title: Three-year clinical evaluation of direct and indirect composite restorations in posterior teeth.
abstract: BACKGROUND
  Objective long-term clinical data are necessary to assess the performance of modern posterior composites as direct and indirect restorations.
  
  
  OBJECTIVE
  This prospective, long-term clinical trial evaluated direct and indirect composite restorations for clinical acceptability as posterior restoratives in single or multisurface cavities and provided a survey on the 3-year results.
  
  
  METHODS
  Under the supervision of an experienced dentist, 9 dental students placed 88 composite restorations (Tetric, blend-a-lux, Pertac-Hybrid Unifil), 43 direct composite restorations, and 45 indirect inlays. Clinical evaluation was performed at baseline and in yearly intervals after placement by 2 other experienced dentists, using modified USPHS criteria. A third follow-up of 60 restorations took place within 33 to 36 months after placement.
  
  
  RESULTS
  A total of 93% of indirect and 87% of direct restorations were assessed to be clinically excellent or acceptable. During the third year, 1 direct restoration in a molar failed because of margin opening. Indirect inlays exhibited a significantly better anatomic form of the surface than direct composite restorations. Premolars revealed a significantly better marginal integrity and anatomic form of the surface than molars. Restorations in molars exhibited a significantly higher failure rate compared with premolars.
  
  
  CONCLUSIONS
  Posterior composite restorations provided a satisfactory clinical performance over a 3-year period, even if placed by relatively inexperienced but supervised students.
authors.affiliation: School of Dentistry, Ludwig-Maximilians-University, Munich, Germany. manhart@manhart.com
authors.forename: J
authors.initials: J
authors.lastname: Manhart
authors.forename: P
authors.initials: P
authors.lastname: Neuerer
authors.forename: A
authors.initials: A
authors.lastname: Scheibenbogen-Fuchsbrunner
authors.forename: R
authors.initials: R
authors.lastname: Hickel
mesh_terms: D001641:Bicuspid; D017438:Bisphenol A-Glycidyl Methacrylate; D016009:Chi-Square Distribution; D003188:Composite Resins; D003737:Dental Cavity Preparation; D003793:Dental Restoration, Permanent / Q000379:methods*; D005899:Glass Ionomer Cements; D006801:Humans; D007284:Inlays; D008963:Molar; D015588:Observer Variation; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D003188:Composite Resins; D005899:Glass Ionomer Cements; C079764:Pertac hybrid; C090969:Tetric; C098567:blend-a-lux; D017438:Bisphenol A-Glycidyl Methacrylate