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Factors Influencing the Longevity of Composite Restorations
TAKE-HOME MESSAGE
- There are multiple factors influencing the longevity of composite resin restorations. This systematic review assessed the global longevity of composite restorations from 33 studies. A wide range of annual failure rates (0.08%–6.3%), survival rates (23.0%–97.7%), and success rates (43.4%–98.7%) were reported. The main reasons for failure included secondary caries, fractures, and esthetic compromise. Patient-related factors, operator-related factors, and tooth-specific conditions were the main influencers of failure.
- The longevity of composite restorations is largely dependent on the patient's condition, the operator's skills, and tooth-specific factors but not on the patient's sex or the type of composite material used.
abstract
This abstract is available on the publisher's site.
Access this abstract now Full Text Available for ClinicalKey SubscribersOBJECTIVES
This review study provides an overview of factors that influence the longevity of all types of direct resin composite restorations.
METHODS
A systematic search was performed in PubMed, Scopus, and Web of Science databases for articles reporting data from primary longitudinal clinical studies on composite longevity published 2011-2021. Prospective or retrospective studies with restorations in permanent dentition, with follow-up periods of at least 5 years were included.
RESULTS
In total, 33 articles were included with different study designs, practice settings, datasets, countries of origin, and sample sizes. Annual failure rates of restorations ranged from 0.08% to 6.3%. Survival rates varied between 23% and 97.7%, success rates varied between 43.4% and 98.7%. Secondary caries, fractures, and esthetic compromise were main reasons for failures. Risk factors for reduced restoration durability included patient-level factors (e.g., caries risk, parafunctional habits, number of check-ups per year, socioeconomic status), dentist factors (different operators, operator's experience), and tooth/restoration factors (endodontic treatment, type of tooth, number of restored surfaces). Patient gender and the composite used generally did not influence durability.
SIGNIFICANCE
A number of risk factors are involved in the longevity of composite restorations. Differences between composites play a minor role in durability, assuming that materials and techniques are properly applied by dentists. Patient factors play a major role in longevity. The decision-making process implemented by dentists relative to the diagnosis of aging or failed restorations may also affect the longevity of restorations. Clinicians should treat patients comprehensively and promote a healthy lifestyle to ensure longevity.
Additional Info
Disclosure statements are available on the authors' profiles:
Longevity of composite restorations is definitely not only about materials
Dent Mater 2023 Jan 01;39(1)1-12, FF Demarco, MS Cenci, AF Montagner, VP de Lima, MB Correa, RR Moraes, NJM OpdamFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
This paper describes a systematic review of the literature on the factors that affect the longevity of resin-based composite restorations. All clinicians who have worked with these materials know that many factors are important; so, this review is extremely valuable. The confirmation that many studies found that larger resin-based composite restorations are more vulnerable is nice to have but will not surprise anyone.
Much more interesting is the finding that most studies did not detect a difference in longevity among different restorative materials. A lot of emphasis has been placed on material quality, in this journal among others, but these results suggest that the development of resin-based composites has reached the point where it makes little difference which material a clinician chooses because other factors are more important to longevity. As the authors indicated, this suggests that the choice of material can be made based on other factors, such as cost, ease of use, and preferred technique.
The results for other factors are interesting but not conclusive. Tooth type and position may influence longevity — in particular, posterior restorations may well be more vulnerable — but, as the authors noted, more research would be valuable.
As they say, this is even more true for patient factors. For example, the evidence for parafunctional habits, caries risk, and socioeconomic status is suggestive, as almost all studies found that they have an effect, but still very limited, as relatively few studies have recorded these factors. This is particularly true for socioeconomic status. Retrospective studies based on big data may be an effective way to investigate these points, and I am currently pursuing such research. This review is valuable to all clinicians using resin-based composites in daily practice.