108 Indirect CAD/CAM blocks versus direct composite restorations: randomized clinical trial

Abstract

Purpose The aim of this prospective study was to compare the clinical performance of large indirect versus direct composite restorations in posterior teeth. Methods Thirty patients received two class II restorations (n=60), one with nanohybrid precured composite block (Grandio blocs, Voco) for indirect technique (IT) and the other with nanohybrid light-cured composite (GrandioSO, Voco) for direct technique (DT), in a split-mouth design. The self-etching adhesive system (Futurabond U, Voco) was used for all restorations. For IT, after scanning tooth preparation, the restoration was designed and milled using the CAD/CAM system and cemented with a dual-curing cement (Bifix QM, Voco). For DT, the material was applied and light-cured using the layering technique. All restorations were evaluated using the FDI criteria after 7 days, 12 and 24 months postoperatively by two calibrated examiners. Results After 24 months, 23 patients attended the recall, and 46 restorations were evaluated. The Fisher’s exact test showed no significant differences between the techniques for most parameters analyzed (p>0.05). For “color match and translucency” at 7 days and 6 months, better results were observed for DT (p=0.013 and 0.033, respectively). In relation to the overall scores, all restorations were esthetically acceptable after 24m, while 93.3% of DT and 90% of IT showed acceptable function. For biological scores, 96.67% of direct and 100% of indirect were acceptable after 24 months. Considering all properties, the success rates were 93.3% for direct and 90% for indirect restoration. Conclusion After 2 years of clinical service, both direct and indirect restorations presented similar and good clinical behavior for all properties analyzed.