• Marc Bolla, Michele Muller-Bolla, Cybele Borg, Laurence Lupi-Pegurier, Olivier Laplanche, and Eric Leforestier.
• Biomatériaux Dentaires (Biomaterials), Faculté de Chirurgie Dentaire, 24 rue des diables bleus, Nice, France, 06 357.
• Cochrane Db Syst Rev. 2016 Nov 28; 11 (11): CD004623CD004623.

BackgroundThe foundation for the reconstruction of endodontically-treated teeth can be provided by a metal or a non-metal post and core system but no guidelines exist for choosing one or the other in particular clinical cases.ObjectivesTo assess the effectiveness of different post and core systems for the restoration of endodontically-treated teeth. The primary objective of this review was to compare the clinical failure rates of the different types of posts.Search MethodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2005, Issue 3), MEDLINE (from 1966 to September 2005), Scopus (from January 1985 to December 2004) and EMBASE (until December 2004). We looked through reference lists of articles and dental conference proceedings. We contacted researchers in the field and manufacturers.Selection CriteriaRandomised or quasi-randomised clinical trials (RCTs) comparing failures on endodontically-treated permanent teeth with different types of post. The outcomes were loss of retention, post fracture and root fracture.Data Collection And AnalysisTwo review authors independently assessed the quality of trials and extracted data. Study authors were contacted for additional information.Main ResultsTwo trials involving 317 participants were included but only one of them, involving 200 participants, compared metal to non-metal posts. The other answered to the secondary objective. The risk of failure was greater with metal-cast posts (9/98) compared to carbon fibre posts (0/97) (risk ratio (RR) = 0.05 (95% confidence interval (CI) 0.00 to 0.90)) but the study was at high risk of bias. Thus fewer failures occurred when using non-metal posts but the evidence is unreliable.Authors' ConclusionsOur systematic review could not specify which type of post and core system should be used when two or three dentine walls remain. More RCTs are needed to confirm whether fibre-reinforced post and core systems are superior and to clarify the influence of the remaining tooth structure on the treatment outcome of the different post and core systems available. Well-defined inclusion criteria focusing on the number of dentine walls (two or three) should be used.

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