Effect of partial ferrule on fracture resistance of endodontically treated teeth: A meta-analysis of in-vitro studies

Fuad Ateik Al-Sanabani; Bandar Mohammed Al-Makramani; Wafa Hassan Alaajam; Mohammed Sultan Al-Ak'hali; Mohammed Nasser Alhajj; Mohammad Zakaria Nassani; Mounzer Assad; Sadeq Ali Al-Maweri

doi:10.2186/jpr.JPR_D_22_00170

Effect of partial ferrule on fracture resistance of endodontically treated teeth: A meta-analysis of in-vitro studies

J Prosthodont Res. 2023 Jul 31;67(3):348-359. doi: 10.2186/jpr.JPR_D_22_00170. Epub 2023 Jan 14.

Authors

Affiliations

¹ Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia.
² Department of Restorative Dentistry, Faculty of Dentistry, Sana'a University, Sana'a, Yemen.
³ Department of Restorative Dental Science, College of Dentistry, King Khalid University, Abha, Saudi Arabia.
⁴ Department of Conservative Dentistry, Faculty of Dentistry, Sana'a University, Sana'a, Yemen.
⁵ Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia.
⁶ Department of Periodontology, Faculty of Dentistry, Sana'a University, Sana'a, Yemen.
⁷ Department of Prosthodontics, Faculty of Dentistry, Thamar University, Dhamar, Yemen.
⁸ Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, Dar Al Uloom University, Riyadh, Saudi Arabia.
⁹ Department of Oral Surgery, Faculty of Dentistry, Tishreen University, Lattakia, Syria.
¹⁰ College of Dental Medicine, QU Health, Qatar University, Doha, Qatar.

PMID: 36642507
DOI: 10.2186/jpr.JPR_D_22_00170

Abstract

Purpose: The present meta-analysis aimed to answer the following research question: In endodontically treated teeth (ETT), what is the effect of partial ferrule (PF) on fracture resistance compared to complete ferrule (CF) and/or no ferrule (NF)?

Study selection: PubMed, Scopus, Web of Science, and Google Scholar were searched for relevant studies published until May 20, 2022. In vitro studies that compared the effect of partial ferrule with that of complete ferrule and/or no ferrule on fracture resistance of ETT were included. The studies were assessed for risk of bias, and a meta-analysis was performed.

Results: Seventeen in vitro studies comprising 807 teeth were included. Nine studies were at a high risk of bias and eight presented a moderate risk of bias. Overall, the results showed that CF was superior to PF in increasing fracture resistance (SMD= 0.93, CI_95%= 0.57-1.29, P< 0.0001), with no change in the effect based on the type of teeth (P< 0.001). However, the subgroup analysis found that PF 2 mm buccal, lingual, and buccal and lingual ferrule were comparable to CF (P= 0.06). Additionally, the PF group showed significantly higher fracture resistance than the NF group (SMD= 2.02, CI_95%= 1.54-2.49, P< 0.00001).

Conclusions: Although CF design provided the highest fracture resistance to restored ETT, PF can still be a viable option for restoring ETT in cases where CF is not feasible.

Keywords: Endodontically treated teeth; Fracture resistance; Partial ferrule.

Publication types

Meta-Analysis

MeSH terms

Crowns
Dental Stress Analysis
Humans
Post and Core Technique*
Tooth Fractures* / prevention & control
Tooth, Nonvital*