A 5-year evaluation of semipermanent composite resin crowns

ABSTRACT – The use of composite resin crowns in the restoration of traumatized and hypoplastic permanent incisors has proved to be of great clinical and aesthetic value for the pedodontic practice. Due to the composite resin materials and the acid etch technique, an easy method of making and retaining the restorations is at hand. The present study deals with long-term observations of composite resin crowns in restoring Ellis Class II and Class III coronal fractures of traumatized permanent incisors. In all, 253 composite resin crowns were controlled every year for a minimum of 5 years. In no case was an intermediate resin layer applied on etched enamel before the restoration material was placed. Surface, marginal and "body" discoloration, marginal leakage, marginal caries, abrasion, and fractures were controlled. The study demonstrated that discoloration of the surface of the restorations, and a discoloration of the restorative material not restricted to its surface ("body" discoloration) were the most frequent causes for considering the crowns as semipermanent restorations. The other factors seemed to be of minor clinical significance.     

Clinical performance of a packable resin composite for a period of 3 years.

OBJECTIVE: The purpose of this clinical study was to evaluate SureFil packable resin composite for posterior restoration of permanent teeth for a period of 3 years. METHOD AND MATERIALS: Fifty-five resin composite restorations were placed in 36 patients (16 Class I and 39 Class II restorations). After cavity preparation, the enamel was etched with 34% phosphoric acid. Prime & Bond NT was applied 20 seconds to dentin and etched enamel and cured for 20 seconds. The teeth were restored in 3- to 5-mm increments. The restorations were assessed after placement, at 6 months, 1 year, 2 years, and 3 years for color stability, marginal discoloration, marginal adaptation, secondary caries, surface texture, anatomic form, and postoperative sensitivity according to Ryge's criteria. The changes in the parameters were assessed with Friedman test analysis with a Bonferroni correction at a significance level of .05. RESULTS: Forty of the monitored 47 restorations were classified as excellent after 3 years. Thirty-one restorations were graded Bravo at baseline for color match. At the 3-year assessment (n = 47) the color of the 31 restorations had not changed. Two restorations (same patient) were lost after 1 month and were scored as Charlie until the end of the study. After 3 years there were five Bravos and one Charlie with marginal discoloration, five Bravos with marginal adaptation, and three Bravos with anatomic form (P < .05). CONCLUSION: After 3 years of clinical service, SureFil packable resin composite, with a failure rate of 6%, was considered to be successful in Class I and II restorations.     

Clinical evaluation of a polyacid-modified resin composite (Dyract) in class III cavities: three-year results

This study evaluated the three-year clinical performance of a polyacid-modified resin composite material, Dyract (DeTrey/Dentsply, Konstanz, Germany), in Class III cavities. Sixty-two Class III cavities in 30 patients were restored with Dyract. Restorations were clinically evaluated at baseline, one-, two- and three-year recalls according to the modified Ryge criteria by two experienced, calibrated examiners. After three years, the retention rate was 96.7%. At the one-year interval, one restoration had to be replaced due to sensitivity. At the two-year recall, one restoration, with a caries lesion adjacent to its margin, was clinically unacceptable and had to be replaced. Except for these two restorations, all other restorations were clinically acceptable in regard to color match, marginal discoloration, wear or loss of anatomical form, caries, marginal adaptation and surface texture after three years. At the end of three years, marginal discoloration was statistically significant (p=0.017) but did not require replacement of any of the restorations. Dyract exhibited significant marginal discoloration after three-year clinical performance in Class III cavities.     

Clinical evaluation of a polyacid-modified resin composite (Dyract AP) in class I cavities: 5-year results

PURPOSE: This study evaluated the five-year clinical performance of Dyract AP, a polyacid-modified resin composite, in restorations of Class I carious lesions. MATERIALS AND METHODS: One hundred eight Class I carious lesions in 21 patients were restored with Dyract AP. The lesions, which were macroscopically diagnosed with a probe, involved fissures. The average buccolingual width of the cavities was equal to or less than one-third of the intercuspal width. Restorations were clinically evaluated by two experienced, calibrated examiners at baseline and at 1, 2, 3, 4, and 5 years, utilizing the modified Ryge criteria. The evaluation criteria included color match, marginal discoloration, wear or loss of anatomical form, caries, marginal adaptation, and surface texture. RESULTS: At the end of the 5-year period, a total of 13 restorations had failed, and the cumulative rate of success was 93.37%. By the 5-year recall, 12 restorations had carious lesions adjacent to the margins, and 1 restoration had discoloration that was rated as Charlie. Color changes, marginal discoloration, wear or loss of anatomical form, caries, marginal adaptation, and change in surface texture were found to be statistically significant (p < 0.001) after 5 years. Aside from the thirteen failed restorations, the degrees of color matching, marginal discoloration, wear or loss of anatomical form, caries, marginal adaptation, and surface texture were clinically acceptable at 5 years after treatment. CONCLUSION: At the end of 5 years, Dyract AP exhibited acceptable clinical performance in the treatment of Class I carious lesions. Therefore, it can be considered an alternative material for the restoration of Class I cavities.     

One-year clinical evaluation of an anterior composite resin.

An anterior composite resin was evaluated in a clinical study of 93 Class III and Class IV restorations placed in patients aged 12 to 50 years. The restorations were evaluated at baseline, 6 months, and 1 year. Sixty-four (79%) of the 81 restorations examined at the 1-year recall were unchanged. Marginal discoloration and changes in surface appearance and marginal adaptation accounted for most of the changes. All changes appeared in patients younger than 14 years, which may indicate that the patients had problems in oral hygiene. Replicas of randomly selected restorations showed smooth surfaces and well-sealed margins with a smooth transition from restoration to enamel. Some restorations showed marginal breakdown and a pitted irregular surface.     

Clinical evaluation of occlusal glass ionomer, resin, and amalgam restorations

The purpose of the study was to evaluate four materials (a glass ionomer (polyalkenoate) silver cermet, two composite resin restoratives and a high copper content dental amalgam) placed in either conventional Class I cavities or in modified odontotomy-enameloplasty-sealant (OES) fissure preparations. One experienced operator inserted 438 occlusal. Class I restorations in the posterior permanent teeth of 124 patients in a private dental practice. Restorations were assessed for bulk loss of material, surface voids and cracking, restoration margin fractures and staining, and surface staining and roughness, by using colour transparencies taken at baseline and at recalls for up to 3 years. The glass ionomer cermet was the most difficult material to handle and also gave the least satisfactory clinical result. Loss of material and surface voids were common in the cermet restorations with surface cracking or crazing being seen in 11.4 per cent of the restorations, especially in the larger, conventional Class I preparations. One posterior resin was more viscous and difficult to handle than the other resin and exhibited more surface voids. The amalgam alloy was used in Class I preparations only and showed more restoration margin fractures and surface staining than did the other three materials. However, there were no unsatisfactory clinical assessments given for either restoration margin fracture and staining, or surface staining and roughness for any of the materials. Patient acceptance of the modified OES fissure preparation was extremely good.     

Five-year study of Class II restorations in permanent teeth using amalgam, glass polyalkenoate (ionomer) cermet and resin-based composite materials

The aim of this study was to compare the clinical performance of an amalgam, a glass polyalkenoate (ionomer) cermet material and a resin-based composite material used in small Class II cavities in permanent teeth. All restorations were inserted under rubber dam. They were examined yearly for 3 years. One clinician continued the study up to 5 years. The clinical examination focused on two criteria: clinically acceptable and failure. In addition, impressions were taken of the prepared cavities immediately before restoration and at each clinical examination using an elastomeric material. The study comprised 274 Class II restorations (88 amalgams, 95 cermets and 91 resin composites) placed in 142 adolescent patients. One hundred and sixty-seven restorations were in molar and 107 in premolar teeth. Patient dropout after 5 years resulted in the loss of 161 restorations, evenly distributed for restorative material and type of tooth involved. Four amalgam restorations, 22 glass ionomer cermet and nine resin composite restorations failed. The glass ionomer cermet and amalgam restorations failed primarily due to bulk fractures, while the resin composite restorations failed due to secondary caries and bulk fractures.     

Four-year in vivo evaluation of the composite/bonding resin-tooth interface

The objective of this study was to evaluate the color match, marginal discoloration, recurrent caries, anatomic form, and marginal adaptation of 41 paired Class III and Class V preparations restored with a conventional chemically cured resin composite with and without a low-viscosity bonding resin (LVBR). In addition, the wear of the restorations was evaluated from scanning electron micrographs of epoxy replicas of the restorations. The subjects were re-called 48 months after placement of the restorations. The marginal discoloration and wear of the composite restorations placed without a LVBR were significantly greater than in restorations placed with a LVBR. The results of this clinical study suggest that a LVBR should be applied prior to the placement of a conventional chemical-activated resin composite.     

Clinical evaluation of packable and conventional hybrid resin-based composites for posterior restorations in permanent teeth: results at 12 months

BACKGROUND: Packable resin-based composites and simplified resin bonding systems are marketed to offer many advantages over conventional posterior hybrid composites and total-etch bonding systems. The authors conducted a study to evaluate the initial clinical performances of a packable and a conventional hybrid resin-based composite used with a simplified bonding system. METHODS: A total of 57 Class I and 45 Class II restorations were placed in the permanent teeth of 65 adult patients. The carious lesions were restored with either packable resin-based composite (SureFil, Dentsply DeTrey GmbH, Konstanz, Germany) or conventional hybrid resin-based composite (SpectrumTPH, Dentsply DeTrey GmbH), using a resin adhesive (Non-Rinse Conditioner and Prime & Bond NT, both manufactured by Dentsply DeTrey GmbH). The authors evaluated the restorations using U.S. Public Health Service-Ryge modified criteria (in which Alfa is the highest rating) and by using color transparencies and die stone replicas. RESULTS: Three SureFil restorations failed before their baseline evaluation. There were no failures among the 78 SpectrumTPH restorations evaluated at 12 months. For both resin-based composites, Alfa ratings were 90 percent or higher for marginal discoloration, anatomical form, surface texture and surface staining. Lower percentages of restorations were rated Alfa for color match, marginal integrity and gingival health. Occasional mild postoperative sensitivity was reported for four SureFil restorations and one SpectrumTPH restoration. The mean occlusal wear rate was 38 micrometers for the larger SureFil restorations and 25 microm for the smaller SpectrumTPH restorations. CONCLUSIONS: The 12-month clinical performances of the two restorative materials were satisfactory and not significantly different for each of the parameters evaluated. CLINICAL IMPLICATIONS: A packable and a conventional hybrid resin-based composite placed with a simplified bonding system in posterior permanent teeth showed satisfactory and similar results after 12 months.     

树脂嵌体修复儿童第一磨牙大面积缺损的临床疗效观察

目的：观察树脂嵌体用于修复儿童第一磨牙牙体大面积缺损的临床效果。方法：采用间接法复合树脂嵌体修复技术,修复儿童第一磨牙牙体大面积缺损28例,随访观察18个月以上。采用USPHS评价标准,分别从边缘着色、边缘密合度、解剖形态、基牙继发龋、修复体折裂方面进行评价。结果：观察18个月以上,除一例出现牙体部分折裂外,其余27例临床效果满意。结论：应用复合树脂嵌体修复第一磨牙牙体大面积缺损,能有效恢复年轻恒牙牙体外形和邻接关系,临床效果满意。     

Recovering the function and esthetics of fractured teeth using several restorative cosmetic approaches. Three clinical cases

Abstract – The teeth most commonly affected by trauma are the maxillary central incisors. The most frequent types of traumatic dental injuries to permanent teeth are enamel fractures, enamel and dentine fractures, and enamel and dentine fractures with pulp involvement. This article describes three clinical cases with different levels of traumatized maxillary incisors and several cosmetic approaches for recovery of the esthetics and the masticatory function, as well as the social/psychological aspects of treatment. All cases involved young adult men. The three clinical cases involve dentin and enamel fractures, dentin and enamel fractures with pulp exposure, and dentin and enamel fractures with pulp exposure associated with root fracture. The cosmetic treatments used to resolve fractures were direct composite resin by layering technique, indirect all‐ceramic restorations (laminate veneer and ceramic crowns over the teeth), and immediate implant after extraction followed by immediate loading (ceramic abutments with ceramic crown over implant). In all three cases, excellent functional and esthetic results were achieved by use of these treatment modalities. The patients were very satisfied with the results.     

Comparative clinical evaluation of different treatment approaches using a microfilled resin composite and a compomer in Class III cavities: two-year results

This study evaluated the 24-month clinical performance of a microfilled composite using a one-bottle bonding system and a compomer that uses one-bottle bonding systems, which include a non-rinse conditioner or 36% phosphoric acid gel in Class III cavities. Each patient received three restorations due to primary caries of the anterior teeth, resulting in a total of 96 restorations. Three types of restoration/adhesive combinations were used: a microfilled resin composite (Filtek A110) with a one-bottle bonding system (Single Bond); a polyacid-modified resin composite (compomer) (Dyract AP) with a filled one-bottle bonding system (Prime & Bond NT) using 36% phosphoric acid pretreatment and a polyacid-modified resin composite (compomer) (Dyract AP) with a filled one-bottle bonding system (Prime & Bond NT) using a non-rinse conditioner (NRC) and a self-priming pretreatment. At baseline and one- and two-year recalls, color match, marginal discoloration, wear or loss of anatomical form, caries, marginal adaptation and surface texture of the restorations were evaluated by two experienced, calibrated examiners using the modified Ryge criteria. After two years, one restoration from each group had a rating of Charlie (C) for both color match and marginal discoloration and needed to be replaced. Therefore, the failure rate was 3.6% (success rate: 96.4%) for each group at the end of two years. Statistical analysis showed no significant differences among the three groups in color match, marginal discoloration, wear or loss of anatomical form, marginal adaptation and surface texture after two years. Also, no statistically significant differences were determined for each group with respect to color match, marginal discoloration, wear or loss of anatomical form, marginal adaptation and surface texture at the end of two years.     

Bonding all-ceramic restorations with two resins cement techniques: a clinical report of three-year follow-up

Ceramics have been widely used for esthetic and functional improvements. The resin cement is the material of choice for bonding ceramics to dental substrate and it can also dictate the final esthetic appearance and strength of the restoration. The correct use of the wide spectrum of resin luting agents available depends on the dental tooth substrate. This article presents three-year clinical results of a 41 years old female patient B.H.C complaining about her unattractive smile. Two all-ceramic crowns and two laminates veneers were placed in the maxillary incisors and cemented with a self-adhesive resin luting cement and conventional resin luting cement, respectively. After a three-year follow-up, the restorations and cement/teeth interface were clinically perfect with no chipping, fractures or discoloration. Proper use of different resin luting cements shows clinical appropriate behavior after a three-year follow-up. Self-adhesive resin luting cement may be used for cementing all-ceramic crowns with high predictability of success, mainly if there is a large dentin surface available for bonding and no enamel at the finish line. Otherwise, conventional resin luting agent should be used for achieving an adequate bonding strength to enamel.     

The use of resin-based composite in children

Resin-based composites are an integral component of contemporary pediatric restorative dentistry. They can be utilized effectively for preventive resin restorations, moderate Class II restorations, Class III restorations, Class IV restorations, Class V restorations and strip crowns. Tooth isolation to prevent contamination is a critical factor, and high-risk children may not be ideal candidates for resin-based composite restorations. Important factors to consider during composite placement are isolation, polymerization shrinkage and extent of restoration. When utilized correctly, resin-based composites can provide excellent restorations in the primary and permanent dentition.     

Three-year clinical evaluation of a resin modified glass-ionomer cement and a composite resin in non-carious class V lesions

The purpose of this study was a 3-year clinical evaluation of a resin modified glass-ionomer and a composite resin restorative material in non-carious class V lesions. In 24 patients 98 non-carious class V lesions were restored with either a resin modified glass-ionomer (Vitremer), or a composite resin restoration (Z100). The restorations were clinically evaluated after 6, 12, 24 and 36 months with the US Public Health Service criteria. At 3 years, 88 teeth of 21 patients were evaluated. All restorations were rated clinically acceptable for colour match, marginal discoloration, marginal adaptation and anatomical form. Restoration retention of both groups was high without any statistically significant difference. However, Vitremer restorations showed a lower incidence of Alfa scores for colour match and marginal discoloration than Z100 restorations (P < 0.05).     

双步成形树脂充填重建后牙邻接关系2年随访研究

目的评价双步成形法树脂直接充填重建大面积后牙邻缺损的邻接关系临床效果。方法332例大面积邻缺损患牙由同一术者采用Ivory型成形系统成形龈向1/3区＋Palodent成形系统成形向2/3区的双步成形技术,直接树脂充填修复。术后由第三方即时检查并记录牙邻接紧密度和充填物悬突情况,术后1、12、24个月复查牙邻接紧密度、树脂修复体边缘密合度和边缘染色、修复区及毗邻牙间乳头出血指数并作牙线作用习惯问卷调查。结果所有患例术后均重建临床可接受邻接紧密度,未发现悬突形成,2年内所有患例均保持临床可接受邻接紧密度,树脂修复体边缘密合度和边缘染色评分均保持Ryge′s A级。术后1、12、24个月,常用和非常用牙线人群组内,修复区与毗邻牙间乳头出血指数差异无统计学意义（P〉0.05）。结论采用双步成形技术树脂直接充填可有效重建大面积缺损后牙的符合生理功能性邻接关系。     

A 3-year clinical evaluation of Cerana prefabricated ceramic inlays

PURPOSE: The present study was carried out to evaluate Cerana Class I and II tunnel preparations in combination with Cerana inlays. MATERIALS AND METHODS: Sixty-eight patients were treated with 89 Cerana restorations, 53 in the maxilla and 36 in the mandible. Of these, 47 were Class I and 42 were Class II. The restorations were examined after 1, 2, and 3 years by the author together with the treating clinician. for the evaluation, the California Dental Association quality evaluation system was used. RESULTS: At the 3-year recall, 59 (66%) restorations were examined. One restoration had been exchanged after 1 week, and 10 (11%) restorations had fractured before the 3-year follow-up. A total of 19% of the marginal ridges had fractured over the 3 years. These fractures were in connection with Class II tunnel preparations, except for one Class I filling. All of the Cerana inlays had acceptable marginal adaptation. Marginal discoloration was seen around 8% of the restorations. The color match was excellent, and the majority of the restorations had a smooth surface. Caries was seen in five teeth, three in connection with fractured marginal ridges. CONCLUSION: The results indicate that Cerana is an alternative to composite resin restorations in Class I situations, but should be avoided in connection with Class II tunnel preparations.     

Observations on a composite resin for Class II restorations: Three-year report

The results of these three-year observations comparing a composite resin with amalgam in Class II restorations do not differ greatly from those reported after two years. Secondary caries has not been a problem to date, regardless of the material used. Anatomic form of the amalgam restorations continued to be maintained while it deteriorated further in the composite resin restorations. On the other hand the composite restorations maintained the same level of superiority for marginal adaptation throughout the three years. No significant increase in the discoloration of the composite restorations or their margins were observed at three years, although most restorations had already shown evidence of discoloration at the previous evaluations.     

Two year clinical evaluation of a low-shrink resin composite material in UK general dental practices

Objective

A novel resin composite system, Filtek Silorane (3M ESPE) with reduced polymerization shrinkage has recently been introduced. The resin contains an oxygen-containing ring molecule (‘oxirane’) and cures via a cationic ring-opening reaction rather than a linear chain reaction associated with conventional methacrylates and results in a volumetric shrinkage of ∼1%. The purpose of this study was to review the literature on a recently introduced resin composite material, Filtek Silorane, and evaluate the clinical outcome of restorations formed in this material.

Methods

Filtek Silorane restorations were placed where indicated in loadbearing situations in the posterior teeth of patients attending five UK dental practices. These were evaluated, after two years, using modified USPHS criteria.

Results

A total of 100 restorations, of mean age 25.7 months, in 64 patients, were examined, comprised of 30 Class I and 70 Class II. All restorations were found to be present and intact, there was no secondary caries. Ninety-seven per cent of the restorations were rated optimal for anatomic form, 84% were rated optimal for marginal integrity, 77% were rated optimal for marginal discoloration, 99% were rated optimal for color match, and 93%% of the restorations were rated optimal for surface quality. No restoration was awarded a “fail” grade. No staining of the restoration surfaces was recorded and no patients complained of post-operative sensitivity.

Significance

It is concluded that, within the limitations of the study, the two year assessment of 100 restorations placed in Filtek Silorane has indicated satisfactory clinical performance.