Clinical performance of resin-based versus ceramic posterior indirect partial-coverage restorations: A systematic review

Background: The present systematic review aimed to compare the survival, failure patterns, marginal integrity, biological outcomes, and patient-reported outcomes of resin-based and ceramic posterior indirect partial-coverage restorations. Methods: PubMed, Embase, Scopus, and the Cochrane Central Register of Controlled Trials were searched from inception through March 31, 2026. A supplementary Google Scholar search screened the first 200 relevance-ranked records. Direct comparative clinical studies involving adults who received resin-based and ceramic posterior indirect partial-coverage restorations, with a minimum follow-up of 6 months, were eligible. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool and Newcastle–Ottawa Scale. Certainty of evidence was evaluated using the GRADE approach. Results: Eight studies involving approximately 458 participants and 762 restorations were included: five randomized clinical trials and three comparative cohort studies. Both material categories generally demonstrated acceptable survival during the first 1 to 3 years. Some studies reported similar survival, whereas others recorded more debonding or repairable chipping among resin-based restorations. Restoration fracture occurred in both categories. Longer-term retrospective evidence suggested greater survival and surface stability for lithium disilicate than for indirect resin composite. Conclusion: Resin-based and ceramic posterior indirect partial-coverage restorations appear clinically acceptable over short-term follow-up. Lithium disilicate may provide greater long-term stability. However, definitive superiority cannot be established because of heterogeneity and the limited certainty of the long-term evidence.