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Dipalma G, Inchingolo AD, Guglielmo M, Morolla R, Palumbo I, Riccaldo L, Mancini A, Palermo A, Malcangi G, Inchingolo AM, Inchingolo F. Nanotechnology and Its Application in Dentistry: A Systematic Review of Recent Advances and Innovations. J Clin Med 2024; 13:5268. [PMID: 39274481 PMCID: PMC11396671 DOI: 10.3390/jcm13175268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2024] [Revised: 08/22/2024] [Accepted: 09/04/2024] [Indexed: 09/16/2024] Open
Abstract
Background: This study looks at the clinical applications of nanotechnology in dentistry, with an emphasis on implantology, preventive care, orthodontics, restorative dentistry, and endodontics. Methods: Following PRISMA criteria and registered in PROSPERO (ID: CRD 564245), a PubMed, Scopus, and Web of Science search was conducted for studies from January 2014 to April 2024. The criteria were English-language research on nanotechnology in dental coatings, with a focus on clinical trials and observational studies. The electronic database search yielded 8881 publications. Following the screening process, 17 records were selected for qualitative analysis. Results: Nanotechnology has revolutionized dentistry. In orthodontics, nanoparticles improve antibacterial characteristics, durability, and biocompatibility, lowering bacterial colonization and plaque. In preventative care, Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) combined with stannous fluoride (SnF2) and nano-sized sodium trimetaphosphate (TMPnano) substantially remineralizes enamel. Nanostructured surfaces in dental implants, particularly those containing calcium, improve osseointegration and stability. Nanoparticles in restorative dentistry improve composite and adhesive strength, aesthetics, and longevity. Conclusions: Nanotechnology improves dental materials and equipment, resulting in better treatment outcomes and increased patient comfort. Its integration provides more effective treatments, which improves dental care and patient outcomes. More research is needed to overcome present problems and expand nanotechnology's medicinal applications.
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Affiliation(s)
- Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | | | | | - Roberta Morolla
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Irene Palumbo
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Lilla Riccaldo
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | - Andrea Palermo
- College of Medicine and Dentistry, Birmingham B4 6BN, UK
| | - Giuseppina Malcangi
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
| | | | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70121 Bari, Italy
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Francois P, Attal JP, Fasham T, Troizier-Cheyne M, Gouze H, Abdel-Gawad S, Le Goff S, Dursun E, Ceinos R. Flexural Properties, Wear Resistance, and Microstructural Analysis of Highly Filled Flowable Resin Composites. Oper Dent 2024; 49:597-607. [PMID: 39169507 DOI: 10.2341/24-033-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2024] [Indexed: 08/23/2024]
Abstract
OBJECTIVE This study aimed to evaluate the flexural properties and two-body wear resistance of nine highly filled flowable resin composites relative to those of viscous and conventional low-filled flowable composites. In addition, scanning electron microscopy (SEM) analysis of the microstructures was performed. METHODS AND MATERIALS For each resin composite group (n=12), 12 specimen bars (25 mm × 2 mm × 2 mm) were fabricated using a silicon mold for performing flexural strength (FS), flexural modulus (E), flexural toughness (FT), Weibull modulus (m) tests, and SEM microstructural analysis. For each group, ten bars were tested using a three-point flexural test on a universal testing machine, while the other two were embedded in acrylic resin before being observed by SEM for structural analysis. During the two-body wear test with a chewing simulator, 8 specimens (12 groups, n=8) of each resin composite group were manufactured in a specific mold and subjected to 120,000 cycles of wear against a steatite ball, and the depth loss was measured. Three one-way ANOVA tests followed by Tukey's post hoc tests were conducted to compare the flexural and wear properties among the different groups. RESULTS The majority of highly filled composites tested in this study exhibited similar flexural strengths (between 105.68 MPa and 135.49 MPa) and superior wear resistance to those of viscous composites. The flexural moduli (between 5.12 GPa and 9.62 GPa) of these composites were in between those of the viscous and low-filled composites tested in this study. CONCLUSIONS The highly filled flowable composites tested in this study exhibited different in vitro properties but were often superior to those of viscous resin composite suggesting their possible use for posterior restorations.
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Affiliation(s)
- P Francois
- Philippe Francois, DDS, Faculty of Dental Surgery, Innovative Dental Materials and Interfaces Research Unit (URB2i), Paris Cité University; Bretonneau Hospital, Paris, France
| | - J P Attal
- Jean-Pierre Attal, DDS, PhD, Faculty of Dental Surgery, Innovative Dental Materials and Interfaces Research Unit (URB2i), Paris Cité University; Charles Foix Hospital, Ivry-sur-Seine, France
| | - T Fasham
- Timothy Fasham, DDS, Faculty of Dental Surgery, Innovative Dental Materials and Interfaces Research Unit (URB2i), Paris Cité University; Bretonneau Hospital, Paris, France
| | - M Troizier-Cheyne
- Max Troizier-Cheyne, DDS, Faculty of Dental Surgery, Innovative Dental Materials and Interfaces Research Unit (URB2i), Paris Cité University; Bretonneau Hospital, Paris, France
| | - H Gouze
- Hélène Gouze, MD, Department of Rheumatology, Ambroise Paré Hospital, Boulogne, France; Centre for Research in Epidemiology and Population Health U1808, Paris Saclay University, Villejuif, France
| | - S Abdel-Gawad
- Sarah Abdel-Gawad, EMSE, Faculty of Dental Surgery, Innovative Dental Materials and Interfaces Research Unit (URB2i), Paris Cité University, Paris, France
| | - S Le Goff
- Stéphane Le Goff, EMSE, Faculty of Dental Surgery, Innovative Dental Materials and Interfaces Research Unit (URB2i), Paris Cité University, Paris, France
| | - E Dursun
- Elisabeth Dursun, DDS, PhD, Faculty of Dental Surgery, Innovative Dental Materials and Interfaces Research Unit (URB2i), Paris Cité University; Henri Mondor Hospital, Créteil, France
| | - R Ceinos
- *Romain Ceinos, DDS, PhD, faculty of Dental Surgery, Restorative Department, Côte d'Azur University, Nice, France; hospital practitioner, Institute of Bucco-Dental Medicine, Nice University Hospital, Nice, France; Innovative Dental Materials and Interfaces Research Unit (URB2i), Paris-Cité, France
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Daher R, Krejci I, Ardu S. Time-and cost-effective 3-dimensional-printing workflow to rehabilitate worn dentitions: A clinical report. J Prosthet Dent 2024; 131:996-999. [PMID: 36959005 DOI: 10.1016/j.prosdent.2023.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/08/2023] [Accepted: 02/08/2023] [Indexed: 03/25/2023]
Abstract
Current restorative methods of restoring worn or eroded dentition present drawbacks that may deter dentists or patients from pursuing complete mouth rehabilitation. A novel additive manufacturing approach using 3D printed definitive composite resin restorations is described as a less technique-sensitive and more cost-effective alternative. These restorations are straightforward to repair, modify, or replace.
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Affiliation(s)
- René Daher
- Senior Lecturer, Division of Cariology and Endodontology, Clinique Universitaire de Médecine Dentaire (CUMD), University of Geneva, Geneva, Switzerland.
| | - Ivo Krejci
- Full Professor and Chairman, Division of Cariology and Endodontology, Clinique Universitaire de Médecine Dentaire (CUMD), University of Geneva, Geneva, Switzerland
| | - Stefano Ardu
- Senior Lecturer, Division of Cariology and Endodontology, Clinique Universitaire de Médecine Dentaire (CUMD), University of Geneva, Geneva, Switzerland
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Nguyen AD, Pütz N, Michaelis M, Bitter K, Gernhardt CR. Influence of Cavity Lining on the 3-Year Clinical Outcome of Posterior Composite Restorations: A Randomized Controlled Clinical Trial. Dent J (Basel) 2024; 12:128. [PMID: 38786526 PMCID: PMC11120593 DOI: 10.3390/dj12050128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 02/20/2024] [Accepted: 04/30/2024] [Indexed: 05/25/2024] Open
Abstract
The purpose of this randomized, split-mouth-designed controlled and single-blinded clinical study was to evaluate the 3-year clinical performance of Class I and Class II resin composite restorations placed with or without cavity lining with a flowable composite. Fifty patients with treatment needs in two premolars or molars were included. One of the teeth was restored using the nanohybrid composite (Grandio®SO, control group), in the test group a high viscosity flowable composite was additionally applied as a first layer. In both groups, the same self-etch adhesive system was applied. Clinical evaluation after 3 years was carried out using the modified USPHS/Ryge criteria. At the 3-year follow-up the recall rate was 92%. Four restorations failed in the test group (8.7%), three due to the loss of vitality and one after fracture. The control group exhibited a cumulative success rate of 100%, while the test group achieved a success rate of 91.3%. This led to significant differences in the annual failure rate (AFR) between the two groups, with rates of 0% and 2.9% (p < 0.05; Mann-Whitney U-test). After 3 years the cumulative survival rate including all restorations was 95.7%. Statistical analysis revealed significant differences for the parameters: tooth vitality, marginal discoloration, success rate, and AFR. The other parameters exhibited no significant differences. Consequently, the nanohybrid composite demonstrated excellent performance over a 3-year period, whereas the utilization of a flowable composite for the cavity lining did not appear to exert a beneficial influence on clinical outcomes.
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Affiliation(s)
- Anh Duc Nguyen
- Correspondence: (A.D.N.); (N.P.); (C.R.G.); Tel.: +49-345-557-3741 (A.D.N.)
| | - Natalie Pütz
- Correspondence: (A.D.N.); (N.P.); (C.R.G.); Tel.: +49-345-557-3741 (A.D.N.)
| | | | | | - Christian Ralf Gernhardt
- University Outpatient Clinic for Conservative Dentistry and Periodontology, Department of Dentistry, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Magdeburger Strasse 16, 06112 Halle, Germany (K.B.)
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Daher R, Ardu S, di Bella E, Krejci I, Duc O. Efficiency of 3D printed composite resin restorations compared with subtractive materials: Evaluation of fatigue behavior, cost, and time of production. J Prosthet Dent 2024; 131:943-950. [PMID: 36333176 DOI: 10.1016/j.prosdent.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 08/03/2022] [Accepted: 08/08/2022] [Indexed: 11/05/2022]
Abstract
STATEMENT OF PROBLEM Three-dimensionally (3D)-printed composite resins have been marketed as materials for definitive restorations. However, limited information is available regarding the stability of the adhesive interface and the efficiency of 3D printed composite resins. PURPOSE The purpose of this in vitro study was to evaluate the integrity of the marginal adhesive interface before and after thermal and mechanical fatigue of an initial formulation of a 3D printed composite resin and to evaluate the efficiency of this manufacturing method. MATERIAL AND METHODS Freshly extracted molars were prepared for onlays and adhesively restored with either 3D printed composite resin (VarseoSmile Crown Plus) (Group 3D), milled composite resin (Tetric CAD) (Group MCOMP), milled PMMA (Telio CAD) (Group PMMA), and milled lithium disilicate (IPS e.max CAD) (Group EM). Marginal analysis was performed under a scanning electron microscope before and after fatigue by thermomechanical cyclic loading, and initial and terminal percentages of continuous margin (%CM) were compared. The time required for the production of each type of restoration was recorded, and the production costs were also compared. RESULTS Before aging, 3D, MCOMP, and EM presented comparable values of %CM (69.8%, 75.9%, and 63.1%, respectively) that were statistically significantly higher (P<.05) than those of PMMA (45.1%). After aging, 3D and EM had comparable results (44.7% and 43.7%, respectively), which were lower than those of the MCOMP group (68.5%) but higher than those of the PMMA group (20.5%). Regarding time efficiency, 3D printing took less time than MCOMP or PMMA if more than 8 restorations were fabricated. For the production costs, 3D printing was 5.5, 8.7, and 10.2 times less expensive than PMMA, MCOMP, and EM, respectively. The initial equipment cost was also lower for the additive manufacturing method. However, 3D printing did not always considerably reduce waste. CONCLUSIONS In terms of marginal adaptation, the evaluated initial formulation of a 3D printed composite resin behaved similarly to other well-established definitive restoration materials and better than milled PMMA, both before and after fatigue. Three-dimensionally printed resins present advantages in terms of equipment and consumable costs, even for a single restoration, but also for production time when more than 8 restorations were fabricated.
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Affiliation(s)
- René Daher
- Lecturer, Division of Cariology and Endodontology, Clinique Universitaire de Médecine Dentaire (CUMD), University of Geneva, Geneva, Switzerland.
| | - Stefano Ardu
- Senior Lecturer, Treatment Plan Unit and Division of Cariology and Endodontology, Clinique Universitaire de Médecine Dentaire (CUMD), University of Geneva, Geneva, Switzerland
| | - Enrico di Bella
- Assistant Professor, Department of Political Science, University of Genoa, Genoa, Italy
| | - Ivo Krejci
- Full Professor and Chairman, Division of Cariology and Endodontology, Clinique Universitaire de Médecine Dentaire (CUMD), University of Geneva, Geneva, Switzerland
| | - Olivier Duc
- Senior Lecturer, Division of Cariology and Endodontology, Clinique Universitaire de Médecine Dentaire (CUMD), University of Geneva, Geneva, Switzerland
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Banon R, Vandenbulcke J, Van Acker J, Martens L, De Coster P, Rajasekharan S. Two-year clinical and radiographic evaluation of ACTIVA BioACTIVE versus Compomer (Dyract® eXtra) in the restoration of class-2 cavities of primary molars: a non-inferior split-mouth randomised clinical trial. BMC Oral Health 2024; 24:437. [PMID: 38600533 PMCID: PMC11005273 DOI: 10.1186/s12903-024-04132-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 03/11/2024] [Indexed: 04/12/2024] Open
Abstract
OBJECTIVES The trial aimed to compare the clinical performance and radiographic success of ACTIVA BioACTIVE versus Compomer in restoring class-II cavities of primary molars. MATERIALS AND METHODS A non-inferior split-mouth design was considered. A pre-calculated sample size of 96 molars (48 per group) with class-2 cavities of twenty-one children whose ages ranged from 5 to 10 years were randomly included in the trial. Pre-operative Plaque Index (PI), DMFT/dmft scores and the time required to fill the cavity were recorded. Over 24 months, the teeth were clinically evaluated every six months and radiographically every 12 months by two calibrated and blinded evaluators using the United States public health service (USPHS)-Ryge criteria. The two-sided 95% confidence interval (CI) for the difference in success rate was considered to assess non-inferiority, and the margin was set at -18%. The linear mixed model and Firth's logistic regression model were used for data analysis (P < 0.05). RESULTS After 24 months, 86 teeth (43 per group) were evaluated. The mean PI score was 1.1(± 0.9), while DMFT/dmft was 0.35 (± 0.74) and 6.55 (± 2.25) respectively. The clinical and radiographic success rate of Dyract vs. ACTIVA was 95.3% and 88.3% vs. 93% and 86%, respectively. The two-sided 95% CI for the difference in success rate (-2.3%) was - 3.2 to 1.3% and didn't reach the predetermined margin of -18% which had been anticipated as the non-inferiority margin. Clinically, ACTIVA had a significantly better colour match (P = 0.002) but worse marginal discolouration (P = 0.0143). There were no significant differences regarding other clinical or radiographic criteria (P > 0.05). ACTIVA took significantly less placement time than Dyract, with a mean difference of 2.37 (± 0.63) minutes (P < 0.001). CONCLUSION The performance of ACTIVA was not inferior to Dyract and both materials had a comparable high clinical and radiographic performance in children with high-caries experience. ACTIVA had a significantly better colour match but more marginal discolouration. It took significantly less time to be placed in the oral cavity. TRIAL REGISTRATION The study was registered at ClinicalTrials.gov on 4 May 2018 (#NCT03516838).
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Affiliation(s)
- Reda Banon
- Paediatric Dentistry, Oral Health Sciences, ELOHA (Equal Lifelong Oral Health for All) research group, Ghent University Hospital, Ghent, Belgium.
| | - Jeroen Vandenbulcke
- Paediatric Dentistry, Oral Health Sciences, ELOHA (Equal Lifelong Oral Health for All) research group, Ghent University Hospital, Ghent, Belgium
| | - Jakob Van Acker
- Paediatric Dentistry, Oral Health Sciences, ELOHA (Equal Lifelong Oral Health for All) research group, Ghent University Hospital, Ghent, Belgium
| | - Luc Martens
- Paediatric Dentistry, Oral Health Sciences, ELOHA (Equal Lifelong Oral Health for All) research group, Ghent University Hospital, Ghent, Belgium
| | - Peter De Coster
- Department of Reconstructive Dentistry and Oral Biology, Oral Health Sciences, Ghent University Hospital, Ghent, Belgium
| | - Sivaprakash Rajasekharan
- Paediatric Dentistry, Oral Health Sciences, ELOHA (Equal Lifelong Oral Health for All) research group, Ghent University Hospital, Ghent, Belgium
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Prause E, Malgaj T, Kocjan A, Beuer F, Hey J, Jevnikar P, Schmidt F. Mechanical properties of 3D-printed and milled composite resins for definitive restorations: An in vitro comparison of initial strength and fatigue behavior. J ESTHET RESTOR DENT 2024; 36:391-401. [PMID: 37680013 DOI: 10.1111/jerd.13132] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 08/06/2023] [Accepted: 08/25/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVE To evaluate the flexural strength and fatigue behavior of a novel 3D-printed composite resin for definitive restorations. MATERIALS AND METHODS Fifty disc-shaped specimens were manufactured from each of a nanohybrid composite resin (NHC), polymer-infiltrated ceramic network (PICN), and 3D-printed composite resin (3D) with CAD-CAM technology. Biaxial flexural strength (σin ) (n = 30 per group) and biaxial flexural fatigue strength (σff ) (n = 20 per group) were measured using piston-on-three-balls method, employing a staircase approach of 105 cycles. Weibull statistics, relative-strength degradation calculations, and fractography were performed. The results were analyzed with 1-way ANOVA and Games-Howell post hoc test (α = 0.05). RESULTS Significant differences in σin and σff among the groups (p < 0.001) were detected. The NHC group provided the highest mean ± standard deviation σin and σff (237.3 ± 31.6 MPa and 141.3 ± 3.8 MPa), followed by the PICN (140.3 ± 12.9 MPa and 73.5 ± 9.9 MPa) and the 3D (83.6 ± 18.5 MPa and 37.4 ± 23.8 MPa) groups. The 3D group exhibited significantly lower Weibull modulus (m = 4.7) and up to 15% higher relative strength degradation with areas of nonhomogeneous microstructure as possible fracture origins. CONCLUSIONS The 3D-printed composite resin exhibited the lowest mechanical properties, where areas of nonhomogeneous microstructure developed during the mixing procedure served as potential fracture origins. CLINICAL SIGNIFICANCE The clinical indications of the investigated novel 3D-printed composite resin should be limited to long-term provisional restorations. A cautious procedure for mixing the components is crucial before the 3D-printing process, since nonhomogeneous areas developed during the mixing could act as fracture origins.
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Affiliation(s)
- Elisabeth Prause
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Tine Malgaj
- Department of Prosthodontics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Andraž Kocjan
- Department for Nanostructured Materials, Jožef Stefan Institute, Ljubljana, Slovenia
| | - Florian Beuer
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Jeremias Hey
- Department of Prosthodontics, School of Dental Medicine, Martin-Luther-University, Halle, Germany
| | - Peter Jevnikar
- Department of Prosthodontics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Franziska Schmidt
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Liu X, Zhang R, Yu X, Hua F, Zhang L, Chen Z. Self-adhesive flowable composite resins and flowable composite resins in permanent teeth with occlusal cavities: A systematic review and meta-analysis. J Dent 2023; 138:104691. [PMID: 37683798 DOI: 10.1016/j.jdent.2023.104691] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 09/10/2023] Open
Abstract
OBJECTIVES To compare the clinical performance (retention, secondary caries, marginal adaptation, marginal discoloration, and postoperative hypersensitivity) of self-adhesive flowable composite resins (SAFCs) and flowable composite resins (FCs) in permanent teeth with occlusal cavities. DATA Randomized controlled trials (RCTs) of SAFCs versus FCs with a follow-up length of at least one year. No restrictions were placed on language or publication date. SOURCES Five databases, including PubMed, Embase, Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials, were searched manually by browsing ten related journals. On 14 June 2023, all electronic and manual searches were updated. STUDY SELECTION Five RCTs with 138 participants were included. Cochrane's risk of bias tool (2.0) was implemented in selected studies, and the GRADE tool was utilised to evaluate the evidence quality. To summarize the effects of the treatments and pool the data, a random-effects model was used. CONCLUSIONS According to the modified United States Public Health Service Evaluation (USPHS) criteria, there was no discernible difference between the groups during the two-year follow-up period (maximum follow-up time). Nevertheless, FCs applied with the etch-and-rinse mode demonstrated superior marginal adaptation and marginal discoloration at the two-year follow-up (relative risk = 3.21 [1.50 to 6.83], 3.40 [1.10, 10.48]). The evidence for marginal discoloration at any recall time and marginal adaptation at the one-year follow-up was graded as moderate quality due to inconsistency. Moreover, low-quality evidence for marginal adaptation at two-year follow-up was due to imprecision and inconsistency. CLINICAL SIGNIFICANCE SAFCs exhibited clinical performance comparable to that of FCs in occlusal cavities. Further high-quality clinical trials are needed to provide solid evidence to support the clinical application of SAFCs. REGISTRATION PROSPERO (CRD42022374983).
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Affiliation(s)
- Xinya Liu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key, Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of, Stomatology School & Hospital of Stomatology Wuhan University, Wuhan, China; Department of Cariology & Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Ruonan Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key, Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of, Stomatology School & Hospital of Stomatology Wuhan University, Wuhan, China; Department of Cariology & Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Xueqian Yu
- Library, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fang Hua
- Center for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Lu Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key, Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of, Stomatology School & Hospital of Stomatology Wuhan University, Wuhan, China; Department of Cariology & Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
| | - Zhi Chen
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key, Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of, Stomatology School & Hospital of Stomatology Wuhan University, Wuhan, China; Department of Cariology & Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
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9
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Suzuki M, Miyano Y, Sato F, Shinkai K. Surface Properties of Resin Composites and CAD/CAM Blocks After Simulated Toothbrushing. Oper Dent 2023; 48:575-587. [PMID: 37635455 DOI: 10.2341/22-123-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2023] [Indexed: 08/29/2023]
Abstract
OBJECTIVES This study aimed to evaluate the surface gloss, surface roughness, and color change of restorative materials after a three-body wear abrasion. METHODS AND MATERIALS Four resin composites with different filler particle size (Gracefil Flo [GFF, 0.7 μm], Gracefil LoFlo [GFL, 0.25 μm], Gracefil ZeroFlo [GFZ, 0.15 μm], and Gracefil Putty [GFP, 0.3 μm]), two CAD/CAM resin composite blocks with different filler particle size (Cerasmart 300 [CS3, 0.7 μm] and Cerasmart Prime [CSP, 0.3 μm], GC), and one CAD/CAM lithium disilicate glass-ceramic block (Initial LiSi Block [ILS], GC) as a control were evaluated. Twenty slab-shaped specimens were obtained from each material. Ten specimens were subjected to 80,000 toothbrushing strokes and measured for surface gloss (Gloss Unit, GU), surface roughness (Ra, μm), and color (L*, a*, and b* values) before toothbrushing and at every 20,000 strokes. Color differences (ΔL*, Δa*, Δb*, and ΔE00) before and after toothbrushing were calculated. After 80,000 strokes, abraded surfaces were observed using scanning electron microscopy. The other 10 specimens were measured for Vickers microhardness (VHN). RESULTS After 80,000 toothbrushing strokes, the mean GU ranged from 60.43 to 16.12 (the highest for ILS and lowest for GFL), and the mean Ra ranged from 0.079 to 4.085 (the lowest for ILS and highest for GFL). At all measuring stages, the calculated ΔE00 values ranged from 0.31 to 0.92 for all materials. The mean VHN ranged from 632.34 to 39.08 (the highest for ILS and lowest for GFZ). The resin composite containing the largest filler particle (GFF) showed significantly lower Ra and higher VHN than other resin composites (GFL, GFZ, and GFP). The CAD/CAM resin composite block containing a smaller filler particle (CSP) retained significantly higher GU than that containing a larger filler particle (CS3). A negative correlation between GU and Ra was detected. CONCLUSIONS Based on the findings, toothbrush abrasion induced a decrease in GU and an increase in Ra for all resin-based materials tested. Resin-based materials with larger filler size tended to show lower Ra, while resin-based materials with smaller filler size tended to show a smaller reduction in GU. These were more pronounced for light-cure resin composites than for resin composite blocks for CAD/CAM.
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Affiliation(s)
- M Suzuki
- *Masaya Suzuki, DDS, PhD, Department of Operative Dentistry, The Nippon Dental University School of Life Dentistry at Niigata
| | - Y Miyano
- Yuko Miyano, DDS, Advanced Operative Dentistry-Endodontics, The Nippon Dental University Graduate School of Life Dentistry at Niigata
| | - F Sato
- Fumiaki Sato, DDS, PhD, Department of Operative Dentistry, The Nippon Dental University School of Life Dentistry at Niigata
| | - K Shinkai
- Koichi Shinkai, DDS, PhD, Department of Operative Dentistry, The Nippon Dental University School of Life Dentistry at Niigata
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Souza LVS, Pavanello L, Picolo MZD, Kury M, Matos ICRT, Cogo-Müller K, Esteban Florez FL, Cavalli V. Mechanical and antibacterial properties of an experimental flowable composite containing Nb 2O 5 and NF_TiO 2 nanoparticles. J Mech Behav Biomed Mater 2023; 143:105919. [PMID: 37279637 DOI: 10.1016/j.jmbbm.2023.105919] [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: 04/12/2023] [Revised: 05/15/2023] [Accepted: 05/16/2023] [Indexed: 06/08/2023]
Abstract
This study developed an experimental flowable composite incorporated with niobium pentoxide (Nb2O5) combined or not with titanium dioxide co-doped with fluorine and nitrogen (NF_TiO2) and evaluated the mechanical and antibacterial properties. The experimental flowable composite (TEGDMA + BisGMA 1:1 + 60%wt - inorganic filler - borosilicate 0.7 μm) was formulated according to the type and concentration of Nb2O5 and NF_TiO2 (0.5, 1, 1.5 and 2 wt%) or NF_TiO2 + Nb2O5 (0.25, 0.5, 0.75 and 1 wt% - 1:1). The control groups were formed by the experimental composite without the incorporation of Nb2O5 and/or NF_TiO2 (GC-E) and by a commercial flowable composite (GC). The characterization of the surface of the composite and its particles was carried out using scanning electron microscopy (SEM) and energy dispersive x-rays (EDX). Specimens were manufactured and subjected to mechanical tests of flexural strength (FS) (n = 12), flexural modulus (FM) (n = 12), roughness (Ra) (n = 10), microhardness (n = 10), and contact angle (n = 10); and, to evaluate the antibacterial activity, they were submitted to tests of biofilm formation against S. mutans (CFU/mL) (n = 5), biofilm biomass by dry weight (n = 5) and confocal laser microscopy (%LIVE/DEAD) (n = 5). Data were submitted to one-way ANOVA and Tukey's post-hoc and, those that were not homoscedastic, but with normality, were submitted to Welch's ANOVA and Games-Howell's post-hoc. Dunnet's test was used to compare the controls with the other experimental groups (α = 5). The Nb2O5 particles had an average size of 32.4 μm and the nanoparticles (NPs) of NF_TiO2, 10 nm. EDX analysis identified isolated peaks of N, F, Ti, and Nb confirming the presence of these particles in the resin matrix. The 1.5% NF_TiO2 group had a higher FS and FM than the controls (p < 0.05). GC showed higher microhardness between groups (p < 0.05). There was no difference between the experimental groups regarding contact angle and roughness (p > 0.05), except for GC, which had the highest Ra values and the lowest contact angle between groups (p < 0.05). Composites containing 0.5%, 1%, 1.5%, and 2% Nb2O5, 1%, 1.5%, and 2% NF_TiO2 and 2% Nb2O5 + NF_TiO2 showed lower biofilm formation (p < 0.05), lower total biofilm biomass (p < 0.05), and a higher percentage of dead cells (44%, 52%, 52%, 79%, 42% 43%, 62%, 65%, respectively) than GC and GC-E (5% and 1%, respectively). It is concluded that the incorporation of 1.5% NF_TiO2 promoted a greater FS and FM among the experimental composites and that the addition of Nb2O5 particles (0.5%, 1%, 1.5%, and 2%), NF_TiO2 (1%, 1.5% and 2%) and the combination Nb2O5 + NF_TiO2 (2%) showed significant antibacterial effects.
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Affiliation(s)
| | - Larissa Pavanello
- Department of Biosciences, University of Campinas, Piracicaba Dental School, Piracicaba, SP, Brazil
| | - Mayara Zaghi Dal Picolo
- Department of Restorative Dentistry, University of Campinas - Piracicaba Dental School, Piracicaba, SP, Brazil
| | - Matheus Kury
- Department of Restorative Dentistry, University of Campinas - Piracicaba Dental School, Piracicaba, SP, Brazil
| | | | - Karina Cogo-Müller
- Faculty of Pharmaceutical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Fernando Luis Esteban Florez
- Division of Dental Biomaterials, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Vanessa Cavalli
- Department of Restorative Dentistry, University of Campinas - Piracicaba Dental School, Piracicaba, SP, Brazil.
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11
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Sulca Gonzales EL, López-Flores AI. [Flexural strength of conventional flowable, bulk fill flowable and highly filled flowable resin composites: in vitro study.]. REVISTA CIENTÍFICA ODONTOLÓGICA 2023; 11:e161. [PMID: 38288001 PMCID: PMC10809959 DOI: 10.21142/2523-2754-1103-2023-161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 09/04/2023] [Indexed: 01/31/2024] Open
Abstract
Objective To evaluate and compare the flexural strength of conventional flowable, bulk fill flowable and highly filled flowable resins. Materials and methods Thirty 2mm x 2mm x 25mm specimens of Tetric N-Flow (TNF), Filtek Bulk Fill Flowable Restorative (FBF) and Beautifil Flow Plus F00 (BFP) flowable resins were made up; they were distributed into three groups according to brand (n=10) and stored in distilled water for 24 hours at 37ºC. The 3-point bending test according to ISO 4049 was performed on a universal testing machine at a speed of 0.5 mm/min until fracture. The results were evaluated with Anova and Tukey tests. P<0.05. Results Statistically significant differences were found between the groups with a value of p=0.011. According to the statistical analysis, the groups that showed statistically significant differences were the BFP and TNF groups (p=0.015) and the BFP and FBF groups (p=0.035), while no statistically significant difference was found in the TNF and FBF groups. Conclusion The high-filled flowable resin presents better flexural strength compared to the conventional flowable and bulk fill flowable resins, while the conventional and bulk fill flowable resins have no statistically significant difference.
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Affiliation(s)
- Edith Liliana Sulca Gonzales
- División de Rehabilitación Oral, Carrera de Estomatología, Universidad Científica del Sur. Lima, Perú. , Universidad Científica del Sur División de Rehabilitación Oral Carrera de Estomatología Universidad Científica del Sur Lima Peru
| | - Ana Isabel López-Flores
- División de Rehabilitación Oral, Carrera de Estomatología, Universidad Científica del Sur. Lima, Perú. , Universidad Científica del Sur División de Rehabilitación Oral Carrera de Estomatología Universidad Científica del Sur Lima Peru
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12
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Kalakijuybari FZ, Pasdar N, Ahmadi G, Seyedmajidi A. Investigating the impact of flowable composite liner on the fracture strength and microleakage of large composite resin restorations of primary anterior teeth. Eur Arch Paediatr Dent 2023:10.1007/s40368-023-00812-3. [PMID: 37341920 DOI: 10.1007/s40368-023-00812-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 06/02/2023] [Indexed: 06/22/2023]
Abstract
PURPOSE To investigate the effect of pre-cured and co-cured flowable composite liner on fracture strength and microleakage of primary anterior teeth with extended composite resin restorations. METHODS In the current in vitro experimental study, the crowns of 54 extracted primary canine teeth were cut 1 mm above the CEJ, and a pulpectomy procedure was performed. The samples were randomly divided into three groups to restore the coronal part up to 4 mm above the CEJ. In group 1, the samples were built up with Filtek Z250 packable composite resin. In group 2 (pre-cure), first, 1 mm of Filtek Z350 XT flowable liner was applied to the sample, and after curing, the restoration process continued using packable composite resin. In group 3 (co-cure), the flowable composite liner was cured while the first layer of packable composite resin was applied; then, the same restorative procedure similar to the other groups was followed. The samples' cross-sectional area in the fracture strength test was calculated by AutoCAD software. Subsequently, the samples were subjected to a force in a universal testing machine. The samples related to the microleakage experiment were cut vertically, and then, the dye penetration percentage (10% methylene blue) was measured under a stereomicroscope. ANOVA was used to analyze the data. RESULTS Mean fracture strength in group 2 was significantly higher than in group 1 (P = 0.016). The microleakage mean in group 3 was significantly lower than in groups 1 (P = 0.000) and 2 (P = 0.026). CONCLUSION The flowable composite liner and its relevant separate curing increased the fracture strength of composite resin restorations. However, less microleakage was reported in the group where the liner was applied as a co-cure.
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Affiliation(s)
- F Z Kalakijuybari
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran.
| | - N Pasdar
- Dental Materials Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - G Ahmadi
- Oral Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - A Seyedmajidi
- Dental Materials Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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13
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Ozer F, Patel R, Yip J, Yakymiv O, Saleh N, Blatz MB. Five-year clinical performance of two fluoride-releasing giomer resin materials in occlusal restorations. J ESTHET RESTOR DENT 2022; 34:1213-1220. [PMID: 35934807 DOI: 10.1111/jerd.12948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 06/21/2022] [Accepted: 07/10/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To evaluate and compare the clinical performance of two nano-hybrid giomer restorative composite materials after 5 years. MATERIALS AND METHODS Forty-four pairs of restorations (total n = 88) of a flowable giomer (Beautifil Flow Plus F00; Shofu Inc., Kyoto, Japan) and a conventional nano-hybrid giomer restorative material (Beautifil II; Shofu Inc.) were placed in Class I cavities after the application of a dentin adhesive (FL-Bond II; Shofu Inc.) and a flowable liner (Beautifil Flow Plus F03; Shofu Inc). After 5 years, 32 pairs of restorations were assessed using the modified United States Public Health Service criteria. Both tested materials were compared using Fisher's exact test and each tested clinical criterion for each material was analyzed separately with respect to different follow-up periods using Friedman's test (a = 0.05). RESULTS None of the restorations showed complete retention loss, post-operative sensitivity, secondary caries or color change. There were no significant changes to any of the clinical criteria for each material during the 5-year evaluation period (p > 0.05) and no significant differences between the two materials in all clinical parameters after 5 years (p > 0.05). CONCLUSIONS Five-year clinical performance of both two nano-hybrid giomer restorative materials was comparably acceptable and not significantly different for any of the parameters evaluated. CLINICAL SIGNIFICANCE Nano-hybrid giomer-based materials are clinically acceptable for the restoration of occlusal cavities as they demonstrate excellent performance after 5 years.
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Affiliation(s)
- Fusun Ozer
- Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Rishi Patel
- Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jacqueline Yip
- Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Oksana Yakymiv
- Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Najeed Saleh
- Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Markus B Blatz
- Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Clinical efficacy of resin-based direct posterior restorations and glass-ionomer restorations – An updated meta-analysis of clinical outcome parameters. Dent Mater 2022; 38:e109-e135. [DOI: 10.1016/j.dental.2021.10.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 10/26/2021] [Accepted: 10/29/2021] [Indexed: 12/13/2022]
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Bonding States of In Vitro Class 2 Direct Resin Composite Restoration Applied by Various Incremental Techniques. MATERIALS 2021; 14:ma14206037. [PMID: 34683637 PMCID: PMC8541412 DOI: 10.3390/ma14206037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/05/2021] [Accepted: 10/09/2021] [Indexed: 11/16/2022]
Abstract
Incremental techniques are always required for clinical cases of deep and/or large cavities restored with resin composite materials. The purpose of this study was to examine the bonding states of class 2 direct resin composite restoration applied by various incremental techniques after cyclic loading to simulate the intra-oral environment to define the appropriate technique. Three types of resin composites, namely, bulk-fill (B), flowable (F), and conventional resin composite (C), were applied to standardized class 2 cavities by incremental techniques with single- or bi-resin restoratives. After cyclic loading, the micro-tensile bond strength (μ-TBS) of the dentin cavity floor was measured. The Weibull modulus and Weibull stress values at 10%/90% probability of failure were analyzed. Single-resin incremental restorations with B or F and bi-resin incremental restorations with F + B and F + C demonstrated superior μ-TBS (quantitative ability), bonding reliability, and durability (qualitative ability) compared with the single-resin restoration with C (as control). Furthermore, F + B and F + C restoration yielded an excellent performance compared with the single-resin restorations with B, F, and C. In particular, the F + C restoration, which indicates not only the maximum mean µ-TBS, but also the highest values of the Weibull parameters, may be the optimal restoration method, including the esthetic benefits.
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Rezende M, Martins ACR, da Silva JA, Reis A, de Geus JL. Compliance of randomized controlled trials in posterior restorations with the CONSORT statement: a systematic review of methodology. Clin Oral Investig 2021; 26:41-64. [PMID: 34595606 DOI: 10.1007/s00784-021-04198-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/21/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study aims to investigate the compliance of randomized controlled trials (RCTs) in posterior restorations with the Consolidated Standards of Reporting Trials Statement (CONSORT) statement and to analyze the risk of bias (RoB) of these studies. METHODS A systematic search was performed in PubMed, Scopus, Web of Science, LILACS/BBO, and Cochrane Library. Only RCTs published in peer-reviewed journals were included. The compliance with the CONSORT was evaluated in a 0-2 scale where 0 = no description, 1 = poor description and 2 = adequate description. Descriptive analyses of the CONSORT mean score by journal, country, and RoB were performed. The RoB in RCTs was evaluated by using the Cochrane Collaboration's tool version 1.0. RESULTS A total of 15,476 studies were identified after duplicates removal. O only 202 meet the eligibility criteria, among which 31 were follow-up studies. Concerning the overall RoB, only 29 out of 171 were classified as low risk of bias. The overall mean CONSORT score was 19 ± 5.4 points, which means compliance of approximately 59%. Significant differences among countries, publication period, and RoB were observed (p < 0.001). The journal's impact factor was not correlated with the overall CONSORT score (p = 0.36). CONCLUSIONS The adherence of RCTs conducted in posterior restorations to the CONSORT Statement is still low. In addition, most studies were classified as at unclear risk of bias. These results call up an urgent need for improvement. CLINICAL RELEVANCE Most RCTs conducted in posterior teeth have poor reporting and are mainly classified as having an unclear risk of bias.
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Affiliation(s)
- Márcia Rezende
- Department of Dentistry, Paulo Picanço School of Dentistry, Joquim Sá, 900, Fortaleza, Ceará, 60135-218, Brazil
| | | | - Jadson Araújo da Silva
- Department of Dentistry, Paulo Picanço School of Dentistry, Joquim Sá, 900, Fortaleza, Ceará, 60135-218, Brazil
| | - Alessandra Reis
- Department of Dentistry, State University of Ponta Grossa, Avenida Carlos Cavalcanti, 4748, Paraná, 84030-900, Brazil
| | - Juliana Larocca de Geus
- Department of Dentistry, Paulo Picanço School of Dentistry, Joquim Sá, 900, Fortaleza, Ceará, 60135-218, Brazil.
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Rocha Gomes Torres C, Caroline Moreira Andrade A, Valente Pinho Mafetano AP, Stabile de Abreu F, de Souza Andrade D, Cintra Mailart M, Aun de Barros Lima Rocha Campello de Souza ML, Guimarães Alarça Nunes L, Ariel Rodrigues de Araújo C, Di Nicoló R, Bühler Borges A. Computer-aided design and computer-aided manufacturing indirect versus direct composite restorations: A randomized clinical trial. J ESTHET RESTOR DENT 2021; 34:776-788. [PMID: 34590418 DOI: 10.1111/jerd.12820] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 08/31/2021] [Accepted: 09/09/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study compared the clinical performance of large indirect restorations (IRs) versus direct restorations (DRs) in posterior teeth. METHODS Thirty subjects received two class II restorations (n = 60), one fabricated from a precured composite block (Grandio Blocs, VOCO) for the indirect technique (IT) and the other with light-cured composite (GrandioSO, VOCO) for the direct technique (DT). For IT, the restoration was created using the computer-aided design and computer-aided manufacturer (CAD/CAM) system. For DT, the material was applied light-cured by using a layering technique. All restorations were evaluated by using the World Dental Federation criteria. RESULTS Twenty-three subjects attended the 2-year recall, and 46 restorations were evaluated. No significant differences were detected between the techniques for most parameters analyzed (p > 0.05). For "color match" at 7 days and 6 months, better results were observed for the DT. In relation to the overall scores, all restorations were esthetically acceptable after 2 years, while 93.3% of DT and 90% of IT showed acceptable function. For biological scores, 96.67% of DRs and 100% of IRs was acceptable after 24 months. Considering all properties, the success rates were 93.3% for DRs and 90% for IRs. CONCLUSIONS After 2 years, both restorations presented similar and good clinical behavior for all the properties analyzed. CLINICAL SIGNIFICANCE Light-cured direct posterior composite restorations may perform similarly to indirect composite restorations made with precured CAD/CAM composite blocks up to 2 years.
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Affiliation(s)
- Carlos Rocha Gomes Torres
- Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University-UNESP, São Paulo, Brazil
| | | | | | - Fabrícia Stabile de Abreu
- Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University-UNESP, São Paulo, Brazil
| | - Danilo de Souza Andrade
- Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University-UNESP, São Paulo, Brazil
| | - Mariane Cintra Mailart
- Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University-UNESP, São Paulo, Brazil
| | | | - Lilian Guimarães Alarça Nunes
- Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University-UNESP, São Paulo, Brazil
| | | | - Rebeca Di Nicoló
- Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University-UNESP, São Paulo, Brazil
| | - Alessandra Bühler Borges
- Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University-UNESP, São Paulo, Brazil
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Badr C, Spagnuolo G, Amenta F, Khairallah C, Mahdi SS, Daher E, Battineni G, Baba NZ, Zogheib T, Qasim SSB, Daher T, Chintalapudi N, Zogheib CM. A Two-Year Comparative Evaluation of Clinical Performance of a Nanohybrid Composite Resin to a Flowable Composite Resin. J Funct Biomater 2021; 12:jfb12030051. [PMID: 34564200 PMCID: PMC8482203 DOI: 10.3390/jfb12030051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 08/31/2021] [Accepted: 09/06/2021] [Indexed: 11/16/2022] Open
Abstract
Objective: This prospective in vivo study aimed to compare the clinical behavior of a flowable composite resin (Genial Universal Flo, GC) and a nanohybrid universal composite resin (Tetric Evo Ceram, Ivoclar Vivadent) used in Class I and II direct esthetic restorations in posterior teeth. Methods: A total of 108 Class I and II direct restorations were performed in patients aged between 20 and 60 years. The originality of this study lies in the fact that both materials were placed in pairs, in the same clinical environment (i.e., the same patient and the same type of tooth). The evaluations were performed now of restoration and after 2-weeks, 6-, 12-, and 24-months intervals using clinical examination, clinical photographs, and radiological examination, according to modified USPHS criteria. Statistical analysis was performed using the Fisher exact test and chi-square analysis. Results: At baseline, the universal composite resin showed better esthetic properties such as surface luster, surface staining marginal staining. Both materials regressed significantly over time with no significant difference between groups. Conclusions: Both flowable and nanohybrid composite resins exhibit acceptable clinical performance. The present 24 months of evaluation of different composites showed that the G-ænial Universal Flo could be an effective esthetic material for posterior restoration. No significant difference between both materials over time concerning surface luster, surface staining, and marginal staining.
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Affiliation(s)
- Carelle Badr
- Department of Esthetic and Restorative Dentistry, School of Dentistry, Saint Joseph University of Beirut, Beirut 1004 2020, Lebanon; (C.B.); (C.K.); (E.D.); (T.D.); (C.M.Z.)
| | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, 80131 Napoli, Italy
- Institute of Dentistry, I. M. Sechenov First Moscow State Medical University, 119435 Moscow, Russia
- Correspondence:
| | - Francesco Amenta
- Center of Clinical Research, Telemedicine & Telepharmacy Department, School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy; (F.A.); (S.S.M.); (G.B.); (N.C.)
| | - Carlos Khairallah
- Department of Esthetic and Restorative Dentistry, School of Dentistry, Saint Joseph University of Beirut, Beirut 1004 2020, Lebanon; (C.B.); (C.K.); (E.D.); (T.D.); (C.M.Z.)
| | - Syed Sarosh Mahdi
- Center of Clinical Research, Telemedicine & Telepharmacy Department, School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy; (F.A.); (S.S.M.); (G.B.); (N.C.)
- Department of Community Dentistry, Jinnah Medical and Dental College, Sohail University, Karachi 74800, Pakistan
| | - Elie Daher
- Department of Esthetic and Restorative Dentistry, School of Dentistry, Saint Joseph University of Beirut, Beirut 1004 2020, Lebanon; (C.B.); (C.K.); (E.D.); (T.D.); (C.M.Z.)
| | - Gopi Battineni
- Center of Clinical Research, Telemedicine & Telepharmacy Department, School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy; (F.A.); (S.S.M.); (G.B.); (N.C.)
| | - Nadim Z. Baba
- Advanced Specialty Education Program in Implant Dentistry, School of Dentistry, Loma Linda University, Loma Linda, CA 92354, USA;
| | - Tatiana Zogheib
- Department of Orthodontics and Dentofacial Orthopedics, International University of Catalunya, 08017 Sant Cugat del Vallés, Barcelona, Spain;
| | | | - Tony Daher
- Department of Esthetic and Restorative Dentistry, School of Dentistry, Saint Joseph University of Beirut, Beirut 1004 2020, Lebanon; (C.B.); (C.K.); (E.D.); (T.D.); (C.M.Z.)
| | - Nalini Chintalapudi
- Center of Clinical Research, Telemedicine & Telepharmacy Department, School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy; (F.A.); (S.S.M.); (G.B.); (N.C.)
| | - Carina Mehanna Zogheib
- Department of Esthetic and Restorative Dentistry, School of Dentistry, Saint Joseph University of Beirut, Beirut 1004 2020, Lebanon; (C.B.); (C.K.); (E.D.); (T.D.); (C.M.Z.)
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Gornig DC, Maletz R, Ottl P, Warkentin M. Influence of artificial aging: mechanical and physicochemical properties of dental composites under static and dynamic compression. Clin Oral Investig 2021; 26:1491-1504. [PMID: 34453210 PMCID: PMC8817055 DOI: 10.1007/s00784-021-04122-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 08/01/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate the influence of filler content, degradation media and time on the mechanical properties of different dental composites after in vitro aging. MATERIALS AND METHODS Specimens (1 mm3) of three commercially available composites (GrandioSO®, Arabesk Top®, Arabesk Flow®) with respect to their filler content were stored in artificial aging media: artificial saliva, ethanol (60%), lactic acid (pH 5) and citric acid (pH 5). Parameters (Vickers microhardness, compressive strength, elastic modulus, water sorption and solubility) were determined in their initial state (control group, n = 3 for microhardness, n = 5 for the other parameters) and after 14, 30, 90 and 180 days (n = 3 for microhardness, n = 5 for the other parameters for each composite group, time point and media). Specimens were also characterized with dynamic-mechanical-thermal analysis (compression tests, F = ± 7 N; f = 0.5 Hz, 1 Hz and 3.3 Hz; t = 0-170 °C). RESULTS Incorporation of fillers with more than 80 w% leads to significantly better mechanical properties under static and dynamic compression tests and a better water sorption behavior, even after chemical degradation. The influence of degradation media and time is of subordinate importance for chemical degradation. CONCLUSION Although the investigated composites have a similar matrix, they showed different degradation behavior. Since dentine and enamel occur only in small layer thickness, a test specimen geometry with very small dimensions is recommended for direct comparison. Moreover, the use of compression tests to determine the mechanical parameters for the development of structure-compatible and functionally adapted composites makes sense as an additional standard. Clinical relevance Preferential use of highly filled composites for occlusal fillings is recommended.
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Affiliation(s)
- D. C. Gornig
- Dres. Irina & Thorsten Brandt, Orthodontic Practice, Wiesbaden, Germany
| | - R. Maletz
- Department of Material Science and Medical Engineering, Faculty of Mechanical Engineering and Marine Technology, University of Rostock, Rostock, Germany
| | - P. Ottl
- Department of Prosthodontics and Material Science, Faculty of Medicine, University of Rostock, Rostock, Germany
| | - M. Warkentin
- Department of Material Science and Medical Engineering, Faculty of Mechanical Engineering and Marine Technology, University of Rostock, Rostock, Germany
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20
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Zhang H, Wang L, Hua L, Guan R, Hou B. Randomized controlled clinical trial of a highly filled flowable composite in non-carious cervical lesions: 3-year results. Clin Oral Investig 2021; 25:5955-5965. [PMID: 33797635 DOI: 10.1007/s00784-021-03901-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 03/19/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES This prospective, randomized, split-mouth clinical trial assessed the 3-year clinical performance of a highly filled flowable composite and a conventional paste-type composite in non-carious cervical lesions (NCCLs). MATERIALS AND METHODS A total of 84 NCCLs in 27 subjects were included in this split-mouth design study and randomly divided into two groups: a highly filled flowable composite Clearfil Majesty ES Flow group (ES, n = 42) and a conventional paste-type composite Majesty group (MJ, n = 42). Clearfil SE Bond was used following the manufacturer's instructions. The restorations were evaluated at baseline (BL) and 1, 2, and 3 years using FDI (World Dental Federation) criteria. Data were analysed by a paired chi-squared test for intergroup comparisons and the Friedman test for intragroup comparisons (α = 0.05). RESULTS Both groups had a 97.3% retention rate at the 3-year evaluation. The acceptable scores (FDI scores 1-3) for each criterion exhibited no significant difference between the MJ and ES groups at any time point (p = 1.00). The marginal adaptation performance of ES was significantly better than that of MJ at every evaluation point (p < 0.05). CONCLUSIONS The 3-year clinical performance of ES in NCCLs was similar to that of MJ. When the restorations were clinically acceptable, ES showed better marginal adaptation than MJ. CLINICAL RELEVANCE Compared with conventional paste-type composites, highly filled flowable composites showed similar clinical performance and better marginal adaptation for restoring NCCLs after 3 years. TRIAL REGISTRATION TRN: ChiCTR1900028484 . Date of registration: December 22, 2019, retrospectively registered.
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Affiliation(s)
- Haiying Zhang
- Department of Endodontics, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Luxuan Wang
- Department of Endodontics, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Lin Hua
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Rui Guan
- Department of Endodontics, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Benxiang Hou
- Department of Endodontics, Beijing Stomatological Hospital, Capital Medical University, Beijing, China.
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Ypei Gia NR, Sampaio CS, Higashi C, Sakamoto A, Hirata R. The injectable resin composite restorative technique: A case report. J ESTHET RESTOR DENT 2020; 33:404-414. [PMID: 32918395 DOI: 10.1111/jerd.12650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/31/2020] [Accepted: 08/16/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To describe the use of the injectable resin composite restorative technique with a flowable resin material, in a clinical case with esthetic problems associated with irregular tooth anatomies, allied with a finishing, and polishing protocol due to staining after 1 year of use. CLINICAL CONSIDERATIONS The presented case report helped to achieve an immediate highly esthetic restoration with appropriate width proportions based on a previous wax-up. After 1 year of use, restorations presented staining; therefore, finishing and polishing procedures were required to re-achieve acceptable esthetic results and thus increase restoration's survival. CONCLUSIONS The use of the presented technique allowed to obtain a simple and predictable workflow; however, care must be taken on the follow up of the restorations due to intrinsic characteristics of the flowable resin material. CLINICAL SIGNIFICANCE The use of the presented injectable technique helped on obtaining a precise anatomy replicating a diagnostic wax-up, thus improving marginal precision and achieving a highly esthetic and functional immediate outcome, with an easy workflow when appropriately planned and executed. However, it also presented low color stability after 1 year of use only, thus, requiring attention from clinicians in regard to its maintenance over time.
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Affiliation(s)
| | | | | | | | - Ronaldo Hirata
- Department of Biomaterials and Biomimetics, NYU College of Dentistry, New York, New York, USA
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Torres C, Augusto MG, Mathias-Santamaria IF, Di Nicoló R, Borges AB. Pure Ormocer vs Methacrylate Composites on Posterior Teeth: A Double-blinded Randomized Clinical Trial. Oper Dent 2020; 45:359-367. [PMID: 32053457 DOI: 10.2341/19-079-c] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2019] [Indexed: 11/23/2022]
Abstract
CLINICAL RELEVANCE The clinical behavior of pure ormocer composite is reliable when used in class II restorations after 24 months of evaluation. SUMMARY
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Oz FD, Ergin E, Cakir FY, Gurgan S. Clinical Evaluation of a Self-Adhering Flowable Resin Composite in Minimally Invasive Class I Cavities: 5-year Results of a Double Blind Randomized, Controlled Clinical Trial. Acta Stomatol Croat 2020; 54:10-21. [PMID: 32523153 PMCID: PMC7233123 DOI: 10.15644/asc54/1/2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 03/01/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the long-term clinical performance of a self-adhering flowable resin composite compared to a conventional flowable resin composite used with an etch&rinse adhesive system in minimally invasive Class I cavities. MATERIALS AND METHODS Twenty-five patients received at least one pair of Class I restorations (n=65). After class I cavities had been prepared, they were randomly restored either with a self-adhering flowable resin composite (VertiseFlow/Kerr-VR) [Group-1 (n=33)], or with a flowable resin composite (Luxaflow/DMG-LX) in combination with an etch&rinse adhesive (Teco/DMG) [Group-2 (n=32)] according to the manufacturers' instructions. The restorations were evaluated at baseline and yearly during 5 years according to the FDI criteria by two evaluators. A statistical analysis was carried out using the Pearson Chi-Square test and the Cochran Q-test followed by the Mc Nemar's test (p=0.05). RESULTS After 5 years a total of 47 restorations were evaluated with a recall rate of 68%. At 4-year, 3 (11.5%) VR and 2 LX (7.6%) restorations exhibited a cumulative retention loss. Seventeen (73.9%) VR and 14 LX (58.3%) restorations exhibited clinically acceptable (2) scores for marginal adaptation. At 5-year evaluations VR and LX showed similar results regarding all evaluated criteria (p > 0.05). The cumulative retention loss rates of VR and LX were 15.3% and 7.6%, respectively. None of the restorations demonstrated a recurrence of caries and post operative sensitivity. Both materials showed significant changes at 4 and 5 years regarding marginal staining when compared to baseline (p<0.001). Furthermore, significant changes were observed for VR and LX at 1, 2, 3, 4 and 5 years for marginal adaptation according to baseline (p<0.001). CONCLUSION The use of both materials for the restoration of Class-I cavities demonstrated clinically acceptable performance at the end of 5-year. The self-adhering flowable composite exhibited a clinical performance similar to the conventional flowable applied with an etch&rinse adhesive.
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Affiliation(s)
- Fatma Dilsad Oz
- Department of Restorative Dentistry, School of Dentistry, Hacettepe University, Sihhiye, 06100, Ankara, TURKEY
| | - Esra Ergin
- Department of Restorative Dentistry, School of Dentistry, Hacettepe University, Sihhiye, 06100, Ankara, TURKEY
| | - Filiz Yalcin Cakir
- Department of Restorative Dentistry, School of Dentistry, Hacettepe University, Sihhiye, 06100, Ankara, TURKEY
| | - Sevil Gurgan
- Department of Restorative Dentistry, School of Dentistry, Hacettepe University, Sihhiye, 06100, Ankara, TURKEY
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A randomized clinical trial of class II composite restorations using direct and semidirect techniques. Clin Oral Investig 2019; 24:1053-1063. [DOI: 10.1007/s00784-019-02999-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 06/28/2019] [Indexed: 10/26/2022]
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Effect of Camphorquinone Concentration in Physical-Mechanical Properties of Experimental Flowable Resin Composites. BIOMED RESEARCH INTERNATIONAL 2018; 2018:7921247. [PMID: 29951545 PMCID: PMC5987321 DOI: 10.1155/2018/7921247] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 04/03/2018] [Accepted: 04/11/2018] [Indexed: 12/15/2022]
Abstract
The aim of this study was to evaluate the effect of camphorquinone concentration in physical-mechanical properties of experimental flowable composites in order to find the concentration that results in maximum conversion, balanced mechanical strength, and minimum shrinkage stress. Model composites based on BISGMA/TEGDMA with 70% wt filler loading were prepared containing different concentrations of camphorquinone (CQ) on resin matrix (0.25%, 0.50%, 1%, 1.50%, and 2% by weight). Degree of conversion was determined by FTIR. Surface hardness was assessed before and after 24 h ethanol storage and softening rate was determined. Depth of cure was determined by Knoop hardness evaluation at different depths. Color was assessed by reflectance spectrophotometer, employing the CIE-Lab system. Flexural strength and elastic modulus were determined by a three-point bending test. Shrinkage stress was determined in a Universal Testing Machine in a high compliance system. Data were submitted to ANOVA and Tukey's test (α = 0.05). The increase in CQ concentration caused a significant increase on flexural strength and luminosity of composites. Surface hardness was not affected by the concentration of CQ. Composite containing 0.25% wt CQ showed lower elastic modulus and shrinkage stress when compared to others. Depth of cure was 3 mm for composite containing 1% CQ and 2 mm for the other tested composites. Degree of conversion was inversely correlated with softening rate and directly correlated with elastic modulus and shrinkage stress. In conclusion, CQ concentration affects polymerization characteristics and mechanical strength of composites. The concentration of CQ in flowable composite for optimized polymerization and properties was 1% wt of the resin matrix, which allows adequate balance among degree of conversion, depth of cure, mechanical properties, and color characteristics of these materials.
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Shaalan OO, Abou-Auf E, El Zoghby AF. Clinical evaluation of flowable resin composite versus conventional resin composite in carious and noncarious lesions: Systematic review and meta-analysis. J Conserv Dent 2017; 20:380-385. [PMID: 29430087 PMCID: PMC5799981 DOI: 10.4103/jcd.jcd_226_17] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The purpose of this systematic review was to evaluate clinical performance of flowable composite in carious and noncarious lesions. An electronic search was conducted using specific databases (PubMed, Embase, Cochrane Library, and LILACS) through March 2017. Clinical trials for restoration of carious and noncarious lesions were included with no date restrictions; follow-up was 6 months at least and dental restorations were evaluated using the United States Public Health Service criteria. The systematic search generated 908 papers, of which 35 papers were included for full-text review. Inclusion criteria were met by eight papers, six papers were for noncarious lesions and two papers were for restoration of carious lesions. The results of this review have shown no statistical or clinical difference between flowable and conventional composites for all tested outcomes in both carious and noncarious lesions. Both materials have shown clinically acceptable scores for all criteria, with no evidence of clinically unacceptable scores except in retention, with a retention rate of 83% in both materials after 36 months. Flowable composites had clinical efficacy after 3 years of service similar to that of conventional composite in both carious and noncarious lesions, these results are based on low quality of evidence. Based on the available literature and the best available evidence, flowable composites can be used in restoration of noncarious cervical lesions and minimally invasive occlusal cavities.
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Affiliation(s)
- Omar Osama Shaalan
- Department of Conservative Dentistry, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Eman Abou-Auf
- Department of Conservative Dentistry, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Amira Farid El Zoghby
- Department of Conservative Dentistry, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Lawson NC, Radhakrishnan R, Givan DA, Ramp LC, Burgess JO. Two-year Randomized, Controlled Clinical Trial of a Flowable and Conventional Composite in Class I Restorations. Oper Dent 2015; 40:594-602. [PMID: 26237643 DOI: 10.2341/15-038-c] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES This study evaluated the two-year clinical performance and volumetric wear of a flowable resin composite compared to a conventional highly filled composite resin in Class I restorations. METHODS AND MATERIALS In this single-center, single-blinded, comparator-controlled clinical study (Institutional Review Board approved), 120 carious teeth distributed in 60 patients were randomly assigned to four calibrated practitioners who placed occlusal restorations (n=60 flowable and n=60 conventional composite). Direct and indirect assessment at baseline, six months, one year, and two years occurred during which the modified Cvar and Ryge criteria were evaluated. Volumetric wear was determined by superimposition of profilometer scans of baseline and two-year casts. RESULTS At two years, there was no significant difference in anatomic form (p=0.80), color match (p=0.08), marginal adaptation (p=0.89), marginal discoloration (p=0.79), surface integrity (p=0.18), secondary caries (p=0.66), cold sensitivity (p=0.522), occlusal sensitivity (p=0.818), or volumetric wear (p=0.661) between materials. Both materials showed a decrease in all criteria except secondary caries (p=0.95) over time. Two-year mean volumetric wear was 3.16 ± 2.38 mm(3) for the flowable composite and 3.43 ± 2.50 mm(3) for the conventional composite. CONCLUSIONS The flowable and conventional composites used in this study have similar clinical efficacy after two years of service when placed as Class I occlusal restorations having isthmus widths less than one-half the intercuspal distance.
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Survival of direct resin restorations in posterior teeth within a 19-year period (1996-2015): A meta-analysis of prospective studies. Dent Mater 2015; 31:958-85. [PMID: 26091581 DOI: 10.1016/j.dental.2015.05.004] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 05/08/2015] [Accepted: 05/08/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVES The aim of this study is to analyze the survival of posterior composite restorations published within the last 19 years (1996-2015). METHODS In this study only prospective, clinical trials with specification of the failure rate according to Class I/II composite fillings were included. Studies were analyzed according to the observation period (all studies vs. short-term vs. long-term studies). Retrospective studies and/or open laminate studies, tunnel restorations and Class V restorations were excluded. The following variables possibly influencing the failure rate were extracted from the studies: observation period, recall rate, average age of patients, number of patients, ratio of Class I/II fillings, number of restorations, ratio of premolars/molars, operator, method of isolation, bonding generation and filler size. RESULTS A total of 88 studies were included for statistical analysis. The observation period of the studies varied between 1 and 17 years, while most of the studies did not last longer than 5 years. Fracture of the restorations, secondary caries and marginal gap are the main causes for failure in the first 5 years (in descending order), while fracture and secondary caries are similarly distributed in long-term studies. Variables of investigation differed greatly in significance according to the respective observation period. The observation period, the recall rate, the ratio of Class I/II fillings and the number of restorations and patients had a significant influence on the overall failure rate when including all studies (short- and long-term). A linear correlation between the observation period and the failure rate was observed. In long-term studies these variables were not significant any longer. No significant difference in the failure rates between the materials per study was observed. The most common commercial composites investigated were: Tetric Ceram, Surefil, Filtek Supreme (incl. XT), Filtek Z250. The mean annual failure rate was 1.46% (±1.74%) for short-term studies and 1.97% (±1.53) for long-term studies. There is still a big need for clinical studies lasting longer than 5 years, as failure rates of composite restorations in posterior teeth increases with longer observation periods. SIGNIFICANCE A decreasing failure rate with an increasing recall rate as observed in our study suggests a patient selection in regard to availability and dental awareness. Internationally standardized evaluation criteria are mandatory in order to allow comparisons of the outcomes of clinical studies.
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