Extensive composite molar restorations: 3 years clinical evaluation.

Abstract Objective. To evaluate the clinical performance of extensive direct composite restorations in molars after 1 and 3 years and to find out the importance of extent of the restorations and other factors related to their performance. Materials and methods. Seventy-four patients with a molar tooth in need of a restoration covering at least three surfaces and one cusp were selected. Patient-related factors were registered and the tooth was prepared and restored by using a nano-filled composite. A topographic system for classification of extensive posterior restorations was developed. At baseline, the operator recorded a clinical evaluation, using modified USPHS-criteria. After 1 and 3 years, an independent observer evaluated the restorations. Post-operative problems arising during the observation period were registered. Results. A change in clinical score from baseline to the 1 and 3 year recall was recorded for all clinical criteria. A total of nine restorations were graded as unacceptable after 3 years (3-year survival rate of 87.7% and a mean annual failure rate of 4.2%). Except for gender (p = 0.022), none of the patient-related factors investigated (age, caries risk, extension of the restoration and presence of cervical enamel) had a significant influence on the survival of the restorations. Conclusions. Extensive direct posterior composite restorations showed an acceptable clinical performance after 3 years. Men had a significantly greater restoration failure rate than women.