Non-Cochrane · intervention · PM29466366
Meta-analysis of the clinical behavior of posterior direct resin restorations: Low polymerization shrinkage resin in comparison to methacrylate composite resin.
Kruly Paula de Castro, Giannini Marcelo, Pascotto Renata Corrêa, et al. · PloS one · 2018 · PubMed · doi:10.1371/journal.pone.0191942
Full textEvery question was extracted from the full text, figures and supplements by two independent LLM extractors, disagreements adjudicated. Rows cite where in the review the value comes from.
Questions
15
current version
GRADE rated
0
No studies
0
Included studies
23
linked below
No studies 0 · 0%Ungraded 15 · 100%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients with class I or II restorations in permanent (posterior) teeth | People with permanent posterior teeth restored with class I/II restorations (21 RCTs) |
| Intervention | Resin composites with monomers designed to reduce polymerization shrinkage (e.g., silorane, ormocer, bulk-fill, or other modified/new monomers) | Low polymerization shrinkage composites: silorane (13 studies), ormocer (4), bulk-fill (3), InTen-S (1) |
| Comparison | Conventional methacrylate-based (BIS-GMA/dimethacrylate) resin composite | Conventional methacrylate-based resin composite |
| Outcomes | Marginal integrity/adaptation, marginal discoloration, recurrent (secondary) caries, retention, postoperative sensitivity | Marginal adaptation, marginal discoloration, secondary caries, retention, postoperative sensitivity (5 outcomes) |
| Study designs | Randomized controlled clinical trials | 21 randomized controlled clinical trials (20 included in the meta-analysis; 1 excluded for lacking results-table data) |
| Timing | At least 6 months follow-up | Follow-up 12, 18, 24, 36 and 60 months (longest 60 months) |
Search date: Not specified. Databases: PubMed; Web of Science; EMBASE; Scopus; Lilacs
Questions and results
Low polymerization shrinkage resin composite (silorane, ormocer, bulk-fill or other modified-monomer composite) vs Conventional methacrylate-based resin composite
Population: People with permanent posterior teeth restored with class I or II direct restorations
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Marginal adaptation (clinically detectable deterioration) 36 months At 36 months, marginal adaptation did not differ significantly between the composites (6 groups; ungraded). Source: Results (Marginal adaptation) · same question in other reviews | 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 | Ungraded |
Marginal discoloration 24 months At 24 months, marginal discoloration did not differ significantly (7 groups; p = 0.77; ungraded). Source: Results (Marginal discoloration); Fig 8 · same question in other reviews | Odds ratio (OR) 1.08 [0.64, 1.84] | 6 studies | Ungraded |
Marginal adaptation (clinically detectable deterioration) 60 months At 60 months, marginal adaptation did not differ significantly between the composites (4 groups; ungraded). Source: Results (Marginal adaptation) · same question in other reviews | 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 | Ungraded |
Marginal adaptation (clinically detectable deterioration) 18 months At 18 months, marginal adaptation did not differ significantly between low polymerization shrinkage and methacrylate composites (2 studies; not statistically significant; ungraded). Source: Results (Marginal adaptation) · same question in other reviews | 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 | Ungraded |
Secondary caries 24 months No secondary caries was reported at 24 months in any of seven studies, so no meta-analysis was possible (ungraded). Source: Results (Secondary caries) · same question in other reviews | 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 | Ungraded |
Secondary caries 12 months Secondary caries at 12 months did not differ significantly between low polymerization shrinkage and methacrylate composites (OR 1.51, 95% CI 0.64 to 3.57; Moderate certainty). Source: Table 3 (Summary of findings); Fig 6; Results (Secondary caries) · same question in other reviews | OR 1.51 [0.64, 3.57] | 14 studies · 2087 participants | Ungraded |
Marginal discoloration 60 months At 60 months, marginal discoloration did not differ significantly (3 groups; ungraded). Source: Results (Marginal discoloration) · same question in other reviews | Two articles (three experimental groups) evaluated marginal discoloration after 60 months; the meta-analysis showed no difference in the overall effect. | 2 studies | Ungraded |
Retention (restoration loss) 24 months At 24 months, retention did not differ significantly between the composites (6 studies; ungraded). Source: Results (Retention) · same question in other reviews | 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 | Ungraded |
Postoperative sensitivity 12 months 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). Source: Table 3 (Summary of findings); Results (Postoperative sensitivity) · same question in other reviews | OR 1.65 [0.71, 3.81] | 10 studies · 970 participants | Ungraded |
Retention (restoration loss) 12 months Retention at 12 months did not differ significantly between low polymerization shrinkage and methacrylate composites (OR 0.83, 95% CI 0.33 to 2.09; Moderate certainty). Source: Table 3 (Summary of findings); Fig 9; Results (Retention) · same question in other reviews | OR 0.83 [0.33, 2.09] | 11 studies · 1834 participants | Ungraded |
Marginal discoloration 12 months Marginal discoloration at 12 months did not differ significantly between low polymerization shrinkage and methacrylate composites (OR 1.53, 95% CI 0.98 to 2.41; Moderate certainty). Source: Table 3 (Summary of findings); Fig 7; Results (Marginal discoloration) · same question in other reviews | OR 1.53 [0.98, 2.41] | 13 studies · 2082 participants | Ungraded |
Marginal discoloration 18 months At 18 months, marginal discoloration did not differ significantly between the composites (2 studies; ungraded). Source: Results (Marginal discoloration) · same question in other reviews | 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 | Ungraded |
Postoperative sensitivity 24 months At 24 months, postoperative sensitivity did not differ significantly between the composites (7 groups; ungraded). Source: Results (Postoperative sensitivity) · same question in other reviews | 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 | Ungraded |
Marginal adaptation (clinically detectable deterioration) 12 months Conventional methacrylate composites had significantly better 12-month marginal adaptation than low polymerization shrinkage composites (OR 1.77, 95% CI 1.25 to 2.50; Moderate certainty). Source: Table 3 (Summary of findings); Fig 4; Results (Marginal adaptation); Abstract · same question in other reviews | OR 1.77 [1.25, 2.50] | 15 studies · 2280 participants | Ungraded |
Marginal adaptation (clinically detectable deterioration) 24 months At 24 months, marginal adaptation did not differ significantly between the composites (8 groups; p = 0.11; ungraded). Source: Results (Marginal adaptation); Fig 5 · same question in other reviews | Odds ratio (OR) 1.46 [0.92, 2.33] | 7 studies | Ungraded |
AMSTAR 2 appraisal
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | Yes | No | no |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · The report states that RevMan was used but does not describe pooling methods, heterogeneity assessment, or why the meta-analysis methods were appropriate.: No | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | No | No | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | No | no |
| Overall | Critically Low | Critically Low | yes |
Included primary studies 23
Open as a trial list| Study | Also included by | Outcomes it informs here | Trial PICO | Results |
|---|---|---|---|---|
| Attia et al. 2014 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Baracco et al. 2012 Clinical Evaluation of a Low-shrinkage Composite in Posterior Restorations: One-Year Results DOI:10.2341/11-179-c | this review only | not stated | not extracted yet | not extracted yet |
| Baracco et al. 2013 Two-Year Clinical Performance of a Low-Shrinkage Composite in Posterior Restorations DOI:10.2341/12-364-c | this review only | not stated | not extracted yet | not extracted yet |
| Bayraktar et al. 2016 One‐year clinical evaluation of different types of bulk‐fill composites DOI:10.1111/jicd.12210 | this review only | not stated | not extracted yet | not extracted yet |
| Beck et al. 2014 One-year evaluation of two hybrid composites placed in a randomized-controlled clinical trial DOI:10.1016/j.dental.2014.05.006 | this review only | not stated | not extracted yet | not extracted yet |
| Bottenberg 2007 DOI:10.1016/j.dental.2006.07.002 | this review only | not stated | not extracted yet | not extracted yet |
| Bottenberg et al. 2007 A prospective randomised clinical trial of one bis-GMA-based and two ormocer-based composite restorative systems in class II cavities:… DOI:10.1016/j.jdent.2006.07.002 | this review only | not stated | not extracted yet | not extracted yet |
| Bottenberg et al. 2009 A prospective randomized clinical trial of one bis-GMA-based and two ormocer-based composite restorative systems in class II cavities:… DOI:10.1016/j.jdent.2008.11.011 | this review only | not stated | not extracted yet | not extracted yet |
| Efes et al. 2006 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Efes et al. 2013 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| El-Eraky et al. 2014 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Gasparello et al. 2016 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Gonçalves 2013 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Goncalves et al. 2013 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Karaman et al. 2016 Three-year clinical evaluation of class II posterior composite restorations placed with different techniques and flowable composite… DOI:10.1007/s00784-016-1940-y | this review only | not stated | not extracted yet | not extracted yet |
| Mahmoud et al. 2014 DOI:10.3290/j.jad.a31939 | this review only | not stated | not extracted yet | not extracted yet |
| Santos et al. 2014 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Schmidt et al. 2011 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| Schmidt et al. 2015 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| van Dijken and Lindberg 2009 matched by author and year (probable) | this review only | not stated | not extracted yet | not extracted yet |
| van Dijken and Pallesen 2014 A randomized controlled three year evaluation of “bulk-filled” posterior resin restorations based on stress decreasing resin technology DOI:10.1016/j.dental.2014.05.028 | this review only | not stated | not extracted yet | not extracted yet |
| Walter et al. 2014 Three‐Year Clinical Evaluation of a Silorane Composite Resin DOI:10.1111/jerd.12077 | this review only | not stated | not extracted yet | not extracted yet |
| Yazici et al. 2014 Three-year Clinical Evaluation of Different Restorative Resins in Class I Restorations DOI:10.2341/13-221-c | this review only | not stated | not extracted yet | not extracted yet |