Effect of surface treatment on the dislocation resistance of prefabricated esthetic fiber posts bonded with self-adhesive resin cement: A systematic review and meta-analysis

BACKGROUND: This systematic review aimed to determine the presence of any in vitro proof to validate the utilization of surface treatments to advance the bond strength of fiber posts to intraradicular dentin with self-adhesive resin cements. METHODOLOGY: Laboratory studies that assessed the push-out or pull-out bond strength of the prefabricated esthetic posts whose surface was treated with either chemical or physical treatment or a combination and bonded using self-adhesive resin cement within root canal model were included for this systematic review. The review began after obtaining the registration number from the International Prospective Register of Systematic Reviews (PROSPERO ID-CRD42020165009). Study reporting was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Relevant articles were identified using a literature database search in Web of Science, Scopus, PubMed, and EBSCO. Besides this, handsearch was also done to ensure complete capture of the articles. RESULTS: Fifteen articles were then selected and included in this study, out of which four were excluded for meta-analysis due to usage of the artificial substrate. It was shown that an additional step of surface treatment of esthetic fiber post did not result in significant improvement in dislocation resistance. Assessment of risk of bias categorized the available research into high risk and medium risk. The results showed heterogeneity. CONCLUSION: The use of additional steps such as chemical, mechanical, or a combination of post surface treatment does not have any added benefit. However, the results must be interpreted with caution due to methodological shortcomings.