title: A randomized clinical trial of cusp-replacing resin composite restorations: efficiency and short-term effectiveness.
abstract: OBJECTIVE
  This study aimed to assess the efficacy and short-term effectiveness of the morphology and function of direct and indirect cusp-replacing resin composite restorations.
  
  
  METHODS
  In 94 patients, 106 cusp-replacing restorations for maxillary premolars were fabricated to restore Class II caries lesions with 1 cusp missing. Fifty-four direct (Clearfil AP-X) and 52 indirect (Estenia) resin composite restorations were placed following a strict protocol. The treatment technique and operator were assigned randomly. Treatment time was recorded for all restorations. One-month postoperative evaluation included assessment of postoperative sensitivity and presence of occlusal and proximal contacts.
  
  
  RESULTS
  Treatment time for the indirect technique (68 +/- 17 min) was longer than for the direct technique (45 +/- 13 min). Regression analysis revealed that the restorative method, operator, and location of the preparation outline had a statistically significant effect on the total treatment time. Occlusal contacts were observed in 94% of the direct restorations and in 98% of the indirect restorations (chi-square, P>.05). Mesial proximal contacts were present in 98% of the direct and in 97% of the indirect restorations (chi-square, P > .05). Distal contacts were present in 100% of the restorations for both techniques. Postoperative sensitivity within 1 week posttreatment was reported for 11% of the direct restorations and for 13% of the indirect restorations, but decreased to 4% and 6%, respectively, after 1 month (chi-square, P > .05).
  
  
  CONCLUSIONS
  The results of this study suggest that in the short term, both direct and indirect adhesive techniques are adequate to restore the morphology and function of premolars presenting with Class II caries lesions and a missing cusp.
authors.affiliation: Department of Preventive and Curative Dentistry, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands. R.Kuijs@dent.umcn.nl
authors.forename: Ruud H
authors.initials: RH
authors.lastname: Kuijs
authors.forename: Willem M
authors.initials: WM
authors.lastname: Fennis
authors.forename: Cees M
authors.initials: CM
authors.lastname: Kreulen
authors.forename: F Joost M
authors.initials: FJ
authors.lastname: Roeters
authors.forename: Nico H J
authors.initials: NH
authors.lastname: Creugers
authors.forename: Rob C W
authors.initials: RC
authors.lastname: Burgersdijk
mesh_terms: D000328:Adult; D000368:Aged; D001641:Bicuspid / Q000293:injuries / Q000473:pathology; D003188:Composite Resins / Q000737:chemistry; D003731:Dental Caries / Q000628:therapy; D003737:Dental Cavity Preparation / Q000379:methods; D003743:Dental Enamel / Q000293:injuries; D003793:Dental Restoration, Permanent / Q000009:adverse effects / Q000379:methods*; D003807:Dentin Sensitivity / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008437:Maxilla; D008689:Methacrylates / Q000737:chemistry; D008875:Middle Aged; D011140:Polyurethanes / Q000737:chemistry; D019279:Resin Cements / Q000737:chemistry; D013499:Surface Properties; D013997:Time Factors; D014082:Tooth Fractures / Q000628:therapy; D016896:Treatment Outcome
chemical_list: C112828:Clearfil AP-X; D003188:Composite Resins; D008689:Methacrylates; D011140:Polyurethanes; D019279:Resin Cements; C091839:urethanetrimethacrylate