3-Year clinical evaluation of posterior packable composite resin restorations.

This study evaluated the clinical performance of four packable resin composite restorative materials in posterior teeth (Class I and II) compared with one hybrid composite after 3 years. Eighty-four restorations were placed in 16 patients. The tested materials were: (i) Solitaire + Solid Bond; (ii) ALERT + Bond-1; (iii) Surefil + Prime & Bond NT; (iv) Filtek P60 + Single Bond and (v) TPH Spectrum + Prime & Bond 2.1. All restorations were made using rubber dam isolation, and the cavity design was restricted to the elimination of carious tissue. Deeper cavities were covered with calcium hydroxide and/or glass-ionomer cement. Each adhesive system and composite resin was placed according to the manufacturer's instructions. One week later, the restorations were finished/polished and evaluated according USPHS modified criteria. Fourteen patients attended the 3-year recall and 75 restorations were evaluated at that time based on the same evaluation criteria. Friedman repeated measures analysis of variance by rank and Wilcoxon sign-ranked test for pair-wise comparison was used for data analysis (alpha = 0.05). The analysis was performed only for the baseline and for the 3-year period. Solitaire showed some fractures at marginal ridges in 25% of the cases. Solitaire and ALERT showed some concerns related to colour match (43 and 77%, respectively) and surface texture (86 and 77%, respectively). TPH Spectrum showed a great percentage of colour mismatch after 3 years, around 50%. Surefil and Filtek P60 showed an excellent clinical performance after 3 years, similar to the hybrid resin tested, TPH Spectrum. Solitaire did not fulfil the ADA acceptance criteria for restorative materials and, therefore, is not recommended for use in posterior restorations.

Biological restorations using tooth fragments.

A "biological" restoration technique using dental fragments and adhesive materials is described. These fragments were obtained from extracted human teeth which had been previously sterilized and stored in a tooth bank. The advantages are: the use of extracted teeth as restorative material, esthetics, and treatment cost. The positive sensation of having back the missing tooth was the most mentioned comment among patients. The disadvantages are: the difficulty of obtaining teeth with the needed characteristics, problems of making an indirect restoration, matching the original color, and the non-acceptance by some patients who consider it strange to have other people's teeth placed in their mouths.