Directly Placed Restorative Materials: Review and Network Meta-analysis

Area of Science:

• Dental Materials Science
• Restorative Dentistry
• Evidence Synthesis

Background:

• Numerous material combinations exist for restoring dental cavities.
• Comparative data on restorative material survival is crucial for clinical decision-making.

Purpose of the Study:

• To systematically review and synthesize data from comparative dental restorative trials.
• To compare the survival rates of various restorative and adhesive materials for different lesion types.

Main Methods:

• Systematic review of randomized controlled trials (2005-2015).
• Inclusion of trials comparing survival of ≥2 restorative/adhesive materials.
• Pairwise and Bayesian network meta-analyses for cervical and load-bearing lesions.

Main Results:

• Resin-modified glass ionomer cements showed highest survival for cervical lesions.
• Conventional composites demonstrated highest survival for load-bearing lesions; siloranes performed worst.
• Adhesive strategies using 2-step etch-and-rinse or 1-step self-etch performed poorly for cervical lesions.

Conclusions:

• Resin-modified glass ionomer cements are recommended for cervical lesions; conventional composites for load-bearing lesions.
• Evidence is insufficient for definitive recommendations, particularly regarding adhesive strategies in posterior load-bearing situations.
• Future trials need improved power, follow-up, and standardized material classification.