The longevity of direct dental restorations is one of the most widely studied topics in restorative dentistry. A recent scientific analysis examined multiple systematic reviews and meta-analyses to evaluate the clinical survival of different restorative materials used in everyday dental practice.
This type of research compares and summarizes results from many previously published scientific reviews, providing an overall picture of the current state of evidence on the subject.
The analysis included 16 systematic reviews and meta-analyses, covering more than 15,000 restorations with follow-up periods ranging from 6 months to approximately 10 years.
Clinical survival of composites
The results show that conventional composite resins present survival rates above 90% after five years, particularly when appropriate adhesive protocols are used.
Bulk-fill composites, designed to allow thicker increments during restoration placement, showed similar clinical performance in the short to medium term, with failure rates generally below 7%.
However, the authors note that long-term clinical evidence for these materials is still more limited compared with conventional composites.
Other restorative materials
The analysis also evaluated other restorative materials.
Ormocer-based composites showed slightly higher failure rates, around 12%, mainly associated with marginal degradation of the restoration.
Glass ionomer cements and resin-modified glass ionomers (RMGIC) demonstrated lower overall survival compared with composite resins. Nevertheless, they remain useful in certain clinical situations, particularly in patients with high caries risk or when moisture control is difficult.
The sandwich technique, combining a glass ionomer base with a composite restoration, also showed improved retention in non-carious cervical lesions.
Factors influencing restoration longevity
The authors emphasize that the longevity of restorations does not depend solely on the material used. Factors such as operative technique, adhesive protocol and patient caries risk play a major role in clinical survival.
Overall, current scientific evidence supports the use of conventional and bulk-fill composite resins as reliable restorative options, while glass ionomers and combined techniques continue to play an important role in specific clinical indications.
Source:
Fernández E. Clinical Longevity of Direct Dental Restorations – Umbrella Review.
https://pubmed.ncbi.nlm.nih.gov/41159592/