Ceramic inlays for restoring posterior teeth

Hayashi M, Yeung A

Published Online:

January 21, 2009

More research is needed to determine whether tooth-coloured ceramic inlays compare well over the long term with amalgam, resin or gold inlays.
When tooth decay (caries) has caused cavities in the back (posterior) teeth, various materials can be used as fillings. These include amalgam, gold inlays, composite resin inlays and ceramic inlays. Amalgam is commonly used on back teeth for its longevity, although some are concerned about its dark appearance and mercury content. Other concerns about fillings include relative costs and pain during or after treatment. Ceramic inlays are tooth-coloured, and may be preferred for this reason. The review found that there is not enough strong evidence to compare ceramic inlays with other types of fillings.

Abstract (click to read)

Background:

In recent decades ceramic inlays have been used with the increasing requirements from patients for tooth-coloured restorations in posterior teeth. Ceramic inlays can offer an excellent appearance, however, their long-term prognosis is uncertain, as only a few studies have reported the long-term clinical performance of these restorations.

Objectives:

To compare the effectiveness of ceramic inlays in posterior teeth with other posterior restorations.

Search strategy:

We conducted an electronic search of the Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2002, Issue 1), MEDLINE and EMBASE from 1990 to 2001. Handsearching included relevant journals and bibliographies of all relevant papers and review articles from 1990 up to 2001. In addition, we contacted experts and companies conducting clinical research on ceramic restorations to find other trials or unpublished materials or to clarify ambiguous or missing data.

Selection criteria:

Randomised controlled trials, in which the longevity of ceramic inlays is compared with those of other posterior restorations.

Data collection and analysis:

Screening of possible studies and data extraction were independently conducted by two review authors using a specially designed chart. Authors of studies were contacted for additional information. The methodological quality of studies was assessed in duplicate using individual components. The Cochrane Collaboration statistical guidelines were followed and the results expressed as odds ratio (OR) and 95% confidence interval for dichotomous outcomes.

Main results:

Two studies fulfilled the criteria to be included in the review. However, one of them was later excluded from the review, as the study design was not clearly described. The remaining included study evaluated the clinical performance of 60 ceramic inlays and 20 gold inlays for 5 years. Seven of the 60 ceramic inlays and two of the 20 gold inlays failed at 5-year review. No ceramic inlays resulted in postoperative pain/discomfort after the treatment, however, one gold inlay did. The power of the included study was not great enough to detect an important difference in longevity and postoperative pain/discomfort between ceramic and gold inlays.

Authors' conclusions:

There is no strong evidence available to support any differences in the clinical performance of ceramic inlays and other posterior restorations. There is a limited number of well-designed clinical trials within this research area. Greater attention to the design and reporting of studies should be given to improve the study quality of ceramic restoration trials.

This record should be cited as:

Hayashi M, Yeung A. Ceramic inlays for restoring posterior teeth. Cochrane Database of Systematic Reviews 2003, Issue 1. Art. No.: CD003450. DOI: 10.1002/14651858.CD003450

Assessed as up to date:

November 1, 2002

Find the research

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Primary Review Group:

Oral Health Group

Health topics:

Dentistry & oral health > Dental caries > Treatment

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Ceramic inlays for restoring posterior teeth

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