No differences in longevity of direct and indirect composite restorations

Data sourcesMedline, Cochrane Library, Web of Science, Scopus, Latin American and Caribbean Health Sciences (LILACS), Brazilian Library of Dentistry (BBO), clinicaltrials.gov and SIGLE databases.Study selectionOnly randomised clinical trials were considered that compared direct vs indirect composite restorations, with or without cusp involvement, having a follow-up period of two years or greater.Data extraction and synthesisTwo reviewers selected studies for inclusion, abstracted data and assessed risk of bias. A fixed effects meta-analysis was conducted.ResultsNine studies met the inclusion criteria with six contributing to the meta-analysis. There was no statistically significant difference in clinical longevity for direct and indirect resin composite restorations; relative risk (RR) = 1.494 (95% CI; 0.893-2.500, p = 0.126). Comparing molars and premolars restored with DRC and IRC at three years there was no significant difference; RR = 0.716 (95% CI; 0.177-2.888, p = 0.638).ConclusionsThe results of the review indicate that there is no statistically significant difference in failure rate of direct resin composites vs indirect resin composites. Longitudinal studies on today's improved materials should, however, be considered for further review.