Dental Composite Restorations Repair: A Systematic Review and Meta-analysis
Abdulmohsen Al Rabiah *
Restorative Dentistry, Dental Services Central Region, King Abdulaziz Medical City, Ministry of National Guard Health Affairs P.O. Box 22490, Riyadh 11426, Kingdom of Saudi Arabia.
Alamri Zahrah
King Saud bin Abdulaziz for Health Science, Riyadh, Saudi Arabia.
Tuwaym Malath
King Saud University, Dental College, Riyadh, Saudi Arabia.
Al Daghri Ebtihal
King Saud University, Dental College, Riyadh, Saudi Arabia.
Al Suhaibani Daniyah
King Saud University, Dental College, Riyadh, Saudi Arabia.
Al Qahtani Abdullah
Restorative Dentistry, Dental Services Central Region, King Abdulaziz Medical City, Ministry of National Guard Health Affairs P.O. Box 22490, Riyadh 11426, Kingdom of Saudi Arabia.
*Author to whom correspondence should be addressed.
Abstract
Background: Controversy exists in the literature regarding the most optimal repair procedure for improving the adhesion between the repair resin and the existing resin composite materials. Hence the aim of the present study was to do a systematic review and to analyze the adhesion potential of resin-based composites to similar and dissimilar composites and aimed to determine the possible dominant factors affecting the bond strength results.
Materials & Methods: Randomized clinical trials (RCTs) and prospective cohort design were searched through electronic databases including MEDLINE, PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials for randomized clinical trials (RCTs) until July 2020 that compared different methods of composite restoration repair and a minimum mean follow-up time of 1 year. There were no restrictions on a particular treatment indication or outcome measures. Two authors independently conducted screening, risk of bias assessment, and data extraction of eligible trials in duplicate. We applied the Cochrane risk of bias assessment tool to consider the risk of bias.
Results: We identified 10 articles; two of them were RCTs, and eight prospective cohort studies. There were 530 participants, with 990 teeth, dealing with resin-based composite (RBC) restorations. The intervention of defective restorations ranged from minimal intervention to total restoration replacement. The evaluation criteria were also varied with different evaluation protocols. The low number and heterogeneity of RCTs did not allow for meta-analyses.
Conclusions: Although different repair protocols are mentioned in the literature according to the included studies, an appropriate and definitive conclusion can't be drawn. However, it seems repairs versus replacements should be considered as the first line of treatment when all factors lead to repair rather than replacement. Further randomized controlled trials with high methodological quality need to be conducted in order to establish evidence-based recommendations, particularly for RBC repair.
Keywords: Resin-based composites, clinical protocols, repair, alternative treatments, replacement, randomized clinical trial, prospective cohorts studies, restorative dentistry