Desempenho clínico de restaurações diretas com resina composta autoadesiva: uma revisão sistemática e meta-análise

Abstract

This study aimed to conduct a systematic review and meta-analysis to compare the clinical performance of direct restorations using conventional or bulk-fill resin composites (RC) with self-adhesive RCs in permanent teeth, regardless of cavity type or adhesive strategy employed. Clinical performance was assessed based on the FDI (World Dental Federation) or the USPHS criteria (United States Public Health Service). After applying the search strategy across databases (Medline/PubMed, Web of Science, Scopus, Embase, LILACS, The Cochrane Library, Base, Google Scholar, and OpenGray), 971 articles were identified, and 13 were included for analysis. A total of 486 participants aged 6 to 79 years received 1.159 restorations, of which 658 were performed with conventional or bulk-fill RCs and 501 with self-adhesive RCs. The follow-up period ranged from immediately after restoration (baseline) to 60 months. Overall, the studies revealed no significant differences in the outcomes: marginal staining, color stability, fracture/retention, marginal adaptation, wear, postoperative sensitivity, recurrence of caries, erosion, or abrasion. The studies demonstrated a low risk of bias for most domains; however, the certainty of evidence was considered low for most of the evaluated criteria. Considering the limitations of this study, it can be concluded that self-adhesive RCs exhibit adequate clinical performance comparable to that of conventional or bulk-fill RCs. Nonetheless, the low certainty of evidence suggests that further clinical studies are needed to consolidate the findings of this review.