IJRDE Indonesian Journal of Restorative Dentistry and Endodontics IJRDE XXXX-XXXX XXXX-XXXX Pengurus Pusat Ikatan Konservasi Gigi Indonesia (PP IKORGI) 2 10.22146/ijrde.2027.01.002 Original Article Clinical Performance of Short-Fiber Reinforced Composite in Deep Posterior Cavities: A 2-Year Randomized Controlled Trial Biomimetic Bilayered Substructure Restoration in Extensive Class II MOD Cavities https://orcid.org/0000-0003-4567-8901 Sp.KG Dr. drg. Fitria Maharani, fitria.maharani@unpad.ac.id 1 Departemen Konservasi Gigi, Universitas Padjadjaran 01 06 2027 1 1 13 24 Copyright (c) 2027 Indonesian Journal of Restorative Dentistry and Endodontics 2027 Indonesian Journal of Restorative Dentistry and Endodontics This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0).

Objective: To evaluate the 2-year clinical performance of short-fiber reinforced composite (SFRC) substructure bases in extensive Class II MOD cavities with cusp loss. Methods: Eighty restorations were evaluated using modified FDI criteria at baseline, 6, 12, and 24 months. Results: The SFRC group exhibited a 97.5% retention rate with significantly reduced marginal fracture. Conclusion: Short-fiber composite bases substantially enhance the fracture resistance of vital posterior restorations.

 Keywords Biomimetic Dentistry Short-Fiber Composite Posterior Restoration Randomized Trial INTRODUCTION

Biomimetic restorative dentistry aims to replicate the biomechanical, structural, and optical properties of intact natural tooth tissues [1]. Extensive Class II mesio-occluso-distal (MOD) cavities with cusp loss present a high risk of catastrophic vertical root fracture due to polymerization shrinkage stress and occlusal cyclic fatigue [2].

 MATERIALS AND METHODS

Eighty vital posterior molars and premolars requiring extensive Class II MOD restorations were randomly assigned into two clinical groups (n = 40): bilayered restorations utilizing a discontinuous short-fiber reinforced composite (SFRC, everX Posterior) dentin substructure capped with nano-hybrid composite, versus conventional bulk-fill composite restorations. Modified USPHS/FDI clinical criteria were evaluated at baseline, 6, 12, and 24 months.

 RESULTS

At the 24-month recall, the biomimetic SFRC substructure group demonstrated a 97.5% clinical survival rate with superior marginal adaptation and zero catastrophic cusp fractures compared to 87.5% in the control group (Table 1).

 DISCUSSION

Randomly oriented millimeter-scale E-glass fibers within the semi-interpenetrating polymer network (semi-IPN) act as crack-stoppers that redirect and arrest propagating microcracks, mimicking the toughening mechanism of the dentinoenamel junction [1,3].

 CONCLUSION

Short-fiber reinforced composite (SFRC) substructure bases significantly improve the 2-year clinical fracture resistance and marginal integrity of extensive posterior restorations.

 Figures

Biomimetic bilayered restoration protocol using short-fiber reinforced composite (SFRC) dentin replacement core.

 Tables

Modified FDI clinical evaluation scores at 24-month follow-up (n = 80).

*Statistically significant difference at p < 0.05 (Chi-square and Mann-Whitney U test).

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