title: Recontouring teeth and closing diastemas with direct composite buildups: a clinical evaluation of survival and quality parameters.
abstract: OBJECTIVE
  Irregular tooth shape and position in the anterior maxilla and mandible are major aesthetic problems for patients. In recent years such conditions have increasingly been treated minimally or even non-invasively by recontouring teeth with direct composite resin buildups. Although clinical experience with this treatment option is promising, evidence-based data about longevity are limited.
  
  
  METHODS
  The authors evaluated survival and quality of 327 composite buildups that were placed in 101 patients in the Department of Conservative Dentistry, University of Heidelberg, between 2002 and 2008. Follow-up intervals and failures were recorded. Quality was assessed by grading restorations (modified USPHS/Ryge critera) still in situ without adverse event during the follow-up period.
  
  
  RESULTS
  After a mean follow-up interval of 27.8 months, 284 restorations were in situ and had no event. Forty-two restorations were in situ but had events that were mostly minor fractures of the composite resin. One restoration had been lost. Analysis of the time from insertion to any event or end of follow-up yielded an estimated 5-year survival rate of 79.2% (95% CI, 70.5-87.9). Quality was assessed by grading in situ restorations without event. More than 90% of graded restorations were categorized as "clinically excellent" (1) or "clinically good" (2). A correlation between those rated "clinically sufficient" or worse (≥3) and the follow-up period was observed.
  
  
  CONCLUSIONS
  Direct composite buildups are aesthetic, functional, and biologically sound treatment options for recontouring teeth and closing diastemas with clinically promising survival rates. Therefore, tooth shape correction can be recommended in cases in which minimally invasive or non-invasive procedures on healthy teeth are indicated.
authors.affiliation: Department of Conservative Dentistry, School of Dental Medicine, Ruprecht Karls University, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. Diana.Wolff@med.uni-heidelberg.de
authors.forename: Diana
authors.initials: D
authors.lastname: Wolff
authors.forename: Theresa
authors.initials: T
authors.lastname: Kraus
authors.forename: Cornelia
authors.initials: C
authors.lastname: Schach
authors.forename: Maria
authors.initials: M
authors.lastname: Pritsch
authors.forename: Johannes
authors.initials: J
authors.lastname: Mente
authors.forename: Hans Joerg
authors.initials: HJ
authors.lastname: Staehle
authors.forename: Paul
authors.initials: P
authors.lastname: Ding
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003188:Composite Resins; D001840:Dental Bonding; D019232:Dental Restoration Failure; D058250:Dental Restoration Repair; D003793:Dental Restoration, Permanent / Q000379:methods*; D003970:Diastema / Q000628:therapy*; D004955:Esthetics, Dental; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D014070:Tooth / Q000033:anatomy & histology; D055815:Young Adult
chemical_list: D003188:Composite Resins