INTRODUCTION

There has been a radical transformation in the dental restorative industry in recent years that has seen a shift from traditional methods to novel alternate materials that record enhanced outcomes [1-3]. The treatment of the root canal results in a considerable lowering of the strength of the tooth, hence, it necessitating post-endodontic restoration to help it fortify.  Raju et al. (2021) claim that flowable composites are utilized in bulk-fill and conventional modes since they are easy to handle and have the ability to penetrate the complex spaces of cavities [4]. However, as Shah et al. (2021) noted there is a need to consider the diminished tooth’s elasticity and morphology of the lost structure of the tooth during post-endodontic treatment [5]. This idea means that the selection of the restoration material should be a careful endeavor that is reported in the existing literature.

Fibers can be used as restorative materials during post-endodontic treatment to avoid tooth fractures. Fibers can modify the stress by initiating a Monoblock effect that aids to dispel the stress along the tooth’s long axis [5]. Fibers can also prevent the formation of cracks due to the dispersal of stress to the fibers from the polymer matrix. Specific fibers such as glass fibers, short fiber-reinforced composites, and polythene fibers can be leveraged as core materials. Polythene fiber-reinforced composites help in changing the pattern of the stress as well as transferring and distributing stress. On the other hand, glass fibers avail adequate aesthetics and a reinforcing capacity. Modifying effect on the stress provided by the composite polyethylene fiber combination [6].

Glass fiber-reinforced composite is one of the materials that can be used in dentistry for restoration. Safwat et al. (2021) assert that enclosing glass fibers into a resin matrix produces glass fiber-reinforced composites [7]. Glass fibers exist in numerous compositions such as E-glass, S-glass, D glass, AR glass, A glass, and C glass. These different forms of glass fibers have diverse uses and properties despite that they are all amorphous and formed of a 3-dimensional silica network characterized by a random arrangement of oxygen and other atoms [7]. Various advantages are associated with the use of glass fiber-reinforced composite in dental restoration. For instance, they provide non-corrosive, acceptable aesthetics, metal-free, high toughness, and non-allergic effect. Also, this dental material can be tailored to help address the specific needs of numerous dental applications. This systematic review aims to establish the efficacy of glass fiber-reinforced composite restoration in the dental industry.

MATERIALS AND METHODS

The methodology discussed in this section includes the search strategy and the exclusion and inclusion criteria for the articles considered in the systematic review. The selection of articles was based on the Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. This guiding principle is comprised of various components such as the identification of articles, screening of the selected studies, eligibility, and inclusion. The PICO question that guided the research is as follows: Among patients undergoing dental restoration, how does the effectiveness of glass fiber-reinforced composite restoration compare to other restoration materials?

Search Strategy

The search strategy entailed looking for reliable sources to provide data that expound on the topic. As a result, different databases were used to obtain a variety of articles that availed data from different viewpoints based on the area of focus for each study. The first search strategy was to formulate keywords that could be used to narrow down the content of interest. The keywords include “glass fiber-reinforced composite” and “dental restoration.” The databases utilized include EBSCO host, PubMed, SCOPUS, and Google Scholar.

Inclusion Criteria

For this systematic review, the inclusion criteria for articles included setting some requirements that must be met before a study is selected. The first criterion entailed identifying documents that focus on glass fiber-reinforced composite. Second, all articles that were peer-reviewed and scholarly were considered for review. Also, all the selected articles were printed in English. Finally, articles that discussed the restoration of endodontically treated teeth were considered for review.

Exclusion Criteria

The first criteria for exclusion entailed examining the abstract to determine whether the study focused on glass fiber-reinforced composite. Articles that focused on other dental restoration materials without mentioning glass fiber-reinforced composite were not included for review. Also, studies that had only abstracts without full access to the article were not considered for review.

The elaborate inclusion and exclusion strategy was meant to ensure that the selected articles are reliable in terms of the information contained therein. As a result, the obtained studies addressed the topic of interest using different approaches that will be presented in the discussion section. As shown in Figure 1 below, the PRISMA guidelines were used to screen and select articles.

Bias Risk Assessment

To determine whether there was any form of bias in the selected studies, the Cochrane risk of bias assessment tool was used. This tool is crucial in assessing the risk of bias in randomized trials by concentrating on different aspects of reporting, conduct, and trial design. The rationale for using the Cochrane risk of the bias assessment tool is to evaluate the validity of the outcomes by examining how the study was conducted. The five domains that the tool utilizes include performance, selection, reporting, attrition, and other bias. Tables 1 and 2 below display the Cochrane risk of a bias assessment tool and the overall risk of biased judgment respectively.

RESULTS AND DISCUSSION

As shown in the PRISMA guidelines above, the employed search strategy yielded a total of 130 studies. Among these 130, the exclusion and inclusion metrics were applied to identify articles that could qualify for review. The first step was to remove the duplicates, a process that saw 35 articles excluded, leaving 95 studies for screening., The titles of the 95 articles were screened, a procedure that led to the further exclusion of 70 articles. The remaining 25 articles were assessed for eligibility, yielding 4 articles that were included in the review. The included articles addressed glass fiber-reinforced composite. Those excluded did not meet the set criteria for selection such as not having access to full texts. The four picked articles provided comprehensive information about glass fiber-reinforced composite restoration and its efficacy compared to other restoration materials. Table 3 below displays a summary of the included studies.