Effectiveness of horizontal posts to support MOD cavities compared with other restorative approaches in endodontically treated teeth: systematic review with meta-analysis of laboratory studies
Abstract Background Endodontically treated teeth often face challenges in maintaining structural integrity, particularly when restored with MOD cavities. This systematic review aimed to evaluate the mechanical behavior of endodontically treated premolar and molar teeth with MOD cavities, restored wi...
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BMC
2025-05-01
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| Series: | BMC Oral Health |
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| Online Access: | https://doi.org/10.1186/s12903-025-06022-1 |
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| author | Mohammed Ahmed Alghauli Ahmed Yaseen Alqutaibi Redhwan Saleh Al-Gabri Abdulmajeed Abdulaziz Baik Anas Mazen Mahrous Arwa Bafail Samah Saker |
| author_facet | Mohammed Ahmed Alghauli Ahmed Yaseen Alqutaibi Redhwan Saleh Al-Gabri Abdulmajeed Abdulaziz Baik Anas Mazen Mahrous Arwa Bafail Samah Saker |
| author_sort | Mohammed Ahmed Alghauli |
| collection | DOAJ |
| description | Abstract Background Endodontically treated teeth often face challenges in maintaining structural integrity, particularly when restored with MOD cavities. This systematic review aimed to evaluate the mechanical behavior of endodontically treated premolar and molar teeth with MOD cavities, restored with horizontal posts and composite materials, compared with alternative restorative approaches such as fiber-reinforced composites and indirect restorations. Methods A comprehensive search was conducted in December 2024 across various databases, including PubMed, Scopus, Web of Science, and Google Scholar. All studies that examined the application of horizontal posts in posterior endodontically treated teeth compared to other restorative methods were included, and manual searches of included studies and associated scientific websites were performed. The meta-analysis was accomplished through the Review Manager (RevMan 5.4) of the Cochrane Collaboration. Results The web search yielded 718 records, and 1 was added from the manual search. Following the PRISMA guidelines, 26 studies were ultimately included in this review. Horizontal posts in endodontically treated teeth significantly improved fracture resistance compared with untreated MOD cavities and many restorative methods, though they did not match sound teeth. Combining horizontal posts with materials like polyethylene fiber Ribbond or nanohybrid composites achieved fracture resistance comparable to sound teeth, while finite element analyses showed reduced stress concentrations. Horizontal posts also reduced non-restorable fractures compared to MOD cavities and bulk-fill composites, highlighting their mechanical advantage, especially when paired with advanced composites. Conclusions The insertion of horizontal posts significantly increased the fracture resistance of endodontically treated premolars and molars compared to composite restorations. Notably, fracture resistance levels were comparable to those observed in teeth restored with glass-fiber-reinforced composite and indirect ceramic restorations. However, there was no evident benefit from inserting root canal posts in enhancing fracture resistance. None of the restorative approaches achieved the fracture resistance levels of intact premolar and molar teeth. Clinical significant Proper support of ETTs with MOD cavities restored with direct composite restorations can preserve tooth integrity, particularly in case of large cavities. These supporting concepts are crucial in achieving complications-free restorations that maintain long-term clinical functionality. |
| format | Article |
| id | doaj-art-92a711eadebc44f4a2c4cdbed133497e |
| institution | OA Journals |
| issn | 1472-6831 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
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| series | BMC Oral Health |
| spelling | doaj-art-92a711eadebc44f4a2c4cdbed133497e2025-08-20T01:53:25ZengBMCBMC Oral Health1472-68312025-05-0125111410.1186/s12903-025-06022-1Effectiveness of horizontal posts to support MOD cavities compared with other restorative approaches in endodontically treated teeth: systematic review with meta-analysis of laboratory studiesMohammed Ahmed Alghauli0Ahmed Yaseen Alqutaibi1Redhwan Saleh Al-Gabri2Abdulmajeed Abdulaziz Baik3Anas Mazen Mahrous4Arwa Bafail5Samah Saker6Department of Prosthodontics, Faculty of Dentistry, Ibb UniversityDepartment of Prosthodontics, Faculty of Dentistry, Ibb UniversityDepartment of Prosthodontics, Faculty of Dentistry, Ibb UniversityEndodontics Resident, College of Dentistry, Taibah UniversityDental Student, College of Dentistry, Taibah UniversityRestorative Dental Sciences, College of Dentistry, Taibah UniversitySubstitutive Dental Sciences Department, College of Dentistry, Taibah UniversityAbstract Background Endodontically treated teeth often face challenges in maintaining structural integrity, particularly when restored with MOD cavities. This systematic review aimed to evaluate the mechanical behavior of endodontically treated premolar and molar teeth with MOD cavities, restored with horizontal posts and composite materials, compared with alternative restorative approaches such as fiber-reinforced composites and indirect restorations. Methods A comprehensive search was conducted in December 2024 across various databases, including PubMed, Scopus, Web of Science, and Google Scholar. All studies that examined the application of horizontal posts in posterior endodontically treated teeth compared to other restorative methods were included, and manual searches of included studies and associated scientific websites were performed. The meta-analysis was accomplished through the Review Manager (RevMan 5.4) of the Cochrane Collaboration. Results The web search yielded 718 records, and 1 was added from the manual search. Following the PRISMA guidelines, 26 studies were ultimately included in this review. Horizontal posts in endodontically treated teeth significantly improved fracture resistance compared with untreated MOD cavities and many restorative methods, though they did not match sound teeth. Combining horizontal posts with materials like polyethylene fiber Ribbond or nanohybrid composites achieved fracture resistance comparable to sound teeth, while finite element analyses showed reduced stress concentrations. Horizontal posts also reduced non-restorable fractures compared to MOD cavities and bulk-fill composites, highlighting their mechanical advantage, especially when paired with advanced composites. Conclusions The insertion of horizontal posts significantly increased the fracture resistance of endodontically treated premolars and molars compared to composite restorations. Notably, fracture resistance levels were comparable to those observed in teeth restored with glass-fiber-reinforced composite and indirect ceramic restorations. However, there was no evident benefit from inserting root canal posts in enhancing fracture resistance. None of the restorative approaches achieved the fracture resistance levels of intact premolar and molar teeth. Clinical significant Proper support of ETTs with MOD cavities restored with direct composite restorations can preserve tooth integrity, particularly in case of large cavities. These supporting concepts are crucial in achieving complications-free restorations that maintain long-term clinical functionality.https://doi.org/10.1186/s12903-025-06022-1Fiber postsInlayOnlayHorizontal postsStress distributionOcclusal Ribbonds |
| spellingShingle | Mohammed Ahmed Alghauli Ahmed Yaseen Alqutaibi Redhwan Saleh Al-Gabri Abdulmajeed Abdulaziz Baik Anas Mazen Mahrous Arwa Bafail Samah Saker Effectiveness of horizontal posts to support MOD cavities compared with other restorative approaches in endodontically treated teeth: systematic review with meta-analysis of laboratory studies BMC Oral Health Fiber posts Inlay Onlay Horizontal posts Stress distribution Occlusal Ribbonds |
| title | Effectiveness of horizontal posts to support MOD cavities compared with other restorative approaches in endodontically treated teeth: systematic review with meta-analysis of laboratory studies |
| title_full | Effectiveness of horizontal posts to support MOD cavities compared with other restorative approaches in endodontically treated teeth: systematic review with meta-analysis of laboratory studies |
| title_fullStr | Effectiveness of horizontal posts to support MOD cavities compared with other restorative approaches in endodontically treated teeth: systematic review with meta-analysis of laboratory studies |
| title_full_unstemmed | Effectiveness of horizontal posts to support MOD cavities compared with other restorative approaches in endodontically treated teeth: systematic review with meta-analysis of laboratory studies |
| title_short | Effectiveness of horizontal posts to support MOD cavities compared with other restorative approaches in endodontically treated teeth: systematic review with meta-analysis of laboratory studies |
| title_sort | effectiveness of horizontal posts to support mod cavities compared with other restorative approaches in endodontically treated teeth systematic review with meta analysis of laboratory studies |
| topic | Fiber posts Inlay Onlay Horizontal posts Stress distribution Occlusal Ribbonds |
| url | https://doi.org/10.1186/s12903-025-06022-1 |
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