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. 2025 Feb;50(1):e5.
doi: 10.5395/rde.2025.50.e5. Epub 2025 Feb 17.

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

Meghana Aditya Vartak  1 , Vibha Rahul Hegde  1 , Sanitra Rahul Hegde  1 , Ushaina Fanibunda  1
Affiliations

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

Meghana Aditya Vartak et al. Restor Dent Endod. 2025 Feb.

Abstract

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.

Keywords: Fracture strength; Post and core technique; Ribbond; Systematic review.

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Conflict of interest statement

CONFLICT OF INTEREST

No potential conflict of interest relevant to this article was reported.

Figures

Figure 1.
Figure 1.
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flowchart showing search strategy and selection of studies.
Figure 2.
Figure 2.
Overall summary of the risk of bias assessment.
Figure 3.
Figure 3.
Meta-analysis comparing fracture resistance of the Ribbond post (Ribbond, Inc., Seattle, WA, USA) groups and other experimental groups. (A) Ribbond posts and endodontically-treated teeth (ETT) without posts. (B) Ribbond posts and prefabricated metal posts. (C) Ribbond posts and prefabricated fiber posts. (D) Ribbond posts and custom e-glass fiber posts. CI, confidence interval; SD, standard deviation; SMD, standardized mean difference.
Figure 4.
Figure 4.
Begg’s Funnel plot with 95% confidence intervals demonstrating symmetric distribution with the absence of systematic heterogeneity of individual study compared with the standard error (SE) of each study, indicating an absence of any publication bias. SMD, standardized mean difference.
See this image and copyright information in PMC

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