Clinical Performance of Short-Fiber Reinforced Composite in Deep Posterior Cavities: A 2-Year Randomized Controlled Trial
Biomimetic Bilayered Substructure Restoration in Extensive Class II MOD Cavities
Departemen Konservasi Gigi, Universitas Padjadjaran
fitria.maharani@unpad.ac.id
Abstrak
INTRODUCTION
Biomimetic restorative dentistry aims to replicate the biomechanical, structural, and optical properties of intact natural tooth tissues [1]. Extensive Class II mesio-occluso-distal (MOD) cavities with cusp loss present a high risk of catastrophic vertical root fracture due to polymerization shrinkage stress and occlusal cyclic fatigue [2].
MATERIALS AND METHODS
Eighty vital posterior molars and premolars requiring extensive Class II MOD restorations were randomly assigned into two clinical groups (n = 40): bilayered restorations utilizing a discontinuous short-fiber reinforced composite (SFRC, everX Posterior) dentin substructure capped with nano-hybrid composite, versus conventional bulk-fill composite restorations. Modified USPHS/FDI clinical criteria were evaluated at baseline, 6, 12, and 24 months.
RESULTS
At the 24-month recall, the biomimetic SFRC substructure group demonstrated a 97.5% clinical survival rate with superior marginal adaptation and zero catastrophic cusp fractures compared to 87.5% in the control group (Table 1).
DISCUSSION
Randomly oriented millimeter-scale E-glass fibers within the semi-interpenetrating polymer network (semi-IPN) act as crack-stoppers that redirect and arrest propagating microcracks, mimicking the toughening mechanism of the dentinoenamel junction [1,3].
CONCLUSION
Short-fiber reinforced composite (SFRC) substructure bases significantly improve the 2-year clinical fracture resistance and marginal integrity of extensive posterior restorations.
Gambar & Ilustrasi Klinis
Tabel Data
Table 1. Modified FDI clinical evaluation scores at 24-month follow-up (n = 80).
| Evaluation Criterion | SFRC Bilayer Group (n=40) | Conventional Control (n=40) | p-value |
|---|---|---|---|
| Retention Rate (%) | 97.5% | 87.5% | 0.038* |
| Marginal Integrity (Score 1-2) | 95.0% | 82.5% | 0.041* |
| Anatomic Form & Fracture Resistance | 97.5% | 85.0% | 0.029* |
*Statistically significant difference at p < 0.05 (Chi-square and Mann-Whitney U test).
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Referensi (3)
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