Two-year clinical evaluation of direct and indirect composite restorations in posterior teeth. Three-year clinical evaluation of direct and indirect composite restorations in posterior teeth. Clinical performance of bonded leucite-reinforced glass ceramic inlays and onlays after eight years. Computer-aided direct ceramic restorations: a 10-year prospective clinical study of Cerec CAD/CAM inlays and onlays. Clinical study of indirect composite resin inlays in posterior stress-bearing cavities placed by dental students: results after 4 years. Dentists' molar restoration choices and longevity: a web-based survey. One-year clinical evaluation of composite and ceramic inlays in posterior teeth. Leucite-reinforced glass ceramic inlays and onlays after 12 years. Four-year clinical evaluation of a self-adhesive luting agent for ceramic inlays Direct composite inlays versus conventional composite restorations: three-year clinical results Composite resin fillings and inlays. An 11-year evaluation
STATEMENT OF PROBLEM Few long-term clinical studies have reported data of modern posterior composites as direct and indirect restorations . PURPOSE This prospect i ve , long-term clinical trial ( 1 ) evaluated direct and indirect composite restorations for clinical acceptability as posterior restoratives in single or multisurface carious teeth and ( 2 ) provided a survey on the 2-year results . MATERIAL AND METHODS Nine dental students placed 88 composite restorations ( Tetric , blend-a-lux , Pertac-Hybrid Unifil ) , 43 direct composite restorations and 45 indirect inlays , under the supervision of an experienced dentist . The first clinical evaluation was performed 11 to 13 months after placement by 2 other experienced dentists , using modified USPHS criteria . A second follow-up of 60 restorations took place within 20 to 26 months after placement . RESULTS A total of 93 % of indirect and 90 % of direct composite restorations were assessed to be clinical ly excellent or acceptable . Two restorations ( 1 indirect composite inlay and 1 margin of a direct composite restoration )  failed during the second year because of fracture . Indirect inlays demonstrated a significantly better " anatomic form of the surface " than direct composite restorations . Premolars revealed a significantly better margin integrity and postoperative symptoms than molars . CONCLUSION Posterior composite restorations provided a satisfactory clinical performance over a 2-year period when placed by relatively inexperienced but supervised students STATEMENT OF THE PROBLEM Objective long-term clinical data are necessary to assess the performance of modern posterior composites as direct and indirect restorations . PURPOSE This prospect i ve , long-term clinical trial evaluated direct and indirect composite restorations for clinical acceptability as posterior restoratives in single or multisurface cavities and provided a survey on the 3-year results . MATERIAL AND METHODS Under the supervision of an experienced dentist , 9 dental students placed 88 composite restorations ( Tetric , blend-a-lux , Pertac-Hybrid Unifil ) , 43 direct composite restorations , and 45 indirect inlays .  Clinical evaluation was performed at baseline and in yearly intervals after placement by 2 other experienced dentists , using modified USPHS criteria . A third follow-up of 60 restorations took place within 33 to 36 months after placement . RESULTS A total of 93 % of indirect and 87 % of direct restorations were assessed to be clinical ly excellent or acceptable . During the third year , 1 direct restoration in a molar failed because of margin opening . Indirect inlays exhibited a significantly better anatomic form of the surface than direct composite restorations . Premolars revealed a significantly better marginal integrity and anatomic form of the surface than molars . Restorations in molars exhibited a significantly higher failure rate compared with premolars . CONCLUSION Posterior composite restorations provided a satisfactory clinical performance over a 3-year period , even if placed by relatively inexperienced but supervised students OBJECTIVE Ceramic inlays and onlays are a tooth colored alternative to metallic restorations . Clinical long-term data are scarce though , especially about inlays and onlays having proximal margins in dentin . The present prospect i ve controlled clinical study evaluated the clinical performance of IPS Empress inlays and onlays with cuspal replacements and proximal margins below the cementoenamel junction over eight years . METHODS Ninety six ceramic restorations were placed in 34 patients by six dentists . The restorations were bonded with an enamel/dentin bonding system ( Syntac Classic ) and four different resin composite systems . The restorations were assessed after placement by two calibrated investigators using modified USPHS codes and criteria at the following time periods : baseline , 1,2,4,6 and 8 years . RESULTS Eight of the 96 restorations investigated had to be replaced ( failure rate 8 % ; Kaplan-Meier ) : Six inlays suffered cohesive bulk fractures , two teeth required endodontic treatment . After eight years of clinical service , significant deterioration ( Friedman 2-way ANOVA ; P < 0.05 ) was found for marginal adaptation of the remaining restorations . 98 % of the surviving restorations exhibited marginal deficiencies , independent of the luting composite . CONCLUSIONS IPS Empress inlays and onlays demonstrated to be successful even in large defects . Neither the absence of enamel margins , nor cuspal replacement significantly affected the quality of the restorations PURPOSE The objective of this follow-up study was to examine the performance of Cerec inlays and onlays in terms of clinical quality over a functional period of 10 years . MATERIAL S AND METHODS Of 200 Cerec inlays and onlays placed in a private practice between 1989 and early 1991 , 187 restorations were observed over a period of 10 years . The restorations were fabricated chairside using the Cerec-1 computer-aided design /manufacturing ( CAD/CAM ) method and Vita MK I feldspathic ceramic . An adhesive technique and luting composite resin were used for seating the restorations . After 10 years , the clinical performance of the restorations was evaluated using modified USPHS criteria . The results were used to classify success and failure . RESULTS According to Kaplan-Meier analysis , the success rate of Cerec inlays and onlays dropped to 90.4 % after 10 years . A total of 15 ( 8 % ) failures were found in 11 patients . Of these failures , 73 % were caused by either ceramic fractures ( 53 % ) or tooth fractures ( 20 % ) . The reasons for the remaining failures were caries ( 20 % ) and endodontic problems ( 7 % ) . The three-surface Cerec reconstructions were found to have the most failures . CONCLUSION The failure rate of 8 % and the drop of the survival probability rate to 90.4 % after 10 years of clinical service of Cerec-1 CAD/CAM restorations made of Vita MK I feldspathic ceramic appear to be acceptable in private practice . This is particularly true in light of the very high patient satisfaction OBJECTIVES This longitudinal r and omized controlled clinical trial evaluated the longevity of composite resin inlays in single- or multi-surface cavities up to 4 years . METHODS 21 dental students placed 75 Artglass and 80 Charisma composite resin inlays in class I and II cavities in posterior teeth ( 89 adult patients ) luted with dual-curing resin cements .  Clinical evaluation was performed up to 4 years using modified USPHS criteria . RESULTS 87.2 % of Artglass and 76.6 % of Charisma inlays were assessed to be clinical ly excellent or acceptable . Up to the 4-year recall 5 Artglass and 11 Charisma inlays failed mainly because of postoperative symptoms , bulk fracture , and loss of marginal integrity . No significant differences between both composite resin material s could be detected at 4 years for all clinical criteria ( Mann-Whitney U-test , p>0.05 ) . The comparison of restoration performance with time yielded a significant increase in marginal discolouration and postoperative symptoms ( p<0.05 ) , deterioration of surface texture quality , marginal and restoration integrity ( p<0.05 ) for both inlay systems . However , the changes were mainly effects of scoring shifts from alfa to bravo . Small inlays compared to large inlays and premolar restorations compared to molar restorations showed significant better outcome for some of the tested clinical parameters for the Artglass inlays ( p<0.05 ) . For Charisma inlays no such influences were revealed . CONCLUSIONS Clinical assessment of Artglass and Charisma composite resin inlays exhibited an annual failure rate of 3.2 % and 5.9 % that is within the range of published data . Within the limitations of this study indirect composite inlays are a competitive restorative procedure in stress-bearing preparations STATEMENT OF PROBLEM The increasing trend toward esthetics has led to controversy as to the longevity of esthetic restorations and the wisdom of having traditional restorations replaced for esthetic reasons . With the assumption that the way dentists treat their own teeth may be a good indication of the accumulated wisdom of the profession , knowledge of dentists ' own restorative choices may provide guidance in selecting the most appropriate restorations . PURPOSE The purpose of this article was to determine restorative choices of dentists for personal molars and estimate restoration longevity . MATERIAL AND METHODS Information about dentists ' molars was obtained from a Web-based survey design ed to receive dentists ' demographic data and charting of 8 molar teeth with estimated longevity . Approximately 12,000 e-mails asking to access the website were sent to dentists ' addresses r and omly selected from a commercial data base . Nonrespondents received 1 reminder . The responses were statistically analyzed with a chi-square analysis ( alpha=.05 ) . RESULTS Seven hundred fifty-seven valid replies provided information for 6,034 teeth ( 22 % unrestored , 75 % restored , 2 % missing ) . Restorations reported included amalgam ( 36 % ) , gold inlay/onlay ( 13 % ) , complete veneer crown ( CVC ) ( 10 % ) , metal-ceramic crown ( MCC ) ( 8 % ) , and composite ( 7 % ) . Other esthetic options accounted for less than 3 % . Restorations with more than 20 years longevity included amalgam restorations ( 58 % ) , gold inlays/onlays ( 48 % ) and crowns ( 23 % ) . Fifty-six percent of esthetic restorations and 5 % of amalgams were placed in the last 5 years . The following restorations were placed in the last year ( n=186 ) : 38 % esthetic , 29 % crowns ( 18 % MCC ; 11 % CVC ) , and 17 % gold inlay/onlay or amalgam . Significant differences ( P<.001 ) were identified for dentist 's gender , year of graduation and practice location . CONCLUSIONS Most dentists have not replaced traditional metallic restorations with esthetic alternatives . Dentists still choose nonesthetic options for significant numbers of their own restorations STATEMENT OF PROBLEM There are only a few studies available that deal with the clinical behavior of composite and ceramic inlay systems as potential substitutes for amalgam restorations . PURPOSE This prospect i ve clinical trial evaluated composite and ceramic inlay systems for clinical acceptability as restorative material s in single or multisurface cavities of posterior teeth and provided 1-year results . MATERIAL AND METHODS Forty-seven composite inlays ( Tetric , Blend-a-lux , Pertac ) and 24 heat-pressed ceramic inlays ( IPS Empress )  were placed in 45 patients by 7 student operators under the supervision of an experienced dentist . The first clinical evaluation was performed 11 to 13 months after placement of the restorations and used modified United States Public Health Services criteria . RESULTS Satisfactory results over this period were found , as 100 % of ceramic inlays and 94 % of composite inlays were assessed to be clinical ly excellent and acceptable . Only 3 composite inlay restorations were scored delta ( unacceptable ) . Two inlays exhibited secondary caries and 1 demonstrated loss of pulp vitality . For the criteria " anatomic form of the surface " and " marginal integrity , " ceramic inlays were significantly better than composite inlays . CONCLUSION Posterior tooth-colored inlays provided acceptable and excellent clinical service , even if they are placed by relatively inexperienced student operators PURPOSE This controlled clinical trial aim ed to evaluate  IPS Empress inlays and onlays over 12 years . The null hypothesis was that different luting resins would have no influence on clinical outcome . MATERIAL S AND METHODS In the course of a prospect i ve clinical long-term trial , 96 ceramic inlays and onlays were placed in 34 patients using one adhesive ( Syntac ) and four different luting composites ( Tetric , Variolink Low , Variolink Ultra , Dual Cement ) . Recalls were carried out by two calibrated investigators using modified USPHS codes and criteria at baseline , 1 , 2 , 4 , 6 , 8 , and 12 years . RESULTS Fifteen of the 96 restorations had to be replaced ( failure rate 16 % ; Kaplan-Meier ) ; 12 of them suffered bulk fractures . After twelve years of clinical service , significantly more bulk fractures were found when light-curing composite was used for luting ( p < 0.05 ) . Fractures were noticed between 3 and 4 years of clinical service and later after 11 to 12 years ; aside from those times , no single fracture occurred . Secondary caries was not observed . CONCLUSION IPS Empress inlays and onlays exhibited satisfactory clinical outcomes over a 12-year clinical period . Restorations luted with dual-cured resin composites revealed significantly fewer bulk fractures Objectives The aim of this r and omized controlled clinical trial was to evaluate the 4-year clinical performance of a self-adhesive resin cement , RelyX Unicem ( 3 M ESPE ) , used for cementation of ceramic inlays . In addition , the influence of selectively acid-etching enamel prior to luting on the clinical performance of the restorations was assessed . Methods Sixty-two IPS Empress 2 inlays/onlays were placed in 31 patients by two experienced clinicians . The restorations were luted with RelyX Unicem with ( = experimental group : E ) or without ( = control group : NE ) prior enamel etching with phosphoric acid . At baseline , 6 months , and 1 , 2 , and 4 years after placement , the restorations were assessed by two calibrated investigators using modified USPHS criteria . Ten selected sample s of each group were investigated under SEM regarding morphological changes at the cement – inlay interface . Results The recall rate at 4 years was 97 % . Two restorations ( 1 E , 1 NE ) were lost , and one ( E ) had to be replaced due to inlay and tooth fracture result ing in a survival rate of 95 % . No significant differences between the experimental and control group were noticed regarding all criteria ( McNemar , p < 0.05 ) . An obvious deterioration in marginal integrity was observed after 4 years as only 5 % ( E = 7 % ; NE = 3 % ) of the restorations exhibited an excellent marginal adaptation . In 90 % of the restorations small , still clinical ly acceptable marginal deficiencies were observed . SEM of the luting gap showed an increased wear of the RelyX Unicem cement over the 4-year period . Conclusions The self-adhesive luting cement RelyX Unicem can be recommended for bonding of ceramic inlays/onlays . Additional selective enamel etching does not improve the clinical performance of the restorations within the 4-year period . Clinical relevance The self-adhesive resin composite RelyX Unicem showed acceptable clinical performance after 4 years of clinical service A clinical trial of direct composite inlays versus conventionally ( incrementally ) placed restorations made from the same material was started in January 1989 . Restorations were r and omly allocated to matched pairs of cavities . This study reports the 3-year performance of 71 of the 100 pairs of restorations placed over a 2-year period and followed-up every 6 months .  Clinical assessment s were made using USPHS criteria ( indirect measurements of occlusal wear were made using Ivoclar st and ard dies ) and annual bite wing radiographs . Direct inlays showed significantly less occlusal wear than conventional restorations , but the difference was small . The clinical performance of both types of restoration was similar and compared favourably with studies of other material s. No secondary decay was diagnosed . The direct inlays , however , took longer to place and did not reduce postoperative sensitivity or failure rate ( 8 % failure of inlays and 4 % of conventional composites over 3 years ) . Contouring of proximal and occlusal aspects was not facilitated with direct inlays but may be easier with indirect inlays on removable The purpose of this r and omized , clinical study was to evaluate the clinical performance of composite resin material s used for fillings and indirect inlays . Twenty-eight sets of five class II restorations ( two fillings , three inlays ) were placed in 88 premolars and 52 molars in 28 adults .  Brilliant Dentin and Estilux Posterior were used for both fillings and inlays , and SR-Isosit for inlays only . After 11 years , 27 sets of restorations ( 96 % ) were evaluated clinical ly using modified United States Public Health Service criteria . Replaced or repaired restorations were observed in 16 % of the fillings and 17 % of the inlays , and a further 5 % of the restorations were replaced for reasons not related to the restoration . The remaining 107 restorations exhibited optimal ratings in 30 % of the fillings and 12 % of the inlays ( P<0.05 ) and acceptable ratings in 70 % and 88 % , respectively . The reasons for failure were fracture of restoration ( four fillings , five inlays ) , secondary caries ( two fillings , four inlays ) , fracture of tooth ( two inlays ) , loss of proximal contact ( two fillings ) , and loss of restoration ( one inlay ) . Failures were seen more frequently in molar than premolar restorations ( P<0.05 ) , with no significant difference between fillings and inlays or between the five types of restoration ( P>0.05 )
The difference of the two techniques did not reach statistical significance in order to recommend one technique over the other .
CLINICAL SIGNIFICANCE Resin composite material s , placed directly or indirectly , exhibit a promising long-term clinical performance when rehabilitation of posterior teeth is needed .
OBJECTIVE To evaluate the long-term clinical performance of direct versus indirect composite inlays/onlays  in posterior teeth .
Although many years in clinical practice , the selection of the best treatment protocol still remains subjective .