Alert (10 yr)

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  THE DENTAL ADVISOR was the first to publish Long-term Clinical Performance Report results on ceramics, cements, composites, laboratory composites, and bonding agents. With over 24 years of data on these materials, THE DENTAL ADVISOR is capable of providing the long-term data many customers require.

10-Year Clinical Performance

Consultants' Comments

• "Overall the restorations have held up very well over time.”
• "Very slight wear was observed with some of the restorations, mostly at the occlusal surface.”
• "Looks very nice at 11 years.”
• "Even very large four-surface restorations have held up very well.”
• "I have noticed some yellowing in a few of the restorations.”
• "At times the surface is grainy, not perfectly glossy.”

Description

Alert is a packable posterior composite first introduced and evaluated by THE DENTAL ADVISOR in March 1999. Alert is highly filled (84% by weight) with glass fibers of various dimensions. It is stiff in consistency, packs well, is non-sticky, and can be cured in 5-mm increments. This product received a 92% clinical rating.

Clinical Evaluation Protocol

• A total of 651 posterior restorations were placed from 1998 to 2002.
• Three hundred and twenty four of these restorations have been in function for 10 years or longer (Figure 1).
• One hundred and thirty one restorations were available for recall and evaluation. They represented 1-, 2-, 3-, and 4-surface composites and were evaluated in the follow areas:
  • Resistance to fracture/chipping
  • Esthetics
  • Resistance to marginal discoloration
  • Wear resistance
• Each category was rated on a scale of 1 to 5: 1 = poor, 2 = fair, 3 = good, 4 = very good, 5 = excellent

Clinical Results

Resistance to Fracture/Chipping
Alert restorations have proven to be very durable at 10 years or more in function.  Seventy-seven percent of the recalled restorations showed no fractures or chipping, while 15% exhibited very slight chipping and 5% more moderate chipping necessitating repair (Figure 2). Only 3% needed to be replaced.

Esthetics
Forty-seven percent of restorations were rated excellent for shade and esthetics blending well with the surrounding tooth (Figure 2). Thirty-three percent showed slight discoloration, while 19% showed moderate discoloration with consultants describing them as slightly yellow or opaque. While esthetics ratings have decreased over the 10 years, most restorations were still considered clinically acceptable. Only 1% was considered clinically unacceptable.

Resistance to Marginal Discoloration
Sixty-four percent of Alert restorations did not exhibit any marginal staining at 10 years (Figure 2). Twenty-seven percent showed slight staining while 9% showed more moderate staining at the margins. None of the restorations needed to be replaced because of staining.

Wear Resistance
Occlusal wear was not an issue at the five-year recall and it continues not to be an issue at the 10-year recall. Sixty-six percent of the restorations exhibited no wear at 10 years and 27% exhibited slight wear (Figure 2). Only 7% of the restorations exhibited moderate occlusal wear.

Conclusions
Alert performed very well at the 10-year recall with each category rating very highly:

• 92% of the restorations received very good to excellent ratings in lack of fracture or chipping.
• 80% of the restorations received very good to excellent ratings in the area of esthetics.
• 91% of the restorations received very good to excellent ratings in lack of marginal staining.
• 93% of the restorations received very good to excellent ratings in wear resistance.