Clinical Evaluation of Direct Cuspal Coverage with Posterior Composite Resin Restorations (original) (raw)

Comparison between published clinical success of direct resin composite restorations in vital posterior teeth in 1995-2005 and 2006-2016 periods

Australian Dental Journal, 2017

Composites are increasing in popularity as restorative materials. This growing role indicates the necessity of studies on their clinical outcome. In this study, clinical studies published on the performance of posterior composite restorations were included except those of less than a 24-month assessment period. Results of non-vital, anterior or primary teeth and cervical single-surface restorations were also excluded. Records about composite type, number of final recall restorations, failure/survival rate, assessment period and failure reasons were analysed for each decade. Overall survival/failure rates for studies in 1995-2005 were 89.41%/10.59% and for 2006-2016 were 86.87%/13.13%, respectively. In 1995-2005, the reasons for failure were secondary caries (29.47%) and composite fracture (28.84%) with low tooth fracture (3.45%) compared with reasons of failure in 2006-2016, which were secondary caries (25.68%), composite fracture (39.07%), and tooth fracture (23.76%). An increase in incidence of composite fracture, tooth fracture and need for endodontic treatment as failure reasons was noted in the latter decade in addition to a decrease in secondary caries, postoperative sensitivity, unsatisfactory marginal adaptation and wear. The overall rates of failure showed little difference, but the causes showed a notable change. This is believed to be a reflection of increased use of composites for larger restorations and possibly changes of material characteristics.

A Comparison between published clinical success of direct resin composite restorations in vital posterior teeth in 1995-2005 and 2006-2016 periods

Australian dental journal, 2016

Composites are increasing in popularity as restorative materials. This growing role indicates the necessity of studies on their clinical outcome. Clinical studies published on the performance of posterior composite restorations were included except those of less than a 24-month assessment period. Results of non-vital, anterior or primary teeth and cervical-single-surface restorations were also excluded. Records about composite type, number of final recall restorations, failure/survival rate, and assessment period and failure reasons were analyzed for each decade. Overall survival/failure rates for studies in 1995-2005 were 89.41%/10.59% and for 2006-2016 were 86.87%/13.13% respectively. In 1995-2005 the reasons for failure were secondary caries (29.47%) and composite-fracture (28.84%) with low tooth-fracture (3.45%) compared to reasons of failure in 2006-2016, which were secondary caries (25.68%), composite-fracture (39.07%), and tooth-fracture (23.76%). An increase in incidence of ...

One year clinical evaluation of two different types of composite resins in posterior teeth

The journal of contemporary dental practice, 2008

The aim of this study was to assess the clinical performance of two adhesive restorative systems (Single Bond/Filtek P-60 and Single Bond/Filtek Z-250) in posterior teeth using a modified United States Public Health Service (USPHS) system. A total of 70 restorations were placed in molars and premolars in 30 patients (14 females and 16 males; 18-40 years) by one operator. All restorations were directly evaluated by two examiners at baseline, six months, and 12 months using the following modified USPHS rating criteria: marginal integrity, marginal discoloration, surface texture, contour, postoperative sensitivity, and recurrent caries. At six and 12 months all restorations were available for evaluation of marginal discoloration, surface texture, contour, postoperative sensitivity, and recurrent caries that remained with 100% Alpha-ratings at recalls for both restorative systems. Marginal integrity for P-60 was scored as 94.3% and 91.4% Alpha at six and 12 months, respectively, and rat...

Two-year clinical evaluation of direct and indirect composite restorations in posterior teeth

The Journal of Prosthetic Dentistry, 1999

Estheti c considerations are gaining in importance for the restoration of posterior teeth. Patients refuse amalgam restorations and even gold inlays, despite excellent material properties. 1-3 Esthetic alternatives to cast gold inlays and amalgam restorations include glass ionomers, compomers, direct composites, composite inlays, and ceramic inlays. Composite application requires accurate use of the adhesive technique and knowledge about complex bonding mechanisms.

Randomized Control Trial of Composite Cuspal Restorations: Five-year Results

Journal of Dental Research, 2014

The objective of this randomized control trial was to compare the five-year clinical performance of direct and indirect resin composite restorations replacing cusps. In 157 patients, 176 restorations were made to restore maxillary premolars with Class II cavities and one missing cusp. Ninety-two direct and 84 indirect resin composite restorations were placed by two operators, following a strict protocol. Treatment technique and operator were assigned randomly. Follow-up period was at least 4.5 yrs. Survival rates were determined with time to reparable failure and complete failure as endpoints. Kaplan-Meier five-year survival rates were 86.6% (SE 0.27%) for reparable failure and 87.2% (SE 0.27%) for complete failure. Differences between survival rates of direct and indirect restorations [89.9% (SE 0.34%) vs. 83.2% (SE 0.42%) for reparable failure and 91.2% (SE 0.32%) vs. 83.2% (SE 0.42%) for complete failure] were not statistically significant (p = .23 for reparable failure; p = .15 for complete failure). Mode of failure was predominantly adhesive. The results suggest that direct and indirect techniques provide comparable results over the long term (trial registration number: ISRCTN29200848).

Randomized Control Trial of Composite Cuspal Restorations

Journal of Dental Research, 2013

The objective of this randomized control trial was to compare the five-year clinical performance of direct and indirect resin composite restorations replacing cusps. In 157 patients, 176 restorations were made to restore maxillary premolars with Class II cavities and one missing cusp. Ninety-two direct and 84 indirect resin composite restorations were placed by two operators, following a strict protocol. Treatment technique and operator were assigned randomly. Follow-up period was at least 4.5 yrs. Survival rates were determined with time to reparable failure and complete failure as endpoints. Kaplan-Meier five-year survival rates were 86.6% (SE 0.27%) for reparable failure and 87.2% (SE 0.27%) for complete failure. Differences between survival rates of direct and indirect restorations [89.9% (SE 0.34%) vs. 83.2% (SE 0.42%) for reparable failure and 91.2% (SE 0.32%) vs. 83.2% (SE 0.42%) for complete failure] were not statistically significant ( p = .23 for reparable failure; p = .15...

Implications of resin-based composite (RBC) restoration on cuspal deflection and microleakage score in molar teeth: Placement protocol and restorative material

Dental Materials, 2017

Objective. To assess the cuspal deflection of standardised large mesio-occluso-distal (MOD) cavities in third molar teeth restored using conventional resin-based composite (RBC) or their bulk fill restorative counterparts compared with the unbound condition using a twin channel deflection measuring gauge. Following thermocycling, the cervical microleakage of the restored teeth was assessed to determine marginal integrity. Methods. Standardised MOD cavities were prepared in forty-eight sound third molar teeth and randomly allocated to six groups. Restorations were placed in conjunction with (and without) a universal bonding system and resin restorative materials were irradiated with a light-emitting-diode light-curing-unit. The dependent variable was the restoration protocol, eight oblique increments for conventional RBCs or two horizontal increments for the bulk fill resin restoratives. The cumulative buccal and palatal cuspal deflections from a twin channel deflection measuring gauge were summed, the restored teeth thermally fatigued, immersed in 0.2% basic fuchsin dye for 24 h, sectioned and examined for cervical microleakage score. Results. The one-way analysis of variance (ANOVA) identified third molar teeth restored using conventional RBC materials had significantly higher mean total cuspal deflection values compared with bulk fill resin restorative restoration (all p < 0.0001). For the conventional RBCs, Admira Fusion (bonded) third molar teeth had significantly the lowest microleakage scores (all p < 0.001) while the Admira Fusion x-tra (bonded) bulk fill resin restored teeth had significantly the lowest microleakage scores compared with Tetric EvoCeram Bulk Fill (bonded and non-bonded) teeth (all p < 0.001). Significance. Not all conventional RBCs or bulk fill resin restoratives behave in a similar manner when used to restore standardised MOD cavities in third molar teeth. It would appear that light irradiation of individual conventional RBCs or bulk fill resin restoratives may be problematic such that material selection is vital in the absence of clinical data.

Five-year retrospective clinical study of indirect composite restorations luted with a light-cured composite in posterior teeth

Clinical Oral Investigations, 2013

Objectives The purpose of this study was to evaluate the clinical performance of indirect composite onlays-overlays bonded with a light-cured composite on vital molars. Materials and methods Forty-one patients were restored with 79 indirect composite restorations. The restorations were studied for an observation time of 5 years. Marginal adaptation, marginal discolouration, secondary caries, colour match and anatomic form were clinically examined following modified United States Public Health Service criteria. Each restoration was also examined for fractures and debonding. Endodontic complications were registered. Survival rate, based just on failures that required a replacement, and success rate that included also failures that required a repair intervention were statistically determined using a restoration and a patient-related analysis. Results After 5 years, using each restoration as a statistical unit, the survival rate was 91.1 % and the success rate 84.8 %, with a high Kaplan-Meier estimated success probability of 0.852. Using the patient as the statistical unit, the survival rate was 90.2 % and the success rate 85.4 %, corresponding to a Kaplan-Meier estimated success probability of 0.857. On the basis of the criteria used, most of the restorations rated Alpha. Regarding marginal adaptation and marginal discolouration, 5 and 10.1 % of the restorations, respectively, revealed Bravo ratings Conclusions Indirect composite restorations offer a predictable and successful treatment modality giving an optimal preservation of sound tooth tissue. Clinical relevance The preparation, cementation and finishing procedures are considered key factors for the long-term success of the indirect composite restorations.

A randomized controlled three year evaluation of “bulk-filled” posterior resin restorations based on stress decreasing resin technology

Dental Materials, 2014

Objective. The objective of this randomized controlled prospective clinical trial was to evaluate the efficacy of a flowable resin composite (SDR) bulk fill technique in posterior restorations and to compare it intraindividually with a conventional 2 mm resin composite curing technique in a 3-year follow up. Materials and methods. Thirty-eight pairs Class II and 15 pairs Class I restorations were placed in 38 patients with a mean age of 55.3 years (range 32-87). Each patient received at random at least two, as similar as possible, Class II or Class I restorations of two restorative techniques. In all cavities a single step self-etch adhesive (Xeno V) was applied. In one of the cavities of each pair, a flowable resin composite (SDR) was placed, in bulk increments up to 4 mm as needed to fill the cavity 2 mm short of the occlusal cavosurface. The occlusal part was completed with a nano-hybrid resin composite (Ceram X mono) layer. In the second cavity, the hybrid resin composite was placed in 2 mm increments. The restorations were evaluated using slightly modified USPHS criteria at baseline and then yearly during 3 years. Caries risk and parafunctional habits of the participants were estimated. Results. After three years, 76 Class II and 28 Class I restorations could be observed. One molar resin composite-only tooth showed post-operative sensitivity during 3 weeks for temperature changes and occlusal forces. Two failed Class II molar restorations in the resin composite-only group were observed during the first year, one cusp fracture and one resin composite fracture. An annual failure rate of 1.3% was found for the resin composite only restorations and of 0% in the bulk-filled restorations (n.s.). Ten participants were estimated as having high caries risk and eleven showed active bruxing habits. Significance. The 4 mm bulk-fill technique with the flowable resin composite SDR showed highly clinical effectiveness, which was comparable during the 3-year follow-up with the 2 mm resin composite layering technique.

A Five-Year Clinical Evaluation of Direct Nanofilled and Indirect Composite Resin Restorations in Posterior Teeth

Operative Dentistry, 2013

Under clinical conditions, posterior direct nanofilled composites and indirect composite inlay systems have the potential to present a high success rate and were clinically satisfactory at five years postplacement. SUMMARY Aim: To assess the clinical efficacy of posterior composite resin restorations placed directly and indirectly in posterior teeth after five years. Materials and Methods: A total of 108 cavities in 54 patients were restored with three direct composite resins (Filtek SupremeXT [FSXT], Tetric Evo Ceram [TEC], AELITE Aesthetic [AA]) and two indirect composite resins (Estenia [E] and Tescera ATL [TATL]). All restorations were evaluated by two examiners using the United States Public Health Service criteria at baseline and five years after placement. Statistical analysis was completed with Fisher exact and McNemar v 2 tests. Results: At baseline, 4% (five) of the restored teeth presented postoperative sensitivity; however, only one of them (a member of the E group) required canal treatment and replacement after two years. At the five-year evaluation, all restorations were retained, with Alpha ratings at 100%. Only one tooth (in the TEC group) required replacement after three years due to secondary caries. Color match, surface texture, and marginal integrity were predominantly scored as Alpha after five years for all