Longevity of Posterior Composite Restorations

Abstract

The aim of this meta-analysis, based on individual participant data from several studies, was to investigate the influence of patient-, materials-, and tooth-related variables on the survival of posterior resin composite restorations. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a search resulting in 12 longitudinal studies of direct posterior resin composite restorations with at least 5 years' follow-up. Original datasets were still available, including placement/failure/censoring of restorations, restored surfaces, materials used, reasons for clinical failure, and caries-risk status. A database including all restorations was constructed, and a multivariate Cox regression method was used to analyze variables of interest [patient (age; gender; caries-risk status), jaw (upper; lower), number of restored surfaces, resin composite and adhesive materials, and use of glass-ionomer cement as base/liner (present or absent)]. The hazard ratios with respective 95% confidence intervals were determined, and annual failure rates were calculated for subgroups. Of all restorations, 2,816 (2,585 Class II and 231 Class I) were included in the analysis, of which 569 failed during the observation period. Main reasons for failure were caries and fracture. The regression analyses showed a significantly higher risk of failure for restorations in high-caries-risk individuals and those with a higher number of restored surfaces.

One-year aging effects on microtensile bond strengths of composite and repairs with different surface treatments

“…5 Restorative composites are not stable and continue to interact with the environment after polymerization. 16 Based on findings of the present study, composite resin aging influenced the bond strength of repair in an artificial saliva environment.…”

“…1,2 Recent clinical studies and meta-analyses have established that repair is an alternative to replacement of defective restorations and increases the longevity of restorations with minimal intervention. 3,4,5 The total replacement of defective restorations may result in the loss of healthy dental structure and cause injury to the dentin-pulp complex. 6,7 The concept of repair instead of restoration is part of the philosophy of minimally Declaration of Interests: The authors certify that they have no commercial or associative interest that represents a conflict of interest in connection with the manuscript.…”

Should my composite restorations last forever? Why are they failing?

“…Systematic reviews have shown that composite restorations might have good clinical performance, with annual failure rates (AFRs) varying from 1% to 4%. 5,6,7,8,9 However, replacement of restorations is still very frequent in public and private practices, consuming a significant amount of clinical time and imposing high financial costs for health systems. At the end of the last century, it was estimated that £ 173 million of annual cost of England's national health care was only for replacing dental restorations.…”

“…10 Clinical studies evaluating the longevity of restorations usually aim to determine the risk factors and reasons for failures of restorations. Whilst the main reasons for failure in posterior restorations are dental caries and fractures of tooth and/or restoration, 9 in anterior teeth the esthetics factor play an important role in the choice of dentist and patient desire for new interventions. 6 In addition, the decision-making process on how to deal with a restoration with large or small defects can vary widely among dentists with different training status or background.…”

Características de reporte e condução de revisões sistemáticas que avaliaram a longevidade de restaurações de resina composta em dentes posteriores

“…Foram avaliados então, 15 artigos na íntegra para elegibilidade, e desses, 4 foram excluídos com as seguintes razões: 1) Não apresentaram método explícito; 2) Resumo de uma revisão; e 3) Objetivo principal não era avaliar a longevidade das restaurações. Portanto, 11 artigos foram incluídos pela síntese qualitativa [8][9][10][11][12][13][14][15][16][17][18] e, desses, extraídos dados relevantes ao tema. A Tabela 1 mostra as características dos estudos incluídos e as comparações nas revisões.…”