Influence of presence or absence of posts on the failure rates of post endodontic restorations: A systematic review and meta-analysis

AIM: The study was designed to evaluate the existing evidence on the failure rates of post-endodontic restorations retained with and without post in endodontically treated teeth (ETT). SETTINGS AND DESIGN: Preferred Reporting Items for Systematic Reviews and Meta-Analyses- Protocol (PRISMA-P) guidelines were used to formulate the review. MATERIALS AND METHODS: Randomized controlled trials (RCT's) and prospective clinical studies comparing post endodontic restorations retained with and without post were included. PubMed/Medline, Embase, Cochrane Library and Scopus databases were searched to recognize relevant full-text articles in English language. The quality of the RCT's were evaluated using the Cochrane collaboration tool to assess the risk of bias and reported as having high, low or unclear risk. Random-effects model at a 95% confidence interval was used for the meta-analysis. STATISTICAL ANALYSIS USED: Meta-analyses was performed using the Mantel -Haenszel method31 and risk ratio, with a 95% confidence interval (CI), was estimated for dichotomous data. Random effects model32 was used as the pooling method and 95% confident interval (α = .05 for RR values) in Review Manager (RevMan) [Computer program]. Version 5.4. The Cochrane Collaboration, 2020). RESULTS: Four studies comparing post retained and post free restorations in ETT with a total of 916 restorations were included in the analysis. The total risk ratio was 2.16, (95% CI:1.25 to 3.72). CONCLUSION: ETT with post retained restorations exhibited significantly lower failure rates compared to restorations without post. Well-designed RCT's are warranted to develop a clinical protocol with respect to post-retained restorations.