{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T22:43:09Z","timestamp":1790116989124,"version":"4.0.1"},"reference-count":61,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T00:00:00Z","timestamp":1679616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>The aim of this retrospective study was to investigate the clinical performance of posterior complex resin composite (RC) and amalgam (AM) restorations after a five-year period. One hundred and nineteen complex Class II restorations placed by dental students were evaluated using the USPHS criteria. Data were analyzed using Chi-square, Mann\u2013Whitney, and Wilcoxon tests at a 0.05 level of significance. After five years, the percentages of clinically satisfactory complex Class II RC and AM restorations were 78% and 76.8%, respectively. The main reasons for the failure of AM restorations included secondary caries (Bravo\u201410.1%), defective marginal adaptation (Charlie\u20148.7%), and fracture of the tooth (Bravo\u20147.2%). RC restorations presented failures related to the fracture of the restoration (Bravo\u201416%) and defective marginal adaptation (Charlie\u20148.2%). There was a significantly higher incidence of secondary caries for AM restorations (AM\u201410.1%; RC\u20140%; p = 0.0415) and a higher number of fractures for RC restorations (AM\u20144.3%; RC\u201416%; p = 0.05). Regarding anatomy, AM restorations presented a significantly higher number of Alfa scores (49.3%) compared to RC restorations (22.4%) (p = 0.0005). The results of the current study indicate that complex class II RC and AM restorations show a similar five year clinical performance.<\/jats:p>","DOI":"10.3390\/dj11040088","type":"journal-article","created":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T04:31:05Z","timestamp":1679632265000},"page":"88","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Five-Year Clinical Performance of Complex Class II Resin Composite and Amalgam Restorations\u2014A Retrospective Study"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8942-7091","authenticated-orcid":false,"given":"Maria Jacinta M. C.","family":"Santos","sequence":"first","affiliation":[{"name":"Division of Restorative Dentistry, Schulich School of Medicine and Dentistry, The University of Western Ontario, Room # 0149, Dental Sciences Building, London, ON N6A 5C1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heleine Maria C.","family":"R\u00eago","sequence":"additional","affiliation":[{"name":"Division of Restorative Dentistry, Schulich School of Medicine and Dentistry, The University of Western Ontario, Room # 0149, Dental Sciences Building, London, ON N6A 5C1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imad","family":"Siddique","sequence":"additional","affiliation":[{"name":"Division of Restorative Dentistry, Schulich School of Medicine and Dentistry, The University of Western Ontario, Room # 0149, Dental Sciences Building, London, ON N6A 5C1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7728-2067","authenticated-orcid":false,"given":"Abbas","family":"Jessani","sequence":"additional","affiliation":[{"name":"Division of Restorative Dentistry, Schulich School of Medicine and Dentistry, The University of Western Ontario, Room # 0149, Dental Sciences Building, London, ON N6A 5C1, Canada"},{"name":"Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON N6A 5C1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1038\/s41415-022-4204-z","article-title":"Dental amalgam: The history and legacy you perhaps never knew?","volume":"232","author":"Chadwick","year":"2022","journal-title":"Br. 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