title: Clinical performance and marginal adaptation of class II direct and semidirect composite restorations over 3.5 years in vivo.
abstract: OBJECTIVE
  The study evaluated the clinical performance and marginal adaptation of direct and semi-direct class II composite restorations in a split-mouth design over 3.5 years.
  
  
  METHODS
  44 upper posterior teeth in 11 adults with primary carious lesions were treated with 22 direct and 22 semi-direct restorations. Conventional cavities were prepared for both types of restorations. A fine fine hybrid composite (APH) and a multifunctional adhesive system (Prisma universal bond 3) were used for all restorations. The incremental "3-sited light curing" technique was applied to direct restorations. Semi-direct inlays were prefabricated on silicone casts and post-cured using light and heat. Clinical performance was evaluated using modified USPHS parameters, while marginal adaptation was judged on replicas, using SEM and a standardized evaluation technique.
  
  
  RESULTS
  Clinical results after 3.5 years revealed a 100% retention rate with no fractures, sensitivity or recurrent caries for both types of restorations. SEM-evaluation of the occlusal margins showed at the tooth-restoration interface relatively low rates of marginal openings over the observation period (4-8%). Marginal restoration fractures ranged between 1 and 2%, marginal tooth fractures between 3 and 9%. Differences between the restorative techniques and after the different time observation periods were not statistically significant. Proportions of marginal fractures and openings at the restoration-luting composite interface were less than 10% after 3.5 years.
  
  
  CONCLUSIONS
  The results indicated no significant differences for direct and semi-direct fine hybrid composite restorations in medium size cavities in posterior teeth with respect to clinical performance and marginal adaptation over 3.5 years.
authors.affiliation: Department of Cariology and Endodontology, School of Dentistry, University of Geneva, 19 Rue Barthélémy Menn, 1205 Geneva, Switzerland.
authors.forename: Roberto C
authors.initials: RC
authors.lastname: Spreafico
authors.forename: Ivo
authors.initials: I
authors.lastname: Krejci
authors.forename: Didier
authors.initials: D
authors.lastname: Dietschi
mesh_terms: D000180:Acrylic Resins / Q000737:chemistry*; D000293:Adolescent; D000328:Adult; D003188:Composite Resins / Q000737:chemistry*; D003731:Dental Caries / Q000628:therapy*; D018772:Dental Marginal Adaptation; D019232:Dental Restoration Failure; D005260:Female; D006801:Humans; D007284:Inlays; D008137:Longitudinal Studies; D008297:Male; D011140:Polyurethanes / Q000737:chemistry*; D011446:Prospective Studies; D018709:Statistics, Nonparametric
chemical_list: D000180:Acrylic Resins; C029012:Composite Dental Resin; D003188:Composite Resins; D011140:Polyurethanes