Longevity of direct and indirect resin composite restorations in permanent posterior teeth: A systematic review and meta-analysis

Information about the long-term clinical survival of large amalgam and composite restorations is still lacking. This retrospective study compares the longevity of three- and four-/five-surface amalgam and composite restorations relative to patients' caries risk. Patient records from a general practice were used for data collection. We evaluated 1949 large class II restorations (1202 amalgam/747 composite). Dates of placement, replacement, and failure were recorded, and caries risk of patients was assessed. Survival was calculated from Kaplan-Meier statistics. After 12 years, 293 amalgam and 114 composite restorations had failed. Large composite restorations showed a higher survival in the combined population and in the low-risk group. For three-surface restorations in high-risk patients, amalgam showed better survival. Show more

This retrospective longitudinal study investigated the longevity of posterior restorations placed in a single general practice using 2 different composites in filler characteristics and material properties: P-50 APC (3M ESPE) with 70vol.% inorganic filler loading (midfilled) and Herculite XR (Kerr) with 55vol.% filler loading (minifilled). Show more

This practice-based retrospective study evaluated the survival of resin composite restorations in posterior teeth, focusing on the influence of potential patient risk factors. In total, 306 posterior composite restorations placed in 44 adult patients were investigated after 10 to 18 yrs. The history of each restoration was extracted from the dental records, and a clinical evaluation was performed with those still in situ. The patient risk status was assessed for caries and "occlusal-stress" (bruxism-related). Statistical analysis was performed by the Kaplan-Meier method and Cox-regression multivariate analysis. In total, 30% of the restorations failed, of which 82% were found in patients with 1 or 2 risk factors. Secondary caries was the main reason of failure within caries-risk patients, whereas fracture was the main reason in "occlusal-stress-risk" patients. The patient variables gender and age did not significantly affect survival, but risk did (p < .001). Tooth type (p < .001), arch (p = .013), and pulpal vitality (p = .003) significantly affected restoration survival. Within the limits of this retrospective evaluation, the survival of restorations is affected by patient risk factors, which should be included in survival analyses of restorations. Show more