Table of Contents:
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
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].
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).
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.