Sobrevida de restaurações estéticas onlay direta e indireta: uma revisão integrativa

Abstract

Dental caries is the second most prevalent disease in the world, when left untreated, great loss of tooth structure can occur. Onlay restorations are indicated in cases of extensive structure loss in posterior teeth involving at least one cusp. With the advancement of technology, various aesthetic materials have been used in this type of restoration. Objective: To evaluate clinical studies with direct and indirect esthetic onlays in order to identify which treatment option has the highest survival. Materials and methods: A search for papers was carried out in the MEDLINE/PubMed, Web of Science, Scopus and Cochrane Library databases without restriction of language or publication date. In vitro, animal, computerized studies, case reports, reviews, studies involving only metallic onlays, that involved inlays and overlays and that had a follow-up of less than 1 year were excluded. Clinical studies with a minimum of 10 patients, who received direct or indirect esthetic onlays with a follow-up of more than 12 months, which evaluated the survival of the restoration, were included. Results: 9 studies were selected, with 596 patients, mean age of 32.83 years. 741 onlays were evaluated by the studies, being 653 indirect restorations and 88 direct composite resin restorations. They had a mean follow-up of 33.4 months. The main failures were fractures, secondary caries, retention and marginal discoloration. Conclusion: Studies have shown that indirect onlays had a survival rate greater than 82%, but it was not possible to reach a quantitative conclusion for direct onlays due to lack of clinical studies in the area.