1. LITERATURE Review COMPOSITE RESTORATIONS - Long term controlled clinical studies Study study design obervation period results (YFR) Mair, 1998 longitudinal 10Y 0.7% Mertz-Fairhurst et al, 1991 longitudinal 10Y 2.0% Raskin et al, 1999 longitudinal 10Y 4-5% Wilder et al, 1999 longitudinal 17Y 1.4% Gaengler et al, 2001 longitudinal 10Y 2.5% Palessen & Qvist, 2003 longitudinal 11Y 0.7% da Rosa Rodolpho et al, 2006 longitudinal 17Y 2.04% Study study design obervation period results (YFR) Mair, 1998 longitudinal 10Y 0.7% Mertz-Fairhurst et al, 1991 longitudinal 10Y 2.0% Raskin et al, 1999 longitudinal 10Y 4-5% Wilder et al, 1999 longitudinal 17Y 1.4% Gaengler et al, 2001 longitudinal 10Y 2.5% Palessen & Qvist, 2003 longitudinal 11Y 0.7% da Rosa Rodolpho et al, 2006 longitudinal 17Y 2.04%

2. LITERATURE Review Class II Sandwich GIC/ Resin Composite - In vivo STUDIES Study n. of restorations observ. period results Gaengler et al, 2001 194 GIC/RC Class II10 Years 74.2% survival USPHS failures = fractures++ da Rosa Rodolpho et al, 2006 282 GIC/RC Class II 17 Years 65.2% survival USPHS failures = fractures ++ Study n. of restorations observ. period results Gaengler et al, 2001 194 GIC/RC Class II10 Years 74.2% survival USPHS failures = fractures++ da Rosa Rodolpho et al, 2006 282 GIC/RC Class II 17 Years 65.2% survival USPHS failures = fractures ++

3. LITERATURE Review Class II Sandwich with rmGIC - In vitro STUDIES Study exp. protocol level of evidence results Kosmas Tolidis et al, 1998 volum. shrinkage rmGIC liner reduces shrinkage Wibowo & Stockton, 2001 microleakage rmGIC liner < FRC liner Dietrich et al, 1999 marg. adaptation (SEM) rmGIC > GIC or full Cp (3M, ESPE,Vivadent,GC, Dentpsly) Dietrich et al, 2000 marg. Adaptation (SEM) rmGIC > Full CP ( Z100/Vitremer) Study exp. protocol level of evidence results Kosmas Tolidis et al, 1998 volum. shrinkage rmGIC liner reduces shrinkage Wibowo & Stockton, 2001 microleakage rmGIC liner < FRC liner Dietrich et al, 1999 marg. adaptation (SEM) rmGIC > GIC or full Cp (3M, ESPE,Vivadent,GC, Dentpsly) Dietrich et al, 2000 marg. Adaptation (SEM) rmGIC > Full CP ( Z100/Vitremer)

4. LITERATURE Review Class II Sandwich with rmGIC - In vitro STUDIES Study exp. protocol level of evidence results Dietschi et al, 2002 marg. adaptation (SEM) Compomer > Full Cp (Dyract)Closed sandwich Config. !!! Study exp. protocol level of evidence results Dietschi et al, 2002 marg. adaptation (SEM) Compomer > Full Cp (Dyract)Closed sandwich Config. !!!

5. LITERATURE Review Sandwich with rmGIC - In vivo STUDIES Study n. of restorations observ. period results Lindberg et al, 2000 n= 2o class II (pm)1 Monthbetter adapt. in E &D SEM marg. adapt.for PMRC / RC Andersson-Wenckert et al, 2002 n= 40 class II (pm) 1 Month better adapt. in E&D SEM marg. adapt.rmGIC / RC Opdam et al, 2007 n= 458 class II9 Yearshigher failure rate USPHSwith rmGIC Study n. of restorations observ. period results Lindberg et al, 2000 n= 2o class II (pm)1 Monthbetter adapt. in E &D SEM marg. adapt.for PMRC / RC Andersson-Wenckert et al, 2002 n= 40 class II (pm) 1 Month better adapt. in E&D SEM marg. adapt.rmGIC / RC Opdam et al, 2007 n= 458 class II9 Yearshigher failure rate USPHSwith rmGIC

6. LITERATURE Review Sandwich Class II Vitremer/Z100 - In vivo STUDIES Study n. of restorations observ. period results Van Dijken et al, 1999 274 open sandwich 3 Years 2.5% tooth fractures class II & 6 exp. cond.4% dissolution rmGIC Andersson-Wenckert et al, 2004 220 open sandwich 6-7 Years 19%/34% failures class II & 6 exp. cond. dissolution rmGIC ++ failure = tooth & rest. fractures <1% AFR @ 3Y 3.16% AFR @ 6Y 4.85% AFR @7Y Study n. of restorations observ. period results Van Dijken et al, 1999 274 open sandwich 3 Years 2.5% tooth fractures class II & 6 exp. cond.4% dissolution rmGIC Andersson-Wenckert et al, 2004 220 open sandwich 6-7 Years 19%/34% failures class II & 6 exp. cond. dissolution rmGIC ++ failure = tooth & rest. fractures <1% AFR @ 3Y 3.16% AFR @ 6Y 4.85% AFR @7Y

7. LITERATURE Review Class II Sandwich with FRC - In vitro STUDIES Study exp. protocol level of evidence results Chuang et al, 2004 marg. adaptation (SEM) thin FRC > Dewaele et al, 2006 marg. adaptation (LM) gaps if: (12 exp. rubbery liners) flow, flexibility, shrinkage Study exp. protocol level of evidence results Chuang et al, 2004 marg. adaptation (SEM) thin FRC > Dewaele et al, 2006 marg. adaptation (LM) gaps if: (12 exp. rubbery liners) flow, flexibility, shrinkage

8. LITERATURE Review Class II Sandwich with FRC - In vivo STUDIES Study Comparisonobserv. period results Ernst et al, 2003 Class II with / without flow 2Yno difference Lindberg et al, 2005 Class II with / without flow § 1mno difference Efes et al, 2006 Class II with / without flow 2Y no difference Study Comparisonobserv. period results Ernst et al, 2003 Class II with / without flow 2Yno difference Lindberg et al, 2005 Class II with / without flow § 1mno difference Efes et al, 2006 Class II with / without flow 2Y no difference

9. CHOICE between Direct & Indirect Restorations: Literature Review Direct vs Indirect Restorations in Medium Size Cavities

10. LITERATURE Review Inlay vs Direct composite Restoration - Medium Size Cavities Study results van Dijken JW, 2000 The difference in failure rate between the resin composite direct technique and the inlay technique was not large, indicating that the more time-consuming and expensive inlay technique may not be justified Wassell RW, Walls AW, McCabe JF, 2000 In this study the direct inlay technique gave no clinical advantage over conventional direct restorations Pallesen U, Qvist V, 2003 No significant difference between composite fillings and composite inlays Study results van Dijken JW, 2000 The difference in failure rate between the resin composite direct technique and the inlay technique was not large, indicating that the more time-consuming and expensive inlay technique may not be justified Wassell RW, Walls AW, McCabe JF, 2000 In this study the direct inlay technique gave no clinical advantage over conventional direct restorations Pallesen U, Qvist V, 2003 No significant difference between composite fillings and composite inlays

11. LITERATURE Review Inlay vs Direct composite Restoration - Medium Size Cavities Study results Spreafico RC, Dietschi D, Krejci I, 2005The clinical performance and the marginal adaptation did not show significative differences Study results Spreafico RC, Dietschi D, Krejci I, 2005The clinical performance and the marginal adaptation did not show significative differences

12. CHOICE between Direct & Indirect Restorations: Literature Review Direct vs Indirect Restorations in Large Cavities

13. LITERATURE Review Inlay vs Direct composite Restoration - Large Size Cavities Study results Klaiber and Haller, 1989 Luted restorations permit a better marginal adaptation and seal when compared to the direct composite resin restorations Milleding, 1992 Agosto,1993 Lida et al, 2003 To prevent marginal microfracture, an adhesive inlay restoration is preferable for a large class II cavity van Dijken JW. 2000 The direct inlay / onlay technique is recommended to be used in class II cavities of high caries risk patients with cervical margins placed in dentin Study results Klaiber and Haller, 1989 Luted restorations permit a better marginal adaptation and seal when compared to the direct composite resin restorations Milleding, 1992 Agosto,1993 Lida et al, 2003 To prevent marginal microfracture, an adhesive inlay restoration is preferable for a large class II cavity van Dijken JW. 2000 The direct inlay / onlay technique is recommended to be used in class II cavities of high caries risk patients with cervical margins placed in dentin

14. Clinical trials : Direct Resin Composites Material Observation period no of restoration survival rate annual f. rate study BRILLANT 1 y 24 100% 0% Fülleman et al. 1992 BRILLANT 2Y 30 80% 10% Haas et al. 1992 BRILLANT-ESTILUX 1Y 29 96.5% 3.4% Thordrup et al. 1994 BRILLANT 3 y 71 92% 2.7% Wassel et al. 1996 BRILLANT-APH 5Y 24 100%0% Wiedmer et al. 1997

15. Clinical trials : Direct Resin Composites Material Observation period no of restoration survival rate annual f. rate study BRILLANT 5Y 21 100% 0% Van Dijken et al.1996 BRILLANT 5 y 15 85% 3% Thordrup et al. 2001 VITADUR N 15 85% 3% CEREC C OS2.02 15 92.5% 1.5% OCCLUSIN 3 y 60 96.7% 1.1% Wendt et al. 1992

16. Clinical trials : Direct Resin Composites Material Observation period no of restoration survival rate annual f. rate study TETRIC - PERTAC 2 y 45 93% 3.5% Schleibenbogen et al. 1992 TETRIC - PERTAC 3Y 30 93% 2.3% Manhart et al. 2000 APH 1Y 29 96.5% 3.4% Krejci et al. 1994 TETRIC - Z100 4-6Y 50 94% 1.2% Leirskar et al. 2003

17. Clinical trials : Direct Resin Composites Material Observation period no of restoration survival rate annual f. rate study Annual Failure Rate range = 0-10% « Without extremes » range 1.1-3.5%

18. Material Observation period no of restoration survival rate annual f. rate study SR ISOSIT- CONCEPT 1y 34 88.2% 11.8% Bessing et al. 1991 SR ISOSIT -CONCEPT 7Y 36 75% 3.6% Donly et al. 1999 SR ISOSIT -CONCEPT 11Y 135 83% 1.6% Pallesen et al. 2003 VISIO-GEM 6y 118 41% 9.8% Krämer et al. 1996 Clinical trials : Laboratory Resin Composites

19. Material Observation period no of restoration survival rate annual f. rate study TARGIS 1.5Y 43 100% 0% Monaco et al. 2001 TARGIS 1Y 118 41% 9.8% Yilmaz et al. 2003 TARGIS 2Y (0.5-4Y) 40 100% 0% Kukrer et al. 2004 SIGNUM 3Y 113 97.4% 0.86% Barone et al. 2008 Clinical trials : Laboratory Resin Composites

20. Material Observation period no of restoration survival rate annual f. rate study SR ISOSIT 11Y 84 83% 1.54% Palessen et al, 2003 BRILLANT 28 84% 1.45% ESTILUX 28 TPH direct 3.5Y 2x22 100% 0% Spreafico et al, 2005 indirect 100% 0% Clinical trials : Laboratory Resin Composites

21. Material Observation period no of restoration survival rate annual f. rate study Clinical trials : Laboratory Resin Composites 9 studies YFR = 0% – 11.8% 0% - 3.6% (without extremes)

22. Material Observation period no of restoration survival rate annual f. rate study MIRAGE 2y 310 95.8% 2.1% Jensen et al. 1988 MIRAGE 3Y 50 96.6% 1.3% Hoglung et al. 1994 MIRAGE 4Y 50 100% 0% Friedl et al. 1997 MIRAGE 6Y 58 88% 2% van Dijken et al 1998 MICROBOND-FORTUNE 10y 183 97% 0.3% Fuzzi et al. 1998 Clinical trials : Feldspathic Porcelains

23. Clinical trials : Feldspatic Porcelains Material Duration n= survival YFR study MIRAGE 5Y 20 95.8% 1.6% Molin et al, 2000 CEREC 20 96.6% " EMPRESS 20 100% -- GOLD 20 100% -- COSMOTECH II 8Y 45 80% 2.5% Hayashi et al, 2000 Diff. FP brands 3Y 47 90% 3.6% Manhart et al, 2000 EMPRESS 24 100% --

24. Clinical trials : Feldspatic Porcelains Material Duration n= survival YFR study LFC DUCERAM 2.1Y 45 Gemalanaz et al, 2001 (3-46m) LC: rmGIC 77% 15.7 LC: composite 87% 6.2 9 studies YFR = 0% – 6.2%

25. Material Observation period no of restoration survival rate annual f. rate study EMPRESS 1y 130 97.5% 1.3% Studer et al. 1996 EMPRESS 4.5Y 125 95.6% 1% Fradeani et al. 1997 EMPRESS 6Y 138 94.9% 0.9% Lehner et al. 1998 EMPRESS 4y 96 93% 1.8% Krämer et al. 1999 EMPRESS 6Y 39 93% 1.2% Krämer et al. 2000 100% marginal ditching Clinical trials : Pressed Ceramics

26. Material Duration n= survival YFR study EMPRESS 4Y 21100% -- Barghi et al, 2002 EMPRESS 2Y 86100% -- Coehlo Santos et al, 2004 LFC DUCERAM 86100% EMPRESS 3Y 40 100% -- Fabianelli et al, 2006 EMPRESS 4Y 13093% 1.75% Naeselius et al. 2008 EMPRESS 12Y 9684% 1.33% Franckenberger et al. 2008 EMPRESS 6Y 6494% 1.05% Galiatsatos et al. 2008

27. J Can Dent Assoc 2002;68:233-237. Longevity and clinical performance of IPS-Empress ceramic restorationsa literature review. El-Mowafy O, Brochu JF. 6 studies YFR = 0.88% – 1.28% LITERATURE Review

28. J Adhesive Dent. 2001;3:45-64. Longevity of Restorations in Posterior Teeth and Reasons for Failures Hickel R, Manhart J. Aust Dent. 1999;44:157-168. The clinical performance of ceramic inlays: a review Bergman MA. Main failure pattern of porcelain inlays is bulk fracture Contraindicated in case of bruxism Require minimal dimensions Differential wear between ceramics & luting composite Wear of opposing structures