Clinical outcome of bonded partial indirect posterior restorations on vital and non-vital teeth: a systematic review and meta-analysis

Clin Oral Investig. 2021 Dec;25(12):6597-6621. doi: 10.1007/s00784-021-04187-x. Epub 2021 Oct 10.


Objectives: The survival rate of indirect partial adhesive restorations on vital versus endodontically treated teeth is still controversial. The hypothesis is that there may be a difference in the survival rate of partial adhesive restorations performed on non-vital teeth compared to vital teeth.

Materials and methods: This systematic review was conducted following the PRISMA guidelines. The considered clinical studies investigated the outcomes of adhesive inlays, onlays, and overlays conducted over the past 40 years, focusing on Kaplan-Meier survival curves to calculate the hazard ratio (primary objective) and the survival rate (secondary objective) between vital and non-vital teeth. The risk of bias was assessed using the Newcastle-Ottawa Scale. Studies included in the review were identified through bibliographic research on electronic databases ("PubMed," "Scopus," "Cochrane Central Register of Controlled Trial," and "Embase"). The K agreement between the two screening reviewers was evaluated.

Results: A total of 55,793 records were identified on PubMed, Scopus, and other bibliographic sources, and after the application of the eligibility and inclusion criteria, eight articles were included for qualitative analysis and six for quantitative analysis. The meta-analysis of the primary and secondary outcomes demonstrated that hazard ratios (HR = 8.41, 95% CI: [4.50, 15.72]) and survival rates (OR = 3.24, 95% CI: [1.76, 5.82]) seemed more favorable for indirect partial adhesive restorations on vital teeth than for those on endodontically treated teeth.

Conclusions: Within the limits of this study, these findings suggest that the risk of failure of indirect partial adhesive restorations on endodontically treated teeth is higher than on vital teeth.

Clinical relevance: The use of partial adhesive restorations on vital and endodontically treated teeth showed different long-term clinical outcomes.

Keywords: Dental restoration failure; Endodontically treated teeth; Inlay; Onlay; Overlay; Survival rates.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Composite Resins
  • Dental Restoration Failure
  • Dental Restoration, Permanent*
  • Humans
  • Inlays
  • Kaplan-Meier Estimate
  • Mass Screening
  • Tooth, Nonvital*


  • Composite Resins