Reconstruction of nonvital teeth using direct fiber-reinforced composite resin: a pilot clinical study

To evaluate the clinical performance of direct Class II fiber-reinforced composite restorations on nonvital teeth.

Thirty patients age 18 or older were included in this clinical trial restoring 35 molars. The inclusion criteria were: two- to four-surface restorations, replacement of composite and amalgam restorations necessary or unrestored teeth with decay reaching the pulp, teeth having homogeneous root canal fillings terminating 0 to 2 mm from the radiographic apex. Teeth with residual cavity walls less than 1 mm or with complete loss of the clinical crown were excluded. Teeth were restored using a combination of Ultra etch 35% phosphoric acid, PQ1 adhesive system, and Vit-l-escence microhybrid composite resin. The enamel peripheral shell of the restoration was built up first; a resin-impregnated piece of polyethylene ribbon fiber (Ribbond Triaxial) was covered with B1 Perma-Flo flowable composite, placed into a prepared canal, folded, and light cured; then, dentin and enamel occlusal surface stratification was completed. All 35 restorations were evaluated at 6 months and 1 year by two independent evaluators using modified USPHS criteria.

No failure was reported and alpha scores were recorded for all parameters. Before starting the treatment, 26 out of 35 teeth (74%) had apical periodontitis as diagnosed radiographically. At the 1-year recall, no signs of periapical lesions were detected and radiographs reported neither periodontal ligament widening nor periapical radiolucency.

Direct fiber-reinforced composite resin restorations demonstrated excellent clinical performance at 1 year.