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Related Experiment Video

Updated: Jul 30, 2025

Quasistatic Mechanical Testing for Computer-Aided Design and Manufacturing Occlusal Veneers Cemented to Milled Dentin Analog Material
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EPA Consensus Project Paper: Failure Rates of Direct Versus Indirect Single-Tooth Restorations. A Systematic Review

P Kamposiora1, I Papathanasiou2, A B Barmak3

  • 1Assistant Professor, Department of Prosthodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.

The European Journal of Prosthodontics and Restorative Dentistry
|May 16, 2023
PubMed
Summary

Direct and indirect dental restorations for single teeth show similar annual failure rates of 1%. This systematic review found high heterogeneity and risk of bias across studies, indicating a need for more research.

Keywords:
Direct RestorationsFailureIndirect RestorationsSingle-Tooth RestorationsSystematic Review

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Area of Science:

  • Dental Materials Science
  • Restorative Dentistry
  • Evidence-Based Dentistry

Background:

  • Dental restorations are crucial for tooth function and aesthetics.
  • Direct and indirect restoration techniques are commonly employed for single-tooth replacements.
  • Understanding their comparative longevity is essential for clinical decision-making.

Purpose of the Study:

  • To systematically review and compare the failure rates of direct versus indirect restorations for single-tooth applications.
  • To synthesize existing evidence through meta-analysis to determine comparative success rates.

Main Methods:

  • Comprehensive literature search of electronic databases and reference lists.
  • Inclusion of clinical studies with a minimum 3-year follow-up.
  • Risk of bias assessment using ROB2 and ROBINS-I tools; heterogeneity assessed with I2 statistic.

Main Results:

  • 52 studies met inclusion criteria; no direct comparative studies were found.
  • Annual failure rates for both direct and indirect restorations were similar, estimated at 1% via random-effects model.
  • High heterogeneity (80-91%) and significant risk of bias were noted in most included studies.

Conclusions:

  • Direct and indirect single-tooth restorations exhibit comparable annual failure rates.
  • Further high-quality randomized clinical trials are necessary to establish more definitive conclusions due to study limitations.