Three-year Clinical Evaluation of Cuspal Coverage with Combined Composite–Amalgam in Endodontically-treated Maxillary Premolars

Abstract

This clinical study evaluated the clinical performance of cuspal coverage with combined composite-amalgam restorations in endodonticallytreated maxillary premolars over a three-year period. Thirty-six maxillary premolars, each with a Class II cavity in 36 patients ranging in age between 28 and 52 years, were selected after endodontic treatment. After reduction of the buccal and palatal cusps, internal coverage and veneering of the reduced buccal cusp was performed with composite. The remaining cavity and reduced palatal cusp were restored with high-copper amalgam. The restorations were evaluated at baseline and in one-, two-and threeyear recalls with USPHS criteria.Changes in characteristics of the restorations were analyzed with the Cochran Q-test at a significance level of p<0.05. Most of the restorations received an overall score of alpha, except two restorations, which showed a slight discrepancy at the composite-amalgam interface after one year (p>0.05). Four restorations exhibited slight discoloration of the composite veneering after three years (p<0.05). No restoration exhibited fracture after three years. It was concluded that combined composite-amalgam cusp coverage of endodontically-treated maxillary premolars Clinical RelevanceThe results of a three-year follow-up of a small sample of patients suggest that combined composite-amalgam restoration for cuspal coverage is useful as a conservative, one-appointment complementary procedure for endodontically-treated maxillary premolars. Clinical Researchshowed acceptable clinical performance after three years.

Prognosis of Indirect Composite Resin Cuspal Coverage on Endodontically Treated Premolars and Molars: An In Vivo Prospective Study

“…The present study showed 20% margin discolorations. This data is consistent with the literature . This may be explained by natural pigmentation of the composite over time.…”

“…The best scientific evidence shows that prognosis of an endodontically treated tooth not only depends on endodontic variables, but also on correct tooth rehabilitation . To the best of the authors’ knowledge, there are only two in vivo studies on a critical issue such as the one explored in this investigation. The difficulty in performing a proper follow‐up and standardizing the study are cited as possible reasons for the lack of literature on this topic.…”

Fracture Resistance of Cuspal Coverage of Endodontically Treated Maxillary Premolars with Combined Composite-Amalgam Compared to Other Techniques

“…29 A retrospective clinical assessment of 12 combined restorations in extended class II cavities of vital maxillary posterior teeth reported that the composite-amalgam interface in all restorations seemed to be clinically acceptable, even in a sixyear-old restoration.…”

“…The remaining cavity and the reduced palatal cusp are restored with amalgam. 29 However, fracture resistance with this technique and with amalgam applied beneath the direct composite coverage is unclear. One study reported that applying amalgam under the composite to restore nonvital maxillary premolars with an MOD cavity without coverage increased resistance to fracture in the treated tooth up to 51% compared to teeth restored with amalgam alone.…”

THE GEAR OF RETENTION –PIN RETAINED AMALGAM Two Case Reports

“…Conversely, recent studies have concluded that the combined amalgam-composite cusp coverage restoration showed acceptable clinical performance over a period of time [12,13]. Yet, amalgam continues to be the best bargain in the restorative armamentarium because of its durability and technique insensitivity.…”