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Meta-Analysis
. 2018 Feb 21;13(2):e0191942.
doi: 10.1371/journal.pone.0191942. eCollection 2018.

Meta-analysis of the clinical behavior of posterior direct resin restorations: Low polymerization shrinkage resin in comparison to methacrylate composite resin

Paula de Castro Kruly  1 , Marcelo Giannini  2 , Renata Corrêa Pascotto  1 , Laíse Midori Tokubo  1 , Uhana Seifert Guimarães Suga  1 , Any de Castro Ruiz Marques  3 , Raquel Sano Suga Terada  1
Affiliations
Meta-Analysis

Meta-analysis of the clinical behavior of posterior direct resin restorations: Low polymerization shrinkage resin in comparison to methacrylate composite resin

Paula de Castro Kruly et al. PLoS One. .

Abstract

Polymerization shrinkage of resin composite can compromise the longevity of restorations. To minimize this problem, the monomeric composition of composites have been modified. The objective of this study was to conduct a meta-analysis to assess the clinical behavior of restorations performed with low polymerization shrinkage resin composite in comparison with traditional methacrylates-based resin composite. This systematic review was registered at Prospero data system (CRD42015023940). Studies were searched in the electronic databases PubMed, Web of Science, Scopus, Lilacs and EMBASE according to a predefined search strategy. The inclusion criteria were as follow: (1) randomized controlled clinical trials with at least six months of follow-up; (2) studies investigating composites with monomers designed to reduce polymerization shrinkage; (3) studies conducted with class I or II restorations in the permanent dentition; and (4) studies that assessed at least one of the following criteria: marginal integrity/adaptation, marginal discoloration, recurent caries, retention of composite restorations, and postoperative sensitivity. Two independent reviewers analyzed the articles to determine inclusion and risk of bias. The search conducted in the databases resulted in a total of 14,217 studies. After reviewing the references and citations, 21 articles remained. The longest clinical follow-up time was 60 months. The meta-analysis of the data in the included studies demonstrated that only one variable (marginal adaptation after 12 months) showed statistically significant outcomes, in which methacrylates-based composites presented significantly better results than resin composites containing modified monomers. The good level of the scientific evidence as well as the overall low risk of bias of the included studies indicate that composites with silorane, ormocer or bulk-fill type modified monomers have a clinical performance similar to conventional resin composites.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flowchart showing the number of publications identified, retrieved, extracted, and included in the final analysis.
Fig 2
Fig 2. Risk of bias of selected studies.
Fig 3
Fig 3. Graphic representation of risk of bias of the selected studies.
Fig 4
Fig 4. Marginal adaptation at the 12-month clinical follow-up examination.
Fig 5
Fig 5. Marginal adaptation at the 24-month clinical follow-up examination.
Fig 6
Fig 6. Secondary caries at 12-month clinical follow-up examination.
Fig 7
Fig 7. Marginal discoloration at the 12-month clinical follow-up examination.
Fig 8
Fig 8. Marginal discoloration at the 24-month clinical follow-up examination.
Fig 9
Fig 9. Retention at the 12-month clinical follow-up examination.
See this image and copyright information in PMC

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