Longevity of restorations in posterior teeth and reasons for failure.
OBJECTIVE
This article compiles a survey on the longevity of restorations in stress-bearing posterior cavities and assesses possible reasons for failure.


METHODS
The dental literature predominantly of the last decade was reviewed for longitudinal, controlled clinical studies and retrospective cross-sectional studies of posterior restorations. Only studies investigating the clinical performance of restorations in permanent teeth were included. Longevity and annual failure rates of amalgam, direct composite restorations, glass ionomers and derivative products, composite and ceramic inlays, and cast gold restorations were determined for Class I and II cavities.


RESULTS
Annual failure rates in posterior stress-bearing restorations are: 0% to 7% for amalgam restorations, 0% to 9% for direct composites, 1.4% to 14.4% for glass ionomers and derivatives, 0% to 11.8% for composite inlays, 0% to 7.5% for ceramic restorations, 0% to 4.4% for CAD/CAM ceramic restorations, and 0% to 5.9% for cast gold inlays and onlays.


CONCLUSIONS
Longevity of dental restorations is dependent upon many different factors that are related to materials, the patient, and the dentist. The principal reasons for failure were secondary caries, fracture, marginal deficiencies, wear, and postoperative sensitivity. A distinction must be made between factors causing early failures and those that are responsible for restoration loss after several years of service.
Hickel
R
R
Department of Restorative Dentistry and Periodontology, Ludwig Maximilians University, Munich, Germany. hickel@dent.med.uni-muenchen.de
Manhart
J
J
D001641:Bicuspid; D002516:Ceramics / Q000737:chemistry; D003188:Composite Resins / Q000737:chemistry; D017076:Computer-Aided Design; D018849:Controlled Clinical Trials as Topic; D003430:Cross-Sectional Studies; D003723:Dental Amalgam / Q000737:chemistry; D003731:Dental Caries / Q000209:etiology; D003734:Dental Casting Investment / Q000737:chemistry; D003737:Dental Cavity Preparation / Q000145:classification; D018772:Dental Marginal Adaptation; D003764:Dental Materials / Q000737:chemistry*; D019232:Dental Restoration Failure; D019554:Dental Restoration Wear; D003793:Dental Restoration, Permanent / Q000145:classification / Q000379:methods*; D003807:Dentin Sensitivity / Q000209:etiology; D005899:Glass Ionomer Cements / Q000737:chemistry; D006047:Gold Alloys / Q000737:chemistry; D006801:Humans; D007284:Inlays; D008137:Longitudinal Studies; D008963:Molar; D019279:Resin Cements / Q000737:chemistry; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors
D003188:Composite Resins; D003734:Dental Casting Investment; D003764:Dental Materials; D005899:Glass Ionomer Cements; D006047:Gold Alloys; D019279:Resin Cements; D003723:Dental Amalgam