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

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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.	张骞, 王倩, 张晓明, 等. 3 种窝洞修复方法之间微渗漏的比较. 实用口腔医学杂志, 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, 陈亚明, 吕令毅, 等. 复合树脂嵌体修复后牙体抗力的三维有限元研究. 实用口腔医学杂志, 2007, 23(2): 264-267.
7.	陈亚明. 间接性树脂嵌体新进展. 中国实用口腔科杂志, 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.	陈亚明, 冯海兰, 孙亚洲, 等. 复合树脂直接与间接修复后的牙体抗力实验研究. 实用口腔医学杂志, 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, Młotkowski 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.	张凌琳, 刘天佳, 方关贤, 等. 复合树脂嵌体修复磨牙缺损的临床疗效观察. 中华口腔医学杂志, 2008, 43(1): 44-47.
20.	洪席超, 文静, 于世德, 等. 直接树脂修复与间接树脂嵌体的临床应用比较. 国际医药卫生导报, 2012, 18(10): 1415-1417.
21.	吕亚林, 江青松. 复合树脂间接法和直接法修复的疲劳破坏研究. 首都医科大学学报, 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.	何园, 赵守亮, 张晓磊, 等. 增强牙体抗折强度的树脂修复研究. 中华口腔医学杂志, 2007, 42(5): 300-303.
25.	冯希平. 牙体充填后继发龋的产生和预防. 华西口腔医学杂志, 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, 陈霞云, 陈强, 等. 树脂直接充填与超瓷嵌体修复牙体缺损的微渗漏比较. 中华口腔医学研究杂志(电子版), 2014, 8(3): 18-21.

1. 张骞, 王倩, 张晓明, 等. 3 种窝洞修复方法之间微渗漏的比较. 实用口腔医学杂志, 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, 陈亚明, 吕令毅, 等. 复合树脂嵌体修复后牙体抗力的三维有限元研究. 实用口腔医学杂志, 2007, 23(2): 264-267.
7. 陈亚明. 间接性树脂嵌体新进展. 中国实用口腔科杂志, 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. 陈亚明, 冯海兰, 孙亚洲, 等. 复合树脂直接与间接修复后的牙体抗力实验研究. 实用口腔医学杂志, 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, Młotkowski 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. 张凌琳, 刘天佳, 方关贤, 等. 复合树脂嵌体修复磨牙缺损的临床疗效观察. 中华口腔医学杂志, 2008, 43(1): 44-47.
20. 洪席超, 文静, 于世德, 等. 直接树脂修复与间接树脂嵌体的临床应用比较. 国际医药卫生导报, 2012, 18(10): 1415-1417.
21. 吕亚林, 江青松. 复合树脂间接法和直接法修复的疲劳破坏研究. 首都医科大学学报, 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. 何园, 赵守亮, 张晓磊, 等. 增强牙体抗折强度的树脂修复研究. 中华口腔医学杂志, 2007, 42(5): 300-303.
25. 冯希平. 牙体充填后继发龋的产生和预防. 华西口腔医学杂志, 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, 陈霞云, 陈强, 等. 树脂直接充填与超瓷嵌体修复牙体缺损的微渗漏比较. 中华口腔医学研究杂志(电子版), 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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