Comparative clinical evaluation of direct-indirect heat tempered and direct composite restoration technique in...

Noncarious cervical lesions (NCCLs) are increasingly prevalent and present a restorative challenge due to their multifactorial etiology and complex cervical substrate. Composite resins are commonly used; however, limitations such as polymerization shrinkage and reduced retention affect their clinical performance. The direct-indirect heat-tempered composite technique has been proposed to enhance mechanical properties and clinical outcomes.

The aim of this study was to comparatively evaluate the clinical performance of direct-indirect heat-tempered composite restorations and direct composite restorations in NCCLs.

This single-center, single-blinded randomized clinical trial included 82 systemically healthy patients with NCCLs, divided into two groups (n = 41 each). Group A received direct-indirect heat-tempered composite restorations, whereas Group B received conventional direct composite restorations. Clinical evaluation was performed at baseline, 6 months, and 1 year using modified United States Public Health Service criteria. Data were analyzed using Chi-square test and Mann-Whitney U test with significance set at P < 0.05.

At baseline, all restorations were rated Alpha. Over time, both groups showed deterioration in marginal discoloration and surface texture. However, Group A demonstrated significantly superior outcomes in marginal adaptation, anatomic form, and retention compared to Group B (P ≤ 0.001). Retention in Group A remained 100% throughout the study, whereas Group B showed a significant decline (48.8% at 6 months and 19.5% at 1 year). No secondary caries or postoperative sensitivity was observed in either group.

Direct-indirect heat-tempered composite restorations exhibited superior clinical performance compared to direct composite restorations in NCCLs, particularly in terms of retention, marginal adaptation, and anatomical stability. Both techniques were equally effective in preventing secondary caries and postoperative sensitivity.