Thirty-Six-Month Clinical Comparison of Bulk Fill and Nanofill Composite Restorations

SUMMARY Objectives: The aim of this study was to evaluate the clinical performance of a nanofill and a bulk fill resin composite in class II restorations. Methods and Materials: In accordance with a split-mouth design, 50 patients received at least one pair of restorations, restored with a nanofill resin composite (Filtek Ultimate [FU]) and with a bulk fill resin composite (Tetric EvoCeram Bulk Fill [TB]). Each restorative resin was used with its respective adhesive system according to the manufacturers' instructions. A total of 104 class II restorations were placed by two operators. The restorations were blindly evaluated by two examiners at baseline and at six, 12, 18, 24, and 36 months using modified US Public Health Service Ryge criteria. The comparison of the two restorative materials for each category was performed with the chi-square test (α=0.05). The baseline scores were compared with those at the recall visits using the Cochran Q-test. Results: At six, 12, 18, and 24 months, the recall rate was 100%, 98%, 94%, and 82%, respectively, with a retention rate of 100%. At 36 months, 81 restorations were evaluated in 39 patients with a recall rate of 78%. For marginal adaptation, four restorations from the TB group and 10 from the FU group rated as Bravo. Two restorations from the TB and eight restorations from the FU group showed marginal discoloration. There were statistically significant differences between the two restorative resins in terms of marginal adaptation and marginal discoloration (p<0.05). No differences were observed between the restorative resins in terms of retention (p>0.05). One restored tooth from the FU group was crowned. The retention rates for the TB and the FU groups were 100%. In the FU group, two restorations showed slightly rough surfaces, and two showed a slight mismatch in color. None of the restorations showed postoperative sensitivity, secondary caries, or loss of anatomic form. Conclusions: The tested bulk fill restorative resin demonstrated better clinical performance in terms of marginal discoloration and marginal adaptation.

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24-Month Clinical Evaluation of Different Bulk-Fill Restorative Resins in Class II Restorations

Operative Dentistry ◽

10.2341/18-144-c ◽

2020 ◽

Vol 45 (2) ◽

pp. 123-133

Author(s):

T Guney ◽

AR Yazici

Keyword(s):

Clinical Performance ◽

Evaluation Criteria ◽

Class Ii ◽

Recall Rate ◽

Marginal Adaptation ◽

Chi Square ◽

Posterior Group ◽

Significant Difference ◽

Chi Square Test ◽

Molar Teeth

SUMMARY The objective of this study was to evaluate the 24-month clinical performance of three different bulk-fill restorative resin materials in class II restorations. Forty patients with at least three approximal lesions in premolar and molar teeth participated in the study. A total of 120 class II cavities were restored using Tetric EvoCeram Bulk Fill (n=40), SureFil SDR flow + Ceram.X mono (n=40), and everX Posterior + G-aenial Posterior (n=40) with their respective adhesives according to the manufacturers' instructions. All restorations were placed by one operator. The restorations were evaluated at baseline and at six, 12, 18, and 24 months using modified US Public Health Service criteria by one examiner. The restoration groups for each category were compared using the Pearson chi-square test, while the Cochran Q-test was used to compare the changes across different time points within each restorative material (p<0.05). At the end of 24 months, 94 restorations were evaluated in 33 patients, with a recall rate of 82.5%. There were no statistically significant differences between the groups in terms of retention (p>0.05). At the 24-month recall, two restorations from the SureFil SDR flow + Ceram.X mono group and four from the everX Posterior + G-aenial Posterior group showed slight marginal discoloration and were rated as bravo. No marginal discoloration was observed in any of the Tetric EvoCeram Bulk Fill restorations. Six restorations from the Tetric EvoCeram Bulk Fill group, six from the SureFil SDR flow + Ceram.X mono group, and 12 from the everX Posterior + G-aenial Posterior group received bravo scores in terms of marginal adaptation. No difference was found among the three groups for any of the evaluation criteria tested (p>0.05). There were statistically significant differences between the baseline and 24-month recall in the everX Posterior + G-aenial Posterior group in terms of marginal discoloration (p<0.05). For marginal adaptation, a significant difference was observed between baseline and 24 months for all the restorative resins (p<0.05). All the restorative resins tested performed similarly and showed acceptable clinical performance during the 24-month evaluation.

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Clinical Evaluation of a Silorane- and a Methacrylate-Based Resin Composite in Class II Restorations: 24-Month Results

Operative Dentistry ◽

10.2341/15-286-c ◽

2017 ◽

Vol 42 (4) ◽

pp. E102-E110 ◽

Cited By ~ 1

Author(s):

E Karaman ◽

AR Yazici ◽

G Ozgunaltay ◽

I Ustunkol ◽

A Berber

Keyword(s):

Clinical Performance ◽

Resin Composite ◽

Adhesive System ◽

Class Ii ◽

Resin Composites ◽

Chi Square ◽

Significant Difference ◽

Restorative Materials ◽

Chi Square Test ◽

Self Etch

SUMMARY Objective: To compare the 24-month clinical performance of two different resin composites in class II slot restorations. Methods and Materials: Thirty-seven patients having at least two approximal carious lesions were enrolled in the study. A total of 116 teeth (58 pairs) were restored with either a silorane-based composite (Filtek Silorane) and its self-etch adhesive (Silorane Adhesive System, 3M ESPE) or a methacrylate-based packable resin composite (X-tra Fil) and its self-etch adhesive (Futurabond NR, VOCO GmbH) according to the toss of a coin. The restorations were evaluated at baseline and at six-, 12-, and 24-month recalls by two calibrated examiners according to the modified US Public Health Service criteria. The comparison of the two restorative materials for each category was performed with the Pearson chi-square test. Within group differences of the materials at different recall times were compared using the Cochran Q and Friedman tests. Bonferroni-adjusted McNemar test was used when significant difference was found (p<0.05). Results: After 24 months, no statistically significant differences were found between the two restorative materials for the criteria evaluated. Conclusions: Both silorane- and methacrylate-based resin composites showed clinically acceptable performance in class II slot restorations after 24 months.

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CLINICAL EVALUATION OF THE NANO HYBRID BULK FILL COMPOSITE AND NANO HYBRID FLOWABLE COMPOSITE IN CLASS I RESTORATIONS--- AN IN VIVO STUDY

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i2.1726 ◽

2021 ◽

Vol 5 (2) ◽

Author(s):

Anil K. Tomer ◽

Hysum Mushtaq ◽

Anila Krishna Saxena ◽

Megna Bhatt ◽

Ayush Tyagi ◽

...

Keyword(s):

Clinical Performance ◽

Retention Rate ◽

Resin Composite ◽

Adhesive System ◽

Recall Rate ◽

Class I ◽

In Vivo Study ◽

Marginal Adaptation ◽

Flowable Composite

Objectives: The aim of this study was to evaluate the clinical performance of a nano filled flowable and nano hybrid bulk fill resin composite in class I restorations. Methods and Materials: Twenty patients were selected for this in vivo study. Each patient received at least one pair of restorations, restored with nano hybrid bulk fill resin composite (IPS Empress direct [IED]) and nano hybrid Tetric N Ceram flowable composite [TNC]. Each restorative resin system was used with its respective adhesive system according to manufacturers’ instructions. A total of 40 class I restorations were placed by one operator. Restorations were blindly evaluated by two examiners at baseline and 3, 6, and 12 months respectively using modified US Public Health Service Ryge criteria. The data obtained was statistically analyzed using Chi square test to compare the two restorative materials for each category. Results: At 3, 6 and 12, months, recall rate was 100%, 95% and 85%, respectively, with a retention rate of 100%. There were statistically significant differences between the two restorative resins in terms of marginal adaptation and marginal discoloration (p<0.05). No differences were observed between the restorative resins in terms of retention (p<0.05). None of the restorations showed postoperative sensitivity, or loss of anatomic form. Conclusion: Within the limitations of this study, nano hybrid bulk fill composite resin viz. IPS EMPRESS DIRECT showed better clinical performance than nano filled flowable composite in terms of marginal discoloration and marginal adaptation. Keywords: direct composite, bulk, hybrid filled resin

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Comparison of Acid Versus Laser Etching on the Clinical Performance of a Fissure Sealant: 24-Month Results

Operative Dentistry ◽

10.2341/11-435-c ◽

2013 ◽

Vol 38 (2) ◽

pp. 151-158 ◽

Cited By ~ 15

Author(s):

E Karaman ◽

AR Yazici ◽

M Baseren ◽

J Gorucu

Keyword(s):

Clinical Performance ◽

Recall Rate ◽

Retention Rates ◽

Laser Etching ◽

Chi Square ◽

Preparation Methods ◽

Fissure Sealant ◽

Chi Square Test ◽

Pit And Fissure Sealant

SUMMARYObjectiveTo compare the clinical performance of a pit and fissure sealant placed with the use of different enamel preparation methods, i.e. acid or Er,Cr:YSGG laser etching, over 24 months.MethodsSixteen subjects (15 female, 1 male) with no restorations or sealant present on their fissures and no detectable caries participated. Using a table of random numbers, a total of 112 sealants (56 with acid-etching, 56 with laser etching) were placed on the permanent premolar and molar teeth. All restorative procedures except for application of the laser were performed by the same dentist. After completion of the fissure preparation either with acid or laser, the adhesive was applied; then a pit and fissure sealant, Clinpro Sealant, was placed and polymerized. Clinical evaluations were done at baseline and at 6-, 12-, 18-, and 24-month follow-up visits by two calibrated examiners, who were unaware of which etching method had been used. The retention of sealants and caries were evaluated with the aid of a dental explorer and an intra-oral mirror. Each sealant was evaluated using the following criteria: 1=completely retained; 2= partial loss; 3= total loss. The Pearson chi-square test was used to evaluate differences in the retention rates among the sealants used with different etching methods.ResultsAll patients attended the 24-month follow-up visit and all sealants were evaluated (total recall rate 100%). At the end of 24 months, 83.9% of the sealants from laser group and 85.7% of those from acid-etch group were recorded as “completely retained”. There were no statistically significant differences in retention rates among the preparation methods after all evaluation periods (p>0.05). No statistically significant differences were found between the retention rates of premolar and molars at each evaluation period. No secondary caries was detected in association with any sealants. Conclusion: The clinical performance of fissure sealants placed after acid or Er,Cr:YSGG laser etching was similar.

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Three-year Clinical Evaluation of Different Restorative Resins in Class I Restorations

Operative Dentistry ◽

10.2341/13-221-c ◽

2014 ◽

Vol 39 (3) ◽

pp. 248-255 ◽

Cited By ~ 22

Author(s):

AR Yazici ◽

I Ustunkol ◽

G Ozgunaltay ◽

B Dayangac

Keyword(s):

Clinical Performance ◽

Retention Rate ◽

Resin Composite ◽

Adhesive System ◽

Class I ◽

Marginal Adaptation ◽

Significance Level ◽

Bonferroni Adjustment ◽

Etch And Rinse ◽

Restorative Materials

SUMMARY The aim of the present study was to evaluate the three-year clinical performance of a nanofilled resin composite, a packable resin composite, and silorane-based resin restorations in Class I occlusal cavities. Twenty-eight patients with at least three similar-sized occlusal lesions in molar teeth participated in the study. A total of 84 Class I occlusal restorations were placed: 28 with nanofilled resin composite (Filtek Supreme), 28 with packable resin composite (P60), and 28 with silorane-based resin (Filtek Silorane). Filtek Supreme and P60 were used with their respective etch-and-rinse adhesive system, Adper Single Bond 2, and Filtek Silorane was used with its respective self-etch adhesive, Filtek Silorane Adhesive. All restorations were placed by the same operator. The restorations were evaluated at baseline, at six months, and annually for three years according to modified US Public Health Service criteria by two calibrated examiners who did not know which restorative resin had been used. The three restorative materials for each category were compared using the χ2 test at a significance level of 0.05. Cochran's Q test was used to compare the changes across the five time points for each restorative material. McNemar's test followed by Bonferroni adjustment was used when significance differences were found. At the end of the three years, 60 restorations were evaluated in 20 patients, with a recall rate of 71.4%. The retention rate was 100% for all restorative resins. Eight restorations from the P60 group, ten from the Filtek Supreme group, and nine from the Filtek Silorane group were rated Bravo for marginal discoloration. For marginal adaptation, three P60, five Filtek Supreme, and 11 Filtek Silorane restorations were rated Bravo. No statistically significant differences in overall clinical performance were found between the restorative materials except for marginal adaptation. P60 showed the best marginal adaptation at the end of the three years. No differences were observed between the restorative resins for any of the evaluation criteria tested (p>0.05). None of the restorations showed postoperative sensitivity, secondary caries, or loss of anatomic form. All restorative resins performed equally well in clinical conditions during the three-year evaluation, and no significant differences were found among them, except for marginal adaptation, in which P60 showed superior results.

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Marginal Integrity of Bulk Versus Incremental Fill Class II Composite Restorations

Operative Dentistry ◽

10.2341/14-306-l ◽

2016 ◽

Vol 41 (2) ◽

pp. 146-156 ◽

Cited By ~ 26

Author(s):

F Al-Harbi ◽

D Kaisarly ◽

D Bader ◽

M El Gezawi

Keyword(s):

Resin Composite ◽

Class Ii ◽

Chi Square ◽

Sandwich Technique ◽

Thermomechanical Cycling ◽

Composite Restorations ◽

Marginal Integrity ◽

Chi Square Test ◽

Maxillary Premolars ◽

Self Etch

SUMMARY Bulk-fill composites have been introduced to facilitate the placement of deep direct resin composite restorations. This study aimed at analyzing the cervical marginal integrity of bulk-fill vs incremental and open-sandwich class II resin composite restorations after thermomechanical cycling using replica scanning electron microscopy (SEM) and ranking according to the World Dental Federation (FDI) criteria. Box-only class II cavities were prepared in 91 maxillary premolars with the gingival margin placed 1 mm above and below the cemento-enamel junction. Eighty-four premolars were divided into self-etch and total-etch groups, then subdivided into six restorative subgroups (n=7): 1-Tetric Ceram HB (TC) was used incrementally and in the open-sandwich technique with 2-Tetric EvoFlow (EF) and 3-Smart Dentin Replacement (SD). Bulk-fill restoratives were 4-SonicFill (SF), 5-Tetric N-Ceram Bulk Fill (TN), and 6-Tetric EvoCeram Bulk Fill (TE). In subgroups 1-5, Tetric N-Bond self-etch and Tetric N-Bond total-etch adhesives were used, whereas in subgroup 6, AdheSE self-etch and ExciTE F total etch were used. One more group (n=7) was restored with Filtek P90 Low Shrink Posterior Restorative (P9) only in combination with its self-etch P90 System Adhesive. Materials were manipulated and light cured (20 seconds, 1600 mW/cm2), and restorations were artificially aged by thermo-occlusal load cycling. Polyvinyl-siloxane impressions were taken and poured with epoxy resin. Resin replicas were examined by SEM (200×) for marginal sealing, and percentages of perfect margins were analyzed. Moreover, samples were examined using loupes (3.5×) and explorers and categorized according to the FDI criteria. Results were statistically analyzed (SEM by Kruskal-Wallis test and FDI by chi-square test) without significant differences in either the replica SEM groups (p=0.848) or the FDI criteria groups (p>0.05). The best SEM results at the enamel margin were in TC+EF/total-etch and SF/total-etch and at the cementum margins were in SF/total-etch and TE/self-etch, while the worst were in TC/self-etch at both margins. According to FDI criteria, the best was TE/total-etch at the enamel margin, and the poorest was P9/self-etch at the cementum margin. Groups did not differ significantly, and there was a strong correlation in results between replica SEM and FDI ranking.

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Catechin-based Dentin Pretreatment and the Clinical Performance of a Universal Adhesive: A Two-year Randomized Clinical Trial

Operative Dentistry ◽

10.2341/19-088-c ◽

2020 ◽

Vol 45 (5) ◽

pp. 473-483 ◽

Cited By ~ 1

Author(s):

CAGA Costa ◽

NLG Albuquerque ◽

JS Mendonça ◽

AD Loguercio ◽

VPA Saboia ◽

...

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Clinical Performance ◽

Resin Composite ◽

Retention Rates ◽

Marginal Adaptation ◽

Single Bond ◽

Etch And Rinse ◽

Significant Difference ◽

Self Etch

Clinical Relevance At 24 months, the dentin pretreatment with epigallocatechin-3-gallate did not impair the clinical performance of the adhesive Single Bond Universal regardless of the bonding strategy used. SUMMARY Purpose: To evaluate the two-year effect of dentin pretreatment with epigallocatechin-3-gallate (EGCG) on the clinical performance of restorations of noncarious cervical lesions (NCCLs) with Single Bond Universal, applied in two different modes (self-etch and etch-and-rinse). Methods and Materials: In this randomized clinical trial, 33 volunteers were selected, and 156 NCCLs were assigned to four groups: ER, etch-and-rinse; ER-EGCG, 0.1% EGCG dentin pretreatment + etch-and-rinse; SE, self-etch; and SE-EGCG, 0.1% EGCG dentin pretreatment + self-etch. The NCCLs were restored with a nanofilled resin composite and evaluated at baseline and at six, 12, 18, and 24 months using FDI criteria for retention, marginal staining, marginal adaptation, caries, and postoperative sensitivity. Two evaluators were blinded to the treatments performed, and impressions were taken for resin replicas to allow indirect observations. Statistical analyses were performed with Kruskal-Wallis and McNemar tests with a significance level of 5%. Results: Six restorations (one from ER, two from SE, one from ER-EGCG, and two from SEEGCG) were lost at 24 months with no significant differences (p>0.05). The retention rates were 97.0% (ER and ER-EGCG), 94.1% (SE), and 94.2% (SE-EGCG). For marginal adaptation, a significant difference was detected between the baseline and 24 months for the SE group (p=0.0313). There were no statistical differences among all other evaluated criteria at 24 months, neither for each group at baseline nor for 24-month comparisons (p>0.05). Conclusions: The pretreatment with EGCG provided no benefit in the clinical performance of the adhesive regardless of the bonding strategy used. In addition, it adds an additional required step to the restorative procedure.

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Five-year Randomized Clinical Trial on the Performance of Two Etch-and-rinse Adhesives in Noncarious Cervical Lesions

Operative Dentistry ◽

10.2341/20-103-c ◽

2021 ◽

Author(s):

TP Matos ◽

TA Hanzen ◽

R Almeida ◽

C Tardem ◽

MC Bandeca ◽

...

Keyword(s):

Repeated Measures ◽

Clinical Performance ◽

Retention Rate ◽

Resin Composite ◽

Marginal Adaptation ◽

Dihydrogen Phosphate ◽

Single Bond ◽

Cervical Lesions ◽

Repeated Measures Anova ◽

Etch And Rinse

SUMMARY Objectives: To evaluate the 5-year clinical performance of two-step etch-and-rinse adhesives in noncarious cervical lesions (NCCL). Methods and Materials: The sample comprised 35 adults with at least two similar-sized NCCL. Seventy restorations were placed, according to one of the following groups: Adper Single Bond 2 (SB) and Ambar (AM). The restorations were placed incrementally using a resin composite (Opallis). The restorations were evaluated at baseline and after 6 and 18 months and 5 years using some items of the FDI criteria. The differences in the ratings of the two materials after 6 months, 18 months, and 5 years were performed with Friedman repeated measures ANOVA by rank and McNemar test for significance in each pair (α=0.05). Results: Five patients did not attend the 60-month recall. No significant differences were observed between the materials for any criteria evaluated. Twenty-one restorations failed (12 for SB and 9 for AM) after 60 months. Thus, the retention rate for SB at 60 months were 55.6% for SB and 71% for AM (p=0.32). After 60 months, 12 restorations (6 for SB and 6 AM) showed some loss of marginal adaptation (p=1.0). Slight marginal discoloration was observed in 10 restorations (6 for SB and 4 AM; p=0.91). Five restorations (2 for SB and 3 for AM) showed recurrences of caries (p=1.0). Conclusions: Both two-step etch-and-rinse adhesives—Adper Single Bond 2, a polyalkenoic acid-containing adhesive, and Ambar, a 10-methacryloyloxydecyl dihydrogen phosphate (MDP)-containing adhesive—showed acceptable clinical performance after 60 months.

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Influence of Surface Treatment on Composite Adhesion in Noncarious Cervical Lesions: Systematic Review and Meta-analysis

Operative Dentistry ◽

10.2341/17-086-l ◽

2018 ◽

Vol 43 (5) ◽

pp. 508-519 ◽

Cited By ~ 7

Author(s):

AC Rocha ◽

WLO Da Rosa ◽

AR Cocco ◽

AF Da Silva ◽

E Piva ◽

...

Keyword(s):

Clinical Trials ◽

Retention Rate ◽

Resin Composite ◽

Adhesive System ◽

Surface Treatments ◽

Retention Rates ◽

Cervical Lesions ◽

Dentin Surface ◽

Composite Restorations ◽

Mechanical Removal

SUMMARY The purpose of this study was to analyze the influence of dentin surface treatments on the retention rate of resin composite restorations in non-carious cervical lesions (NCCLs). Seven randomized clinical trials were included in this review. Data regarding retention rate, type of surface treatment, and the main characteristics of studies were analyzed. Two reviewers performed a literature search up to December 2016 in eight databases: PubMed (Medline), Lilacs, Ibecs, Web of Science, BBO, Scopus, Scielo and The Cochrane Library. Only clinical trials evaluating dentin surface treatments in resin composite restoration in NCCLs were included. Noncontrolled clinical trials, reviews, editorial letters, case reports, case series and studies published in a language other than English, Portuguese, or Spanish were not included. The included studies evaluated different surface treatments, such as using an adhesive system with a frictional technique, drying the dentin, and removing sclerotic dentin by using a bur and applying EDTA before primer use. The analysis considering the mechanical removal of dentin surface with a bur and the application of an adhesive system in a frictional mode showed these treatments improved retention rates of the resin composite restorations in NCCLs (p<0.05). There is evidence in the literature suggesting that the mechanical removal of dentin surface with a bur and the application of an adhesive system in a frictional mode could improve the retention rates of resin composite restorations in NCCLs. However, the studies showed high heterogeneity, and additional clinical trials are needed to determine the best dentin treatment option in NCCLs.

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Clinical Evaluation of Silorane and Nano-hybrid Resin Composite Restorations in Class II Cavities up to 3 Years

Operative Dentistry ◽

10.2341/15-259-c ◽

2016 ◽

Vol 41 (6) ◽

pp. 599-606 ◽

Cited By ~ 1

Author(s):

F Öztürk-Bozkurt ◽

T Toz ◽

A Kara-Tuncer ◽

H Gözükara-Bağ ◽

M Özcan

Keyword(s):

Clinical Performance ◽

Resin Composite ◽

United States Public Health ◽

Class Ii ◽

Marginal Adaptation ◽

Significant Deterioration ◽

Final Recall ◽

Hybrid Resin ◽

Significant Difference ◽

Sensitivity Changes

SUMMARY In this study, the clinical performance of a silorane-based resin composite (SC) vs a nano-hybrid resin composite (NHC) was evaluated in Class II cavities. From January 2012 to February 2013, a total of 29 patients (eight men, 21 women; mean age, 24 ± 5 years) received 29 pairs of restorations using both SC (Filtek Silorane, 3M ESPE) and NHC (Filtek Z550, 3M ESPE) materials. Patients were followed until February 2015. One operator performed all restorations using the corresponding adhesive resins according to the manufacturers' instructions. Two calibrated independent examiners evaluated the restorations at one week, six months, and then annually using the modified United States Public Health Service (USPHS) criteria for anatomic form, marginal adaptation, color match, surface roughness, marginal discoloration, secondary caries, and postoperative sensitivity. Changes in the USPHS parameters were analyzed with the McNemar test (α=0.05). The mean observation period was 31.2 months. Marginal adaptation was the only parameter that showed a significant difference and was worse for SC than NHC (p=0.012). At the final recall, 17 restorations from the SC group and five from the NHC group received a score of 1 (explorer catches). These scores were significantly different between baseline and final recall for SC (p<0.001) but not for NHC (p>0.05). Both NHC and SC performed similarly in Class II restorations up to three years except for marginal adaptation, for which the latter demonstrated significant deterioration at the final recall compared with baseline.

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