Fracture resistance and failure modes of endodontically-treated permanent teeth restored with Ribbond posts vs other post systems: a systematic review and meta-analysis of <i>in vitro</i> studies

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Abstract

Objectives

This systematic review aimed to investigate the fracture resistance and mode of failure of endodontically-treated permanent teeth restored with Ribbond posts (Ribbond, Inc.) compared with endodontically-treated permanent teeth restored with other post systems.

Methods

A comprehensive, systematic literature search was carried out using several electronic databases: MEDLINE/PubMed, Google Scholar, and Cochrane Library. Two separate researchers were appointed to identify the studies meeting the eligibility criteria, and to perform the data extraction, risk of bias, and quality assessment.

Results

Twelve studies were included in the quantitative analysis. Meta-analysis was performed with 11 of the 12 included articles. The meta-analysis showed that Ribbond posts have a fracture strength less than prefabricated metal posts, cast metal posts, and prefabricated fiber posts and greater than custom e-glass fiber posts. Mode of failure analysis revealed that Ribbond posts have the most favorable non-catastrophic fractures.

Conclusions

Although Ribbond posts have lower fracture resistance, their favorable mode of failure makes them potentially the most biomimetic post system.

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Most cited references 52

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Measuring inconsistency in meta-analyses.

Julian P T Higgins, Simon G Thompson, Jonathan J Deeks … (2003)

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Reduction in tooth stiffness as a result of endodontic and restorative procedures.

Ernest Reeh, Harold Messer, William Douglas (1989)

Endodontically treated teeth are thought to be more susceptible to fracture as a result of the loss of tooth vitality and tooth structure. This study was designed to compare the contributions of endodontic and restorative procedures to the loss of strength by using nondestructive occlusal loading on extracted intact, maxillary, second bicuspids. An encapsulated strain gauge was bonded on enamel just above the cementoenamel junction on both the buccal and lingual surfaces, and the teeth were mounted in nylon rings leaving 2 mm of root surface exposed. Under load control, each tooth was loaded at a rate of 37 N per s for 3 s and unloaded at the same rate in a closed loop servo-hydraulic system to measure stiffness. A stress-strain curve was generated from each gauge prior to alteration of the tooth and after each procedure performed on the tooth. Cuspal stiffness, as a measure of tooth strength, was evaluated on one of two series of sequentially performed procedures: 1. (a) unaltered tooth, (b) access preparation, (c) instrumentation, (d) obturation, and (e) MOD cavity preparation; or 2. (a) unaltered tooth, (b) occlusal cavity preparation, (c) two-surface cavity preparation, (d) MOD cavity preparation, (e) access, (f) instrumentation, and (g) obturation. Results on 42 teeth indicate that endodontic procedures have only a small effect on the tooth, reducing the relative stiffness by 5%. This was less than that of an occlusal cavity preparation (20%). The largest losses in stiffness were related to the loss of marginal ridge integrity. MOD cavity preparation resulted in an average of a 63% loss in relative cuspal stiffness.(ABSTRACT TRUNCATED AT 250 WORDS)

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Guidelines for reporting pre-clinical in vitro studies on dental materials.

Clovis Faggion (2012)

In vitro pre-clinical research is an important aspect of the development of new dental materials and techniques, because it can provide essential information for further testing of therapeutic approaches in clinical trials. These pre-clinical experiments should therefore be reported with the same rigor as studies involving humans. The objectives of this paper were twofold: (a) to search and assess existing guidelines for reporting in vitro studies in dentistry, and (b) to present a methodology for reporting these studies, based on the CONSORT checklist for reporting randomized clinical trials. After a comprehensive search in PubMed database, no guidelines for reporting in vitro studies in dentistry were found. The proposed methodology is presented and the rationale for the choice of fourteen guidelines for producing the different sections of such papers is described in detail. The assessment of a sample of in vitro studies using the proposed guidelines showed that the standards of reporting should be improved. Good standards of reporting of studies are necessary for improvement of efficiency in dental research. The guidelines presented are the first standards for reporting in vitro studies in dentistry. As with the original CONSORT document, the modified checklist is evolving. It should, therefore, be further tested by researchers and the results of these assessments should be used for further improvement of this tool.

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Author and article information

Journal

Journal ID (nlm-ta): Restor Dent Endod

Journal ID (iso-abbrev): Restor Dent Endod

Journal ID (publisher-id): RDE

Title: Restorative Dentistry & Endodontics

Publisher: Restorative Dentistry & Endodontics

ISSN (Print): 2234-7658

ISSN (Electronic): 2234-7666

Publication date Collection: February 2025

Publication date (Electronic): 17 February 2025

Volume: 50

Issue: 1

Electronic Location Identifier: e5

Affiliations

Department of Conservative Dentistry and Endodontics, Post Graduate Program, YMT Dental College and Hospital, Navi Mumbai, India

Author notes

Citation: Vartak MA, Hegde VR, Hegde SR, Fanibunda U. Fracture resistance and failure modes of endodontically-treated permanent teeth restored with Ribbond posts vs other post systems: a systematic review and meta-analysis of in vitro studies. Restor Dent Endod 2024;50(1):e5.

[* ]Correspondence to Meghana Aditya Vartak, BDS, MDS Department of Conservative Dentistry and Endodontics, YMT Dental College and Hospital, Institutional Area, Sector 4, Kharghar, Navi Mumbai, Maharashtra 410210, India Email: meghanavartak@ 123456gmail.com

[* ]Correspondence to Ushaina Fanibunda, BDS, MDS Department of Conservative Dentistry and Endodontics, YMT Dental College and Hospital, Institutional Area, Sector 4, Kharghar, Navi Mumbai, Maharashtra 410210, India Email: ushaina@ 123456gmail.com

Meghana Aditya Vartak and Ushaina Fanibunda contributed equally to this work as corresponding authors.

Author information

Meghana Aditya Vartak https://orcid.org/0009-0003-0335-4226

Vibha Rahul Hegde https://orcid.org/0000-0002-9508-1469

Sanitra Rahul Hegde https://orcid.org/0009-0007-5061-152X

Ushaina Fanibunda https://orcid.org/0000-0001-7647-3144

Article

Publisher ID: rde-2025-50-e5

DOI: 10.5395/rde.2025.50.e5

PMC ID: 11921462

PubMed ID: 39979229

SO-VID: 492b3ef7-bc92-41da-9903-9305972f13c9

License:

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 31 July 2024

Date revision received : 3 October 2024

Date accepted : 10 November 2024

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Fracture resistance and failure modes of endodontically-treated permanent teeth restored with Ribbond posts vs other post systems: a systematic review and meta-analysis of in vitro studies

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Most cited references 52

Measuring inconsistency in meta-analyses.

Reduction in tooth stiffness as a result of endodontic and restorative procedures.

Guidelines for reporting pre-clinical in vitro studies on dental materials.

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