Intervention Review

Ceramic inlays for restoring posterior teeth

  1. Mikako Hayashi1,*,
  2. Albert Yeung2

Editorial Group: Cochrane Oral Health Group

Published Online: 20 JAN 2003

Assessed as up-to-date: 31 OCT 2002

DOI: 10.1002/14651858.CD003450


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.

Author Information

  1. 1

    Osaka University Graduate School of Dentistry, Department of Restorative Dentistry & Endodontology, Osaka, Japan

  2. 2

    Lanarkshire NHS Board, Public Health Department, Hamilton, UK

*Mikako Hayashi, Department of Restorative Dentistry & Endodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka Suita, Osaka, 565-0871, Japan. mikarin@dent.osaka-u.ac.jp.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 20 JAN 2003

SEARCH

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

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 methods

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we contacted experts and companies conducting clinical research on ceramic restorations to find other trials or unpublished materials or to clarify ambiguous or missing data.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.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

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.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

應用在後牙復形的陶瓷嵌體

近十年來,因為患者對於後牙美觀修復的需求越來越高,陶瓷嵌體(ceramic inlays)也開始被大量使用。陶瓷嵌體可以提供完美的外觀,但是他們的長期預後尚未被確定,因為目前關於此類復形體的長期臨床報告數目有限。

目標

比較陶瓷嵌體與其他後牙填補體在後牙復形之效果。

搜尋策略

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。

選擇標準

以陶瓷嵌體相對其他後牙填補體之持久性為衡量結果的隨機對照試驗。

資料收集與分析

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。

主要結論

只有兩個試驗符合篩選標準,但是其中一個之後也因為其實驗設計說明不清被排除。剩下的唯一試驗,則是評估60個陶瓷嵌體及20個金嵌體(gold inlays)在5年研究時間中的臨床表現。在5年的觀察期中,有7個陶瓷嵌體及2個金嵌體最後失敗。所有的陶瓷嵌體都沒有引起術後疼痛或不適,但有一個金嵌體發生不適的現象。這個試驗並無法提供足夠的能力去證實陶瓷嵌體及金嵌體在臨床持久性及術後疼痛或不適感之間的關係。

作者結論

目前沒有較強的證據去證實陶瓷嵌體與其他後牙復型法臨床表現上有無不同。目前在此研究領域內,具有良好設計的臨床試驗較少,因此我們必須花更多心力去設計並報告實驗結果,以提升陶瓷復形試驗的研究品質。

翻譯人

本摘要由臺灣大學附設醫院劉耀方翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

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。