title: Survival of directly placed ormocer-based restorative materials: A systematic review and meta-analysis of clinical trials.
abstract: In-vitro experiments on ormocers (ORganically MOdified CERamics) have provided controversial results. Consequently, the objectives of this meta-analysis were to (1) compare clinical performances of first generation ormocers versus conventional composite restorations, (2) explore the influence of various clinical factors and the impact of the quality of studies on published results.
  
  
  
  The following databases were explored until 2017/01/08: Ovid MEDLINE In-Process, Pubmed, CENTRAL, HTA, DARE, LILACS and Google Scholar. Studies of more than two years with quantitative comparisons between ormocers and control groups were selected. Outcome was the failure of a restoration (need to repair, remove or replace). Multivariate random-effects Poisson's regression was used to obtain a summary estimate.
  
  
  
  75% of the 8 included trials concerned Class I/II restorations. Although non-significant, the global failures were higher for ormocers (0.22 [-0.16; 0.61]). For Class I/II restorations, a significantly higher sensitivity was observed for ormocer-based materials compared to other composites (0.75 [0.01; 1.50]). An increase of the number of restorations per patient was associated with higher marginal adaptation failures for ormocers in Class I/II obturations (0.59 [0.11; 1.08]).
  
  
  
  This study did not identify clear advantages of using the first generation of ormocer-based fillings rather than conventional composites. Given the recent development of new, dimethacrylate-diluent-free ormocer matrices, potentially more stable and resistant, new randomized clinical trials should be developed comparing this new family of pure ormocers with current composites.
authors.affiliation: Paul Sabatier University, Dental Faculty, Department of Biomaterials, Anatomical Sciences and Radiology, Toulouse University Hospital, Toulouse, France; STROMALab, University of Toulouse, CNRS ERL 5311, EFS, INP-ENVT, Inserm U1031, UPS, Toulouse, France. Electronic address: paul.monsarrat@gmail.com.
authors.forename: Paul
authors.initials: P
authors.lastname: Monsarrat
authors.affiliation: Paul Sabatier University, Dental Faculty, Department of Biomaterials, Anatomical Sciences and Radiology, Toulouse University Hospital, Toulouse, France.
authors.forename: Sarah
authors.initials: S
authors.lastname: Garnier
authors.affiliation: Paul Sabatier University, Dental Faculty, Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France; Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada.
authors.forename: Jean-Noel
authors.initials: JN
authors.lastname: Vergnes
authors.affiliation: Paul Sabatier University, Dental Faculty, Department of Biomaterials, Anatomical Sciences and Radiology, Toulouse University Hospital, Toulouse, France.
authors.forename: Karim
authors.initials: K
authors.lastname: Nasr
authors.affiliation: Université de Lyon, Université Lyon 1, Faculté Dentaire & Hospices Civils de Lyon, Service d'Odontologie, Lyon, France; Université de Lyon, Université Lyon 1, Laboratoire des Multimatériaux et Interfaces, LMI UMR CNRS 5615, Lyon, France.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Grosgogeat
authors.affiliation: Paul Sabatier University, Dental Faculty, Department of Biomaterials, Anatomical Sciences and Radiology, Toulouse University Hospital, Toulouse, France.
authors.forename: Sabine
authors.initials: S
authors.lastname: Joniot
mesh_terms: D002986:Clinical Trials as Topic; D003188:Composite Resins; D003764:Dental Materials; D003793:Dental Restoration, Permanent; D006801:Humans; D063225:Organically Modified Ceramics
chemical_list: D003188:Composite Resins; D003764:Dental Materials; D063225:Organically Modified Ceramics
keywords: Composite resins; Dental materials; Dental restoration; Meta-analysis; Organically modified ceramics; Permanent