Influence of Cementation Strategies on the Incidence of Fiber Post Debonding in Root Canal Treated Teeth: A Systematic Review and Meta-Analysis.

Abstract

The objective of this systematic review was to investigate the incidence of debonding of fiber posts in root canal-treated teeth with a focus on the cementation strategy employed. This study was registered at PROSPERO (sob number: CRD42022334791). Six databases were searched, in addition to the gray literature. Two independent reviewers performed the selection of the studies as well as data collection. The risk of bias was assessed using the QUIPS (Quality in Prognosis Studies) tool. A meta-analysis was carried out to verify the overall incidence of debonding and the influence of different variables. Random effects were adopted, with a confidence interval (CI) of 95%. Twentynine studies met the eligibility criteria. The overall incidence of debonding was 2.7% (CI: 2.1-3.6%). Similar debonding rates were found when using total-etch and self-adhesive systems while a trend towards a higher debonding rate was observed for self-etch systems. Posterior teeth presented a higher incidence of debonding (3.9%) (CI: 2.5-6.0%) than anterior teeth (1.6%) (CI: 1.0-2.5%). A higher debonding incidence was found when 2 or fewer coronal walls were reported at 3.5% (CI:2.0-5.9%). Debondings in fiber posts are multifactorial, with no direct cementation strategy influence.