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Randomized controlled trial comparing glass fiber posts and cast metal posts.

Rafael Sarkis-Onofre1, Helena Amaral Pinheiro2, Victório Poletto-Neto2

  • 1Graduate Program in Dentistry, Meridional Faculty (IMED), 304 Senador Pinheiro Machado Street, 99070-220, Passo Fundo, Brazil; Graduate Program in Dentistry, Federal University of Pelotas, 457 Gonçalves Chaves Street, Pelotas, Brazil.

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Summary

Glass fiber posts and cast metal posts demonstrate comparable survival and success rates in endodontically treated teeth lacking a ferrule. This five-year study found similar clinical performance, offering valuable insights for dental rehabilitation techniques.

Keywords:
Clinical studies/trialsEndodonticsEvidence-based dentistry/health care restorative dentistry

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Area of Science:

  • Restorative Dentistry
  • Dental Materials Science
  • Prosthodontics

Background:

  • Endodontically treated teeth often require post-and-core restorations.
  • Teeth without a ferrule present a unique challenge for post retention and tooth survival.
  • Evaluating the long-term performance of different post materials in compromised teeth is crucial.

Purpose of the Study:

  • To compare the survival and success rates of glass fiber posts versus cast metal posts.
  • To assess the clinical performance of these posts in teeth without a ferrule.
  • To provide evidence-based guidance for rehabilitating endodontically treated teeth with limited coronal structure.

Main Methods:

  • A prospective, double-blind, randomized controlled trial (RCT) was conducted.
  • 183 posts (72 cast metal, 111 glass fiber) were placed in endodontically treated teeth without ferrule.
  • Kaplan-Meier analysis and log-rank tests were used to evaluate success and survival over a median follow-up of 62 months.

Main Results:

  • No statistically significant differences were found in success (P=0.26) or survival (P=0.63) between glass fiber and cast metal posts.
  • The overall annual failure rate (AFR) after five years was 1.5% (cast metal: 1.2%, glass fiber: 1.7%).
  • Most failures (16/23) occurred in posterior teeth, primarily due to root fractures (10) and post debonding (5).

Conclusions:

  • Glass fiber posts and cast metal posts exhibit similar and favorable clinical performance.
  • Both materials are viable options for restoring endodontically treated teeth without a ferrule.
  • The study supports the use of both post types, aiding dentists in treatment planning for challenging cases.