Title:  Evaluation of composite restorations in hypomineralised permanent molars: a four year clinical study

Abstract:  Aim The objective of this investigation was to evaluate the clinical performance of composite restorations in enamel hypomineralised posterior teeth. Methods 52 composite restorations were placed in 52 permanent molars of 46 children, aged 8-10 years. All the teeth were clinically diagnosed as hypomineralised and restorations were placed on two or more surfaces of the teeth, including cusps. All treated teeth had at least 2 sound surfaces, thus excluding defective teeth with total disruption of the crown. The materials used were a hybrid composite and a fourth generation one-bottle adhesive material and manufacturer’s instructions were carefully followed. The restorations were initially evaluated 7 days after the treatment and subsequent evaluation was performed at 12, 24, 36, 48 months. Clinical evaluation of the restorations was made according to the criteria of Ryge [1980]. Results In 6 cases, postoperative complaint was relieved after occlusal re-adjustment at the second appointment, 7 days later. At the end of the 48 months study period, 49 restorations were available for evaluation, all with full retention. Radiographically there was no periapical pathology. Problems were found in colour match in 10, surface appearance in 3 and anatomic form in 4 restorations. Hypersensitivity was recorded in 17 teeth after one week and in 3 teeth one year later. All teeth were sensitivity free after two years and until the end of the study period. Conclusions Composite resin restorations using contemporary materials, in certain cases of hypomineralised permanent molars, can be an acceptable restorative procedure with satisfactory long-term results.