EQUIA vs Composite Restorations Class I, II and V - a Systematic Review

Objectives: To answer the PICO (Patient, Intervention, Control, Outcome) question: Do patients, who have received Class I, II or V tooth restorations placed with EQUIA, in comparison to patients who have received tooth restorations placed with resin composite, experience a higher restoration failure rate?
Methods: A systematic literature search for prospective clinical controlled trials was conducted in PubMed, DOAJ, GoogleScholar (Search cut-off: April 12, 2018). Reference check of included trial reports was undertaken and bias risk assessed. The number of restorations included at start of study, number of evaluated restorations and number of failed restorations at end of study was extracted for all intervention groups. The comparative effect estimate between EQUIA and resin composite restorations was computed as Risk ratio with 95% Confidence interval (CI).
Results: 1898 citations were found. Of these, 1890 were as non-relevant excluded. One case report and two older reports of an already included study were further excluded. Five trials were accepted for review. Selection bias risk of all trials and attrition bias risk of 2 trials was judges as high. The sample size of all intervention groups was low (N < 200). All established Risk ratios for Class I (after 9, 36 and 72-month trial follow-up); Class II (after 36 and 72-month) and Class V (after 12-month) were found not statistically significant (95% CI range between < 1.00 to > 1.00).
Conclusions: The current evidence suggests that patients, who have received Class I, II or V tooth restorations placed with EQUIA may not experience a higher restoration failure rate than patients who have received tooth restorations placed with composite resin, after up to 72, 36 and 12 months, respectively.