The longevity of posterior restorations in primary teeth

Data sourcesSciVerse Scopus, ISIS Web of Science, Cochrane library, Medline/PubMed. Studies published from 1996 to 2017 in English were considered.Study selectionTwo independent reviewers screened the literature. Randomised clinical trials, non-randomised clinical trials with parallel groups or single group, retrospective studies) evaluating different posterior restorations (class I, class II restorations and crowns) with different materials (amalgam, compomer, composite, glass ionomer cement, stainless steel crown) placed in primary teeth by reporting different outcomes measures (survival rate, success rate, annual failure rate).Data extraction and synthesisTwo independent reviewers extracted data. Risk of bias was assessed using the Cochrane tool. A qualitative analysis was conducted.ResultsThirty-one studies were included. Seven different materials were used for restorations: amalgam (six studies), compomer (nine studies), composite (six studies), conventional glass ionomer cement (five studies), metal-reinforced glass ionomer cement (MRGIC) (four studies), resin-modified glass ionomer cement (ten studies), and stainless steel crown (SSC) (three studies). When considering the annual failure rate (AFR), composite showed the lowest (1.7-12.9%) and MRGIC showed the highest (10.0-29.9%). For the success rate, SSC presented the highest (96.1%) and MRGIC presented the lowest (57.4%). Class I restorations and restorations placed under the use of rubber dam revealed better results in both AFR and success rate. The main reason for failure was secondary caries.ConclusionsThere is a large variation in longevity of posterior restorations in primary teeth. Secondary caries is the main reason causing failure.