Three-year clinical evaluation of direct and indirect composite restorations in posterior teeth. Two-year clinical evaluation of direct and indirect composite restorations in posterior teeth. One-year clinical evaluation of composite and ceramic inlays in posterior teeth. Clinical study of indirect composite resin inlays in posterior stress-bearing cavities placed by dental students: results after 4 years. Longitudinal clinical evaluation of bonded composite inlays: a 3-year study. Direct composite inlays versus conventional composite restorations: three-year clinical results Clinical performance of novel resin composites in posterior teeth: 18-month results. Three-year clinical evaluation of a self-cured posterior composite resin. Clinical performance and marginal adaptation of class II direct and semidirect composite restorations over 3.5 years in vivo. Direct and indirect evaluation of posterior composite restorations at three years. Direct resin composite restorations in vital versus root-filled posterior teeth: a controlled comparative long-term follow-up. Clinical evaluation of two posterior composite resins: two-year results. One year clinical evaluation of two different types of composite resins in posterior teeth. Retrospective clinical study of single-retainer cantilever anterior and posterior glass-ceramic resin-bonded fixed dental prostheses at a mean follow-up of 6 years. A randomized clinical trial of cusp-replacing resin composite restorations: efficiency and short-term effectiveness. Clinical evaluation of two packable resin-based composite restorations: a three-year report. Clinical evaluation of nanofill and nanohybrid composite in Class I restorations: a 12-month randomized trial.
STATEMENT OF THE PROBLEM Objective long-term clinical data are necessary to assess the performance of modern posterior composites as direct and indirect restorations . PURPOSE This prospect i ve , long-term clinical trial evaluated direct and indirect composite restorations for clinical acceptability as posterior restoratives in single or multisurface cavities and provided a survey on the 3-year results . MATERIAL AND METHODS Under the supervision of an experienced dentist , 9 dental students placed 88 composite restorations ( Tetric , blend-a-lux , Pertac-Hybrid Unifil ) , 43 direct composite restorations , and 45 indirect inlays .  Clinical evaluation was performed at baseline and in yearly intervals after placement by 2 other experienced dentists , using modified USPHS criteria . A third follow-up of 60 restorations took place within 33 to 36 months after placement . RESULTS A total of 93 % of indirect and 87 % of direct restorations were assessed to be clinical ly excellent or acceptable . During the third year , 1 direct restoration in a molar failed because of margin opening . Indirect inlays exhibited a significantly better anatomic form of the surface than direct composite restorations . Premolars revealed a significantly better marginal integrity and anatomic form of the surface than molars . Restorations in molars exhibited a significantly higher failure rate compared with premolars . CONCLUSION Posterior composite restorations provided a satisfactory clinical performance over a 3-year period , even if placed by relatively inexperienced but supervised students STATEMENT OF PROBLEM Few long-term clinical studies have reported data of modern posterior composites as direct and indirect restorations . PURPOSE This prospect i ve , long-term clinical trial ( 1 ) evaluated direct and indirect composite restorations for clinical acceptability as posterior restoratives in single or multisurface carious teeth and ( 2 ) provided a survey on the 2-year results . MATERIAL AND METHODS Nine dental students placed 88 composite restorations ( Tetric , blend-a-lux , Pertac-Hybrid Unifil ) , 43 direct composite restorations and 45 indirect inlays , under the supervision of an experienced dentist . The first clinical evaluation was performed 11 to 13 months after placement by 2 other experienced dentists , using modified USPHS criteria . A second follow-up of 60 restorations took place within 20 to 26 months after placement . RESULTS A total of 93 % of indirect and 90 % of direct composite restorations were assessed to be clinical ly excellent or acceptable . Two restorations ( 1 indirect composite inlay and 1 margin of a direct composite restoration )  failed during the second year because of fracture . Indirect inlays demonstrated a significantly better " anatomic form of the surface " than direct composite restorations . Premolars revealed a significantly better margin integrity and postoperative symptoms than molars . CONCLUSION Posterior composite restorations provided a satisfactory clinical performance over a 2-year period when placed by relatively inexperienced but supervised students STATEMENT OF PROBLEM There are only a few studies available that deal with the clinical behavior of composite and ceramic inlay systems as potential substitutes for amalgam restorations . PURPOSE This prospect i ve clinical trial evaluated composite and ceramic inlay systems for clinical acceptability as restorative material s in single or multisurface cavities of posterior teeth and provided 1-year results . MATERIAL AND METHODS Forty-seven composite inlays ( Tetric , Blend-a-lux , Pertac ) and 24 heat-pressed ceramic inlays ( IPS Empress )  were placed in 45 patients by 7 student operators under the supervision of an experienced dentist . The first clinical evaluation was performed 11 to 13 months after placement of the restorations and used modified United States Public Health Services criteria . RESULTS Satisfactory results over this period were found , as 100 % of ceramic inlays and 94 % of composite inlays were assessed to be clinical ly excellent and acceptable . Only 3 composite inlay restorations were scored delta ( unacceptable ) . Two inlays exhibited secondary caries and 1 demonstrated loss of pulp vitality . For the criteria " anatomic form of the surface " and " marginal integrity , " ceramic inlays were significantly better than composite inlays . CONCLUSION Posterior tooth-colored inlays provided acceptable and excellent clinical service , even if they are placed by relatively inexperienced student operators OBJECTIVES This longitudinal r and omized controlled clinical trial evaluated the longevity of composite resin inlays in single- or multi-surface cavities up to 4 years . METHODS 21 dental students placed 75 Artglass and 80 Charisma composite resin inlays in class I and II cavities in posterior teeth ( 89 adult patients ) luted with dual-curing resin cements .  Clinical evaluation was performed up to 4 years using modified USPHS criteria . RESULTS 87.2 % of Artglass and 76.6 % of Charisma inlays were assessed to be clinical ly excellent or acceptable . Up to the 4-year recall 5 Artglass and 11 Charisma inlays failed mainly because of postoperative symptoms , bulk fracture , and loss of marginal integrity . No significant differences between both composite resin material s could be detected at 4 years for all clinical criteria ( Mann-Whitney U-test , p>0.05 ) . The comparison of restoration performance with time yielded a significant increase in marginal discolouration and postoperative symptoms ( p<0.05 ) , deterioration of surface texture quality , marginal and restoration integrity ( p<0.05 ) for both inlay systems . However , the changes were mainly effects of scoring shifts from alfa to bravo . Small inlays compared to large inlays and premolar restorations compared to molar restorations showed significant better outcome for some of the tested clinical parameters for the Artglass inlays ( p<0.05 ) . For Charisma inlays no such influences were revealed . CONCLUSIONS Clinical assessment of Artglass and Charisma composite resin inlays exhibited an annual failure rate of 3.2 % and 5.9 % that is within the range of published data . Within the limitations of this study indirect composite inlays are a competitive restorative procedure in stress-bearing preparations OBJECTIVE The aims of this prospect i ve clinical study were ( 1 ) to evaluate the clinical performance of Signum composite inlays over a 3-year period ; ( 2 ) to investigate the clinical efficacy of  composite inlays in premolars versus molars ; and ( 3 ) to evaluate differences between 1- or 2-surface inlays and multisurface inlays . METHOD AND MATERIAL S One hundred thirteen composite inlays were placed in 30 patients by a clinician . All the inlays were made by the same laboratory technician using only one composite material ( Signum , Heraeus Kulzer ) . All the restorations were bonded with a 3-step bonding system and a composite luting cement . The restorations were assessed after placement by a clinician who had not been involved with the placement of the restorations , in accordance with the modified US Public Health Service criteria . RESULTS Three of the 113 experimental restorations had to be replaced ; the total failure rate was 2.6 % after 3 years . At baseline , 88.5 % to 100 % of the inlay restorations were rated as excellent ( Alpha ) . Statistically significant ( P < .05 ) differences were observed during the study for surface roughness , anatomic form at the margin , marginal integrity , and inlay integrity . The comparison of the clinical outcome of inlays in premolars versus molars and with 1 or 2 surfaces versus multisurfaces showed no significant differences , except for the parameters anatomic form at the margin and marginal integrity . CONCLUSION Composite inlays demonstrated a very high success rate ( 97.4 % ) after 3 years . Neither the size of the restorations nor the tooth type significantly affected the clinical outcome of the restorations A clinical trial of direct composite inlays versus conventionally ( incrementally ) placed restorations made from the same material was started in January 1989 . Restorations were r and omly allocated to matched pairs of cavities . This study reports the 3-year performance of 71 of the 100 pairs of restorations placed over a 2-year period and followed-up every 6 months .  Clinical assessment s were made using USPHS criteria ( indirect measurements of occlusal wear were made using Ivoclar st and ard dies ) and annual bite wing radiographs . Direct inlays showed significantly less occlusal wear than conventional restorations , but the difference was small . The clinical performance of both types of restoration was similar and compared favourably with studies of other material s. No secondary decay was diagnosed . The direct inlays , however , took longer to place and did not reduce postoperative sensitivity or failure rate ( 8 % failure of inlays and 4 % of conventional composites over 3 years ) . Contouring of proximal and occlusal aspects was not facilitated with direct inlays but may be easier with indirect inlays on removable PURPOSE The aim of this study was to evaluate the clinical success potential of two nanocomposites placed in posterior teeth using an antibacterial adhesive system over 18 months . METHODS A total of 49 Class I and 47 Class II restorations were placed in the permanent teeth of thirty adult patients . The carious lesions were restored with Gr and io ( Voco ) or Filtek Supreme ( 3 M ESPE ) using a two-step self-etching antibacterial adhesive system Clearfil Protect Bond ( Kuraray ) . The restorations were finished with fine-grit diamond burs , Enhance polishing system , and Sof-Lex finishing brushes . The restorations were evaluated at baseline , 6 , 12 , and 18 months after placement using modified Ryge criteria for color stability , marginal discoloration , marginal adaptation , caries formation , anatomic form , postoperative sensitivity , surface roughness , and retention . RESULTS The changes in the parameters were assessed using the Cochran Q test and the McNemar test at a significance level of p < 0.05 . All restorations were classified as clinical ly satisfactory after 18 months . Statistical analysis demonstrated differences only in superficial roughness , with Gr and io exhibiting more surface roughness than Filtek Supreme ( p < 0.05 ) . CONCLUSION Posterior restorations built up with the novel nanocomposites using an antibacterial self-etching system showed satisfactory results at the 18-month recall appointment relative to all criteria except the surface texture in the case of Gr and io . Further evaluations are necessary for a more in-depth analysis A study was conducted to determine whether the wear resistance of a posterior composite could be improved by maximizing filler particle-to-particle contacts . This was expected to reduce stress concentrations on the resin matrix and thus reduce occlusal wear . A self-curing quartz-filled composite with this design , P-10 , was used to restore 90 Class I and II cavity preparations in adult teeth . Restorations were recalled after baseline at six months , one year , two years , and three years to measure wear by direct and indirect evaluation methods . There was no apparent advantage for this material compared with other previously evaluated posterior composites . The average cumulative wear for P-10 after three years was 145 microns . In addition , the restorations were evaluated for color-matching , interfacial staining , secondary caries , marginal adaptation , surface texture , and postoperative sensitivity . This material was not significantly different in those ways from other posterior composite products except in terms of more rapid color change , because it is self-cured OBJECTIVE The study evaluated the clinical performance and marginal adaptation of  direct and semi-direct class II composite restorations  in a split-mouth design over 3.5 years . DESIGN 44 upper posterior teeth in 11 adults with primary carious lesions were treated with 22  direct and 22  semi-direct restorations . Conventional cavities were prepared for both types of restorations . A fine fine hybrid composite ( APH ) and a multifunctional adhesive system ( Prisma universal bond 3 ) were used for all restorations . The incremental " 3-sited light curing " technique was applied to direct restorations . Semi-direct inlays were prefabricated on silicone casts and post-cured using light and heat .  Clinical performance was evaluated using modified USPHS parameters , while marginal adaptation was judged on replicas , using SEM and a st and ardized evaluation technique . RESULTS Clinical results after 3.5 years revealed a 100 % retention rate with no fractures , sensitivity or recurrent caries for both types of restorations . SEM-evaluation of the occlusal margins showed at the tooth-restoration interface relatively low rates of marginal openings over the observation period ( 4 - 8 % ) . Marginal restoration fractures ranged between 1 and 2 % , marginal tooth fractures between 3 and 9 % . Differences between the restorative techniques and after the different time observation periods were not statistically significant . Proportions of marginal fractures and openings at the restoration-luting composite interface were less than 10 % after 3.5 years . CONCLUSION The results indicated no significant differences for direct and semi-direct fine hybrid composite restorations  in medium size cavities in posterior teeth with respect to clinical performance and marginal adaptation over 3.5 years The purpose of this study was to compare the use of direct ( USPHS ) and indirect ( M-L ) systems of evaluating the  occlusal wear of posterior composite restorations . Additionally , this study has utilized the USPHS method to compare the in vivo performance of  posterior resin composite restorations made from four different visible-light-cured material s. Of the 202 restorations placed for this r and omized clinical trial , only those restorations that were scored by both direct and indirect evaluation systems were included in these comparisons . Restorations were evaluated by two calibrated examiners from baseline to 36 months . While there were some differences noted among the four material s , the majority ( 99 % ) of the restorations evaluated in this study received " alpha " or " bravo " scores for all USPHS parameters , indicating acceptable in vivo performance . The results of this study also indicate that there was a consistent relationship between the direct ( USPHS ) and indirect ( M-L scale ) scoring systems . For those restorations that changed anatomic form scores , the mean wear at the alfa/bravo transition was 100 + /- 80 microns . By the 24-month recall examination , the use of the USPHS evaluation system category of anatomic form enabled examiners to differentiate restorations and material s that had experienced little occlusal wear from those that had experienced greater amounts of wear This study compared direct composite restorations on vital versus endodontically-treated posterior teeth , six to eight years after placement . All clinical procedures were performed using st and ardized material s and protocol s. The patients were identified with the aid of a computerized billing system followed by a chart search . With each patient , the prime investigator matched a r and omly chosen endodontically-treated tooth ( test tooth ) with a vital counterpart ( control tooth ) with a direct composite restoration . Of the 84 patients who fulfilled the inclusion criteria , 44 were available for recall . Two calibrated observers , blinded to the tooth vitality status , evaluated the fillings by applying the modified USPHS criteria . The outcome was dichotomized to revision indicated/recommended vs revision not indicated . Odds Ratios ( OR ) and corresponding 95 % Confidence Intervals ( 95 % CI ) were calculated . Residual confounding was corrected using a multivariable regression analysis with the remaining known confounders filling size , tooth type and age of the fillings in months as independent variables . The crude association between the presence/absence of root canal treatment and the need for revision ( OR , 95 % CI ) was 2.12 ( 1.02 - 4.38 ; p = 0.04 ) . Correcting for all potential confounders in the multivariable analysis changed this association marginally to an OR of 1.98 ( 0.90 - 4.38 ; p = 0.09 ) Two composite resins were evaluated for clinical acceptability as restorative material s in Class I and II cavities over a 2-year-period . In addition , dispersed phase alloy was evaluated for comparison . All restorations were assessed for anatomical form , marginal integrity and marginal leakage using modified United States Public Health Service ( USPHS ) criteria . At the 2-year recall , 96 % of the composites and 100 % of the amalgams were rated ' alpha ' or ' bravo ' , using the parameters of assessment defined in this study . However , a significant number of shifts from the baseline , within the level of acceptability , had occurred . The two composites showed the greatest number of shifts for anatomical form and marginal leakage , while there were no differences between the composites and the amalgam for shifts in marginal integrity . Although a very high level of acceptability was determined for all of the material s , the frequency of rating change within categories for the composites was a cause of concern with regard to their long-term clinical use AIM 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 . METHODS AND MATERIAL S 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 . RESULTS 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 rates for Z-250 were 100 % and 97.1 % Alpha at six and 12 months , respectively . Statistical analysis was completed with Fisher 's exact and McNemar Chi-square tests at a significance level of 5 % ( P<0.05 ) . CONCLUSION All restorations were clinical ly satisfactory and no significant differences were found among them . CLINICAL SIGNIFICANCE Posterior resin composite restorations placed under appropriate conditions provide a satisfactory clinical performance PURPOSE To retrospectively evaluate the 6-year survival rates and technical/ biologic complication rates of single-retainer glass-ceramic resin-bonded fixed dental prostheses ( RBFDPs ) .  MATERIAL S AND METHODS Forty patients with 49 anterior/posterior glass-ceramic RBFDPs were included . The RBFDPs  replaced 11 maxillary/m and ibular central incisors , 18 lateral incisors , 18 premolars , and 2 molars . Patients willing to participate were clinical ly and radiologically examined . The technical outcome was assessed with modified United States Public Health Service criteria . Fracture and /or chipping of the restoration , occlusal wear , marginal adaptation , marginal discoloration , shape , surface texture , and esthetic integration were recorded . Tooth vitality and postoperative sensitivity were tested . The following biologic parameters were assessed at test and control teeth : probing pocket depth , gingival recession , attachment loss , bleeding on probing , furcation involvement , and periodontal mobility . Statistical analysis was performed with exact 95 % confidence intervals to relative frequencies and the paired t test . RESULTS Twenty-eight patients with 35 RBFDPs participated . The mean follow-up of the RBFDPs was 6 years . Twelve patients with 14 RBFDPs were not willing to participate or not available . No catastrophic failures occurred . The 6-year survival rate of the examined RBFDPs was 100 % . No debonding was recorded . Chipping of the ceramic was found in 5.7 % of the RBFDPs . Biologic outcomes were similar at test and control teeth . CONCLUSION Glass-ceramic RBFDPs exhibited promising clinical outcomes in both anterior and posterior regions PURPOSE This study aim ed to assess the efficacy and short-term effectiveness of the morphology and function of direct and indirect cusp-replacing resin composite restorations . MATERIAL S AND METHODS In 94 patients , 106 cusp-replacing restorations for maxillary premolars were fabricated to restore Class II caries lesions with 1 cusp missing . Fifty-four direct ( Clearfil AP-X ) and 52 indirect ( Estenia ) resin composite restorations were placed following a strict protocol . The treatment technique and operator were assigned r and omly . Treatment time was recorded for all restorations . One-month postoperative evaluation included assessment of postoperative sensitivity and presence of occlusal and proximal contacts . RESULTS Treatment time for the indirect technique ( 68 + /- 17 min ) was longer than for the direct technique ( 45 + /- 13 min ) . Regression analysis revealed that the restorative method , operator , and location of the preparation outline had a statistically significant effect on the total treatment time . Occlusal contacts were observed in 94 % of the direct restorations and in 98 % of the indirect restorations ( chi-square , P>.05 ) . Mesial proximal contacts were present in 98 % of the direct and in 97 % of the indirect restorations ( chi-square , P > .05 ) . Distal contacts were present in 100 % of the restorations for both techniques . Postoperative sensitivity within 1 week posttreatment was reported for 11 % of the direct restorations and for 13 % of the indirect restorations , but decreased to 4 % and 6 % , respectively , after 1 month ( chi-square , P > .05 ) . CONCLUSION The results of this study suggest that in the short term , both direct and indirect adhesive techniques are adequate to restore the morphology and function of premolars presenting with Class II caries lesions and a missing cusp This r and omized clinical trial sought to evaluate the performance of two packable composites over a period of 36 months . A total of 39 Class I and II restorations were placed in the permanent teeth of 20 patients . Using United States Public Health Services criteria , two investigators evaluated the restorations immediately after placement and again after 12 and 36 months , examining color match , marginal discoloration , marginal integrity , recurrent caries , proximal contact , anatomical shape , surface texture , and postoperative sensitivity . It was concluded that the packable composites evaluated showed satisfactory clinical performance after three years This r and omized trial evaluated the 12-month clinical performance of nanofill , a nanohybrid , and a microhybrid composite in restorations in occlusal cavities of posterior teeth . This study utilized 41 patients , each of whom had three molars affected by primary caries or the need to replace restorations . All restorations were performed in accordance with the manufacturer 's recommendations and evaluated in accordance with U.S. Public Health Service-modified criteria . Based on the results of the present study , the material investigated demonstrated acceptable clinical performance after 12 months of clinical service . Long-term re-evaluations are necessary for a more detailed analysis of these composites
The difference of the two techniques did not reach statistical significance in order to recommend one technique over the other .
CLINICAL SIGNIFICANCE Resin composite material s , placed directly or indirectly , exhibit a promising long-term clinical performance when rehabilitation of posterior teeth is needed .
OBJECTIVE To evaluate the long-term clinical performance of direct versus indirect composite inlays/onlays  in posterior teeth .
Although many years in clinical practice , the selection of the best treatment protocol still remains subjective .