Can composite packaging and selective enamel etching affect the clinical behavior of bulk-fill composite resin in posterior restorations? 24-month results of a randomized clinical trial

Abstract

Objectives This is a double-blind, split-mouth, randomized clinical study that aims to evaluate the influence of bulk-fill composite packaging presented in syringes (BSy) and capsules (BCa), and the effect of selective enamel etching (SEE) on the clinical performance of class I and II bulk-fill resin composite restorations after 24 months. Methodology A total of 295 class I or class II restorations were performed on 70 patients. One universal adhesive was applied in all restorations. SEE was used in 148 restorations and self-etching mode (SET) in 147 restorations. After the adhesive application, cavities were restored with Filtek Bulk-fill Posterior Restorative in syringes (BSy), Filtek One Bulk-fill in capsules (BCa), or Filtek Supreme Ultra in syringes with the incremental technique (In). All restorations were evaluated using the FDI criteria after one week and after six, 12, and 24 months. Kaplan-Meier survival analysis and Pearson’s Chi-square test were used (α=0.05) for statistical analysis. Results After 24 months, 62 patients were evaluated and four restorations were lost due to fracture (one for SEEBSy, two for SEEIn, and one for SETIn). No significant differences in the fracture and retention rate were found between groups (p>0.05). SEE showed significantly fewer marginal adaptation defects than SET (p<0.05). BCa and BSy groups showed fewer marginal discrepancies compared to In (p<0.05). Restorations performed with BCa showed less color mismatch than BSy or In (p<0.05). Conclusion Although all restorations exhibited satisfactory clinical performance after 24 months of clinical service, the clinical behavior of class I and II restorations’ improved when performed with a bulk-fill composite in capsules, mainly when associated with a universal adhesive applied with SEE.

Clinical Performance and Wear Resistance of Highly Translucent Nano Zirconia Reinforced Glass Ionomer Filling Versus Conventional Resin Composite Restorations in Patients with Proximal Carious Teeth: Randomized Clinical Trial

“…In relation to the color match, intergroup comparisons of both materials have revealed statistically significant variations over three monitoring time frames: the starting point, six, and twelve months Which was in match with the examination managed by Balkaya et al, that reported that the color and translucency qualities of HVGIC restorations were still insufficient, and their color match was not exactly the same as composite resin restorations [8][9][10][11][12][13][14][15].…”

Characterization of whitening toothpastes and their effect on the physical properties of bulk-fill composites

“…5 Perceptibility/acceptability thresholds were considered for ΔE ab and ΔE 00 (1.2/2.7 and 0.8/1.8, respectively), in order to evaluate overall color change. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] The ΔE ab and ΔE 00 values after brushing were significantly higher for the RT than the HP group.…”

“… 5 The use of bulk-fill composites in clinical practice is an attractive proposition since single increments of 4–5 mm thickness can be cured by light, resulting in a consequential reduction in clinical time. 6 - 7 The basic aesthetic and surface characteristics of these composites, mostly color alteration, gloss, and roughness, are important factors that can affect the longevity and replacement of the restorations. 8 The decrease in composite properties may be associated with adverse conditions existing in the oral cavity, such as attritional wear promoted by masticatory forces, toothbrushing, and changes in temperature and pH of the oral environment.…”