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Composite versus amalgam restorations. A three-year clinical evaluation.

F H Hendriks, H Letzel, M M Vrijhoef

    Journal of Oral Rehabilitation
    |September 1, 1986
    PubMed
    Summary

    This clinical study evaluated posterior composite restorations over 3 years. Microfilled composites demonstrated acceptable anatomic form, unlike other materials, indicating their suitability for long-term dental restorations.

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    Area of Science:

    • Restorative Dentistry
    • Dental Materials Science

    Background:

    • Posterior composite restorations are widely used in clinical practice.
    • Evaluating the long-term clinical performance of different composite materials is crucial for guiding treatment decisions.

    Purpose of the Study:

    • To compare the 3-year clinical behavior of a strontium glass-filled composite, a microfilled composite, and a macrofilled composite against a high copper amalgam control.
    • To assess parameters including anatomic form, marginal adaptation, color match, marginal staining, and secondary caries using USPHS criteria.

    Main Methods:

    • A clinical study involving 232 Class I or II restorations placed in premolars and molars in 49 adult patients.
    • Four materials were tested: Profile (strontium glass-filled), Estic MF (microfilled), Adaptic Radiopaque (macrofilled), and Dispersalloy (high copper amalgam).

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  • Restorations were evaluated annually for 3 years using USPHS criteria, with statistical analysis of differences between materials, tooth type, and evaluation year.

    • Main Results:

    • Overall, 3.6% of restorations required replacement after 3 years.
    • Material type, tooth type, and evaluation year significantly influenced anatomic form and color match.
    • The microfilled composite (Estic MF) was the only composite material that maintained acceptable anatomic form after 3 years.
    • All three composite materials exhibited acceptable color match, marginal adaptation, and marginal staining.

    Conclusions:

    • Microfilled composite restorations, specifically Estic MF, show promising long-term durability regarding anatomic form in posterior teeth.
    • While other tested composites offer acceptable color match and marginal integrity, their long-term anatomic form may be a concern.
    • Clinical performance varies significantly based on material type, tooth location, and time, emphasizing the need for careful material selection.