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  • Clinical longevity of direct and indirect posterior resin composite restorations : an updated systematic review and meta-analysis
    Publication . Josic, Uros; D’Alessandro, Carlo; Miletic, Vesna; Maravic, Tatjana; Mazzitelli, Claudia; Jacimovic, Jelena; Sorrentino, Roberto; Zarone, Fernando; Mancuso, Edoardo; Delgado, António H. S.; Breschi, Lorenzo; Mazzoni, Annalisa
    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]), medium-term (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.
    2023-12Contributo em revista Acesso aberto Ver mais