Dental Materials
Volume 26, Issue 10 , Pages 993-1000, October 2010

Clinical performance of cervical restorations—A meta-analysis

  • Siegward D. Heintze

      Affiliations

    • R&D, Ivoclar Vivadent AG, Schaan, Liechtenstein
    • Corresponding Author InformationCorresponding author at: Preclinical Research, R&D, Ivoclar Vivadent AG, Bendererstrasse 2, FL-9494 Schaan, Liechtenstein. Tel.: +423 235 3570; fax: +423 233 1279.
    • ,
  • Christiane Ruffieux

      Affiliations

    • Biostatistics Unit, Institute for Social and Preventive Medicine, University of Lausanne, Switzerland
    • ,
  • Valentin Rousson

      Affiliations

    • Biostatistics Unit, Institute for Social and Preventive Medicine, University of Lausanne, Switzerland

Received 4 November 2009; received in revised form 26 February 2010; accepted 16 June 2010.

Abstract 

Objectives

To carry out a meta-analysis in order to assess the influencing factors on retention loss and marginal discoloration of cervical restorations made of composites and glass ionomer (derivates).

Methods

The literature was searched for prospective clinical studies on cervical restorations with an observation period of at least 18 months.

Results

Fifty clinical studies involving 40 adhesive systems matched the inclusion criteria. On average, 10% of the cervical fillings were lost and 24% exhibited marginal discoloration after 3 years. The variability ranged from 0% to 50% for retention loss and from 0% to 74% for marginal discoloration. Hardly any secondary caries was detected. When linear mixed models with a study and experiment effect were used, the analysis revealed that the adhesive/restorative class had the most significant influence, with 2-step self-etching adhesive systems performing best and 1-step self-etching adhesive systems performing worst; 3-step etch-and-rinse systems, glass ionomers/resin-modified glass ionomers, 2-step etch-and-rinse systems and polyacid-modified resin composites were ranked in between. Restorations placed in teeth whose dentin/enamel had been prepared/roughened showed a statistically significant higher retention rate than those placed in teeth with unprepared dentin (p<0.05). Beveling of the enamel and the type of isolation used (rubberdam/cotton rolls) had no significant influence.

Significance

The clinical performance of cervical restorations is significantly influenced by the type of adhesive system used and/or the adhesive class to which the system belonged and whether the dentin/enamel is prepared or not. 2-Step self-etching- and 3-step etch&rinse systems shall be chosen over 1-step self-etching systems and glass ionomer derivates. The dentin (and enamel) surface shall be roughened before placement of the restoration.

Keywords: Class V, Retention, Marginal discoloration, Dentin preparation, Rubberdam, Meta-analysis

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PII: S0109-5641(10)00162-4

doi:10.1016/j.dental.2010.06.003

Dental Materials
Volume 26, Issue 10 , Pages 993-1000, October 2010

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