A five-year clinical evaluation of Class II composite resin restorations

OBJECTIVES: To study the clinical efficacy of posterior composite resin restorations placed in general practice after five years. METHODS: Two commercial composite resin systems were used. Three general practitioners placed the restorations at a Public Dental Health Service Office. The patients were not selected specifically for this study. Class II cavities were restored with Superlux Molar and P-50 APC composite systems on an alternate basis. At baseline, 63 restorations were placed in molars and premolars in 45 patients. For primary caries, generally a conservative cavity design was used (n = 23), while replacements of amalgams resulted in the larger conventional Class II design (n = 40). The restorations were assessed using a modified USPHS criteria. Wear measurements were determined by the Leinfelder method. Photographs and bite-wing radiographs were taken to supplement the clinical evaluation of colour match, marginal adaptation and recurrent caries. Saliva sampling was performed to determine the rate of secretion and the level of mutans streptococci and lactobacilli. RESULTS: At the five-year review 51 restorations were available for examination, of which nine restorations were rated clinically unacceptable. Including the failed restorations (n = 7), at the three-year review, a total of 16 restorations had failed (27.6%) over a five-year period. The most common reasons for failure were recurrent caries (n = 7) and marginal defects (n = 4). The mean wear of Superlux Molar was 167 microns and of P-50 APC 158 microns. Eight of the 11 patients with failed restorations due to caries and marginal defects had high counts of mutans streptococci at baseline. CONCLUSIONS: The failures in the present group of patients did not specifically relate to material, tooth type or cavity design. However, it is suggested that patient factors such as caries activity should be monitored and managed.     

Twenty-four-month clinical evaluation of different posterior composite resin materials

BACKGROUND: In a 24-month clinical trial, the authors compared three brands of light-cured composite resins that were used to restore the posterior teeth of 38 patients. METHODS: A total of 88 Class I and 32 Class II restorations were made using Z100 (3M Dental Products Div.), Clearfil Ray-Posterior (Kuraray Co. Ltd.) and Prisma TPH (Caulk/Dentsply). Quadrant impressions were taken using a polyvinyl siloxane impression material, and stone casts were obtained every six months for indirect evaluations of anatomical form and marginal adaptation. The restorations were evaluated directly by three clinicians using the Ryge criteria. RESULTS: The authors statistically evaluated parameters at each recall period, using a chi 2 test; compared baseline scores with the recall scores, using a McNemar test; and evaluated changes in the parameters, using the Cochran Q test. Color match, cavosurface margin discoloration and secondary caries remained unchanged at the end of the 24-month recall period for all materials (P > or = .05). A total of 11.5 percent of the Z100 restorations and 16.7 percent of the Prisma TPH restorations showed a slight crevice along the margin (P < or = .05). The surface texture was scored as Bravo only for Clearfil Ray-Posterior restorations at the end of the study (P < or = .05). The authors found that the indirect evaluation results were different from the direct evaluations for Z100 and Prisma TPH. CONCLUSIONS: According to these findings, all the materials used are suitable for posterior restorations. The difference between the two evaluation methods can be attributed to the level of sensitivity. CLINICAL IMPLICATIONS: With the improvement in materials, careful case selection and application of the restorative techniques, posterior composites placed under appropriate conditions and monitored routinely can be expected to last 10 years or longer.     

Clinical evaluation of composite and compomer restorations in primary teeth: 24-month results

PURPOSE: This split-mouth, blind study evaluated the clinical performance of Dyract AP, F2000, and Heliomolar placed in primary molars of 30 children (mean age, 6 years and 2 months). MATERIALS AND METHODS: From a total of 79 restorations accomplished, 27 were built with Heliomolar (18 Class I, and 9 Class II), 30 were with F2000 (21 Class I and 9 Class II), and 22 were built with Dyract AP (14 Class I and 8 Class II). All of teeth restored had primary caries lesions. At 6, 12, 18 and 24 months, 60 restorations (75%) were evaluated using USPHS criteria for: color match (CM), marginal adaptation (MA), marginal discoloration (MD), anatomic form (AF) and secondary caries (SC) by three calibrated operators. The Alpha+Bravo score percentage was considered as clinical success. The data were subjected to statistical analysis by Mann-Whitney and Kruskal-Wallis tests (p<0.05). RESULTS: Heliomolar showed the smallest success clinical at 12 months for marginal adaptation and secondary caries, and at 18 months for marginal discoloration. Regarding color match and anatomic form, no significant differences were found among the groups at each evaluation period. When materials were compared, Heliomolar did not show a significant difference among the evaluated periods for any criteria, remaining with the lowest scores. Significant differences were observed at 12 months for F2000 (marginal adaptation), and at 24 months for Dyract AP (marginal discoloration and secondary caries) and for F2000 (color match and marginal discoloration). CONCLUSIONS: It was concluded that Dyract AP and F2000 showed the best clinical performance over 24 month-evaluations for marginal discoloration and secondary caries, and color match and marginal adaptation, respectively. The use of the resin composite Heliomolar in Class I/II restorations in primary molars should be carefully considered.     

Clinical evaluation of a self-etching and a one-bottle adhesive system at two years

Objectives. The clinical performances of a self-etching adhesive system, Clearfil SE Bond, and a one-bottle adhesive system, Prime&Bond NT, were evaluated in non-carious Class V restorations for a period of two years.

Methods. Ninety-eight restorations were made by one operator for 32 patients. The resin composite used to restore the teeth were Clearfil AP-X and Spectrum TPH for Clearfil SE Bond and Prime&Bond NT, respectively. Two clinicians at the baseline, 6th, 12th and 24th months evaluated the posterior composites according to the modified Ryge criteria's. For this, color match, marginal discoloration, marginal adaptation, recurrent caries, anatomic form, postoperative sensitivity and retention rates were considered. The changes across time and across groups were evaluated statistically.

Results. At two years, 88 restorations were reviewed in 28 patients. The retention rates for Clearfil SE Bond were 93 and 91% for Prime&Bond NT. The percentages of the retention rates of both adhesive systems were not found to be different when calculating the failure rates. Recurrent caries, anatomic form and postoperative sensitivity were scored as Alpha for all restorations. Two cases of both adhesive systems showed slight marginal discoloration problems. Three restorations of Prime&Bond NT and one of Clearfil SE Bond had marginal adaptation problems at two years. One case for each adhesive system had slight color change after the same period.

Conclusion. We can conclude that both adhesive systems tested exhibited very good clinical performance at the end of two years.     

Clinical evaluation of a polyacid-modified resin composite (Dyract AP) in class I cavities: 5-year results

PURPOSE: This study evaluated the five-year clinical performance of Dyract AP, a polyacid-modified resin composite, in restorations of Class I carious lesions. MATERIALS AND METHODS: One hundred eight Class I carious lesions in 21 patients were restored with Dyract AP. The lesions, which were macroscopically diagnosed with a probe, involved fissures. The average buccolingual width of the cavities was equal to or less than one-third of the intercuspal width. Restorations were clinically evaluated by two experienced, calibrated examiners at baseline and at 1, 2, 3, 4, and 5 years, utilizing the modified Ryge criteria. The evaluation criteria included color match, marginal discoloration, wear or loss of anatomical form, caries, marginal adaptation, and surface texture. RESULTS: At the end of the 5-year period, a total of 13 restorations had failed, and the cumulative rate of success was 93.37%. By the 5-year recall, 12 restorations had carious lesions adjacent to the margins, and 1 restoration had discoloration that was rated as Charlie. Color changes, marginal discoloration, wear or loss of anatomical form, caries, marginal adaptation, and change in surface texture were found to be statistically significant (p < 0.001) after 5 years. Aside from the thirteen failed restorations, the degrees of color matching, marginal discoloration, wear or loss of anatomical form, caries, marginal adaptation, and surface texture were clinically acceptable at 5 years after treatment. CONCLUSION: At the end of 5 years, Dyract AP exhibited acceptable clinical performance in the treatment of Class I carious lesions. Therefore, it can be considered an alternative material for the restoration of Class I cavities.     

Clinical evaluation of a polyacid-modified resin composite (Dyract) in Class III cavities: 5-year results

PURPOSE: This study evaluated the 5-year clinical performance of Dyract polyacid-modified resin composite material in Class III cavities. METHODS: 62 Class III cavities in 30 patients were restored with Dyract. Two experienced, calibrated examiners evaluated the restorations clinically at baseline and at 1-, 2-, 3-, 4-, and 5-year recalls, according to the modified Ryge criteria. RESULTS: After 5 years, a total of six restorations had failed and the cumulative failure rate was 94.6%. By the 5-year recall, one restoration was replaced due to pulpitis and five were replaced due to secondary caries. After 5 years, marginal discoloration was statistically significant (P= 0.0002).     

Clinical evaluation of a polyacid-modified resin composite (Dyract) in class III cavities: three-year results

This study evaluated the three-year clinical performance of a polyacid-modified resin composite material, Dyract (DeTrey/Dentsply, Konstanz, Germany), in Class III cavities. Sixty-two Class III cavities in 30 patients were restored with Dyract. Restorations were clinically evaluated at baseline, one-, two- and three-year recalls according to the modified Ryge criteria by two experienced, calibrated examiners. After three years, the retention rate was 96.7%. At the one-year interval, one restoration had to be replaced due to sensitivity. At the two-year recall, one restoration, with a caries lesion adjacent to its margin, was clinically unacceptable and had to be replaced. Except for these two restorations, all other restorations were clinically acceptable in regard to color match, marginal discoloration, wear or loss of anatomical form, caries, marginal adaptation and surface texture after three years. At the end of three years, marginal discoloration was statistically significant (p=0.017) but did not require replacement of any of the restorations. Dyract exhibited significant marginal discoloration after three-year clinical performance in Class III cavities.     

Clinical evaluation of four Class 5 restorative materials: 3-year recall

PURPOSE: To place four restorative materials, including two resin-based composites (Pertac III and Synergy), an improved resin-modified glass-ionomer (Fuji II LC Improved), and a compomer (Dyract AP), in Class 5 non-carious cervical lesions and to evaluate and compare those restorations for marginal discoloration, anatomic form, surface texture, secondary caries, retention, and marginal adaptation at baseline and annually for 3 years. METHODS: The tested materials were used to restore moderate-size Class 5 non-carious cervical lesions. All materials were used following the manufacturers' directions for etching, bonding, curing, and finishing. Thirty restorations of each material were placed. After rubber-dam isolation, a bevel was placed on the occlusal margin of all preparations except the Fuji II LC Improved, and all preparations were cleaned with pumice. Each restorative material was placed and cured in increments except Fuji II LC Improved. All restorations were evaluated at baseline, 6 months, 1, 2, and 3-year recalls using a modified USPHS scale. RESULTS: Analysis with Chi Square and Logit Analysis revealed that, at 3 years, Pertac III and Fuji II LC Improved were significantly rougher than all other materials. Pertac III had significantly poorer marginal adaptation than all other materials. All other comparisons were not significant. At 3-year recall, most restorations were satisfactory.     

10-year clinical evaluation of a self-etching adhesive system

This study evaluated the long-term clinical performance of a self-etching adhesive system, Clearfil Liner Bond 2. Two operators placed a total of 87 restorations among 42 patients. Carious dentin was identified with the help of Caries Detector and was removed using only a low speed round bur. Clearfil Liner Bond 2 was applied following the manufacturer's directions, and the resin composite was then placed. The number of restorations placed by cavity classification were: 8-Class I, 11-Class II, 21-Class III, 2-Class IV and 45-Class V. The restorations were evaluated in 5 categories according to modified USPHS criteria: pulpal response, marginal integrity, marginal discoloration, retention and secondary caries. Assessments were done at baseline, immediately after placement and at 6-months and 1, 5, 7 and 10 years. Recall rates at each assessment period were 83.9% (6-months), 82.8% (1 year), 59.8% (5 years), 77.0% (7 years) and 50.6% (10 years). In terms of assessment categories, there were no recorded sensitivity, retention loss or secondary caries at any of the five recall periods. At the 10-year assessment, 40 out of 44 restorations (90.9%) were rated Bravo for marginal integrity and 39 restorations (88.6%) were rated Bravo for marginal discoloration (Wilcoxon signed-ranks test p < 0.05). This data demonstrates the retention rate and pulpal response of the self-etching adhesive system Clearfil Liner Bond 2 was excellent at 10 years. Most cases showed slight marginal changes during clinical function; however, these changes were not clinically severe by USPHS criteria. These data demonstrate that placement of the Clearfil Liner Bond 2 self-etching adhesive system was demonstrated to be acceptable for the clinical restoration of human teeth following 10 years of clinical function.     

后牙超瓷聚体嵌体3年临床疗效观察

目的:观察后牙超瓷聚体嵌体的临床疗效。方法:前磨牙及磨牙Ⅰ类洞患者345例,随机分为2组:超瓷聚体嵌体组170例(前磨牙42颗,磨牙128颗),复合树脂嵌体组175例(前磨牙45颗,磨牙130颗)作为对照。随访3年后,从边缘着色、边缘密合度、解剖形态、基牙继发龋、修复体折裂、颜色匹配等方面进行比较,采用χ2检验进行统计学处理。结果:超瓷聚体嵌体组获得随访166例、复合树脂嵌体组获得随访169例,超瓷聚体嵌体组边缘着色2例、边缘密合158例、外形完整162例、基牙继发龋1例、修复体折裂5例、颜色匹配161例;复合树脂嵌体组边缘着色27例、边缘密合134例、外形完整150例、基牙继发龋20例、修复体折裂5例、颜色匹配146例。超瓷聚体嵌体组在边缘着色、边缘密合度、外形完整、基牙继发龋、颜色匹配等方面优于复合树脂嵌体(P<0.05),但在修复体折裂方面无显著差异(P>0.05)。结论:超瓷聚体嵌体是一种较好的新型牙体修复体。     

Clinical evaluation of a polyacid-modified resin composite (Dyract AP) in Class I cavities: 3-year results

PURPOSE: This study evaluated the 3-year clinical performance of the polyacid-modified resin composite Dyract AP in restorations for Class I carious lesions. METHODS: 108 Class I cavities in 21 subjects were restored with Dyract AP. The lesions, which were diagnosed macroscopically with a probe, involved fissures and had reached the dentin, while lateral spread was limited and localized to the dentin. The average facio-lingual width of the cavities was equal to or less than one-third the intercuspal width. Restorations were evaluated clinically by two experienced, calibrated examiners at baseline and at 1, 2, and 3 years, according to the modified Ryge criteria, (color match, marginal discoloration, wear or loss of anatomical form, caries, marginal adaptation, and surface texture). RESULTS: None of the restorations failed at the end of the first year. At 2 years, two restorations required immediate replacement due to caries lesions adjacent to the margins. At 3 years, six restorations had caries lesions adjacent to their margins, and the cumulative rate of success was 93.4%. Color changes and marginal discolorations were found to be statistically significant (P < 0.001) at 3 years, although none of the restorations needed to be replaced. Significant differences were also observed in the caries rate (P < 0.001) at 3 years. Aside from the eight failed restorations, the degrees of color matching, marginal discoloration, wear or loss of anatomical form, caries, marginal adaptation, and surface texture were clinically acceptable at 3 years post-treatment.     

3-year clinical evaluation of glass ionomer cements as Class III restorations

Two glass ionomer restorative materials, Chelon and Ketac-Fil were placed in Class III cavity preparations and compared to a conventional composite resin. Patients were recalled at 6 months, 1 year, 2 years, and 3 years for evaluation using the USPHS-Ryge criteria. The glass ionomer cements compared favorably to the composite resin in color match, anatomic form, and caries rate, but did exhibit substancial cavosurface discoloration and marginal deterioration. However, post-operative sensitivity was not evident, and no restorations required replacement during the 3 years.     

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.     

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 a Nanohybrid and a Flowable Resin Composite in Non-carious Cervical Lesions: 24-Month Results

Purpose: To evaluate the 24-month clinical performance of cervical restorations using a nanohybrid and a flowable resin composite with a one-step self-etching adhesive. Materials and Methods: Twenty-one patients with at least one pair of non-carious cervical lesions participated in this study. A total of 134 non-carious cervical lesions were restored (67 with a nanohybrid resin composite, Grandio; 67 with a flowable resin composite, Grandio Flow) using a one-step self-etching adhesive system, Futura Bond NR, by one dentist. The restorations were evaluated for retention, color match, marginal discoloration, marginal adaptation, surface texture, anatomic form, and secondary caries by two calibrated examiners at baseline and after 6, 12, and 24 months using modified USPHS criteria. The survival rates of the restorations were calculated by the Kaplan-Meier estimator. The comparison of resin composites for each category was performed with the Pearson chi-square test, and the performance of restorations at baseline and after each recall time was evaluated using McNemar's test (p < 0.05). Results: All patients attended the 24-month recall. The retention rates at 6 months were 66% and 58%, and 61% and 57% at 12 months for Grandio and Grandio Flow, respectively. At the 24-month recall, the retention rate was 60% for Grandio and 54% for Grandio Flow. No statistically significant differences were found in retention rates among the restorative materials in any evaluation period (p > 0.05). For marginal discoloration and anatomical form, three Grandio and three Grandio Flow restorations showed Bravo scores at the end of 24 months. The restorations in both groups had Alfa ratings of 100% for the rest of the criteria evaluated. Conclusion: The nanohybrid and flowable resin composites showed similar clinical performances in the restoration of non-carious cervical lesions over 24 months.     

Seven-year clinical performance of CEREC-2 all-ceramic CAD/CAM restorations placed within deeply destroyed teeth

Objectives

Adhesively luted all-ceramic restorations represent a promising way to preserve and stabilize weakened tooth substance, but little information is published about the clinical performance of extensive all-ceramic restorations.

Materials and methods

A total of 78 large CEREC 2? single-tooth all-ceramic restorations had been placed in 35 patients. After 7?years, 59 teeth in 25 patients were reevaluated according to USPHS or modified USPHS criteria regarding aesthetic properties, e.g., “anatomic form,” “color match,” and “marginal discoloration”; functional properties, e.g., “marginal integrity,” wear expressed by the criteria “proximal contact” and “static/dynamic occlusal relationship”; and biological properties, e.g., “tooth vitality” and “secondary caries”. Additionally, the “proportion of margin below/above cemento-enamel junction” was included.

Results

Two restorations had failed prior to the 7-year recall, one due to a bulk fracture of the restoration and one due to poor marginal integrity (rated “Charlie”) after 4?years. Other six restorations were rated as failure at the 7-year evaluation (three restorations revealed secondary caries, one was bulk fracture of the Cerec 2 restoration, and two failures were related to endodontic problems resulting in extraction or amputation of one root, respectively), resulting in a failure rate of 13.1% after 7?years. A total of 96.4% of the restorations revealed sufficient ratings for esthetic properties "anatomic form,” "color match,” "marginal discoloration,” and "marginal integrity".

Conclusions

The survival rate of 86.9% at the 7-year recall demonstrates that adhesively luted all-ceramic CAD/CAM-generated restorations are suitable for restoration of extended coronal defects.

Clinical relevance

CAD/CAM-generated all-ceramic restorations facilitate the reconstruction of deeply destroyed teeth irrespectively of the location of the cavity margins.     

Clinical evaluation of a resin composite and bonding agent in Class I and II restorations: 2-year results.

OBJECTIVE: The purpose of this study was to evaluate the clinical performance and longevity of Tetric Ceram and Syntac Sprint restorations in stress-bearing areas performed in general practice. METHOD AND MATERIALS: The light-curing resin composite Tetric Ceram in combination with the bonding material Syntac Sprint were used as restorative materials in three public dental health clinics. All the restorations were done by general practitioners in an ordinary patient pool attending a public health clinic. Before starting, the general practitioners were instructed and trained in performing the restorations according to a standardized clinical procedure, and the evaluations were done according to United States Public Health Service criteria. One hundred forty-eight restorations (27 Class I, 121 Class II) were done in 123 patients. After 2 years, 140 restorations (95%) could be assessed. Color slides and bitewings were taken to supplement the clinical evaluations of color match, marginal discoloration, secondary caries, and marginal adaptation. Wear of the restorations was evaluated according to the Leinfelder method. RESULTS: After 2 years, 7 out of 148 restorations had failed, giving a failure rate of 5% of the tested materials. Five restorations failed due to hypersensitivity, one to secondary caries, and one to fracture. The wear rate was low (mean 37 microm) and did not result in any replacement. CONCLUSION: This 2-year study showed that clinically satisfactory results could be obtained using resin composite Class I and II restorations in stress-bearing areas done in general practice on an ordinary clientele when the clinical procedure is standardized.     

Two-year clinical evaluation of four polyacid-modified resin composites and a resin-modified glass-ionomer cement in Class V lesions.

OBJECTIVE: The aim of the study was to compare the clinical performances of four polyacid-modified resin composites (F2000, Dyract AP, Compoglass F, and Elan) and one resin-modified glass-ionomer cement (Vitremer) in Class V abrasion/erosion lesions. METHOD AND MATERIALS: Twenty restorations of each of the five restorative materials were placed in noncarious cervical abrasion/erosion lesions by one dentist. No cavity preparation was attempted. All teeth were isolated with cotton rolls and gingival retraction cord. The materials were manipulated according to the manufacturer's instructions and placed with the help of cervical matrixes. Restorations were finished and polished immediately after the placement. Evaluations were performed at baseline and 6 months, 1 year, and 2 years after placement for retention, color match, cavo-surface marginal discoloration, anatomic form, marginal adaptation, secondary caries, and postoperative sensitivity. RESULTS: Retention levels at 2 years were 90% for F2000, 90% for Dyract AP, 89% for Compoglass F, 84% for Elan, and 95% for the Vitremer restorations. No statistically significant differences were found among the materials after 2 years for any evaluation category. CONCLUSION: Polyacid-modified resin composite and resin-modified glass-ionomer cement restorations showed acceptable clinical performance after 2 years.     

Clinical evaluation of 2 flowable composites.

OBJECTIVE: This study evaluated the clinical efficacy of 2 flowable resin composites used to restore occlusal carious lesions. Tetric Flow (Vivadent) and Esthet-X Flow (Dentsply/Caulk) are resin composites with decreased filler loading and lower viscosity compared to conventional resin composites. METHOD AND MATERIALS: Sixty occlusal restorations (30 of each material) were placed. After tooth preparation and caries removal, each material was inserted with rubber dam isolation. Prime & Bond NT (Dentsply/Caulk) was used to bond both flowable composites, which were incrementally placed and light-cured for 20 seconds. Each restoration was evaluated at baseline (1 week after restoration placement), 3 months, 6 months, and 1 year for marginal discoloration, secondary caries, anatomic form, retention, polishability, marginal adaptation, and color match. Groups were compared at 1 year and the data analyzed statistically with a .05 level of significance. RESULTS: A marginally significant difference in color match was observed at 1 year (favoring Esthet-X Flow). No other differences were observed between materials. Marginal discoloration significantly worsened for all restorations at 6 months and 1 year, and marginal adaptation significantly worsened at 1 year for all restorations. A positive association between preparation size and sensitivity was detected at 3 months; no association was found at 6 months and 1 year. At 1 year, restoration size was positively associated with marginal adaptation. Despite some changes from baseline, all restorations were clinically acceptable at 1 year. CONCLUSION: Although flowable resin composites are advocated for occlusal restorations, it is recommended that they be limited to small and moderate-sized restorations.     

A 5- and 8-year clinical evaluation of a posterior composite resin

Class I and II posterior composite resin (Ful-Fil) restorations were placed and were clinically evaluated, according to the US Public Health Service criteria, at baseline, 6 months, 5 years, and 8 years. At 5 years/8 years, alpha scores were assigned to the following percentages of restorations: 16%/31% for color match; 65%/62% for marginal discoloration; 74%/54% for cavosurface marginal discoloration; 100%/100% for axial contour; and 81%/65% for anatomic form. At 5 years/8 years, 56%/33% of Class II restorations had tight proximal contacts; 45%/44% had light contacts; and 0%/22% had no contacts. Transient postoperative sensitivity was reported in 6% of the restorations. Indirect evaluation indicated that there was an average of 64 +/- 35 microns of wear at baseline (because of overfinishing), 105 +/- 67 microns at 6 months, 217 +/- 76 microns at 5 years, and 253 +/- 82 microns at 8 years. At 5 years, three of the restorations, and at 8 years, four additional restorations, were clinically unacceptable because of recurrent caries and/or excessive wear. Final success rates of 90% and 77% at 5 and 8 years, respectively, were calculated.