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Meta-Analysis
. 2025 Mar;37(3):620-641.
doi: 10.1111/jerd.13353. Epub 2024 Nov 19.

Survival and Complications of Partial Coverage Restorations on Posterior Teeth-A Systematic Review and Meta-Analysis

L S Prott  1   2 , S Pieralli  3 , P Klein  1 , F A Spitznagel  1 , F Ibrahim  1 , M-I Metzendorf  4 , A Carrasco-Labra  2   5 , M B Blatz  2 , P C Gierthmuehlen  1
Affiliations
Meta-Analysis

Survival and Complications of Partial Coverage Restorations on Posterior Teeth-A Systematic Review and Meta-Analysis

L S Prott et al. J Esthet Restor Dent. 2025 Mar.

Abstract

Objective: To determine the clinical performance of partial coverage restorations (PCR) (onlays, occlusal veneers, and partial crowns) composed of different ceramic and ceramic-based materials to treat extended posterior defects.

Materials and methods: MEDLINE, Scopus, CENTRAL, ClinicalTrials.gov, and the International Clinical Trials Registry Platform were searched (inception-February 2024) for randomized controlled trials (RCT) comparing posterior PCRs composed of different ceramic and ceramic-based materials with a minimum follow-up of 1 year.

Results: Six RCTs were included. Resin matrix ceramic (RMC) and lithium disilicate (LDS) restorations had a 3-year survival rate of 89.3% (95% CI 76.4-95.3) and 93.7% (95% CI 83.7-97.7), respectively, and leucite-reinforced glass ceramic (LRGC) restorations a range between 96.1% (95% CI 90.1-98.9) compared with RMC and 98.3% (95% CI 90.8-100) compared with LDS. After 1-3 years of follow-up, LDS slightly outperformed RMC on restoration failure and loss of retention (1.56 more failures and 1.78 more loss of retentions for RMC per 100 restoration-years [low certainty evidence]). No statistically significant differences between ceramic and ceramic-based materials were detected in short-term follow-up (1-3 years of follow-up). The long-term performance of posterior PCRs is uncertain.

Conclusion: The survival of LDS restorations may slightly outperform RMC restorations after 3 years of follow-up across outcomes, except for bulk fracture. RCTs providing medium to long-term data are needed.

Clinical significance: Ceramic and ceramic-based PCRs are a reliable treatment option to restore extended posterior defects.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Prisma Flow chart for article selection.
FIGURE 2
FIGURE 2
Risk of bias assessment summary according the Revised Cochrane risk‐of‐bias tool for randomized trials (Rob2).
FIGURE 3
FIGURE 3
Forest plot on the outcome of restoration failure including four RCTs with a comparison of RMC and LDS.
FIGURE 4
FIGURE 4
Forest plot on the outcome of bulk fracture including four RCTs with a comparison of RMC and LDS.
FIGURE 5
FIGURE 5
Forest plot on the outcome of chipping including four RCTs with a comparison of RMC and LDS.
FIGURE 6
FIGURE 6
Forest plot on the outcome of loss of retention including three RCTs with a comparison of RMC and LDS.
FIGURE 7
FIGURE 7
Forest plot on the outcome of endodontic complication including four RCTs with a comparison of RMC and LDS.
See this image and copyright information in PMC

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