Clinical performance and SEM evaluation of direct composite restorations in primary molars

PURPOSE: To evaluate the clinical outcome of composite restorations performed in primary molars after 18 months and the morphology of the dentin/resin interface. METHODS: 41 primary molars from children aged 4-9 years were restored with Scotchbond Multi-Purpose Plus adhesive system and Z100 resin-based composite. The restorations were evaluated at baseline, 6, 12 and 18 months using the USPHS method for direct clinical analysis. Plaster models were made at each evaluation period for indirect evaluation. For the morphologic analysis of the dentin/resin interface, seven exfoliated teeth were sectioned longitudinally in a mesio/distal direction and observed in the electro scanning electron microscope. RESULTS: 100% (n = 40) of the restorations evaluated at 6 months were scored as Alpha for anatomical form, color matching, secondary caries, color alteration, and marginal degradation. At 12 months, 96.4% (n = 28) of the restorations received Alpha score and 3.4% Charlie score. At 18 months, all restorations evaluated (27/27) received Alpha score. 23 restorations were indirectly evaluated at 6, 12 and 18 months postoperatively. No significant wear or fractures were observed in any of the restorations. In the evaluation of the dentin/resin interface, the formation of a consistent hybrid layer was observed and the restorations were well adapted to the dentin at 18 months postoperatively.