Efficacy of indirect and direct resin composite restorations in permanent posterior teeth: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

LIU Yuan ¹ , HOU Xinshan ¹ , ZHANG Wanting ¹ ,  ZHAO Jin ^1,2

1. Department of Stomatology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, P.R.China;
2. Xinjiang Oral Medical Research Institute, Urumqi, 830054, P.R.China;

Corresponding?author：

ZHAO Jin, Email: merryljin@sina.com

Keywords：

Resin composite; Direct restorations; Indirect restorations; Posterior teeth; Randomized controlled trial; Meta-analysis; Systematic review

DOI：

10.7507/1672-2531.201702022

Video：

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ObjectiveTo systematically review the clinical efficacy of indirect and direct resin composite restorations in permanent posterior teeth.MethodsThe Cochrane Library (Issue 12, 2016), PubMed, EMbase, WanFang Data, CBM and CNKI databases were searched for randomized controlled trials (RCTs) about indirect and direct resin composite restorations in permanent posterior teeth from inception to December 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by RevMan 5.3 software.ResultsNine RCTs involving 671 patients and 1 012 teeth (544 in indirect restorations group and 468 in direct restorations group) were included. The results of meta-analysis indicated that: there was no significant difference in the overall failure rate between direct and indirect resin composite restorations (RR=0.91, 95%CI 0.52 to 1.58, P=0.73). In further analysing the reasons of failure, there were no significant differences between both groups on fractured restorations (RR=1.71, 95%CI 0.76 to 3.84, P=0.19) and fractured remaining cusp (RR=1.27, 95%CI 0.62 to 2.59, P=0.52). In addition, the secondary caries in the direct composite restorations group was higher than that in the indirect group (RR=0.33, 95%CI 0.13 to 0.85, P=0.02). Subgroup analysis according to molars and premolars restored indicated that there was no statistical difference in the restorations failure rate between two groups.ConclusionThe clinical efficacy of indirect and direct resin composite restorations in permanent posterior teeth are equivalent. Due to the limitation of quality and quantity of the included RCTs, the above conclusions are needed to be verified by more high quality and large sample RCTs.

Citation： LIU Yuan, HOU Xinshan, ZHANG Wanting, ZHAO Jin. Efficacy of indirect and direct resin composite restorations in permanent posterior teeth: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2017, 17(6): 685-691. doi: 10.7507/1672-2531.201702022 Copy

1.	張騫, 王倩, 張曉明, 等. 3 種窩洞修復方法之間微滲漏的比較. 實用口腔醫學雜志, 2015, (3): 357-359.
2.	Lopes GC, Vieira LC, Araujo E, et al. Direct composite resin restorations: a review of some clinical procedures to achieve predictable results in posterior teeth. J Esthet Restor Dent, 2004, 16(1): 19-31.
3.	Cetin AR, Unlu N. One year clinical evaluation of direct nanofilled and indirect composite restorations in posterior teeth. Dent Mater J, 2009, 28(5): 620-626.
4.	Ozakarilda N, Zorba YO, Yildiz M, et al. Three-year clinical performance of two indirect composite inlays compared to direct composite restorations. Med Oral Patol Oral Cir Bucal, 2013, 18(3): e521-528.
5.	Huth KC, Chen HY, Mehl A, et al. Clinical study of indirect composite resin inlays in posterior stress-bearing cavities placed by dental students: results after 4 years. J Dent, 2011, 39(7): 478-488.
6.	梅蕾, 陳亞明, 呂令毅, 等. 復合樹脂嵌體修復后牙體抗力的三維有限元研究. 實用口腔醫學雜志, 2007, 23(2): 264-267.
7.	陳亞明. 間接性樹脂嵌體新進展. 中國實用口腔科雜志, 2009, 2(1): 29-32.
8.	Jackson RD, Ferguson RW. An esthetic, bonded inlay/onlay technique for posterior teeth. Quintessence Int, 1990, 21(1): 7-12.
9.	陳亞明, 馮海蘭, 孫亞洲, 等. 復合樹脂直接與間接修復后的牙體抗力實驗研究. 實用口腔醫學雜志, 2005, 21(5): 600-602.
10.	Batalhasilva S, de Andrada MA, Maia HP, et al. Fatigue resistance and crack propensity of large MOD composite resin restorations: direct versus CAD/CAM inlays. Dent Mater, 2013, 29(3): 324-331.
11.	Dejak B, M?otkowski A. A comparison of stresses in molar teeth restored with inlays and direct restorations, including polymerization shrinkage of composite resin and tooth loading during mastication. Dent Mater, 2015, 31(3): 77-87.
12.	Wassell RW, Walls AWG, Mccabe JF, et al. Direct composite inlays versus conventional composite restorations: 5-year follow-up. J Dent, 2000, 28(6): 375-382.
13.	van Dijken JW. Direct resin composite inlays/onlays: An 11 year follow-up. J Dent, 2000, 28(5): 299-306.
14.	Manhart J, Neuerer P, Scheibenbogen-Fuchsbrunner A, et al. Three-year clinical evaluation of direct and indirect composite restorations in posterior teeth. J Prosthet Dent, 2000, 84(3): 289-296.
15.	Pallesen U, Qvist V. Composite resin fillings and inlays: an 11-year evaluation. Clin Oral Investig, 2003, 7(2): 71-79.
16.	Bartlett D, Sundaram G. An up to 3-year randomized clinical study comparing indirect and direct resin composites used to restore worn posterior teeth. Int J Prosthodont, 2006, 19(6): 613-617.
17.	Cetin AR, Unlu N, Cobanoglu N. A five-year clinical evaluation of direct nanofilled and indirect composite resin restorations in posterior teeth. Oper Dent, 2013, 38(2): E1-11.
18.	Fennis WM, Kuijs RH, Roeters FJ, et al. Randomized control trial of composite cuspal restorations: five-year results. J Dent Res, 2014, 93(1): 36-41.
19.	張凌琳, 劉天佳, 方關賢, 等. 復合樹脂嵌體修復磨牙缺損的臨床療效觀察. 中華口腔醫學雜志, 2008, 43(1): 44-47.
20.	洪席超, 文靜, 于世德, 等. 直接樹脂修復與間接樹脂嵌體的臨床應用比較. 國際醫藥衛生導報, 2012, 18(10): 1415-1417.
21.	呂亞林, 江青松. 復合樹脂間接法和直接法修復的疲勞破壞研究. 首都醫科大學學報, 2006, 27(3): 315-317.
22.	Hickel R, Manhart J. Longevity of restorations in posterior teeth and reasons for failure. J Adhes Dent, 2001, 3(1): 45-64.
23.	Manhart J, Chen HG, Hickel R, et al. Buonocore Memorial Lecture. Review of the clinical survival of direct and indirect restorations in posterior teeth of the permanent dentition. Oper Dent, 2004, 29(5): 481-508.
24.	何園, 趙守亮, 張曉磊, 等. 增強牙體抗折強度的樹脂修復研究. 中華口腔醫學雜志, 2007, 42(5): 300-303.
25.	馮希平. 牙體充填后繼發齲的產生和預防. 華西口腔醫學雜志, 2014, 32(2): 107-110.
26.	Pallesen U, van Dijken JW. A randomized controlled 27 years follow up of three resin composites in Class Ⅱ restorations. J Dent, 2015, 43(12): 1547-1558.
27.	管婷婷, 陳霞云, 陳強, 等. 樹脂直接充填與超瓷嵌體修復牙體缺損的微滲漏比較. 中華口腔醫學研究雜志(電子版), 2014, 8(3): 18-21.

1. 張騫, 王倩, 張曉明, 等. 3 種窩洞修復方法之間微滲漏的比較. 實用口腔醫學雜志, 2015, (3): 357-359.
2. Lopes GC, Vieira LC, Araujo E, et al. Direct composite resin restorations: a review of some clinical procedures to achieve predictable results in posterior teeth. J Esthet Restor Dent, 2004, 16(1): 19-31.
3. Cetin AR, Unlu N. One year clinical evaluation of direct nanofilled and indirect composite restorations in posterior teeth. Dent Mater J, 2009, 28(5): 620-626.
4. Ozakarilda N, Zorba YO, Yildiz M, et al. Three-year clinical performance of two indirect composite inlays compared to direct composite restorations. Med Oral Patol Oral Cir Bucal, 2013, 18(3): e521-528.
5. Huth KC, Chen HY, Mehl A, et al. Clinical study of indirect composite resin inlays in posterior stress-bearing cavities placed by dental students: results after 4 years. J Dent, 2011, 39(7): 478-488.
6. 梅蕾, 陳亞明, 呂令毅, 等. 復合樹脂嵌體修復后牙體抗力的三維有限元研究. 實用口腔醫學雜志, 2007, 23(2): 264-267.
7. 陳亞明. 間接性樹脂嵌體新進展. 中國實用口腔科雜志, 2009, 2(1): 29-32.
8. Jackson RD, Ferguson RW. An esthetic, bonded inlay/onlay technique for posterior teeth. Quintessence Int, 1990, 21(1): 7-12.
9. 陳亞明, 馮海蘭, 孫亞洲, 等. 復合樹脂直接與間接修復后的牙體抗力實驗研究. 實用口腔醫學雜志, 2005, 21(5): 600-602.
10. Batalhasilva S, de Andrada MA, Maia HP, et al. Fatigue resistance and crack propensity of large MOD composite resin restorations: direct versus CAD/CAM inlays. Dent Mater, 2013, 29(3): 324-331.
11. Dejak B, M?otkowski A. A comparison of stresses in molar teeth restored with inlays and direct restorations, including polymerization shrinkage of composite resin and tooth loading during mastication. Dent Mater, 2015, 31(3): 77-87.
12. Wassell RW, Walls AWG, Mccabe JF, et al. Direct composite inlays versus conventional composite restorations: 5-year follow-up. J Dent, 2000, 28(6): 375-382.
13. van Dijken JW. Direct resin composite inlays/onlays: An 11 year follow-up. J Dent, 2000, 28(5): 299-306.
14. Manhart J, Neuerer P, Scheibenbogen-Fuchsbrunner A, et al. Three-year clinical evaluation of direct and indirect composite restorations in posterior teeth. J Prosthet Dent, 2000, 84(3): 289-296.
15. Pallesen U, Qvist V. Composite resin fillings and inlays: an 11-year evaluation. Clin Oral Investig, 2003, 7(2): 71-79.
16. Bartlett D, Sundaram G. An up to 3-year randomized clinical study comparing indirect and direct resin composites used to restore worn posterior teeth. Int J Prosthodont, 2006, 19(6): 613-617.
17. Cetin AR, Unlu N, Cobanoglu N. A five-year clinical evaluation of direct nanofilled and indirect composite resin restorations in posterior teeth. Oper Dent, 2013, 38(2): E1-11.
18. Fennis WM, Kuijs RH, Roeters FJ, et al. Randomized control trial of composite cuspal restorations: five-year results. J Dent Res, 2014, 93(1): 36-41.
19. 張凌琳, 劉天佳, 方關賢, 等. 復合樹脂嵌體修復磨牙缺損的臨床療效觀察. 中華口腔醫學雜志, 2008, 43(1): 44-47.
20. 洪席超, 文靜, 于世德, 等. 直接樹脂修復與間接樹脂嵌體的臨床應用比較. 國際醫藥衛生導報, 2012, 18(10): 1415-1417.
21. 呂亞林, 江青松. 復合樹脂間接法和直接法修復的疲勞破壞研究. 首都醫科大學學報, 2006, 27(3): 315-317.
22. Hickel R, Manhart J. Longevity of restorations in posterior teeth and reasons for failure. J Adhes Dent, 2001, 3(1): 45-64.
23. Manhart J, Chen HG, Hickel R, et al. Buonocore Memorial Lecture. Review of the clinical survival of direct and indirect restorations in posterior teeth of the permanent dentition. Oper Dent, 2004, 29(5): 481-508.
24. 何園, 趙守亮, 張曉磊, 等. 增強牙體抗折強度的樹脂修復研究. 中華口腔醫學雜志, 2007, 42(5): 300-303.
25. 馮希平. 牙體充填后繼發齲的產生和預防. 華西口腔醫學雜志, 2014, 32(2): 107-110.
26. Pallesen U, van Dijken JW. A randomized controlled 27 years follow up of three resin composites in Class Ⅱ restorations. J Dent, 2015, 43(12): 1547-1558.
27. 管婷婷, 陳霞云, 陳強, 等. 樹脂直接充填與超瓷嵌體修復牙體缺損的微滲漏比較. 中華口腔醫學研究雜志(電子版), 2014, 8(3): 18-21.

Chinese Journal of Evidence-Based Medicine

Efficacy of indirect and direct resin composite restorations in permanent posterior teeth: a meta-analysis

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