A 23-Year Observational Follow-Up Clinical Evaluation of Direct Posterior Composite Restorations

Influence of Cavity Lining on the 3-Year Clinical Outcome of Posterior Composite Restorations: A Randomized Controlled Clinical Trial

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.

Clinical performance of a glass-hybrid system in comparison with a resin composite in two-surface class II restorations: a 5-year randomised multi-centre study

OBJECTIVE

To evaluate the 5-year clinical performance of a glass hybrid restorative system and a nano-hybrid resin composite in moderate to large two-surface class II cavities.

MATERIALS AND METHODS

This study was carried out by dental schools in Zagreb, Croatia; Izmir, Turkey; Belgrade, Serbia; and Milan, Italy. A total of 180 patients requiring two class-II two-surface restorations in the molars of the same jaw were recruited. The teeth were randomly restored with either a nano-hybrid resin composite (Tetric EvoCeram, Ivoclar Vivadent) or a glass-hybrid material (EQUIA Forte, GC). During the 5-year follow-up, two calibrated evaluators at each centre scored the restorations annually using the FDI-2 scoring system. The survival rates were calculated using the Kaplan-Meier method and compared using non-parametric matched pair tests (p < 0.05).

RESULTS

There were no statistically significant differences between the overall survival and success rates of the two types of restorations (p>0.05). The success rates (FDI-2 scores 1-3) for EQUIA Forte were 81.9% (average annual failure rate: 3.9%) and 90.7% for Tetric EvoCeram (average annual failure rate: 1.9%). The survival rates (FDI-2 scores 1-4) for EQUIA Forte and Tetric EvoCeram were 94.5% and 94.4%, respectively, with an average annual failure rate of 1.1%.

CONCLUSIONS

In terms of success and survival rates, both the glass-hybrid restorative system and the nano-hybrid resin composite have been shown to perform satisfactorily.

CLINICAL RELEVANCE

The results of this study indicate that EQUIA Forte can be one of the therapeutic options for moderate to large two-surface class II restorations of posterior teeth.

Highly Reinforced Acrylic Resins for Hard Tissue Engineering and Their Suitability to Be Additively Manufactured through Nozzle-Based Photo-Printing

Mineralized connective tissues represent the hardest materials of human tissues, and polymer based composite materials are widely used to restore damaged tissues. In particular, light activated resins and composites are generally considered as the most popular choice in the restorative dental practice. The first purpose of this study is to investigate novel highly reinforced light activated particulate dental composites. An innovative additive manufacturing technique, based on the extrusion of particle reinforced photo-polymers, has been recently developed for processing composites with a filler fraction (w/w) only up to 10%. The second purpose of this study is to explore the feasibility of 3D printing highly reinforced composites. A variety of composites based on 2,2-bis(acryloyloxymethyl)butyl acrylate and trimethylolpropane triacrylate reinforced with silica, titanium dioxide, and zirconia nanoparticles were designed and investigated through compression tests. The composite showing the highest mechanical properties was processed through the 3D bioplotter AK12 equipped with the Enfis Uno Air LED Engine. The composite showing the highest stiffness and strength was successfully processed through 3D printing, and a four-layer composite scaffold was realized. Mechanical properties of particulate composites can be tailored by modifying the type and amount of the filler fraction. It is possible to process highly reinforced photopolymerizable composite materials using additive manufacturing technologies consisting of 3D fiber deposition through extrusion in conjunction with photo-polymerization.