A clinical evaluation of posterior composite resin restorations

There is a trend towards manufacturers seeking to provide dentists with a single, all-purpose composite resin, usually of the small particle hybrid type. This three-year clinical study compared the clinical performance of three different types of composite resin used in posterior teeth and identified several modes of failure. Of the 330 restorations (three composite resins and one amalgam control) initially placed in 72 patients, 223 restorations in 48 patients were available for evaluation at three years. Modified clinical criteria for assessing the restorations were able to discriminate among the composite resins. A microfilled composite and a small particle hybrid exhibited increasing evidence of marginal fracture (crevice) with time. In addition, the small particle hybrid showed evidence of wear at the margins more frequently than the other materials. Of the restorations available for assessment, four restorations of each of these two types of composite resin required replacement during the study. Coarse particle hybrid restorations showed evidence of wear but little evidence of marginal fracture.