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Table 1 Baseline characteristics of the included studies.

From: Incidence and influential factors in pulp necrosis and periapical pathosis following indirect restorations: a systematic review and meta-analysis

Author, year, country, study design

Sample age; gender; medical history

Pre-operative pulpal and periapical status

Assessment method

Restoration type (single unit or FPD) and material

Impression material

Temporization cement and duration

Permanent cement

Clinical expertise

Follow-up time; PN; PP

Aziz et al., 2022 [21], Canada, Cohort

28–88 years; F:121, M:68; NA

Pulpal: Vital (55 teeth); Periapical: NA

Radiographic

Single-unit; Ceramic

Polyvinyl siloxane

NA; NA

Resin

Predoctoral students and trained dentists

 > 5–10 years; 2; NA

Bergenholtz & Nyman [22], 1984, Sweden, Cohort

21–68 years; NA; NA

Pulpal: Vital (255 teeth); Periapical: NA

Objective

FPD; NA

NA

NA; NA

NA

NA

 > 10 years; 38; 38

Chaar et al., 2020 [23], Germany, Cohort

37–70 years; F:23, M:16; NA

Pulpal: Vital (44 teeth); Periapical: Normal

Subjective

Single-unit; PFM

Polyether

NA; NA

GIC

NA

 > 10 years; 1; NA

Cheung, 1991 [24], Hong Kong, Cohort

17–73 years; F:85, M:47; NA

Pulpal: Vital (73 teeth); Periapical: NA

Subjective

Single-unit; Gold, metal, porcelain

NA

NA; NA

NA

Students and general practitioners

 ≤ 5 years; 3; NA

Cheung et al., 2005 [1], China, Cohort

NA; NA; NA

Pulpal: Vital (199 teeth); Periapical: NA

Objective

Single-unit and FPD; PFM

NA

NA; NA

NA

NA

 > 10 years; 44; NA

Denner et al., 2007 [25], Germany, RCT

22–65 years; F:22, M:38; NA

Pulpal: Vital (120 teeth); Periapical: NA

Objective

Single-unit and FPD; Metal or PFM

NA

Eugenol-based; NA

GIC or resin

NA

 ≤ 5 years; 2; NA

Derchi et al., 2019 [26], Germany, Cohort

23–65 years; F:17, M:13; NA

Pulpal: Vital (99 teeth); Periapical: Normal

Objective

Single-unit; Composite resin

Polyvinyl siloxane

NA; ≤ 2 weeks

Resin

General practitioners

 > 10 years; 2; NA

Encke et al., 2009 [27], Germany, RCT

41.0–42.7 years; F:118, M:104; NA

Pulpal: Vital (138 teeth); Periapical: Normal

Objective

Single-unit; Ceramic or gold

Polyvinyl siloxane

Eugenol-free; NA

GIC

NA

 ≤ 5 years; 8; NA

Ericson et al., 1966 [28], Sweden, Cohort

20–79 years; F:178, M:94; NA

Pulpal: Vital (642 teeth); Periapical: Normal

Radiographic

FPD; NA

Compound

Eugenol-based; NA

Zinc phosphate

Students

 ≤ 5 years; 21; 21

Fayyad & AL-Rafee, 1996 [29], Saudi Arabia, Cohort

NA; NA; NA

Pulpal: Vital: (288 teeth); Periapical: NA

Radiographic

FPD; PFM, metal, or metal with acrylic facing

NA

NA; NA

NA

NA

 > 5–10 years; 12; 12

Forrer et al., 2020 [30], Switzerland, Cohort

NA; F:52, M:30; NA

Pulpal: Vital (171 teeth); Periapical: NA

Objective

Single-unit and FPD; Ceramic or PFM

NA

NA; NA

GIC or resin

Predoctoral and postgraduate dentists

 > 5–10 years; 6; 6

Hämmerle et al., 2000 [31], Switzerland, Cohort

29–84 years; F:70%, M:30%; NA

Pulpal: Vital: (120 teeth); Periapical: NA

Objective

FPD; PFM with gold frames

Polyvinyl siloxane or polysulfide

NA; NA

Zinc phosphate

Students and prosthodontists

 > 10 years; 12; 3

Ioannidis & Bindl, 2016 [32], Switzerland, Cohort

52.6 ± 10.1 years; F:32, M:23; NA

Pulpal: Vital (57 teeth); Periapical: Normal

Objective

FPD; Ceramic with Y-TZP frameworks

Polyvinyl siloxane

Eugenol-free; NA

Resin

NA

 > 5–10 years; 3; 1

Johnson et al., 1993 [33], United States of America, RCT

NA; NA; NA

Pulpal: Vital (214 teeth); Periapical: NA

Subjective

Single-unit; Gold or ceramic

Polyvinyl siloxane

Eugenol-based; NA

Zinc phosphate or GIC

Prosthodontists

 ≤ 5 years; 2; 2

Jokstad & Mjör, 1996 [34], Norway, Cohort

NA; NA; NA

Pulpal: Vital (86 teeth); Periapical: NA

Objective

Single-unit and FPD; Gold-resin or PFM

NA

Eugenol-based; > 2 weeks

Zinc phosphate or GIC

General practitioners

 > 5–10 years; 5; NA

Karlsson, 1986 [35], Sweden, Cohort

34–78 years; F:89, M:75; NA

Pulpal: Vital (641 teeth); Periapical: NA

Radiographic

FPD; Acrylic resin veneer, gold or porcelain bonded to gold

NA

NA; NA

NA

General practitioners

 > 5–10 years; 64; 64

Khazin et al., 2021 [36], Malaysia, Cohort

23–79 years; F:31, M:23; NA

Pulpal: Vital (73 teeth); Periapical: Normal

Objective

Single-unit and FPD; Metal, PFM, or ceramic

Polyvinyl siloxane

NA; NA

GIC, RMGIC, resin

NA

 ≤ 5 years; 1; NA

Kontakiotis et al., 2015 [6], Greece, Cohort

33–62 years; NA; NA

Pulpal: Vital (120 teeth); Periapical: Normal

Objective

Single-unit; NA

NA

Eugenol-free; > 2 weeks

NA

Students

 ≤ 5 years; 11; NA

Lockard et al., 2002 [37], Florida, Cohort

NA; F:172, M:84; NA

Pulpal: Vital (1847 teeth); Periapical: Normal

Subjective

Single-unit and FPD; Ceramic, PFM or metal

Reversible hydrocolloid

Eugenol-based; > 2 weeks

Zinc phosphate, poly-carboxylate, orthoethoxybenzoic acid, resin, GIC

Prosthodontists

 > 10 years; 22; 22

Lundgren et al., 2018 [38], Sweden, RCT

11–22 years; F:15, M:12; Amelogenesis imperfecta

Pulpal: Vital (227 teeth); Periapical: NA

Radiographic

Single-unit; Ceramic with zirconia framework

Polyether

Eugenol-based; > 2 weeks

Resin

General practitioners and prosthodontists

 > 5–10 years; 7; 7

Lundqvist & Nilson, 1982 [39], Sweden, Cohort

21–90 years; F:22, M:18; NA

Pulpal: Vital (35 teeth); Periapical: NA

Objective

Single-unit and FPD; NA

NA

NA; NA

NA

Students

 > 5–10 years; 5; 1

Olley et al., 2018 [4], United Kingdom, Cohort

49.11 ± 15.65 years; F:27, M:20; NA

Pulpal: Vital (143 teeth); Periapical: NA

Subjective

Single-unit; PFM, gold or ceramic

Polysulfide and alginate

NA; NA

GIC, zinc phosphate or resin

General practitioners

 > 10 years; 6; 6

Piemjai and Adunphichet, 2022 [40], Thailand, Cohort

61.44 ± 10.81 years; F: 177, M: 83; NA

Pulpal: Vital (642 teeth); Periapical: NA

Objective

Single-unit and FPD; metal, PFM

NA

NA; NA

Zinc phosphate, polycarboxylate, GIC, Resin

Postgraduates

 > 10 years; 13; NA

Rauch et al., 2017 [41], Germany, Cohort

46.5 ± 13.1 years; F:21, M:13; Healthy

Pulpal: Vital (17 teeth); Periapical: NA

Objective

Single-unit; Ceramic

NA

NA; NA

Resin

NA

 > 5–10 years; 3; NA

Reich & Schierz, 2013 [42], Germany, Cohort

26.2–73.8 years; F:21, M:13; Healthy

Pulpal: Vital (24 teeth) Periapical: NA

Objective

Single-unit; Ceramic

NA

NA; NA

Resin

NA

 ≤ 5 years; 2; NA

Reichen-Graden & Lang, 1989 [43], Switzerland, Cohort

26–72 years; F:42, M:16; NA

Pulpal: Vital (134 teeth); Periapical: NA

Objective

FPD; Ceramic

NA

NA; NA

Zinc phosphate

Students

 > 5–10 years; 5; 1

Rinke et al., 2013 [44], Germany, Cohort

26–76 years; F:36, M:39; NA

Pulpal: Vital (200 teeth); Periapical: NA

Objective

FPD; Ceramic with zirconia framework

Polyether

NA; NA

Zinc phosphate

Students

 > 5–10 years; 4; NA

Rinke et al., 2015 [45], Germany, Cohort

25–74 years; F:39, M:29; NA

Pulpal: Vital (221 teeth); Periapical: NA

Subjective

Single-unit; Zirconia

Polyvinyl siloxane or polyether

NA; NA

Zinc phosphate or GIC

General practitioners

 > 5–10 years; 19; NA

Rinke et al., 2020 [46], Germany, Cohort

48.9 ± 12, 9 years; F:45, M:24; NA

Pulpal: Vital (81 teeth); Periapical: NA

Objective

FPD; Ceramic

NA

NA; NA

Resin

General practitioners

 ≤ 5 years; 1; NA

Scheibenbogen et al., 1998 [47], Germany, Cohort

23–58 years; NA; NA

Pulpal: Vital (71 teeth); Periapical: NA

Objective

Single-unit; Ceramic and composites

Polyether

Eugenol-free; ≤ 2 weeks

Resin

Students

 ≤ 5 years; 1; NA

Selz et al., 2014 [48], Germany, RCT

25–65 years; F:33, M:27; NA

Pulpal: Vital (149 teeth); Periapical: NA

Objective

Single-unit; Ceramic

Polyether

Eugenol-free; NA

Resin and GIC

Prosthodontists

 ≤ 5 years; 11; NA

Tinschert et al., 2008 [49], Germany, Cohort

20–58 years; F:27, M:19; NA

Pulpal: Vital (104 teeth); Periapical: Normal

Subjective

FPD; PFM

NA

Eugenol-free; ≤ 2 weeks

Zinc phosphate or Resin

Students and General practitioners

 ≤ 5 years; 3; NA

Uzgur et al., 2016 [50], Turkey, Cohort

21–73 years; F:214, M:310; NA

Pulpal: Vital (1633 teeth); Periapical: NA

Objective

FPD; PFM

NA

Eugenol-based; ≤ 2 weeks

Zinc polycarboxylate

Prosthodontists

 ≤ 5 years; 18; NA

Valderhaug et al., 1997 [17], Norway, Cohort

25–69 years; NA; NA

Pulpal: Vital (291 teeth); Periapical: NA

Subjective

Single-unit and FPD; Gold with acrylic resin

NA

Eugenol-based; NA

Zinc phosphate

Students

 > 10 years; 30; 4

Walther, 1995 [51], Germany, Cohort

19–88 years; NA; NA

Pulpal: Vital (1983 teeth); Periapical: NA

Objective

Single-unit; NA

Polyether

Eugenol-based; NA

NA

NA

 ≤ 5 years; 124; NA

Wolleb et al., 2012 [52], Switzerland, Cohort

34–84 years; F:28, M:17; 22% smokers, 11% diabetic patients

Pulpal: Vital (311 teeth); Periapical: NA

Objective

Single-unit and FPD; PFM or ceramic

Polyether

NA; NA

GIC or resin

Students

 > 5–10 years; 9; 9

Zitzmann et al., 2021 [53], Switzerland, Cohort

13–80 years; F: 39, M: 32; NA

Pulpal: Vital (107 teeth); Periapical: NA

Objective

FPD; metal or ceramic

NA

NA; NA

Resin

Postgraduate and prosthodontists

 ≤ 5 years; 1; NA

  1. Abbreviations according to their first appearance: FPD Fixed partial denture, PN Pulp necrosis, PP Periapical pathosis, NA Not applicable, F Female, M Male, PFM Porcelain fused to metal, GIC Glass ionomer cement, RMGIC Resin modified glass ionomer cement.