A Two-year Clinical Comparison of Three Different Restorative Materials in Class II Cavities

Abstract

SUMMARY Objectives: The aim of this clinical study was to evaluate the clinical performance of Class II restorations of a high-viscosity glass ionomer material, of a bulk-fill composite resin, and of a microhybrid composite resin. Methods and Materials: One hundred nine Class II restorations were performed in 54 patients using three different restorative materials: Charisma Smart Composite (CSC; a conventional composite resin), Filtek Bulk Fill Posterior Restorative (FBF; a high-viscosity bulk-fill composite), and Equia Forte Fil (EF; a high-viscosity glass ionomer). Single Bond Universal adhesive (3M ESPE, Neuss, Germany) was used for both conventional and bulk-fill composite resin restorations. The restorations were evaluated using modified US Public Health Service criteria in terms of retention, color match, marginal discoloration, anatomic form, contact point, marginal adaptation, secondary caries, postoperative sensitivity, and surface texture. The data were analyzed using the chi-square, Fisher, and McNemar tests. Results: Eighty-four restorations were evaluated at two-year recalls. There were clinically acceptable changes in composite resin restorations (FBF and CSC). In addition, no statistically significant difference was observed between the clinical performances of these materials in terms of all criteria (p>0.05). However, there was a statistically significant difference between the EF group and the FBF and CSC groups in all parameters except for marginal discoloration, secondary caries, and postoperative sensitivity (p<0.05). Conclusions: The tested bulk-fill and conventional composite resins showed acceptable clinical performance in Class II cavities. However, if EF is to be used for Class II restoration, its use should be carefully considered.

Clinical Effectiveness of Bulk-Fill and Conventional Resin Composite Restorations: Systematic Review and Meta-Analysis

“…The included articles were published between 2010 and 2020 ( Table 2 ). In all included studies [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ], the number of patients ranged from 22 to 86, with a follow-up time of between 6 months and 10 years. The countries, where the studies were carried out were: Turkey [ 14 , 16 , 18 , 20 , 27 ], Brazil [ 22 , 23 , 25 ], Germany [ 21 , 26 ], Sweden [ 17 , 19 ], Denmark [ 19 ], and Saudi Arabia [ 24 ].…”

“…The countries, where the studies were carried out were: Turkey [ 14 , 16 , 18 , 20 , 27 ], Brazil [ 22 , 23 , 25 ], Germany [ 21 , 26 ], Sweden [ 17 , 19 ], Denmark [ 19 ], and Saudi Arabia [ 24 ]. Ten studies [ 15 , 16 , 17 , 19 , 20 , 21 , 23 , 25 , 27 , 29 ] reported that the mean age of the patients was between 7.41 and 55.30 years. Three studies [ 14 , 27 , 28 ] reported that the patients were children or under 18 years of age.…”

“…Three studies [ 14 , 27 , 28 ] reported that the patients were children or under 18 years of age. Eight studies [ 15 , 16 , 17 , 18 , 19 , 20 , 22 , 25 ] reported that the total number of patients in relation to their gender (men and women) was 186 and 206, respectively ( Table 2 ).…”

“…The total number of treated patients and restored teeth was 764 and 1915, respectively. In 5 studies [ 17 , 19 , 20 , 21 , 26 ], class I and class II restorations were performed, 3 studies [ 24 , 27 , 28 ] performed class I restorations, 6 studies [ 14 , 15 , 16 , 18 , 23 , 29 ] performed class II restorations, and 2 studies [ 22 , 25 ] performed non-carious cervical lesions (NCCL) restorations. Among the types of teeth restored, it was observed that the restorations were made in the permanent incisors, canines, premolars, and molars.…”

“…Six studies [ 14 , 18 , 21 , 23 , 26 , 27 ] reported that the etching and rinsing method was used and 12 studies [ 16 , 17 , 19 , 20 , 21 , 22 , 25 , 26 , 28 , 29 ] used the self-engraving method. The adhesives used in the studies were: Single Bond Universal Adhesive [ 15 , 27 , 29 ], Clearfil SE Bond [ 14 , 22 , 29 ], Xeno III [ 20 , 21 , 26 ], Xeno V [ 17 , 19 ], AdheSE Bond [ 16 , 29 ], OptiBond All-in-One [ 28 , 29 ], Adper Single Bond 2 [ 18 , 23 ], Syntac classic [ 21 , 26 ], XP Bond [ 23 ], Tetric N Bond Total-etch [ 24 ], Scotchbond Universal Adhesive [ 25 ], Excite F [ 18 ], Futurabond NR [ 20 ], and Peak Universal [ 23 ]. The composite resins used in the studies were inserted in the cavities with the following placement techniques: (1) the incremental method, involving Filtek Z550 [ 14 ], Charisma Smart Composite [ 15 ], Filtek Z350 XT [ 22 ], Amelogen Plus [ 23 ], Tetric EvoCeram [ 16 , ...…”