Insufficient evidence to support or refute the effectiveness of conventional fillings over crowns for the restoration of root filled teeth

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Root canal filling is a regular dental procedure. However root filled teeth can be weaker than healthy ones so restoration of these teeth can prove challenging. The aim of this Cochrane review was to assess whether restoring endodontically treated teeth (with or without post and core) using crowns or conventional filling materials was more effective.

What did they do

The Cochrane Oral Health Group’s Trials Register, Cochrane CENTRAL, Medline , Embase  CINAHL and LILACS  databases  together with the reference lists of articles as well as ongoing trials registries were searched.Randomised controlled trials (RCTs) or quasi-randomised controlled trials in adult permanent teeth were included. Two review authors independently assessed trial quality and extracted data.

 They found

  • Only one trial judged to be at high risk of bias due to missing outcome data, was included. 117 participants with a root filled premolar tooth restored with a carbon fibre post, were randomised to either a full coverage metal-ceramic crown or direct adhesive composite restoration.
  • At 3 years there was no reported difference between the non-catastrophic failure rates in both groups.
  • De-cementation of the post and marginal gap formation occurred in a small number of teeth.

 They concluded

There is insufficient evidence to support or refute the effectiveness of conventional fillings over crowns for the restoration of root filled teeth. Until more evidence becomes available clinicians should continue to base decisions on how to restore root filled teeth on their own clinical experience, whilst taking into consideration the individual circumstances and preferences of their patients.

Fedorowicz Z, Carter B, de Souza RF, de Andrade Lima Chaves C, Nasser M, Sequeira-Byron P. Single crowns versus conventional fillings for the restoration of root filled teeth. Cochrane Database of Systematic Reviews 2012, Issue 5. Art. No.: CD009109. DOI: 10.1002/14651858.CD009109.pub2.


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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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