Bhagwat Sumita, Mandke Lalitagauri, Vandekar Mansi, Basmatkar Nidhi, Pawar Aishwarya, Khatri Rajni
Department of Conservative Dentistry and Endodontics, D.Y. Patil University School of Dentistry, Navi Mumbai, IND.
Cureus. 2025 Jul 27;17(7):e88836. doi: 10.7759/cureus.88836. eCollection 2025 Jul.
The present systematic review aims to compare the longevity of amalgam and composite resin restorations in adult human posterior permanent teeth, evaluating clinical performance, survival rates, failure causes, and influencing factors. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search was conducted in PubMed, Scopus, Web of Science, and other databases. Studies were included if they assessed the longevity of amalgam and composite resin restorations in adult posterior teeth with at least one year of follow-up. The Newcastle-Ottawa Scale (NOS) and Cochrane Risk of Bias (ROB) tool were used for the assessment of risk of bias. Eight studies (2003-2023) met the inclusion criteria, comprising randomized clinical trials, prospective, retrospective, and cross-sectional studies. Amalgam restorations exhibited superior longevity, with median survival times exceeding 16 years, compared to 11 years for composite restorations. Secondary caries was the most common cause of composite failure, whereas fracture was the primary reason for amalgam replacement. Patient factors, including oral hygiene and bruxism, significantly influenced restoration longevity. Amalgam restorations demonstrate greater durability than composite resins in posterior teeth. However, aesthetic preferences and advancements in composite materials continue to drive their usage. Future research should focus on improving composite longevity to provide viable alternatives to amalgam.
本系统评价旨在比较成人恒牙后牙中汞合金和复合树脂修复体的使用寿命，评估其临床性能、生存率、失败原因及影响因素。按照系统评价和Meta分析的首选报告项目（PRISMA）指南，在PubMed、Scopus、Web of Science和其他数据库中进行了全面检索。纳入的研究需评估成人后牙中汞合金和复合树脂修复体的使用寿命，且随访时间至少为一年。采用纽卡斯尔-渥太华量表（NOS）和Cochrane偏倚风险（ROB）工具评估偏倚风险。八项研究（2003 - 2023年）符合纳入标准，包括随机临床试验、前瞻性、回顾性和横断面研究。汞合金修复体表现出更长的使用寿命，中位生存时间超过16年，而复合树脂修复体为11年。继发龋是复合树脂修复失败最常见的原因，而折裂是汞合金修复体替换的主要原因。患者因素，包括口腔卫生和磨牙症，对修复体使用寿命有显著影响。在恒牙后牙中，汞合金修复体比复合树脂表现出更高的耐久性。然而，美学偏好和复合材料的进步继续推动其使用。未来的研究应专注于提高复合树脂的使用寿命，以提供汞合金的可行替代方案。
