Fracture resistance and failure modes of endodontically-treated permanent teeth restored with Ribbond posts vs other post systems: a systematic review and meta-analysis of in vitro studies

Objectives: This systematic review aimed to investigate the fracture resistance and mode of failure of endodontically-treated permanent teeth restored with Ribbond posts (Ribbond, Inc.) compared with endodontically-treated permanent teeth restored with other post systems.Methods: A comprehensive, systematic literature search was carried out using several electronic databases: MEDLINE/PubMed, Google Scholar, and Cochrane Library. Two separate researchers were appointed to identify the studies meeting the eligibility criteria, and to perform the data extraction, risk of bias, and quality assessment.Results: Twelve studies were included in the quantitative analysis. Meta-analysis was performed with 11 of the 12 included articles. The meta-analysis showed that Ribbond posts have a fracture strength less than prefabricated metal posts, cast metal posts, and prefabricated fiber posts and greater than custom e-glass fiber posts. Mode of failure analysis revealed that Ribbond posts have the most favorable non-catastrophic fractures.Conclusions: Although Ribbond posts have lower fracture resistance, their favorable mode of failure makes them potentially the most biomimetic post system.