Ceramic inlays for restoring posterior teeth
Editorial Group: Cochrane Oral Health Group
Published Online: 20 JAN 2003
Assessed as up-to-date: 31 OCT 2002
Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
How to Cite
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.
- Publication Status: Edited (no change to conclusions)
- Published Online: 20 JAN 2003
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.
To compare the effectiveness of ceramic inlays in posterior teeth with other posterior restorations.
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we contacted experts and companies conducting clinical research on ceramic restorations to find other trials or unpublished materials or to clarify ambiguous or missing data.
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.
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.
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.
Plain language summary
Ceramic inlays for restoring posterior teeth
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.
我們透過電腦搜尋了the Cochrane Oral Health Group Trials Register、the Cochrane Central Register of Controlled Trials (The Cochrane Library 2002年Issue 1)、MEDLINE、EMBASE從1990年到2001年的資料。也搜尋了從1990年到2001年相關領域期刊中的相關文章。另外也聯繫陶瓷復型體領域的專家或公司，詢問是否有其他試驗或未公開的資訊，來釐清模稜兩可或散失的數據。
我們篩選出所有的實驗數據是由不同的兩位回顧作者(MH and AY)利用特別設計的表格記錄下來的試驗。聯絡這些實驗的作者以取得更進一步的資訊。這些實驗的實驗方法會使用獨立的材料再做一次，以驗證其再現性。實驗會遵照Cochrane Oral Health Group statistical guidelines，所有實驗結果會用勝算比(OR)及95%信賴區間來表達。
此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。
我們必須做更多的研究去決定牙齒顏色的陶瓷嵌體，在長期來看會比銀粉(amalgam)、樹脂(resin)或金嵌體具有更好的表現。當因為蛀牙(tooth decay)導致後牙(back (posterior) teeth)產生凹陷時，有很多材料可以用來充填。這些材料包含有銀粉、金嵌體、複合樹脂嵌體 (composite resin inlays)和陶瓷嵌體。銀粉因為其持久性，較常使用在後牙區，雖然有人質疑其較暗的外觀及汞含量，也有人較關注其相對價格及填補過程及術後的疼痛問題。陶瓷嵌體因為其顏色較接近牙齒，在美觀因素上比較受到喜愛。本文獻回顧發現並沒有足夠強烈的證據，可以比較陶瓷嵌體與其他類型填補方式的差異。