title: A 4-year clinical evaluation of direct composite build-ups for space closure after orthodontic treatment.
abstract: OBJECTIVE
  To evaluate the medium-term clinical performance of direct composite build-ups for diastema closures and teeth recontouring using a nano and a nanohybrid composite in combination with three- or two-step etch-and-rinse adhesives following treatment with fixed orthodontic appliances.
  
  
  METHODS
  A total of 30 patients (mean age, 19.5 years) received 147 direct composite additions for teeth recontouring and diastema closures. A nano and a nanohybrid composite (Filtek Supreme XT and CeramX Duo) were bonded to tooth structure by using a three-step (Scotchbond Multipurpose) or a two-step (XP Bond) etch and rinse adhesive. Ten out of 147 composite build-ups (composite addition) constituted tooth recontouring cases, and the remaining 137 constituted diastema closure cases. The restorations were evaluated by two experienced, calibrated examiners according to modified Ryge criteria at the following time intervals: baseline, 1, 2, 3, and 4 years.
  
  
  RESULTS
  The 4-year survival rates were 92.8 % for Filtek Supreme XT/Scotchbond Multi-Purpose Plus and 93 % for CeramX Duo/XP Bond. Only ten restorations failed (5 Filtek Supreme XT and 5 CeramX Duo). Statistical analysis revealed no significant differences between the two composite-adhesive combinations with respect to color match, marginal discoloration, wear/loss of anatomical form, caries formation, marginal adaptation, and surface texture on comparing the five time periods (baseline, 1, 2, 3, and 4 years)
  
  
  CONCLUSIONS
  The 4-year survival rates in the present study were favorable. The restorations exhibited excellent scores with regard to color match, marginal adaptation, surface texture, marginal discoloration, wear/loss of anatomical form, and caries formation, after 4 years of clinical evaluation. Clinical relevance An alternative clinical approach for correcting discrepancies in tooth size and form, such as performing direct composite restorations following fixed orthodontic treatment, may be an excellent and minimally invasive treatment.
authors: Department of Restorative Dentistry, Faculty of Dentistry, Istanbul University, Çapa, 34390, Istanbul, Turkey. md.demirci@gmail.com.
authors: Mustafa
authors: M
authors: Demirci
authors: Department of Restorative Dentistry, Faculty of Dentistry, Istanbul University, Çapa, 34390, Istanbul, Turkey.
authors: Safa
authors: S
authors: Tuncer
authors: Department of Orthodontics, Faculty of Dentistry, Istanbul University, Çapa, 34390, Istanbul, Turkey.
authors: Evren
authors: E
authors: Öztaş
authors: Department of Restorative Dentistry, Faculty of Dentistry, Kocaeli Üniversity, Kocaeli, 41190, Turkey.
authors: Neslihan
authors: N
authors: Tekçe
authors: Department of Biostatistics and Medical Informatics, Faculty of Medicine, Bezmialem Vakif University, Çapa, 34093, Istanbul, Turkey.
authors: Ömer
authors: Ö
authors: Uysal
mesh_terms: D000134:Acid Etching, Dental; D000293:Adolescent; D000328:Adult; D003188:Composite Resins / Q000737:chemistry; D003738:Dental Cements / Q000737:chemistry; D003793:Dental Restoration, Permanent / Q000379:methods*; D017220:Dentin-Bonding Agents; D003970:Diastema / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D049329:Nanostructures / Q000737:chemistry; D019516:Orthodontic Space Closure / Q000379:methods*; D019279:Resin Cements; D016896:Treatment Outcome
chemical_list: C520091:CeramX; D003188:Composite Resins; D003738:Dental Cements; D017220:Dentin-Bonding Agents; C474035:Filtek Supreme; D019279:Resin Cements; C084018:Scotchbond Multi-Purpose; C532387:XP-Bond
keywords: Diastema; Direct composite resin build-up; Orthodontics; Recontouring; Survival; Tooth form; Tooth size discrepancy