title: Two-year clinical evaluation of direct and indirect composite restorations in posterior teeth.
abstract: BACKGROUND
  Few long-term clinical studies have reported data of modern posterior composites as direct and indirect restorations.
  
  
  OBJECTIVE
  This prospective, long-term clinical trial (1) evaluated direct and indirect composite restorations for clinical acceptability as posterior restoratives in single or multisurface carious teeth and (2) provided a survey on the 2-year results.
  
  
  METHODS
  Nine dental students placed 88 composite restorations (Tetric, blend-a-lux, Pertac-Hybrid Unifil), 43 direct composite restorations and 45 indirect inlays, under the supervision of an experienced dentist. The first clinical evaluation was performed 11 to 13 months after placement by 2 other experienced dentists, using modified USPHS criteria. A second follow-up of 60 restorations took place within 20 to 26 months after placement.
  
  
  RESULTS
  A total of 93% of indirect and 90% of direct composite restorations were assessed to be clinically excellent or acceptable. Two restorations (1 indirect composite inlay and 1 margin of a direct composite restoration) failed during the second year because of fracture. Indirect inlays demonstrated a significantly better "anatomic form of the surface" than direct composite restorations. Premolars revealed a significantly better margin integrity and postoperative symptoms than molars.
  
  
  CONCLUSIONS
  Posterior composite restorations provided a satisfactory clinical performance over a 2-year period when placed by relatively inexperienced but supervised students.
authors.affiliation: School of Dentistry, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Scheibenbogen-Fuchsbrunner
authors.forename: J
authors.initials: J
authors.lastname: Manhart
authors.forename: L
authors.initials: L
authors.lastname: Kremers
authors.forename: K H
authors.initials: KH
authors.lastname: Kunzelmann
authors.forename: R
authors.initials: R
authors.lastname: Hickel
mesh_terms: D001641:Bicuspid; D003188:Composite Resins / Q000627:therapeutic use*; D003793:Dental Restoration, Permanent / Q000379:methods* / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D005899:Glass Ionomer Cements / Q000627:therapeutic use*; D006801:Humans; D007284:Inlays / Q000379:methods / Q000706:statistics & numerical data; D008963:Molar; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors
chemical_list: D003188:Composite Resins; D005899:Glass Ionomer Cements; C090969:Tetric; C098567:blend-a-lux