Direct composite inlays versus conventional composite restorations: 5-yearfollow-up

Objectives: To determine at 5 year follow-up the failure rate, wear rates a nd other aspects of clinical performance of direct composite inlays compare d with conventional composite restorations placed incrementally. Methods: 100 matched pairs of restorations were originally entered into the trial. Each pair consisted of a direct composite inlay and a conventional composite restoration made from the same material. At 5 years it was possib le to recall 65 pairs, of which 54 were complete. Clinical assessments were made using USPHS criteria (indirect measurements of occlusal wear were mad e using Ivoclar standard dies) and annual bite wing radiographs. Results: There was a trend to more failure of inlays than conventional comp osites (17.4 c.f. 7.5%) but this was not significant. The clinical performa nce of both types of restoration was similar and compared favourably with t he results of studies of other materials. Secondary decay was diagnosed in only one restoration. Between 3 and 5 years there was some deterioration in cave-marginal discoloration, marginal adaptation (occlusally) and surface roughness (occlusally). There was no apparent deterioration in colour match , proximal contact, shim stock contacts and Gingival Index. Wear rates of b oth types of restoration showed no significant difference and were essentia lly linear with a mean of 33-34 mu m per year. Conclusions: Both inlays and conventional composite restorations complied w ith ADA specification minimum requirements for posterior composite restorat ions. In this study the direct inlay technique gave no clinical advantage o ver conventional, incremental placement. (C) 2000 Elsevier Science Ltd. All rights reserved.