Non-Cochrane · intervention · PM40578032
Failure Risk of Composite Resin and Amalgam Restorations: A Systematic Review and Meta-Analysis.
Al-Sulimmani Woroud, Al-Rasheed Asmaa, Al-Daraan Hebah, et al. · International dental journal · 2025 · PubMed · doi:10.1016/j.identj.2025.100871
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
1
current version
GRADE rated
0
No studies
0
Included studies
21
linked below
No studies 0 · 0%Ungraded 1 · 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 | Permanent posterior teeth (molars/premolars) receiving direct restoration | Permanent posterior teeth (13 studies) |
| Intervention | Composite resin restorations | Composite resin restorations |
| Comparison | Amalgam restorations | Amalgam restorations |
| Outcomes | Restoration failure (replacement, tooth/restoration fracture, secondary caries, postoperative sensitivity, toothache) | Restoration failure; pooled RR 0.96 (95% CI 0.68 to 1.34), no statistically significant difference; heterogeneity I2 = 97.02% |
| Study designs | Clinical trials and observational studies with at least 12 months follow-up; English-language; published 1990 onwards | 5 RCTs, 4 prospective cohort studies, 4 retrospective cohort studies (n=13) |
| Timing | At least 12 months follow-up | Follow-up 24 to 144 months (authors' reported range) |
Search date: Search performed August 2023 to December 2023 (records from 1990 onwards). Databases: PubMed/MEDLINE; Cochrane Central Register of Controlled Trials; Google Scholar
Questions and results
Composite resin restorations vs Amalgam restorations
Population: Permanent posterior teeth (molars/premolars) receiving direct restoration
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Restoration failure (replacement, tooth/restoration fracture, secondary caries, postoperative sensitivity, toothache) At least 12 months follow-up (included studies followed 24 to 144 months) 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%). Source: Abstract; Results (Meta-analysis paragraph); Figure 2 (forest plot) · same question in other reviews | RR 0.96 [0.68, 1.34] | 13 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 | No | No | yes |
| 3Choice of study designs explained | No | Yes | no |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | No | No | yes |
| 6Data extraction in duplicate | No | No | 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: Partial Yes | NRSI: Yes · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: No · NRSI: No | NRSI: No · RCT: 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 | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |
Included primary studies 21
Open as a trial list| Study | Also included by | Outcomes it informs here | Trial PICO | Results |
|---|---|---|---|---|
| Jardim 2020 Restorations after selective caries removal: 5-Year randomized trial. PMID:32585263 | 1 other review | not stated | not extracted yet | not extracted yet |
| Jardim et al. 2020 Restorations after selective caries removal: 5-Year randomized trial DOI:10.1016/j.jdent.2020.103416 | 1 other review | Restoration failure (replacement, tooth/restoration fracture, secondary caries, postoperative sensitivity, toothache) | not extracted yet | not extracted yet |
| Bencheikh et al. 2023 matched by author and year (probable) | this review only | Restoration failure (replacement, tooth/restoration fracture, secondary caries, postoperative sensitivity, toothache) | not extracted yet | not extracted yet |
| Bernardo 2007 Survival and reasons for failure of amalgam versus composite posterior restorations placed in a randomized clinical trial. PMID:17545266 | this review only | not stated | not extracted yet | not extracted yet |
| Bernardo et al. 2007 Survival and reasons for failure of amalgam versus composite posterior restorations placed in a randomized clinical trial DOI:10.14219/jada.archive.2007.0265 | this review only | Restoration failure (replacement, tooth/restoration fracture, secondary caries, postoperative sensitivity, toothache) | not extracted yet | not extracted yet |
| Birch 2016 Variations in survival time for amalgam and resin composite restorations: a population based cohort analysis. PMID:28509516 | this review only | not stated | not extracted yet | not extracted yet |
| Birch et al. 2016 Variations in survival time for amalgam and resin composite restorations: a population based cohort analysis DOI:10.1922/cdh_3825birch05 | this review only | Restoration failure (replacement, tooth/restoration fracture, secondary caries, postoperative sensitivity, toothache) | not extracted yet | not extracted yet |
| Collins 1998 A clinical evaluation of posterior composite resin restorations: 8-year findings. PMID:9611936 | this review only | not stated | not extracted yet | not extracted yet |
| Collins et al. 1998 A clinical evaluation of posterior composite resin restorations: 8-year findings DOI:10.1016/s0300-5712(97)00019-5 | this review only | Restoration failure (replacement, tooth/restoration fracture, secondary caries, postoperative sensitivity, toothache) | not extracted yet | not extracted yet |
| da Fonseca Cumerlato 2019 Reasons for direct restoration failure from childhood to adolescence: A birth cohort study. PMID:31449840 | this review only | not stated | not extracted yet | not extracted yet |
| da Fonseca Cumerlato et al. 2019 Reasons for direct restoration failure from childhood to adolescence: A birth cohort study DOI:10.1016/j.jdent.2019.103183 | this review only | Restoration failure (replacement, tooth/restoration fracture, secondary caries, postoperative sensitivity, toothache) | not extracted yet | not extracted yet |
| Estay 2017 Effect of Refurbishing Amalgam and Resin Composite Restorations After 12 Years: Controlled Clinical Trial. PMID:28857709 | this review only | not stated | not extracted yet | not extracted yet |
| Estay et al. 2017 Effect of Refurbishing Amalgam and Resin Composite Restorations After 12 Years: Controlled Clinical Trial DOI:10.2341/16-267-cr | this review only | Restoration failure (replacement, tooth/restoration fracture, secondary caries, postoperative sensitivity, toothache) | not extracted yet | not extracted yet |
| Kemaloglu et al. 2016 A 3-year randomized clinical trial evaluating two different bonded posterior restorations: Amalgam versus resin composite. PMID:27011734 | this review only | Restoration failure (replacement, tooth/restoration fracture, secondary caries, postoperative sensitivity, toothache) | not extracted yet | not extracted yet |
| Kim et al. 2013 The effect of clinical performance on the survival estimates of direct restorations. PMID:23493438 | this review only | Restoration failure (replacement, tooth/restoration fracture, secondary caries, postoperative sensitivity, toothache) | not extracted yet | not extracted yet |
| Letzel 1989 Survival rates and reasons for failure of posterior composite restorations in multicentre clinical trial DOI:10.1016/0300-5712(89)90156-5 | this review only | Restoration failure (replacement, tooth/restoration fracture, secondary caries, postoperative sensitivity, toothache) | not extracted yet | not extracted yet |
| Letzel 1989 Survival rates and reasons for failure of posterior composite restorations in multicentre clinical trial. PMID:2659634 | this review only | not stated | not extracted yet | not extracted yet |
| Opdam 2007 A retrospective clinical study on longevity of posterior composite and amalgam restorations. PMID:16417916 | this review only | not stated | not extracted yet | not extracted yet |
| Opdam et al. 2007 A retrospective clinical study on longevity of posterior composite and amalgam restorations DOI:10.1016/j.dental.2005.11.036 | this review only | Restoration failure (replacement, tooth/restoration fracture, secondary caries, postoperative sensitivity, toothache) | not extracted yet | not extracted yet |
| Santos et al. 2023 Five-Year Clinical Performance of Complex Class II Resin Composite and Amalgam Restorations-A Retrospective Study. PMID:37185466 | this review only | Restoration failure (replacement, tooth/restoration fracture, secondary caries, postoperative sensitivity, toothache) | not extracted yet | not extracted yet |
| Vieira et al. 2017 A Pragmatic Study Shows Failure of Dental Composite Fillings Is Genetically Determined: A Contribution to the Discussion on Dental Amalgams. PMID:29164121 | this review only | Restoration failure (replacement, tooth/restoration fracture, secondary caries, postoperative sensitivity, toothache) | not extracted yet | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match).
| Review | Shared studies | Jaccard |
|---|---|---|
| Comparative Meta-Analysis of Minimally Invasive and Conventional Approaches for Caries Removal in Permanent Dentition. (2024) | 2 | 0.07 |