Marchionatti Ana Maria Estivalete, Wandscher Vinícius Felipe, Rippe Marília Pivetta, Kaizer Osvaldo Bazzan, Valandro Luiz Felipe
Universidade Federal de Santa Maria - UFSM, Faculty of Dentistry, Department of Restorative Dentistry, Santa Maria, RS, Brazil.
Braz Oral Res. 2017 Jul 3;31:e64. doi: 10.1590/1807-3107BOR-2017.vol31.0064.
The aim of this systematic review was to compare the clinical performance and failure modes of teeth restored with intra-radicular retainers. A search was performed on PubMed/Medline, Central and ClinicalTrials databases for randomized clinical trials comparing clinical behavior and failures of at least two types of retainers. From 341 detected papers, 16 were selected for full-text analysis, of which 9 met the eligibility criteria. A manual search added 2 more studies, totalizing 11 studies that were included in this review. Evaluated retainers were fiber (prefabricated and customized) and metal (prefabricated and cast) posts, and follow-up ranged from 6 months to 10 years. Most studies showed good clinical behavior for evaluated intra-radicular retainers. Reported survival rates varied from 71 to 100% for fiber posts and 50 to 97.1% for metal posts. Studies found no difference in the survival among different metal posts and most studies found no difference between fiber and metal posts. Two studies also showed that remaining dentine height, number of walls and ferrule increased the longevity of the restored teeth. Failures of fiber posts were mainly due to post loss of retention, while metal post failures were mostly related to root fracture, post fracture and crown and/or post loss of retention. In conclusion, metal and fiber posts present similar clinical behavior at short to medium term follow-up. Remaining dental structure and ferrule increase the survival of restored pulpless teeth. Studies with longer follow-up are needed.
本系统评价的目的是比较采用根管内固位体修复牙齿的临床性能和失败模式。在PubMed/Medline、Central和ClinicalTrials数据库中进行检索，以查找比较至少两种类型固位体的临床行为和失败情况的随机临床试验。从检测到的341篇论文中，选择了16篇进行全文分析，其中9篇符合纳入标准。手动检索又增加了2项研究，本评价共纳入11项研究。评估的固位体包括纤维桩（预成和定制）和金属桩（预成和铸造），随访时间从6个月到10年不等。大多数研究表明，所评估的根管内固位体具有良好的临床行为。纤维桩的报告生存率为71%至100%，金属桩为50%至97.1%。研究发现不同金属桩之间的生存率没有差异，大多数研究发现纤维桩和金属桩之间也没有差异。两项研究还表明，剩余牙本质高度、牙壁数量和箍效应可提高修复后牙齿的寿命。纤维桩失败主要是由于桩固位丧失，而金属桩失败大多与牙根折断、桩折断以及冠和/或桩固位丧失有关。总之，在短期至中期随访中，金属桩和纤维桩表现出相似的临床行为。剩余的牙齿结构和箍效应可提高无髓牙修复后的生存率。需要进行更长时间随访的研究。
