Findings

What do systematic reviews say?

4 questions · 11 findings · 4 reviews · Oral Health

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No studies found 0 · 0%GRADE not reported 10 · 90.9%Very low 0 · 0%Low 1 · 9.1%Moderate 0 · 0%High 0 · 0%

Direct composite resin restoration vs Amalgam restoration

Secondary caries · People with permanent or adult posterior teeth requiring restoration (parallel-group trials involved children aged 6 to 12 years)

Direct composite resin restoration showed no clear difference in secondary caries compared with amalgam restoration; GRADE not reported.

3 findings from 1 review

Direct composite resin fillings versus amalgam fillings for permanent posterior teeth 2021 · Cochrane All outcomes
Follow-up >= 3 years · Parallel-group and split-mouth trials combined
RR 1.93 [0.98, 3.80]
7 studies
GRADE not reported
Direct composite resin fillings versus amalgam fillings for permanent posterior teeth 2021 · Cochrane All outcomes
Follow-up >= 3 years · Split-mouth trials
RR 1.30 [0.34, 4.97]
5 studies
GRADE not reported
Direct composite resin fillings versus amalgam fillings for permanent posterior teeth 2021 · Cochrane All outcomes
Follow-up: 5 to 7 years
RR 2.14 [1.67, 2.74]
2 studies · 921 participants
Low

Composite resin vs Amalgam restoration

Restoration failure · Permanent posterior teeth (molars/premolars) receiving direct restoration

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%).

1 finding from 1 review

Failure Risk of Composite Resin and Amalgam Restorations: A Systematic Review and Meta-Analysis. 2025 All outcomes
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)
RR 0.96 [0.68, 1.34]
13 studies
GRADE not reported

Low polymerization shrinkage resin composite (silorane, ormocer, bulk-fill or other modified-monomer composite) vs Conventional methacrylate-based resin composite

Secondary caries · People with permanent posterior teeth restored with class I or II direct restorations

No secondary caries was reported at 24 months in any of seven studies, so no meta-analysis was possible (ungraded).

2 findings from 1 review

Meta-analysis of the clinical behavior of posterior direct resin restorations: Low polymerization shrinkage resin in… 2018 All outcomes
24 months · Posterior class I/II restorations in permanent teeth; multicenter randomized controlled trials conducted across Europe, the Americas, and the Middle East
After 24 months, seven articles evaluated secondary caries, but none reported any secondary caries in either group; a meta-analysis was therefore not conducted.
7 studies
GRADE not reported
Meta-analysis of the clinical behavior of posterior direct resin restorations: Low polymerization shrinkage resin in… 2018 All outcomes
12 months · Posterior class I/II restorations in permanent teeth; multicenter randomized controlled trials conducted across Europe, the Americas, and the Middle East
OR 1.51 [0.64, 3.57]
14 studies · 2087 participants
GRADE not reported

Replacement of the defective restoration vs Repair of the defective restoration

Composite: Preference for replacement over repair - Scenario 3: secondary caries · Dentists managing a defective direct resin composite restoration (posterior occlusal Class I; standardized vignette of a 30-year-old,…

Subgroup (Continent: Africa): pooled preference was replacement over repair for a defective composite restoration with secondary caries (RR 4.62); significant continental variation, p < 0.001.

5 findings from 1 review

Clinical Decision-Making of Repair vs. Replacement of Defective Direct Dental Restorations: A Multinational… 2025 All outcomes
Not applicable (single time-point survey, June to October 2023) · Multinational (21 countries across Africa, Asia, Europe, South America); general dental practice · Continent: Africa
RR 4.62 [3.64, 5.86]
2 studies · 339 participants
GRADE not reported
Clinical Decision-Making of Repair vs. Replacement of Defective Direct Dental Restorations: A Multinational… 2025 All outcomes
Not applicable (single time-point survey, June to October 2023) · Multinational (21 countries across Africa, Asia, Europe, South America); general dental practice · Overall (all 21 countries pooled)
RR 2.43 [1.87, 3.16]
21 studies · 3680 participants
GRADE not reported
Clinical Decision-Making of Repair vs. Replacement of Defective Direct Dental Restorations: A Multinational… 2025 All outcomes
Not applicable (single time-point survey, June to October 2023) · Multinational (21 countries across Africa, Asia, Europe, South America); general dental practice · Continent: Europe
RR 3.07 [2.41, 3.89]
6 studies · 1075 participants
GRADE not reported

Show 2 more findings

Clinical Decision-Making of Repair vs. Replacement of Defective Direct Dental Restorations: A Multinational… 2025 All outcomes
Not applicable (single time-point survey, June to October 2023) · Multinational (21 countries across Africa, Asia, Europe, South America); general dental practice · Continent: South America
RR 1.33 [1.03, 1.71]
2 studies · 349 participants
GRADE not reported
Clinical Decision-Making of Repair vs. Replacement of Defective Direct Dental Restorations: A Multinational… 2025 All outcomes
Not applicable (single time-point survey, June to October 2023) · Multinational (21 countries across Africa, Asia, Europe, South America); general dental practice · Continent: Asia
RR 2.13 [1.40, 3.24]
11 studies · 1917 participants
GRADE not reported