Material Wars: Which Actually Last Longer in Real Mouths?

Every dentist wants to know which restorative material truly lasts the longest.
But modern evidence is clear: longevity isn’t determined by the material alone. 

It is the combination of material, operator skill, patient factors, and design.

A major 2023 review summed it up perfectly. “Longevity of composite restorations is definitely not only about materials¹.”

Still, to clear the confusion about which materials work the best, let’s dive in,

Here are common materials in practice- 

1. Bulk-Fill Composites

A 2025 mapping review analysing 26 clinical studies reported:²

• Survival rates: 78.9%–100%
• Annual failure rate: 0–3%
• High-viscosity bulk-fills consistently performed the best
• Clinical success was comparable to incremental techniques

A 2024 randomized clinical trial evaluating four bulk-fill systems showed 100% survival at 2 years, with no clinical differences between viscosity types.³

Clinical meaning: High-viscosity bulk-fills hold up extremely well, more or less as long as conventional composites.

2. Nanohybrid Composites

Systematic reviews show that posterior nanohybrid/nanofill composites:¹

• Composite survival 10–15 years when executed well
• Failure rates 1–3% annually
• Technique and patient factors will outweigh material differences
• Modern nanohybrids achieve survival comparable to amalgam

Their superior filler technology gives better wear resistance, smoother margins, and higher gloss retention.

Clinical meaning: Nanohybrids remain the most predictable long-term material, provided good technique is used.

3. Universal Composites

Universal composites simplify shade selection and reduce inventory, but evidence shows no superiority in longevity.

A major review emphasizes that although universal composites deliver excellent esthetics, the data do not show any inherent longevity advantage. The clinical performance depends more on patient and operator factors.⁴

4. Glass Hybrids

For high-caries or moisture-challenged situations, glass hybrids remain valuable. Their chemical bonding, fluoride release, and moisture tolerance make them ideal for:

• Geriatric patients
• Cervical lesions
• Deep box-only restorations
• High-caries risk mouths

A large multi-center trial showed glass hybrids perform exceptionally well over five years, though they score slightly lower in esthetics and retention when compared to resin composites.⁵

They survive well, but may not be the universal replacements for composites.

5. Giomers and Bioactive Composites

Giomers excel in plaque resistance, polish retention, and color stability. But trials still show that nanohybrids still outperform them mechanically.

Bioactive materials offer ion release and potential remineralization benefits, which can be promising for high-caries patients. But recent evaluations state that they cannot compensate for poor bonding or heavy occlusal load.⁶

Therefore, it is advised to use them selectively and avoid them for posterior restorations.

The Truth About Material Comparison

In the end, let’s encapsulate the differences:

• Well-executed composite restorations can give you amalgam survival rates¹
• Differences between premium and mid-range composites are not significant
• Operator skill can influence longevity more than just the material brand¹
• Patient factors like caries risk, hygiene, etc, can predict failure more than just material chemistry⁴

You can choose an excellent material, but technique and patient biology will ultimately decide the outcome.

Clinical Pearls for Attaining Maximum Longevity

These hold true, irrespective of the material you choose:
 ✔ Rubber dam isolation should be a non-negotiable practice
 ✔ Follow manufacturer instructions as indicated
 ✔ Use adequate curing always
 ✔ Layer strategically in high C-factor cavity preparations
 ✔ Adjust occlusion after restoration
 ✔ Polish margins to have smoother surfaces that reduce biofilm
 ✔ Schedule recalls for early failure detection

Final Takeaway

Modern materials are excellent now, but it is important to understand that technique, patient biology, and design will determine whether a restoration lasts 5 years or 15 years. 

There is no doubt that a well-placed composite can survive as long as amalgam, but poorly done ones can fail early.

References

1. Demarco FF, Cenci MS, Montagner AF, de Lima VP, Correa MB, Moraes RR, Opdam NJM. Longevity of composite restorations is definitely not only about materials. Dent Mater. 2023;39(2):181–200.
2. Menezes AJO, Barbosa LN, Leite JVC, Navarro RS, da Silva AV, Loretto SC, Figueiredo FED, Gurgel CV, Loguercio AD, Reis A. Clinical outcomes of bulk-fill resin composite restorations: a 10-year mapping review and evidence gap map. J Esthet Restor Dent. 2025;37(4):920–933.
3. Goda B, Hamdi K, Eltoukhy RI, Ali AI, Mahmoud SH. Clinical performance of different bulk-fill composite resin systems in class II cavities: A 2-year randomized clinical trial. J Esthet Restor Dent. 2024 Aug;36(8):1122-1137
4. Burke FJT, Lucarotti PSK.The ultimate guide to restoration longevity in England and Wales. Part 4: resin composite restorations. Br Dent J. 2018;224:945–956.
5. Miletić I, Baraba A, Jukić Krmek S, Perić T, Marković D, Basso M, Atalayin Özkaya Ç, et al. Clinical performance of a glass-hybrid system in comparison with a resin composite in two-surface Class II restorations: a 5-year randomised multi-centre study. Clin Oral Investig. 2024;28(1):1–12.
6. Toz-Akalin T, Öztürk-Bozkurt F, Kusdemir M, Özsoy A, Yüzbaşıoğlu E, Özcan M. Three-year clinical performance of direct restorations using low-shrinkage giomer vs nano-hybrid resin composite. Front Dent Med. 2024;5:1459473.