Clinical Longevity of Sonicated and Unsonicated Composite Resin Restorations in Posterior Permanent Teeth: A Systematic Review and Meta-Analysis

Abstract

Objective: To evaluate the clinical longevity of Class I and II composite resin restorations with and without using sonic energy through a systematic literature review and meta-analysis. Material and Methods: Five databases were consulted: PubMed, Cochrane Library, Web of Science, Scopus, VHL-LILACS, and BBO and gray literature. The search was carried out in January 2024. The inclusion criteria comprised clinical trials evaluating the success/longevity of composite resin restorations with and without sonic energy. RoB and ROBINS-I assessed the risk of bias. The meta-analysis analyzed the number of restorations with alpha USPHS scores. Heterogeneity was assessed (I² index, p0.05) for: anatomical shape (CI=1.05 [0.95,1.15]; I²=0%; p=0.37); color stability (CI=1.02 [0.93,1.13; I²=0%, p=0.65); marginal adaptation (CI=1.05 [0.95,1.16]; I²=%; p=0.38); postoperative sensitivity (CI=1.01 [0.93,1.10]; I²=0%; p=0.80); secondary caries (CI=1.01 [0.93,1.10]; I²=0%; p=0.80); marginal discoloration (CI=1.05 [0.95,1.16]; I²=0%; p=0.38), surface texture (CI=1.09 [0.97,1.23]; I²=19%; p=0.14) and retention (CI=1.00 [1.91,1.10]; I²=0%; p=1.00). The certainty of the evidence was very low. Conclusion: No evidence supports using sonic energy for direct composite resin restorations, regardless of the technique and the restored tooth. More robust and well-conducted studies should be performed.

Keywords

• Composite Resins
• Longevity
• Systematic Review
• Meta-Analysis