Tunnel restorations placed in routine practice and observed for 24 to 54 months

Objective: The purpose of this study was to evaluate the feasibility and pe rformance of tunnel restorations placed in routine public dental service. M ethod and materials: A total of 420 small approximal lesions received tunne l restorations 12 general practitioners. Three hundred two restorations in 179 patients were available for evaluation after a minimum period of 24 mon ths. The restorations were evaluated by modified US Public Health Service c riteria. Results: After service periods up to 54 months, 57% of the restora tions were found to be clinically and radiographically acceptable. The rema inder had already been replaced or were assessed as unacceptable. High leve ls of carious activity and internal-type preparations resulted in the poore st prognosis. The success rates Varied considerably among the operators, bu t these differences did not reach statistical significance. Conclusion: The indications for use of the tunnel restoration technique for the treatment of primary approximal lesions seem to be limited at present. Partial tunnel restorations may have a somewhat better prognosis than the internal tunnel s, but high carious activity has a detrimental effect. Tunnel restorations may be considered for particularly cooperative patients with a low caries r ate as a semipermanent treatment for small lesions.