The management of occlusal caries in permanent molars. A 5-year clinical trial comparing a minimal composite with an amalgam restoration

Abstract

A clinical trial comparing the efficacy of an occlusal amalgam restoration with a minimal composite restoration and fissure sealant in the management of occlusal caries in young patients has been performed. One hundred and fifty pairs of restorations were placed in 103 patients and assessed during the 5-year follow-up period. Nineteen restorations failed during this period: 11 amalgam and 8 minimal composite. There was some deterioration in anatomical form and marginal integrity of the remaining amalgam restorations. Of the remaining minimal composites, seven suffered clinically detectable wear and a further five had some marginal staining. Forty-nine of the minimal composites needed to have repairs to the fissure sealant. The amalgam restorations occupied, on average, 25% of the occlusal surface of the tooth, compared with 5% for the minimal composite resin. The results after a 5-year follow-up showed no significant difference in median survival times between the amalgam and the minimal composite restorations.