ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Posterior Ceramics are less affected by bruxism with a greater longevity than posterior direct composite resins.
Clinical Question In an adult patient with bruxism wanting an esthetic posterior restoration, would ceramics compared to direct composite restorations have a greater longevity?
Clinical Bottom Line Posterior Ceramics seem to be less affected and have greater longevity than posterior direct composite resins in patients with bruxism.
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) 22192253Demarco/ 201234 studiesSystematic Review
Key resultsThe studies showed annual failure rates between 1% and 3% over a period of at least 5 years. The main reasons for failure were secondary caries related to individual caries risk, and fractures related to the strength of the material as well as bruxism.
#2) 22720292Beier/201246 Males, 74 Females Cohort Study
Key resultsSurvival rates 5 years: Onlays- 98.9% Inlays- 98.9% 10 years: Onlays- 92.4% Inlays- 96.8% 12 years: Onlays- 92.4% Inlays- 89.6% There was no greater risk of failure associated with a patient with parafunctional habits. Restorations on premolars survived longer than the restorations on molars, however, gold is still the most effective treatment when considering longevity.
Evidence Search "Ceramics"[Mesh] AND "Composite Resins"[Mesh]
Comments on
The Evidence
Demarco and colleagues had a systematic review which is a high level of evidence. They reviewed several randomized control trials of the success rate of composite restorations and reasons for failure. No meta-analysis was done. Beier and colleagues completed a cohort study with groups similar at the start. There was a >80% completion rate and the groups were not treated the same. The follow-up was adequate and the study was not double blind. The compliance was adequate and recall bias is likely. There weren’t any competing interests. There were no studies that specifically looked at bruxism and compared longevity of posterior resin composites to ceramic restorations. The demarco article was a five year study of resin composites and the Bier study was a fifteen year study.
Applicability The subjects in these articles are not representative of patients in general, as bruxism was only one factor that was being looked at in these studies. We can only extrapolate from this evidence that since the resin composites restorations were noted to have break down and failures at five years attributed to bruxism and the ceramic restorations did not show any greater failure associated with bruxism after 15 years, that the ceramic restorations would have greater longevity.
Specialty/Discipline (General Dentistry) (Restorative Dentistry)
Keywords Composite resin, dental ceramics, longevity
ID# 2408
Date of submission: 03/25/2013spacer
E-mail Garciam38@livemail.uthscsa.edu
Author Maya M. Garcia
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Rita Renee Parma, DDS
Faculty mentor/Co-author e-mail Parma@uthscsa.edu
Basic Science Rationale
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