Retrospektive Studie zur klinischen Überlebenszeit von Kompositfüllungen der Klasse I und II hinsichtlich der Verwendung von keramischen Inserts

Aim of the Study: The purpose of this study was the evaluation of the long-term survival of three different Insert-systems (SDS, Cerafil and Sonicsys) in comparison to composite fillings placed in increment technique. For this purpose the patient data was examined in retrospect and statistically evaluated. Methods: All insert restorations placed between 1998 and 2003 within the Department of Operative Dentistry at the Philipps University of Marburg were prospectively recorded in a database. The corresponding patient files were revised between 2005 and 2007. The information gathered as described was used to evaluate the survival of the restorations using the method by Kaplan and Meier [Kaplan & Meier 1958]. Results The estimated survival rate (Kaplan and Meier) for insert restorations was 32,5% after a mean observation period of 91,72 months. No significant difference (log-rank-test p= 0,792) was shown in comparison to the control group of composite restorations placed in increments (43,5% after a mean observation period of 98,57 months). Concerning the influence of different factors on the clinical long time survival of the fillings examined the investigation showed the following results: The comparison of all fillings placed in sensitive teeth to fillings placed in non-sensitive teeth revealed a statistically significant difference (log-rank-test p = 0,01) for all composite fillings investigated. Furthermore a highly significant difference was shown in this respect for the insert restorations investigated (log-rank-test p= 0,001). Concerning the patient’s age the comparison of group 1 (> 30 years) with group 3 (7 60 years) showed a significant difference (p= 0,018). Regarding the ‚number of surfaces’ fillings placed in increments showed a significant difference between fillings with one and three surfaces (log-rank-test p= 0,028). However, comparing the survival rates of both groups with the matching counterpart of insert restorations no volume-dependent differences were shown concerning the clinical survival of composite fillings with or without ceramic inserts (log-rank-test 1-1 p= 0,604, 3-3 p= 0,495). No significant difference was found between the insert restorations placed by students and those placed by qualified dentists (p= 0,708). Significance/Conclusion The longevity of insert restorations compared to direct composite fillings placed in increments showed no explicit improvement. The results of this study suggest that both investigated filling materials can be used for the restoration of class I and II cavities in the posterior dental region. However, the restoration of non-vital teeth is to be excluded from this recommendation.