METHODS: A literature search was conducted by using electronic databases and relevant references for clinical studies on direct and indirect dental restorations with a follow-up of at least 3 years. The risk of bias was assessed with the ROB2 and the ROBINS- I tools. The I2 statistic was used for the assessment of heterogeneity. The authors reported summary estimates of annual failure rates of single-tooth restorations using a random-effects model.
RESULTS: Of 1415 screened articles, 52 (18 RCTs, 30 prospective, 4 retrospective) met the inclusion criteria. No articles with direct comparisons were identified. No significant difference was found in the annual failure rates of single teeth restored with either direct or indirect restorations, which were calculated as 1% using a random-effects model. High heterogeneity was found, ranging from 80% (P⟨0.01) for studies on direct restorations to 91% (P⟨0.01) for studies on indirect restorations. Most of the studies presented some risk of bias.
CONCLUSIONS: Annual failure rates were similar for direct and indirect single-tooth restorations. Further randomized clinical trials are needed to draw more definitive conclusions.
方法:使用电子数据库和相关参考文献对直接和间接牙科修复的临床研究进行了文献检索,随访至少3年。使用ROB2和ROBINS-I工具评估偏倚风险。I2统计量用于异质性的评估。作者报告了使用随机效应模型对单齿修复的年故障率的汇总估计。
结果:在1415篇筛选的文章中,52(18项随机对照试验,30个潜在的,4回顾性)符合纳入标准。没有发现直接比较的文章。用直接或间接修复修复的单颗牙齿的年失败率没有发现显着差异。使用随机效应模型计算为1%。发现高度异质性,从直接修复研究的80%(P﹤0.01)到间接修复研究的91%(P﹤0.01)。大多数研究都存在一些偏见的风险。
结论:直接和间接单齿修复的年失败率相似。需要进一步的随机临床试验来得出更明确的结论。