Clinical Follow-up of Posterior Fiber-Reinforced Composite Restorations

Objectives: Composite restorations are commonly used to restore both anterior and posterior teeth. Survival rates of posterior composite restorations vary between 65 and 92 %. Main reasons for failure of posterior stress-bearing restorations are secondary caries, fractures, marginal deficiencies and wear. A technique sensitive and time consuming incremental technique is advised for optimal clinical performance. Short-fiber-reinforced composite (SFRC) was recently introduced to improve load-bearing capacity and decrease polymerization-shrinkage of direct composite restorations. The aim of this study was to evaluate the clinical performance of posterior composite restorations with a short-fiber composite base filling, in the short term.
Methods: Four clinicians placed 36 restorations with a SFRC base filling in 33 patients. Majority of teeth restored were molars (n=28). Eight of the teeth were vital and 28 were non-vital. Size of restorations ranged from 1-3 surface (n=18) to 4-5 surface (n=18). Restorations were clinically evaluated at yearly re-call visits.
Results: Average follow up time of the restorations was 30.6 months (2.5 years), ranging from 16.2 to 51.3 months (1.3-4.3 years). One restoration (2.7%) failed during the follow-up period due to secondary caries, at time point 39.5 months. Three fillings had minor fractures during the follow-up. All fractures occurred in age group 30-40 (p<0.001). More chippings (p= 0.019) and marginal discoloration (p=0.188) was seen in large (4-5 surface) restorations compared to small (1-3 surface) restorations. Overall survival rate of the restorations was 97.2% and success rate (no maintenance needed) 88.9% respectively.
Conclusions: Posterior composite restorations reinforced with a short-fiber composite base filling performed well in a short term clinical follow-up.