Findings

What do systematic reviews say?

38 questions · 62 findings · 9 reviews

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No studies found 9 · 14.5%GRADE not reported 46 · 74.2%Very low 1 · 1.6%Low 6 · 9.7%Moderate 0 · 0%High 0 · 0%

Direct resin composite veneer vs Indirect resin composite veneer

Colour match (aesthetic achievement) · Patients with permanent anterior teeth with intrinsic staining suitable for laminate veneer restorations

The review found no eligible studies for this question.

1 finding from 1 review

Direct versus indirect veneer restorations for intrinsic dental stains 2004 · Cochrane All outcomes
Planned outcome; colour match was not reported by the single included trial (Meijering 1998).
0 studies
No studies found

Resin composite restorations containing antibacterial agents vs Non-antibacterial containing composite restorations

Costs (direct costs of interventions) · Adults and adolescents in any age group with restorations in the permanent dentition and children with restorations in the primary dentition

The review found no eligible studies for this question.

1 finding from 1 review

Antibacterial agents in composite restorations for the prevention of dental caries 2013 · Cochrane All outcomes
No studies were included in this review, as we were unable to find any trials directly comparing antibacterial containing composites to other active interventions or controls.
0 studies
No studies found

Replacement of the defective restoration vs Repair of the defective restoration

Composite: Preference for replacement over repair - Scenario 2: loss of dental hard substance adjacent to the restoration · Dentists managing a defective direct resin composite restoration (posterior occlusal Class I; standardized vignette of a 30-year-old,…

For a defective composite restoration with loss of dental hard substance adjacent to the restoration, surveyed dentists most often preferred repair over replacement (pooled RR 0.75; p = 0.004); ungraded.

1 finding 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 · Overall (all 21 countries pooled)
RR 0.75 [0.62, 0.91]
21 studies · 3680 participants
GRADE not reported

Replacement of the defective restoration vs Repair of the defective restoration

Composite: Preference for replacement over repair - Scenario 1: partial loss or fracture of the restoration · Dentists managing a defective direct resin composite restoration (posterior occlusal Class I; standardized vignette of a 30-year-old,…

For a defective composite restoration with partial loss or fracture of the restoration, surveyed dentists most often preferred repair over replacement (pooled RR 0.72; p = 0.002); ungraded.

1 finding 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 · Overall (all 21 countries pooled)
RR 0.72 [0.58, 0.89]
21 studies · 3680 participants
GRADE not reported

Replacement of the defective restoration vs Repair of the defective restoration

Composite: Preference for replacement over repair - Scenario 7: non-stable (mobile) restoration · Dentists managing a defective direct resin composite restoration (posterior occlusal Class I; standardized vignette of a 30-year-old,…

For a defective composite restoration with non-stable (mobile) restoration, surveyed dentists most often preferred replacement over repair (pooled RR 12.17; p < 0.001); ungraded.

1 finding 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 · Overall (all 21 countries pooled)
RR 12.17 [8.17, 18.11]
21 studies · 3680 participants
GRADE not reported

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

Retention (restoration loss) · People with permanent posterior teeth restored with class I or II direct restorations

At 24 months, retention did not differ significantly between the composites (6 studies; 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
Six articles assessed restoration retention after 24 months; four showed no loss of retention in either group and two favored the control group, with no difference in the overall meta-analytic effect.
6 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 0.83 [0.33, 2.09]
11 studies · 1834 participants
GRADE not reported

Direct resin composite veneer vs Porcelain (indirect) veneer

Patient satisfaction · Patients with permanent anterior teeth with intrinsic staining suitable for laminate veneer restorations

1 finding from 1 review

Direct versus indirect veneer restorations for intrinsic dental stains 2004 · Cochrane All outcomes
2 years
Meijering 1998 (Table 4): patients satisfied at 2 years - direct resin composite 67%, porcelain 93%. No statistical comparison performed.
1 study
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

Replacement of the defective restoration vs Repair of the defective restoration

Composite: Preference for replacement over repair - Scenario 4: marginal discoloration · Dentists managing a defective direct resin composite restoration (posterior occlusal Class I; standardized vignette of a 30-year-old,…

For a defective composite restoration with marginal discoloration, surveyed dentists most often preferred replacement over repair (pooled RR 1.97; p < 0.001); ungraded.

1 finding 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 · Overall (all 21 countries pooled)
RR 1.97 [1.55, 2.49]
21 studies · 3680 participants
GRADE not reported

Replacement of the defective restoration vs Repair of the defective restoration

Composite: Preference for replacement over repair - Scenario 5: open margin · Dentists managing a defective direct resin composite restoration (posterior occlusal Class I; standardized vignette of a 30-year-old,…

For a defective composite restoration with open margin, surveyed dentists most often preferred replacement over repair (pooled RR 3.93; p < 0.001); ungraded.

1 finding 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 · Overall (all 21 countries pooled)
RR 3.93 [2.68, 5.76]
21 studies · 3680 participants
GRADE not reported

Replacement of the defective restoration vs Repair of the defective restoration

Composite: Preference for replacement over repair - Scenario 8: disruption of occlusal integrity · Dentists managing a defective direct resin composite restoration (posterior occlusal Class I; standardized vignette of a 30-year-old,…

For a defective composite restoration with disruption of occlusal integrity, surveyed dentists most often preferred repair over replacement (pooled RR 0.37; p < 0.001); ungraded.

1 finding 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 · Overall (all 21 countries pooled)
RR 0.37 [0.29, 0.48]
21 studies · 3680 participants
GRADE not reported

Replacement of the defective restoration vs Repair of the defective restoration

Composite: Preference for replacement over repair - Scenario 6: superficial discoloration · Dentists managing a defective direct resin composite restoration (posterior occlusal Class I; standardized vignette of a 30-year-old,…

For a defective composite restoration with superficial discoloration, surveyed dentists most often preferred repair over replacement (pooled RR 0.28; p < 0.001); ungraded.

1 finding 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 · Overall (all 21 countries pooled)
RR 0.28 [0.20, 0.38]
21 studies · 3680 participants
GRADE not reported

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

Marginal adaptation (clinically detectable deterioration) · People with permanent posterior teeth restored with class I or II direct restorations

At 60 months, marginal adaptation did not differ significantly between the composites (4 groups; ungraded).

5 findings from 1 review

Meta-analysis of the clinical behavior of posterior direct resin restorations: Low polymerization shrinkage resin in… 2018 All outcomes
60 months · Posterior class I/II restorations in permanent teeth; multicenter randomized controlled trials conducted across Europe, the Americas, and the Middle East
Three articles (four experimental groups) evaluated marginal adaptation after 60 months; two favored the experimental group but the overall meta-analytic effect was not statistically significant.
3 studies
GRADE not reported
Meta-analysis of the clinical behavior of posterior direct resin restorations: Low polymerization shrinkage resin in… 2018 All outcomes
36 months · Posterior class I/II restorations in permanent teeth; multicenter randomized controlled trials conducted across Europe, the Americas, and the Middle East
Five articles (six experimental groups) evaluated marginal adaptation after 36 months; results were mixed and the overall meta-analytic effect was not statistically significant.
5 studies
GRADE not reported
Meta-analysis of the clinical behavior of posterior direct resin restorations: Low polymerization shrinkage resin in… 2018 All outcomes
18 months · Posterior class I/II restorations in permanent teeth; multicenter randomized controlled trials conducted across Europe, the Americas, and the Middle East
Only two studies, both testing silorane composites, evaluated marginal adaptation after 18 months; one favored the experimental group and one the control group, and the overall meta-analytic effect was not…
2 studies
GRADE not reported

Show 2 more findings

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 1.77 [1.25, 2.50]
15 studies · 2280 participants
GRADE not reported
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
Odds ratio (OR) 1.46 [0.92, 2.33]
7 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

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

Marginal discoloration · People with permanent posterior teeth restored with class I or II direct restorations

At 24 months, marginal discoloration did not differ significantly (7 groups; p = 0.77; ungraded).

4 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
Odds ratio (OR) 1.08 [0.64, 1.84]
6 studies
GRADE not reported
Meta-analysis of the clinical behavior of posterior direct resin restorations: Low polymerization shrinkage resin in… 2018 All outcomes
60 months · Posterior class I/II restorations in permanent teeth; multicenter randomized controlled trials conducted across Europe, the Americas, and the Middle East
Two articles (three experimental groups) evaluated marginal discoloration after 60 months; the meta-analysis showed no difference in the overall effect.
2 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 1.53 [0.98, 2.41]
13 studies · 2082 participants
GRADE not reported

Show 1 more finding

Meta-analysis of the clinical behavior of posterior direct resin restorations: Low polymerization shrinkage resin in… 2018 All outcomes
18 months · Posterior class I/II restorations in permanent teeth; multicenter randomized controlled trials conducted across Europe, the Americas, and the Middle East
Only two articles, both testing silorane resins, evaluated marginal discoloration after 18 months; one favored the experimental group and one the control group, with the meta-analysis showing no difference in the…
2 studies
GRADE not reported

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

Postoperative sensitivity · People with permanent posterior teeth restored with class I or II direct restorations

Postoperative sensitivity at 12 months did not differ significantly between low polymerization shrinkage and methacrylate composites (OR 1.65, 95% CI 0.71 to 3.81; Moderate certainty).

2 findings from 1 review

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 1.65 [0.71, 3.81]
10 studies · 970 participants
GRADE not reported
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
Six articles (seven experimental groups) evaluated postoperative sensitivity after 24 months; four showed no sensitivity in either group and three favored the control group, but the overall meta-analytic effect was not…
6 studies
GRADE not reported

Selective caries removal (SCR) + composite resin vs Complete caries removal (CCR) + composite resin

Treatment failure (annual failure rate) · Children with deep dentine caries in primary molars restored with composite resin (indirect pulp treatment; pulpotomy only if pulp exposed…

Complete caries removal with composite resin had an annual failure rate of 6.8% in primary molars (single high-risk-of-bias RCT; low quality of evidence; not GRADE-rated).

2 findings from 1 review

Clinical effectiveness of restorative materials for the restoration of carious lesions in pulp treated primary teeth:… 2022 All outcomes
36 months · University, Brazil (Liberman et al. 2020 / Franzon et al. 2015) · Complete caries removal (CCR) arm
AFR 6.8
1 study · 48 participants
GRADE not reported
Clinical effectiveness of restorative materials for the restoration of carious lesions in pulp treated primary teeth:… 2022 All outcomes
36 months · University, Brazil (Liberman et al. 2020 / Franzon et al. 2015) · Selective caries removal (SCR) arm
AFR 17.1
1 study · 48 participants
GRADE not reported

Ceramic inlays (all types) vs Composite resin (direct restoration)

Outcome not reported · Adults who require restorative treatment in posterior teeth

The review found no eligible studies for this question.

1 finding from 1 review

Ceramic inlays for restoring posterior teeth 2003 · Cochrane All outcomes
No eligible randomised controlled trial comparing ceramic inlays with composite resin (direct) restorations was identified; this planned comparison could not be evaluated.
0 studies
No studies found