4-year Wear and Clinical Performance of Packable Posterior Composite

Introduction: Early lab tests suggested poor wear resistance for some packable composites versus traditional hybrids.  Objective:  Evaluate 4-year clinical performance of packable composite versus ADA guidelines (1989) for use as “unrestricted” amalgam-replacement material.  Methods:  60 Class-I (20%) and II (80%) packable composites were placed in 30 patients (62% women; 65% 1M and 35% 2M; mean age = 42y) as large preparations (F-L width ³⅓ intercuspal distance; no bevel) with normal techniques (local anesthesia; rubber dam).  Enamel and dentin were etched (34%-H3PO4 15s, rinsed 10s, glistening), bonded (P&B-2.1 [Dentsply]), and restored (SureFil [Dentsply], 1997).  Wear was rated (mm, casts, Leinfelder Method, 6m baseline values subtracted) and analyzed (ANOVA, a=0.05, superscripts indicate differences) for key evaluations [0y (or 6m), 2y, 4y].  Failures were tallied (SF).  Direct evaluation (modified-USPHS categories, %-charlie [clinically unacceptable]) for color match (cm), marginal discoloration (md), secondary caries (sc), marginal integrity (mi), interproximal contact (ic), and post-op sensitivity (ps) were compared to ADA guidelines for acceptable clinical performance.  Results:  UNC clinical results versus ADA guidelines are shown below.