Comparison and Evaluation of Quality and Survival of Indirect Composite Resin and Ceramic in Fixed Restorations: A Systematic Review and Meta-analysis

Abstract Aim: The following study aims to systematically review the quality and survival of indirect composite resin and ceramic in fixed restorations. Materials and Methods: Only clinical studies conducted were assessed, and the success and survival of the restorations were noted. The systematic review was registered at the National Institute of Health Research PROSPERO, the International Prospective Register of Systematic Reviews. The registration number is CRD42017079002. PubMed, Scopus, LILAC, Google Scholar, and Cochrane databases were searched and filtered. The most eligible and relevant studies were selected and tabulated based on their reasons for the selection. The patient/population, intervention, comparison, and outcomes strategy were used to decide the structured question. Population—Fixed restorations, Intervention—Indirect composite resin restorations, Comparison—All-ceramic or metal-ceramic restorations, and Outcome—Quality and survival. Hence the complete structured question of this review was: “In patients with fixed restorations, does the use of indirect composite resin restorations exhibit the same outcomes as all ceramic or metal-ceramic restorations?” A total of 250 articles were shortlisted from the databases. After the removal of the duplicates and automation screening, 43 articles remained. From these articles, 28 were excluded and 15 articles were sought for retrieval. After a full-text reading of these articles, four were chosen for the systematic review. Results: The meta-analysis included four studies, which compared survival rates of indirect composite resin restoration and ceramic restoration. The forest plot was produced according to the follow-up period. The pooled survival rate at 6 months showed no significant difference in the risk ratio between indirect composite resin and ceramic restoration ( P = 0.23). Survival rates at 12, 18, 24, and 36 months showed a significant difference in the risk ratio favoring ceramic restoration with less risk ( P = 0.007, 0.004, 0.002, and 0.002) having low to moderate heterogeneity ( I 2 = 0%, 25%, 33%, and 33%, respectively). There is no significant difference in the risk ratio at 42 and 120 months ( P = 0.20 and 0.32). Conclusions: From the level of evidence that is, available at our disposal, it could be said that ceramic restorations could be still considered as the restoration of choice in long-term cases. Indirect composite restorations could be used over a shorter period and this could make a difference.