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1Department of Adult Oral Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, and Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Evidence-Based Dentistry
|June 28, 2014
Summary
Dental resin composites show higher failure rates than dental amalgams, primarily due to secondary caries. This meta-analysis indicates a greater risk of failure for composite restorations over a five-to-seven-year period.
Area of Science:
- Dental materials science
- Evidence-based dentistry
- Clinical trial methodology
Background:
- Dental amalgam has been a common restorative material for posterior teeth.
- Resin composites offer aesthetic advantages but their long-term clinical performance compared to amalgam is debated.
Purpose of the Study:
- To compare the clinical effectiveness and failure rates of dental resin composites versus dental amalgams in permanent posterior teeth.
- To synthesize evidence from randomized controlled trials with a minimum follow-up of three years.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials.
- Searched multiple databases (CENTRAL, Medline, Embase, LILACS) and hand-searched journals.
- Included studies comparing resin composites and amalgams in permanent posterior teeth with at least three years follow-up.
Main Results:
- Seven studies were included, with data from 871 participants in two parallel-design studies used for primary meta-analysis.
- All included studies were assessed as having a high risk of bias.
- The risk ratio for failure of composite versus amalgam was 1.89 (95% CI 1.52-2.35), with increased failures mainly due to secondary caries.
Conclusions:
- Low-quality evidence suggests resin composites have higher failure rates than amalgam restorations.
- Resin composites are associated with an increased risk of secondary caries compared to amalgam.
- Further high-quality research is needed to definitively compare these restorative materials.
