Related Experiment Video
Updated: May 24, 2026
Quasistatic Mechanical Testing for Computer-Aided Design and Manufacturing Occlusal Veneers Cemented to Milled Dentin Analog Material
Published on: December 20, 2024
Two-year clinical comparison of direct and indirect composite restorations in severely damaged molars: A split-mouth
Marcia Belleflamme1, Laurence Seidel2, Adelin Albert2
1Department of Fixed Prosthetics and Restorative Dentistry, University of Liège Hospital (CHU), School of Dental Medicine, Liège, Belgium; Dental Biomaterials Research Unit (d-BRU), Institute of Dentistry, University of Liège (ULiège), Liège, Belgium.
Objectives:
This randomized, split-mouth clinical study compared the clinical performance of direct restorations using a short fiber-reinforced composite veneered with a microhybrid composite and indirect CAD-CAM restorations fabricated from a hybrid CAD-CAM block in severely damaged molars.
Methods:
One hundred restorations in 42 patients-50 direct short fiber-reinforced composite restorations veneered with a microhybrid composite and 50 indirect CAD-CAM nanoceramic composite restorations-were randomly assigned to severely damaged molars in a split-mouth design; all restorations involved reconstruction of at least one cusp. All restorations were performed by a single qualified operator, and two independent calibrated examiners evaluated the restorations at baseline, 6 months, 1 year and 2 years using modified USPHS criteria. Patient satisfaction was also assessed at each evaluation.
Results:
After two years of follow-up, all restorations remained functional, resulting in a 100% survival rate. One indirect restoration experienced debonding one week after placement, which was successfully re-bonded and showed no further complications during follow-up. Both restorative approaches demonstrated excellent clinical performance across all USPHS criteria, with no significant differences between direct and indirect composite restorations.
Conclusions:
Direct and indirect restorations showed high survival and success rates after 2 years. Patient satisfaction was high, with no significant difference between the two restorative approaches.
Clinical Significance:
At the 2-year follow-up, direct restorations based on short fiber-reinforced composite showed clinical results comparable to those of indirect CAD-CAM composite restorations in severely damaged molars.
