{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T19:02:10Z","timestamp":1790449330426,"version":"4.1.0"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:00:00Z","timestamp":1761696000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:00:00Z","timestamp":1761696000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Esthet Restor Dent"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This umbrella review synthesized high\u2010level evidence on the clinical longevity and failure patterns of direct restorative materials, including conventional composites, bulk\u2010fill resins, ormocer\u2010based composites, and glass ionomer cements (GIC\/RMGIC) used in posterior restorations and non\u2010carious cervical lesions (NCCLs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>Sixteen systematic reviews and meta\u2010analyses published between 2012 and 2025 were included, representing over 15,000 restorations with follow\u2010up periods ranging from 6 to 120\u2009months. Methodological quality was assessed using AMSTAR 2, and evidence certainty was graded with the GRADE framework. Outcomes included survival rates, failure types, and comparative risk estimates (RR, OR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Conventional composites demonstrated &gt;\u200990% 5\u2010year survival, especially with multi\u2010step adhesives. Bulk\u2010fill resins showed similar short\u2013medium\u2010term outcomes (failure rates &lt;\u20097%), but long\u2010term data remain limited. Ormocer\u2010based composites had significantly higher failure rates (12.1%), primarily due to marginal degradation. GICs exhibited lower survival but remain useful in high caries risk or moisture challenged conditions. The sandwich technique with RMGIC bases improved retention in NCCLs. Adhesive protocol emerged as a key prognostic factor across all materials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clinical longevity is influenced by material class, bonding strategy, and patient risk profile. Conventional and bulk\u2010fill composites remain the most reliable options. RMGICs and sandwich approaches are effective in specific indications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Significance<\/jats:title>\n                    <jats:p>This umbrella review provides clinicians with consolidated, high\u2010level evidence to optimize restorative decisions. The integration of AMSTAR 2 and GRADE strengthens the clinical applicability of findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jerd.70052","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T18:34:38Z","timestamp":1761762878000},"page":"307-324","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Clinical Longevity of Direct Dental Restorations: An Umbrella Review of Systematic Reviews"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2616-1510","authenticated-orcid":false,"given":"Eduardo","family":"Fern\u00e1ndez","sequence":"first","affiliation":[{"name":"Restorative Dentistry Department Faculty of Dentistry, University of Chile  Santiago Chile"},{"name":"Instituto de Ciencias Biom\u00e9dicas, Universidad Aut\u00f3noma de Chile  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8571-4429","authenticated-orcid":false,"given":"Alain Chaple","family":"Gil","sequence":"additional","affiliation":[{"name":"Universidad Aut\u00f3noma de Chile, Facultad de Ciencias de la Salud  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0440-3593","authenticated-orcid":false,"given":"Rodrigo","family":"Caviedes","sequence":"additional","affiliation":[{"name":"Restorative Dentistry Department Faculty of Dentistry, University of Chile  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4261-2000","authenticated-orcid":false,"given":"Leonardo","family":"D\u00edaz","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, Faculty of Dentistry, University of Chile  Santiago Chile"},{"name":"Department of Stomatology, Faculty of Dentistry, Universidad de Sevilla  Sevilla Spain"},{"name":"Perioplastic Institute  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1465-8308","authenticated-orcid":false,"given":"Cristian","family":"Bersezio","sequence":"additional","affiliation":[{"name":"Restorative Dentistry Department Faculty of Dentistry, University of Chile  Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,29]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dental.2015.01.015"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034514544217"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-018-2429-7"},{"issue":"2","key":"e_1_2_8_5_1","first-page":"89","article-title":"Longevity of Bulk Fill and Ormocer Composites in Permanent Posterior Teeth: Systematic Review and Meta\u2010Analysis","volume":"35","author":"Abreu N. M.","year":"2022","journal-title":"American Journal of Dentistry"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdent.2023.104447"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0191942"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784\u2010024\u201005371\u20103"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdent.2024.104736"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdent.2017.07.007"},{"issue":"6","key":"e_1_2_8_11_1","first-page":"497","article-title":"Clinical Performance of Non\u2010Carious Cervical Restorations Restored With the \u2018Sandwich Technique\u2019 and Composite Resin: A Systematic Review and Meta\u2010Analysis","volume":"21","author":"Pires A. 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