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To investigate the clinical behavior of two different resin-based restorative systems in extended Class II cavities in a controlled prospective split-mouth study over 12 years and to assess marginal quality under a SEM using epoxy replicas.Thirty patients received 68 resin composite restorations (Solobond M+Grandio: n=36; Syntac+Tetric Ceram: n=32) by one dentist in a private practice. 35% of cavities revealed no enamel at the bottom of the proximal box, 48% of cavities provided0.5mm remaining proximal enamel. Restorations were examined according to modified USPHS criteria at baseline, and after six months, one, two, four, six, eight, 10, and 12 years. Expoxy replicas of 21 restoration pairs were analysed under a SEM at 200× magnification regarding marginal quality.At the 12-years recall, 59 of the original 68 restorations in 27 of 30 patients were available (drop out 13%). Two restorations failed due to cusp fracture (Tetric Ceram) and marginal fracture (Grandio). The overall success rate of all restorations was 97.1% (Kaplan-Meier survival algorithm) with no differences between the two materials (p=0.923). After 144 months of clinical service, restorations in molars performed worse than in premolars regarding the integrity of restoration and tooth (p0.05) being detected as wear, chippings, and cracks. Beyond the 4-year recall, marginal staining significantly increased. SEM evaluation of replicas revealed that perfect margin (49% baseline vs. 10% after 12 years), overhang (13% at baseline vs. 3% after 12 years), negative step formation (34% at baseline vs. 75% after 12 years), and marginal fractures (0% at baseline vs. 6% after 12 years) significantly changed during the evaluation period (p0.001).Extended direct resin composite restorations performed satisfactorily over 12 years of clinical service. SEM analysis delivered qualitative data regarding marginal deterioration over time.

In a controlled prospective split-mouth study, clinical behavior of two different resin composites in extended class II cavities was observed over 8 years. Thirty patients received 68 direct resin composite restorations (Solobond M/Grandio, Voco—n = 36; Syntac/Tetric Ceram, Ivoclar Vivadent—n = 32) by one dentist in a private practice. Thirty-five percent of cavities revealed no enamel at the bottom of the proximal box, 48 % of cavities provided

ObjectivesIn a controlled prospective split-mouth study, clinical behavior of two different resin composites in extended Class II cavities was observed over six years.MethodsThirty patients received 68 direct resin composite restorations (Solobond M + Grandio: n = 36; Syntac + Tetric Ceram: n = 32) by one dentist in a private practice. All restorations were replacement fillings, 35% of cavities revealed no enamel at the bottom of the proximal box, in 48% of cavities remaining proximal enamel width was ResultsSuccess rate was 100% after six years of clinical service, while the drop out of patients was 0%. Neither materials nor localization of the restoration (upper vs. lower jaw) had a significant influence on clinical outcome in any criterion after six years (p > 0.05; Mann-Whitney U-test). Molar restorations performed worse regarding marginal integrity (4 years), filling integrity (6, 12, 24, 48 months), and tooth integrity (4 and 6 years). Irrespective of the resin composite used, significant changes over time were found for all criteria recorded (Friedman test; p < 0.05). Marginal quality revealed a major portion of overhangs having been clearly reduced after the one year recall (baseline: 44%; 6 months: 65%; 1 year: 47%; 2 years: 6%; 4 years: 4%; and 6 years: 3%). Beyond the 1 year recall, negative step formations significantly increased due to wear (p < 0.05), having been more pronounced in molars (87% bravo after 4 years) than in premolars (51% bravo after 4 years). Tooth integrity significantly deteriorated due to enamel cracks, which increased over time (p < 0.05). Enamel chippings and cracks were significantly more frequent in molars (26% bravo after 4 years to 35% after six years) than in premolars (9% bravo after 4 years, 11% after six years). Restoration integrity over time mainly suffered surface roughness and wear (28% after one year, 75% after two years, 84% after four years, 91% after six years).SignificancesBoth materials performed satisfactorily over the 6-year observation period. Due to the extension of the restorations, wear was clearly visible after six years of clinical service with 91% bravo ratings.

The aim of the present study was to evaluate the ormocer Definite (Degudent, Hanau, Germany) as resin luting cement.In a controlled prospective clinical study, 57 Cergogold (Degudent) all-ceramic inlays were placed in 24 patients by four dentists. The restorations were luted with two different systems (MD=Definite Multibond+Definite; SV=Syntac+Variolink Ultra, Ivoclar Vivadent, Liechtenstein) without lining. At baseline, after 12, 24, and 48 months, restorations were examined according to modified USPHS scores and criteria.One patient including three restorations missed the 4 years recall (dropout). After 48 months of clinical service, four restorations in four patients (three luted with Definite, one with Variolink) failed due to inlay fracture (n=3) and tooth fracture (n=1), all other fillings were clinically acceptable (survival rate 93.3% for Definite vs. 95.2% for Variolink; Kaplan-Meier algorithm). Except for the rate of hypersensitivity at baseline (MD: 27%; SV 0%; p0.05), no differences were evident between the luting cements at any recalls (Mann-Whitney U-test; p0.05). Between the four recalls, a statistically significant deterioration was detected for both groups regarding the criteria marginal adaptation, filling integrity (cracks/chippings/fractures), and tooth integrity (Friedman test; p0.001). After 4 years, mainly distinct deterioration with marginal fractures or chippings in proximal and marginal areas of the inlays were observed. No differences were found for surface roughness, color matching, and proximal contact (p0.05).For luting of ceramic inlays, only slight differences between the two luting systems were detectable.

To investigate the clinical behavior of two different resin-based restorative systems in Class II cavities in a controlled prospective split-mouth study over 10 years.Thirty patients received 68 resin composite restorations (Solobond M + Grandio: n = 36; Syntac + Tetric Ceram: n = 32) by one dentist in a private practice. 35% of cavities revealed no enamel at the bottom of the proximal box, 48% of cavities provided0.5 mm of remaining proximal enamel. Restorations were examined according to modified USPHS criteria at baseline, after 6 months, and 1, 2, 4, 6, 8, and 10 years.Twenty-nine out of 30 patients attended the 10-year recall. The overall success rate of all restorations was 96.9%. One Grandio restoration suffered marginal fracture with exposed dentin and one Tetric Ceram restoration failed due to cusp fracture. After 10 years, Grandio showed higher surface roughness (p = 0.03) and less color match (p = 0.024; Mann-Whitney U-test). Molar restorations performed worse than premolar fillings regarding marginal integrity (4 and 10 years), filling integrity (4, 8, and 10 years), and tooth integrity (4, 8, and 10 years). The main reasons for degradation of resin composites were chipping and cracks in molar restorations after 8 years. Beyond the 4-year recall, marginal staining increased (43% bravo for stained margins at four years, 52% at 8 years, and 71% at 10 years). Tooth integrity deteriorated significantly due to more enamel cracks and chipping over time (9% at baseline and 89% after 10 years (p0.05).Direct resin composite restorations performed satisfactorily over 10 years of clinical service.

To evaluate the clinical behavior of two different resin composites in Class II cavities over a period of 2 years in a controlled prospective split-mouth study.30 subjects received 68 direct resin composite restorations (Grandio bonded with Solobond M: n=36, Tetric Ceram bonded with Syntac: n=32) by one dentist in a private practice. All restorations were replacement restorations, 24 cavities (35%) revealed no enamel at the bottom of the proximal box, in 33 cavities (48%) the proximal enamel width was0.5 mm. The restorations were examined according to modified USPHS criteria at baseline, and after 0.5, 1, and 2 years. At each recall, impressions were taken to prepare replicas. Replicas of 44 selected subjects were assessed for marginal quality under a stereo light microscope (SLM) at x130, and 22 replicas were assessed under a SEM at x200.Both recall rate and survival rate were 100% after 2 years of clinical service. No significant difference was found between the restorative materials (P0.05; Mann-Whitney U-test). A significant deterioration was found over time for marginal integrity, tooth integrity, restoration integrity and proximal contact (P0.05; Friedman test). SLM and SEM analysis of restoration margins only revealed differences in the amount of detectable perfect margins, in favor of Tetric Ceram (P0.05). Both materials performed satisfactorily over the 2-year observation period.

The aim of the present study was to clinically evaluate the suitability of Definite Multibond and Definite ormocer resin composite for luting of Cergogold glass ceramic inlays in a two-center trial involving two dentists.Thirty-nine patients received 98 Cergogold inlays with at least one inlay luted with Definite Multibond/Definite (n=45) and at least one inlay luted with Syntac/Variolink Ultra (n=53) in a split mouth design. Treatments were carried out in two private practices by two operators (Operator A: n=38; Operator B: n=60). Forty-four cavities required caries profunda treatment, 23 cavities exhibited no enamel at the cervical margin. At baseline (2 months), and after 6, 14, 27, and 51 months of clinical service, the restorations were investigated according to modified USPHS criteria.The drop-out rate was 3% after 4 years. After 48 months of clinical service, 21 restorations in 16 patients (9 luted with Definite, 12 with Variolink; 2 placed by operator A and 19 by operator B) had to be replaced due to inlay fracture (n=11), tooth fracture (n=4), hypersensitivities (n=3), or marginal gap formation (n=3). Seventy-seven inlays were in good condition (survival rate 89.9%, median survival time 4.2 years (95% confidence interval +/-0.25; survival analysis by Kaplan-Meier algorithm). Survival rate after 4 years was 97.4% for operator A, and 75.4% for operator B (p=0.002; Log Rank/Mantel-Cox) resulting in annual failure rates of 0.6% and 6.2%, respectively. The operators did not differently judge the clinical behaviour of the luting procedures (Mann-Whitney U-test, p0.05). Independent of the operator and the used luting system, the following criteria significantly changed over time: color match, marginal integrity, tooth integrity, inlay integrity, sensitivity, hypersensitivity, and X-ray control (p0.05; Friedman test). Significant differences between operators over the whole period were computed for the criteria marginal integrity, tooth integrity, and inlay integrity (p0.05, Mann-Whitney test). Differences between luting materials were only present during single recalls.For luting of ceramic inlays, only slight differences between the two luting systems were detectable. The operator influence on clinical outcome was clearly proven.

This controlled prospective split-mouth study evaluated the clinical behavior of two different resin composites in extended Class II cavities over a period of four years.Thirty patients received 68 direct resin composite restorations (Grandio bonded with Solobond M: n=36, Tetric Ceram bonded with Syntac: n=32) by one dentist in a private practice. All restorations were replacement fillings, 24 cavities (35%) revealed no enamel at the bottom of the proximal box, in 33 cavities (48%) the proximal enamel width was less than 0.5mm. The restorations were examined according to modified USPHS criteria at baseline, and after six months, one, two, and four years. At each recall, impressions were taken for replica preparation. Replicas of 44 select subjects were assessed for marginal quality under a stereo light microscope (SLM) at 130x and 22 replicas were assessed under a scanning electron microscope (SEM) at 200x.Both recall rate and survival rate were 100% after four years of clinical service. No significant difference was found between the restorative materials (p0.05; Mann-Whitney U-test). Hypersensitivities were significantly reduced over time (p0.05; Friedman test). A significant deterioration over time was found for the criteria marginal integrity (66% bravo after four years), tooth integrity (15% bravo), filling integrity (73% bravo) and proximal contact (p0.05; Friedman test). SLM and SEM analysis of restoration margins revealed differences in the amount of perfect margins, in favor of Tetric Ceram (p0.05).Both materials performed satisfactorily over the four-year observation period. Due to the extension of the restorations, wear was clearly visible after four years of clinical service with 50% bravo ratings.

To clinically 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.In a controlled prospective 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 PrimeBond 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.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 materials 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.