Two-year clinical performance of two one-step self-etching adhesives in the restoration of cervical lesions

The aim of the study was to evaluate the clinical performance of two different one-step self-etching adhesives (Hybrid Bond/Sun Medical, Xeno III/Dentsply) in adhesive cervical resin composite restorations. In accordance with a split-mouth study design, 50 patients (57.3 +/- 13.5) received at least one pair of restorations. In each of two comparable cervical cavities, either the adhesive systems Hybrid Bond or Xeno III was used with the resin composite Filtek Supreme (3M ESPE). After 6, 12 and 24 months, the restorations were scored according to the Ryge and California Dental Association criteria. After 2 years, the resulting scores (percent) of the Ryge evaluation for the groups Hybrid Bond/ Filtek Supreme and Xeno III/ Filtek Supreme were marginal integrity, Alpha (92/78), Bravo (8/2), Charlie (0/0) and Delta (0/10); anatomic form, Alpha (92/82), Bravo (8/8) and Charlie (0/10); secondary caries, Alpha (100/100) and Bravo (0/0); marginal discoloration, Alpha (80/84), Bravo (20/12), Charlie (0/0) and not available (0/4); color match, Oscar (39/47), Alpha (51/45), Bravo (10/4), Charlie (0/0) and not available (0/4); surface, Romeo (78/69), Sierra (22/22), Tango (0/0) and Victor (0/10); tooth vitality, Alpha (98/94), Bravo (2/6); and integrity of tooth, alpha 1 (96/96) and alpha 2 (4/4). After 2 years, all Hybrid Bond restorations were retained and showed clinically acceptable results, while five Xeno III restorations were lost in part or in toto. For marginal integrity, anatomic form and surface, significant differences (p < 0.05) were found but did not prove statistically significant after Bonferroni adjustment.     

Two-year clinical performance of a nanofiller vs a fine-particle hybrid resin composite

The aim of the study was to evaluate the clinical performance of the nanofiller resin composite Filtek Supreme (3M ESPE) vs the conventional fine hybrid resin composite Tetric Ceram (Ivoclar Vivadent) in stress-bearing posterior cavities. In accordance with a split mouth study design, 50 patients (35.7±11.3 years) received at least one pair of Filtek Supreme and Tetric Ceram restorations in each of two comparable class II cavities. To obtain comparability, the adhesive Scotchbond 1 was used for all the restorations. After 2 years, the restorations (total number 112) were scored according to the Ryge criteria. After 2 years (recall rate 100%), the results (%) of the Ryge evaluation for the two groups Filtek Supreme/Tetric Ceram were marginal adaptation: Alfa 96/96, Bravo 2/2, Charlie 2/0, and Delta 0/2; anatomic form: Alfa 98/98, Bravo 0/0, and Charlie 2/2; secondary caries: Alfa 100/100 and Bravo 0/0; marginal discoloration: Alfa 98/100, Bravo 2/0, and Charlie 0/0; surface: Romeo 95/95, Sierra 4/4, Tango 0/0, and Victor 2/2; and color match: Oscar 46/57, Alfa 50/39, Bravo 2/4, and Charlie 2/0. One Tetric Ceram and one Filtek Supreme restoration showed fractures that needed restorative intervention. No severe postoperative sensitivities were reported within the observation period. All restored teeth remained vital; the integrity of all the teeth was scored Alfa. After 2 years, no statistically significant differences (Wilcoxon–Mann–Whitney test) was found between the two restorative materials investigated. Therefore, Filtek Supreme, based on a new nanofiller technology, has proved efficaciousness for clinical use in stress-bearing posterior cavities.     

Two-year clinical performance of a packable posterior composite with and without a flowable composite liner

The aim of the study was to evaluate the clinical performance of a packable fine hybrid dental composite (Prodigy Condensable) and the influence of the additional application of a flowable resin composite (Revolution, SDS Kerr) layer on marginal integrity after 2 years in stress-bearing posterior cavities according to the Ryge criteria. In 50 patients (40.5±17.5 years of age), 116 class II fillings (metal matrix system, glass ionomer-cement-base in 36%, rubberdam isolation in 70%) were placed, with at least two restorations per patient. The adhesive Optibond Solo Plus was used for all the restorations. In one of the two fillings in each patient, an additional layer of the flowable composite Revolution was applied in the entire cavity and separately light-cured. Baseline scores have been rated Alfa in 95% and Bravo in <5%. After 2 years, the results [%] of the Ryge evaluation for the two groups with/without the additional use of Revolution were: (1) Marginal Adaptation: Alfa:78/70, Bravo:16/27, Charlie:0/0, Delta:6/4; (2) Anatomic Form: Alfa:89/95, Bravo:6/2, Charlie:6/4; (3) Secondary Caries: Alfa:98/100, Bravo:2/0; (4) Marginal Discoloration: Alfa:76/68, Bravo:24/32, Charlie:0/0; (5) Surface: Alfa:90/91, Bravo:4/5, Charlie:0/0, Delta:6/4; (6) Color Match: Oscar:56/57, Alfa:44/39, Bravo:0/4, Charlie:0/0. Within the observation period (recall rate: 95%), three restorations out of 116 at baseline fractured, one restoration showed a secondary caries, one tooth received endodontic treatment, and all other restored teeth remained vital. After 2 years, no statistically significant difference (Chi-square test) in the overall survival rate between the group with the additional use of Revolution (92.8%) and that without Revolution (94.6%) was found. The combined survival rate for both groups together was 93.7% of clinically acceptable restorations.     

Clinical performance of a packable resin composite for a period of 3 years.

OBJECTIVE: The purpose of this clinical study was to evaluate SureFil packable resin composite for posterior restoration of permanent teeth for a period of 3 years. METHOD AND MATERIALS: Fifty-five resin composite restorations were placed in 36 patients (16 Class I and 39 Class II restorations). After cavity preparation, the enamel was etched with 34% phosphoric acid. Prime & Bond NT was applied 20 seconds to dentin and etched enamel and cured for 20 seconds. The teeth were restored in 3- to 5-mm increments. The restorations were assessed after placement, at 6 months, 1 year, 2 years, and 3 years for color stability, marginal discoloration, marginal adaptation, secondary caries, surface texture, anatomic form, and postoperative sensitivity according to Ryge's criteria. The changes in the parameters were assessed with Friedman test analysis with a Bonferroni correction at a significance level of .05. RESULTS: Forty of the monitored 47 restorations were classified as excellent after 3 years. Thirty-one restorations were graded Bravo at baseline for color match. At the 3-year assessment (n = 47) the color of the 31 restorations had not changed. Two restorations (same patient) were lost after 1 month and were scored as Charlie until the end of the study. After 3 years there were five Bravos and one Charlie with marginal discoloration, five Bravos with marginal adaptation, and three Bravos with anatomic form (P < .05). CONCLUSION: After 3 years of clinical service, SureFil packable resin composite, with a failure rate of 6%, was considered to be successful in Class I and II restorations.     

A prospective, double-blind, randomized clinical trial of a one-step, self-etch adhesive with and without an intermediary layer of a flowable composite: A 2-year evaluation

Objective: The aim of this prospective, double-blind, randomized long-term study was to evaluate the clinical performance of the self-etch adhesive AdheSE One in combination with the nanohybrid composite resin Tetric Evo Ceram for Class 1 and 2 restorations. The improvement of the clinical performance with the additional use of a flowable composite resin for cavity lining was tested. Method and Materials: In accordance with a split-mouth design, 50 patients received 100 restorations in premolars and molars. One restoration of each patient was chosen at random to be restored with an intermediary layer of a flowable composite resin. Each restoration was scored according to the modified Ryge criteria at baseline and after 6, 12, and 24 months. Results: After 24 months (recall rate 88%), the results of the Ryge evaluation for groups without (group T) and with application (group TF) of Tetric Flow were as follows: marginal adaptation, Alpha 40/40 and Bravo 3/4; marginal discoloration, Alpha 39/41 and Bravo 4/3; and filling integrity, Alpha 42/42 and Bravo 1/2. All restored teeth remained vital. The parameters hypersensitivity, recurrent caries, surface, color match, and proximal contact were scored Alpha for all teeth. Between groups, no statistically significant differences could be detected (Mann-Whitney U test, P > .05). Conclusion: In consideration of the short observation period, the clinical use of AdheSE One in stress-bearing posterior cavities reached acceptable clinical results with a 1.1% cumulative failure rate after 2 years. The use of a flowable composite resin did not show an improved clinical performance. (Quintessence Int 2012;43:279?286).     

Clinical performance of resin composite restorations after 2 years

The objective of this study was to evaluate the clinical performance of a packable restorative material, after 2 years in stress-bearing posterior cavities, according to the Ryge criteria. At least two Class 2 restorations (occluso-mesial, mesial-occlusal-distal, occlusal-distal) were placed in 46 patients (36.7 +/- 16 years). In each of the restorations (lot 221, metal matrix band system, glass ionomer-cement-base in 53% of the cavities, mostly no rubber dam) an adhesive system was used. Additionally, in each patient a flowable composite was used in one of the two fillings. After 2 years, 70% of the patients were available for reevaluation. Two restorations needed to be replaced as a result of postoperative sensitivities within the observation period, and one tooth received root canal treatment. All other restored teeth remained vital. One restoration with marginal discoloration received a score of Charlie; another with secondary caries received a score of Bravo. All the others revealed excellent and clinically acceptable results. No statistically significant difference (Chi-square-test) was observed between the two groups, with and without an additional flowable composite. After 2 years, the restorative material performed clinically well, with no observable fractures in the restoration.     

3-Year clinical evaluation of posterior packable composite resin restorations

This study evaluated the clinical performance of four packable resin composite restorative materials in posterior teeth (Class I and II) compared with one hybrid composite after 3 years. Eighty-four restorations were placed in 16 patients. The tested materials were: (i) Solitaire + Solid Bond; (ii) ALERT + Bond-1; (iii) Surefil + Prime & Bond NT; (iv) Filtek P60 + Single Bond and (v) TPH Spectrum + Prime & Bond 2.1. All restorations were made using rubber dam isolation, and the cavity design was restricted to the elimination of carious tissue. Deeper cavities were covered with calcium hydroxide and/or glass-ionomer cement. Each adhesive system and composite resin was placed according to the manufacturer's instructions. One week later, the restorations were finished/polished and evaluated according USPHS modified criteria. Fourteen patients attended the 3-year recall and 75 restorations were evaluated at that time based on the same evaluation criteria. Friedman repeated measures analysis of variance by rank and Wilcoxon sign-ranked test for pair-wise comparison was used for data analysis (alpha = 0.05). The analysis was performed only for the baseline and for the 3-year period. Solitaire showed some fractures at marginal ridges in 25% of the cases. Solitaire and ALERT showed some concerns related to colour match (43 and 77%, respectively) and surface texture (86 and 77%, respectively). TPH Spectrum showed a great percentage of colour mismatch after 3 years, around 50%. Surefil and Filtek P60 showed an excellent clinical performance after 3 years, similar to the hybrid resin tested, TPH Spectrum. Solitaire did not fulfil the ADA acceptance criteria for restorative materials and, therefore, is not recommended for use in posterior restorations.     

Two-year clinical evaluation of a packable resin-based composite

BACKGROUND: Packable resin-based composites were introduced in 1998, but few clinical studies have been conducted to evaluate them. The authors conducted a clinical study to determine the two-year performance of SureFil (Dentsply DeTrey GmbH, Konstanz, Germany) packable posterior resin-based composite in Class I and II restorations. METHODS: An operator (L.S.T.) restored 55 cavities in 36 patients (16 Class I restorations and 39 Class II restorations). After cavity preparation, she etched the enamel with 34 percent phosphoric acid, applied Prime & Bond NT (Dentsply DeTrey GmbH) to dentin and etched enamel for 20 seconds and then cured it for 20 seconds. She restored the cavity using 3- to 5-millimeter increments of SureFil. Independent examiners assessed the restorations after placement and at six months, one year and two years for color matching, marginal discoloration, marginal adaptation, secondary caries, surface texture, anatomical form and postoperative sensitivity, using the Ryge criteria. RESULTS: The authors assessed the changes in the parameters during the two-year period using a software program with Friedman test analysis with a Bonferroni adjustment at significant level of P = .05. At baseline, 31 restorations were graded as Bravo for color match. At the six-month and one-year recall periods (n = 55), 53 restorations remained unchanged. Two restorations from the same patient fell out after one month. After two years (n = 50), there were five Bravos for surface staining and three for marginal adaptation (P < .05). CONCLUSION: After two years of clinical service, SureFil packable resin-based composite had a success rate of 96 percent, and the authors considered it successful in Class I and II restorations. CLINICAL IMPLICATIONS: SureFil packable resin-based composite can be successful in clinical situations with limited-sized cavities and proper application of restorative techniques.     

Eighteen‐month clinical evaluation of microhybrid,packable and nanofilled resin composites in Class I restorations

Summary The aim of this article was to report the results of an 18‐month longitudinal randomized clinical trial that evaluated the clinical performance of microhybrid, packable and nanofilled resin composite restorations placed in Class I cavities of molar teeth. Three Class I resin composite restorations were placed in each of 35 patients. Each patient received one microhybrid (‘Point 4’; Kerr, Orange, CA, USA), one packable (‘Packable Premise’; Kerr, Orange, CA, USA) and one nanofilled (‘Nanofilled Premise’; Kerr, Orange, CA, USA) resin composite restoration. Clinical evaluation was performed at baseline (2 weeks after placement), and after 6, 12 and 18 months after placement using modified Ryge criteria. No patients were lost from the study. At the final appointment (after 18 months), 95·4%, 93·7% and 96·2% respectively of the microhybrid (‘Point 4’), packable (‘Packable Premise’ and nanofilled (‘Nanofilled Premise’) resin composite restorations received Alfa ratings. Regardless of the type of restorative material, no significant changes were observed in the modified Ryge criteria at the baseline and 18‐month recalls (P ≤0·05). Three restorations (one from each group) exhibited post‐operative sensitivity at the baseline and 6‐month appointment. After 18 months, one packable resin composite restoration failed because of secondary caries, while secondary caries was not detected on any of the other restorations. The clinical performance of microhybrid (‘Point 4’), packable (‘Packable Premise’) and nanofilled (‘Nanofilled Premise’) resin composite restorations was acceptable after 18 months. Further studies with longer follow‐up periods are recommended to investigate the long‐term survival of these restorations.     

A clinical study of composite restorations in anterior teeth using the Ryge criteria. Apropos of 120 cases performed at the University Hospital Center in Dakar]

In this two years retrospective study the authors determined the rate of survival composite restorations and evaluated clinically the remaining restorations by the Public Health Service (P.H.S.) criteria of Ryge. These restorations were performed by students using Heliomolar composite with scotchbond 2 adhesive dentin system. Results have shown that after two years, 98 (81.67%) out of 120 restorations were present and 51.2% were still working. Clinical evaluation of the remaining restorations needed replacement mainly because of severe color mismatch. Anatomic form and marginal adaptation were well scored after two years (score Alpha or Bravo). This study has shown that composite material is a valuable and effective technology for conservative treatment of anterior teeth in Senegal to avoid tooth extractions and prosthetic. However the knowledge about the type of composite material used must be improved and the operative procedures should be more controlled.     

Clinical assessment of high-strength all-ceramic crowns

STATEMENT OF PROBLEM: All-ceramic crowns are being used extensively. Little data are available on their clinical performance. PURPOSE: This study evaluated the clinical performance of In-Ceram (Vita Zahnfabrik) crowns. MATERIAL AND METHODS: Forty-one patients (16 men, 25 women; mean age 47.3 years, range 18 to 77 years) were examined with a total of 80 In-Ceram all-ceramic crowns fabricated at the University of Iowa College of Dentistry from 1994 to 1997. The percentage distribution for crowns included: 67% anterior single crowns, 26% posterior single crowns, 6% anterior implant crowns, and 1% posterior implant crowns. This study documented the integrity of the junction between crown and tooth, color match to adjacent teeth, secondary dental caries, wear of crown and opposing dentition, and visible cracks in the crown. Alpha, Bravo, and Charlie ratings were assigned with a modified USPHS criteria. The patients were also surveyed with respect to oral hygiene and satisfaction of treatment. Estimations of 4-year success rates and corresponding confidence intervals were calculated by fitting a constant hazard function model with the SAS procedure GENMOD. RESULTS: Marginal integrity for 88% of artificial crowns was rated Alpha or Bravo. Shade match for 99% was Bravo or better. Only 1% of the crowns were carious, and 1 crown exhibited occlusal wear. One premolar crown had a small fracture of veneering porcelain. One molar crown was remade after core fracture. All patients (100%) expressed satisfaction with their crowns. The estimated 4-year success rates (Alpha or Bravo), with 95% confidence intervals in parentheses were calculated as: 83.5% (65.7%-94.6%) for marginal integrity, 95.8% (82.9%-99.8%) for shade match, and 95.5% (81.6%-99.7%) for secondary caries, 100% (88%-100%) for wear, and 100% (88%-100%) for cracks.     

A clinical evaluation of packable and microhybrid resin composite restorations: one-year report.

OBJECTIVE: The objective of this study was to evaluate the clinical performance of two packable and one microhybrid resin composites placed in occlusal cavities of posterior permanent teeth after 1 year. METHOD AND MATERIALS: Sixty occlusal restorations were placed in 18 male or female patients aged 21 to 44 years. The restorations were divided into three groups according to the restorative material: G1 (Surefil + Prime&Bond NT); G2 (Filtek P60 + Singlebond), and G3 (Suprafill + Suprafill). They were placed by two previously calibrated operators. The restorations were directly evaluated for color matching, marginal discoloration, secondary caries, wear, marginal adaptation, and postoperative sensitivity. RESULTS: Of the total restorations, 66.7% were scored A (ideal) for color matching; 98.2% for marginal discoloration; 100% for secondary caries; 92.6% for wear; and 92.6% for marginal adaptation. Postoperative sensitivity was reported in 5% of the restorations. Fisher's exact, McNamara's, and chi-square tests did not indicate statistical difference between the groups, related to the evaluated criteria. CONCLUSIONS: The packable (Filtek P60 and Surefil) and the microhybrid (Suprafill) resin composites exhibited excellent clinical performance after 1 year and may be considered possible materials for the restoration of posterior teeth.     

One-year clinical evaluation of posterior packable resin composite restorations

This study evaluated the clinical performance of four packable resin composite restorative materials in posterior teeth (Class I and II) compared with one hybrid composite after one year. Eighty-four restorations were placed in 16 patients. Each patient received at least five restorations. The tested materials were: (1) Solitaire + Solid Bond; (2) ALERT + Bond-1; (3) Surefil + Prime & Bond NT (4) Filtek P60 + Single Bond and; (5) TPH Spectrum + Prime & Bond 2.1. All restorations were made using rubber dam isolation, and the cavity design was restricted to the elimination of carious tissue. Deeper cavities were covered with calcium hydroxide and/or glass ionomer cement. In shallow and medium cavities, no protection was performed except for the respective adhesive system used in each group. Each adhesive system and resin composite was placed according to the manufacturer's instructions. One week later, the restorations were finished/polished and evaluated according to the USPHS modified criteria. All patients attended the one-year recall, and the 84 restorations were evaluated at that time based on the same evaluation criteria. The scores were submitted to statistical analysis (Chi-square test, p<0.05). Solitaire and TPH showed some fractures at marginal ridges. Solitaire, ALERT and TPH showed some concerns related to color match and surface texture. Surefil and Filtek P60 showed an excellent clinical performance after one year.     

Total amalgam reconstruction. Clinical evaluation after three years

This study reports the results of the evaluation after three years of total amalgam restorations, made on molars and premolars vital and devitalized. The clinical parameters examinated were: 1) anatomic form and axial contour 2) marginal integrity 3) recurrent caries 4) occlusal contacts 5) interproximal contacts 6) pulpar or periodontal complication. To each of these parameters was given a degree of judgement expressed by Alpha, Bravo, Charlie, Delta. Alpha is the best evaluation, Bravo expresses a lower degree but clinically acceptable, Charlie and Delta are worse. Considering for each parameter the sum of the evaluations Alpha + Bravo, the clinically acceptable rate per cent of results has been quite good.     

Clinical evaluation of packable and conventional hybrid posterior resin-based composites: results at 3.5 years

BACKGROUND: The authors evaluated clinical performances of a packable and a conventional hybrid resin-based composite used with a self-etch adhesive system. METHODS: Three dentists placed 105 posterior restorations in 65 adults. They placed a packable (SureFil, Dentsply DeTrey GmbH, Konstanz, Germany) and a conventional (Spectrum, Dentsply DeTrey GmbH) resin-based composite using a self-etch resin adhesive system. The authors evaluated the restorations using Ryge modified criteria, photographs and die stone replicas. RESULTS: After 3.5 years, six large SureFil and two Spectrum restorations had failed from bulk fracture and secondary caries, resulting in cumulative survival rates of 81.3 and 92.0 percent, respectively. Failed SureFil restorations generally were larger than the remaining intact restorations. Other ratings were satisfactory, with no significant differences between the two materials for any restoration parameter. Alfa ratings for both materials were approximately 80 percent or greater for marginal discoloration, anatomical form, surface texture and surface staining. Lower percentages of restorations were rated Alfa for color match, marginal integrity and gingival health. No postoperative sensitivity was reported. Net mean occlusal wear (+/- standard deviation) was 28.9 (+/- 32.9) micrometers for SureFil and 33.8 (+/- 29.6) microm for Spectrum restorations; the difference was not statistically significant. CONCLUSIONS: When used with a self-etch adhesive, the 3.5-year clinical performances of both composites were similar and satisfactory for the restoration of Class I and moderate-sized Class II cavities. Clinical Implications. The two composites placed in this study have an increased risk of bulk fracture when placed in large intracoronal Class II molar preparations.     

Clinical evaluation of ceramic inlays and onlays fabricated with two systems: two-year clinical follow up

This study evaluated the clinical performance of ceramic inlays and onlays made with two systems: sintered (Duceram, Dentsply-Degussa)--D and pressable (IPS Empress, Ivoclar-Vivadent)--IPS after two years. Eighty-six restorations, 44 IPS and 42 D, were cemented into the mouths of 35 patients. Twenty-seven premolars and 59 molars received Class II preparations totaling 33 onlays and 53 inlays. All restorations were cemented with dual-cured resin cement (Variolink II, Ivoclar-Vivadent) and Syntac Classic adhesive under rubber dam. The evaluations were conducted by two independent investigators at the baseline and after one and two years using the modified USPHS criteria. Additionally, radiographs and slides were made. After two years, 100% of the restorations were assessed and all the restorations were considered clinically excellent or acceptable. Among the analyzed criteria, the following received Bravo ratings: marginal discoloration--IPS (31.82%), D (23.81%); marginal integrity--IPS (18.18%), D (11.9%), color match-IPS (4.55%), D (9.52%) and surface texture-IPS (2.27%); D (14.29%). No "Charlie" or "Delta" scores were attributed to the restorations. The results were subjected to the Fisher and McNemar Statistical Tests. No significant differences were noticed between the two ceramic materials. Among the analyzed criteria, only marginal discoloration presented an increased percentage of "Bravo" scores that increased with time for both ceramic materials. Compared with the baseline data, the difference was statistically significant (p < 0.05). No difference was found between inlay and onlay restorations or between restorations placed in premolars or molars. In conclusion, these two types of ceramic materials demonstrated excellent clinical performance after two years.     

A clinical comparison of resin composite inlay and onlay posterior restorations and cast-gold restorations at 7 years.

OBJECTIVE: The purpose of this study was to evaluate the clinical performance of Concept indirect posterior heat- and pressure-polymerized restorative material and compare it to the performance of cast gold. METHOD AND MATERIALS: Inlays and onlays placed in a standardized manner as part of a clinical study were evaluated at 7 years. Eighteen patients (45%) who had received 36 Concept restorations returned and were evaluated using the US Public Health Service criteria. Restorations were evaluated in seven categories as the percentage receiving Alfa (ideal), Bravo (clinically acceptable), or Charlie (clinically unacceptable) scores or as restoration no longer present. Fourteen of the restorations were cemented with Heliobond bonding resin and 13 were cemented with Special Bond bonding resin. Each patient also received a cast-gold restoration for comparison. RESULTS: Concept restorations received scores of Alfa at the following rates: color match, 64%; interfacial staining, 47%; secondary caries, 75%; wear, 58%; marginal integrity, 64%; surface texture, 72%; and axial contour, 58% (in 14% this category was not applicable because they were Class I restorations). Nine Concept restorations (25%) were no longer present. Fifteen of 18 gold restorations were present at this recall. Statistical analysis indicated no significant differences in any categories between the two bonding resins used with Concept restorative material and the gold restorations. CONCLUSION: At 7 years in vivo, the Concept indirect posterior restorative system yields clinically acceptable restorations, particularly in premolars.     

Clinical performance and SEM evaluation of direct composite restorations in primary molars

PURPOSE: To evaluate the clinical outcome of composite restorations performed in primary molars after 18 months and the morphology of the dentin/resin interface. METHODS: 41 primary molars from children aged 4-9 years were restored with Scotchbond Multi-Purpose Plus adhesive system and Z100 resin-based composite. The restorations were evaluated at baseline, 6, 12 and 18 months using the USPHS method for direct clinical analysis. Plaster models were made at each evaluation period for indirect evaluation. For the morphologic analysis of the dentin/resin interface, seven exfoliated teeth were sectioned longitudinally in a mesio/distal direction and observed in the electro scanning electron microscope. RESULTS: 100% (n = 40) of the restorations evaluated at 6 months were scored as Alpha for anatomical form, color matching, secondary caries, color alteration, and marginal degradation. At 12 months, 96.4% (n = 28) of the restorations received Alpha score and 3.4% Charlie score. At 18 months, all restorations evaluated (27/27) received Alpha score. 23 restorations were indirectly evaluated at 6, 12 and 18 months postoperatively. No significant wear or fractures were observed in any of the restorations. In the evaluation of the dentin/resin interface, the formation of a consistent hybrid layer was observed and the restorations were well adapted to the dentin at 18 months postoperatively.     

Physical properties of three packable resin-composite restorative materials

This study evaluated selected physical properties of three packable resin composites (Alert, SureFil and Solitaire) and compared them to two conventional hybrid materials (Prodigy and Z-100). The specific properties investigated were diametral tensile strength, transverse strength, elastic modulus and fracture toughness. Following photopolymerization, specimens for each composite material were stored in deionized water at 37 degrees C for 35 days. A one-way ANOVA and Tukey's post-hoc test were employed for each property to determine whether significant differences occurred with respect to specific restorative materials. All materials had statistically similar diametral tensile strengths. Alert had the highest mean fracture toughness and elastic modulus but had a low mean transverse-strength value. SureFil exhibited good mean physical property values compared to both the conventional and packable materials. Solitaire had low mean fracture toughness, transverse strength and elastic modulus values, which could cause concern regarding use in posterior restorations. The packable resin composites tested had a wide range of mean values for the physical properties investigated. Generally, Alert and SureFil were superior to Solitaire and comparable to the hybrid materials Prodigy and Z-100, but clear discrimination among performance of these materials requires clinical testing.     

One-year clinical evaluation of two polyacid-modified resin composites (compomers) in posterior permanent teeth

PURPOSE: The aim of this study was to evaluate the clinical performance of two polyacid-modified resin composites (Dyract AP and F2000) in posterior teeth after 1 year of clinical service. MATERIALS AND METHODS: Seventy-two Class I restorations were performed in 33 patients (average age 25 years) by one operator. Eighty-two per cent of the restorations were located in molars. Before the proceedings, patients were informed about the aim of the study and they gave written consent to participate. At least one restoration of each material was placed in each individual. The materials were applied according manufacturer's instructions. Following finishing and polishing, one examiner performed the clinical baseline examination using the adapted USPHS system. To be included in the clinical trial, a restoration had to be rated "Alpha". After one year, 25 patients were recalled and 56 restorations were evaluated using the adapted USPHS system. RESULTS: All restorations were classified as clinically satisfactory (Alpha or Bravo). However, there was a decrease in restoration quality compared to baseline. Statistical analysis (chi2 and Fisher's exact test) demonstrated differences only in relation to superficial roughness, with exhibiting F2000 more surface roughness than Dyract AP (p < 0.01). CONCLUSION: Based on the methodology employed, all restorations were satisfactory after one year and the two materials performed similarly, except for the surface roughness criteria.