{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T14:16:04Z","timestamp":1784729764456,"version":"3.55.0"},"reference-count":38,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T00:00:00Z","timestamp":1755561600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Self-adhesive flowable resins (SAFR) entered the market, eliminating the adhesive system application due to their self-adhesive technology. Guided by the PICO framework (Population, Intervention, Comparison, Outcome), the aim was to conduct a systematic review of clinical studies to compare the clinical performance of Self Adhesive Flowable Resin (SAFRs) with conventional flowable resins used for direct restorations. Methods: The protocol of this systematic review was registered in the International Prospective Register of Systematic Reviews (CRD42023394297) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Five databases (PubMed, Embase, Web of Science, Scopus, and Cochrane Library) were searched from inception to July 2025. Nine randomized clinical trials were included, totaling 493 restorations in 232 patients. Clinical performance was assessed using USPHS or FDI criteria, with follow-up periods ranging from 6 months to 5 years. Data were pooled using a random-effects meta-analysis to calculate risk differences (RD) and 95% confidence intervals (CI) for marginal adaptation, retention, marginal staining, post-operative sensitivity, color stability, surface roughness, secondary caries, and anatomical form. Results: Meta-analysis showed no significant differences between SAFRs and CFRCs for in terms of: marginal adaptation (RD = 0.01; 95% CI: \u22120.02 to 0.04; p = 0.53; I2 = 0%), retention (RD = 0.00; 95% CI: \u22120.02 to 0.03; p = 0.81; I2 = 0%), marginal staining (RD = 0.01; 95% CI: \u22120.01 to 0.02; p = 0.51; I2 = 0%), and post-operative sensitivity (RD = \u22120.01; 95% CI: \u22120.03 to 0.02; p = 0.62; I2 = 0%). The certainty of the evidence for all outcomes was rated as moderate to high according to the GRADE assessment. Conclusions: SAFR restorations demonstrated comparable clinical performance to conventional resins; however, heterogeneity in follow-up duration and the scarcity of long-term data (&gt;5 years) warrant caution.<\/jats:p>","DOI":"10.3390\/jcm14165862","type":"journal-article","created":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T13:08:51Z","timestamp":1755608931000},"page":"5862","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Clinical Performance of Self-Adhesive vs. Conventional Flowable Resin Composite Restorations in Posterior Teeth: A Systematic Review and Meta-Analysis of Randomized Trials"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3475-7303","authenticated-orcid":false,"given":"Samille Biasi","family":"Miranda","sequence":"first","affiliation":[{"name":"Department of Dental Materials, Faculty of Dentistry, University of Pernambuco, Recife 50100-130, PE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline de Farias Charamba","family":"Leal","sequence":"additional","affiliation":[{"name":"Department of Dental Materials, Faculty of Dentistry, University of Pernambuco, Recife 50100-130, PE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovana Lordsleem de","family":"Mendon\u00e7a","sequence":"additional","affiliation":[{"name":"Department of Dental Materials, Faculty of Dentistry, University of Pernambuco, Recife 50100-130, PE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renally Bezerra Wanderley e","family":"Lima","sequence":"additional","affiliation":[{"name":"Department of Restorative Dentistry, Federal University of Para\u00edba, Jo\u00e3o Pessoa 58051-900, PB, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4520-5176","authenticated-orcid":false,"given":"Ana Karina Maciel de","family":"Andrade","sequence":"additional","affiliation":[{"name":"Department of Restorative Dentistry, Federal University of Para\u00edba, Jo\u00e3o Pessoa 58051-900, PB, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8224-6578","authenticated-orcid":false,"given":"Rodrigo Barros Esteves","family":"Lins","sequence":"additional","affiliation":[{"name":"Department of Restorative Dentistry, School of Dentistry, Federal University of Alagoas, Macei\u00f3 57072-900, AL, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1197-9985","authenticated-orcid":false,"given":"Marcos Antonio Japiass\u00fa Resende","family":"Montes","sequence":"additional","affiliation":[{"name":"Department of Dental Materials, Faculty of Dentistry, University of Pernambuco, Recife 50100-130, PE, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,19]]},"reference":[{"key":"ref_1","first-page":"1","article-title":"Development of Dental Composites","volume":"Volume 1","author":"Miletic","year":"2018","journal-title":"Dental Composite Materials for Direct Restorations"},{"key":"ref_2","first-page":"1","article-title":"Utiliza\u00e7\u00e3o de resinas compostas em dentes anteriores","volume":"13","author":"Neto","year":"2021","journal-title":"Rev. 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