Given the lower mechanical properties of most bulk-fill materials compared to a highly filled nano-hybrid composite, their use for restorations under high occlusal load is subject to caution. Further, the swelling behaviour of some of the bulk-fill materials may be a reason for concern, which highlights the critical requirement for a veneering material, not only to improve aesthetic quality of the translucent material, but to reduce the impact of degradation.

The purposes of this study were to determine the weight fraction of filler in thirty-nine resin-based materials including flowable and packable composites, and to examine the morphology of the filler particles. The percentages of inorganic fillers by weight were determined by Thermogravimetric Analysis and by ashing in air technique at 900 degrees C. The size and shape of the filler particles were examined using scanning electron microscopy (SEM) after dissolution of the organic matrix. The weight fraction of inorganic fillers ranged between 41.6 and 84.6%. Wide variations were found among materials of the same category. Values found in the present study were sometimes different from those given by the manufacturers. The SEM photomicrographs showed various shapes, and sizes of inorganic fillers. Compared with universal hybrid restorative materials, flowable composites have lower filler loading and packable resin composites did not show higher values as claimed by some manufacturers. Various factors may explain the observed discrepancies between the manufacturer's data and our results. The silane treatment as well as the incorporation of organic material as part of the fillers of the composite could be responsible for those differences.

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Purpose: The aim of present investigation was to evaluate marginal bone level after 5-year follow-up of implants placed in healed ridges and fresh extraction sockets in maxilla with immediate loading protocol.Materials and Methods: Thirty-six patients in need of a single-tooth replacement in the anterior maxilla received 42 Astra Tech implants (Astra Tech Implant system™, Dentsply Implants, Mölndal, Sweden). Implants were placed either in healed ridges (group I) or immediately into fresh extraction sockets (group II). Implants were restored and placed into functional loading immediately by using a prefabricated abutment. Marginal bone level relative to the implant reference point was recorded at implant placement, crown cementation, 12, 36, and 60 months following loading using intra-oral radiographs. Measurements were made on the mesial and distal sides of each implant.Results: Overall, two implants were lost from the group II, before final crown cementation: they were excluded from the study. The mean change in marginal bone loss (MBL) after implant placement was 0.26 ± 0.161 mm for 1 year, and 0.26 ± 0.171 mm for 3 years, and 0.21 ± 0.185 mm for 5 years in extraction sockets and was 0.26 ± 0.176 mm for 1 year and 0.21 ± 0.175 mm for 3 years, and 0.19 ± 0.172 mm for 5 years in healed ridges group. Significant reduction of marginal bone was more pronounced in implants inserted in healed ridges (P < 0.041) compared to fresh surgical extraction sockets (P < 0.540). Significant MBL was observed on the mesial side of the implant after cementation of the provisional (P < 0.007) and after 12 months (P < 0.034) compared to the distal side which remained stable for 3 and 5 years observation period.Conclusions: Within the limitations of this study, responses of local bone to immediately loaded implants placed either in extraction sockets or healed ridges were similar. Functional loading technique by using prefabricated abutment placed during the surgery time seems to maintain marginal bone around implant in both healed and fresh extraction sites.

Objectives. To compare the clinical performances of a self-adhering resin composite and a conventional flowable composite with a self-etch bonding system on permanent molars. The influence of using rubber dam versus cotton roll isolation was also investigated. Materials and Methods. Patients aged between 6 and 12 years and presenting at least two permanent molars in need of small class I restorations were selected. Thirty-four pairs of restorations were randomly placed by the same operator. Fifteen patients were treated under rubber dam and nineteen using cotton rolls isolation and saliva ejector. They were evaluated according to the modified USPHS criteria at baseline, 6 months, and 1 and 2 years by two independent evaluators. Results. All patients attended the two-year recall. For all measured variables, there was no significant difference between rubber dam and cotton after 2 years of restoration with Premise Flowable or Vertise Flow (p value > 0.05). The percentage of restorations scored alpha decreased significantly over time with Premise Flowable and Vertise Flow for marginal adaptation and surface texture as well as marginal discoloration while it did not vary significantly for color matching. After 2 years, Vertise Flow showed a similar behaviour to the Premise Flowable used with a self-adhesive resin system.