Non-Cochrane · intervention · PM41851361
"Vertical safety zone" as a clinical framework: Is temporarization necessary when increasing VDO within the VDR? A systematic review and meta-analysis.
Hajeer Osama, Hasan Amal · The Saudi dental journal · 2026 · PubMed · doi:10.1007/s44445-026-00146-y
Findings
4 findings
| Population | ||||
|---|---|---|---|---|
| Adults undergoing full-mouth or multi-unit fixed prosthodontic rehabilitation | Increase in VDO maintained within or equal to VDR (immediate or short-term mock-up) | None (single-arm pooled proportion) | Restoration survival (replacement-free) 3 to 5.5 years follow-up · Fixed restorations placed at increased VDO within or equal to VDR · Overall | Pooled proportion (%) 97.8 [95.6, 98.9] Moderate 4 studies · 2201 participants |
| Adults undergoing full-mouth or multi-unit fixed prosthodontic rehabilitation | Increase in VDO maintained within or equal to VDR (immediate or short-term mock-up) | None (single-arm pooled proportion) | Annual failure rate Per year of follow-up (3 to 5.5 years) · Fixed restorations placed at increased VDO within or equal to VDR · Overall | Annual failure rate (%/year) 1.28 [0.7, 2.1] Moderate 4 studies · 2201 participants |
| Adults undergoing full-mouth or multi-unit fixed prosthodontic rehabilitation | Increase in VDO maintained within or equal to VDR (immediate or short-term mock-up) | None (single-arm pooled proportion) | Clinical success (including minor repairs) 3 to 5.5 years follow-up · Fixed restorations placed at increased VDO within or equal to VDR · Overall | Pooled proportion (%) 94.0 [90.5, 96.5] Moderate 4 studies · 2201 participants |
| Adults undergoing full-mouth or multi-unit fixed prosthodontic rehabilitation with VDO increased within or equal to VDR | Temporarization phase before definitive restorations | Immediate definitive restorations without temporarization | Restoration survival, clinical success, adverse functional effects, patient-reported adaptation Fixed restorations placed at increased VDO within or equal to VDR | None of the studies conducted a direct comparison between full temporarization (>= 2 weeks) and immediate restoration. No studies found 0 studies |
Included primary studies 10
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Mehta 2015 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Abduo 2024 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Gulamali 2011 Survival analysis of composite Dahl restorations provided to manage localised anterior tooth wear (ten year follow-up). PMID:21869770 | 2011 | this review only | not stated | not extracted yet |
| Hemmings 2000 Tooth wear treated with direct composite restorations at an increased vertical dimension: results at 30 months. PMID:10709036 | 2000 | this review only | not stated | not extracted yet |
| Loomans 2018 Quantitative discoloration assessment of peri-implant soft tissue around zirconia and other abutments with different colours: A systematic… DOI:10.1016/j.jdent.2018.01.003 | 2018 | this review only | not stated | not extracted yet |
| Maier 2024 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Malchiodi 2019 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Proschel 2002 Secondary caries susceptibility of teeth with long-term performing composite restorations. PMID:12472848 | 2002 | this review only | not stated | not extracted yet |
| Ramseyer 2015 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Ramseyer 2015 Bond Strength of a Flowable Bulk-fill Resin Composite in Class II MOD Cavities. PMID:26525007 | 2015 | this review only | not stated | 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). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
| Review | Shared studies | Jaccard |
|---|---|---|
| Efficacy of various interventions for the management of white spot lesions associated with fixed orthodontic treatment: a systematic… (2026) | 1 | 0.01 |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adults undergoing full-mouth or multi-unit fixed prosthodontic rehabilitation | Patients with fixed rehabilitations at increased VDO within VDR (2,201 restorations; n=9 studies) |
| Intervention | Increase in VDO maintained within or equal to VDR | Increased VDO of 1.5 to 5 mm within VDR; direct composite and indirect ceramic restorations |
| Comparison | Rehabilitation with or without a temporarization phase | Temporarization absent or mock-up under 48 h; no direct comparison with full temporarization (n=0) |
| Outcomes | Restoration survival; clinical success; adverse functional effects (muscle pain, TMD); patient-reported adaptation | Replacement-free survival, clinical success, annual failure rate (n=4); TMD and muscular complications narrative |
| Study designs | Randomized trials, prospective or retrospective cohorts, case series with at least 10 patients | 1 RCT, 3 prospective cohorts, 4 observational studies, 1 case series |
| Timing | Not specified | 2.5 to 5.5 years follow-up |
AMSTAR 2 items
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 | No | No | yes |
| 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: Partial Yes · NRSI: Yes | NRSI: Yes · RCT: Partial Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: Yes | NRSI: No · RCT: Partial Yes | 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 | No | no |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Low | Critically Low | no |