title: Anterior composite restorations: A systematic review on long-term survival and reasons for failure.
abstract: OBJECTIVE
  In this study the literature was systematically reviewed to investigate the clinical longevity of anterior composite restorations.
  
  
  METHODS
  Clinical studies investigating the survival of anterior light-cured composite restorations with at least three years of follow-up were screened and main reasons associated with restoration failure were registered.
  
  
  METHODS
  PubMed, Scopus, and Cochrane databases were searched without restriction on date or language. Reference lists of eligible studies were hand-searched. The grey literature search was not made systematically.
  
  
  METHODS
  Two reviewers screened titles and/or abstracts of 2273 unique studies. In total, 41 studies were selected for full-text reading, from which 17 were included in the qualitative synthesis. The included studies evaluated the clinical performance of Class III and/or IV restorations (10 studies), which were placed due to caries, fracture, or replaced old restorations; veneers and full-coverage restorations placed for aesthetic reasons (five studies); and restorations in worn teeth (two studies). Annual failure rates (AFRs) were calculated for each study.
  
  
  CONCLUSIONS
  In total, 1821 restorations were evaluated and the total failure rate was 24.1%. AFRs varied from 0 to 4.1% and survival rates varied from 53.4% to 100%. Class III restorations generally had lower AFRs than the other restorations. Few studies addressed factors associated with failure, which included adhesive technique, composite resin, retreatment risk, and time required to build-up the restoration. Fracture of tooth/restoration was the most common reason for failure, whereas failures related to aesthetic qualities (color, anatomical form, surface stain) were more frequent when restorations were placed for aesthetic reasons.
authors: Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil. Electronic address: flavio.demarco@pq.cnpq.br.
authors: Flávio F
authors: FF
authors: Demarco
authors: Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil.
authors: Kauê
authors: K
authors: Collares
authors: School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
authors: Fabio H
authors: FH
authors: Coelho-de-Souza
authors: Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil.
authors: Marcos B
authors: MB
authors: Correa
authors: Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil.
authors: Maximiliano S
authors: MS
authors: Cenci
authors: Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil.
authors: Rafael R
authors: RR
authors: Moraes
authors: Department of Restorative and Preventive Dentistry, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors: Niek J M
authors: NJ
authors: Opdam
mesh_terms: D003188:Composite Resins / Q000627:therapeutic use*; D003764:Dental Materials; D019232:Dental Restoration Failure; D003793:Dental Restoration, Permanent / Q000379:methods*; D006801:Humans
chemical_list: D003188:Composite Resins; D003764:Dental Materials
keywords: Anterior teeth; Build-ups; Clinical trials; Composite resins; Longevity; Survival; Veneers