Please cite this article in press as: Monsarrat P, et al. Survival of directly placed ormocer-based restorative materials: A systematic review and meta-analysis of clinical trials. Dent Mater (2017), http://dx.doi.org/10.1016/j.dental.2017.01.019 ARTICLE IN PRESS DENTAL-2914; No. of Pages 9 d e n t a l m a t e r i a l s x x x ( 2 0 1 7 ) xxx.e1–xxx.e9 Available online at www.sciencedirect.com ScienceDirect journal homepage: www.intl.elsevierhealth.com/journals/dema Survival of directly placed ormocer-based restorative materials: A systematic review and meta-analysis of clinical trials Paul Monsarrat a,b,* , Sarah Garnier a , Jean-Noel Vergnes c,d , Karim Nasr a , Brigitte Grosgogeat e,f , Sabine Joniot a a Paul Sabatier University, Dental Faculty, Department of Biomaterials, Anatomical Sciences and Radiology, Toulouse University Hospital, Toulouse, France b STROMALab, University of Toulouse, CNRS ERL 5311, EFS, INP-ENVT, Inserm U1031, UPS, Toulouse, France c Paul Sabatier University, Dental Faculty, Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France d Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada e Université de Lyon, Université Lyon 1, Faculté Dentaire & Hospices Civils de Lyon, Service d’Odontologie, Lyon, France f Université de Lyon, Université Lyon 1, Laboratoire des Multimatériaux et Interfaces, LMI UMR CNRS 5615, Lyon, France a r t i c l e i n f o Article history: Received 11 July 2016 Received in revised form 28 January 2017 Accepted 30 January 2017 Available online xxx Keywords: Organically modified ceramics Dental materials Dental restoration Permanent Composite resins Meta-analysis a b s t r a c t Objectives. In-vitro experiments on ormocers (ORganically MOdified CERamics) have provided controversial results. Consequently, the objectives of this meta-analysis were to (1) compare clinical performances of first generation ormocers versus conventional composite restora- tions, (2) explore the influence of various clinical factors and the impact of the quality of studies on published results. Methods. The following databases were explored until 2017/01/08: Ovid MEDLINE In-Process, Pubmed, CENTRAL, HTA, DARE, LILACS and Google Scholar. Studies of more than two years with quantitative comparisons between ormocers and con- trol groups were selected. Outcome was the failure of a restoration (need to repair, remove or replace). Multivariate random-effects Poisson’s regression was used to obtain a summary estimate. Results. 75% of the 8 included trials concerned Class I/II restorations. Although non- significant, the global failures were higher for ormocers (0.22 [-0.16; 0.61]). For Class I/II restorations, a significantly higher sensitivity was observed for ormocer-based materials compared to other composites (0.75 [0.01; 1.50]). An increase of the number of restorations per patient was associated with higher marginal adaptation failures for ormocers in Class I/II obturations (0.59 [0.11; 1.08]). Significance. This study did not identify clear advantages of using the first generation of ormocer-based fillings rather than conventional composites. Given the recent develop- ment of new, dimethacrylate-diluent-free ormocer matrices, potentially more stable and * Correspondence to: UFR Odontologie de Toulouse 3, Chemin des Maraîchers 31062, Toulouse, Cedex 9, France. Fax: +33 5 61 25 47 19. E-mail address: paul.monsarrat@gmail.com (P. Monsarrat). http://dx.doi.org/10.1016/j.dental.2017.01.019 0109-5641/© 2017 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.