Clinical performance of full rehabilitations with direct composite in severe tooth wear patients: 3.5 years results

Journal of Dentistry Available online 12 January 2018 In Press, Accepted Manuscript — Note to users Abstract Objectives To evaluate the mid-term clinical performance of direct composite restorations placed in patients with pathological tooth wear needing full rehabilitation with an increase of vertical dimension of occlusion. Methods In a prospective trial 34 patients (34.0 ± 8.4 years; 25 males, 9 females) were treated with a minimal invasive additive technique using composite restorations. The restorative treatment protocol was to provide all teeth with composite build-up restorations in an increased vertical dimension of occlusion (VDO) using the DSO-technique. Recall appointments were planned after 1 month, 1 and 3 years after treatment. Restorations were scored for clinically acceptability (FDI-criteria) and scores 4 and 5 were recorded as clinically unacceptable. Frequencies of failures and Kaplan Meier survival curves are presented and effect of relevant variables was calculated with a multifactorial Cox regression (p<0 .05="" p=""> Results 1256 restorations were placed, 687 anterior, 324 premolar, and 245 molar restorations. After a mean observation time of 39.7 months a total of 69 failures were observed, of which 61 restorations were repaired (score 4) and 8 were replaced (score 5). Most common reasons for failure were (chip) fractures (n=43) and caries (n=11). Placement of anterior restorations in two sessions led to significant 4.6 times more failures then placed in one session. Conclusions In patients with severe tooth wear direct composite resin restorations show annual failure rates of 94.8% for success and 99.3% for survival after full rehabilitations in an increased vertical dimension of occlusion after a period of 3.5 years.