Clinical Longevity of Sonicated and Unsonicated Composite Resin Restorations in Posterior Permanent Teeth: A Systematic Review and Meta-Analysis


  • Lorrane Salvador de Mello
  • Fabiola Fontes Galdino
  • Jayzon Stephan Brooks
  • Tatiana Kelly da Silva Fidalgo
  • Kátia Rodrigues Reis


Composite Resins, Longevity, Systematic Review, Meta-Analysis


Objective: To evaluate the clinical longevity of Class I and II composite resin restorations with and without using sonic energy through a systematic literature review and meta-analysis. Material and Methods: Five databases were consulted: PubMed, Cochrane Library, Web of Science, Scopus, VHL-LILACS, and BBO and gray literature. The search was carried out in January 2024. The inclusion criteria comprised clinical trials evaluating the success/longevity of composite resin restorations with and without sonic energy. RoB and ROBINS-I assessed the risk of bias. The meta-analysis analyzed the number of restorations with alpha USPHS scores. Heterogeneity was assessed (I² index, p<0.05). Certain evidence was assessed using the GRADE tool. Results: A total of 8,582 studies were identified, including four studies, 2 RCTs, and two controlled clinical trials, with moderate and low risk of bias, respectively. No difference was observed in the longevity (p>0.05) for: anatomical shape (CI=1.05 [0.95,1.15]; I²=0%; p=0.37); color stability (CI=1.02 [0.93,1.13; I²=0%, p=0.65); marginal adaptation (CI=1.05 [0.95,1.16]; I²=%; p=0.38); postoperative sensitivity (CI=1.01 [0.93,1.10]; I²=0%; p=0.80); secondary caries (CI=1.01 [0.93,1.10]; I²=0%; p=0.80); marginal discoloration (CI=1.05 [0.95,1.16]; I²=0%; p=0.38), surface texture (CI=1.09 [0.97,1.23]; I²=19%; p=0.14) and retention (CI=1.00 [1.91,1.10]; I²=0%; p=1.00). The certainty of the evidence was very low. Conclusion: No evidence supports using sonic energy for direct composite resin restorations, regardless of the technique and the restored tooth. More robust and well-conducted studies should be performed.


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How to Cite

Mello, L. S. de, Galdino, F. F., Brooks, J. S., Fidalgo, T. K. da S., & Reis, K. R. (2024). Clinical Longevity of Sonicated and Unsonicated Composite Resin Restorations in Posterior Permanent Teeth: A Systematic Review and Meta-Analysis. Pesquisa Brasileira Em Odontopediatria E Clínica Integrada, 24, e230120. Retrieved from



Systematic Reviews (and Meta-Analysis)