Systematic Reviews Comparing Direct and Indirect Restorations: An Umbrella Review That Examines Restoration Type and Confidence in Results

IF 2.2 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical and Experimental Dental Research Pub Date : 2025-05-26 DOI:10.1002/cre2.70149

Mona Kimmel, Clovis Mariano Faggion Jr.

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引用次数: 0

Abstract

Objectives

There are two technologies for restoring individual structurally defective teeth. A direct restoration is applied chairside in one appointment, while an indirect restoration needs to be lab-produced before application. This umbrella review of previous English systematic reviews was conducted to determine if there was any difference between the two restoration types in adults regarding failure and the review methodological quality.

Materials and Methods

On November 7, 2023, three databases (PubMed, Web of Science, and Cochrane) were searched for systematic reviews comparing direct and indirect restorations. Two researchers independently selected the studies and extracted the information from the full texts of the articles. The methodological quality of the reviews was assessed with the measurement tool to assess systematic reviews (AMSTAR-2) checklist.

Results

Initially, 436 articles were identified; after screening, a total of 20 systematic reviews were included. Overall, the reviews indicated that both restorations produced similar results. There was a preference for direct restoration of small defects and indirect restoration for teeth with fewer than two remaining walls. Direct restoration was more cost and production-efficient, but indirect restoration offered better long-term results for larger defects. The overall confidence in the systematic review results ranged from critically low to high.

Conclusions

Either restoration is a valid option for restoring damaged teeth. The success of the restoration depends on the patient, operator, remaining tooth structure, and restoration material. Because of the high heterogeneity of patients, teeth, and material factors, there is no recommendation on the restoration type.

Abstract Image

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比较直接和间接修复的系统评价：检查修复类型和结果信心的总括性评价

目的修复个体结构缺陷牙有两种技术。直接修复在一次预约中应用，而间接修复需要在应用前进行实验室生产。本综述对以往的英语系统综述进行了综述，以确定两种成人修复类型在失败和综述方法质量方面是否存在差异。2023年11月7日，检索PubMed、Web of Science和Cochrane三个数据库，比较直接修复和间接修复的系统评价。两名研究人员独立选择研究并从文章全文中提取信息。评价的方法学质量用评估系统评价的测量工具（AMSTAR-2）检查表进行评估。最初，共鉴定出436篇文献；筛选后，共纳入20篇系统评价。总的来说，回顾表明两种修复产生了相似的结果。对于小缺损的直接修复和剩余牙壁少于2个的间接修复是首选。直接修复成本更高，生产效率更高，但是对于较大的缺陷，间接修复提供了更好的长期效果。对系统评价结果的总体信心从极低到高不等。结论两种修复体均是修复损伤牙的有效选择。修复的成功取决于患者、操作者、剩余牙齿结构和修复材料。由于患者、牙齿和材料因素的高度异质性，对修复类型没有推荐。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical and Experimental Dental Research DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

3.30

自引率

5.60%

发文量

165

审稿时长

26 weeks

期刊介绍： Clinical and Experimental Dental Research aims to provide open access peer-reviewed publications of high scientific quality representing original clinical, diagnostic or experimental work within all disciplines and fields of oral medicine and dentistry. The scope of Clinical and Experimental Dental Research comprises original research material on the anatomy, physiology and pathology of oro-facial, oro-pharyngeal and maxillofacial tissues, and functions and dysfunctions within the stomatognathic system, and the epidemiology, aetiology, prevention, diagnosis, prognosis and therapy of diseases and conditions that have an effect on the homeostasis of the mouth, jaws, and closely associated structures, as well as the healing and regeneration and the clinical aspects of replacement of hard and soft tissues with biomaterials, and the rehabilitation of stomatognathic functions. Studies that bring new knowledge on how to advance health on the individual or public health levels, including interactions between oral and general health and ill-health are welcome.