title: Randomized control trial of composite cuspal restorations: five-year results.
abstract: The objective of this randomized control trial was to compare the five-year clinical performance of direct and indirect resin composite restorations replacing cusps. In 157 patients, 176 restorations were made to restore maxillary premolars with Class II cavities and one missing cusp. Ninety-two direct and 84 indirect resin composite restorations were placed by two operators, following a strict protocol. Treatment technique and operator were assigned randomly. Follow-up period was at least 4.5 yrs. Survival rates were determined with time to reparable failure and complete failure as endpoints. Kaplan-Meier five-year survival rates were 86.6% (SE 0.27%) for reparable failure and 87.2% (SE 0.27%) for complete failure. Differences between survival rates of direct and indirect restorations [89.9% (SE 0.34%) vs. 83.2% (SE 0.42%) for reparable failure and 91.2% (SE 0.32%) vs. 83.2% (SE 0.42%) for complete failure] were not statistically significant (p = .23 for reparable failure; p = .15 for complete failure). Mode of failure was predominantly adhesive. The results suggest that direct and indirect techniques provide comparable results over the long term (trial registration number: ISRCTN29200848).
authors.affiliation: Department of Oral-Maxillofacial Surgery, Prosthodontics and Special Dental Care, University Medical Centre Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: W M
authors.initials: WM
authors.lastname: Fennis
authors.forename: R H
authors.initials: RH
authors.lastname: Kuijs
authors.forename: F J
authors.initials: FJ
authors.lastname: Roeters
authors.forename: N H
authors.initials: NH
authors.lastname: Creugers
authors.forename: C M
authors.initials: CM
authors.lastname: Kreulen
mesh_terms: D000134:Acid Etching, Dental / Q000379:methods; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001641:Bicuspid / Q000473:pathology; D003188:Composite Resins / Q000737:chemistry*; D001840:Dental Bonding; D003737:Dental Cavity Preparation / Q000145:classification; D003738:Dental Cements / Q000737:chemistry; D003764:Dental Materials / Q000737:chemistry*; D017269:Dental Prosthesis Repair; D019232:Dental Restoration Failure; D003793:Dental Restoration, Permanent / Q000145:classification*; D017220:Dentin-Bonding Agents / Q000737:chemistry; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008689:Methacrylates / Q000737:chemistry; D008875:Middle Aged; D010756:Phosphoric Acids / Q000737:chemistry; D019279:Resin Cements / Q000737:chemistry; D016019:Survival Analysis; D019228:Tooth Crown / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: C112828:Clearfil AP-X; C076805:Clearfil Porcelain Bond; C581302:Clearfil SA; C438313:Clearfil SE Bond; D003188:Composite Resins; D003738:Dental Cements; D003764:Dental Materials; D017220:Dentin-Bonding Agents; D008689:Methacrylates; C438843:Panavia-Fluoro; D010756:Phosphoric Acids; D019279:Resin Cements; C074669:Clearfil Photo Bond; C030242:phosphoric acid
keywords: clinical studies/trials; composite materials; operative dentistry; prosthetic dentistry/prosthodontics; restorative dentistry; restorative materials