Clinical Evaluation of Indirect, Posterior, Inlay-retained Fiber-reinforced-composite Restorations: 4.5-year Follow-up

Objectives: This study evaluated the clinical performance of indirect, posterior, inlay-retained fiber-reinforced-composite restorations (IIFRCR) up to 4.5 years. Methods: Between June-2003 and January-2008, 43 patients (24 females, 19 males, 18-63 years old) received a total number of 55 IIFRCRs at the Dental School, Ege University, Izmir, Turkey. All restorations were made indirectly using unidirectional E-glass fibers (everStick C&B, StichTech) in combination with a laboratory resin composite (Dialog, Schütz Dental) and cemented according to the instructions of 4 adhesive cements (RelyX ARC, 3M-ESPE, n=20), Bifix DC, VOCO, n=12), Variolink 2 (Ivoclar-Vivadent, n=14) and Multilink (Ivoclar-Vivadent, n=9). After baseline recordings, patients were followed at 6 months and annual recalls. Patients were instructed to call upon experience of a failure. The evaluation protocol involved technical failures like chipping or fracture (tooth/restoration). Results: One catastrophic failure (cement:RelyX ARC), one partial debonding (cement:Multilink) and two delaminations of veneering composite (cement:Bifix DC) were observed at 6-months' recall. Except one replacement, all defective restorations were repaired or recemented and remained functional. Life-tables calculated from the data and Kaplan-Meier curves revealed an overall survival rate of 92.8%. Conclusions: Indirect, inlay-retained, fiber-reinforced-composite restorations offer acceptable clinical survival rate regardless of the veneering composite or the adhesive cement used.