Tunnel restorations. A 3 1/2-year follow up study of Class I and II tunnel restorations in permanent and primary teeth

During 1988-89, 224 patients with approximal caries in the premolar/molar regions were provided with 318 tunnel restorations. In case of perforation of the enamel in the enamel/dentin border, (23%), complete Class II-tunnel restorations with glass ionomer cement and composite resin were made. In case of "intact" enamel, (77%), partial Class I-tunnel restorations were made. The restorations were controlled at annual routine recalls and the success rate after 3 1/2 years was 74% for permanent teeth, and 10% for primary teeth. Restorations in permanent teeth, made during the second year of the study were successful in 82%, as compared with 62% for restorations made during the first year, indicating a learning effect. Failures in the permanent dentition were due to marginal ridge fracture (35%), cavitation in the approximal enamel (31%), and recurrent caries (38%). Failures in primary teeth were predominantly due to marginal ridge fractures (84%). A comparison with the longevity of conventional Class II restorations is made and the possible advantages of the present method are presented.