Displaying publications 1 - 20 of 35 in total

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  1. Yaacob I, Ariffin Z
    Singapore Med J, 1991 Feb;32(1):63-6.
    PMID: 2017709
    The case histories of 22 patients with lung abscess and empyema presenting to Hospital University Sains Malaysia (HUSM) between 1984 and 1989 are reviewed. The presenting features of both lung abscess and empyema were similar. The commonest predisposing factor was pneumonia, and the commonest organism isolated was Staphylococcus aureus but in the majority of cases, no causal organisms were identified. All the patients were treated with antibiotics and in addition, closed chest tube drainage was performed initially in all patients with empyema. Three patients with empyema required additional surgical drainage procedures. Death occurred in one patient with empyema and in one patient with lung abscess. The features, aetiology, treatment and outcome of thoracic empyema and lung abscess are discussed.
  2. Ariffin Z, Ngo H, McIntyre J
    Aust Dent J, 2006 Dec;51(4):328-32.
    PMID: 17256308
    BACKGROUND: This study investigated the extent to which a coating of 10% silver fluoride (AgF) on discs of glass jonomer cements (GIGs) would enhance the release of fluoride ion into eluting solutions at varying pH.

    MATERIALS AND METHODS: Forty discs each of Fuji LX, Fuji VII and of Vitrebond were prepared in a plastic mould. Twenty discs of each material were coated for 30 seconds with a 10% solution of AgF. Five discs each of coated and uncoated material were placed individually in 4m1 of differing eluant solutions. The eluant solutions comprised deionized distilled water (DDW) and three separate acetate buffered solutions at pH 7, pH 5 and pH 3. After 30 minutes the discs were removed and placed in five vials containing 4m1 of the various solutions for a further 30 minutes. This was repeated for further intervals of time up to 216 hours, and all eluant solutions were stored. Fluoride concentrations in the eluant solutions were estimated using a fluoride specific electrode, with TISAB IV as a metal ion complexing and ionic concentration adjustment agent. Cumulative fluoride release patterns were determined from the incremental data.

    RESULTS: The coating of AgF greatly enhanced the level of fluoride ion release from all materials tested. Of the uncoated samples, Vitrehond released the greater concentrations of fluoride ion, followed by Fuji VII. However, cumulative levels of fluoride released from coated samples of the GICs almost matched those from coated Vitrebond.

    CONCLUSIONS: It was concluded that a coating of 10% AgF on GICs and a resin modified GIC greatly enhanced the concentration of fluoride released from these materials. This finding might be applied to improving protection against recurrent caries, particularly in high caries risk patients, and in the atraumatic restorative technique (ART) of restoration placement.

  3. Khalaf S, Ariffin Z, Husein A, Reza F
    J Prosthodont, 2015 Jul;24(5):419-23.
    PMID: 25219956 DOI: 10.1111/jopr.12213
    PURPOSE: This study aimed to compare the surface roughness of maxillofacial silicone elastomers fabricated in noncoated and coated gypsum materials. This study was also conducted to characterize the silicone elastomer specimens after surfaces were modified.

    MATERIALS AND METHODS: A gypsum mold was coated with clear acrylic spray. The coated mold was then used to produce modified silicone experimental specimens (n = 35). The surface roughness of the modified silicone elastomers was compared with that of the control specimens, which were prepared by conventional flasking methods (n = 35). An atomic force microscope (AFM) was used for surface roughness measurement of silicone elastomer (unmodified and modified), and a scanning electron microscope (SEM) was used to evaluate the topographic conditions of coated and noncoated gypsum and silicone elastomer specimens (unmodified and modified) groups. After the gypsum molds were characterized, the fabricated silicone elastomers molded on noncoated and coated gypsum materials were evaluated further. Energy-dispersive X-ray spectroscopy (EDX) analysis of gypsum materials (noncoated and coated) and silicone elastomer specimens (unmodified and modified) was performed to evaluate the elemental changes after coating was conducted. Independent t test was used to analyze the differences in the surface roughness of unmodified and modified silicone at a significance level of p < 0.05.

    RESULTS: Roughness was significantly reduced in the silicone elastomers processed against coated gypsum materials (p < 0.001). The AFM and SEM analysis results showed evident differences in surface smoothness. EDX data further revealed the presence of the desired chemical components on the surface layer of unmodified and modified silicone elastomers.

    CONCLUSIONS: Silicone elastomers with lower surface roughness of maxillofacial prostheses can be obtained simply by coating a gypsum mold.

  4. Aal-Saraj AB, Ariffin Z, Masudi SM
    Aust Endod J, 2012 Aug;38(2):60-3.
    PMID: 22827817 DOI: 10.1111/j.1747-4477.2010.00241.x
    The aim of this study was to evaluate the antimicrobial activity of a new experimental nano-hydroxyapatite epoxy resin-based sealer (Nanoseal) with several other commercially available sealers; AH26, Tubliseal, Sealapex and Roekoseal against Enterococcus faecalis, Pseudomonas aeruginosa, Streptococcus mutans, Streptococcus sobrinus and Escherichia coli for up to 7 days. Agar diffusion was used in this study. Fifty Muller-Hinton agar plates were prepared and divided into five experimental groups (n = 10), for each micro-organism. Another 10 agar plates were used as positive and negative controls. Endodontic sealers were tested against each micro-organism. Inhibition zones produced were recorded. The results of this study showed that all test materials exhibited inhibition zones towards the tested micro-organisms for 7 days except for Roekoseal, which showed no inhibition zones. Nanoseal and AH26 exhibited similar zones of inhibition. Significant difference was found between Nanoseal and the other tested sealers (P < 0.001).
  5. Mohd Ariffin ZA, Jamaluddin FA
    Malays J Pathol, 2020 Dec;42(3):395-400.
    PMID: 33361720
    INTRODUCTION: One commonly used equation which continues to be widely mentioned in text books and hence familiar to clinical people is total calcium + 0.02 (40 - albumin). This equation was derived using cresophthalein complexone and bromocresol green (BCG) methods for measuring serum total calcium and serum albumin respectively. However this equation maybe invalid when applied to calcium and albumin results generated by alternative assays. Hence we aim to derive an albumin-adjusted calcium equation specific to our laboratory's total calcium and albumin methodologies.

    MATERIALS AND METHODS: A total of 3,175 adult University Malaya Medical Centre (UMMC) patients deemed free of any calcium metabolism disorders were selected and divided into two groups for derivation and validation. Simple linear regression associating total calcium and albumin was constructed from the data in the derivation group. The new albumin-adjusted calcium equation was validated in the validation group. Differences in calcium status classification following adjustments based on existing and new albumin-adjusted calcium equation was compared in a 469 hypoalbuminaemic patients.

    RESULT: The new albumin adjusted calcium equation was: total calcium + 0.014 x (39-albumin). Of the 469 hypoalbuminemic patients, 78 were classified differently based on new equation. Based on the new equation, 55 normocalcemic patients were classified as hypocalcemic and 22 were classified as normocalcemic instead of hyperclacaemic.

    CONCLUSION: Based on the newly derived albuminadjusted calcium equation 17% of patients had different adjusted calcium classifications. This could potentially impact in the management. It is recommended that laboratories derive equations specific to their calcium/albumin methods and analytical platforms.

  6. Khalaf S, Ariffin Z, Husein A, Reza F
    J Prosthodont, 2017 Dec;26(8):664-669.
    PMID: 28177575 DOI: 10.1111/jopr.12460
    PURPOSE: To compare the adhesion of three microorganisms on modified and unmodified silicone elastomer surfaces with different surface roughnesses and porosities.

    MATERIALS AND METHODS: Candida albicans, Streptococcus mutans, and Staphylococcus aureus were incubated with modified and unmodified silicone groups (N = 35) for 30 days at 37°C. The counts of viable microorganisms in the accumulating biofilm layer were determined and converted to cfu/cm2 unit surface area. A scanning electron microscope (SEM) was used to evaluate the microbial adhesion. Statistical analysis was performed using t-test, one-way ANOVA, and post hoc tests as indicated.

    RESULTS: Significant differences in microbial adhesion were observed between modified and unmodified silicone elastomers after the cells were incubated for 30 days (p < 0.001). SEM showed evident differences in microbial adhesion on modified silicone elastomer compared with unmodified silicone elastomer.

    CONCLUSIONS: Surface modification of silicone elastomer yielding a smoother and less porous surface showed lower adhesion of different microorganisms than observed on unmodified surfaces.

  7. Beh YH, Halim MS, Ariffin Z
    PeerJ, 2023;11:e16469.
    PMID: 38025677 DOI: 10.7717/peerj.16469
    BACKGROUND: This study aimed to evaluate the load capacity of maxillary central incisors with simulated flared root canal restored with different fiber-reinforced composite (FRC) post cemented with either self-adhesive or self-etch resin cement and its mode of fracture.

    METHODS: Sixty-five extracted maxillary incisors were decoronated, its canal was artificially flared and randomly categorized into group tFRC (tapered FRC post) (n = 22), mFRC (multi-FRC post) (n = 21), and DIS-FRC (direct individually shaped-FRC (DIS-FRC) post) (n = 22), which were further subdivided based on cementation resin. The posts were cemented and a standardized resin core was constructed. After thermocycling, the samples were loaded statically and the maximum load was recorded.

    RESULTS: The load capacity of the maxillary central incisor was influenced by the different FRC post system and not the resin cement (p = 0.289), and no significant interaction was found between them. Group mFRC (522.9N) yielded a significantly higher load capacity compared to DIS-FRC (421.1N). Overall, a 55% favorable fracture pattern was observed, and this was not statistically significant.

    CONCLUSION: Within the limitation of the study, it can be concluded that prefabricated FRC posts outperform DIS-FRC posts in terms of the load capacity of a maxillary central incisor with a simulated flared root canal. The cementation methods whether a self-adhesive or self-etch resin cement, was not demonstrated to influence the load capacity of a maxillary central incisor with a flared root canal. There were no significant differences between the favorable and non-favorable fracture when FRC post systems were used to restored a maxillary central incisor with a flared root canal.

  8. Ab-Ghani Z, Jaafar W, Foo SF, Ariffin Z, Mohamad D
    J Conserv Dent, 2015 Sep-Oct;18(5):355-9.
    PMID: 26430296 DOI: 10.4103/0972-0707.164028
    To evaluate the shear bond strength between the dentin substrate and computer-aided design and computer-aided manufacturing feldspathic ceramic and nano resin ceramics blocks cemented with resin cement.
  9. Abdul Hamid NF, Wan Bakar WZ, Ariffin Z
    Eur J Dent, 2019 Feb;13(1):17-21.
    PMID: 31170751 DOI: 10.1055/s-0039-1688740
    OBJECTIVE: This study was carried out to assess and compare the marginal gap of conventionally used metal onlays and new resin nanoceramic (RNC) (Lava Ultimate block) onlays.

    MATERIALS AND METHODS: This is an in vitro study using two extracted sound human mandibular molars. One tooth was prepared to receive the metal onlays and another one for the RNC onlays which were fabricated using the computer-aided design and computer-aided manufacturing (CAD/CAM) technology. Twelve metals and 12 ceramic onlays were fabricated before they were placed at their respective preparation and examined under the Leica stereomicroscope, M125C (Leica Microsystems, Wetzlar, Germany) for a marginal analysis. The gap width was measured at 10 predefined landmarks which included 3 points on the buccal and lingual surfaces each and 2 points each on the mesial and distal surfaces, respectively.

    STATISTICAL ANALYSIS: Mann-Whitney post hoc test was used for statistical analysis (P ≤ 0.05).

    RESULTS: Overall, the RNC onlays showed significant lower marginal gap with the exception of the landmarks 5 and 6 (on distolingual) and no significant difference at landmark 7 (on midlingual). It was observed that the marginal gap were all within the clinically acceptable limit of 120 μm.

    CONCLUSIONS: Based on the results obtained, it can be concluded that the RNC CAD/CAM onlays are a promising alternative to the metal onlays.

  10. Kermani S, Megat Abdul Wahab R, Zarina Zainol Abidin I, Zainal Ariffin Z, Senafi S, Hisham Zainal Ariffin S
    Cell J, 2014 Feb 3;16(1):31-42.
    PMID: 24518973
    Our research attempted to show that mouse dental pulp stem cells (DPSCs) with characters such as accessibility, propagation and higher proliferation rate can provide an improved approach for generate bone tissues. With the aim of finding and comparing the differentiation ability of mesenchymal stem cells derived from DPSCs into osteoblast and osteoclast cells; morphological, molecular and biochemical analyses were conducted.
  11. Zainal Ariffin SH, Kermani S, Megat Abdul Wahab R, Senafi S, Zainal Ariffin Z, Abdul Razak M
    ScientificWorldJournal, 2012;2012:827149.
    PMID: 22919354 DOI: 10.1100/2012/827149
    A major challenge in the application of mesenchymal stem cells in cartilage reconstruction is that whether the cells are able to differentiate into fully mature chondrocytes before grafting. The aim of this study was to isolate mouse dental pulp stem cells (DPSC) and differentiate them into chondrocytes. For this investigation, morphological, molecular, and biochemical analyses for differentiated cells were used. To induce the chondrocyte differentiation, DPSC were cultured in chondrogenic medium (Zen-Bio, Inc.). Based on morphological analyses using toluidine blue staining, proteoglycan products appear in DPSC after 21 days of chondrocyte induction. Biochemical analyses in differentiated group showed that alkaline phosphatase activity was significantly increased at day 14 as compared to control (P < 0.05). Cell viability analyses during the differentiation to chondrocytes also showed that these cells were viable during differentiation. However, after the 14th day of differentiation, there was a significant decrease (P < 0.05) in the viability proportion among differentiated cells as compared to the control cells. In RT-PCR molecular analyses, mouse DPSC expressed Cd146 and Cd166 which indicated that these cells belong to mesenchymal stem cells. Coll I and Coll II markers showed high expression after 14 and 21 days, respectively. In conclusion, this study showed that DPSC successfully differentiated into chondrocytes.
  12. Zainal Ariffin SH, Yamamoto Z, Zainol Abidin IZ, Megat Abdul Wahab R, Zainal Ariffin Z
    ScientificWorldJournal, 2011;11:1788-803.
    PMID: 22125437 DOI: 10.1100/2011/761768
    Tooth movement induced by orthodontic treatment can cause sequential reactions involving the periodontal tissue and alveolar bone, resulting in the release of numerous substances from the dental tissues and surrounding structures. To better understand the biological processes involved in orthodontic treatment, improve treatment, and reduce adverse side effects, several of these substances have been proposed as biomarkers. Potential biological markers can be collected from different tissue samples, and suitable sampling is important to accurately reflect biological processes. This paper covers the tissue changes that are involved during orthodontic tooth movement such as at compression region (involving osteoblasts), tension region (involving osteoclasts), dental root, and pulp tissues. Besides, the involvement of stem cells and their development towards osteoblasts and osteoclasts during orthodontic treatment have also been explained. Several possible biomarkers representing these biological changes during specific phenomenon, that is, bone remodelling (formation and resorption), inflammation, and root resorption have also been proposed. The knowledge of these biomarkers could be used in accelerating orthodontic treatment.
  13. Zainal Ariffin SH, Mohamed Rozali NA, Megat Abdul Wahab R, Senafi S, Zainol Abidin IZ, Zainal Ariffin Z
    Cytotechnology, 2016 Aug;68(4):675-86.
    PMID: 26231833 DOI: 10.1007/s10616-014-9819-8
    Transplantation of stem cells requires a huge amount of cells, deeming the expansion of the cells in vitro necessary. The aim of this study is to define the optimal combination of basal medium and serum for the expansion of suspension peripheral blood mononucleated stem cells (PBMNSCs) without resulting in loss in the differentiation potential. Mononucleated cells were isolated from both mice and human peripheral blood samples through gradient centrifugation and expanded in α-MEM, RPMI, MEM or DMEM supplemented with either NBCS or FBS. The suspension cells were then differentiated to osteoblast. Our data suggested that α-MEM supplemented with 10 % (v/v) NBCS gives the highest fold increase after 14 days of culture for both mice and human PBMNSCs, which were ~1.51 and ~2.01 times, respectively. The suspension PBMNSCs in the respective medium were also able to maintain osteoblast differentiation potential as supported by the significant increase in ALP specific activity. The cells are also viable during the differentiated states when using this media. All these data strongly suggested that α-MEM supplemented with 10 % NBCS is the best media for the expansion of both mouse and human suspension PBMNSCs.
  14. Alhajj MN, Ariffin Z, Celebić A, Alkheraif AA, Amran AG, Ismail IA
    PLoS One, 2020;15(9):e0239232.
    PMID: 32941532 DOI: 10.1371/journal.pone.0239232
    BACKGROUND: The perception of dentofacial esthetics differs considerably between patients and dentists. Patient's expectations regarding his/her esthetics are important and should be assessed ahead of any planning of esthetic treatment. The aim of this study was to explore the differences in perception of orofacial appearance by laypersons with different social and demographic status.

    MATERIALS AND METHODS: Self-administered questionnaires were distributed to 400 subjects. The questionnaire comprised three parts; the first part addressed the demographic variables. The second part queried about dental prosthesis, orthognathic or plastic surgery, and/or ongoing or previous orthodontic treatment. The third part included the Arabic version of the-8-item Orofacial Esthetic Scale (OES-Ar) whose responses were scored in the 5-point Likert scale. These scores were compared by different grouping factors (age, gender, marital status, and education) using non-parametric Mann-Whitney U and Kruskal Willis tests with 95% confidence interval (α > 0.05).

    RESULTS: A total of 268 questionnaires were eligible for analysis, representing 67% response rate. The satisfaction with facial profile appearance was the highest (4.0±1.1) followed by facial appearance (3.9±1.1), while the color of teeth was the least satisfying item (3.1±1.3). No significant differences were found between age groups for the mean summary score as well as for each item independently. No significant difference was found between both sexes except for the last item "overall impression". Married subjects rated one item (alignment of teeth) better than their counterparts. Positive perception of orofacial appearance increased significantly with the increase of education level, the perception of the oral health status, and the perception of the general health status.

    CONCLUSION: Good oral health and/or high education level are significant determinants of more positive perception of orofacial esthetic appearance. Patients with these characteristics might be more concerned about their orofacial appearance, and this should be taken into consideration before planning any esthetic restorative dental treatment.

  15. Alhajj MN, Salim NS, Johari Y, Syahrizal M, Abdul-Muttlib NA, Ariffin Z
    Acta Stomatol Croat, 2020 Sep;54(3):263-272.
    PMID: 33132389 DOI: 10.15644/asc54/3/4
    Objective: Endodontically treated teeth may require posts for retaining the core and replacing the coronal structures that have been lost. The objective of this study was to evaluate and compare the push-out bond strength between different types of post cemented with different types of luting cement at different types of root level.

    Materials and Methods: In this in-vitro study, a total of 48 single-rooted permanent human teeth were decoronated, and the roots were treated endodontically. Following post space preparation, the sample was divided into four groups (n= 12 each) based on the types of post and cement. Two different types of post [GC everStick®POST (ES) and Parapost® Fiber LuxTM (PF)], and two different types of cement [G-CEMTM (G), and RelyXTM Unicem (R)] were used according to the manufacturer's instructions. All roots were sectioned at the coronal and middle thirds with a thickness of 3±0.1mm. The Push-out bond strength (PBS) test was performed using a universal testing machine at a cross-head speed of 0.5mm/ min. The bond strength values were recorded, and the data were analyzed using the SPSS program. Apart from descriptive statistics, three-way ANOVA was used for the interaction of the independent variables (post, cement, and root level). For differences between the groups, the Mann-Whitney U test was used. A P-value of less than 0.05 was considered significant for all analyses.

    Results: Push-out bond strength of samples at the middle level (11.38±10.31 MPa), with PF posts (11.18±9.98 MPa), and of those luted with RelyXTM Unicem cement (13.26±8.73 MPa) was higher than that of their counterparts. The PBS means of RelyXTM Unicem cement at both root levels were much higher than PBS means of G-CEMTM cement. Three-way ANOVA test revealed a significant effect for each variable with a higher effect of cement (Sum of Squares= 1310.690; P< 0.001). No significant difference (P= 0.153) was found between the coronal and middle parts and between ES and PF posts (P= 0.058). However, a highly significant difference (P< 0.001) was found between RelyXTM Unicem and G-CEMTM cements.

    Conclusion: The type of cement had a significant effect on push-out bond strength with RelyXTM Unicem which had higher values than G-CEMTM. However, the type of post and root level had no significant effect on PBS, although Parapost® Fiber LuxTM and middle root level had higher values than their counterparts.

  16. Ashraf S, Al-Maweri SA, Alaizari N, Umair A, Ariffin Z, Alhajj MN, et al.
    J Oral Pathol Med, 2020 Nov;49(10):969-976.
    PMID: 32746493 DOI: 10.1111/jop.13093
    BACKGROUND: Oral lichen planus (OLP) is a relatively common inflammatory disease, with unclear etiology. A number of studies have linked Epstein-Barr virus (EBV) with OLP. The present systematic review and meta-analysis aimed to evaluate the available evidence regarding the potential association between EBV and OLP.

    METHODS: Online databases (PubMed, Scopus, Web of Science, ProQuest, and Google Scholar) were searched from date of inception till May 2020. Studies were included if they met the following criteria: 1) observational studies that assessed the relationship between EBV and OLP, 2) the study comprised OLP patients and control subjects, 3) diagnosis of OLP was confirmed histopathologically, and 4) articles were in English. Studies without control groups, experimental studies, case reports, and reviews were excluded. The fixed-effects model was performed for meta-analyses using RevMan 5.3 software.

    RESULTS: A total of 10 studies comprising 386 OLP cases and 304 controls were included. Of these, only 8 studies were eligible for the meta-analysis. The results of the quality assessment showed that only 2 studies were of high quality, while the remaining studies were of moderate quality. The results of the pooled eight studies revealed a significant positive association between EBV and OLP (OR = 4.41, 95% CI: [2.74, 7.11], P 

  17. Alhajj MN, Mashyakhy M, Ariffin Z, Ab-Ghani Z, Johari Y, Salim NS
    J Contemp Dent Pract, 2020 Sep 01;21(9):956-960.
    PMID: 33568578
    AIM: This study aimed to assess the quality and readability of the available health information on the net regarding denture hygiene.

    MATERIALS AND METHODS: Three search engines (Google, Yahoo!, and Bing) were searched. The first 20 consecutive websites from each engine were obtained and checked for eligibility. For the quality of the websites, the Health on the Net Foundation Code of Conduct (HONcode), the DISCERN tool, the Journal of the American Medical Association (JAMA) Benchmarks, and Google PageRank were used for the assessment of the included websites. For readability, an online web tool was used, including well-known analyzing indices [Flesch Kincaid grade level (FKGL), Simple Measure of Gobbledygook (SMOG), and Flesch Reading Ease (FRE)]. The acceptable readability level was set to be ≥80.0 for the FRE and <7 for the FKGL and SMOG. The data were presented in frequencies and percentages.

    RESULTS: Out of the 60 screened websites, 14 websites were eligible for analysis. There was only one (7.1%) website that had the HONcode seal. The mean score of all websites based on the DISCERN tool was 29.6 ± 12.1, with no website achieved the high score (≥65). Only one (7.1%) website scored >5 based on Google PageRank. Regarding JAMA benchmarks, all websites achieved a mean score of 2.57 ± 1.1. The mean grade level based on the FKGL was 8.4 ± 6.3. All websites had a score of <7 according to the SMOG index. The mean score of the readability ease index was 90.5 ± 16.4.

    CONCLUSION: Most of the dental health information on denture hygiene available on the Arabic websites did not have the required level of quality, regardless of being readable and comprehensible by most of the general people.

    CLINICAL SIGNIFICANCE: Directing the patients to the appropriate websites related to their cases is the responsibility of the dentists.

  18. Alhajj MN, Qi CH, Sayed ME, Johari Y, Ariffin Z
    J Prosthodont, 2021 Sep 09.
    PMID: 34499376 DOI: 10.1111/jopr.13428
    PURPOSE: The fracture resistance of dental post systems is influenced by the material of the post. The purpose of this systematic review and meta-analysis was to assess if there is a difference in fracture resistance between prefabricated dental titanium posts and fiber posts.

    METHODS: An online electronic search was performed using the PubMed, Scopus, and Web of Science databases for in vitro studies published from 2010 to 2020 in English. The retrieved eligible studies that compared the fracture resistance of titanium and fiber posts on human teeth were selected. The pooled standardized mean difference (SMD) with a 95% confidence interval was calculated. In addition, the trial sequential analysis (TSA) was performed to test if the available studies are sufficient to make conclusive evidence.

    RESULTS: Of the 1165 retrieved studies, 17 studies were included in the qualitative analysis, while 16 studies were included in the quantitative analysis. Because of the high heterogeneity among studies, data from 10 studies were pooled and submitted to TSA. A total of 852 teeth were evaluated for fracture of the posts in 27 independent comparison groups. The pooled effect of the residual studies revealed no significant difference between titanium and fiber posts (SMD = -0.12; 95% CI = -0.30, 0.06; p = 0.20). Results of the TSA revealed no conclusive evidence.

    CONCLUSIONS: The results of the current evidence revealed no significant difference between fiber and titanium posts. The evidence is insufficient, and more standardized in vitro studies are required.

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