Clinical performance of novel resin composites in posterior teeth: 18-month results. Three-year clinical evaluation of direct and indirect composite restorations in posterior teeth. One year clinical evaluation of two different types of composite resins in posterior teeth. Four-year clinical evaluation of posterior resin-based composite restorations placed using the total-etch technique. Clinical performance of posterior compomer restorations over 4 years. Clinical performance and marginal adaptation of class II direct and semidirect composite restorations over 3.5 years in vivo. Prospective clinical study of zirconia-based posterior four-unit fixed dental prostheses: four-year follow-up. Two-year clinical evaluation of direct and indirect composite restorations in posterior teeth. Clinical evaluation of polyacid-modified resin composite posterior restorations: one-year results. Clinical evaluation of two packable resin-based composite restorations: a three-year report. Two-year clinical performance of sonic-resin placement system in posterior restorations. The longevity of different restorations in primary teeth. Dental restoration longevity: survival functions and statistical indices in low and high failure rate groups. Three-year clinical evaluation of a self-cured posterior composite resin. Clinical performance of posterior composite resin restorations. Evaluation of composite restorations in hypomineralised permanent molars: a four year clinical study. Restorations in abrasion/erosion cervical lesions: 8-year results of a triple blind randomized controlled trial.
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 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 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 report the 4-year clinical performance of  posterior resin-based composite restorations placed using the total-etch technique . MATERIAL S AND METHODS Over a period of 1 year , 726 restorations ( 248 molars , 478 premolars ; 260 Class I , 466 Class II ; 540 replacements , 186 primary decay ) were placed on conservative preparations , using the incremental placement technique in a clinical environment . Baseline data were collected , and the restorations were evaluated after 4 years . Z100 and Scotchbond Multi- Purpose ( SBMP ) ( 3 M Dental Products , St. Paul , Minnesota ) were used as the restorative system . The criteria evaluated were color match , marginal adaptation , anatomic form , cavosurface marginal discoloration , axial contour , interproximal contact , secondary caries , postoperative sensitivity , and tooth vitality . RESULTS At baseline , 24 % of the teeth restored presented postoperative sensitivity ; 86 % of the sensitive teeth were from the replacement group . At 4 years , all teeth were vital to cold test . Eighteen restorations ( 2.5 % ) presented clinical ly detectable marginal fracture . The shade was acceptable in all restorations . Cavosurface marginal discoloration was observed in 47 restorations ( 6.5 % bravo scores ) . Axial contour , interproximal contact , and marginal adaptation received 100 % alfa scores . No secondary caries was diagnosed in any of the teeth examined . None of the examined restorations required replacement . CLINICAL SIGNIFICANCE Under controlled clinical conditions , posterior resin-based composite restorations placed with the total-etch technique and restorative Z100/SBMP have the potential to present a high success rate at 4 years . None of the examined restorations required replacement , and there was no clinical ly detectable wear in any of the restorations . Simultaneous etching of enamel and dentin followed by the application of a resin adhesive can be considered an adequate modality of pulp protection in nonexposed tooth preparations PURPOSE To clinical ly evaluate two polyacid-modified resin composites ( Hytac and Dyract AP ) for the restoration of posterior teeth over a 4-year period and to investigate accessible margins by light microscopy . METHODS In a controlled prospect i ve clinical study , 71 cavities ( 21 occlusal , 41 MO/OD , 9 MOD ) in 30 patients were restored with compomers by three dentists . Thirty-eight restorations were placed with the combination OSB/Hytac , the same patients received 33 restorations with Prime&Bond 2.1/Dyract AP . Enamel margins of the cavities were etched with phosphoric acid . At baseline , after 12 , 24 , and 48 months , the restorations were examined by two independent investigators according to modified USPHS- criteria . Focusing on the 40 restorations available at all recalls , a semi-quantitative margin analysis was carried out at each recall using replicas and light microscopy at x130 magnification . RESULTS Twenty restorations were not investigated at the 4-year recall ( drop-out ) . After 48 months , 11 restorations ( Hytac : n = 8 , Dyract AP : n = 3 ) had to be replaced due to tooth fracture ( n = 4 ) , gap formation ( n = 5 ) , and adhesive failure ( n = 2 ) . Forty restorations were still in function after 4 years ( overall failure rate 16 % ; Hytac : 21 % ; Dyract : 9 % ) . Between the recalls , statistically significant differences were detected for the criteria marginal integrity ( Alpha dropping from 76 % at baseline to 32 % after 4 years ) , restoration integrity ( Alpha ratings at baseline 99 % vs. 40 % after 4 years ) , and occlusion ( 100 % vs. 24 % ) . For the criteria surface roughness ( from the 6-month recall ) and anatomical shape ( after 4 years ) , a significant difference between the material s was evident in favor of Dyract AP . Except gap-free margins , the predominant criterion in the microscopic analysis at baseline was marginal overhang ( 24 % ) and 30 % negative step formation after 4 years 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 PURPOSE The aim of this prospect i ve study was to evaluate the clinical performance of zirconia-based posterior four-unit fixed dental prostheses ( FDPs )  after 4 years of clinical observation . MATERIAL S AND METHODS Between 2006 and 2010 , 10 patients ( 5 women , 5 men ; mean age : 52.8 years ) received 17 posterior four-unit FDPs .  Two calibrated examiners evaluated the FDPs independently 1 week ( baseline ) , 6 months , and 1 , 2 , 3 , and 4 years after placement using California Dental Association ( CDA ) criteria . Periodontal status was assessed on both the abutment and contralateral control teeth using Plaque Index , Gingival Index , probing attachment level , and Margin Index parameters . Statistical analysis was performed using descriptive statistics and the Wilcoxon signed-rank test . RESULTS Three restorations were lost because of fractures at their distal connectors after a mean clinical service of 25.3 months , and one abutment tooth was extracted because of vertical root fracture 23 months after cementation . Three FDPs presented chipping of a moderate size 1 week before framework fracture , and minor chipping was observed in 2 other FDPs 1 week and 36 months after cementation . After 4 years of clinical service , the cumulative survival rate of the posterior four-unit FDPs was 76.5 % . No caries lesions were detected on the abutment teeth . The remaining restorations were judged to be satisfactory according to the CDA criteria . Periodontal parameters did not show significant differences between test and control teeth , but Gingival Index scores demonstrated a slight increase in inflammation in the distal abutments after 4 years ( P = .016 ) . CONCLUSIONS The use of zirconia-based posterior four-unit FDPs should be restricted for patients with high esthetic dem and s , except in patients where at least 4 mm of height is available for connector thickness 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 OBJECTIVE The aim of this investigation was to evaluate the clinical performance of a new compomer restorative system , Dyract AP , placed in combination with Non-Rinse Conditioner and Prime & Bond NT in permanent posterior teeth . METHOD AND MATERIAL S Fifty Class II and 41 Class I restorations were placed in 39 patients by 1 dentist . The restorations were evaluated directly , with modified US Public Health Service criteria , and indirectly , with color slides and polyvinyl siloxane impressions , at baseline and 6 months and 1 year after placement . Preoperative and 1-year postoperative bitewing radiographs were also taken . RESULTS All 82 restorations available for 1-year evaluation were in situ . No postoperative sensitivity or pulpal problems were reported . Four Class II restorations ( 4.9 % ) failed because of partial fracture or recurrent caries . The percentages of Alfa score for each criterion were color match , 95.1 % ; marginal discoloration , 57.3 % ; marginal integrity , 35.4 % ; anatomic form , 98.8 % ; and surface texture , 91.5 % . The average wear rate of Dyract AP was low ( 18.5 + /- 11.7 microns at 6 months and 35.7 + /- 13.6 microns at 12 months ) . CONCLUSION The excellent h and ling characteristics , the good clinical performance , and the improved wear resistance suggest that this compomer will provide reliable direct tooth-colored restorations in stress-bearing areas 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 OBJECTIVE The objective of this split-mouth r and omized controlled study was to compare the 2-year clinical performance of two restorative techniques and material s for posterior permanent carious teeth . METHOD AND MATERIAL S After signing informed consent , 30 patients aged between 7 and 16 received two Class 1 restorations on cavities on permanent first or second molar teeth performed with one of two systems : incrementally placed conventional posterior composite resin ( Herculite Ultra , Kerr ) , and sonic-resin placement system ( SonicFill , Kerr ) with single-component self-etch adhesive system ( Kerr ) according to the manufacturers ' directions . Two blinded observers evaluated the restorations at three times ( baseline , and after 1 and 2 years ) according to the US Public Health Service modified criteria . Kruskal-Wallis test and Mann-Whitney U-test were used to compare the clinical performance of the restorative systems . RESULTS The restorative systems showed similar clinical performance at 2 years . At the end of 2 years in both groups , one restoration 's marginal staining Alpha ratings decreased . In the same period , two restorations in the conventional group and one in the SonicFill group received Bravo ratings for color match and surface roughness scorings . CONCLUSION The sonic-resin placement system demonstrated similar results to incrementally placed conventional composite resin in terms of clinical success . Considering the advantages of providing up to 5 mm in a single layer , and the adjustability of the viscosity , bulk-fill composite restorations seem to be a good alternative to posterior Class 1 composite restorations . CLINICAL RELEVANCE This study suggests that a new dental material for bulk-fill technology exhibits similar clinical success to incrementally placed composite resin BACKGROUND AND AIM This paper review s three published papers and adds results from a fourth study which aim ed to determine which restorative material would be the best alternative(s ) to amalgam ( AM )  in primary teeth . DESIGN All studies had a practice -based design and were part of the routine treatment of children and adolescents . The clinicians were assigned which material s to use in a r and omised matter in the first three studies which lasted for 7 - 8 years . In the fourth study conducted 4 years after the initial studies , the clinicians were free to select the restorative material s. RESULTS AND CONCLUSIONS Resin modified glass ionomer ( RMGI ) and compomer ( COM ) restorations showed similar longevity compared with AM , whereas conventional GI restorations showed significantly shorter longevity . The studies indicated that the ' new and improved ' material s based on in vitro tests did not always show enhanced clinical properties . In the last study , where clinicians freely selected the restorative material s they used in their practice s , seven used COM , one used conventional GI material s and one used a combination of the two types of material A group of 71 patients was examined to determine the longevity of restorations placed at the University of North Carolina School of Dentistry . Patients with an overall restorations failure rate of equal to or greater than 40 per 1000 restoration-yr were categorized as having a " high failure rate " and those below that were considered " low failure rate " . An investigation was made to determine statistical differences between these two groups of patients using survival analysis and various statistical indices . Time of exposure and age of patients for both groups were similar . High rate patients had a greater number of anterior restorations and anterior teeth restored . In addition , the number of restorations per tooth was significantly greater in anterior and posterior teeth of the high failure rate group . No single variable was found to account for the differences in the failure rates in the two groups of patients . A prospect i ve study is needed in order to examine possible causes for restoration failures 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 Two formulations of posterior composite resin ( P-30 and Bisfil-P ) were evaluated and compared to a high-copper , dispersed-phase amalgam ( Dispersalloy ) .  One hundred twenty-eight restorations were placed in 27 patients so that each patient received at least one of each material . After 3 years of clinical service , all three restorative material s produced clinical ly acceptable restorations , according to US Public Health Service and Leinfelder criteria . The amalgam restorations , however , underwent less wear ( 44 microns ) than did the posterior composite resin restorations ( 60 to 74 microns ) . Stratification of data by type of tooth , class of restoration , and size of restoration produced the same ranking of wear from lowest to highest : Dispersalloy , Bisfil-P , and P-30 . Resin restorations showed 45 % more wear in molars than in premolars , and more wear was associated with moderately sized restorations than with conservative restorations . The surface texture of restorations of composite resin with porous strontium glass filler was nearly as smooth as that of enamel and was significantly smoother than that of the restorations of composite resin with zinc glass filler or of unpolished amalgam AIM The objective of this investigation was to evaluate the clinical performance of  composite restorations in enamel hypomineralised posterior teeth . METHODS 52 composite restorations were placed in 52 permanent molars of 46 children , aged 8 - 10 years . All the teeth were clinical ly diagnosed as hypomineralised and restorations were placed on two or more surfaces of the teeth , including cusps . All treated teeth had at least 2 sound surfaces , thus excluding defective teeth with total disruption of the crown . The material s used were a hybrid composite and a fourth generation one-bottle adhesive material and manufacturer 's instructions were carefully followed . The restorations were initially evaluated 7 days after the treatment and subsequent evaluation was performed at 12 , 24 , 36 , 48 months . Clinical evaluation of the restorations was made according to the criteria of Ryge [ 1980 ] . RESULTS In 6 cases , postoperative complaint was relieved after occlusal re-adjustment at the second appointment , 7 days later . At the end of the 48 months study period , 49 restorations were available for evaluation , all with full retention . Radiographically there was no periapical pathology . Problems were found in colour match in 10 , surface appearance in 3 and anatomic form in 4 restorations . Hypersensitivity was recorded in 17 teeth after one week and in 3 teeth one year later . All teeth were sensitivity free after two years and until the end of the study period . CONCLUSIONS Composite resin restorations using contemporary material s , in certain cases of hypomineralised permanent molars , can be an acceptable restorative procedure with satisfactory long-term results PURPOSE An equivalence r and omized controlled trial within the subject was organized to evaluate the clinical long-term success of a new 2-step etch & rinse adhesive and a new nano-filled ormocer . METHODS 50 subjects , 21 males and 29 females aged between 21 and 65 , were r and omized to receive 150 restorations , 100 with the new restorative material , 50 with the composite as control , placed in non-carious cervical lesions with the same bonding system . The main outcome measure was the cause of failure at 8 years . R and omization was number table-generated , with allocation concealment by opaque sequentially numbered sealed and stapled envelopes . Subjects , examiner , and analyst were blinded to group assignment . Two interim analyses were performed . Data were analyzed by ANOVA and Cox test ( P < 0.05 ) . RESULTS After 8 years , 40 subjects and 120 teeth were included in the analysis of the primary outcome . There were eight failures in the experimental group and four failures in the control group . The cumulative loss rate was 7 % for both restorative material s , with the annual failure lower than 1 % , without any statistically significant difference . There were two key elements of failure : the presence of sclerotic dentin and the relationship between lesion and gingival margin
However , variability was substantial .
Restoration type , material s , the patient , the operator , the practice environment and type of care system appeared to influence longevity .
Objective To conduct a systematic review of the literature on the longevity of routine dental restorations in permanent posterior teeth , and to identify and examine factors influencing its variability .