Five-year study of Class II restorations in permanent teeth using amalgam, glass polyalkenoate (ionomer) cerment and resin-based composite materials.

The aim of this study was to compare the clinical performance of an amalgam, a glass polyalkenoate (ionomer) cerment material and a resin-based composite material used in small Class II cavities in permanent teeth. All restorations were inserted under rubber dam. They were examined yearly for 3 years. One clinician continued the study up to 5 years. The clinical examination focused on two criteria: clinically acceptable and failure. In addition, impressions were taken of the prepared cavities immediately before restoration and at each clinical examination using an elastomeric material. The study comprised 274 Class II restorations (88 amalgams, 95 cerments and 91 resin composites) placed in 142 adolescent patients. One hundred and sixty-seven restorations were in molar and 107 in premolar teeth. Patient dropout after 5 years resulted in the loss of 161 restorations, evenly distributed for restorative material and type of tooth involved. Four amalgam restorations, 22 glass ionomer cerment and nine resin composite restorations failed. The glass ionomer cerment and amalgam restorations failed primarily due to bulk fractures, while the resin composite restorations failed due to secondary caries and bulk fractures.