title: Longevity of posterior composite restorations: a systematic review and meta-analysis.
abstract: The aim of this meta-analysis, based on individual participant data from several studies, was to investigate the influence of patient-, materials-, and tooth-related variables on the survival of posterior resin composite restorations. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a search resulting in 12 longitudinal studies of direct posterior resin composite restorations with at least 5 years' follow-up. Original datasets were still available, including placement/failure/censoring of restorations, restored surfaces, materials used, reasons for clinical failure, and caries-risk status. A database including all restorations was constructed, and a multivariate Cox regression method was used to analyze variables of interest [patient (age; gender; caries-risk status), jaw (upper; lower), number of restored surfaces, resin composite and adhesive materials, and use of glass-ionomer cement as base/liner (present or absent)]. The hazard ratios with respective 95% confidence intervals were determined, and annual failure rates were calculated for subgroups. Of all restorations, 2,816 (2,585 Class II and 231 Class I) were included in the analysis, of which 569 failed during the observation period. Main reasons for failure were caries and fracture. The regression analyses showed a significantly higher risk of failure for restorations in high-caries-risk individuals and those with a higher number of restored surfaces.
authors.affiliation: Radboud University Nijmegen Medical Centre, College of Dental Sciences, Preventive and Restorative Dentistry, Ph van Leydenlaan 25, PO Box 9101 6500HB Nijmegen, The Netherlands niek.opdam@radboudumc.nl.
authors.forename: N J M
authors.initials: NJ
authors.lastname: Opdam
authors.affiliation: Federal University of Pelotas, Graduate Program in Dentistry, Gonçalves Chaves, 457, 5th floor, Pelotas, RS, 96015560, Brazil.
authors.forename: F H
authors.initials: FH
authors.lastname: van de Sande
authors.affiliation: Radboud University Nijmegen Medical Centre, College of Dental Sciences, Preventive and Restorative Dentistry, Ph van Leydenlaan 25, PO Box 9101 6500HB Nijmegen, The Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Bronkhorst
authors.affiliation: Federal University of Pelotas, Graduate Program in Dentistry, Gonçalves Chaves, 457, 5th floor, Pelotas, RS, 96015560, Brazil.
authors.forename: M S
authors.initials: MS
authors.lastname: Cenci
authors.affiliation: Vrije Universiteit Brussels, Dept. of Oral Health Sciences, Laarbeeklaan 103, BE 1090 Brussels, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Bottenberg
authors.affiliation: Faculty of Health and Medical Sciences, University of Copenhagen, Institute of Odontology, Nørre Allé 20, DK-2200, Copenhagen, Denmark.
authors.forename: U
authors.initials: U
authors.lastname: Pallesen
authors.affiliation: Universität Witten/Herdecke, Abteilung für Zahnerhaltung und Präventive Zahnmedizin, Alfred-Herrhausen-Str. 44, D-58455 Witten, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Gaengler
authors.affiliation: Umeå University, Department of Odontology, SE-901 85 Umeå, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Lindberg
authors.affiliation: Radboud University Nijmegen Medical Centre, College of Dental Sciences, Preventive and Restorative Dentistry, Ph van Leydenlaan 25, PO Box 9101 6500HB Nijmegen, The Netherlands.
authors.forename: M C D N J M
authors.initials: MC
authors.lastname: Huysmans
authors.affiliation: Umeå University, Department of Odontology, SE-901 85 Umeå, Sweden.
authors.forename: J W
authors.initials: JW
authors.lastname: van Dijken
mesh_terms: D003188:Composite Resins / Q000737:chemistry*; D003733:Dental Caries Susceptibility; D003764:Dental Materials / Q000737:chemistry*; D019232:Dental Restoration Failure; D003793:Dental Restoration, Permanent / Q000592:standards*; D006801:Humans; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors
chemical_list: D003188:Composite Resins; D003764:Dental Materials
keywords: clinical outcomes; clinical studies/trials; operative dentistry; resin-based composite materials; restorative materials; risk factor(s)