{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T01:08:55Z","timestamp":1790644135373,"version":"4.1.0"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Prosthodontics"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To systematically review and meta\u2010analyze clinical, in vitro, and finite\u2010element studies assessing how ferrule height, width, and circumferential extent influence fracture resistance and survival of endodontically treated teeth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This review followed PRISMA 2020 guidelines. Two reviewers conducted the screening, with a third resolving disagreements. Eligible designs included clinical studies, in vitro experiments, and finite\u2010element analyses evaluating ferrule characteristics. Risk of bias was assessed using RoB 2, the Newcastle\u2013Ottawa Scale, and CRIS\/CONSORT\u2010adapted criteria. Random\u2010effects models were applied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty\u2010three primary studies (6 clinical, 18 in vitro, 9 finite\u2010element) were included. Ferrule height \u2265 2 mm significantly improved fracture resistance (MD +165 N; 95% CI: 110\u2013215). Ferrule presence increased clinical survival (RR 1.34; 95% CI: 1.12\u20131.59). Dentin thickness \u2265 1\u00a0mm and complete 360\u00b0 ferrules provided the most favorable reinforcement, while partial ferrules with \u2265 2 opposing walls remained beneficial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A ferrule height of 1.5\u20132.0\u00a0mm and dentin thickness \u2265 1\u00a0mm are associated with improved biomechanical and clinical outcomes. These findings should be interpreted within the context of variation in study designs and reporting quality. No restorative strategy matched the biomechanical reinforcement provided by a natural dentin ferrule.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jopr.70099","type":"journal-article","created":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T09:07:54Z","timestamp":1769591274000},"page":"450-459","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Ferrule dimensions and restoration outcomes in endodontically treated teeth: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-1219-8610","authenticated-orcid":false,"given":"Osama","family":"Hajeer","sequence":"first","affiliation":[{"name":"Faculty of Dentistry Department of Fixed Prosthodontics, University of Aleppo  Aleppo Syria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amal","family":"Hasan","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry Department of Fixed Prosthodontics, University of Aleppo  Aleppo Syria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaza","family":"Kanout","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry Department of Fixed Prosthodontics, Damascus University  Damascus Syria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Luai","family":"Morad","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry Department of Fixed Prosthodontics, Damascus University  Damascus Syria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2011.09.024"},{"issue":"1","key":"e_1_2_8_3_1","first-page":"31","article-title":"Ferrule effect: a meta\u2010analysis","volume":"1","author":"Skupien JA","year":"2016","journal-title":"JDR Clin Trans Res"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2016.10.025"},{"issue":"4","key":"e_1_2_8_5_1","first-page":"543","article-title":"Endocrown restorations for endodontically treated molars: a systematic review and meta\u2010analysis","volume":"116","author":"Govare S","year":"2016","journal-title":"J Prosthet Dent"},{"issue":"1","key":"e_1_2_8_6_1","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1186\/s12903-023-03053-4","article-title":"Effects of ferrule height and crown\u2010to\u2010root ratio on fracture resistance of endodontically treated teeth","volume":"23","author":"Li Y","year":"2023","journal-title":"BMC Oral Health"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_8_8_1","unstructured":"WellsGA SheaB O'ConnellD PetersonJ WelchV LososM et\u00a0al.The Newcastle\u2013Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta\u2010analyses. 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