Composite resin vs Amalgam restoration: Restoration failure
- Population
- Permanent posterior teeth (molars/premolars) receiving direct restoration
- Intervention
- Composite resin
- Comparison
- Amalgam restoration
- Outcome
- Restoration failure
There was no statistically significant difference in failure risk between composite resin and amalgam restorations in permanent posterior teeth (pooled RR 0.96, 95% CI 0.68 to 1.34; 13 studies; not GRADE-rated, with very high heterogeneity, I2 = 97%).
What each review found
Current versions only| Finding | Effect | Studies | GRADE certainty |
|---|---|---|---|
Composite resin restorations vs Amalgam restorations Restoration failure (replacement, tooth/restoration fracture, secondary caries, postoperative sensitivity, toothache) · Permanent posterior teeth (molars/premolars) receiving direct restoration · At least 12 months follow-up (included studies followed 24 to 144 months), Permanent posterior teeth; clinical/practice settings across multiple countries (not clearly specified) There was no statistically significant difference in failure risk between composite resin and amalgam restorations in permanent posterior teeth (pooled RR 0.96, 95% CI 0.68 to 1.34; 13 studies; not GRADE-rated, with very high heterogeneity, I2 = 97%). Failure Risk of Composite Resin and Amalgam Restorations: A Systematic Review and Meta-Analysis. (2025) All outcomes | RR 0.96 [0.68, 1.34] | 13 studies | GRADE not reported |
Findings are shown side by side, never pooled across reviews.
The reviews
| Review | Searched up to | Included studies | AMSTAR 2 |
|---|---|---|---|
| Failure Risk of Composite Resin and Amalgam Restorations: A Systematic Review and Meta-Analysis. 2025 All outcomes | Search performed August 2023 to December 2023 (records from 1990 onwards) | 21 | Critically Low / Critically Low |
Related questions
The same intervention and outcome, asked in another population or against another comparator.
- Composite resin vs Light-cured compomer (polyacid-modified composite resin) · Children with carious primary teeth after vital or non-vital pulp therapy · 1 review
- Composite resin vs High-viscosity GIC and bulk-fill composite resins · Children with carious primary teeth · 1 review
- Composite resin vs HVGIC · Children with carious primary teeth · 1 review
Studies behind the findings
The primary studies the full-text reviews tie to this outcome. Reviews with headline outcomes only do not list them here.
- Five-Year Clinical Performance of Complex Class II Resin Composite and Amalgam Restorations-A Retrospective Study. · 2023 · included by 1 of these review
- Restorations after selective caries removal: 5-Year randomized trial · 2020 · included by 1 of these review
- Reasons for direct restoration failure from childhood to adolescence: A birth cohort study · 2019 · included by 1 of these review
- Effect of Refurbishing Amalgam and Resin Composite Restorations After 12 Years: Controlled Clinical Trial · 2017 · included by 1 of these review
- A Pragmatic Study Shows Failure of Dental Composite Fillings Is Genetically Determined: A Contribution to the Discussion on Dental Amalgams. · 2017 · included by 1 of these review
- Variations in survival time for amalgam and resin composite restorations: a population based cohort analysis · 2016 · included by 1 of these review
- A 3-year randomized clinical trial evaluating two different bonded posterior restorations: Amalgam versus resin composite. · 2016 · included by 1 of these review
- The effect of clinical performance on the survival estimates of direct restorations. · 2013 · included by 1 of these review
- A retrospective clinical study on longevity of posterior composite and amalgam restorations · 2007 · included by 1 of these review
- Survival and reasons for failure of amalgam versus composite posterior restorations placed in a randomized clinical trial · 2007 · included by 1 of these review
- A clinical evaluation of posterior composite resin restorations: 8-year findings · 1998 · included by 1 of these review
- Survival rates and reasons for failure of posterior composite restorations in multicentre clinical trial · 1989 · included by 1 of these review
- Bencheikh et al. 2023 · included by 1 of these review
How reviews are matched to this question
Reviews word the same question differently. Four decision models (TypeSafe's Jev, Liquid AI's d1-ultra, SubQ Snap and Baseten's Elephant) judged each wording of the population, intervention, comparator and outcome against the others; two wordings count as the same when at least three of them agree and none clearly disagrees, and findings count as this question only when all four elements match. Timing, setting and subgroup never split a question: they are shown on each finding.