A clinical trial comparing the efficacy of a glass polyalkenoate cement (GPC) restoration with an amalgam cement restoration (ACR) in the management of caries in the deciduous molar dentition was undertaken. Two hundred and thirty-eight restorations, that is 119 pairs, were placed in 76 patients with an age range of 5 to 11 years. The durability of these restorations was assessed during a 5-year follow-up period, using modified United States Public Health Service criteria. The glass polyalkenoate cement restorations occupied 16% of the occlusal surface of the tooth compared to 28% for the amalgam restorations, had a lower median survival time (33.4 [SE 2.26] months compared to 41.4 [SE 2.24] months) and underwent greater loss of anatomical form and marginal integrity than the paired amalgam controls.

Sixteen patients completed the study. Patient satisfaction improved significantly between baseline and the new prosthesis with each attachment type for all domains of satisfaction (P<0.05). Ball attachments provided greater satisfaction in the domains of general satisfaction, stability and ability to chew (P<0.05). Patients' general satisfaction with ball attachment retained overdentures was greater than that for magnetic attachments; however, both designs provide significantly greater satisfaction than conventional dentures. In this study, the majority preferred to retain the ball attachment although one-third of patients actively chose the magnetic attachment.

A clinical trial of direct composite inlays versus conventionally (incrementally) placed restorations made from the same material was started in January 1989. Restorations were randomly allocated to matched pairs of cavities. This study reports the 3-year performance of 71 of the 100 pairs of restorations placed over a 2-year period and followed-up every 6 months. Clinical assessments were made using USPHS criteria (indirect measurements of occlusal wear were made using Ivoclar standard dies) and annual bite wing radiographs. Direct inlays showed significantly less occlusal wear than conventional restorations, but the difference was small. The clinical performance of both types of restoration was similar and compared favourably with studies of other materials. No secondary decay was diagnosed. The direct inlays, however, took longer to place and did not reduce postoperative sensitivity or failure rate (8% failure of inlays and 4% of conventional composites over 3 years). Contouring of proximal and occlusal aspects was not facilitated with direct inlays but may be easier with indirect inlays on removable dies.

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