Class II glass ionomer cermet tunnel, resin sandwich and amalgam restorations over 2 years

This study compared the clinical behavior of a glass ionomer (polyalkenoate) silver cermet, a posterior resin composite used with the "tunnel" technique, a posterior resin composite used with the "closed sandwich" technique, and a high-copper amalgam for restoring small, proximal surface carious lesions. Two dentists placed 86 restorations in the posterior permanent teeth of 26 adults treated at a dental hospital. Restorations were assessed at 6-month intervals over 2 years for gingivitis adjacent to them, the tightness of proximal contacts, occlusal wear, surface voids, roughness and cracking, surface and marginal staining, and marginal fracture. Small filling defects, surface voids and occlusal wear were obvious with the cermet material, with surface crazing and cracking present in 48% of the tunnel restorations. Two of the posterior resin composites, but none of the amalgam restorations, also failed. The cermet cannot be recommended as a long-term permanent restorative material in situations where it is likely to be subjected to heavy occlusal stresses and abrasive wear.