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Sengupta A, Naka O, Mehta SB, Banerji S. The clinical performance of bulk-fill versus the incremental layered application of direct resin composite restorations: a systematic review. Evid Based Dent 2023; 24:143. [PMID: 37402908 PMCID: PMC10516750 DOI: 10.1038/s41432-023-00905-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/09/2023] [Indexed: 07/06/2023]
Abstract
OBJECTIVES To systematically review the scientific evidence comparing the clinical effectiveness of bulk-fill versus incrementally layered conventional resin composites and to evaluate if one method offers clear merits with specific clinical outcomes. MATERIALS AND METHODS Using relevant mesh terms and pre-established eligibility criteria in PubMed, Embase, Scopus and Web of Science, a thorough scientific search was conducted with an end-date of 30.04.2023. Randomized controlled clinical trials that involved the direct comparison of Class I and Class II resin composite restorations applied using incremental layering techniques versus bulk-filled in permanent teeth with an observation period of at least six months were considered. To evaluate the bias risk of the finalized records, a revised version of the Cochrane risk-of-bias tool for randomized trials was implemented. RESULTS Out of the 1445 records determined, 18 eligible reports were chosen for qualitative analysis. Data obtained was categorized as per, the cavity design, the intervention, the comparator(s), the methods of success/failure assessment, the outcomes, and follow-up. Two studies demonstrated an overall low-risk of bias, fourteen studies raised some concerns, and two studies exhibited high-risk. CONCLUSION Bulk filled resin composite restorations demonstrated clinical outcomes similar to those of incrementally layered resin composite restorations within a review interval of 6 months to 10 years.
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Affiliation(s)
- Arjita Sengupta
- Faculty of Dentistry Oral and Craniofacial Sciences, King's College London, London, UK
| | - Olga Naka
- Faculty of Dentistry Oral and Craniofacial Sciences, King's College London, London, UK.
- School of Dentistry, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.
| | - Shamir B Mehta
- Faculty of Dentistry Oral and Craniofacial Sciences, King's College London, London, UK
| | - Subir Banerji
- Faculty of Dentistry Oral and Craniofacial Sciences, King's College London, London, UK
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Is the clinical performance of composite resin restorations in posterior teeth similar if restored with incremental or bulk-filling techniques? A systematic review and meta-analysis. Clin Oral Investig 2022; 26:2281-2297. [DOI: 10.1007/s00784-021-04337-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 12/04/2021] [Indexed: 11/26/2022]
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Heck K, Manhart J, Hickel R, Diegritz C. Clinical evaluation of the bulk fill composite QuiXfil in molar class I and II cavities: 10-year results of a RCT. Dent Mater 2018; 34:e138-e147. [PMID: 29636239 DOI: 10.1016/j.dental.2018.03.023] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 10/20/2017] [Accepted: 03/23/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE The objective of this RCT was to compare the 10-year clinical performance of QuiXfil with that of Tetric Ceram in posterior single- or multi-surface cavities. METHODS 46 QuiXfil (Xeno III) and 50 Tetric Ceram (Syntac classic) composite restorations were placed in 14 stress bearing class I and 82 class II cavities in first or second molars. Clinical evaluation was performed at baseline and after up to 10 years by using modified US Public Health Service criteria. At the last recall period, 26 QuiXfil and 30 Tetric Ceram restorations in 11 stress bearing class I and 45 class II cavities, were assessed. RESULTS Ten failed restorations were observed during the follow-up period, four Tetric Ceram restorations failed due to secondary caries (2), tooth fracture (1) and bulk fracture combined with secondary caries (1) whereas six QuiXfil restorations failed due to secondary caries (1), tooth fracture (2), secondary caries combined with restoration fracture (1), restoration fracture (1) and postoperative sensitivity (1). Fisher's exact test yielded no significant difference between both materials (p=0.487). SIGNIFICANCE Both materials, bulk fill QuiXfil restorations and Tetric Ceram restorations, showed highly clinical effectiveness during the 10-year follow-up.
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Affiliation(s)
- Katrin Heck
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University Munich, Goethestr. 70, 80336 Munich, Germany.
| | - Juergen Manhart
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University Munich, Goethestr. 70, 80336 Munich, Germany
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University Munich, Goethestr. 70, 80336 Munich, Germany
| | - Christian Diegritz
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University Munich, Goethestr. 70, 80336 Munich, Germany
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Veloso SRM, Lemos CAA, de Moraes SLD, do Egito Vasconcelos BC, Pellizzer EP, de Melo Monteiro GQ. Clinical performance of bulk-fill and conventional resin composite restorations in posterior teeth: a systematic review and meta-analysis. Clin Oral Investig 2018; 23:221-233. [PMID: 29594349 DOI: 10.1007/s00784-018-2429-7] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 03/19/2018] [Indexed: 01/01/2023]
Abstract
OBJECTIVES The purpose of this systematic review was to compare the clinical performance of bulk-fill resin composites with conventional resin composites used for direct restorations of posterior teeth. METHODS This review followed the PRISMA statement. This review was registered at PROSPERO (registration number CRD42016053436). A search of the scientific literature was performed by two independent reviewers using the PubMed/MEDLINE, Embase, The Cochrane Library, and Web of Science databases from commencement until January 2018. The research question was "Do bulk-fill resin composites have a clinical performance comparable to conventional resin composites in posterior restorations?" Only studies evaluating class I and II direct restorations in permanent teeth with a follow-up period of at least 1 year were included. The RevMan 5 program was used for meta-analysis, calculating the relative risk (RR) and 95% confidence interval (CI) of the dichotomous outcome (restoration failure or success). RESULTS Ten articles were selected, comprising 941 analyzed restorations. The mean follow-up period was 33.6 months (12-72 months). No statistically significant differences in the failure rate were observed between conventional and base/flowable bulk-fill resin composites (p = 0.31; RR 1.49; 95% CI 0.69-3.25) or full-body/sculptable bulk-fill resin composites (p = 0.12; RR 1.89; 95% CI 0.84-4.24). CONCLUSIONS The present systematic review and meta-analysis indicate similar clinical performances of bulk-fill and conventional resin composites over a follow-up period of 12 to 72 months. CLINICAL SIGNIFICANCE Based on the results of this study, the bulk-fill resin composites could be an alternative for direct restorations in posterior teeth. However, clinical trials of longer duration are required.
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Affiliation(s)
- Sirley Raiane Mamede Veloso
- Dental School, Universidade de Pernambuco/FOP-UPE, Av. General Newton Cavalcanti, 1650; Tabatinga, Camaragibe, PE, 54.756-220, Brazil
| | - Cleidiel Aparecido Araújo Lemos
- Araçatuba Dental School, UNESP - Univ Estadual Paulista , R. José Bonifácio, 1193; Vila Mendonca, Araçatuba, SP, 16015-050, Brazil
| | - Sandra Lúcia Dantas de Moraes
- Dental School, Universidade de Pernambuco/FOP-UPE, Av. General Newton Cavalcanti, 1650; Tabatinga, Camaragibe, PE, 54.756-220, Brazil
| | | | - Eduardo Piza Pellizzer
- Araçatuba Dental School, UNESP - Univ Estadual Paulista , R. José Bonifácio, 1193; Vila Mendonca, Araçatuba, SP, 16015-050, Brazil
| | - Gabriela Queiroz de Melo Monteiro
- Dental School, Universidade de Pernambuco/FOP-UPE, Av. General Newton Cavalcanti, 1650; Tabatinga, Camaragibe, PE, 54.756-220, Brazil.
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Opdam N, Collares K, Hickel R, Bayne S, Loomans B, Cenci M, Lynch C, Correa M, Demarco F, Schwendicke F, Wilson N. Clinical studies in restorative dentistry: New directions and new demands. Dent Mater 2018; 34:1-12. [DOI: 10.1016/j.dental.2017.08.187] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 08/24/2017] [Indexed: 10/18/2022]
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Shahidi C, Krejci I, Dietschi D. In Vitro Evaluation of Marginal Adaptation of Direct Class II Composite Restorations Made of Different “Low-Shrinkage” Systems. Oper Dent 2017; 42:273-283. [DOI: 10.2341/15-217-l] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
The present study evaluated the influence of various low-shrinkage restorative systems in class II direct composite restorations following simulated occlusal loading. Forty MOD class II cavities were prepared on freshly extracted human lower third molars with proximal margins located mesially 1.0 mm coronal to and distally 1 mm apical to the cementoenamel junction. The samples were randomly distributed into five experimental groups corresponding to the following restorative systems: a conventional resin composite (Tetric) as active control group, a low-shrinkage composite (Extra Low Shrinkage [ELS]) alone or combined with its corresponding flowable version (ELSflow) used as a 1- to 1.5-mm liner, a bulk-filling flowable composite (Surefil SDR) covered by a 1-mm layer of restorative composite (Ceram-X), and a restorative bulk-filling composite (SonicFill). All specimens were submitted to 1,000,000 cycles with a 100N eccentric load into saline. Tooth restoration margins were analyzed semiquantitatively by scanning electron microscopy before and after loading. The percentage of perfect adaptation to enamel varied from 94.15% (SonicFill) to 100% (ELS) before loading and from 69.22% (SonicFill) to 93.61% (ELS and ELSflow) after loading. Continuous adaptation to cervical dentin varied from 22.9% (Tetric) to 79.48% (SDR/Ceram-X) before loading and from 18.66% (Tetric) to 56.84% (SDR/Ceram-X) after loading. SDR/CeramX and SonicFill showed the best cervical dentin adaptation.
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Affiliation(s)
- C Shahidi
- Cyrus Shahidi, DMD, DDS, MAS, School of Dentistry, University of Geneva, Division of Cariology & Endodontics & Pediatric Dentistry, Geneva, Switzerland
| | - I Krejci
- Ivo Krejci, DMD, privat-docent, School of Dentistry, University of Geneva, Division of Cariology & Endodontics & Pediatric Dentistry, Geneva, Switzerland
| | - D Dietschi
- Didier Dietschi, DMD, PhD, privat-docent, School of Dentistry, University of Geneva, Division of Cariology & Endodontics & Pediatric Dentistry, Geneva, Switzerland, and Department for the Practice of General Dentistry, Case Western University, Cleveland, OH, USA
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Alvanforoush N, Palamara J, Wong RH, Burrow MF. Comparison between published clinical success of direct resin composite restorations in vital posterior teeth in 1995-2005 and 2006-2016 periods. Aust Dent J 2017; 62:132-145. [DOI: 10.1111/adj.12487] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2016] [Indexed: 11/30/2022]
Affiliation(s)
- N Alvanforoush
- Melbourne Dental School; University of Melbourne; Melbourne Victoria Australia
| | - J Palamara
- Melbourne Dental School; University of Melbourne; Melbourne Victoria Australia
| | - RH Wong
- Melbourne Dental School; University of Melbourne; Melbourne Victoria Australia
| | - MF Burrow
- Melbourne Dental School; University of Melbourne; Melbourne Victoria Australia
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Costa T, Rezende M, Sakamoto A, Bittencourt B, Dalzochio P, Loguercio AD, Reis A. Influence of Adhesive Type and Placement Technique on Postoperative Sensitivity in Posterior Composite Restorations. Oper Dent 2016; 42:143-154. [PMID: 27892839 DOI: 10.2341/16-010-c] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE This double blind, randomized clinical trial compared the postoperative sensitivity of the placement technique (incremental and bulk fill) in posterior composite resin restorations bonded with two different adhesive strategies (self-etch and etch-and-rinse). METHODS Posterior dental cavities of 72 participants (n=236), with a cavity depth of at least 3 mm, were randomly divided into four groups. The restorations were bonded using either the etch-and-rinse Tetric N-Bond (Ivoclar Vivadent) or the self-etch Tetric N-Bond SE (Ivoclar Vivadent). The composite resin Tetric N-Ceram Bulk Fill (Ivoclar Vivadent) was placed either incrementally or using the bulk-fill technique. Two experienced and calibrated examiners evaluated the restorations using World Dental Federation criteria after one week of clinical service. Spontaneous postoperative sensitivity was assessed using a 0-4 numerical rating scale and a 0-10 and 0-100 visual analog scale up to 48 h after the restorative procedure and after one week. RESULTS The risk (p>0.49) and intensity of spontaneous postoperative sensitivity (p>0.38) was not affected by the adhesive strategy or the filling technique. The overall risk of postoperative sensitivity was 20.3% (95% confidence interval 15.7-25.9) and typically occurred within 48 hours after the restorative procedure. CONCLUSIONS The overall risk of immediate postoperative sensitivity was 20.3% and was not affected by either the adhesive strategy (etch-and-rinse/self-etch) or the filling technique (incremental/ bulk).
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da Veiga AMA, Cunha AC, Ferreira DMTP, da Silva Fidalgo TK, Chianca TK, Reis KR, Maia LC. Longevity of direct and indirect resin composite restorations in permanent posterior teeth: A systematic review and meta-analysis. J Dent 2016; 54:1-12. [PMID: 27523636 DOI: 10.1016/j.jdent.2016.08.003] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 05/13/2016] [Accepted: 08/10/2016] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVES The aim of this systematic review and meta-analysis was to assess the differences in clinical performance in direct and indirect resin composite restorations in permanent posterior teeth. SOURCES PubMed, the Cochrane Library, Web of Science, Scopus, LILACS, BBO, ClinicalTrials.gov and SiGLE were searched without restrictions. STUDY SELECTION We included randomized clinical trials (RCTs) that compared the clinical performance of direct and indirect resin composite restorations in Class I and Class II cavities in permanent teeth, with at least two years of follow-up. The risk of bias tool suggested by Cochrane Collaboration was used for quality assessment. DATA After duplicate removal, 912 studies were identified. Twenty fulfilled the inclusion criteria after the abstract screening. Two articles were added after a hand search of the reference list of included studies. After examination, nine RCTs were included in the qualitative analysis and five were considered to have a 'low' risk of bias. The overall risk difference in longevity between direct and indirect resin composite restorations in permanent posterior teeth (p>0.05) at five-year follow-up was 1.494 [0.893-2.500], and regardless of the type of tooth restored, that of molar and premolars was 0.716 [0.177-2.888] at three-year follow-up. CONCLUSIONS Based on the findings, there was no difference in longevity of direct and indirect resin composite restorations regardless of the type of material and the restored tooth. CLINICAL SIGNIFICANCE Contemporary dentistry is based on minimally invasive restorations. Any indication of a less conservative technique must have unquestionable advantages. In vitro and in vivo studies reveal contradictory evidence of the clinical performance of direct and indirect resin composite restorations in posterior teeth. Thus this study clarified this doubt.
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Affiliation(s)
- Ana Maria Antonelli da Veiga
- Department of Prosthodontics and Dental Materials, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho, 373, Prédio do CCS, Bloco K, Ilha da Cidade Universitária, Rio de Janeiro, Brazil
| | - Amanda Carneiro Cunha
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho, 373, Prédio do CCS, Bloco K, Ilha da Cidade Universitária, Rio de Janeiro, Brazil
| | - Daniele Masterson Tavares Pereira Ferreira
- Center of Health Science, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho, 373, Prédio do CCS, Bloco I, Ilha da Cidade Universitária, Rio de Janeiro, Brazil
| | - Tatiana Kelly da Silva Fidalgo
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho, 373, Prédio do CCS, Bloco K, Ilha da Cidade Universitária, Rio de Janeiro, Brazil
| | - Thomaz Kauark Chianca
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho, 373, Prédio do CCS, Bloco K, Ilha da Cidade Universitária, Rio de Janeiro, Brazil
| | - Kátia Rodrigues Reis
- Department of Prosthodontics and Dental Materials, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho, 373, Prédio do CCS, Bloco K, Ilha da Cidade Universitária, Rio de Janeiro, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro, Av. Carlos Chagas Filho, 373, Prédio do CCS, Bloco K, Ilha da Cidade Universitária, Rio de Janeiro, Brazil.
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One-year evaluation of two hybrid composites placed in a randomized-controlled clinical trial. Dent Mater 2014; 30:824-38. [DOI: 10.1016/j.dental.2014.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Revised: 04/29/2014] [Accepted: 05/19/2014] [Indexed: 11/19/2022]
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Lynch CD, Opdam NJ, Hickel R, Brunton PA, Gurgan S, Kakaboura A, Shearer AC, Vanherle G, Wilson NH. Guidance on posterior resin composites: Academy of Operative Dentistry - European Section. J Dent 2014; 42:377-83. [DOI: 10.1016/j.jdent.2014.01.009] [Citation(s) in RCA: 138] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 01/13/2014] [Indexed: 11/30/2022] Open
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Çelik Ç, Arhun N, Yamanel K. Clinical evaluation of resin-based composites in posterior restorations: a 3-year study. Med Princ Pract 2014; 23:453-9. [PMID: 25115230 PMCID: PMC5586919 DOI: 10.1159/000364874] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 03/10/2014] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the clinical performance of a nanohybrid and a microhybrid composite in class I and II restorations after 3 years. SUBJECTS AND METHODS A total of 82 class I and class II restorations were performed in 31 patients (10 males and 21 females) using Grandio and QuiXfil with self-etch adhesives (Futurabond and Xeno III). The restorations were clinically evaluated by 2 operators 1 week after placement (baseline) and at 6 months and 1, 2, and 3 years using modified United States Public Health Service (USPHS) criteria. At the 3-year follow-up, 62 class I and class II cavities were reevaluated in 23 patients (7 males and 16 females). Statistical analysis was performed using Pearson's χ(2) and Fisher's exact tests (p < 0.05). RESULTS At the 6-month follow-up, all restorations received Alfa scores with respect to each evaluation criterion. At the 1-year follow-up, 2 QuiXfil restorations had to be replaced and Grandio restorations started to deteriorate in terms of marginal adaptation. At the end of 2 years, 9 Grandio restorations showed significant deterioration of the surface properties, demonstrating Bravo scores. At the end of 3 years, no significant differences were observed regarding color match, marginal adaptation, secondary caries, marginal discoloration, and anatomic form loss between the evaluated materials in 25 class I and 37 class II restorations. At the 3-year follow-up, Grandio restorations had 21% Bravo scores and showed significant deterioration of the surface properties, which were still clinically acceptable according to USPHS criteria. Three QuiXfil and 1 Grandio restorations were replaced because of secondary caries and loss of retention. CONCLUSIONS Both the nanohybrid (Grandio) and the microhybrid (QuiXfil) composites were clinically functional after 3 years.
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Affiliation(s)
| | - Neslihan Arhun
- *Neslihan Arhun, Department of Restorative Dentistry, School of Dentistry, Baskent University, 11. Sok No: 26, TR-06490 Bahcelievler, Ankara (Turkey), E-Mail
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Nanohybrid vs. fine hybrid composite in extended class II cavities: 8-year results. Clin Oral Investig 2013; 18:125-37. [DOI: 10.1007/s00784-013-0957-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Accepted: 02/21/2013] [Indexed: 10/27/2022]
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Nanohybrid vs. fine hybrid composite in extended Class II cavities after six years. Dent Mater 2011; 27:455-64. [DOI: 10.1016/j.dental.2011.01.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Revised: 12/08/2010] [Accepted: 01/24/2011] [Indexed: 11/24/2022]
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Banomyong D, Harnirattisai C, Burrow MF. Posterior resin composite restorations with or without resin-modified, glass-ionomer cement lining: a 1-year randomized, clinical trial. ACTA ACUST UNITED AC 2010; 2:63-9. [DOI: 10.1111/j.2041-1626.2010.00036.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Arhun N, Celik C, Yamanel K. Clinical Evaluation of Resin-based Composites in Posterior Restorations: Two-year Results. Oper Dent 2010; 35:397-404. [DOI: 10.2341/09-345-c] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Clinical Relevance
Nanohybrid and low-shrinkage posterior resin composites, placed with self-etch adhesive systems in posterior teeth, showed satisfactory and similar results after two years.
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