Abstract
PurposeTraditionally, resin composite restorations are claimed by reviews of the dental literature as being superior to glass-ionomer fillings in terms of restoration failures in posterior permanent teeth. The aim of this systematic review is to answer the clinical question, whether conventional high-viscosity glass-ionomer restorations, in patients with single and/or multi-surface cavities in posterior permanent teeth, have indeed a higher failure rate than direct hybrid resin composite restorations.MethodsEight databases were searched until December 02, 2013. Trials were assessed for bias risks, in-between datasets heterogeneity and statistical sample size power. Effects sizes were computed and statistically compared. A total of 55 citations were identified through systematic literature search. From these, 46 were excluded. No trials related to high-viscosity glass-ionomers versus resin composite restorations for direct head-to-head comparison were found. Three trials related to high-viscosity glass-ionomers versus amalgam and three trials related to resin composite versus amalgam restorations could be included for adjusted indirect comparison, only.ResultsThe available evidence suggests no difference in the failure rates between both types of restoration beyond the play of chance, is limited by lack of head-to-head comparisons and an insufficient number of trials, as well as by high bias and in-between-dataset heterogeneity risk. The current clinical evidence needs to be regarded as too poor in order to justify superiority claims regarding the failure rates of both restoration types. Sufficiently large-sized, parallel-group, randomised control trials with high internal validity are needed, in order to justify any clinically meaningful judgment to this topic.
Highlights
In recent years, the use of resin composites for the placement of posterior permanent tooth restorations has increased, because of its better esthetic properties and the general concerns about the limitations of amalgam [1, 2]
The available evidence suggests no difference in the failure rates between both types of restoration beyond the play of chance, is limited by lack of head-to-head comparisons and an insufficient number of trials, as well as by high bias and in-between-dataset heterogeneity risk
The systematic literature search of this review aimed to identify clinical trials that directly compared high-viscous’ C-GICs (HVGIC) with resin composite restorations, in line with the stated inclusion/exclusion criteria
Summary
The use of resin composites for the placement of posterior permanent tooth restorations has increased, because of its better esthetic properties and the general concerns about the limitations of amalgam [1, 2]. High-Viscosity Glass-Ionomer Versus Hybrid Resin Composite Restorations – Failure Rate The Open Dentistry Journal, 2015, Volume 9 439 conclude that C-GICs are less durable, with a far higher failure rate, than resin composite when placed as posterior occlusal or approximal restorations [4 - 7]. For these reasons C-GIC were regarded as lacking adequate mechanical properties for general use as definitive restorations in stress-bearing posterior teeth. In particular for direct HVGIC restorations placed in the permanent dentition, the clinical evidence shows: (i) no difference between single-surface HVGIC and conventional amalgam restorations in their failure rates after six years; (ii) no difference in the failure rates of multiple-surface HVGIC and conventional amalgam restorations after four years [9, 10]
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