Objectives: To answer the PICO(S) question: Is there a difference in clinical longevity between direct and indirect resin composite restorations placed on permanent posterior teeth?Data: Randomized controlled clinical trials (RCTs) investigating direct and indirect resin composite restorations in posterior permanent teeth were considered.Sources: Several electronic databases were searched, with no language or date restrictions. The revised Cochrane Collaboration's tool for assessing risk of bias (RoB-2) was used to analyze the studies; meta-analyses were run and the certainty of evidence was assessed by the GRADE tool. A subgroup meta-analysis was performed for resin composite restorations placed on posterior worn dentition. Study selection: Twenty-three articles were included in qualitative synthesis, while 8 studies were used for meta -analyses. According to the RoB-2 tool, 5 studies were ranked as "low risk", 7 had "some concerns", while 11 papers were rated as "high risk" of bias. There were no statistically significant differences in short-term (p = 0.27; RR=1.54, 95% CI [0.72, 3.33]), mediumterm (p = 0.27; RR=1.87, 95% CI [0.61, 5.72]) and long-term longevity (p = 0.86; RR=0.95, 95% CI [0.57, 1.59]). The choice of restorative technique had no influence on short-term survival of resin composite restorations placed on worn dentition (p = 0.13; RR=0.46, 95% CI [0.17, 1.25]). The certainty of evidence was rated as "very low".Conclusions: Direct and indirect resin composite restorations may show similar clinical longevity in posterior region, regardless of the observation period or substrate (wear-affected and non-affected dentition). The very low quality of evidence suggests that more long-term RCTs are needed to confirm our results.
Clinical longevity of direct and indirect posterior resin composite restorations: An updated systematic review and meta-analysis / Josic, Uros; D'Alessandro, Carlo; Miletic, Vesna; Maravic, Tatjana; Mazzitelli, Claudia; Jacimovic, Jelena; Sorrentino, Roberto; Zarone, Fernando; Mancuso, Edoardo; Delgado, António Hs; Breschi, Lorenzo; Mazzoni, Annalisa. - In: DENTAL MATERIALS. - ISSN 0109-5641. - ELETTRONICO. - 39:12(2023), pp. 1085-1094. [10.1016/j.dental.2023.10.009]
Clinical longevity of direct and indirect posterior resin composite restorations: An updated systematic review and meta-analysis
Josic, Uros;D'Alessandro, Carlo;Maravic, Tatjana;Mazzitelli, Claudia;Mancuso, Edoardo;Breschi, Lorenzo
;Mazzoni, Annalisa
2023
Abstract
Objectives: To answer the PICO(S) question: Is there a difference in clinical longevity between direct and indirect resin composite restorations placed on permanent posterior teeth?Data: Randomized controlled clinical trials (RCTs) investigating direct and indirect resin composite restorations in posterior permanent teeth were considered.Sources: Several electronic databases were searched, with no language or date restrictions. The revised Cochrane Collaboration's tool for assessing risk of bias (RoB-2) was used to analyze the studies; meta-analyses were run and the certainty of evidence was assessed by the GRADE tool. A subgroup meta-analysis was performed for resin composite restorations placed on posterior worn dentition. Study selection: Twenty-three articles were included in qualitative synthesis, while 8 studies were used for meta -analyses. According to the RoB-2 tool, 5 studies were ranked as "low risk", 7 had "some concerns", while 11 papers were rated as "high risk" of bias. There were no statistically significant differences in short-term (p = 0.27; RR=1.54, 95% CI [0.72, 3.33]), mediumterm (p = 0.27; RR=1.87, 95% CI [0.61, 5.72]) and long-term longevity (p = 0.86; RR=0.95, 95% CI [0.57, 1.59]). The choice of restorative technique had no influence on short-term survival of resin composite restorations placed on worn dentition (p = 0.13; RR=0.46, 95% CI [0.17, 1.25]). The certainty of evidence was rated as "very low".Conclusions: Direct and indirect resin composite restorations may show similar clinical longevity in posterior region, regardless of the observation period or substrate (wear-affected and non-affected dentition). The very low quality of evidence suggests that more long-term RCTs are needed to confirm our results.File | Dimensione | Formato | |
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