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Title Insufficient Evidence To Compare Longevity Of Ceramic Restoration vs. Amalgam For Restoring Posterior Teeth
Clinical Question In adult patients requiring a posterior restoration, would ceramic inlays improve longevity compared to amalgam?
Clinical Bottom Line With the current level of evidence, it is difficult to suggest which restoration material is more beneficial for patients due to the lack of evidence.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 15470871Manhart/2004Patients requiring posterior restorations in permanent teeth Literature Review
Key resultsThe longevity and annual failure rates of amalgam and ceramic restorations for Class I and II cavities were determined. The annual failure rates for amalgam restorations was 3%, for ceramic restorations was 1.9% and for CAD/CAM ceramic restorations was 1.7%. The author concluded that the “indirect restorations exhibited a significantly lower mean annual failure rate than direct techniques” and that the “longevity of dental restorations is dependent upon many factors including materials, patient and dentist- related factors.” In addition, it is important to distinguish reasons that “cause early failures and those that are responsible for restoration loss after several years of service.”
Evidence Search Pubmed: "Dental Amalgam"[Mesh] AND "Ceramics"[Mesh]
Comments on
The Evidence
Information comparing dental amalgam and ceramic restoration longevity in posterior restorations is limited. There are many variables to consider when assessing the restorations longevity such as the materials used, the size of the restoration and skill of the provider. Clinical trials need to be conducted on patients requiring posterior restorations to compare the longevity of ceramic restorations and amalgam restorations.
Applicability The information presented was useful, but the literature review did not specify the patient selection criteria and the review is weak due to the lack of clinical study trials and non-randomized trials. Thus more clinical studies need to be made to answer the question.
Specialty/Discipline (General Dentistry) (Restorative Dentistry)
Keywords Ceramic restoration, amalgam, longevity
ID# 866
Date of submission: 04/14/2011spacer
E-mail hany@livemail.uthscsa.edu
Author Annie Yi Han
Co-author(s) e-mail
Faculty mentor/Co-author Joseph Bartoloni, DMD
Faculty mentor/Co-author e-mail Bartoloni@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
Comments and Evidence-Based Updates on the CAT
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by Mark Marbach, Priscilla Barajas (San Antonio, TX) on 11/30/2017
A PubMed search on November 2017 returned a systemic review comparing the longevity of amalgams to ceramic inlays by Hickel et al 2001 [PubMed ID 11317384]. SR results conclude that there are many factors that make it difficult to compare the longevity of restorations and therefore does not change the clinical bottom line and recommendations for further randomized control trials to investigate the many variables that will determine longevity for each material in posterior restorations.

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