# Clinical assessment of marginal and bulk fractures and discoloration in posterior composite after 12 to 36 months: A retrospective study

## TL;DR

This study evaluated the performance of posterior composite dental restorations over 1 to 3 years, focusing on discoloration and fractures.

## Contribution

The study provides clinical insights into the long-term performance of specific composite resins in posterior dental restorations.

## Key findings

- Most restorations showed clinically acceptable performance with minimal marginal discoloration and fractures.
- Bravo discoloration was linked to composite resin type, oral hygiene, and beverage consumption.
- X-tra Fil composite showed higher rates of discoloration compared to other materials.

## Abstract

This retrospective cohort study aimed to evaluate the marginal discoloration, fractures, and bulk fractures of posterior composite restorations over a period of 1 to 3 years.

A total of 281 restorations, performed by a restorative dental specialist, were assessed using modified United States Public Health Service (USPHS) criteria. Demographic data, occlusal information, and patient habits were collected, along with characteristics of the restoration (composite resin type, adhesive, restoration type, and treated tooth). Data were analyzed using the chi-square test and independent t-test (α = 0.05).

Posterior Gradia, P60, and X-tra Fil were employed in 51.2%, 38.07%, and 14.23% of the restorations, respectively. Most of the restorations (81.5%) received an Alpha score for marginal discoloration, which was significantly associated with composite resin type, colored beverage consumption, oral hygiene, caries risk, and restoration classification (P<0.05). Bravo discoloration was more common in patients who received Xtra Fil composite, consumed moderate to high amounts of colored beverages, had moderate to poor oral hygiene, and exhibited high caries risk. Additionally, Bravo discoloration was more frequent in Class II and build-up restorations. Restorations with a Bravo score were found to have significantly higher average restoration age, patient age, and a greater number of missing teeth compared to those with an Alpha score (P<0.05). In terms of marginal fractures, 99.6% of restorations received an Alpha score, with no significant associations with the evaluated variables. Furthermore, 99.6% of restorations showed no bulk fractures.

Posterior composite resin restorations demonstrated clinically acceptable performance with respect to marginal discoloration and integrity after 12 to 36 months.

Key words:Composite filling, marginal fracture, bulk fracture, discoloration.