Clinical evaluation of flowable resins in non-carious cervical lesions: two-year results

This study evaluated the two-year clinical performance of one microhybrid composite and three different types of flowable resin materials in non-carious cervical lesions. A total of 252 noncarious cervical lesions were restored in 37 patients (12 male, 25 female) with Admira Flow, Dyract Flow, Filtek Flow and Filtek Z250, according to manufacturers' instructions. All the restorations were placed by one operator, and two other examiners evaluated the restorations clinically within one week after placement and after 6, 12, 18 and 24 months, using modified USPHS criteria. At the end of 24 months, 172 restorations were evaluated in 26 patients, with a recall rate of 68%. Statistical analysis was completed using the Pearson Chi-square and Fisher-Freeman-Halton tests (p < 0.05). Additionally, survival rates were analyzed with the Kaplan-Meier estimator and the Log-Rank test (p < 0.05). The Log-Rank test indicated statistically significant differences between the survival rates of Dyract Flow/Admira Flow and Dyract Flow/Filtek Z250 (p < 0.05). While there was a statistically significant difference between Dyract Flow and the other materials for color match at 12 and 18 months, no significant difference was observed among all of the materials tested at 24 months. Significant differences were revealed between Filtek Z250 and the other materials for marginal adaptation at 18 and 24 months (p < 0.05). With respect to marginal discoloration, secondary caries, surface texture and anatomic form, no significant differences were found between the resin materials (p > 0.05). It was concluded that different types of resin materials demonstrated acceptable clinical performance in non-carious cervical lesions, except for the retention rates of the Dyract Flow restorations.     

Three-year clinical evaluation of a flowable and a hybrid resin composite in non-carious cervical lesions

Objectives

This randomized controlled clinical trial evaluated the 3-year clinical performance of a hybrid (Clearfil AP-X; AP) and a flowable (Clearfil Flow FX; FX) resin composite in 98 non-carious cervical lesions.

Methods

Twenty-two patients, 11 males and 11 females (mean age: 61.9 years, range: 29–78 years) regularly visiting the Nagasaki University Hospital, participated in the study. Each patient received both materials randomly. All restorations (48 restorations for AP and 50 restorations for FX) were placed in conjunction with an all-in-one system (Clearfil S³ Bond) by one dentist. The restorations were blindly evaluated by two examiners at baseline, 6 months, 1, 2 and 3 years using modified USPHS criteria. The data were statistically analyzed using the Cochran's Q-test and Fisher's exact test.

Results

All the patients were examined at each recall. However, five restorations could not be evaluated at 3-year recall as two teeth had been extracted and three restorations had been lost. The only minor problem was the integrity of the enamel margin. The incidence and extent of marginal staining increased with time, but it was still superficial. Marginal staining occurred adjacent to 11 restorations for AP and 12 restorations for FX after 3 years. Neither lesion size nor depth had influence on marginal staining adjacent to each type of resin composite. There were no significant differences in the clinical performances between AP and FX for each variable.

Conclusions

Under the protocol used in this study, both types of resin composite in conjunction with S³ Bond demonstrated an acceptable clinical performance up to 3 years.     

Clinical effectiveness of a Class V flowable composite resin system

This clinical study evaluated a Class V flowable composite resin restoration system and its ability to reduce dentin sensitivity. Twenty-one patients required Class V restorations because of erosion, abrasion, or decay at the cervical area. Each patient exhibited moderate or severe sensitivity and required replacement of tooth structure. The degree of sensitivity was determined by either tactile scraping of the tip of an explorer over the surface of the tooth or by an air blast from a syringe for 5 seconds. A total of 52 restorations were performed. According to phone conversations and questionnaires, 1 patient experienced continued sensitivity on 1 treated tooth for a duration of 1 week, but this sensitivity was gone at 1-month, 3-month, 6-month, and 1-year recalls. None of the other patients exhibited sensitivity at any phone checks or during recall visits.     

Clinical evaluation of self-etch adhesives in Class V non-carious lesions

PURPOSE: To evaluate the clinical performance of two self-etching and one total-etch adhesives in Class V non-carious cervical lesions (NCCL). METHODS: Two self-etching primers, Clearfil SE Bond and Hybrid Bond, and one total etch adhesive, Admira Bond, were placed in 195 NCCL. Restorations were evaluated at baseline, 1 and 2 years using the USPHS criteria. RESULTS: No restoration was lost after 1 and 2 years for all materials. There was no significant difference between the baseline and 2-year results for Admira Bond and Clearfil SE Bond restorations. In contrast, Hybrid Bond restorations showed significant deterioration in marginal adaptation and cavosurface marginal discoloration after 2 years. Also, there was no significant difference between Admira Bond and Clearfil SE Bond at each recall period.     

Class V lesions restored with flowable composite and added surface sealing resin

This in vitro study evaluates the marginal sealing ability of three different flowable composite systems at enamel and dentin margins, using sealants. Class V preparations were made on the facial surfaces in enamel and dentin/cement of 60 freshly extracted teeth, which were allotted randomly into six groups of ten. The control groups (I, II, and III) showed leakage in the majority of cases. However, Groups IV and V had very limited microleakage scores (2 of 30) in comparison to Group VI (p < 0.001, Mann-Whitney Test).     

Clinical evaluation of hybrid ionomer restoratives in Class V abrasion lesions: two-year results.

Eighty Class V abrasion cavities were selected, and 20 cavities were restored with one of three resin-modified glass-ionomer materials (Fuji II LC, Photac-Fil, and Vitremer) or a polyacid-modified resin composite (Dyract). The restorations were clinically evaluated after 1 and 2 years with the US Public Health Service criteria. The results revealed a statistically significant difference in the percentage of restorations rated Alfa for color match at 2 years. No statistically significant difference was found in the percentage of alfa rating for anatomic form. Restorations of all materials showed some marginal discrepancies that were not statistically significant.     

A clinical evaluation of a resin composite and a compomer in non-carious Class V lesions. A 3-year follow-up

PURPOSE: To compare the clinical performance of a resin composite and a polyacid-modified resin composite (compomer) in non-carious cervical lesions using a one-step self-etch adhesive. METHODS: Thirty patients, each with two non-carious cervical lesions (60 restorations), received one composite (Pertac-II) restoration and one compomer (Hytac) restoration, both used in conjunction with a self-etch adhesive (Prompt L-Pop) and placed following the manufacturer's instructions. Evaluations were at baseline, 6, 12 and 36 months after placement for retention, margin adaptation, marginal discoloration, anatomic form, secondary caries and postoperative sensitivity. Statistical analysis with the Pearson Chi-square test was undertaken. RESULTS: Retention rates were 86.6% for composite and 86.7% for compomer at 36 months. 3.3% of composite and 6.7% of compomer restorations showed a deficiency in marginal adaptation. Both materials showed a slight marginal discoloration of 7.7%. More deterioration in anatomic form occurred with the compomer (11.5%) than the composite (3.8%). None of the restorations exhibited secondary caries or postoperative sensitivity problems. There was no significant difference in performance between the materials in any of the categories evaluated.     

Three-year clinical evaluation of a resin modified glass-ionomer cement and a composite resin in non-carious class V lesions

The purpose of this study was a 3-year clinical evaluation of a resin modified glass-ionomer and a composite resin restorative material in non-carious class V lesions. In 24 patients 98 non-carious class V lesions were restored with either a resin modified glass-ionomer (Vitremer), or a composite resin restoration (Z100). The restorations were clinically evaluated after 6, 12, 24 and 36 months with the US Public Health Service criteria. At 3 years, 88 teeth of 21 patients were evaluated. All restorations were rated clinically acceptable for colour match, marginal discoloration, marginal adaptation and anatomical form. Restoration retention of both groups was high without any statistically significant difference. However, Vitremer restorations showed a lower incidence of Alfa scores for colour match and marginal discoloration than Z100 restorations (P < 0.05).     

Clinical evaluation of a flowable resin composite and flowable compomer for preventive resin restorations

This clinical study evaluated the retention and caries protection of a flowable resin composite (Flow Line) and a flowable compomer (Dyract Flow) used in preventive resin restorations as compared to the conventional preventive resin technique which uses a resin composite (Brilliant) and a sealant (Concise). This study observed 205 permanent molars with small carious cavities less than 1.5 mm in width, which were obtained from 165 children aged 7 to 15 years. Flowable resin composite was used to treat 75 teeth, and 71 teeth were treated with flowable compomer in both cavities and caries-free fissures. For the control group, 59 teeth were treated with resin composite in cavities and sealant in caries-free fissures. The teeth were evaluated at 3, 6, 12, 18 and 24-month intervals. After three months, all 205 treated teeth were completely intact. After six months, 66 of the 71 teeth treated with flowable resin composite and 65 of the 70 teeth treated with flowable compomer were complete, compared to 57 of the 58 teeth treated with the conventional preventive resin technique. After 12 months, 60 of the 67 teeth treated with flowable resin composite and 61 of the 67 teeth treated with flowable compomer were complete, compared to 51 of the 55 teeth treated with the conventional preventive resin technique. After 18 months, 53 of the 61 teeth treated with flowable resin composite and 54 of the 62 teeth treated with flowable compomer were complete, compared to 47 of the 53 teeth treated with the conventional preventive resin technique. After 24 months, 49 of the 58 teeth treated with flowable resin composite and 45 of the 57 teeth treated with flowable compomer were complete, compared to 42 of the 52 teeth treated with the conventional preventive resin technique. There were no statistically significant differences in retention rates among all groups after 3, 6, 12, 18 or 24-months (p>0.05). One tooth treated with flowable resin composite and one tooth treated with flowable compomer developed caries after 18 and 24 months, respectively, resulting from partial loss at "caries-free fissures." Five teeth developed caries in the conventional preventive resin group; one after 12 months, two after 18 months and one after 24 months, due to loss at cavities. The final caries occurred after 24 months, resulting from partial loss at "caries-free fissures." The differences in caries development among the three groups were not statistically significant (p>0.05). This study suggested that flowable resin composite and flowable compomer could be used for preventive resin restorations. Meanwhile, a vigilant recall should be followed-up due to the risk of failure for flowable materials in "caries-free" fissures. The repair should be performed immediately, in case the preventive resin restoration develops a fracture or loss.     

Clinical evaluation of a polyacid-modified resin composite in class V carious lesions: 3-year results

This study evaluated the three-year clinical performance of Class V restorations made of a polyacid-modified resin composite, Dyract. Ninety-two Class V carious lesions in 28 patients were restored with Dyract. Restorations were clinically evaluated at baseline, first, second, and third year recall visits, according to the modified Ryge criteria by two experienced, calibrated examiners. Retention rate after three years in Class V carious restorations was 92.4%, with only seven failed restorations. Color change and marginal discoloration in restorations were found to be statistically significant (p = 0.013 and p < 0.001, respectively) at the end of third year, but none of the affected restorations required replacement. The results of this study revealed that at the end of three years, Dyract exhibited good clinical success rate but significant color change and marginal discoloration in Class V carious lesions.     

Randomized controlled clinical trial of a highly filled flowable composite in non-carious cervical lesions: 3-year results

Clinical Oral Investigations - This prospective, randomized, split-mouth clinical trial assessed the 3-year clinical performance of a highly filled flowable composite and a conventional paste-type...     

A 24-month follow-up of flowable resin composite as an intermediate layer in non-carious cervical lesions

This study compared the clinical performance of a microhybrid resin composite to lined Class V restorations or to those restorations without a flowable resin composite over a 24-month period. Nineteen patients with at least 2 pairs of equivalent cervical erosion/attrition/abfraction lesions, under occlusion, were enrolled in this study. A total of 74 restorations were placed, half for each group (Single-Bond + Filtek-Flow + Filtek Z250 or Single-Bond + Filtek Z250). According to the manufacturers' instructions, 2 calibrated operators placed all restorations. Two other independent examiners evaluated the restorations at baseline and after 24 months, according to the USPHS criteria and modified criteria for color match. The classic alpha score was divided into A1 for "not detectable" and A2 for "slightly discernible" filling. Statistical analysis was conducted using Fisher's exact test (alpha=0.05). For each group, 8 restorations were lost after 24 months (retention rate of 89.2%). All the restorations showed a trend toward dark yellowing after 24 months (color match A2).     

One-year clinical evaluation of bulk-fill flowable vs. regular nanofilled composite in non-carious cervical lesions

Objective

The aim of this double-blind, randomized trial was to evaluate the 1-year clinical performance of a bulk-fill flowable and a regular nanofilled composite in non-carious cervical lesions (NCCLs).

Methods

Twenty-two subjects with at least two NCCLs were enrolled in the study. A total of 89 restorations were performed by a single operator using Filtek Supreme (FS) Ultra Universal or Filtek Bulk (FB) Fill Flowable. A universal adhesive (Scotchbond™ Universal Adhesive) was used with a self-etching approach in dentin. The restorations were evaluated by two independent and previously calibrated examiners at baseline (7 days), 6 months and 1 year, according to the USPHS modified criteria. Mann–Whitney U test was used to analyze the differences between composites and Wilcoxon signed rank test for comparisons between the baseline and follow-ups (α = 5%).

Results

One restoration was considered clinically unacceptable due to loss of retention after 6 months in the FS group. FS presented statistically high scores for surface roughness when compared to FB after 1 year (p < 0.05), but both were considered clinically acceptable. After 1 year, the frequency of clinically unacceptable rates was 3.3% for anatomical form in the FB group, 1.1% for retention in the FS group, and 2.2% for marginal adaptation in both groups. All restorations, in both groups, presented score 0 over the 1-year period for marginal staining, postoperative sensitivity, and secondary caries.

Conclusion

Both composite resins showed acceptable clinical performances for the restoration of NCCLs after 1 year.

Clinical relevance

Both bulk-fill flowable and regular nanofilled composites showed good clinical performances for the restoration of NCCLs after 1 year.

     

Three-year randomized clinical evaluation of a low-shrinkage silorane-based resin composite in non-carious cervical lesions

Objective

The clinical suitability of low-shrinkage resin composites for class V cavities has not been investigated in vivo. The purpose of this double-blind randomized clinical trial was to compare the clinical performances of low-shrinkage resin composite Filtek silorane and nanoceramic resin composite Ceram X mono in non-carious cervical lesions (NCCLs) over 36 months.

Materials and methods

Two calibrated operators restored 144 NCCLs in 24 patients by using Filtek silorane with silorane system adhesive (FS/SSA) and Ceram X mono with Clearfil SE (CXM/CSE) or XP bond (CXM/XPB). Then, two blinded, calibrated evaluators assessed the restorations at the baseline and 6, 12, 24, and 36 months thereafter by using the modified US Public Health Service criteria. Data were analyzed with the Freidman and Wilcoxon signed-rank tests at a significance level of 5 % (P?<?0.05).

Results

No restoration was associated with postoperative sensitivity or secondary caries. Further, no group showed significant changes until 12 months. The retention rates of the FS/SSA (97.5 %), CXM/CSE (97.5 %), and CXM/XPB (92.31 %) restorations did not differ significantly (P?>?0.05). Six (4 CXM/XPB, 1 FS/SSA, and 1 CXM/CSE) of the 121 restorations evaluated at 36 months were completely lost. However, no significant intergroup differences were observed in the other evaluation criteria.

Conclusion

The 3-year clinical performances of the restorative materials in NCCLs were not significantly different.

Clinical relevance

Filtek silorane is suitable for restoring NCCLs.     

In vitro evaluation of microleakage of a flowable composite in Class V restorations

The aim of this study was to evaluate microleakage around class V restorations using a flowable composite compared to a hybrid composite. Forty class V cavities were prepared on buccal and lingual surfaces of 20 human teeth, with occlusal and cervical margins at the enamel and cementum/dentin levels, respectively. Specimens were divided into 2 groups with 10 samples each. Group 1: buccal cavities received Paama 2 (conventional bonding agent) + Wave (flowable composite); lingual cavities were restored with Paama 2 + Glacier (hybrid composite). Group 2: buccal cavities received Optibond Solo (self-priming bonding agent) + Wave; lingual cavities were restored with Optibond Solo + Glacier. After being stored in distilled water and finished, the teeth were thermocycled, immersed in a 50% silver nitrate solution and embedded in resin. They were sectioned and the depth of tracer penetration was scored. The results were analyzed using Kruskal-Wallis and Wilcoxon tests. The restorations with flowable composite and those with hybrid composite from the same group showed similar results of microleakage for both occlusal and cervical margins. Optibond Solo improved the sealing of the restorations when compared with Paama 2 (p < 0.01). None of the restorative materials completely sealed the tooth/restoration interface at the cervical margins.     

Clinical evaluation of a polyacid-modified resin composite (Dyract) in class V carious lesions: 5-year results

This study evaluated the 5-year clinical performance of polyacid-modified resin composite, Dyract (DeTrey/Dentsply, Konstanz, Germany), restorations in class V carious lesions. Ninety-two class V carious lesions in 28 patients were restored with Dyract. Restorations were clinically evaluated at baseline, 1-, 2-, 3-, 4-, and 5-year recalls and were evaluated according to the modified Ryge criteria by two experienced calibrated examiners in regard to color match, marginal discoloration, wear or loss of anatomical form, caries, marginal adaptation, and surface texture. The retention rate after 5 years compared to baseline in class V carious restorations was 84%, with only 12 restorations failing. Color change and marginal discoloration in restorations were found to be statistically significant (p = 0.0238 and p < 0.0001, respectively) at the end of the 5 years, but did not require replacement of any of the restorations. The results of this study revealed that at the end of 5 years, Dyract exhibited a clinically acceptable success rate but had significant color changes and marginal discoloration in class V carious lesions.     

Two-year clinical comparison of a microfilled and a hybrid resin-based composite in non-carious Class V lesions

The purpose of this double-blind clinical trial was to compare the retention rate in noncarious Class V lesions of two resin-based composite restorative materials with contrasting stiffness. Isolation with retraction cord, pressed paper triangles, and cotton rolls was used to closely mimic the procedures generally used in a practice setting. Thirty pairs of restorations were placed, one using Silux Plus and one using Z100. The assignment of material was randomized, and the subjects were unaware of the material used. All restorations were placed with a fourth-generation adhesive liner, Scotchbond Multi-Purpose. Evaluations were performed at baseline, 6, 12, 18, and 24 months by two independent examiners using criteria developed by Cvar and Ryge in a forced consensus model. Examiners were unaware of the restoration's group identity. No difference between the retention rates for the two groups was found after 24 months, bringing into question the role that a material's stiffness plays in determining retention in a noncarious Class V lesion.     

Eight-year clinical evaluation of two types of resin composite in non-carious cervical lesions

Clinical Oral Investigations - In this clinical study, the 8-year clinical performances of a flowable resin composite was compared with that of a conventional resin composite. Ninety non-carious...     

Clinical evaluation of a polyacid-modified resin composite-based fissure sealant: two-year results

A 24-month clinical study was carried out to evaluate and compare the retention rate, marginal integrity and caries preventing effects of a polyacid-modified resin composite based fissure sealant, Dyract Seal, to that of a resin based fluoride fissure sealant, Delton FS+. Fifty-three patients (27 female and 26 male), 7 to 10 years old, were included in the study. At baseline, a total of 192 permanent first molars were sealed with either fissure sealant (n=96, each), using invasive technique. The sealed teeth were evaluated at post-operative 3, 6, 12 and 24 months with respect to evaluation parameters. The data were analyzed with the Chi-Square tests where alpha=0.05. There were no statistically significant differences between fissure sealants as regards to retention and prevention of caries for all periods of the evaluation (p>0.05). However, regarding marginal integrity of the sealants, Delton FS+ gave significantly better results than Dyract Seal for the 3-, 6- and 12-month evaluations, respectively (p<0.05). In conclusion, the use of Dyract Seal on permanent molars with invasive technique was found to be clinically comparable to Delton FS+ for the 24-month evaluation period.