title: A four-year clinical evaluation of a highly filled hybrid resin composite in posterior cavities.
abstract: OBJECTIVE
  To evaluate the four-year performance of a highly filled resin composite in Class II and Class I cavities.
  
  
  METHODS
  Each of 63 participants received at least one pair of restorations of the same size: one resin composite (Tetric Ceram) and one calcium aluminate cement. Seventy-one pairs were placed. The restorations were evaluated clinically according to slightly modified USPHS criteria at baseline, after 6 months, 1, 2, 3, and 4 years. At 3 years, the calcium aluminate cement material showed an inacceptable clinical cumulative failure frequency of 57% and its evaluation was discontinued.
  
  
  RESULTS
  Postoperative sensitivity was reported for 5 restorations (2 resin composite, 3 calcium aluminate cement). At 4 years, a cumulative failure frequency of 7.5% was observed for the resin composite material. Reasons for failure were partial material fracture (2), cusp fracture (2) and endodontic treatment (1).
  
  
  CONCLUSIONS
  An annual failure rate of 1.9% for the resin composite material provided a good clinical performance during the 4-year period, which fulfills the ADA criteria for posterior resin composite materials.
authors.affiliation: Dental Hygienist Education, Department of Odontology, Dental School Umeå, Umeå University, Umeå, Sweden. jan.van.dijken@odont.umu.se
authors.forename: Jan W V
authors.initials: JW
authors.lastname: Van Dijken
authors.forename: Karin
authors.initials: K
authors.lastname: Sunnegårdh-Grönberg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017607:Aluminum Compounds / Q000737:chemistry; D001641:Bicuspid; D017610:Calcium Compounds / Q000737:chemistry; D003188:Composite Resins / Q000737:chemistry*; D003738:Dental Cements / Q000737:chemistry; D019232:Dental Restoration Failure; D003793:Dental Restoration, Permanent / Q000145:classification* / Q000379:methods; D003807:Dentin Sensitivity / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008963:Molar; D012390:Root Canal Therapy; D013499:Surface Properties
chemical_list: D017607:Aluminum Compounds; D017610:Calcium Compounds; D003188:Composite Resins; D003738:Dental Cements; C121818:Tetric ceram; C035219:calcium aluminate