Composite versus amalgam restorations. A three-year clinical evaluation.

In a clinical study the behaviour of posterior composite restorations was evaluated. For the study, 232 Class I or II restorations in premolars and molars were made by three operators in a group of forty-nine adult patients. Each patient underwent one or two series of four restorations. The materials within a series were a strontium glass filled composite (Profile), a microfilled composite (Estic MF), a macrofilled composite (Adaptic Radiopaque) and a high copper amalgam (Dispersalloy). The last two materials served as a negative and positive controls respectively. For a period of 3 years the clinical behaviour was evaluated yearly with the USPHS criteria (anatomic form, marginal adaptation, colour match, marginal staining and caries). Differences in the ratings of the criteria between materials, tooth type and evaluation year were tested statistically for significance. The number of restorations replaced after 3 years in clinical service was eight (= 3.6%). The results showed that the material, tooth type and evaluation year all have an influence on the anatomic form and the colour match of the restoration. The behaviour of the three composites with respect to colour match, marginal adaptation and marginal staining was acceptable. For anatomic form, however, only the behaviour of the microfilled composite Estic MF was still acceptable after 3 years.