Clinical Complications and Survival Rate of Resin Matrix Ceramic Restorations: A Systematic Review and Meta-Analysis.

Objectives: The existing evidence regarding the clinical complications and survival rates associated with resin matrix ceramics (RMC) remains inconclusive. This systematic review aimed to assess the clinical complications, success, and survival rates of RMC restorations.

Materials and methods: A comprehensive search was conducted on PubMed, Scopus, and Cochrane databases in October 2024. Clinical studies evaluating the complications of RMC (polymer infiltrated ceramic network [PICN], and resin nano ceramic [RNC]) restorations were included. The risk of bias was assessed using Cochrane tools. A meta-analysis was performed using review manager, employing the inverse variance test with a fixed effects model, and results were presented as risk ratios with a 95% confidence interval, with an alpha level set at ≤ 0.05.

Results: Twenty-one studies were included. RMC full and partial crowns exhibited higher rates of clinical complications than ceramic restorations. Laminate and occlusal veneers demonstrated comparable outcomes between RMC and lithium disilicate materials. RMC intracoronal restorations showed clinical complications similar to those of lithium disilicate inlays and onlays but demonstrated lower complications compared to direct composite restorations. The overall success and survival rates of RMC restorations were found to be dependent on the restoration size and cavity design, with poorer success and survival rates associated with full and partial coverage crowns.

Conclusions: Resin matrix or hybrid ceramics may not be the preferred choice for full and partial coverage restorations. However, resin matrix ceramics demonstrated favorable clinical outcomes for intracoronal restorations and veneers, showing preference over direct composite restorations. Long-term randomized clinical trials are recommended to provide further evidence.

Clinical implications: The selection of materials is fundamental for the clinical success of restorations, ensuring prolonged, complication-free survival. It is essential to comprehend the clinical behavior of resin matrix ceramics or hybrid ceramics before their adoption in further clinical applications.