The study evaluated the clinical performance of direct and indirect composite resin restorations in endodontically treated posterior teeth for a period of two years.
Method:
126 composite resin restorations were placed in 65 patients on moderately to grossly decayed endodontically treated premolars and molars by one operator. The direct restorations (n=41; 37% Phosphoric acid, adhesive Prime&Bond NT, restorative composites SDR-base and CeramX Mono; Dentsply) and onlays (n=85; composite In:Joy, self-adhesive cement SmartCem2; Dentsply) were evaluated at baseline and after 24 months by two independent evaluators using modified USPHS criteria. Data were analyzed by Fisher exact and McNemar tests (P<.05).
Result:
After two years 95.29% of the indirect and 97.44% of the direct composite restorations were scored as clinically excellent or acceptable. All of the restorations (85 In:Joy/39 CeramX in 64 patients) received score Alpha for Color matching, Secondary caries, Contact point and Changes in interdental papilla. Score Bravo received 10 CeramX and 21 In:Joy restorations for Marginal discoloration, 8 CeramX and 18 In:Joy for Marginal adaptation, 39 CeramX and 5 In:Joy for Surface texture, 2 CeramX for Anatomic form. Charlie and Delta ratings were recorded for Marginal adaptation in one direct and four indirect restorations. A statistically significant difference was recorded in the category Surface texture between the two restorative materials at the 24-th month (P<.05). In both the group of In:Joy restorations as well as the one of CeramX the difference between baseline and recall regarding Marginal discoloration and Marginal adaptation was also significant (P<.05).
Conclusion:
After two years the indirect composite showed a significantly better surface texture than the direct one. The CeramX and In:Joy restorations showed acceptable clinical performance in endodontically treated distal teeth after 24 months of service.