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26 January 2021

Clinical evaluation of class II restorations vs semi-direct restorations: a randomized clinical trial

Co-authors: A. Comba, F. Del Bianco

Lorenzo Breschi

Direct composite restorations are considered an excellent solution for posterior teeth rehabilitation. However, in some cases, despite the evolution of adhesive systems and composite materials, a correct rehabilitation of the proximal wall, especially when the cavity design presents an important bucco-lingual width, could be considered a challenge. 

In literature there is no consensus on which protocol is more suitable in these cases: direct, indirect or semi-direct approach. For that reason, Dr Rocha Gomes Torres et al. from Brasil, decided to compare the clinical performance of posterior class II restorations  performed with direct and semidirect techniques over a period of 24 month.

The authors conducted a splith-mouth study on thirty patients who received two class II restorations (n = 60) using a nanohybrid composite with two different restorative techniques direct (DT), and semidirect (SDT).
The researchers applied the same adhesive system for all restorations. For DT, the restorative material was applied directly inside the tooth preparation. For SDT, an impression of the tooth preparation design was obtained using alginate and a silicone flexible die was prepared. The restoration was made chairside on the model and additionally light cured. After that, it was cemented in preparation using a resinous cement. All restorations were evaluated by the authors using the FDI criteria after 7 days, 6, 12, and 24 months postoperatively.

After 24 months, 24 patients attended the recall and the Brazilian researchers evaluated 48 restorations using FDI criteria. The group of prof Rocha Gomes Torres analyzed all collected data and performed Fisher’s statistical analysis (5%) that showed no difference between the techniques. 

After a 24-month follow-up, the authors obtained no differences between the tested techniques and the restorations performed with both techniques produced clinically acceptable restorations.
Rocha Gomes Torres et al. demonstrated the viability of applying two different operatory techniques (direct and semidirect) for class II restorations.

For more informations: A randomized clinical trial of class II composite restorations using direct and semidirect techniques. 

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