Success and Survival of Composite Resin Restorations for the Management of Localized Anterior Tooth Wear: A Systematic Review and Meta-Analysis.

Purpose: To systematically review the literature and assess the success and survival rates of anterior composite restorations used in the management of anterior tooth surface loss, and to estimate complete posterior occlusion re-establishment when a Dahl approach is utilized.

Materials and methods: An electronic search was performed in the following databases: MEDLINE via Ovid and Scopus, for articles published from 1970 to November 2020. The systematic review was performed according to the PRISMA and Meta-analyses guidelines. Only randomized and non-randomized clinical trials, and Cohort studies that involved the exclusive use of direct/indirect anterior composite restorations for the management of localized anterior tooth wear were included.

Results: From the 724 studies identified through the initial search, six studies fulfilled the inclusion criteria and were included in the review; three prospective and three retrospective. In total, 141 patients received 1068 direct and indirect composite restorations. Follow-up periods ranged between 5 months and 10 years. The survival rate for anterior composite resin restorations reported in this review was 88% (95% CI: 70% to 98%) over a period of 2 and 10 years; however, high heterogeneity was observed amongst included studies; (I² = 97%). Sensitivity analysis reported survival rates of these restorations of 93% (95% CI: 85% to 98%) over a period of 2 and 7 years, (I² = 83%). Success rates were reported for these restorations of 68% (95% CI: 44% to 87%) over a period of 2 and 10 years, high heterogeneity; (I² = 98%). The success of composite Dahl in re-establishing posterior occlusion was 85% (CI: 73% to 94%).

Conclusions: The result of this systematic review and meta-analysis support the use of anterior composite restorations as a short-medium term option for the management of tooth wear. In the long-term, patients should be informed that these restorations will require monitoring, repairs, or replacements.