title: A flood tide of systematic reviews on endodontic posts: methodological assessment using of R-AMSTAR.
abstract: OBJECTIVE
  To help the dental practitioner solve a specific clinical problem, systematic reviews (SRs) are seen as the best guide. In addition to the unmanageable quantity of SRs, however, one should be aware of their variable quality. The present review describes the methodological quality of SRs on postendodontic restorations to work out the value of these reviews for the dental practitioner.
  
  
  METHODS
  SRs were searched in April 2012, independently and in triplicate. Post survival was used as measure of outcome. The methodological quality of included SRs was assessed with the Revised Assessment of Multiple Systematic Reviews (R-AMSTAR) checklist. Kappa statistics were used to assess reviewer agreement.
  
  
  RESULTS
  Three hundred sixty-three papers were retrieved from the initial search. Ten SRs were included. One SR achieved a high R-AMSTAR score, whereas the other nine SRs achieved scores that indicate a substantial lack of methodological quality. Especially the items "grey literature," "combination of findings," "likelihood of publication bias," and conflict of interest" showed low R-AMSTAR scores. The three reviews with the highest R-AMSTAR scores tended to conclude that fewer failures occurred when using nonmetal posts. The reviewer agreement was excellent (kappa ranged from 0.79 to 0.85) in the R-AMSTAR classification.
  
  
  CONCLUSIONS
  The approach presented revealed a lack of SRs with high methodological quality. Thus, no decisive conclusion can be drawn with respect to this topic. It appears that there is a trend for the superiority of fiber-reinforced posts.
  
  
  CONCLUSIONS
  SRs must be of high methodological quality. This can be achieved by taking into consideration the results of this review. Improved methodological quality would make SRs more supportive for the general practitioner.
authors: Department of Prosthodontics, Section Biomaterial Research, University of Heidelberg, Im Neuenheimer Feld 400, Heidelberg, Germany. Marc_Schmitter@med.uni-heidelberg.de
authors: M
authors: M
authors: Schmitter
authors: G
authors: G
authors: Sterzenbach
authors: C M
authors: CM
authors: Faggion
authors: G
authors: G
authors: Krastl
mesh_terms: D000328:Adult; D057189:Checklist; D017268:Dental Prosthesis Retention; D019232:Dental Restoration Failure; D005898:Glass; D006801:Humans; D008670:Metals; D015588:Observer Variation; D011176:Post and Core Technique / Q000295:instrumentation* / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000379:methods*; D012107:Research Design / Q000592:standards*; D019233:Retreatment; D012196:Review Literature as Topic; D012390:Root Canal Therapy / Q000295:instrumentation / Q000379:methods / Q000592:standards*
chemical_list: D008670:Metals; C009753:fiberglass