ABSTRACT
Objective:
The study aims to compare patient-reported outcomes for aesthetic restorations in anterior teeth using composite resins, glass ionomer cements (GICs), and ceramic-based restorations. Patient satisfaction regarding aesthetics, functionality, durability, and overall experience was evaluated.
Materials and Methods:
This prospective cohort study included 180 patients (aged 18–65 years) who required anterior aesthetic restorations. Patients were randomly assigned to receive either composite resin, GIC, or ceramic restorations. Satisfaction with aesthetics, comfort, and durability was measured using a visual analog scale (VAS) at 1-, 6-, and 12-month post-treatment. Statistical analysis was performed using ANOVA, with a P value < 0.05 considered significant.
Results:
Ceramic restorations scored the highest for aesthetics (VAS 9.1), functionality (VAS 9.0), and durability (5% reported issues). Composite resins had lower durability (15% reported issues) but scored well in aesthetics (VAS 8.2). GICs had the lowest overall satisfaction, with 25% reporting durability issues. Overall satisfaction was highest for ceramics (94%), followed by composites (85%) and GICs (68%).
Conclusion:
Ceramic restorations offer superior aesthetic and functional outcomes. Composite resins provide a cost-effective option with acceptable aesthetics, while GICs were rated lower due to their limited durability and aesthetics.
KEYWORDS: Aesthetic restorations, anterior teeth, ceramic restorations, composite resin, durability, glass ionomer cement, patient satisfaction
INTRODUCTION
Aesthetic restorations in anterior teeth significantly impact patient satisfaction due to their role in both function and appearance. The primary restorative materials used—composite resins, glass ionomer cements (GICs), and ceramics—offer varying aesthetic and functional outcomes. Patient-centered care, where patient satisfaction plays a vital role in treatment success, has become increasingly important in dental practice. With advances in material science, it is essential to understand how different materials meet patient expectations for aesthetics, durability, and functionality.[1,2]
Composite resins are widely used due to their affordability, ease of use, and satisfactory aesthetic results. GICs offer the added benefit of fluoride release but are often seen as less aesthetically pleasing. Ceramic restorations, although more expensive, are praised for their natural appearance and superior durability.[3,4,5] This study aims to compare patient-reported outcomes for these three materials, focusing on aesthetics, functionality, and durability.
MATERIALS AND METHODS
This prospective cohort study was conducted over 18 months, including 180 patients requiring anterior restorations. Patients were randomly assigned to receive either composite resin, GIC, or ceramic-based restorations. Inclusion criteria included patients aged 18–65 years with aesthetic concerns or caries in anterior teeth. Exclusion criteria involved those with severe periodontal disease or allergies to restorative materials.
Restorations were performed as follows: composite resins were applied directly, GIC restorations were bonded chemically, and ceramic restorations were placed in two visits (for preparation and bonding of lab-fabricated crowns/veneers). Patient satisfaction was assessed using a visual analog scale (VAS) at 1-, 6-, and 12-month post-treatment.
RESULTS
Patients with ceramic restorations reported the highest satisfaction regarding aesthetics, particularly color matching and translucency. Composite resins were satisfactory but showed signs of discoloration over time, leading to a lower VAS score at 12 months (P < 0.001). GIC restorations scored the lowest due to their opacity and limited color-matching capability [Table 1].
Table 1.
Aesthetic satisfaction (VAS scores)
| Time point | Composite resin | GIC | Ceramic | P |
|---|---|---|---|---|
| 1 month | 8.5±1.1 | 7.0±1.3 | 9.3±0.8 | <0.001 |
| 6 months | 8.3±1.3 | 6.9±1.2 | 9.2±0.9 | <0.001 |
| 12 months | 8.2±1.5 | 6.8±±1.1 | 9.1±0.9 | <0.001 |
Ceramics demonstrated superior durability, with only 5% of patients reporting issues at 12 months. Composite resins, though aesthetically pleasing, were more prone to chipping and wear (15% reported issues), while GICs had the highest durability concerns (25%). Functional satisfaction was also highest for ceramics, with patients citing comfortable chewing and biting experiences [Table 2].
Table 2.
Durability and functionality issues at 12 months
| Group | Durability issues (%) | Functionality satisfaction (VAS) | P |
|---|---|---|---|
| Composite resin | 15% | 8.3±1.4 | <0.05 |
| GIC | 25% | 7.0±1.2 | <0.05 |
| Ceramic | 5% | 9.0±1.0 | <0.05 |
DISCUSSION
The study highlights ceramic restorations as the most aesthetically and functionally superior among the three materials, which aligns with previous literature emphasizing ceramics’ excellent optical and mechanical properties.[4] Their long-term color stability and resistance to wear explain the high patient satisfaction scores. However, ceramics come with higher costs, which may limit their accessibility for some patients.[5]
Composite resins offered a balance of cost-effectiveness, ease of use, and reasonable aesthetic outcomes. However, issues with discoloration and wear over time led to slightly lower patient satisfaction. This is consistent with studies that report composite materials are prone to staining from beverages like coffee and tea.[6] Despite these concerns, composite resins remain a popular choice due to their affordability and ease of application in a single visit.
GICs performed the worst in terms of aesthetics and durability, which can be attributed to their material properties. GICs are less translucent and more prone to wear, making them less suitable for high-aesthetic zones such as the anterior teeth.[7] Nevertheless, their fluoride-releasing property provides additional preventive benefits, particularly in patients prone to caries.[8]
The findings underscore the importance of material selection based on patient needs, expectations, and financial considerations. While ceramics provide superior outcomes, composite resins are an excellent mid-tier option for patients seeking affordability without significant compromises on aesthetics and functionality. GICs, while useful in some clinical situations, may not be the best choice for highly aesthetic restorations in the anterior region.[9,10]
Limitations
The study’s follow-up period of 12 months is relatively short for evaluating long-term durability and esthetics. Future research could involve longer follow-up periods and incorporate clinical evaluations to complement patient-reported outcomes.
CONCLUSION
Ceramic-based restorations offer superior aesthetic and functional outcomes in anterior teeth, though at a higher cost. Composite resins provide a balance of affordability and satisfactory aesthetics, making them a viable option for many patients. GICs, while affordable, performed the worst in terms of aesthetics and durability. These findings emphasize the importance of considering both patient preferences and clinical outcomes when selecting restorative materials for anterior teeth.
Conflicts of interest
There are no conflicts of interest.
Funding Statement
Nil.
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