Comparative evaluation of clinical performance of ceramic and resin inlays, onlays, and overlays: A systematic review and meta analysis

Abstract

Background: Advances in adhesive technologies and escalation in esthetic demands have increased indications for tooth-colored, partial coverage restorations. Recently, material knowledge has evolved, new materials have been developed, and no systematic review has answered the question posed by practitioners: Is the clinical efficacy of resin or ceramic better, for inlay, onlay, and overlay in the long run? Aim: The aim of this systematic review and meta-analysis was to evaluate the clinical performance of ceramic and resin inlays, onlays, and overlays and to identify the complication types associated with the main clinical outcomes. Materials and Methods: Two reviewers (VN and AJ) searched PubMed, Embase, and Cochrane Central registry of controlled trials for published articles between 1983 and 2020 conforming to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines for systematic reviews. Only clinical studies which met the following criteria were included (1) studies regarding ceramic and resin inlays, onlays, and overlays were included; (2) randomized controlled trials, retrospective or prospective studies conducted in humans; (3) studies with a dropout rate <50% 4) studies with a follow-up higher than 5 years. Results: Of 1718 articles, 21 articles were selected. At 5 years, the estimated survival rates for resin ( n = 129) was 86%, feldspathic porcelain ( n = 1048) was 90%, and glass ceramic ( n = 2218) was 92%; at 10 years, the survival of resin was 75% ( n = 115), feldspathic porcelain was 91% ( n = 1829), and glass ceramic was 89% ( n = 1075). Conclusion: The meta-regression indicated that ceramic partial coverage restorations (feldspathic porcelain and glass-ceramic) outperformed resin partial coverage restorations both at 5-year and 10-year follow-up. When compared between ceramic types, glass ceramics outperformed feldspathic porcelain at 5 years' follow-up and feldspathic porcelain outperformed glass ceramics at 10 years' follow-up. The failures were mostly due to fractures (6.2%), endodontic problems (3%), secondary caries (1.7%), and debonding which was 0.9%.

Long-term performance of ceramic in/-onlays vs. cast gold partial crowns – a retrospective clinical study

“…The present study showed excellent and good qualities with 68% (in CGPCs) and 71.8% (in CIOs) for both types of restoration. There are no differences regarding the clinical performance or the survival of ceramic restorations in data pools from university teaching compared with data pools from private practice [ 49 ].…”

“…In literature, there are numerous short-term and a few long-term data with high survival rates for teeth restored with ceramic partial crowns, mostly up to ten years. It was also reported that includable information on the survival of ceramic on- and overlays performing up to 15 years are barely available [ 49 ].…”

Recent advances in glass‐ceramics: Performance and toughening mechanisms in restorative dentistry

“…5 Currently, the main glass-ceramics used for inlays and onlays res- showed that the 5 years survival rate of glass-ceramics inlays and onlays were 92% and the 10 years survival rate were 89%, both higher than resin inlays (86%, 75%), the 5 years survival rate was higher than feldspathic porcelain (90%), and the 10 years survival rate did not differ from feldspathic porcelain (91%). 114 It is shown that glass-ceramics can provide good retention and aesthetic results in inlay restorations, improve the survival rate of restorations and (2 years), 90.37% (4 years), and 87.99% (5 years). 115 Yang et al 116 fabricated 6855 restorations with IPS e.max Press and the 5-year cumulative survival rate was 96.6%, Li 2 Si 2 O 5 glass-ceramics have a mechanical strength of 360-400 MPa, which not only meets clinical restoration requirements, but also has a high survival rate.…”

“…In a prospective study, the expected survival rate of IPS e.max CAD‐repaired inlays and onlays was longer (124 and 30 years, respectively, for a 10% failure rate) 113 . A retrospective study showed that the 5 years survival rate of glass‐ceramics inlays and onlays were 92% and the 10 years survival rate were 89%, both higher than resin inlays (86%, 75%), the 5 years survival rate was higher than feldspathic porcelain (90%), and the 10 years survival rate did not differ from feldspathic porcelain (91%) 114 . It is shown that glass‐ceramics can provide good retention and aesthetic results in inlay restorations, improve the survival rate of restorations and patient satisfaction, and gradually become the main choice for inlays and onlays restorations.…”

Assessment Methods for Marginal and Internal Fit of Partial Crown Restorations: A Systematic Review

“…Holmes defines the internal gap as the perpendicular measurement from the internal surface of the casting to the axial wall of the preparation, and the marginal gap as the same measurement at the margin [16]. Poor marginal fit decreases the long-term durability of the restorations, leading to microleakage, secondary caries, gingival inflammation, and cement dissolution, while insufficient internal fit increases the risk of fracture of the prothesis [17,18]. For marginal and internal fit evaluation, different methods are available, and they are distinguished mainly as destructive or non-destructive and 2D or 3D methods [19,20].…”