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A flood tide of systematic reviews on endodontic posts: methodological assessment using of R-AMSTAR

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Abstract

Objectives

To help the dental practitioner solve a specific clinical problem, systematic reviews (SRs) are seen as the best guide. In addition to the unmanageable quantity of SRs, however, one should be aware of their variable quality. The present review describes the methodological quality of SRs on postendodontic restorations to work out the value of these reviews for the dental practitioner.

Methodology

SRs were searched in April 2012, independently and in triplicate. Post survival was used as measure of outcome. The methodological quality of included SRs was assessed with the Revised Assessment of Multiple Systematic Reviews (R-AMSTAR) checklist. Kappa statistics were used to assess reviewer agreement.

Results

Three hundred sixty-three papers were retrieved from the initial search. Ten SRs were included. One SR achieved a high R-AMSTAR score, whereas the other nine SRs achieved scores that indicate a substantial lack of methodological quality. Especially the items “grey literature,” “combination of findings,” “likelihood of publication bias,” and conflict of interest” showed low R-AMSTAR scores. The three reviews with the highest R-AMSTAR scores tended to conclude that fewer failures occurred when using nonmetal posts. The reviewer agreement was excellent (kappa ranged from 0.79 to 0.85) in the R-AMSTAR classification.

Conclusion

The approach presented revealed a lack of SRs with high methodological quality. Thus, no decisive conclusion can be drawn with respect to this topic. It appears that there is a trend for the superiority of fiber-reinforced posts.

Clinical relevance

SRs must be of high methodological quality. This can be achieved by taking into consideration the results of this review. Improved methodological quality would make SRs more supportive for the general practitioner.

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Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Prosthodontics, Section Biomaterial Research, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany

    M. Schmitter

  2. Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, CC3, Berlin, Germany

    G. Sterzenbach

  3. Department of Oral Sciences, University of Otago, Dunedin, New Zealand

    C. M. Faggion Jr.

  4. Department of Periodontology, Endodontology and Cariology, University of Basel, Basel, Switzerland

    G. Krastl

  5. Department of Oral Surgery, Biomaterials Unit, School of Dentistry, University of Birmingham, Birmingham, UK

    G. Krastl

Authors
  1. M. Schmitter
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  2. G. Sterzenbach
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  3. C. M. Faggion Jr.
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  4. G. Krastl
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Corresponding author

Correspondence to M. Schmitter.

Additional information

Dr. Faggion is a Colgate senior lecturer at the university of Otago. This position is partially supported by an unrestricted grant from Colgate-Palmolive New Zealand to the university of Otago.

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Schmitter, M., Sterzenbach, G., Faggion, C.M. et al. A flood tide of systematic reviews on endodontic posts: methodological assessment using of R-AMSTAR. Clin Oral Invest 17, 1287–1294 (2013). https://doi.org/10.1007/s00784-013-0945-z

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  • DOI: https://doi.org/10.1007/s00784-013-0945-z

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