title: Recontouring teeth and closing diastemas with direct composite buildups: a 5-year follow-up.
abstract: OBJECTIVE
  Adhesive resin composite technology enables dentists to add composite material to tooth surfaces to close gaps and reshape tooth form without cavity preparation. This option creates new possibilities for minimally invasive dentistry as the tooth shape, position and colour can be altered without loss of tooth substance. However, evidence-based data on direct composite buildups are rare.
  
  
  METHODS
  The purpose of this study was to evaluate the outcome and to document the occurrence of unfavourable events and clinical findings of 176 direct composite buildups that had been performed in the Department of Conservative Dentistry, University Hospital Heidelberg, Germany, between 2002 and 2008. Outcome was categorised as failure (F), survival (SR) or success (S). Restorations still in place and without prior failure at follow-up were qualitatively rated using modified USPHS/FDI criteria.
  
  
  RESULTS
  During the follow-up period, 30 restorations were found to have had unfavourable events or clinical findings. All restorations were repaired, and they remained in situ (SR). No complete loss (F) was recorded. The overall survival rate was 84.6% after 60 months (95%, confidence interval [CI]: 78.5 and 90.6). Clinical quality was rated excellent or good for most (>90%) of the restorations examined.
  
  
  CONCLUSIONS
  The direct composite buildups observed in this study were found to have promising clinical outcome and good quality parameters after 5 years. If a noninvasive or minimally invasive treatment approach is indicated, direct composite buildups provide an acceptable treatment alternative for the aesthetic correction and reshaping of anterior teeth.
  
  
  CONCLUSIONS
  The application of direct composite buildups in clinical cases in which a non- or minimally invasive treatment approach is indicated provides an excellent treatment alternative for gold-standard treatment options like laboratory-made crowns and porcelain veneers. Restorations in the present investigation showed a functional survival rate of 100%, an overall survival rate of 84.6% after 5 years.
authors: Department of Conservative Dentistry, School of Dental Medicine, Ruprecht Karls University, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. Electronic address: cornelia.frese@med.uni-heidelberg.de.
authors: Cornelia
authors: C
authors: Frese
authors: Petra
authors: P
authors: Schiller
authors: Hans Joerg
authors: HJ
authors: Staehle
authors: Diana
authors: D
authors: Wolff
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003116:Color; D003188:Composite Resins / Q000737:chemistry*; D001840:Dental Bonding; D018772:Dental Marginal Adaptation; D003764:Dental Materials / Q000737:chemistry*; D019232:Dental Restoration Failure; D058250:Dental Restoration Repair; D003793:Dental Restoration, Permanent / Q000379:methods* / Q000592:standards; D003801:Dental Veneers; D003970:Diastema / Q000628:therapy*; D004955:Esthetics, Dental; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013499:Surface Properties; D016019:Survival Analysis; D014070:Tooth / Q000473:pathology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003188:Composite Resins; D003764:Dental Materials
keywords: Clinical quality parameters; Diastema; Direct composite buildups; Follow-up; Recontouring; Survival