A Randomized Clinical Trial of Short Fiber Reinforced Composite and Glass Hybrid Restoration for Molars Affected by Molar Hypomineralization

Purpose: The purpose of this split-mouth design study was to evaluate the clinical success and survival of glass hybrid (GH) and direct composite with short fiber-reinforced composite (SFRC) after selective caries removal in restorations of permanent first molars that were affected by molar hypomineralization (MH). Methods: Thirty-one children aged six to 12 years with severe MH were randomly assigned as follows: group one equals GH (Equia Forte (R) HT) and group two equals SFRC (EverX FlowTM) covered by micro-hybrid composite (G-Aenial (R) posterior composite). For selective caries removal, only disorganized dentin in the pulpal and the axial wall was removed using low-speed tungsten carbide burs and hand instruments. The restoration longevity was evaluated at baseline and six, 12, and 24 months after treatment according to modified US Public Health Service (USPHS) criteria. Results: Seven GH and two SFRC restorations failed within two years of the follow-up period. The clinical success of all restorations decreased statistically over time for retention and marginal adaptation criteria of USPHS criteria (P<0.001 for both criteria). The direct composite with SFRC was 3.32 times (confidence interval equals 1.26 to 8.79) more successful than GH restorations in terms of retention according to the USPHS criteria (P=0.016). However, survival at 24 months was 93.5 percent (+/- 4.4 standard error [SE]) and 77.4 percent (+/- 7.5 SE) for SFRC and GH restorations, respectively. Conclusion: The retention of the direct composite with short fiber-reinforced composite was superior to glass hybrid restorations at 24 months in the management of molar hypomineralization-affected molars.