Composite Restorations In Posterior Teeth Research Articles

Longevity of composite restorations in posterior teeth placed by dental students: a 12-year retrospective study.

To evaluate the longevity of resin composite restorations placed in posterior teeth by dental students, using data from electronic records from 2008 to 2019. Demographic (gender and age) and clinical variables (dental group, position in dental arch, and the number of restored surfaces) were evaluated. The 5-year follow-up was assessed according to the day the restoration was placed. Kaplan-Meier curves were generated to calculate the annual failure rate. Data were analyzed by Chi-Square, Kruskal-Wallis, and Mann-Whitney tests (α = 0.05). In total, 3.883 records relative to return periodicity were analyzed. The final sample consisted of 900 restorations from 479 patients. The majority were females, aged between 31 and 60. In total, 256 failures were reported (success rate = 78%), showing an annual failure rate of 2.05%. The main reasons for failures were restoration replacement (55.5%), endodontics (21.9%), prosthetics (14.5%) and extraction (8.2%). There was a higher risk of failure in restorations involving three or more surfaces (p = 0.000) and in patients over 60 years (p < 0.001). In females (p = 0.030), molars (p = 0.044), and maxillary teeth (p = 0.038) failed in a shorter time. Resin composite restorations placed in permanent posterior teeth by dental students had high survival rates. The main reason for failure was the replacement of restorations. The age group and the number of restored surfaces significantly affected the success of the restorations. The electronic health records over 12 years showed that 78% of the resin restorations in posterior teeth placed by dental students were successful for a minimum of five years.

Current trends in placing posterior composite restorations: Perspectives from Palestinian general dentists: A questionnair study

Abstract Aim: The success of composite restorations relies on material selection and practitioner-related factors that shape the overall outcome. This study explores the practices of Palestinian general dental practitioners in placing posterior composites, examining the impact of work sector, experience, and gender on their choices. Materials and Methods: The study was conducted as an online cross-sectional questionnaire and involved 351 participants, with a response rate of 69.8%. The survey comprised 18 closed-ended questions covering demographics, material selection, and composite placement in special cases, techniques, and factors influencing the choices. Statistical analyses included descriptive statistics, chi-squared tests, and Fisher’s exact tests. Results: Composite was the predominant choice for small-size (83.7%) and large-size posterior cavities (60.4%). Practitioners commonly opted for composite restorations in cases involving occlusal parafunctional activity (60%), poor oral hygiene (78%), and subgingival cavities (72.2%). Only 19.6% and 5.3% reported occlusal and gingival beveling, respectively. Rubber dams for isolation stood at 30%, one-step self-etch adhesives at 44.9%, and the oblique layering technique at 51%. Light-emitting diode curing units were popular (97.55%), but monitoring output with a radiometer was infrequent (93.5%). Tofflemire metal matrix usage was 46.1%, whereas a sectional matrix system was employed by 29.8%. A 2 mm layer exposure to light curing for 20 s was reported by 62%, and 27.75% utilized additional light-curing postmatrix band removal. Conclusion: The study highlights the need for Palestinian dental professionals to update their clinical approaches in placing composite restorations in posterior teeth. Gender, work sector, and experience influence practitioners’ choices, emphasizing the importance of tailored continuing education programs for improving clinical practices.

Techniques Used by Dental Specialists for Extensive Posterior Composite Restorations

Objective: To assess the techniques used by dental specialists for placement of extensive posterior composite restorations. Methodology: A cross sectional descriptive was conducted in 150 dentists of College of Dentistry, SMDC, Lahore from June 2019 to July 2020 after obtaining ethical approval from Sharif Medical Research Centre (SMRC). Data was collected using a pre validated questionnaire Results: A statistically non-significant association between the specialty of the dentist the technique used for placement of the composite during restoration (p=0.08). The most commonly used techniques for the placement of posterior composite restorations by dentists of all specialties including Periodontology (88%), Prosthodontics (68.4%), Orthodontics (85.7%), Oral Surgery (91.3%), Oral Pathology (71.4%), Oral Biology (33.3%), Dental materials (75%), Community Dentistry (100%), Operative Dentistry (90.9%) and Oral Medicine (75%) is incremental curing. Practical implication: This study will give an insight on the various techniques used by dentists from various specialties for the placement of composite restorations in posterior teeth. This will in turn help them adopt new and revisit old techniques used by them while placing composite restorations. Conclusion: The most commonly used techniques for the placement of posterior composite restorations by dentists of all specialties is incremental curing followed by use of moisture control during the placement of composites both with and without rubber dam isolation. Keywords: Dental Specialists, Composite Restorations, Posterior Dental Restorations, Incremental Curing

Effect of Cellulose Fiber from Coconut Coir as Filler For Dental Flowable Composite

The composite restorations in posterior teeth have recently received an increasing interest due to the improvement of their physical and mechanical properties. However, compositing by the most common polymerization procedure tends to deform the tooth structure that may cause some damage in the marginal seal due to the imperfect interfacial attachment. Several techniques have been used to overcome this problem, one of them is using a flowable composites on the bottom of the cavity as the first layer. The purpose of this study is to develop fiber-reinforced composite (FRC) material made of coir fiber (Cocos nucifera) with matrix (Bis-GMA, TEGDMA, DGEBA, and camphorquinone). Cellulose fiber was formed by an anti-solvent method from an aqueous NaOH-urea cellulose solution dropped into ethanol-water mixture. The resulting cellulose fibers were then mixed with the matrix using a magnetic stirrer. The composition of nanocellulose in the matrix was varied 10:90 and their characteristics were compared with the commercial nanofiller composite (Z 350 and 3M) as control. The sample was tested for cross-linked using a scanning electron microscope (SEM) and Fourier transform infrared (FTIR). The morphology of nanocellulose look like a fiber as cross-linked with matrix. Therefore, the formation of a crosslink bond between cellulose and matrix C-O-C with a new wavenumber in 890 cm-1. The nanocellulose composite also form fibers that binds the matrix, while flowable composites from manufacturers from fibers and particulates. From this experimental method it can be suggested coconut fiber has high potential as raw material to be filler in a dental flowable composite.

A retrospective clinical study on the survival of posterior composite restorations in a primary care dental outreach setting over 11years

ObjectivesTo investigate the survival in terms of time to re-intervention of composite restorations in posterior teeth among patients attending for treatment at a primary care dental outreach setting over an 11-year period and to determine whether dental, patient or operator factors influenced this. MethodsElectronic primary dental care data were collected on individual patients, including information on their dental treatment and socio-demographics as well as service provision, key performance indicators and student activity. ResultsA total of 1086 patients had at least one posterior composite placed between 2007 and 2018. This amounted to 3194 restorations placed of which 308 had a re-intervention within the 11-year period. For all restorations, the annual failure rate at 1 year was 5.73 %, at 5 years was 16.78 % and at 10 years was 18.74 %. A logistic regression showed that when compared to the least deprived 5th quintile, the most deprived 1st and 2nd quintiles were significantly less likely to have a re-intervention, being 49.2 % (p = 0.022) and 53.2 % (p = 0.031) less likely, respectively. ConclusionsThe survival rates of posterior composite restorations placed at a single outreach centre providing undergraduate dental training in the South of England, mirrors other studies. The new findings presented suggest similar re-intervention rates between dental students and dental hygiene-therapy students. This study’s findings around patient deprivation and rate and time of re-intervention raises important questions related to the need for targeted dental and after care for certain groups in the population. Clinical significanceUnderstanding the factors associated with re-intervention of restorations provided to patients has an impact on patients and dental practices. Also, as we consider widening use of skill mix in dentistry to increase access to care, parity in provision of treatments within the dental team increases opportunities for delegation of tasks.

Semidirect vital tooth onlay restoration: a case report

In the loss of much of the coronary structure, either through caries or a fracture, it is indicated to perform restorative laboratory techniques in order to re-establish the patient's health, function and aesthetics, through conservative and minimally invasive techniques. The aim of this manuscript is to report on a clinical case of a posterior restoration using a semidirect composite resin onlay restoration. Initially, a direct morphological reconstruction of bulk-fill resin was performed, followed by cavity preparation with diamond tips. Alginate melding and a model of elastomer-based material were performed. The professional made the onlay piece in micro-hybrid composite resin in the model incrementally. Cementation was performed with dual resin cement following manufacturer's recommendations. Finally, the occlusal adjustment was performed in the maximum habitual intercuspal position and during eccentric mandible movements. We conclude that the semidirect restorative technique in composite resin is as effective as direct and indirect restorations; however, the correct indication of these restorative procedures will define the clinical prognosis.Descriptors: Dental Restoration; Permanent; Molar. Rehabilitation.ReferencesAngeletaki F, Gkogkos A, Papazoglou E, Kloukos D. Direct versus indirect inlay/onlay composite restorations in posterior teeth. A systematic review and meta-analysis. J Dent. 2016;53:12-21.Morimoto S, Rebello de Sampaio FB, Braga MM, Sesma N, Özcan M. Survival Rate of Resin and Ceramic Inlays, Onlays, and Overlays: A Systematic Review and Meta-analysis. J Dent Res. 2016;95:985-94.Spreafico RC, Krejci I, Dietschi D. Clinical performance and marginal adaptation of class II direct and semidirect composite restorations over 3.5 years in vivo. J Dent. 2005;33:499-507.Lins R, Vinagre A, Alberto N, Domingues MF, Messias A, Martins LR, Nogueira R, Ramos JC. Polymerization Shrinkage Evaluation of Restorative Resin-Based Composites Using Fiber Bragg Grating Sensors. Polymers (Basel). 2019a;11;E859.Lins RBE, Aristilde S, Osório JH, Cordeiro CMB, Yanikian CRF, Bicalho AA, Stape THS, Soares CJ, Martins LRM. Biomechanical behaviour of bulk-fill resin composites in class II restorations. J Mech Behav Biomed Mater. 2019b;2:255-261.Opdam NJM, Roeters FJM, Feilzer AJ, Verdonschot EH. Marginal integrity and postoperative sensitivity in Class 2 resin composite restorations in vivo. J. Dent. 1998;26: 555-62.Bicalho AA, Valdívia AD, Barreto BC, Tantbirojn D, Versluis A, Soares CJ. Incremental filling technique and composite material–part II: shrinkage and shrinkage stresses. Operat. Dent. 2014;39:E83–E92.Soares CJ, Faria-E-Silva AL, Rodrigues MP, Vilela ABF, Pfeifer CS, Tantbirojn D, Versluis A. Polymerization shrinkage stress of composite resins and resin cements - What do we need to know? Braz Oral Res. 2017;28:e62.van Dijken JW. A 6-year evaluation of a direct composite resin inlay/onlay system and glass ionomer cement-composite resin sandwich restorations. Acta Odontol Scand. 1994;52:368-76.Ferracane JL, Stansbury JW, Burke FJ. Self-adhesive resin cements - chemistry, properties and clinical considerations. J Oral Rehabil. 2011;38:295-314.Bacelar-Sá R, Sauro S, Abuna G, Vitti R, Nikaido T, Tagami J, Ambrosano GMB, Giannini M. Adhesion Evaluation of Dentin Sealing, Micropermeability, and Bond Strength of Current HEMA-free Adhesives to Dentin. J Adhes Dent. 2017;19:357-364.Alharbi A, Rocca GT, Dietschi D, Krejci I. Semidirect composite onlay with cavity sealing: a review of clinical procedures. J Esthet Restor Dent. 2014;26:97-106.Hirata R, Kabbach W, de Andrade OS, Bonfante EA, Giannini M, Coelho PG. Bulk Fill Composites: An Anatomic Sculpting Technique. J Esthet Restor Dent. 2015;27:335-43.Fron Chabouis H, Prot C, Fonteneau C, Nasr K, Chabreron O, Cazier S, Moussally C, Gaucher A, Khabthani Ben Jaballah I, Boyer R, Leforestier JF, Caumont-Prim A, Chemla F, Maman L, Nabet C, Attal JP. Efficacy of composite versus ceramic inlays and onlays: study protocol for the CECOIA randomized controlled trial. Trials. 2013;3:278.Torres CRG, Zanatta RF, Huhtala MFRL, Borges AB. Semidirect posterior composite restorations with a flexible die technique: A case series. J Am Dent Assoc. 2017;148:671-676.Marcondes M, Souza N, Manfroi FB, Burnett LH Jr, Spohr AM. Clinical Evaluation of Indirect Composite Resin Restorations Cemented with Different Resin Cements. J Adhes Dent. 2016;18:59-67.Liu X, Fok A, Li H. Influence of restorative material and proximal cavity design on the fracture resistance of MOD inlay restoration. Dent Mater. 2014;30:327-33.Fruits TJ, Knapp JA, Khajotia SS. Microleakage in the proximal walls of direct and indirect posterior resin slot restorations. Oper Dent. 2006;31:719-27.

Clinical Evaluation of Fiber-Reinforced Composite Restorations in Posterior Teeth - Results of 2.5 Year Follow-up.

Objectives:The aim of this study was to evaluate the clinical performance of posterior composite restorations reinforced by bulk base of short-fiber composite (everX Posterior, GC Corporation).Methods:Thirty-six short fiber-reinforced composite restorations were placed in premolar and molar teeth of 33 patients. Eight of the teeth were vital and 28 were non-vital. Average follow up time of the restorations was 30.6 months (2.5 years), ranging from 16.2 to 51.3 months (1.3 - 4.3 years).Results:One restoration failed during the follow-up period due to secondary caries, at time point 39.5 months. Three fillings had minor fractures during the follow-up. The overall survival rate of the restorations was 97.2% and success rate (no maintenance needed) was 88.9%, respectively.Conclusion:Posterior composite restorations with a bulk base of short-fiber composite showed good clinical performance in the short term evaluation.

Clinical performance of direct versus indirect composite restorations in posterior teeth: A systematic review.

Background:Composite resin, serves as esthetic alternative to amalgam and cast restorations. Posterior teeth can be restored using direct or indirect composite restorations. The selection between direct and indirect technique is a clinically challenging decision-making process. Most important influencing factor is the amount of remaining tooth substance.Aim:The aim of this systematic review was to compare the clinical performance of direct versus indirect composite restorations in posterior teeth.Materials and Methods:The databases searched included PubMed CENTRAL (until July 2015), Medline, and Cochrane Database of Systematic Reviews. The bibliographies of clinical studies and reviews identified in the electronic search were analyzed to identify studies which were published outside the electronically searched journals. The primary outcome measure was evaluation of the survival of direct and indirect composite restorations in posterior teeth.Results:This review included thirteen studies in which clinical performance of various types of direct and indirect composite restorations in posterior teeth were compared. Out of the thirteen studies which were included seven studies had a high risk of bias and five studies had a moderate risk of bias. One study having a low risk of bias, concluded that there was no significant difference between direct and indirect technique. However, the available evidence revealed inconclusive results.Conclusion:Further research should focus on randomized controlled trials with long term follow-up to give concrete evidence on the clinical performce of direct and indirect composite restorations.

No difference in the long-term clinical performance of direct and indirect inlay/onlay composite restorations in posterior teeth

Data sourcesMedline, Embase, the Cochrane Oral Health Group's Trials Register and CENTRAL. Unpublished literature was searched on ClinicalTrials.gov, the National Research Register, and Pro-Quest Dissertation Abstracts and Thesis database. Hand searching of reference lists only.Study selectionRandomised controlled trials with a minimum of three years follow-up that compared direct to indirect inlays or onlays in posterior teeth. Primary outcome was failure (the need to replace or repair).Data extraction and synthesisTwo reviewers independently and in duplicate performed the study selection and two extracted data independently using a customised data extraction form. The unit of analysis was the restored tooth. Risk of bias was assessed using the Cochrane Risk of Bias tool. Meta-analysis was conducted on two studies using the random-effects model.ResultsThree studies were included. Across these studies there were 239 participants in whom 424 restorations were placed. Two studies compared direct and indirect inlays and had follow-up of five and 11 years respectively. One study compared direct and indirect onlays with a follow-up of five years. The studies were at unclear or high risk of bias. For direct and indirect inlays, Relative Risk (RR) of failure after five years was 1.54 (95% Cl: 0.42, 5.58; p = 0.52) in one study and, in another was 0.95 (95% Cl: 0.34, 2.63; p = 0.92) over 11 years. For onlays there was also no statistically-significant difference in survival, though overall five-year survival was 87% (95% CI: 81-93%).ConclusionsThere is insufficient evidence to favour the direct or indirect technique for the restoration of posterior teeth with inlays and onlays.

Direct light-activated resin-based composite restorations in posterior teeth seem to have a high clinical success rate and long-term survival

Borgia E, Baron R, Borgia JL. Quality and survival of direct light-activated composite resin restorations in posterior teeth: a 5- to 20-year retrospective longitudinal study [published online ahead of print May 17, 2017]. J Prosthodont. http://dx.doi.org/10.1111/jopr.12630.

No evidence of indirect resin composite restorations lasting longer than direct resin composite restorations in posterior teeth

No evidence of indirect resin composite restorations lasting longer than direct resin composite restorations in posterior teeth

What are the Most Important Factors for Composite Failures in the Posterior Teeth?

The biggest factor in success or failure of posterior composites is cavity volume. Large composite restorations in posterior teeth are prone to failure over the long term. This is related to excessive polymerization shrinkage and possibly some inadequately cured resin. One of the best solutions to reducing the amount of resin in the tooth is to combine the composite with some Resin Modified Glass Ionomer or Glass Ionomer. Neither of these two materials have the polymerization shrinkage that Composite resin does. Net result in a large restoration is an inadequate cure. Every potential for error is magnified in a large restoration that is subject to large amounts of occlusal stress.

Longitudinal micromorphological 15-year results of posterior composite restorations using three-dimensional scanning electron microscopy

ObjectivesHybrid composite restorations in posterior teeth were evaluated over 15 years using the semiquantitative Clinical, Photographic and Micromorphologic (CPM) index. It was a further aim to quantitate the surface morphology by three-dimensional scanning electron microscopy (3D-SEM). MethodsThirty seven hybrid composite restorations (Ketac-Bond/Visio-Molar X, ESPE, Seefeld/Germany) were longitudinally followed up.Parallel to clinical assessment replicas were taken at baseline, after 1, 5, 10 and 15 years and evaluated by SEM, and profilometrical analyses of 3D-SEM data were computed. The profilometrical results were statistically analysed by ANOVA. The level of significance was set to p<0.05. ResultsThe semiquantitative micromorphological evaluation exhibited the most considerable deterioration within the first year and up to 5 years of function. Less change was detected during the next 10 years. The profilometrical quantification showed raising depth of the negative marginal ledges with a mean of 27.2μm (range 0.6–94.5μm) after 10 years, with no statistically significant changes from 5 to 10 and 10 to 15 years. The 3D-SEM revealed marginal grooves beneath the level of the ledges (mean 34.5μm after 5 years) within the bonding zone, exposing enamel margins. Leakages, marginal fractures and surface roughness did not seriously deteriorate the quality of restorations. ConclusionsHybrid composite restorations of Class I and II cavities surviving the first five years performed well over 15 years of function. Quantitative 3D-SEM profilometrical measurements revealed the dynamics of marginal behaviour over time. Clinical significanceLong-term parallel clinical and micromorphological evaluation of posterior composite restorations of Class I and Class II cavities documented the clinical safety and acceptable longevity. The longitudinal 3D micromorphologic assessment of the surface changes and of the marginal behaviour revealed deteriorating as well as improving factors hidden in clinical performance.

Patient Risk Factors’ Influence on Survival of Posterior Composites

This practice-based retrospective study evaluated the survival of resin composite restorations in posterior teeth, focusing on the influence of potential patient risk factors. In total, 306 posterior composite restorations placed in 44 adult patients were investigated after 10 to 18 yrs. The history of each restoration was extracted from the dental records, and a clinical evaluation was performed with those still in situ. The patient risk status was assessed for caries and “occlusal-stress” (bruxism-related). Statistical analysis was performed by the Kaplan–Meier method and Cox-regression multivariate analysis. In total, 30% of the restorations failed, of which 82% were found in patients with 1 or 2 risk factors. Secondary caries was the main reason of failure within caries-risk patients, whereas fracture was the main reason in “occlusal-stress-risk” patients. The patient variables gender and age did not significantly affect survival, but risk did (p < .001). Tooth type (p < .001), arch (p = .013), and pulpal vitality (p = .003) significantly affected restoration survival. Within the limits of this retrospective evaluation, the survival of restorations is affected by patient risk factors, which should be included in survival analyses of restorations.

Comparison of different methods for evaluating resin composite restorations in posterior teeth

Aim: To compare different methods for evaluating composite resin restorations in posterior teeth and to evaluate the reliability of each method by determining the intraobserver agreement. &#x0D; Material and methods: 136 class I resin composite restorations were evaluated by a trained examiner using modified Ryge criteria to assess selected restoration characteristics with three different methods: clinical, photographic and dental cast models. &#x0D; Results: The results showed that intraexaminer agreement was better on dental cast models evaluations for marginal integrity and anatomic form and was similar between photographic and clinical evaluations for marginal integrity and marginal discoloration. Surface texture showed the lowest degree of intraexaminer agreement with all the methods tested. Direct clinical method and the two indirect methods were significantly different for all the characteristics assessed (p

One-Year Clinical Evaluation of Composite Restorations in Posterior Teeth: Effect of Adhesive Systems

This clinical study assessed the performance of posterior composite resins applied with the Adper™ Single Bond Plus (SB) and Adper™ Scotchbond SE (SE) adhesive systems and Filtek™ Supreme Plus composite resin, using modified US Public Health Service criteria. A total of 97 restorations were placed in posterior teeth by two calibrated operators. Application of the materials followed manufacturers' instructions. The restorations were evaluated by two examiners at baseline and after one year. Statistical analyses were conducted using the proportion test at a significance level of 5% (p<0.05). All the restorations evaluated (ie, 100%) received an alpha rating for the criteria of marginal discoloration and marginal integrity at baseline. At one year, for marginal discoloration, 64.6% of SB and 61.2% of SE received an alpha rating. For marginal integrity, 72.9% of SB and 77.6% of SE received an alpha rating. The other restorations received bravo ratings for both criteria. None of the teeth that received the restorative systems presented caries lesions around the restorations. A total of eight teeth presented postoperative sensitivity one week after baseline, five with SB and three with SE; the symptom had disappeared one year later. One year later, composite resin restorations using either adhesive system showed satisfactory clinical performance.

A Review of Amalgam and Composite Longevity of Posterior Restorations

Failure of dental restorations is a major concern in dental practice and its replacement constitutes the majority of the operative work. The purpose of this study is to review the longevity of Class I and II amalgam and direct composite restorations in posterior permanent teeth, and to discuss possible reasons for clinical failure. On average, longevity of resin composite restorations in posterior teeth is two to three times lower than amalgam restorations. The resin composite is an appropriate material to restore small Class I and Class II lesions, with margins located in enamel, on patients with low caries risk and, when complete field isolation can be achieved. The use of amalgam is preferable to the use of composite in large and complex restorations, with margins located in dentine or cement, where isolation is deficient. Durability of dental restorations is dependent upon many different factors, such as: operator skills, materials used, technique used, patient compliance and oral environment. The main reasons for restorations failure were secondary caries, restoration fracture, tooth fracture and marginal defects.

Clinical Evaluation of Posterior Resin Composite Restorations Placed by Dental Students of Kuwait University

Objective: To investigate the survival rate over a 3-year period of posterior resin composite restorations placed by dental students of Kuwait University. Materials andMethods: Posterior resin composite restorations placed by 5th-, 6th- and 7th-year dental students between 2004 and 2005 were evaluated. All patients with posterior composite restorations placed during this period of time were recalled. Of the 204 eligible patients, 139 attended the recall. 432 posterior resin composite restorations were evaluated clinically and radiographically according to the United States Public Health Service criteria. For each restoration, the survival time and/or reasons for failure were recorded. Descriptive statistics and logistic regression analysis were used to analyze the data at a statistically significant level of p < 0.05. Results: At 3 years, the survival rate of the restorations was 95.1%, resulting in an annual failure rate of 1.7%. Recurrent caries was the most common cause of failure (71.4%). Oral hygiene and gender and age of the patient were the factors that affected the failure rate of the restoration (p < 0.05). Other factors such as tooth type and location, type of cavity, type of liner used and level of the student who performed the procedure did not affect the failure rate (p > 0.05). Conclusion: Dental students of Kuwait University were able to place resin composite restorations in posterior teeth with a low annual failure rate. Recurrent caries was the most common cause of failure of posterior resin composite restorations. Oral hygiene was the most important factor in determining the survival of resin composite restorations.

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

The aim of this study was to assess the clinical performance of three direct composite resins and two indirect inlay systems in posterior teeth using the modified USPHS criteria. A total of 100 restorations were placed in the molars of 54 patients by one operator. All restorations were directly evaluated by two examiners at baseline, 6 months, and 12 months. Statistical analysis was conducted using McNemar chi-square test at a significance level of 5% (p<0.05). Recall rate was 100% at 6 and 12 months, and all the restorations evaluated (i.e., 100%) received Alpha rating for the criteria of retention and gingival adaptation. At 12 months for the surface texture criterion, 80% of Filtek Supreme XT received Alpha rating while it was 95% for Tetric EvoCeram and AELITE Aesthetic. For marginal discoloration, 85% of Tescera ATL and Filtek Supreme XT received Alpha rating while it was 95% for Tetric EvoCeram and AELITE Aesthetic. Further, none of the restorative systems received a Charlie rating for any of the criteria at all evaluation periods. In summary, all the restorations demonstrated clinically satisfactory performance with no significant differences detected among them.

Amalgam and Composite Posterior Restorations: Curriculum Versus Practice in Operative Dentistry at a US Dental School

This study recorded the number of preclinical lecture and simulation laboratory sessions spent teaching the preparation and placement of amalgam and resin composite posterior restorations. These data were compared to the use of both materials in the operative clinic as placed by third- and fourth-year students. The number of posterior restorations inserted by the students, expressed as a function of the number of restoration surfaces, was also evaluated. The results show that the teaching of posterior restorations pre-clinically has consistently favored amalgam 2.5 to 1 during the last three years. However, clinically, resin composite is being used for posterior restorations 2.3 times more often than amalgam. The only instance that favored amalgam over composite during the last year was in the placement of four surface posterior restorations. This shift in emphasis from amalgam to composite needs to be addressed within dental educational institutions so that newly graduated dentists are prepared to place composite restorations properly.