Effective luting agents for glass-fiber posts: A network meta-analysis

The aims of this study were to systematically review the literature and compare the relative effects of various luting agents on bonding between glass-fiber posts and root canal dentin in short- and long-term aging conditions. The literature was electronically searched in PubMed, Embase, and Scopus. A manual search was performed by scanning the reference lists of the included studies. Two reviewers independently conducted the selection of studies, data extraction, and risk of bias assessment. Pairwise meta-analyses were based on random effect models. Network meta-analyses were conducted within a frequentist framework with a multivariable random effects approach. The standardized mean difference and 95% confidence interval was calculated. One hundred and eighteen studies were included and assessed the effects of five luting agents. For pairwise meta-analyses, in short-term aging conditions, a significantly higher bond strength of self-adhesive resin cement (SARC) compared to etch-and-rinse adhesive composite resin core material (ERCM) in the total, coronal, and middle regions. In long-term aging conditions, a significantly higher bond strength of ERCM compared to etch-and-rinse adhesive resin cement (ERRC) in all regions. Furthermore, SARC showed a significantly higher bond strength compared to self-etch adhesive composite resin core material (SECM) in the total, middle, and apical regions. For network meta-analyses, in the apical region, a significantly higher bond strength of SARC compared to ERRC in both aging conditions. The SARC tended to be the most effective luting agent in bonding between glass-fiber posts and root canal dentin in short- and long-term aging conditions. [Display omitted] •Self-adhesive resin cement is effective in bonding glass-fiber posts to root canal.•Etch-and-rinse adhesive resin cement is ineffective in bonding glass-fiber posts.•Self-etch adhesives exhibit superior short-term bond strength than etch-and-rinse systems.•Composite core materials exhibit superior long-term bond strength than resin cements.