A 3-year clinical evaluation of Ketac-Silver restorations in primary molars

Occlusal and proximal caries lesions in primary molars in 4-7-yr-old children with a high caries activity were restored with a cermet, Ketac Silver. Slice prepared proximal surfaces were restored with one surface restorations. A total number of 119 restorations were available for evaluation. Fiftysix percent of the restorations included two or more tooth-surfaces. The restorations were evaluated 1 yr, 2 yrs and 3 yrs after placement using the USPHS criteria. The percentage of successful and acceptable restorations was 66% after 1 yr, 56% after 2 yrs and 46% after 3 yrs. Three year after placement 27% of the restorations showed severe abrasion into the dentin or were lost, 10% showed poor margin adaption or were fractured. Slightly more than 8% showed deep margin discoloration and the same amount showed secondary caries lesions. There was a general trend toward poor results as both the size of the restoration and the number of surfaces per tooth restored increased. The results indicate that Ketac-Silver is not useful for restorations in primary molars especially not for large restorations in caries active children.