Objective: To report and compare the survival of minimally invasive direct and indirect restorations of different materials for restoring the worn dentition.

Material and methods: A systematic search was conducted in six databases: MEDLINE, Web of Science, Scopus, CENTRAL, VHL, and EMBASE. The eligibility criteria of this systematic review used the PICO framework to address the following research question: "In dentate patients with a worn dentition (P), does rehabilitating their lost tooth structure with indirect restorations (I) or direct (C) effect the survival and success of treatment (O)?". Study characteristics, survival rates of the restorations were extracted from each article. No language restrictions were applied. Survival and prevalence estimates were calculated using random-effect models.

Results: The electronic search yielded 5009 entries, resulting in 14 publications selected for full-text analysis. These included 2 RCTs, 7 prospective, and 5 retrospective studies, with a varying level of methodological quality. This included 52% direct and 48% indirect restorations, using varying materials and follow-up periods. The survival of direct composite resin restorations versus indirect manually processed composite resin restorations showed no significant difference (n = 2; OR, 1.79 [95% CI, 0.64-5.05]; p = 0.270). For the prospective articles, the pooled prevalence estimates of the survival restorations were; direct (n = 3; 99% [95% CI, 0.97-1.00]) and; indirect (n = 5; 100% [95% CI, 0.99-1.00]). Lithium disilicate recorded the least amount of failures at 1.8%.

Conclusions: Although the survival estimates of indirect manually processed and direct composite resins were not significantly different, indirect restorations-especially those made of lithium disilicate ceramic-may offer better survival rates, compared to direct resin restorations in patients with worn dentition.

Clinical significance: Despite the limited evidence, indirect ceramic restorations appear to be well-suited for long-term treatment of worn dentition, whilst direct composite resin restorations are more suited as an medium-term solution.

Keywords: dental erosion; direct restoration; indirect restoration; tooth wear; worn dentition.

© 2024 Wiley Periodicals LLC.

目标： 报告并比较不同材料用于修复磨损牙列的微创直接和间接修复体的生存率。

材料与方法： 在六个数据库（MEDLINE、Web of Science、Scopus、CENTRAL、VHL 和 EMBASE）中进行了系统检索。本系统评价采用 PICO 框架来回答以下研究问题：“对于患有磨损牙列的牙齿患者 (P)，使用间接修复体 (I) 或直接修复体 (C) 来恢复缺失的牙齿结构是否会影响治疗的成功和生存率 (O)?”。从每篇文章中提取了研究特征以及修复体的生存率。没有语言限制。使用随机效应模型计算了生存率和流行病学估计值。

结果： 电子检索产生了 5009 条记录，最终选择 14 篇文章进行全文分析。这些文章包括 2 篇 RCT、7 篇前瞻性研究和 5 篇回顾性研究，方法学质量各异。其中包括 52% 的直接修复体和 48% 的间接修复体，使用不同的材料，并有不同的随访期。直接复合树脂修复体与间接手工加工的复合树脂修复体在生存率方面没有显著差异（n = 2；OR，1.79 [95% CI, 0.64-5.05]；p = 0.270）。对于前瞻性文章，合并后的修复体生存估计为：直接 (n = 3；99% [95% CI, 0.97-1.00]) 和间接 (n = 5；100% [95% CI, 0.99-1.00])。锂二硅酸盐记录的失败率最低，为 1.8%。

结论： 尽管手工加工间接修复体和直接复合树脂在生存估计方面没有显著差异，但间接修复体（特别是用锂二硅酸盐陶瓷制成的）可能比直接树脂修复体提供更高的生存率，在磨损牙列患者中尤其如此。

临床意义： 尽管证据有限，间接陶瓷修复体似乎更适合长期治疗磨损牙列，而直接复合树脂修复体则更适合作为中期解决方案。

关键词： 牙齿侵蚀；直接修复；间接修复；牙齿磨损；磨损牙列。