Direct Resin Composite Restorations in Vital Versus Root-filled Posterior Teeth: A Controlled Comparative Long-term Follow-up

Abstract

This study compared direct composite restorations on vital versus endodontically-treated posterior teeth, six to eight years after placement. All clinical procedures were performed using standardized materials and protocols. The patients were identified with the aid of a computerized billing system followed by a chart search. With each patient, the prime investigator matched a randomly chosen endodontically-treated tooth (test tooth) with a vital counterpart (control tooth) with a direct composite restoration. Of the 84 patients who fulfilled the inclusion criteria, 44 were available for recall. Two calibrated observers, blinded to the tooth vitality status, evaluated the fillings by applying the modified USPHS criteria. The outcome was dichotomized to revision indicated/recommended vs revision not indicated. Odds Ratios (OR) and corresponding 95% Confidence Intervals (95% CI) were calculated. Residual confounding was corrected using a multivariable regression analysis with the remaining known confounders filling size, tooth type and age of the fillings in months as independent variables. The crude association between the presence/absence of root canal treatment and the need for revision (OR, 95% CI) was 2.12 (1.02-4.38; p = 0.04). Correcting for all potential confounders in the multivariable analysis changed this association marginally to an OR of 1.98 (0.90-4.38; p = 0.09).