A Comparison of the Prefabricated Plug-In Stamp and Conventional Freehand Technique in Occlusal Restorations

Restoring the anatomical structure of posterior teeth with significant structure loss is challenging and time-consuming due to anatomical variations. This study assesses the efficiency and effectiveness of using ready-made prefabricated plug-in stamps compared to the conventional freehand method for occlusal restorations.

Following ethical approval, 40 Frasaco typodont teeth and 20 extracted natural teeth were included in the study. Prefabricated plug-in stamps were created using typodont teeth from a different manufacturer. Occlusal cavities were prepared on 40 typodont teeth and restored with resin-based composite (RBC) and glass-ionomer cement (GIC) using two techniques: the conventional freehand and the ready-made prefabricated plug-in stamp. Additionally, extracted teeth were restored with RBC using both techniques. A single clinician prepared all cavities, while 10 volunteer clinicians conducted the restorations, each completing six restorations (two RBCs on typodont teeth, two RBCs on natural teeth, two GICs on typodont teeth) using both techniques. The restoration time was measured for each tooth. Three calibrated examiners assessed the final restorations using a rubric evaluating marginal adaptation, anatomy, contour, surface texture, and occlusion. Restoration times and evaluation scores were analyzed using the Wilcoxon signed-rank test and paired t-test (p = 0.05).

For typodont teeth, the prefabricated plug-in stamp technique with RBC significantly reduced restoration time (p = 0.002), finishing and polishing time (p = 0.010), and total time (p = 0.004) compared to the conventional freehand technique. For natural teeth, the use of prefabricated plug-in stamp also significantly reduced finishing and polishing time (p = 0.002) and total time (p = 0.006). GIC restorations showed significantly shorter evaluation scores and total time with the prefabricated technique (p = 0.002). Restoration evaluation scores were significantly better with the prefabricated plug-in stamp technique than with the conventional freehand technique (p < 0.05).

Utilizing prefabricated plug-in stamp demonstrated superiority in restoring the occlusal part of the tooth and provided more efficient outcomes regarding application, finishing and polishing time, and anatomical accuracy than the conventional freehand technique.

Using the ready-made prefabricated plug-in occlusal stamps can provide dentists with a standardized and time-efficient method for restoring posterior tooth anatomy with greater precision. Potentially enhancing patient outcomes and improving treatment efficiency in clinical settings.