Comparison of Clinical Outcome of Direct Composite Resin Versus Amalgam Restoration in Permanent Posterior Teeth

Abstract

Background: Composite resins are increasingly preferred over dental amalgam due to their aesthetic appeal, conservative preparation, and biocompatibility. However, the durability and long-term clinical performance of composite restorations in posterior teeth remain a subject of debate. Objective: This study aimed to compare the clinical outcomes of direct composite resin versus amalgam restorations in permanent posterior teeth across two dental units at Bolan Medical College, focusing on material preference, longevity, and patient perception. Methods: A cross-sectional observational study was conducted with a total of 327 restorations analyzed from patient records and dentist/student surveys. Inclusion criteria encompassed patients requiring direct restorations in molars or premolars, while those with extensive structural loss requiring indirect restorations were excluded. Data collection included patient records and structured questionnaires. Statistical analysis was performed using SPSS v23.0, employing chi-square tests for categorical comparisons (p<0.05 considered significant). Results: Among 693 posterior restorations, 78.28% were resin-based, while 21.72% were amalgam. The dental department predominantly used composite (92.63%), whereas amalgam was more frequent in public health units (p=0.000). Clinical evaluation suggested superior aesthetics and patient preference for composite, but amalgam remained preferred for durability. Conclusion: While composite is increasingly favored in academic settings, amalgam remains integral in public health dentistry due to cost-effectiveness and longevity. Findings highlight the need for balancing aesthetics with clinical durability in restorative dentistry.