Fiber post-and-core led the strongest functional recovery after tooth defect restoration
In a retrospective cohort of 200 patients with tooth defects, fiber post-and-core restoration produced the most favorable balance of chewing performance, periodontal measures, and gingival crevicular fluid inflammatory markers at 6 months. Bite force and masticatory efficiency were higher after fiber restoration than after zirconia restoration, while the metal group performed worst across the main clinical endpoints. The pattern was not subtle: the restorative material itself emerged as an independent factor shaping post-restoration function, periodontal indices, and local inflammatory activity.
Chewing is not a cosmetic outcome. In daily prosthodontic practice, it is the mechanical test that tells clinicians whether a reconstructed tooth can actually re-enter the work of eating, speaking, and distributing occlusal load without aggravating the surrounding periodontium.
Local inflammation tracked with material choice
The study measured inflammatory factors in gingival crevicular fluid, a clinically relevant compartment where plaque-related and tissue-derived signals converge. Levels of interleukin 1β, matrix metalloproteinase 8, and prostaglandin E2 were lower in the fiber group than in the zirconia group after restoration, pointing to a quieter inflammatory environment around the treated tooth. These markers matter because they reflect the tissue response to mechanical stress and microbial challenge; when they remain elevated, periodontal breakdown becomes more plausible, especially around a restored tooth that must tolerate repeated mastication.
The biological logic is straightforward. A post-and-core system that distributes force more favorably may limit microtrauma at the tooth-restoration interface and reduce irritation to adjacent gingival tissues, which can translate into lower inflammatory signaling in the crevicular fluid. In that setting, the local periodontium is less likely to behave as though it is under constant mechanical and inflammatory siege.
Safety favored fiber and zirconia over metal
Adverse reactions also separated the groups. The incidence reached 8.14% in the fiber group and 14.06% in the zirconia group, both lower than the 30.00% observed in the metal group. Binary logistic regression showed lower risk of adverse reactions for fiber and zirconia compared with metal, with odds ratios of 0.209 and 0.382, respectively. The study therefore suggests that the poorest safety profile belonged to metal post-and-core restoration, while fiber and zirconia occupied a more favorable range.
The contrast between function and safety is clinically important. A restoration may appear mechanically acceptable yet still provoke a broader burden of irritation, discomfort, or other unwanted postoperative events when the material interacts poorly with the tooth and surrounding soft tissues. Here, the material signal ran in the opposite direction for fiber and zirconia, where functional gains were accompanied by fewer adverse reactions than metal.
Why fiber may have performed better at the bedside
The advantage of fiber likely reflects a combination of mechanical and biologic compatibility. Fiber posts tend to behave more like dentin in modulus than traditional metal posts, a feature that can reduce stress concentration within the root and surrounding structures. In practical terms, that may help the restored tooth absorb load in a more physiologic way, preserving bite force while limiting collateral injury. Zirconia is also a modern restorative option, but in this cohort it did not match fiber for bite force, masticatory efficiency, or the inflammatory markers examined.
The study design does not allow a causal claim, yet the observed pattern fits what prosthodontists often look for in an ideal post-and-core material: adequate strength, reasonable load transfer, and a restoration that supports function without provoking a chronic inflammatory response.
Periodontal indicators followed the same direction
Periodontal indicators improved differently across the three groups, and material type remained an independent predictor after restoration. The manuscript does not provide every individual periodontal value in the abstract, but its conclusion is clear enough for clinical interpretation: the fiber post-and-core showed the best overall improvement, zirconia occupied an intermediate position, and metal lagged behind. When periodontal health and chewing performance move in the same direction, the restoration is doing more than filling space; it is interacting with the biology of the surrounding tooth-supporting tissues.
This matters in tooth defect patients because the restored tooth is not isolated from the mouth around it. Contact forces, plaque retention, microgaps, and tissue response all converge, and the material selected for reconstruction can influence that environment over months rather than days.
What clinicians can take from the 6-month data
The study followed patients before restoration and again 6 months later, offering a short-term window into how material selection affects real-world recovery. Within that period, fiber post-and-core delivered the best improvement in chewing function and inflammatory status, while metal produced the weakest results. Zirconia did better than metal for adverse reactions, but did not outperform fiber on the key functional endpoints.
For prosthodontic decision-making, the message is practical: restorative material choice should be individualized, with attention to the patient’s anatomy, the feasibility of the procedure, and the demands of the final restoration. A clinician choosing between fiber, zirconia, and metal is not just selecting a construction material; the choice influences how load is transmitted, how the periodontium responds, and how well the patient regains usable chewing function.
Limits of the evidence remain tied to the retrospective design
This was a retrospective analysis, not a randomized trial, and that design leaves room for selection bias and unmeasured confounding. The abstract does not specify how patients were assigned to each material group, whether baseline defects differed in severity, or how operator preference shaped material choice. Those details matter because complex restorations are rarely distributed evenly across routine practice.
The work still provides a useful clinical signal: in this 200-patient cohort, fiber post-and-core restoration was associated with the strongest short-term improvement in masticatory function and the most favorable inflammatory profile, with safety comparable to zirconia and better than metal. What remains unanswered is whether those differences persist beyond 6 months and whether they hold across broader patient populations, more complex defects, and different prosthodontic settings.