Cochrane · intervention · CD004623

Root canal posts for the restoration of root filled teeth

Cochrane Database of Systematic Reviews · 2007 · Cochrane Library

Oral Health Dental caries Endodontics and dental trauma2 versionsAMSTAR 2: not assessed

Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.

Questions

current version

GRADE rated

No studies

Included studies

as reported

No studies 4 · 66.7%Ungraded 2 · 33.3%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Review question

Element	Planned (methods)	Found (results)
Population	Participants with permanent teeth endodontically treated by a dental practitioner in hospital or private practice. For these teeth, a post was clearly indicated as the means of retention for the final restoration.	Participants with endodontically-treated permanent teeth with significant tooth structure loss needing a post (n=317 across 2 RCTs; both conducted in Italy; mean age 48 years in one study)
Intervention	Category I: passive metal custom-cast posts and cores (burnt-out plastic patterns or cast-on posts); Category II: two-element system comprising a commercial active or passive prefabricated metal post (tapered, parallel or parallel-tapered combination) and a core built up from amalgam, glass-ionomer cement, resin-modified glass ionomer or composite resin; Category III: two-element system comprising a commercial prefabricated non-metal post (fibre-reinforced post or ceramic post) and a composite resin, a glass-ionomer cement or a resin-modified glass-ionomer core	Non-metal carbon-fibre post and core (Composipost, Category III) (n=97); non-metal carbon-fibre post (Category III) restored with direct composite (n=60)
Comparison	A different post and core category (metal versus non-metal posts; metal-cast versus prefabricated metal posts); or the same category under different conditions (prosthetic status, presence of a ferrule, alloy type, presence of a diaphragm)	Metal custom-cast post and core (Category I; gold alloy) (n=98); non-metal carbon-fibre post (Category III) restored with full-coverage metal-ceramic crown (n=57)
Outcomes	Failure rate of post and core systems assessed by clinical and radiographic examination (loss of retention, post fracture, root fracture); survival time of post and core systems	Clinical/technical failure (root fracture) (n=195); post dislodgement (n=104)
Study designs	Randomised or quasi-randomised clinical trials (parallel-group and split-mouth designs); minimum duration 6 months	2 RCTs, both parallel-group (Ferrari a 2000; Mannocci 2002)
Timing	Minimum duration 6 months	48 months (4 years); 36 months (3 years, dislodgement assessed at 24 months)

Search date: September 2005. Databases: Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE; Scopus; EMBASE

Questions and results

Current version only

Non-metal carbon-fibre post and core (Category III; Composipost) vs Metal custom-cast post and core (Category I; gold alloy)

Population: Participants with permanent endodontically-treated (root-filled) teeth for which a post is indicated to retain the final restoration

CD004623.PUB2 (current) · 1 question

Outcome	Effect	Evidence	Status / GRADE
Clinical/technical failure (root fracture) 48 months (4 years) same question in other reviews	RR 0.05 [0.00, 0.90]	1 study · 195 participants	Ungraded

Prefabricated metal post and core (Category II) vs Metal custom-cast post and core (Category I)

Population: Participants with permanent endodontically-treated (root-filled) teeth for which a post is indicated to retain the final restoration

CD004623.PUB2 (current) · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR Minimum 6 months (planned) same question in other reviews	No included trial compared metal-cast posts with prefabricated metal posts (a planned primary comparison); no eligible study identified.	0 studies	No studies

Direct composite restoration (final restoration) vs Full-coverage metal-ceramic crown

Population: Participants with endodontically-treated permanent premolars restored with a carbon-fibre post (Category III)

CD004623.PUB2 (current) · 1 question

Outcome	Effect	Evidence	Status / GRADE
Clinical failure (post dislodgement) 36 months (3 years); dislodgement assessed at 24 months same question in other reviews	RR 1.85 [0.17, 19.8]	1 study · 104 participants	Ungraded

Post and core restoration with a ferrule vs Post and core restoration without a ferrule

Population: Participants with permanent endodontically-treated (root-filled) teeth for which a post is indicated to retain the final restoration

CD004623.PUB2 (current) · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR Minimum 6 months (planned) same question in other reviews	No included trial evaluated the presence of a ferrule (a planned secondary comparison); no eligible study identified.	0 studies	No studies

Metal post of one alloy type vs Metal post of a different alloy type

Population: Participants with permanent endodontically-treated (root-filled) teeth for which a post is indicated to retain the final restoration

CD004623.PUB2 (current) · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR Minimum 6 months (planned) same question in other reviews	No included trial evaluated alloy type in metal posts (a planned secondary comparison); no eligible study identified.	0 studies	No studies

Cast post and core with a diaphragm vs Cast post and core without a diaphragm

Population: Participants with permanent endodontically-treated (root-filled) teeth for which a post is indicated to retain the final restoration

CD004623.PUB2 (current) · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR Minimum 6 months (planned) same question in other reviews	No included trial evaluated the presence of a diaphragm in cast posts (a planned secondary comparison); no eligible study identified.	0 studies	No studies

Non-metal prefabricated post and core (Category III; fibre-reinforced or ceramic) vs Metal custom-cast post and core (Category I)

Population: Participants with permanent endodontically-treated (root-filled) teeth for which a post is indicated to retain the final restoration

CD004623 · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR Minimum 6 months (planned)	Protocol (2004); planned primary comparison (metal versus non-metal posts); no results reported.	0 studies	No studies

Prefabricated metal post and core (Category II) vs Metal custom-cast post and core (Category I)

Population: Participants with permanent endodontically-treated (root-filled) teeth for which a post is indicated to retain the final restoration

CD004623 · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR Minimum 6 months (planned)	Protocol (2004); planned primary comparison (metal-cast versus prefabricated metal posts); no results reported.	0 studies	No studies

Post-retained restoration with one prosthetic status (e.g. full-coverage crown) vs Post-retained restoration with a different prosthetic status (e.g. direct restoration)

Population: Participants with permanent endodontically-treated (root-filled) teeth for which a post is indicated to retain the final restoration

CD004623 · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR Minimum 6 months (planned)	Protocol (2004); planned secondary comparison (differences in failure by prosthetic status of the tooth); no results reported.	0 studies	No studies

Post and core restoration with a ferrule vs Post and core restoration without a ferrule

Population: Participants with permanent endodontically-treated (root-filled) teeth for which a post is indicated to retain the final restoration

CD004623 · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR Minimum 6 months (planned)	Protocol (2004); planned secondary comparison (differences in failure by presence of a ferrule); no results reported.	0 studies	No studies

Metal post of one alloy type vs Metal post of a different alloy type

Population: Participants with permanent endodontically-treated (root-filled) teeth for which a post is indicated to retain the final restoration

CD004623 · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR Minimum 6 months (planned)	Protocol (2004); planned secondary comparison (differences in failure by type of alloy in metal posts); no results reported.	0 studies	No studies

Cast post and core with a diaphragm vs Cast post and core without a diaphragm

Population: Participants with permanent endodontically-treated (root-filled) teeth for which a post is indicated to retain the final restoration

CD004623 · 1 question

Outcome	Effect	Evidence	Status / GRADE
Outcome NR Minimum 6 months (planned)	Protocol (2004); planned secondary comparison (differences in failure by presence of a diaphragm in cast posts); no results reported.	0 studies	No studies