Fracture strength of CAD/CAM glass fiber post-and-cores: a systematic review.

Abstract

Background/objectives/introduction: Endodontically treated teeth with extensive coronal tissue loss often require post-and-core restorations to provide retention and support for definitive restorations. Recent advances in computer-aided design/computer-aided manufacturing (CAD/CAM) technology have enabled the fabrication of customized glass fiber post-and-core systems with improved adaptation to root canal anatomy. However, evidence regarding their fracture strength remains inconsistent. This systematic review aimed to evaluate the fracture strength of CAD/CAM-fabricated glass fiber post-and-core systems, compare their performance with that of other post systems, and identify the factors influencing their fracture strength.

Materials and methods: A systematic review was conducted according to PRISMA guidelines and registered in PROSPERO (CRD420251038278). Electronic searches were performed in PubMed, Scopus, Web of Science, and Cochrane Library in January 2025 and updated in February 2026. Studies evaluating the fracture strength of CAD/CAM glass fiber post-and-core systems were included. Data regarding study characteristics, materials, testing methods, aging procedures, fracture strength outcomes, failure modes, and principal findings were extracted. Methodological quality was assessed using a modified CONSORT checklist adapted for in vitro studies.

Results: A total of 17 studies met the eligibility criteria. Fracture strength values varied considerably according to material composition, testing protocols, and experimental conditions. CAD/CAM glass fiber post-and core systems generally demonstrated fracture strength comparable to cast metal and other contemporary post systems. Improved adaptation to root canal anatomy and thinner cement layers were consistently reported. Although some materials exhibited higher fracture strength values, CAD/CAM glass fiber posts were frequently associated with more favorable and repairable failure modes.

Conclusions: CAD/CAM-fabricated glass fiber post-and-core systems represent a promising alternative to conventional post systems, providing fracture strength comparable to established restorative options while promoting more favorable failure behavior. However, methodological heterogeneity among studies highlights the need for standardized testing protocols and further clinical investigations.