Longevity of Repair Versus Replacement of Partially Fractured Direct Composite Restorations in Permanent Teeth: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
The present systematic review evaluates the comparative longevity of repaired versus replaced partially fractured direct composite restorations in permanent teeth. The decision to repair or replace a fractured restoration is a significant clinical consideration, influencing functional stability, esthetics, and preservation of tooth structure. Following the PRISMA guidelines, a comprehensive search of PubMed, Scopus, and Web of Science was conducted using predefined keywords. Inclusion criteria encompassed clinical and laboratory studies assessing the longevity, success rate, and failure parameters of repaired and replaced restorations. The methodological quality of observational studies was assessed using the Newcastle-Ottawa Scale, while interventional studies were evaluated using the Cochrane Risk of Bias (ROB-2) tool. A meta-analysis was performed to compare restoration longevity based on parameters such as marginal adaptation, anatomic form, surface roughness, marginal staining, and secondary caries. Nine studies published between 2006 and 2018 were included, with follow-up periods ranging from 2 to 15 years. The meta-analysis revealed that repaired restorations demonstrated superior marginal adaptation (RR = 0.47; p < 0.05) and lower secondary caries incidence (RR = 0.72; p > 0.05), favouring repair over replacement. However, no significant differences were found for anatomic form, surface roughness, or marginal staining. While the methodological quality varied, studies consistently highlighted the benefits of repair in preserving tooth structure and minimizing treatment invasiveness. Repaired composite restorations offer comparable longevity to complete replacement while conserving more tooth structure and reducing patient discomfort. The findings advocate for prioritizing repair as a conservative approach before opting for full restoration replacement. Further longitudinal studies with standardized protocols are needed to optimize restorative strategies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.026 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.015 | 0.029 |
| Bibliometrics | 0.007 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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 source (direct Gemma or distilled Codex), 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".