title: Direct resin composite restorations for fractured maxillary teeth and diastema closure: A 7 years retrospective evaluation of survival and influencing factors.
abstract: This retrospective study evaluated the survival rate of anterior direct resin based composite (RBC) build-ups in vital teeth made of microhybrid and nanofill RBC materials and the influence of bruxism, beverage consumption and smoking on the long-term performance of restorations.
  
  
  
  Patients receiving anterior restoration between 2006 and 2011, with the diagnosis of fracture or diastema, were selected. A total of 65 adult patients (mean age: 25.2) with 163 restorations (78 Filtek Supreme XT and 85 Enamel Plus HFO) were evaluated using the USPHS criteria. Data were analyzed with Fisher's Exact Test, Extended Cox-regression analysis and Kaplan-Meier method.
  
  
  
  Mean observation period was 7.2 (±1.4) years and the mean annual failure rate for this period was 1.43%. The reasons of failures included restoration fracture and color mismatch. Nanofill restorations had significantly higher rate of color mismatch (p=0.002), microhybrids more frequently failed in fracture of restoration (p=0.034). The overall difference in potential hazard of using Enamel Plus HFO or Filtek Supreme XT was not significant (p=0.704). Chipping or fracture of the restoration was more frequent in the first year after placement (p=0.036), while beverage consumption was significantly correlated with discoloration of the restorations (p=0.005).
  
  
  
  The application of direct RBC restorations provides an excellent treatment option for fractured teeth and for closing diastemas. The overall survival rate was 88.34% up to 10 years. Microhybrid and nanofill RBC restorations showed similar survival rates, however nanofills discolored at a higher rate, meanwhile chipping of the restoration occurred frequently with microhybrids.
authors.affiliation: Department of Restorative Dentistry and Periodontology, University of Pécs, Pécs, Hungary. Electronic address: lempel.edina@pte.hu.
authors.forename: Edina
authors.initials: E
authors.lastname: Lempel
authors.affiliation: Department of Restorative Dentistry and Periodontology, University of Pécs, Pécs, Hungary.
authors.forename: Bálint Viktor
authors.initials: BV
authors.lastname: Lovász
authors.affiliation: Department of Restorative Dentistry and Periodontology, University of Pécs, Pécs, Hungary.
authors.forename: Réka
authors.initials: R
authors.lastname: Meszarics
authors.affiliation: Faculty of Sciences, University of Pécs, Pécs, Hungary.
authors.forename: Sára
authors.initials: S
authors.lastname: Jeges
authors.affiliation: Faculty of Sciences, University of Pécs, Pécs, Hungary.
authors.forename: Ákos
authors.initials: Á
authors.lastname: Tóth
authors.affiliation: Department of Oral and Maxillofacial Surgery, University of Pécs, Pécs, Hungary.
authors.forename: József
authors.initials: J
authors.lastname: Szalma
mesh_terms: D003188:Composite Resins; D019232:Dental Restoration Failure; D003793:Dental Restoration, Permanent; D003970:Diastema; D005500:Follow-Up Studies; D006801:Humans; D012189:Retrospective Studies
chemical_list: D003188:Composite Resins
keywords: Diastema; Fracture; Longevity; Resin based composite; USPHS criteria