Factors influencing the clinical performance of the restoration of endodontically treated teeth: An assessment of systematic reviews of clinical studies

Lara Dotto; Luiza Paloma S Girotto; Yara Teresinha Correa Silva Sousa; Gabriel Kalil Rocha Pereira; Ataís Bacchi; Rafael Sarkis-Onofre

doi:10.1016/j.prosdent.2022.03.030

Factors influencing the clinical performance of the restoration of endodontically treated teeth: An assessment of systematic reviews of clinical studies

J Prosthet Dent. 2022 May 5:S0022-3913(22)00213-X. doi: 10.1016/j.prosdent.2022.03.030. Online ahead of print.

Authors

Lara Dotto¹, Luiza Paloma S Girotto², Yara Teresinha Correa Silva Sousa³, Gabriel Kalil Rocha Pereira⁴, Ataís Bacchi⁵, Rafael Sarkis-Onofre⁶

Affiliations

¹ PhD student, School of Dentistry, Regional Integrated University of Upper Uruguai and Missions (URI), Erechim, RS, Brazil; and Master Student, Graduate Program in Dentistry, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, RS, Brazil.
² Master Student, Graduate Program in Dentistry, Meridional Faculty (IMED), Passo Fundo, RS, Brazil.
³ Associate Professor, School of Dentistry, University of Ribeirão Preto (UNAERP), Ribeirão Preto, SP, Brazil.
⁴ Associate Professor, Post-Graduate Program in Oral Sciences, Federal University of Santa Maria (UFSM), Santa Maria, RS, Brazil.
⁵ Associate Professor, Post-Graduate Program in Dentistry, Paulo Picanço School of Dentistry, Fortaleza, CE, Brazil.
⁶ Associate Professor, Graduate Program in Dentistry, Meridional Faculty (IMED), Passo Fundo, RS, Brazil. Electronic address: rafaelonofre@gmail.com.

PMID: 35527069
DOI: 10.1016/j.prosdent.2022.03.030

Abstract

Statement of problem: How best to restore endodontically treated teeth is still unclear because many types of material and techniques are involved.

Purpose: The purpose of this overview of systematic reviews of clinical studies was to assess the available evidence-based literature on the influence of associated clinical factors on the clinical performance (survival, failure rate, or success) of restored endodontically treated teeth.

Material and methods: PubMed, Scopus, and Web of Science were searched from inception until September 27, 2021, to identify systematic reviews. Two reviewers independently screened titles, abstracts, and full-text articles, and each reviewer extracted the data of half of the included studies. A single reviewer with an independent verifier completed the quality appraisal. A descriptive analysis of the collected data was made.

Results: A total of 36 systematic reviews fulfilled the inclusion criteria. The factors most assessed were the type of coronal restorative technique (n=22) and type of post (n=22). The results indicated that metal and fiber posts seem to present similar clinical performance, endocrowns could be a suitable restorative option, there is no evidence to confirm whether single crowns are better or worse than direct restoration, the maintenance of the coronal structure is a fundamental factor, and the ferrule effect is still a controversial topic. Most of the studies (n=30, 81%) presented a final Grading of Recommendations, Assessment, Development and Evaluations (GRADE) rating of "critically low."

Conclusions: The post type does not appear to influence the clinical performance of restored endodontically treated teeth. However, conclusive evidence to suggest how different materials or techniques for restoring coronal tooth structure affect the clinical performance of such restorations, as well as the impact of the ferrule effect, is still lacking.

Publication types

Review