LITERATURE Review COMPOSITE RESTORATIONS - Long term controlled clinical studies Study study design obervation period results (YFR) Mair, 1998 longitudinal.

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Study study design obervation period results (YFR)

Mair, 1998 longitudinal 10Y 0.7%

Mertz-Fairhurst et al, 1991 longitudinal 10Y 2.0%

Raskin et al, 1999 longitudinal 10Y 4-5%

Wilder et al, 1999 longitudinal 17Y 1.4%

Gaengler et al, 2001 longitudinal 10Y 2.5%

Palessen & Qvist, 2003 longitudinal 11Y 0.7%

da Rosa Rodolpho et al , 2006 longitudinal 17Y 2.04%

Study study design obervation period results (YFR)

Mair, 1998 longitudinal 10Y 0.7%

Mertz-Fairhurst et al, 1991 longitudinal 10Y 2.0%

Raskin et al, 1999 longitudinal 10Y 4-5%

Wilder et al, 1999 longitudinal 17Y 1.4%

Gaengler et al, 2001 longitudinal 10Y 2.5%

Palessen & Qvist, 2003 longitudinal 11Y 0.7%

da Rosa Rodolpho et al , 2006 longitudinal 17Y 2.04%

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Study n. of restorations observ. period results

Gaengler et al, 2001 194 GIC/RC Class II 10 Years 74.2% survival USPHS failures = fractures++

da Rosa Rodolpho et al, 2006 282 GIC/RC Class II 17 Years 65.2% survivalUSPHS failures = fractures ++

Study n. of restorations observ. period results

Gaengler et al, 2001 194 GIC/RC Class II 10 Years 74.2% survival USPHS failures = fractures++

da Rosa Rodolpho et al, 2006 282 GIC/RC Class II 17 Years 65.2% survivalUSPHS failures = fractures ++

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Study exp. protocol level of evidence results

Kosmas Tolidis et al, 1998 volum. shrinkage rmGIC liner reduces shrinkage

Wibowo & Stockton, 2001 microleakage rmGIC liner < FRC liner

Dietrich et al, 1999 marg. adaptation (SEM) rmGIC > GIC or full Cp

(3M, ESPE,Vivadent,GC, Dentpsly)

Dietrich et al, 2000 marg. Adaptation (SEM) rmGIC > Full CP(Z100/Vitremer)

Study exp. protocol level of evidence results

Kosmas Tolidis et al, 1998 volum. shrinkage rmGIC liner reduces shrinkage

Wibowo & Stockton, 2001 microleakage rmGIC liner < FRC liner

Dietrich et al, 1999 marg. adaptation (SEM) rmGIC > GIC or full Cp

(3M, ESPE,Vivadent,GC, Dentpsly)

Dietrich et al, 2000 marg. Adaptation (SEM) rmGIC > Full CP(Z100/Vitremer)

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Study exp. protocol level of evidence results

Dietschi et al, 2002 marg. adaptation (SEM) Compomer > Full Cp

(Dyract) Closed sandwich Config. !!!

Study exp. protocol level of evidence results

Dietschi et al, 2002 marg. adaptation (SEM) Compomer > Full Cp

(Dyract) Closed sandwich Config. !!!

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Study n. of restorations observ. period results

Lindberg et al, 2000 n= 2o class II (pm) 1 Month better adapt. in E &D SEM marg. adapt. for PMRC / RC

Andersson-Wenckert et al, 2002 n= 40 class II (pm) 1 Month better adapt. in E&D

SEM marg. adapt. rmGIC / RC

Opdam et al, 2007 n= 458 class II 9 Years higher failure rate USPHS with rmGIC

Study n. of restorations observ. period results

Lindberg et al, 2000 n= 2o class II (pm) 1 Month better adapt. in E &D SEM marg. adapt. for PMRC / RC

Andersson-Wenckert et al, 2002 n= 40 class II (pm) 1 Month better adapt. in E&D

SEM marg. adapt. rmGIC / RC

Opdam et al, 2007 n= 458 class II 9 Years higher failure rate USPHS with rmGIC

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Study n. of restorations observ. period results

Van Dijken et al, 1999 274 open sandwich 3 Years 2.5% tooth fractures class II & 6 exp. cond. 4% dissolution rmGIC

Andersson-Wenckert et al, 2004 220 open sandwich 6-7 Years 19%/34% failures class II & 6 exp. cond. dissolution rmGIC ++ failure = tooth & rest.

fractures <1% AFR @ 3Y3.16% AFR @ 6Y4.85% AFR @7Y

Study n. of restorations observ. period results

Van Dijken et al, 1999 274 open sandwich 3 Years 2.5% tooth fractures class II & 6 exp. cond. 4% dissolution rmGIC

Andersson-Wenckert et al, 2004 220 open sandwich 6-7 Years 19%/34% failures class II & 6 exp. cond. dissolution rmGIC ++ failure = tooth & rest.

fractures <1% AFR @ 3Y3.16% AFR @ 6Y4.85% AFR @7Y

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Study exp. protocol level of evidence results

Chuang et al, 2004 marg. adaptation (SEM) thin FRC >

Dewaele et al, 2006 marg. adaptation (LM) gaps if: (12 exp. rubbery liners) flow, flexibility,

shrinkage

Study exp. protocol level of evidence results

Chuang et al, 2004 marg. adaptation (SEM) thin FRC >

Dewaele et al, 2006 marg. adaptation (LM) gaps if: (12 exp. rubbery liners) flow, flexibility,

shrinkage

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Study Comparison observ. period results

Ernst et al, 2003 Class II with / without flow 2Y no difference

Lindberg et al, 2005 Class II with / without flow § 1m no difference

Efes et al, 2006 Class II with / without flow 2Y no difference

Study Comparison observ. period results

Ernst et al, 2003 Class II with / without flow 2Y no difference

Lindberg et al, 2005 Class II with / without flow § 1m no difference

Efes et al, 2006 Class II with / without flow 2Y no difference

CHOICE between Direct & Indirect Restorations:Literature Review

Direct vs Indirect Restorations

in Medium Size Cavities

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Study results

van Dijken JW, 2000 The difference in failure rate between the resin composite direct technique and the inlay technique was not large,

indicating that the more time-consuming and expensive inlay technique

may not be justified

Wassell RW, Walls AW, McCabe JF, 2000 In this study the direct inlay technique gave no clinical

advantage over conventional direct restorations

Pallesen U, Qvist V, 2003 No significant difference between compositefillings and composite inlays

Study results

van Dijken JW, 2000 The difference in failure rate between the resin composite direct technique and the inlay technique was not large,

indicating that the more time-consuming and expensive inlay technique

may not be justified

Wassell RW, Walls AW, McCabe JF, 2000 In this study the direct inlay technique gave no clinical

advantage over conventional direct restorations

Pallesen U, Qvist V, 2003 No significant difference between compositefillings and composite inlays

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Study results

Spreafico RC, Dietschi D, Krejci I, 2005 The clinical performance and the marginal adaptation did not

show significative differences

Study results

Spreafico RC, Dietschi D, Krejci I, 2005 The clinical performance and the marginal adaptation did not

show significative differences

CHOICE between Direct & Indirect Restorations:

Literature ReviewDirect vs Indirect Restorations

in Large Cavities

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Study results

Klaiber and Haller, 1989 Luted restorations permit a better marginal adaptation and seal when compared to the direct composite resin restorations

Milleding, 1992

Agosto,1993

Lida et al, 2003 To prevent marginal microfracture, an adhesive inlay restoration is preferable for a large class II cavity

van Dijken JW. 2000 The direct inlay / onlay technique is recommended to be used in class II cavities of high caries risk patients with cervical

margins placed in dentin

Study results

Klaiber and Haller, 1989 Luted restorations permit a better marginal adaptation and seal when compared to the direct composite resin restorations

Milleding, 1992

Agosto,1993

Lida et al, 2003 To prevent marginal microfracture, an adhesive inlay restoration is preferable for a large class II cavity

van Dijken JW. 2000 The direct inlay / onlay technique is recommended to be used in class II cavities of high caries risk patients with cervical

margins placed in dentin

Clinical trials: Direct Resin CompositesMaterial Observation period no of restoration survival rate annual f. rate study

BRILLANT 1y 24 100% 0% Fülleman et al. 1992

BRILLANT 2Y 30 80% 10% Haas et al. 1992

BRILLANT-ESTILUX 1Y 29 96.5% 3.4% Thordrup et al. 1994

BRILLANT 3y 71 92% 2.7% Wassel et al. 1996

BRILLANT-APH 5Y 24 100% 0% Wiedmer et al. 1997

Clinical trials: Direct Resin CompositesMaterial Observation period no of restoration survival rate annual f. rate study

BRILLANT 5Y 21 100% 0% Van Dijken et al.1996

BRILLANT 5y 15 85% 3% Thordrup et al. 2001

VITADUR N 15 85% 3%

CEREC COS2.02 15 92.5% 1.5%

OCCLUSIN 3y 60 96.7% 1.1% Wendt et al. 1992

Clinical trials: Direct Resin CompositesMaterial Observation period no of restoration survival rate annual f. rate study

TETRIC - PERTAC 2y 45 93% 3.5% Schleibenbogen et al. 1992

TETRIC - PERTAC 3Y 30 93% 2.3% Manhart et al. 2000

APH 1Y 29 96.5% 3.4% Krejci et al. 1994

TETRIC - Z100 4-6Y 50 94% 1.2% Leirskar et al. 2003

Clinical trials: Direct Resin CompositesMaterial Observation period no of restoration survival rate annual f. rate study

Annual Failure Rate range = 0-10%

« Without extremes » range 1.1-3.5%

Material Observation period no of restoration survival rate annual f. rate study

SR ISOSIT-CONCEPT 1y 34 88.2% 11.8% Bessing et al. 1991

SR ISOSIT-CONCEPT 7Y 36 75% 3.6% Donly et al. 1999

SR ISOSIT-CONCEPT 11Y 135 83% 1.6% Pallesen et al. 2003

VISIO-GEM 6y 118 41% 9.8% Krämer et al. 1996

Clinical trials: Laboratory Resin Composites

Material Observation period no of restoration survival rate annual f. rate study

TARGIS 1.5Y 43 100% 0% Monaco et al. 2001

TARGIS 1Y 118 41% 9.8% Yilmaz et al. 2003

TARGIS 2Y (0.5-4Y) 40 100% 0% Kukrer et al. 2004

SIGNUM 3Y 113 97.4% 0.86% Barone et al. 2008

Clinical trials: Laboratory Resin Composites

Material Observation period no of restoration survival rate annual f. rate study

SR ISOSIT 11Y 84 83% 1.54% Palessen et al, 2003 BRILLANT 28 84% 1.45% ESTILUX

28

TPH direct 3.5Y 2x22 100% 0% Spreafico et al, 2005 indirect

100% 0%

Clinical trials: Laboratory Resin Composites

Material Observation period no of restoration survival rate annual f. rate study

Clinical trials: Laboratory Resin Composites

9 studies YFR = 0% – 11.8% 0% - 3.6% (without extremes)

Material Observation period no of restoration survival rate annual f. rate study

MIRAGE 2y 310 95.8% 2.1% Jensen et al. 1988

MIRAGE 3Y 50 96.6% 1.3% Hoglung et al. 1994

MIRAGE 4Y 50 100% 0% Friedl et al. 1997

MIRAGE 6Y 58 88% 2% van Dijken et al 1998

MICROBOND-FORTUNE 10y 183 97% 0.3% Fuzzi et al. 1998

Clinical trials: Feldspathic Porcelains

Clinical trials: Feldspatic PorcelainsMaterial Duration n= survival YFR study

MIRAGE 5Y 20 95.8% 1.6% Molin et al, 2000CEREC 20 96.6% "EMPRESS 20 100% --GOLD 20 100% --

COSMOTECH II 8Y 45 80% 2.5% Hayashi et al, 2000

Diff. FP brands 3Y 47 90% 3.6% Manhart et al, 2000EMPRESS 24 100% --

Clinical trials: Feldspatic PorcelainsMaterial Duration n= survival YFR study

LFC DUCERAM 2.1Y 45 Gemalanaz et al, 2001 (3-46m)

LC: rmGIC 77% 15.7LC: composite 87% 6.2

9 studies YFR = 0% – 6.2%

Material Observation period no of restoration survival rate annual f. rate study

EMPRESS 1y 130 97.5% 1.3% Studer et al. 1996

EMPRESS 4.5Y 125 95.6% 1% Fradeani et al. 1997

EMPRESS 6Y 138 94.9% 0.9% Lehner et al. 1998

EMPRESS 4y 96 93% 1.8% Krämer et al. 1999

EMPRESS 6Y 39 93% 1.2% Krämer et al. 2000 100% marginal ditching

Clinical trials: Pressed Ceramics

Clinical trials: Pressed CeramicsMaterial Duration n= survival YFR study

EMPRESS 4Y 21 100% -- Barghi et al, 2002

EMPRESS 2Y 86 100% -- Coehlo Santos et al, 2004

LFC DUCERAM 86 100%EMPRESS 3Y 40 100% -- Fabianelli et al, 2006

EMPRESS 4Y 130 93% 1.75% Naeselius et al. 2008

EMPRESS 12Y 96 84% 1.33% Franckenberger et al. 2008

EMPRESS 6Y 64 94% 1.05% Galiatsatos et al. 2008

J Can Dent Assoc 2002;68:233-237.Longevity and clinical performance of IPS-Empress ceramic restorations—a literature review.

El-Mowafy O, Brochu JF.

6 studies YFR = 0.88% – 1.28%

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J Adhesive Dent. 2001;3:45-64. Longevity of Restorations in Posterior Teeth and Reasons for Failures

Hickel R, Manhart J.

Aust Dent . 1999;44:157-168. The clinical performance of ceramic inlays: a review

Bergman MA.

Main failure pattern of porcelain inlays is bulk fracture Contraindicated in case of bruxism Require minimal dimensions Differential wear between ceramics & luting composite Wear of opposing structures