Os riscos de falhas são maiores em restaurações com retentores metálicos comparado aos pinos de fibra? Revisão sistemática e meta-análise

Abstract

This study aimed to evaluate evidence on failure rates (FR) of endodontically treated teeth (ETT) restored with fiber (FP) or metallic (MP) posts. The review protocol was registered in PROSPERO (CRD42020189792). Randomized (RCT) and prospective (EP) clinical trials comparing failures between FP and MP restorations for ETT were eligible. A search for articles was conducted via PubMed, Web of Science, Scopus, Cochrane, gray literature, and manual search without language or date restrictions. Meta-analyses evaluated FR through the risk ratio (RR). For the analysis of the risk of bias, the Cochrane and ROBINS-I collaboration tool were used, and the GRADE tool was used for the certainty of the evidence. Ten clinical trials were selected, totaling 844 ETTs with 453 FPs and 391 MPs. FPs presented FR similar to MPs (P = 0.39; RR: 0.82). A subgroup analysis showed the absence of differences in FR between FPs and MPs in relation to the anterior region (P = 0.60; RR: 0.88), posterior region (P = 0.52; RR: 1.18), root fracture (P = 0.44; RR: 0.78) and post decementing (P = 0.56; RR: 1.27). In addition, the FPs presented FR similar to prefabricated MP (P = 0.36; RR: 0.88) and cast MP (P = 0.60; RR: 0.88). The RCT and EP studies had a low risk of bias, however, the certainty of evidence was classified as low. FPs and MPs can be considered to restore ETTs as they have similar FRs, regardless of region and MP type. However, due to the low certainty of evidence, more and well-designed RCTs are encouraged to re-evaluate these findings.