Are CAD-CAM milled glass fiber posts better than prefabricated or custom glass fiber posts for endodontically treated teeth? A systematic review with meta-analysis

Gabriel Barboza Campos; Eduardo Piza Pellizzer; Rodrigo Furtado de Carvalho; Carolina Oliveira de Lima; Hiskell Francine Fernandes E Oliveira; João Pedro Justino de Oliveira Limirio; Cleidiel Aparecido Araujo Lemos

doi:10.1016/j.prosdent.2024.03.041

Are CAD-CAM milled glass fiber posts better than prefabricated or custom glass fiber posts for endodontically treated teeth? A systematic review with meta-analysis

J Prosthet Dent. 2024 May 8:S0022-3913(24)00234-8. doi: 10.1016/j.prosdent.2024.03.041. Online ahead of print.

Authors

Gabriel Barboza Campos¹, Eduardo Piza Pellizzer², Rodrigo Furtado de Carvalho³, Carolina Oliveira de Lima⁴, Hiskell Francine Fernandes E Oliveira⁵, João Pedro Justino de Oliveira Limirio⁶, Cleidiel Aparecido Araujo Lemos⁷

Affiliations

¹ Graduate, Department of Dentistry, Federal University of Juiz de Fora - Campus Governador Valadares (UFJF-GV), Governador Valadares, Brazil.
² Full Professor, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil.
³ Associate Professor, Department of Dentistry, Federal University of Juiz de Fora - Campus Governador Valadares (UFJF-GV), Governador Valadares, Brazil.
⁴ Adjunct Professor, Department of Dentistry, Federal University of Juiz de Fora - Campus Governador Valadares (UFJF-GV), Governador Valadares, Brazil.
⁵ Postdoctoral Research Fellow, Bone Research Lab, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
⁶ Postgraduate student, Department of Dental Materials and Prosthodontics, Sao Paulo State University (UNESP), Araçatuba, Brazil.
⁷ Adjunct Professor, Department of Dentistry, Federal University of Juiz de Fora - Campus Governador Valadares (UFJF/GV), Governador Valadares, Brazil. Electronic address: cleidiel.lemos@ufjf.br.

PMID: 38724337
DOI: 10.1016/j.prosdent.2024.03.041

Abstract

Statement of problem: Prefabricated and custom glass fiber posts have been successfully used to reconstruct endodontically treated teeth. However, the performance of computer-aided design and computer-aided manufacture (CAD-CAM) milled glass fiber posts is unclear.

Purpose: The purpose of this systematic review with meta-analysis was to compare the fracture and bond strength and cement layer thickness of CAD-CAM milled glass fiber posts with prefabricated or custom glass fiber posts.

Material and methods: The protocol was registered in the Open Science Framework (http://osf.io/65jm7). Two reviewers searched the PubMed/MEDLINE, Web of Science, Embase, Scopus, and ProQuest databases for articles up to September 2023. In addition, the reference lists were hand searched. A meta-analysis was performed by using the RevMan 5.4 program. The risk of bias was assessed using the RoBDEMAT tool.

Results: After screening, a total of 18 studies were included. The CAD-CAM milled glass fiber posts showed higher fracture strength (P=.02; Standardized Mean Difference [SMD]: 0.57; 95% Confidence Interval [CI]: 0.07 to 1.07), bond strength (P=.010; SMD: 1.07; 95% CI: 0.26 to 1.89), and lower cement layer thickness (P=.009; SMD: -2.94; 95% CI: -5.15 to -0.73) when compared with prefabricated glass fiber posts. However, fracture strength (P=.53; SMD: 0.38; 95% CI: -0.79 to 1.54) and bond strength (P=.90; SMD: -0.05; 95% CI: -0.81 to 0.72) were statistically similar between CAD-CAM milled and custom glass fiber posts. Significant and substantial heterogeneity was observed in all meta-analyzes (P<.01; I>60%). The studies sufficiently reported most domains related to bias, except for randomization of samples, sample size rationale and reporting and operator blinding.

Conclusions: CAD-CAM milled and custom glass fiber posts provide an effective and safe option for restoring endodontically treated teeth, especially for weakened teeth or enlarged root canals. However, further well-designed clinical research is recommended to strengthen these findings.

Publication types

Review