Success Rate of Composite Resin Restoration Versus Fragment Reattachment in Complicated Crown Fractures of Permanent Anterior Teeth: A Systematic Review and Meta-Analysis.

Objective

This systematic review aimed to compare the clinical performance and survival rates of two restorative techniques, fragment reattachment and direct composite resin restoration, in the management of complicated crown fractures in permanent anterior teeth.

Materials And Methods

A comprehensive search was conducted across seven electronic databases and the gray literature, following PRISMA guidelines. The methodological quality of the studies included was assessed using the QUIPS tool. A meta-analysis and certainty of evidence assessment (GRADE approach) were conducted.

Results

Of the 8140 records identified, six studies met the inclusion criteria, encompassing both prospective and retrospective designs. The meta-analysis suggested a significantly lower failure risk for composite restorations than for fragment reattachment (RR = 0.43; 95% CI: 0.24-0.79); no statistically significant heterogeneity was detected among the included studies (I2 = 0%, p = 0.35), but only two studies were included. Fragment reattachment showed survival rates between 57.7% and 66.6%, whereas direct restorations achieved survival rates of up to 82.1%. Pulpal complications were more frequent in teeth with pulp exposure in cases treated with fragment reattachment. The certainty of the evidence was rated low for the primary outcomes.

Conclusions

Within the limitations of the present study, both restorative strategies demonstrated clinical viability; however, direct composite resin restorations showed higher survival rates and lower complication risks than fragment reattachment.