Two-year clinical comparison of direct and indirect composite restorations in severely damaged molars: A split-mouth randomized clinical study.

Belleflamme, Marcia; Seidel, Laurence; Albert, Adelin; Bolette, Amandine; Gueders, Audrey

doi:10.1016/j.jdent.2026.106785

Article (Scientific journals)

Two-year clinical comparison of direct and indirect composite restorations in severely damaged molars: A split-mouth randomized clinical study.

Belleflamme, Marcia; Seidel, Laurence; Albert, Adelin et al.

2026 • In Journal of Dentistry, 172, p. 106785

Peer Reviewed verified by ORBi

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https://hdl.handle.net/2268/348910

DOI
10.1016/j.jdent.2026.106785

PubMed
42173471

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Keywords :

CAD-CAM; Damaged molar; Minimally invasive dentistry; Short fiber-reinforced composite; Split-mouth randomized clinical study; Undermined cusps; Composite Resins; Dental Materials; Humans; Female; Male; Patient Satisfaction; Computer-Aided Design; Follow-Up Studies; Adult; Dental Restoration Failure; Dental Veneers; Middle Aged; Treatment Outcome; Dental Bonding; Survival Analysis; Young Adult; Composite Resins/chemistry; Molar/pathology; Molar/injuries; Dental Restoration, Permanent/methods; Dental Materials/chemistry; Dental Restoration, Permanent; Molar; Dentistry (all)

Abstract :

[en] [en] OBJECTIVES: This randomized, split-mouth clinical study compared the clinical performance of direct restorations using a short fiber-reinforced composite veneered with a microhybrid composite and indirect CAD-CAM restorations fabricated from a hybrid CAD-CAM block in severely damaged molars. METHODS: One hundred restorations in 42 patients-50 direct short fiber-reinforced composite restorations veneered with a microhybrid composite and 50 indirect CAD-CAM nanoceramic composite restorations-were randomly assigned to severely damaged molars in a split-mouth design; all restorations involved reconstruction of at least one cusp. All restorations were performed by a single qualified operator, and two independent calibrated examiners evaluated the restorations at baseline, 6 months, 1 year and 2 years using modified USPHS criteria. Patient satisfaction was also assessed at each evaluation. RESULTS: After two years of follow-up, all restorations remained functional, resulting in a 100% survival rate. One indirect restoration experienced debonding one week after placement, which was successfully re-bonded and showed no further complications during follow-up. Both restorative approaches demonstrated excellent clinical performance across all USPHS criteria, with no significant differences between direct and indirect composite restorations. CONCLUSIONS: Direct and indirect restorations showed high survival and success rates after 2 years. Patient satisfaction was high, with no significant difference between the two restorative approaches. CLINICAL SIGNIFICANCE: At the 2-year follow-up, direct restorations based on short fiber-reinforced composite showed clinical results comparable to those of indirect CAD-CAM composite restorations in severely damaged molars.

Disciplines :

Dentistry & oral medicine

Author, co-author :

Belleflamme, Marcia ; Université de Liège - ULiège > Département des sciences dentaires > Biomatériaux dentaires

Seidel, Laurence ; CHU of Liège and University of Liège > Biostatistics and Research Methods Center (B-STAT)

Albert, Adelin ; Université de Liège - ULiège > Département des sciences de la santé publique

Bolette, Amandine ; Université de Liège - ULiège > Département des sciences dentaires > Biomatériaux dentaires

Gueders, Audrey ; Université de Liège - ULiège > Dental biomaterials research unit (d-BRU)

Language :

English

Title :

Two-year clinical comparison of direct and indirect composite restorations in severely damaged molars: A split-mouth randomized clinical study.

Publication date :

September 2026

Journal title :

Journal of Dentistry

ISSN :

0300-5712

eISSN :

1879-176X

Publisher :

Elsevier Ltd, England

Volume :

172

Pages :

106785

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

https://api.elsevier.com/content/article/PII:S0300571226004550?httpAccept=text/xml

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