Clinical performance of a packable resin composite for posterior teeth after 3 years

There is a wide range of materials suitable for posterior resin-composite restorations. The objective of this clinical study was to evaluate the clinical performance of a packable resin composite (Solitaire, Heraeus-Kulzer, Hanau, Germany) in stress-bearing posterior cavities according to the Ryge criteria every 6 months over a 3-year period. A total of 250 class I (28%) and II (72%) restorations were placed in 120 patients using adhesive-bonding techniques without the use of rubber dam. After 3 years, 165 restorations (66%) were still in place during the follow-up investigation. Twelve restorations (4.8% out of the baseline number) had to be replaced due to postoperative sensitivity over the 3-year evaluation period. After 3 years, 65.5% of the restorations were scored Alpha for Marginal Adaptation, 18.2% Bravo, 2.4% Charlie, and 13.9% Delta. For the Ryge criteria Anatomic Form 70.9% of the restorations were scored Alpha, 15.2% Bravo, and 13.9% Charlie. Secondary caries was documented in 3.5% of the restorations. A Bravo score for Marginal Discoloration was determined in 26.1% of the restorations; 2.1% were scored Charlie. After 3 years, only 79.0% (summation effect of negative scores) of the restorations were still performing at clinically acceptable levels. Therefore, the packable resin composite Solitaire failed the criteria of the American Dental Association for resin restoratives. Bulk fractures (14 molar and 9 premolar restorations = 9.2% of the baseline number) due to poor physical properties of the material were the main reason for clinical failure.