining procedure and an overall estimate was described considering all studies combined. RESULTS The search provided 2291 results, from which six met the eligibility criteria and were included in the qualitative assessment of the review. Only three studies presented a moderate risk of bias. The meta-analysis results showed that the use of auxiliary posts produced higher mean fracture strengths than non-customized posts (SMD = 2.21; 95%CI: 0.74; 3.68), and it was more effective than the use of composite resin to reline the posts. CONCLUSION Based on laboratories studies, even though has not been observed any difference to a statistically significant level on fracture strength and failure pattern of the customized and non-customized post, future studies should follow a standardized approach to implementation and reporting of data.

[1]  K Genovese,et al.  Finite element analysis of a new customized composite post system for endodontically treated teeth. , 2005, Journal of biomechanics.

[2]  P. Vallittu,et al.  Root canal anchoring systems , 2017 .

[3]  L. Valandro,et al.  Clinical performance and failure modes of pulpless teeth restored with posts: a systematic review. , 2017, Brazilian oral research.

[4]  A. A. Del Bel Cury,et al.  Survival of extensively damaged endodontically treated incisors restored with different types of posts‐and‐core foundation restoration material , 2017, The Journal of prosthetic dentistry.

[5]  M. Mesquita,et al.  Fracture resistance of endodontically treated teeth restored with intra-radicular post: the effects of post system and dentine thickness. , 2013, Journal of biomechanics.

[6]  João Paulo Mendes Tribst,et al.  Influence of Alveolar Bone Loss and Cement Layer Thickness on the Biomechanical Behavior of Endodontically Treated Maxillary Incisors: A 3‐dimensional Finite Element Analysis , 2017, Journal of endodontics.

[7]  M. Miranda,et al.  Effect of Glass Fiber Post Adaptation on Push-Out Bond Strength to Root Dentin. , 2019, Brazilian dental journal.

[8]  A. Kishen.  Biomechanics of fractures in endodontically treated teeth , 2015 .

[9]  S. S. Kimmel.  Restoration and reinforcement of endodontically treated teeth with a polyethylene ribbon and prefabricated fiberglass post. , 2000, General dentistry.

[10]  P. Martins-Filho,et al.  Do metal post-retained restorations result in more root fractures than fiber post-retained restorations? A systematic review and meta-analysis. , 2015, Journal of endodontics.

[11]  A. Farina,et al.  Effect of different protocols of eugenol removal on the bond strength between the fibre post and root dentin. , 2018, Australian endodontic journal : the journal of the Australian Society of Endodontology Inc.

[12]  D. Moher,et al.  Performance of Post‐retained Single Crowns: A Systematic Review of Related Risk Factors , 2017, Journal of endodontics.

[13]  E. AlShwaimi,et al.  Micro-computed tomography analysis of gap and void formation in different prefabricated fiber post cementation materials and techniques , 2019, The Saudi dental journal.

[14]  M. Vitti,et al.  Evaluation of molar and incisor bite force in indigenous compared with white population in Brazil. , 2008, Archives of oral biology.

[15]  L. P. Vansan,et al.  In vitro fracture resistance of glass-fiber and cast metal posts with different lengths. , 2009, The Journal of prosthetic dentistry.

[16]  V. R. Novais,et al.  Effect of surface treatment of fiberglass posts on bond strength to root dentin. , 2014, Brazilian dental journal.

[17]  R. Baxendale,et al.  A preliminary electromyographic study of bite force and jaw-closing muscle fatigue in human subjects with advanced tooth wear. , 1990, Journal of oral rehabilitation.

[18]  C. Davidson,et al.  Polymerization contraction stress in thin resin composite layers as a function of layer thickness. , 1997, Dental materials : official publication of the Academy of Dental Materials.

[19]  C. Soares,et al.  Effect of post type and restorative techniques on the strain and fracture resistance of flared incisor roots. , 2011, Brazilian dental journal.

[20]  Y. Noiri,et al.  Factors that cause endodontic failures in general practices in Japan , 2018, BMC Oral Health.

[21]  M. Sousa-Neto,et al.  Bond strength of fiber posts to weakened roots after resin restoration with different light-curing times. , 2009, Journal of endodontics.

[22]  F. Mannocci,et al.  Restoration of endodontically treated teeth , 2014, BDJ.

[23]  D. Whittaker,et al.  Difficulties in estimating age using root dentine translucency in human teeth of varying antiquity. , 1999, Archives of oral biology.

[24]  M. Giannini,et al.  Influence of adhesive cementation systems on the bond strength of relined fiber posts to root dentin , 2017, The Journal of prosthetic dentistry.

[25]  F. Gokmen,et al.  Effects of storage solutions on mineral contents of dentin , 2011 .

[26]  D. Arola,et al.  On the Mechanics of Fatigue and Fracture in Teeth. , 2014, Applied mechanics reviews.

[27]  R. Moraes,et al.  The role of resin cement on bond strength of glass-fiber posts luted into root canals: a systematic review and meta-analysis of in vitro studies. , 2014, Operative dentistry.

[28]  L. Valandro,et al.  Effect of Ferrule Thickness on Fracture Resistance of Teeth Restored With a Glass Fiber Post or Cast Post. , 2019, Operative dentistry.

[29]  M. Hector,et al.  Age estimation using canine pulp volumes in adults: a CBCT image analysis , 2019, International Journal of Legal Medicine.

[30]  C. Soares,et al.  Effects of post system and length on the strain and fracture resistance of root filled bovine teeth. , 2008, International endodontic journal.

[31]  Samah Saker,et al.  Effect of restoration technique on resistance to fracture of endodontically treated anterior teeth with flared root canals , 2019, Journal of biomedical research.

[32]  C. Turssi,et al.  Oval Versus Circular-Shaped Root Canals: Bond Strength Reached with Varying Post Techniques. , 2018, Brazilian dental journal.

[33]  D. Mehta,et al.  Fracture Resistance of Endodontically Treated Roots Restored with Fiber Posts Using Different Resin Cements- An In-vitro Study. , 2017, Journal of clinical and diagnostic research : JCDR.

[34]  H. Moosavi,et al.  Fracture resistance of endodontically-treated teeth restored using three root-reinforcement methods. , 2008, The journal of contemporary dental practice.

[35]  P. Aruna,et al.  Ascertaining of age by Raman spectroscopic analysis of apical dentin – A forensic study , 2019, Journal of forensic dental sciences.

[36]  C. Soares,et al.  Influence of the endodontic treatment on mechanical properties of root dentin. , 2007, Journal of endodontics.

[37]  L. Pimenta,et al.  Effect of different filling materials in combination with intraradicular posts on the resistance to fracture of weakened roots. , 2003, Journal of oral rehabilitation.

[38]  Dragoslav Lazic,et al.  Effects of bruxism on the maximum bite force , 2017 .

[39]  Henner Alberto Gomide,et al.  Influence of restorative technique on the biomechanical behavior of endodontically treated maxillary premolars. Part II: strain measurement and stress distribution. , 2008, The Journal of prosthetic dentistry.

[40]  I. Naert,et al.  Controlled Clinical Trial on the Outcome of Glass Fiber Composite Cores Versus Wrought Posts and Cast Cores for the Restoration of Endodontically Treated Teeth: A 5-Year Follow-up Study. , 2017, The International journal of prosthodontics.

[41]  Zishan Dangra,et al.  All about Dowels - A Review Part I. Considerations before Cementation. , 2017, Journal of clinical and diagnostic research : JCDR.

[42]  Kimmel Ss.  Restoration and reinforcement of endodontically treated teeth with a polyethylene ribbon and prefabricated fiberglass post. , 2000 .

[43]  Rosaiah Kanaparthy,et al.  A Comparative Analysis of Fracture Resistance and Mode of Failure of Endodontically Treated Teeth Restored Using Different Fiber Posts: An In Vitro Study. , 2019, The journal of contemporary dental practice.

[44]  I. Kangasniemi,et al.  Load-bearing capacity of human incisor restored with various fiber-reinforced composite posts. , 2011, Dental materials : official publication of the Academy of Dental Materials.

[45]  R. A. Bernardes,et al.  Comparison of three retreatment techniques with ultrasonic activation in flattened canals using micro-computed tomography and scanning electron microscopy. , 2016, International endodontic journal.

[46]  A. Baltacı,et al.  Effect of storage solutions on microhardness of crown enamel and dentin , 2015, European journal of dentistry.

[47]  G. Eskitaşçıoğlu,et al.  Effect of restoration technique on stress distribution in roots with flared canals: an FEA study. , 2014, The journal of adhesive dentistry.

[48]  M. Bakhshi,et al.  Frequency of Iatrogenic Errors through Root Canal Treatment Procedure in 1335 Charts of Dental Patients , 2015, Journal of international oral health : JIOH.

[49]  R. Moraes,et al.  Can Silanization Increase the Retention of Glass-fiber posts? A Systematic Review and Meta-analysis of In Vitro Studies. , 2015, Operative dentistry.

[50]  C. Turssi,et al.  Mechanical properties of flared root canals restored with fiber post and chemically activated resin: study using push-out bond strength and fracture load tests , 2016 .

[51]  João Paulo Mendes Tribst,et al.  Resin push-out bonding strength to root canal dentin: effect of the irrigation solution application prior to post cementation , 2017 .

[52]  O. El-Mowafy,et al.  Fracture resistance of anterior teeth restored with a novel nonmetallic post. , 2008, Journal.

[53]  P. Ausiello,et al.  Numerical fatigue 3D-FE modeling of indirect composite-restored posterior teeth. , 2011, Dental materials : official publication of the Academy of Dental Materials.

[54]  M. Cinelli,et al.  The effect of resin cement film thickness on the pullout strength of a fiber-reinforced post system. , 2007, The Journal of prosthetic dentistry.

[55]  P. Vallittu,et al.  Mechanical and structural characterization of discontinuous fiber-reinforced dental resin composite. , 2016, Journal of dentistry.

[56]  N. Ibrahim,et al.  Dental age estimation employing CBCT scans enhanced with Mimics software: Comparison of two different approaches using pulp/tooth volumetric analysis. , 2018, Journal of forensic and legal medicine.

[57]  L. F. Pegoraro,et al.  Fracture strength of teeth with flared root canals restored with glass fibre posts. , 2007, International dental journal.

[58]  A. Bhagat,et al.  Impact of Root Dentin Thickness on the in vitro Compressive Strength of Teeth treated with Recent Post and Core Systems. , 2017, The journal of contemporary dental practice.

[59]  L. Martins,et al.  Effect of cement type, relining procedure, and length of cementation on pull-out bond strength of fiber posts. , 2010, Journal of endodontics.

[60]  G. Borges,et al.  Relined Fiberglass Post: Effect of Luting Length, Resin Cement, and Cyclic Loading on the Bond to Weakened Root Dentin. , 2016, Operative dentistry.

[61]  G. Glass,et al.  Meta-analysis in social research , 1981 .

[62]  P. V. Soares,et al.  Development of a fiber-reinforced material for fiber posts: Evaluation of stress distribution, fracture load, and failure mode of restored roots. , 2020, The Journal of prosthetic dentistry.

[63]  R. Moraes,et al.  A systematic review of factors associated with the retention of glass fiber posts. , 2015, Brazilian oral research.

[64]  M. Menezes,et al.  Etching a fiber post surface with high-concentration bleaching agents. , 2014, Operative dentistry.

[65]  C. Goracci,et al.  SEM evaluation of the cement layer thickness after luting two different posts. , 2005, The journal of adhesive dentistry.

[66]  Y. Cai,et al.  Effects of auxiliary fiber posts on endodontically treated teeth with flared canals. , 2011, Operative dentistry.

[67]  D. Moher,et al.  Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. , 2010, International journal of surgery.

[68]  T. V. Eijden.  Three-dimensional analyses of human bite-force magnitude and moment. , 1991 .

[69]  M. D. Sousa Neto,et al.  Fracture resistance of weakened roots restored with a transilluminating post and adhesive restorative materials. , 2006, The Journal of prosthetic dentistry.

[70]  A. D. Dal Piva,et al.  Resin bonding to root dentin: influence of the alveolar bone level and thickness of the cement layer. , 2014, Minerva stomatologica.

[71]  S. Haralur,et al.  The Effect of Intraradicular Multiple Fiber and Cast Posts on the Fracture Resistance of Endodontically Treated Teeth with Wide Root Canals , 2018, BioMed research international.

[72]  P. Vallittu.  Are we misusing fiber posts? Guest editorial. , 2016, Dental materials : official publication of the Academy of Dental Materials.

[73]  R. Ribeiro,et al.  Fracture Strength of Weakened Anterior Teeth Associated to Different Reconstructive Techniques. , 2016, Brazilian dental journal.

[74]  M. D. de Andrade,et al.  FRACTURE STRENGTH OF FLARED BOVINE ROOTS RESTORED WITH DIFFERENT INTRARADICULAR POSTS , 2009, Journal of applied oral science : revista FOB.