title: Longitudinal micromorphological 15-year results of posterior composite restorations using three-dimensional scanning electron microscopy.
abstract: OBJECTIVE
  Hybrid composite restorations in posterior teeth were evaluated over 15 years using the semiquantitative Clinical, Photographic and Micromorphologic (CPM) index. It was a further aim to quantitate the surface morphology by three-dimensional scanning electron microscopy (3D-SEM).
  
  
  METHODS
  Thirty seven hybrid composite restorations (Ketac-Bond/Visio-Molar X, ESPE, Seefeld/Germany) were longitudinally followed up. Parallel to clinical assessment replicas were taken at baseline, after 1, 5, 10 and 15 years and evaluated by SEM, and profilometrical analyses of 3D-SEM data were computed. The profilometrical results were statistically analysed by ANOVA. The level of significance was set to p<0.05.
  
  
  RESULTS
  The semiquantitative micromorphological evaluation exhibited the most considerable deterioration within the first year and up to 5 years of function. Less change was detected during the next 10 years. The profilometrical quantification showed raising depth of the negative marginal ledges with a mean of 27.2μm (range 0.6-94.5μm) after 10 years, with no statistically significant changes from 5 to 10 and 10 to 15 years. The 3D-SEM revealed marginal grooves beneath the level of the ledges (mean 34.5μm after 5 years) within the bonding zone, exposing enamel margins. Leakages, marginal fractures and surface roughness did not seriously deteriorate the quality of restorations.
  
  
  CONCLUSIONS
  Hybrid composite restorations of Class I and II cavities surviving the first five years performed well over 15 years of function. Quantitative 3D-SEM profilometrical measurements revealed the dynamics of marginal behaviour over time.
  
  
  CONCLUSIONS
  Long-term parallel clinical and micromorphological evaluation of posterior composite restorations of Class I and Class II cavities documented the clinical safety and acceptable longevity. The longitudinal 3D micromorphologic assessment of the surface changes and of the marginal behaviour revealed deteriorating as well as improving factors hidden in clinical performance.
authors.affiliation: Electron Microscopy Centre, Jena University Hospital, Germany. Electronic address: wolfram.dietz@online.de.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Dietz
authors.affiliation: Department of Conservative Dentistry, Jena University Hospital, Germany.
authors.forename: Regina
authors.initials: R
authors.lastname: Montag
authors.affiliation: Department of Conservative Dentistry, Jena University Hospital, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Kraft
authors.affiliation: Institute of Medical Statistics, Computer Sciences and Documentation, Jena University Hospital, Germany.
authors.forename: Mario
authors.initials: M
authors.lastname: Walther
authors.affiliation: Department of Conservative Dentistry, Jena University Hospital, Germany.
authors.forename: Bernd W
authors.initials: BW
authors.lastname: Sigusch
authors.affiliation: Department of Conservative and Preventive Dentistry, Faculty of Health, Witten/Herdecke University, Witten, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Gaengler
mesh_terms: D000328:Adult; D003116:Color; D003188:Composite Resins / Q000737:chemistry*; D001840:Dental Bonding; D003737:Dental Cavity Preparation / Q000145:classification; D003743:Dental Enamel / Q000648:ultrastructure; D003763:Dental Leakage / Q000145:classification; D018772:Dental Marginal Adaptation; D003764:Dental Materials / Q000737:chemistry*; D019554:Dental Restoration Wear; D003793:Dental Restoration, Permanent / Q000145:classification / Q000592:standards*; D005500:Follow-Up Studies; D005899:Glass Ionomer Cements / Q000737:chemistry; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008137:Longitudinal Studies; D008855:Microscopy, Electron, Scanning / Q000379:methods; D010781:Photography / Q000379:methods; D011791:Quartz / Q000737:chemistry; D016628:Replica Techniques; D013499:Surface Properties; D016019:Survival Analysis
chemical_list: D003188:Composite Resins; D003764:Dental Materials; D005899:Glass Ionomer Cements; C061499:Ketac-Bond; C067786:Visio-Molar; D011791:Quartz
keywords: 3D-SEM; Composite restorations; Longevity; Micromorphological evaluation; Profilometry