Evaluation of the clinical success of direct restorations of endodontically treated posterior teeth in the presence of parafunction: a 12-month pilot study

评估根管治疗后牙存在副功能时直接修复的临床成功率:一项为期12个月的试点研究

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Abstract

OBJECTIVES: The objective of this prospective, randomized, parallel-group clinical study was to compare the 6- and 12-month clinical performances of direct composite restorations with or without fiber-reinforced composite applied to endodontically treated posterior teeth (ETpT) in bruxists. MATERIALS AND METHODS: Thirty-two ETpT were randomly restored with only posterior composite (gneal posterior, GC; CR group) or fiber-reinforced composite (EverX flow, GC) + posterior composite (FRCR group) in bruxists aged 18-65 years (n = 16). The inclusion criteria were as follows: bruxists with ETpT; class 1/2 cavities; the remaining functional wall at least 3 mm thick; teeth with a natural tooth in the opposite arch; and adjacent teeth on both approximal sides. The presence of periapical symptoms, posterior teeth with tubercule loss, and teeth with root canal fillings at least 2 mm short of the radiographic apex were excluded. RESULTS: All restorations were evaluated at 6 and 12 months on the basis of the World Dental Federation (FDI) criteria. No failure was reported, and clinical success was recorded for all aesthetic, functional, and biological criteria at 6 and 12 months of follow-up in both groups. CONCLUSIONS: Small/medium-sized direct composite restorations with or without fiber-reinforced composites demonstrated excellent and similar clinical performances at 12 months in bruxists. CLINICAL RELEVANCE: Since parafunctional forces can be significantly higher than normal chewing forces, the study focused exclusively on patients with bruxism. The 12-month clinically successful outcomes of direct composite restorations both with and without SFRC in this study will guide future long-terms studies in evaluating restorations of ETpT in bruxists. DATE OF REGISTRATION: 2025-03-11 (retrospectively registered). CLINICAL TRIAL REGISTRATION: This prospective, randomized, parallel-group clinical study was registered in a publicly accessible database with clinicalTriald.gov.ID No. NCT06870188.

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