title: Six-year clinical evaluation of packable composite restorations.
abstract: OBJECTIVE
  For decades, resin composites have been used with increasing frequency as posterior restorative materials, because of the demand for aesthetic restoration. This study evaluated the six-year clinical performance of Filtek P60 (3M ESPE) packable composite restorations in combination with a one-bottle etch and rinse adhesive, Single Bond (3M ESPE), in Class II restorations.
  
  
  METHODS
  A total of 47 restorations were placed in the Class II cavity preparations (27 premolars and 20 molars) of 33 patients (22 female/11 male; mean age 34) by the same operator. The restorations were evaluated by two examiners at baseline and 1, 2, 3 and 6 years according to the method developed by Ryge, which also is known as the United States Public Health Service (USPHS) criteria. The following characteristics were observed: marginal adaptation, anatomical form, surface texture, marginal discoloration, surface staining, post-operative sensitivity and secondary caries. The Chi-square and Wilcoxon signed rank test with Bonferroni adjustment were used for statistical analysis (p = 0.05).
  
  
  RESULTS
  All the restorations received Alpha scores at baseline assessment, except for one restoration, which showed post-operative sensitivity. At the three-year recall examination, two patients, with a total of three restorations, were not included. From baseline to three years, only two of the 44 restorations changed from Alpha to Bravo, for numerous reasons. At the six-year recall, 44 restorations were available for examination. The majority of restorations exhibited Alpha or Bravo scores for the evaluated criteria. No significant differences were found for any of the clinical criteria (p > 0.05). Only two restorations needed to be repaired due to caries that began independently from the restorations. Three or four restorations showed slight surface staining and marginal discoloration.
  
  
  CONCLUSIONS
  The clinical performance of the posterior composite restorations that were evaluated was acceptable after six years of service.
authors.affiliation: Hacettepe University, School of Dentistry, Department of Restorative Dentistry, Ankara, Turkey.
authors.forename: Arlin
authors.initials: A
authors.lastname: Kiremitci
authors.forename: Tugba
authors.initials: T
authors.lastname: Alpaslan
authors.forename: Sevil
authors.initials: S
authors.lastname: Gurgan
mesh_terms: D000134:Acid Etching, Dental; D000328:Adult; D001641:Bicuspid; D017438:Bisphenol A-Glycidyl Methacrylate / Q000737:chemistry; D003116:Color; D003188:Composite Resins / Q000737:chemistry*; D003731:Dental Caries / Q000209:etiology; D003737:Dental Cavity Preparation / Q000145:classification; D018772:Dental Marginal Adaptation; D003764:Dental Materials / Q000737:chemistry*; D003793:Dental Restoration, Permanent / Q000145:classification; D003807:Dentin Sensitivity / Q000209:etiology; D017220:Dentin-Bonding Agents / Q000737:chemistry; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008422:Materials Testing; D008963:Molar; D012008:Recurrence; D013499:Surface Properties
chemical_list: D003188:Composite Resins; D003764:Dental Materials; D017220:Dentin-Bonding Agents; C438835:Filtek P60 Composite Resin; C115612:single bond; D017438:Bisphenol A-Glycidyl Methacrylate