CLINICAL EVALUATION OF DIRECT RESTORATIONS OF CARIOUS DEFECTS IN HARD TISSUES OF VITAL POSTERIOR TEETH AFTER 6 AND 12 MONTHS ACCORDING TO USPHS CRITERIA
DOI:
https://doi.org/10.35220/2523-420X/2025.4.10Keywords:
caries, hard tissue defects, posterior teeth, direct restoration, composite, adhesive, USPHS criteriaAbstract
To evaluate the condition of direct restorations of carious defects in the hard tissues of vital posterior teeth according to the USPHS criteria before treatment (in the presence of old restorations), immediately after, and at 6 and 12 months, in order to determine their functional stability, aesthetic preservation, and marginal integrity. Research methods. Thirty patients with restorations of 59 vital posterior teeth affected by primary caries or previously restored with old fillings were examined. The restorations were performed using the direct method with the light-curing composite “Asteria” in combination with the adhesive system “OptiBond FL”. Clinical evaluation was carried out using the USPHS criteria for the following parameters: anatomic form, marginal adaptation, marginal discoloration, surface roughness, color match, postoperative sensitivity, and the presence of secondary caries. Each parameter was scored using the Alfa (A), Bravo (B), Charlie (C), and Delta (D) codes at baseline, immediately after treatment, and at 6- and 12-month follow-ups. Results of the study. Immediately after treatment, all USPHS criteria corresponded to the highest rating (code A), indicating high-quality restoration of the functional and aesthetic integrity of the teeth. After 6 months, no significant changes were observed. At 12 months, a slight decrease in the number of restorations rated A and the appearance of several B ratings were noted for anatomic form, marginal adaptation, surface roughness, and color match. Early signs of secondary caries were detected in two patients, requiring retreatment. Overall, the findings confirm the effectiveness of the clinical protocol and the materials used for direct restorations. Conclusions. The obtained results demonstrate high clinical efficacy and functional stability of direct composite restorations in vital posterior teeth over a six-month period, achieved through the selected treatment protocol. After one year, follow-up examinations are recommended to identify potential changes and ensure timely correction. Continued monitoring of restorations is advised
References
Brouwer F., van der Zel J., van der Meer W., et al. The influence of resin composite type on long-term clinical outcomes in posterior teeth. Operative Dentistry. 2019. Vol. 44, No. 5. P. E206–E216. DOI: https://doi.org/10.2341/18-144-C
Murchie B., Jiwan N., Edwards D. What are the success rates of anterior restorations used in localised wear cases? Evidence-Based Dentistry. 2025. URL: https://www.nature.com/articles/s41432-025-01112-z
Kodaman Dokumacıgil N., Şen Yavuz B., Kaya R. Three Years Clinical Success of Glass Hybrid and Short Fiber Reinforced Composite on Molar Incisor Hypomineralization. Marmara University Institutional Repository. 2025. URL: https://avesis.marmara.edu.tr/yayin/246c4252-4cbf-41cc-b409-80a89a825bb7/
van Dijken J.W.V., Pallesen U. Long-term clinical performance of posterior resin composite restorations. Clinical Oral Investigations. 2017. Vol. 21, No. 3. P. 1001–1010. DOI: https://doi. org/10.1007/s00784-016-1850-y
Brunthaler A., König F., Lucas T., et al. Longevity of direct composite restorations in posterior teeth. Clinical Oral Investigations. 2003. Vol. 7, No. 2. P. 63–70. DOI:https://doi.org/10.1007/s00784-003-0206-7
Demarco F.F., Collares K., Coelho-de-Souza F.H., et al. Longevity of posterior composite restorations: Not only a matter of materials. Dental Materials. 2015. Vol. 31, No. 1. P. 87–101. DOI: https://doi. org/10.1016/j.dental.2014.08.003
Opdam N.J.M., van de Sande F.H., Bronkhorst E.M., et al. Longevity of composite restorations: A systematic review and meta-analysis. Journal of Dental Research. 2014. Vol. 93, No. 10. P. 943–949. DOI: https://doi. org/10.1177/0022034514544217
Heintze S.D. Systematic review of the clinical performance of direct composite restorations in posterior
teeth. Journal of Adhesive Dentistry. 2013. Vol. 15, No. 5. P. 407–431. DOI: https://doi.org/10.3290/j.jad. a30209
Lalwani P., Jangade M.K. Clinical Evaluation of Marginal Integrity and Discoloration in Direct Composite Restorations: A One-Year Follow-Up Study. European Journal of Clinical Dentistry. 2025. URL: https://healthcare-bulletin.co.uk/article/clinical-evaluation-ofmarginal ntegrity-and-discoloration-in-direct-compositerestorations-a-one-year-follow-up-study-4233/
Miglani R., Aggarwal V. Comparison of performance of posterior composites using FDI and USPHS criteria – a review. Contemporary Clinical Dentistry. 2016. Vol. 7, No. 4. P. 427–431. DOI: https://doi.org/10.4103/0976-237X.194104
