Failure Risk of Composite Resin and Amalgam Restorations: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
OBJECTIVE: This systematic review and meta-analysis were conducted to compare the failure risk between amalgam and composite resin materials in permanent posterior teeth. MATERIAL AND METHODS: Study eligibility requirements included clinical trials and observational studies with at least 12 months of follow-up. English-language studies from 1990 onwards were the only studies included. This review follows the Cochrane Handbook for Systematic Reviews of Interventions and the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Our search strategy included using the following databases: PubMed, Cochrane, and Google Scholar. The primary outcome was restoration failures, defined as restoration replacements, tooth and restoration fractures, secondary caries, postoperative sensitivity, and toothaches. We conducted a random-effects meta-analysis to determine the risk ratio (RR) of the included studies, and publication bias was assessed. The Cochrane Risk of Bias tool was employed to evaluate the quality of the clinical trials, while the Newcastle-Ottawa scale was used to assess the quality of other studies. RESULTS: The results were derived from 13 studies. The failure proportion for amalgam ranged from 0% to 50.0%, while that of composite resin restorations ranged from 0% to 62.7%. The meta-analysis did not find any statistically significant difference in failure risk between amalgam and composite resin restorations (RR: 0.96, 95% confidence intervals: 0.68-1.34). The Egger's test results did not show any significant evidence of publication bias in the meta-analysis (P > .05). CONCLUSION: This review did not reveal any statistically significant difference in the RR between composite resin and amalgam restorations. However, in their analyses, the 13 studies used varying definitions of failure and did not account for some important factors that might have influenced restoration failures. Future reviews need to account for other influential variables that contributed to restoration failures.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".