Clinical Performance of Class I,II and V Composite Restorations

For more than 20 years Ivoclar Vivadent routinely tested newly developed composites and adhesives in clinical trials. This has resulted in an extensive data collection, including results from pioneering materials such as Heliomolar to the state-of-the-art composite Tetric EvoCeram.

Objectives: to estimate the failure rate of Class I&II and Class V composite restorations by a meta-analysis of a large number of clinical trials with composites from Ivoclar Vivadent.

Methods: Data of class I&II trials with an observation time of 2 and more years (37 trials) and of class V trials with an observation time 18 months or more (9 trials) were included in the analysis. For each trial, the annual failure rate in % was estimated with the following formula: annual failure rate = (cumulative failures at final recall)/(previous failures + restorations evaluated at final recall)/(years of duration)*100.

Results: Clinical trials with class I&II restorations showed an average annual failure rate of 1.8±1.5%; the min-max range was 0–5.8%. The 25% quartile was 0.9%, the median 1.7% and the 75% quartile 2.6%. Class V trials showed an average annual failure rate of 4.2±3.5% with a min-max range of 0–10.7%. The 25% quartile was 1.9%, the median 2.7% and the 75% quartile 6.9%. Hence, a two-fold higher failure rate of class V composite restorations was observed in comparison to class I&II restorations.

Conclusions: Compared to class I&II restorations cervical restorations showed a higher failure rate due loss of adhesion in cavities lacking mechanical retention. Nevertheless, the resin-composites employed in these trials exhibit very well accepted clinical performance in both cervical and posterior restorations.