Restorations in primary teeth: a systematic review on survival and reasons for failures
Abstract
Background: Several restorative materials with specific indications are used for filling cavities in primary teeth. Aim: To systematically review the literature in order to investigate the longevity of primary teeth restorations and the reasons for failure. Design: Electronic databases were screened, and eligible studies were hand‐searched to find longitudinal clinical studies evaluating the survival of restorations (class I, class II , and crown) placed with different materials in primary teeth with at least one year of follow‐up. Results: Thirty‐one studies were included, and a high bias risk was observed. Overall, 12,047 restorations were evaluated with 12.5% of failure rate. A high variation on annual failure rate ( AFR ) was detected (0–29.9%). Composite resin showed the lowest AFR s (1.7–12.9%). Stainless steel crowns ( SSC ) had the highest success rate (96.1%). Class I restorations and restorations placed using rubber dam presented better AFR . The main reason for failure observed was secondary caries (36.5%). Conclusions: An elevated number of failures were observed due to recurrent caries, highlighting the need for professionals to work with a health‐promoting approach. The high variation on failure rate among the materials can be due to children's behavior during the procedure, which demands short dental appointments and a controlled environment.
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High-viscosity glass ionomer cement restorations have survival rates similar to those of composite restorations in primary teeth, highlighting its potential as a cost-effective option in pediatric dentistry.
“Research has shown that high-viscosity glass ionomer cement restorations have survival rates similar to those of composite restorations in primary teeth, highlighting its potential as a cost-effective option in pediatric dentistry [61].”
From Minimally Invasive Techniques for Managing Dental Caries in Children: Efficacy, Applications, and Future Directions (2025) · cites this paper as [61]
A significant challenge with bioactive restorative materials is the mechanical limitation of glass ionomer cement, which tends to fracture in load-bearing posterior teeth, diminishing its appropriateness for high-stress areas.
“A significant challenge lies in the mechanical limitations of glass ionomer cement, which tends to fracture in load-bearing posterior teeth, thereby diminishing its appropriateness for high-stress areas [61].”
From Minimally Invasive Techniques for Managing Dental Caries in Children: Efficacy, Applications, and Future Directions (2025) · cites this paper as [61]
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Elamin, F., Abdelazeem, N., Salah, I., Mirghani, Y., & Wong, F. (2019) · PLOS ONE · doi:10.1371/journal.pone.0217740 · Cited by 57 · see citing works
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Cost-Effectiveness of Silver Diamine Fluoride Depends on Caries Activity: A Decision Analytic Model
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“Research has shown that high-viscosity glass ionomer cement restorations have survival rates similar to those of composite restorations in primary teeth, highlighting its potential as a cost-effective option in pediatric dentistry [61].”
- Authors
- Chisini, L. A., Collares, K., Cademartori, M. G., de Oliveira, L. J. C., Conde, M. C. M., Demarco, F. F., & Corrêa, M. B.
- Affiliations
- Universidade Federal de Pelotas (BR)
- School of Dentistry Catholic University of Pelotas Pelotas RS Brazil
- Univates (BR)
- Corresponding author
- Corrêa, Marcos Britto
- ORCID
- Venue
- International Journal of Paediatric Dentistry
- Publisher
- Wiley
- Published
- 2018-01-10
- Volume
- 28
- Issue
- 2
- Pages
- 123-139
- ISSN
- 0960-7439 (ISSN-L)
- 1365-263X
- OpenAlex
- W2783756485
- Cited by
- 281
- References
- 2
- Citations by year
- 2026: 26 · 2025: 31 · 2024: 39 · 2023: 34 · 2022: 52 · 2021: 39 · 2020: 31 · 2019: 21 · 2018: 8
- FWCI
- 6.14
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Paediatric Dentistry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Dentistry › Orthodontics › Dental materials and restorations
- Health Sciences › Dentistry › Oral Surgery › Endodontics and Root Canal Treatments
- Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
- Keywords
- primary teeth, dental restorations, restoration longevity, annual failure rate, restoration failure, secondary caries, stainless steel crowns, composite resin, Class I restorations, Class II restorations, rubber dam isolation, pediatric dentistry
- MeSH terms
- Child, Dental Caries, Dental Restoration, Permanent, Humans, Tooth, Deciduous, Dental Restoration Failure
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