Biomimetic restorative dentistry: clinical possibilities with a recently developed short fibre-reinforced composite

Objectives: Contemporary resin composites used in large restorations still demonstrate limitations due to their limited mechanical properties. Resin composite reinforced with short randomly oriented glass fibres exhibit improved mechanical properties regarding flexural strength, fracture toughness and polymerisation shrinkage in comparison to particulate filler composite (PFC). Therefore short fibre-reinforced composite (SFRC) can be beneficial in stress-bearing applications. The aim of this case series is to assess the usefulness of SFRC within different restorative indications. Materials and Methods: Four patients presenting different restorative problems were selected. Direct composite restorations were used in each situation: a cusp-replacement, a post-and-core, an endocrown and a fibre-reinforced composite resin-bonded fixed dental prosthesis. For all indications biomimetic principles were applied i.e. dentin was replaced by SFRC that was entirely embedded with enamel-replacing PFC. Results: Handling and aesthetic characteristics of SFRC proved to be appropriate for application in biomimetic restorations. SFRC easily adapted to the dentine by additional use of a small amount of low viscosity PFC and did not interfere with the aesthetic outcome of the restorations. The obtained clinical results were highly assessed by each patient. No restoration failed after six months of function. Conclusion: It seems reasonable to use SFRC in a biomimetic treatment approach for stress-bearing applications. The benefits of SFRC-based biomimetic direct composite restorations needs to be investigated in a properly designed long-term random clinical trial. Clinical Relevance: The use of SFRC as dentin replacement within a biomimetic treatment approach provides a rationale for extended use of direct resin composite restorations in stress-bearing applications