Clinical performance of glass hybrid and short fiber-reinforced composite restorations in MIH-affected molars: A 60-month split-mouth randomized controlled trial.

OBJECTIVES

This study aimed to compare the 60-month clinical performance of glass hybrid (GH) and short fiber-reinforced composite (SFRC)-supported microhybrid composite restorations placed in MIH-affected first permanent molars following selective caries removal (SCR).

MATERIALS AND

METHODS

Thirty-one children (18 girls, 13 boys; 6-12 years) with MIH and at least two fully erupted first permanent molars exhibiting moderate-to-severe lesions (MIH-TNI scores 2 and 4) were enrolled. Following SCR, 62 molars were restored using a randomized split-mouth design. In each participant, one molar received a GH restoration (Equia Forte® HT), whereas the other selected molar was restored with an SFRC material (EverX Flow™) covered with a microhybrid composite resin (G-Aenial® Posterior). Clinical evaluations were performed at baseline and 6, 12, 24, 36, and 60 months using modified United States Public Health Service (USPHS) criteria.

RESULTS

Clinical performance deteriorated significantly over time for both materials (p < 0.001). GEE analysis showed no significant independent effect of material type on any modified USPHS criterion (p > 0.05), while time significantly affected retention, marginal adaptation, postoperative sensitivity, and secondary caries (p < 0.001). Kaplan-Meier analysis demonstrated significantly higher survival rates for SFRC-supported microhybrid composite than for GH restorations at 60-month (75.5% vs. 59.2%; p = 0.002).

CONCLUSIONS

Both GH and SFRC-supported microhybrid composite restorations provided clinically acceptable long-term outcomes in MIH-affected molars after SCR. Although clinical performance per modified USPHS criteria was comparable, SFRC-supported microhybrid composite restorations demonstrated superior long-term survival.

CLINICAL RELEVANCE: When long-term durability is a primary consideration, SFRC-supported microhybrid composite restorations may be preferred for the restorative management of MIH-affected molars.

CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT07733804.