Clinical Performance of Cast Metal and Fiber Post Retained Restorations in Endodontically Treated Teeth: A Systematic Review and Meta-Analysis

Purpose: The purpose of this systematic review was to assess the available literature to evaluate the clinical performance of different post systems for the rehabilitation of endodontically treated teeth (ETT). Clinical Significance: The loss of structural integrity of endodontically treated teeth usually requires the use of intra-radicular posts for the retention of the final restoration. The recent literature has reported controversial results regarding the clinical performance of different systems. Material and Methods: An electronic search restricted to the English language was performed up to May 31, 2020. Articles were selected if they met the following criteria: cohort studies and randomized clinical trials comparing the failure rate incidence between fiber and cast metal post, with a mean follow-up of 3 years. Results: 24 studies (14 cohort studies and 10 RCTs) published between 2000 and 2018 were included in this review. For cast metal posts, 210 cases were classified as failures (17.07%), and for fiber posts, 423 were classified as failures (10.6%). An unpaired t-test revealed that cast metal and fiber post values were not significantly different (p = 0.58) with the difference between means of 5.00 with 95% confidence of interval (-13.38 to 23.39). Four studies that presented cast metal and fiber posts groups were combined in the meta-analysis. There was no significant difference in the general failure analysis (risk ratio of 0.59 [95% CI: 0.30 to 1.18]; p = 0.13). Conclusions: Based on the present analysis results, the clinical performance of ETT restored with either cast metal- or fiber post-retained restorations presented similar results.