A Retrospective Clinical Evaluation of Esthetic Restorations: Class III, IV, And V

Abstract

This study aimed to evaluate direct composite restorations Class III, IV and V through the USPHS and FDI criteria. Eighty-seven patients were selected through a search of the patients’ records present in the School of Dentistry. Restorations performed between 2000 to 2013 which a minimum of six months in service were selected. Adult patients of both sexes were included, who received composite restorations with total-etch adhesive system; on vital and non-vital teeth. Clinical evaluation was performed by USPHS and FDI criteria, by one calibrated examiner. The survival of the restorations was analyzed using the Kaplan-Meier and log-rank test to compare groups, and multivariate Cox regression and hazard ratio were employed to identify factors associated with the failure of the restorations. 272 restorations were evaluated with a time interval in service from 8 months to 13 years (mean 4.8 years). 120 class III restorations were evaluated with 15 failures (12.5%), with an annual failure rate of 2.74%. For class IV, 80 restorations were evaluated, with 38 failures (47.5%), with an annual failure rate of 12.6%. And for class V, 72 restorations were analyzed, with the presence of failures in 27 of them (37.5%), with annual failure rate of 9.3%. The most common reason for failure was fracture and loss of retention, occurring in 73 cases in total. Non-vital teeth showed 50% of failure, with an annual failure rate of 13.4%; while the vital teeth showed 28.1% of failure, with an annual failure rate of 6.6%. It was concluded that composite restorations showed a satisfactory performance over time, with a survival rate of 70.6% in a mean time of 4.8 years. Class III showed better clinical performance than class V and IV. Non-vital teeth restorations had 2.37 times the risk of failures than vital teeth. Both criteria (USPHS and FDI) were effective in the clinical evaluation process.