Which type of post and core system should you use?

Area of Science:

• Dentistry
• Biomaterials Science
• Clinical Trials

Background:

• This systematic review evaluated the failure rates of different post and core systems in endodontically-treated permanent teeth.
• The study focused on comparing metal posts with nonmetal posts, specifically carbon fiber posts, when two or three dentine walls remain.

Discussion:

• One randomized controlled trial (RCT) with 200 participants indicated a lower failure risk with carbon fiber posts (0%) compared to metal-cast posts (9.2%).
• However, this trial was assessed as having a high risk of bias, rendering the findings unreliable.
• The limited evidence prevents definitive conclusions on the superiority of any specific post and core system.

Key Insights:

• Nonmetal posts, particularly carbon fiber, showed a trend towards lower failure rates than metal-cast posts in endodontically-treated teeth.
• The available evidence is currently insufficient to recommend specific post and core systems due to high risk of bias in existing studies.
• Further research is crucial to establish the efficacy of different post materials.

Outlook:

• High-quality randomized controlled trials are required to confirm the potential benefits of fiber-reinforced post and core systems.
• Future research should clarify the influence of remaining tooth structure on treatment outcomes with various post and core systems.
• Standardized inclusion criteria, focusing on the number of dentine walls, are recommended for future studies.