Survival and Complications of Partial Coverage Restorations on Posterior Teeth—A Systematic Review and Meta‐Analysis
Lea S. Prott, Stefano Pieralli, Patrick Klein, Frank A. Spitznagel, Fady Ibrahim, M.‐I. Metzendorf, Alonso Carrasco‐Labra, Markus B. Blatz, Petra C. Gierthmuehlen
Abstract
OBJECTIVE: To determine the clinical performance of partial coverage restorations (PCR) (onlays, occlusal veneers, and partial crowns) composed of different ceramic and ceramic-based materials to treat extended posterior defects. MATERIALS AND METHODS: MEDLINE, Scopus, CENTRAL, ClinicalTrials.gov, and the International Clinical Trials Registry Platform were searched (inception-February 2024) for randomized controlled trials (RCT) comparing posterior PCRs composed of different ceramic and ceramic-based materials with a minimum follow-up of 1 year. RESULTS: Six RCTs were included. Resin matrix ceramic (RMC) and lithium disilicate (LDS) restorations had a 3-year survival rate of 89.3% (95% CI 76.4-95.3) and 93.7% (95% CI 83.7-97.7), respectively, and leucite-reinforced glass ceramic (LRGC) restorations a range between 96.1% (95% CI 90.1-98.9) compared with RMC and 98.3% (95% CI 90.8-100) compared with LDS. After 1-3 years of follow-up, LDS slightly outperformed RMC on restoration failure and loss of retention (1.56 more failures and 1.78 more loss of retentions for RMC per 100 restoration-years [low certainty evidence]). No statistically significant differences between ceramic and ceramic-based materials were detected in short-term follow-up (1-3 years of follow-up). The long-term performance of posterior PCRs is uncertain. CONCLUSION: The survival of LDS restorations may slightly outperform RMC restorations after 3 years of follow-up across outcomes, except for bulk fracture. RCTs providing medium to long-term data are needed. CLINICAL SIGNIFICANCE: Ceramic and ceramic-based PCRs are a reliable treatment option to restore extended posterior defects.