Three-year clinical evaluation of a silorane composite resin. Three-year randomized clinical evaluation of a low-shrinkage silorane-based resin composite in non-carious cervical lesions One-year clinical performance of a self-etching adhesive in class V resin composites cured by two methods. One-year clinical evaluation of two resin composites, two polymerization methods, and a resin-modified glass ionomer in non-carious cervical lesions. The effect of a new-generation flowable composite resin on microleakage in Class V composite restorations as an intermediate layer 5-year clinical performance of resin composite versus resin modified glass ionomer restorative system in non-carious cervical lesions. Clinical study of indirect composite resin inlays in posterior stress-bearing cavities placed by dental students: results after 4 years. Shrinkage assessment of low shrinkage composites using micro-computed tomography. Cost-effectiveness of composite resins and amalgam in the replacement of amalgam Class II restorations. Clinical Status of Ten Dentin Adhesive Systems Two-year clinical evaluation of ormocer, nanohybrid and nanofill composite restorative systems in posterior teeth.
STATEMENT OF PROBLEM Composite resins are still outperformed by amalgams in the clinical practice with secondary caries and fractures being their most common failures . A material that suffers less polymerization shrinkage might improve the clinical performance of composite resins . PURPOSE To evaluate the clinical performance of a low-shrink silorane-based composite resin ( Filtek LS Low Shrink Posterior Restorative , 3 M ESPE , St. Paul , MN , USA ) in comparison with a methacrylate-based composite resin ( Tetric EvoCeram , Ivoclar Vivadent , Schaan , Principality of Liechtenstein ) over time . MATERIAL S AND METHODS C and i date s in need of Class II composite resin restorations participated in this r and omized controlled clinical trial . Those were 25 female and six male subjects with average age of 44.3 ± 12.7 years . Participants received 82 restorations , being 54 in premolars and 28 in molars . Procedures , which included the restoration of primary caries lesions or replacement of failing restorations , were done using modified preparations with no bevels or additional retention . Restorations were placed using Filtek LS ( and dedicated self-etch adhesive ) or Tetric EvoCeram ( with AdheSE , Ivoclar Vivadent ) , following manufacturers ' instructions . Incremental placement technique was applied and the restorations were immediately finished . Follow-up evaluations occurred at six , 12 , 24 , and 36 months and were done using the Fédération Dentaire Internationale criteria . Statistical analysis was performed using generalized estimating equations . RESULTS The recall rate at 36 months was 89 % . All interaction terms were not significant . CONCLUSIONS Filtek LS performs as well  as Tetric EvoCeram performs in the clinical setting at 36 months . CLINICAL SIGNIFICANCE The silorane-based composite resin Filtek LS and the conventional methacrylate-based composite resin Tetric EvoCeram performed similarly well in posterior restorations over at least 36 months of clinical service 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 r and omized 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 . Material s 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 material s in NCCLs were not significantly different . Clinical relevance Filtek silorane is suitable for restoring NCCLs This study evaluated the clinical performance of a self-etching adhesive for resin composites over one year . Thirty pairs of restorations of Pertac II , using the adhesive Prompt L-Pop , were placed in caries-free cervical erosion/abfraction lesions without tooth preparation . One of each pair was cured using " soft-start " polymerization , while the other was polymerized with high-intensity halogen light . Restorations were clinical ly evaluated at baseline , six and 12 months using modified Ryge/USPHS criteria . Although no significant difference ( p>0.05 ) was observed between the curing methods , adhesive performance was poor , with a 35 % loss of restorations overall AIM The aim of this study was to examine clinical ly relevant data on four restorative procedures for non-carious cervical lesions using United States Public Health Service (USPHS)-compatible clinical and photographic criteria and to compare different methods of analyzing clinical data . METHODS AND MATERIAL S Fourteen patients with at least one or two pairs of non-carious lesions under occlusion and a mean age of 50 were enrolled in this study . A total of 56 restorations ( 14 with each material ) were placed by three experienced , calibrated dental practitioners . Two other experienced and calibrated practitioners , under single-blind conditions , followed up on all restorations for a period of one year . Three material s were r and omly placed : a micro-hybrid composite with two polymerization methods ( G1 and G2 ) , a flowable micro-hydrid composite ( G3 ) , and a resin-modified glass ionomer ( G4 ) . Statistical analysis was performed using the Kruskall-Wallis test ( p<0.05 ) and a Mann-Whitney U modified test with a corrected significance level . RESULTS At the one year evaluation time , there were no restorations with secondary caries and the retention rates in G1 ( IntenS with a hard polymerization ) , G2 ( IntenS with a soft polymerization ) , G3 ( Filtek flow ) , and G4 ( Fuji II LC ) were 85.7 % ( two losses ) , 92.8 % ( one loss ) , 100 % , and 100 % , respectively . The total visual comparison of the results at baseline ( 15 days later ) showed significant differences only with the clinical acceptance criterion : G1 was different from G2 , with a soft polymerization device ( p<0.05 ) . In terms of surface quality at one year , G1 , G2 , and G3 exhibited a statistically significant difference from G4 , p<0.05 . The digital analysis at baseline showed significant differences only with the clinical acceptance criterion : G1=G2 was different from G3=G4 , p<0.05 . At one year , only the microporosity criterion showed any statistical differences : G1=G2=G3 was different from G4 , p<0.05 . CONCLUSIONS The resin-modified glass ionomer was easier to use and had a high retention rate , but it failed in terms of surface quality ( visual mode ) and porosity ( digital mode ) criteria compared to the others groups . Overall results showed no difference between groups G1 ( hard-polymerized ) and G2 ( soft-polymerized ) , and only G1 was affected by the marginal edge ( p<0.03 ) and integrity criteria ( p<0.02 ) at one year Aim : To evaluate the effect of application a new-generation bulk-fill flowable composite resin as an intermediate material between composite resin and dental substrates on micro-leakage in Class V composite restorations . Material s and Methods : A total of 144 Class V cavities were prepared in 72 human molars . Specimens were then r and omly distributed among three groups according to adhesive system applied ( Group 1 : Clearfil SE Bond ; Group 2 : Adper Easy One ; Group 3 : Adhesive 200 T ) , and each group was divided into three subgroups according to liner material used ( Group A : No liner-control group ; Group B : Aelite Flo LV , low viscosity microhybrid composite ; Group C : Smart dentin replacement ) . All cavities were restored using resin composite ( Aelite LS , low shrinkage posterior composite ) . Specimens were stained with 0.5 % basic fuchsin and evaluated dye penetration . Results : There was no significant difference in dye penetration was found between the control and the experimental groups . Conclusions : Micro-leakage is not affected by the application of either conventional or new-generation flowable composite resin as an intermediate material between composite resin and dental substrates AIM To comparatively assess the 5-year clinical performance of a 1-bottle adhesive and resin composite system with a resin-modified glass ionomer restorative in non-carious cervical lesions . METHOD AND MATERIAL S One operator placed 70 restorations ( 35 resin modified glass ionomer restorations and 35 resin composite restorations ) in 30 patients under rubber dam isolation without mechanical preparation .  The restorations were directly assessed by 2 independent examiners , using modified USPHS criteria at baseline and 6 , 12 , 24 and 60 months . RESULTS Twenty-two patients were available for recall after 5 years ( 73.3 % recall rate ) and 55 out of 70 restorations were evaluated . Excellent agreement was registered for all criteria between examiners ( kappa > or = 0.85 ) . Sixteen composite restorations were dislodged ( 51.5 % retention ) and 1 ionomer restoration was lost ( 96.4 % retention ) . The McNemar test detected significant differences in resin composite restorations between baseline and 5-year recall for marginal integrity ( p<0.001 ) and retention ( p=0.004 ) . For resin modified glass ionomer restorations , no significant differences were identified for all criteria ( p>0.05 ) . When comparing both material s , the Fisher exact test pointed out significant differences in retention ( p=0.002 ) after 5 years of clinical service . CONCLUSIONS After 5 years of evaluation , the clinical performance of resin modified glass ionomer restorations was superior to resin composite restorations OBJECTIVES This longitudinal r and omized controlled clinical trial evaluated the longevity of composite resin inlays in single- or multi-surface cavities up to 4 years . METHODS 21 dental students placed 75 Artglass and 80 Charisma composite resin inlays in class I and II cavities in posterior teeth ( 89 adult patients ) luted with dual-curing resin cements .  Clinical evaluation was performed up to 4 years using modified USPHS criteria . RESULTS 87.2 % of Artglass and 76.6 % of Charisma inlays were assessed to be clinical ly excellent or acceptable . Up to the 4-year recall 5 Artglass and 11 Charisma inlays failed mainly because of postoperative symptoms , bulk fracture , and loss of marginal integrity . No significant differences between both composite resin material s could be detected at 4 years for all clinical criteria ( Mann-Whitney U-test , p>0.05 ) . The comparison of restoration performance with time yielded a significant increase in marginal discolouration and postoperative symptoms ( p<0.05 ) , deterioration of surface texture quality , marginal and restoration integrity ( p<0.05 ) for both inlay systems . However , the changes were mainly effects of scoring shifts from alfa to bravo . Small inlays compared to large inlays and premolar restorations compared to molar restorations showed significant better outcome for some of the tested clinical parameters for the Artglass inlays ( p<0.05 ) . For Charisma inlays no such influences were revealed . CONCLUSIONS Clinical assessment of Artglass and Charisma composite resin inlays exhibited an annual failure rate of 3.2 % and 5.9 % that is within the range of published data . Within the limitations of this study indirect composite inlays are a competitive restorative procedure in stress-bearing preparations OBJECTIVES The aim of this study was to quantify the polymerization volumetric shrinkage of one regular and two low shrinkage bulk fill composites in class I cavities with or without an adhesive layer , using three-dimensional ( 3D ) micro-computed tomography ( μCT ) . METHODS Class I cavity preparations ( 2.5 mm depth × 4 mm length × 4 mm wide ) were st and ardized in 36 extracted human third molars , which were r and omly divided in six groups ( n = 6 each ) as follows : Group VIT ( regular composite without bonding agent ) ; Group SDR ( low shrinkage flowable composite without bonding agent ) ; Group TET ( low shrinkage composite without bonding agent ) ; Group VIT/P ( regular composite with bonding agent ) ; Group SDR/X ( low shrinkage flowable composite with bonding agent ) ; TET/T ( low shrinkage composite with bonding agent ) . Each tooth was scanned via µCT at cavity preparation , immediately after cavity filling , and after light-curing . Acquired μCT data were imported into Amira software for analysis and volume values evaluated between steps from cavity preparation until light-curing . RESULTS Both low shrinkage composites showed a significantly less volumetric shrinkage than VIT . The use of dental adhesive significantly decreased the average volumetric contraction similarly for the three composites , by about 20 % . CONCLUSION Both low shrinkage composites showed less volumetric polymerization contraction than the regular composite . The use of dental adhesive decreased the total volumetric shrinkage for all evaluated composites OBJECTIVES The replacement of an old amalgam Class II restoration  is a common treatment and will remain so for decades . In addition to effectiveness , possible adverse health effects and esthetics , the costs of the treatment options will play a role in the choice of material . The aim of this study was to yield information on the relative cost-effectiveness of the use of composite resins and amalgam for the rerestoration of amalgam Class II restorations . METHODS As part of a larger r and omized clinical trial , treatment effectiveness and treatment costs were estimated in 73 composite and amalgam Class II posterior re-restorations .  The main treatment outcome was longevity . Secondary outcomes included need of repair and quality of the margin while in situ . Costs were analyzed from the perspective of dentistry , assuming a treatment strategy aim ed at offering ' value for money ' . From this perspective , differential costs were based on personnel costs as approximated by treatment time . RESULTS Replacing an amalgam Class II restoration with amalgam is associated with lower costs than replacing with a composite resin . A sensitivity analysis , considering type of composite , increasing proficiency with the material , and time needed for future removal of material , demonstrated that these differences are fairly robust . The material s performed equally well for the first 5 years after placement with respect to longevity . Differences in secondary outcomes were minor and not all in favor of the same material . CONCLUSIONS It is tentatively concluded that amalgams are more cost-effective than composites for replacing existing Class II amalgam restorations Laboratory testing of dentin adhesive systems still requires corroboration by long-term clinical trials for their ultimate clinical effectiveness to be vali date d. The objective of this clinical investigation was to evaluate , retrospectively , the clinical effectiveness of earlier-investigated dentin adhesive systems ( Scotchbond , Gluma , Clearf il New Bond , Scotchbond 2 , Tenure , and Tripton ) , and to compare their clinical results with those obtained with four modern total-etch adhesive systems ( Bayer exp . 1 and 2 , Clearfil Liner Bond System , and Scotchbond Multi- Purpose ) . In total , 1177 Class V cervical lesions in the teeth of 346 patients were restored following two cavity design s : In Group A , enamel was neither beveled nor intentionally etched , as per ADA guidelines ; in Group B , adjacent enamel was beveled and conditioned . Clinical retention rates definitely indicated the improved clinical efficacy of the newest dentin adhesives over the earlier systems . With regard to adhesion strategy , adhesive systems that removed the smear layer and concurrently demineralized the dentin surface layer performed clinical ly better than systems that modified the disorderly layer of smear debris without complete removal . Hybridization by resin interdiffusion into the exposed dentinal collagen layer , combined with attachment of resin tags into the opened dentin tubules , appeared to be essential for reliable dentin bonding but might be insufficient by itself . The additional formation of an elastic bonding area as a polymerization shrinkage absorber and the use of a microfine restorative composite apparently guaranteed an efficient clinical result . The perfect one-year retention recorded for Clearfil Liner Bond System and Scotchbond Multi- Purpose must be confirmed at later recalls PURPOSE To evaluate and compare the 2-year clinical performance of an ormocer , a nanohybrid , and a nanofill resin composite with that of a microhybrid composite in restorations of small occlusal cavities made in posterior teeth . MATERIAL S AND METHODS Thirty-five patients , each with 4 occlusal restorations under occlusion , were enrolled in this study . A total of 140 restorations  was placed , 25 % for each material : an ormocer-based composite , Admira ; a nanohybrid resin composite , Tetric EvoCeram ; a nanofill resin composite , Filtek Supreme ; and a microhybrid resin composite , Tetric Ceram . Two operators placed all restorations according to the manufacturers ' instructions . One week after placement , the restorations were finished/polished and patients were advised to return for follow-up at 6 months , 1 year , and 2 years . All patients attended the 2-year visit where the clinical performance of all restorations was evaluated . Two independent examiners made all evaluations according to the USPHS modified Ryge criteria immediately after placement of restorations and at subsequent recall visits . The changes in the USPHS parameters during the 2-year period were analyzed with the Friedman test . Comparison of the baseline scores with those at the recall visits was made using the Wilcoxon signed rank test . The level of significance was set at p < 0.05 . RESULTS All material s showed only minor changes , and no differences were detected between their performance at baseline and after 2 years . Only one  ormocer and one  microhybrid composite restoration had failed after 2 years . No failure was detected in nanohybrid and nanofill composite restorations . Regarding the clinical performance , there were no statistically significant differences among the material s used ( p > 0.05 ) . CONCLUSION After 2 years , the ormocer , nanohybrid , and nanofill composites showed acceptable clinical performance similar to that of the microhybrid resin composite
The meta- analysis of the data in the included studies demonstrated that only one variable ( marginal adaptation after 12 months ) showed statistically significant outcomes , in which methacrylates-based composites presented significantly better results than resin composites containing modified monomers .
The good level of the scientific evidence as well as the overall low risk of bias of the included studies indicate that composites with silorane , ormocer or bulk-fill type modified monomers have a clinical performance similar to conventional resin composites
Polymerization shrinkage of resin composite can compromise the longevity of restorations .
To minimize this problem , the monomeric composition of composites have been modified .
The objective of this study was to conduct a meta- analysis to assess the clinical behavior of restorations performed with low polymerization shrinkage resin composite  in comparison with traditional methacrylates-based resin composite .