A Commentary on Mohamed M H, Abouauf E A, Mosallam R S. Clinical performance of class II MOD fiber reinforced resin composite restorations: an 18-month randomized controlled clinical trial. BMC Oral Health 2025;25: 159. <a href="https://doi.org/10.1186/s12903-025-05521-5">https://doi.org/10.1186/s12903-025-05521-5</a>. Design A double blinded 18-month randomised controlled trial was carried out to compare the clinical performance of fibre reinforced resin composites compared to conventional nanohybrid resin composites in restoring Class II MOD cavities. Participants were allocated to one of three groups: Group 1 with short glass fibre reinforced resin composite, Group 2 with polyethylene fibre reinforced resin composite and Group 3 with conventional nanohybrid resin composite. A principal investigator carried out the restorative procedures for all participants. Case selection Participants in the study were enrolled from the educational clinic in Cairo University, Egypt. A total of 45 participants with a mean age of 32.3 ± 7.3 years were included. All participants had class II MOD carious lesions in vital posterior teeth with ICDAS scores of 3,4 or 5. Additionally only those with good oral hygiene, a healthy periodontal status and normal occlusion were included. The study excluded pregnant patients, as well as those with systemic disease or evidence of parafunctional habits. Patients with hypersensitivity, allergy to materials used, secondary caries or delayed response to sensibility testing were also excluded. Data analysis Outcomes were assessed by two examiners at the baseline and at the following time intervals: 3, 6, 12, 18 months using Modified USPHS criteria. The primary outcome assessed was marginal adaptation, followed by gross fracture, marginal discolouration, colour match and recurrent caries. The clinical significance was determined based on relative risk. The chi-Square test compared between groups with significance set at P ≤ 0.016, and Cochran’s Q test compared within groups with significance at P ≤ 0.005, both adjusted using Bonferroni correction. The study was conducted with a 95% confidence level and an 80% statistical power. Results The study had a 97.7% retention rate with all but one patient successfully completing the 18 month follow up period. Colour match was the only outcome that showed a statistically significant difference between the groups, with short glass fibre reinforced restorations displaying some colour discrepancies. Other outcomes such as marginal adaptation, marginal discoloration, recurrent caries and gross fracture showed no significant differences between groups. Age, gender and tooth distribution also showed no significant statistical differences. Conclusions The clinical performance of fibre-reinforced resin composite restorations are similar and comparable to nanohybrid composite restorations over an 18-month duration. Short glass fibre-reinforced restorations displayed variations in colour match, indicating that aesthetic outcomes should be carefully considered.

Fibre or facade? Do fibre reinforced composites really hold up in Class II restorations?

期刊论文
发表日期：

2025年9月8日

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Celine Raseekaanthan,
Pirashani Umassudan

摘要

A Commentary on

Mohamed M H, Abouauf E A, Mosallam R S.

Clinical performance of class II MOD fiber reinforced resin composite restorations: an 18-month randomized controlled clinical trial. BMC Oral Health 2025;25: 159. https://doi.org/10.1186/s12903-025-05521-5.

Design

A double blinded 18-month randomised controlled trial was carried out to compare the clinical performance of fibre reinforced resin composites compared to conventional nanohybrid resin composites in restoring Class II MOD cavities. Participants were allocated to one of three groups: Group 1 with short glass fibre reinforced resin composite, Group 2 with polyethylene fibre reinforced resin composite and Group 3 with conventional nanohybrid resin composite. A principal investigator carried out the restorative procedures for all participants.

Case selection

Participants in the study were enrolled from the educational clinic in Cairo University, Egypt. A total of 45 participants with a mean age of 32.3 ± 7.3 years were included. All participants had class II MOD carious lesions in vital posterior teeth with ICDAS scores of 3,4 or 5. Additionally only those with good oral hygiene, a healthy periodontal status and normal occlusion were included. The study excluded pregnant patients, as well as those with systemic disease or evidence of parafunctional habits. Patients with hypersensitivity, allergy to materials used, secondary caries or delayed response to sensibility testing were also excluded.

Data analysis

Outcomes were assessed by two examiners at the baseline and at the following time intervals: 3, 6, 12, 18 months using Modified USPHS criteria. The primary outcome assessed was marginal adaptation, followed by gross fracture, marginal discolouration, colour match and recurrent caries. The clinical significance was determined based on relative risk. The chi-Square test compared between groups with significance set at P ≤ 0.016, and Cochran’s Q test compared within groups with significance at P ≤ 0.005, both adjusted using Bonferroni correction. The study was conducted with a 95% confidence level and an 80% statistical power.

Results

The study had a 97.7% retention rate with all but one patient successfully completing the 18 month follow up period. Colour match was the only outcome that showed a statistically significant difference between the groups, with short glass fibre reinforced restorations displaying some colour discrepancies. Other outcomes such as marginal adaptation, marginal discoloration, recurrent caries and gross fracture showed no significant differences between groups. Age, gender and tooth distribution also showed no significant statistical differences.

Conclusions

The clinical performance of fibre-reinforced resin composite restorations are similar and comparable to nanohybrid composite restorations over an 18-month duration. Short glass fibre-reinforced restorations displayed variations in colour match, indicating that aesthetic outcomes should be carefully considered.