Three-year clinical evaluation of a silorane composite resin. Three-year randomized clinical evaluation of a low-shrinkage silorane-based resin composite in non-carious cervical lesions One-year clinical performance of a self-etching adhesive in class V resin composites cured by two methods. One-year clinical evaluation of two resin composites, two polymerization methods, and a resin-modified glass ionomer in non-carious cervical lesions. The effect of a new-generation flowable composite resin on microleakage in Class V composite restorations as an intermediate layer 5-year clinical performance of resin composite versus resin modified glass ionomer restorative system in non-carious cervical lesions. Clinical study of indirect composite resin inlays in posterior stress-bearing cavities placed by dental students: results after 4 years. Shrinkage assessment of low shrinkage composites using micro-computed tomography. Cost-effectiveness of composite resins and amalgam in the replacement of amalgam Class II restorations. Clinical Status of Ten Dentin Adhesive Systems Two-year clinical evaluation of ormocer, nanohybrid and nanofill composite restorative systems in posterior teeth. A double-blind randomized clinical trial of a silorane-based resin composite in class 2 restorations: 18-month follow-up. A randomized controlled three year evaluation of "bulk-filled" posterior resin restorations based on stress decreasing resin technology. Two-year clinical performance of Class V resin-modified glass-lonomer and resin composite restorations. Clinical performance of ormocer, nanofilled, and nanoceramic resin composites in Class I and Class II restorations: a three-year evaluation. A clinical evaluation of a resin composite and a compomer in non-carious Class V lesions. A 3-year follow-up. Reasons for restorative therapy and the longevity of restorations in adults Clinical evaluation of two packable posterior composites: a five-year follow-up. Eighteen-month clinical evaluation of microhybrid, packable and nanofilled resin composites in Class I restorations. Clinical evaluation of resin composite and resin-modified glass ionomer cement in non-carious cervical lesions. A randomized 10-year prospective follow-up of Class II nanohybrid and conventional hybrid resin composite restorations. Determination of changes on tooth-colored cervical restorations in vivo using a three-dimensional laser scanning device. Bulk‐filled posterior resin restorations based on stress‐decreasing resin technology: a randomized, controlled 6‐year evaluation
STATEMENT OF PROBLEM Composite resins are still outperformed by amalgams in the clinical practice with secondary caries and fractures being their most common failures . A material that suffers less polymerization shrinkage might improve the clinical performance of composite resins . PURPOSE To evaluate the clinical performance of a low-shrink silorane-based composite resin ( Filtek LS Low Shrink Posterior Restorative , 3 M ESPE , St. Paul , MN , USA ) in comparison with a methacrylate-based composite resin ( Tetric EvoCeram , Ivoclar Vivadent , Schaan , Principality of Liechtenstein ) over time . MATERIAL S AND METHODS C and i date s in need of Class II composite resin restorations participated in this r and omized controlled clinical trial . Those were 25 female and six male subjects with average age of 44.3 ± 12.7 years . Participants received 82 restorations , being 54 in premolars and 28 in molars . Procedures , which included the restoration of primary caries lesions or replacement of failing restorations , were done using modified preparations with no bevels or additional retention . Restorations were placed using Filtek LS ( and dedicated self-etch adhesive ) or Tetric EvoCeram ( with AdheSE , Ivoclar Vivadent ) , following manufacturers ' instructions . Incremental placement technique was applied and the restorations were immediately finished . Follow-up evaluations occurred at six , 12 , 24 , and 36 months and were done using the Fédération Dentaire Internationale criteria . Statistical analysis was performed using generalized estimating equations . RESULTS The recall rate at 36 months was 89 % . All interaction terms were not significant . CONCLUSIONS Filtek LS performs as well  as Tetric EvoCeram performs in the clinical setting at 36 months . CLINICAL SIGNIFICANCE The silorane-based composite resin Filtek LS and the conventional methacrylate-based composite resin Tetric EvoCeram performed similarly well in posterior restorations over at least 36 months of clinical service Objective The clinical suitability of low-shrinkage resin composites for class V cavities has not been investigated in vivo . The purpose of this double-blind r and omized clinical trial was to compare the clinical performances of low-shrinkage resin composite Filtek silorane and nanoceramic resin composite Ceram X mono in non-carious cervical lesions ( NCCLs ) over 36 months . Material s and methods Two calibrated operators restored 144 NCCLs in 24 patients by using Filtek silorane with silorane system adhesive ( FS/SSA ) and Ceram X mono with Clearfil SE ( CXM/CSE ) or XP bond ( CXM/XPB ) . Then , two blinded , calibrated evaluators assessed the restorations at the baseline and 6 , 12 , 24 , and 36 months thereafter by using the modified US Public Health Service criteria . Data were analyzed with the Freidman and Wilcoxon signed-rank tests at a significance level of 5 % ( P < 0.05 ) . Results No restoration was associated with postoperative sensitivity or secondary caries . Further , no group showed significant changes until 12 months . The retention rates of the FS/SSA ( 97.5 % ) , CXM/CSE ( 97.5 % ) , and CXM/XPB ( 92.31 % ) restorations did not differ significantly ( P > 0.05 ) . Six ( 4 CXM/XPB , 1 FS/SSA , and 1 CXM/CSE ) of the 121 restorations evaluated at 36 months were completely lost . However , no significant intergroup differences were observed in the other evaluation criteria . Conclusion The 3-year clinical performances of the restorative material s in NCCLs were not significantly different . Clinical relevance Filtek silorane is suitable for restoring NCCLs This study evaluated the clinical performance of a self-etching adhesive for resin composites over one year . Thirty pairs of restorations of Pertac II , using the adhesive Prompt L-Pop , were placed in caries-free cervical erosion/abfraction lesions without tooth preparation . One of each pair was cured using " soft-start " polymerization , while the other was polymerized with high-intensity halogen light . Restorations were clinical ly evaluated at baseline , six and 12 months using modified Ryge/USPHS criteria . Although no significant difference ( p>0.05 ) was observed between the curing methods , adhesive performance was poor , with a 35 % loss of restorations overall AIM The aim of this study was to examine clinical ly relevant data on four restorative procedures for non-carious cervical lesions using United States Public Health Service (USPHS)-compatible clinical and photographic criteria and to compare different methods of analyzing clinical data . METHODS AND MATERIAL S Fourteen patients with at least one or two pairs of non-carious lesions under occlusion and a mean age of 50 were enrolled in this study . A total of 56 restorations ( 14 with each material ) were placed by three experienced , calibrated dental practitioners . Two other experienced and calibrated practitioners , under single-blind conditions , followed up on all restorations for a period of one year . Three material s were r and omly placed : a micro-hybrid composite with two polymerization methods ( G1 and G2 ) , a flowable micro-hydrid composite ( G3 ) , and a resin-modified glass ionomer ( G4 ) . Statistical analysis was performed using the Kruskall-Wallis test ( p<0.05 ) and a Mann-Whitney U modified test with a corrected significance level . RESULTS At the one year evaluation time , there were no restorations with secondary caries and the retention rates in G1 ( IntenS with a hard polymerization ) , G2 ( IntenS with a soft polymerization ) , G3 ( Filtek flow ) , and G4 ( Fuji II LC ) were 85.7 % ( two losses ) , 92.8 % ( one loss ) , 100 % , and 100 % , respectively . The total visual comparison of the results at baseline ( 15 days later ) showed significant differences only with the clinical acceptance criterion : G1 was different from G2 , with a soft polymerization device ( p<0.05 ) . In terms of surface quality at one year , G1 , G2 , and G3 exhibited a statistically significant difference from G4 , p<0.05 . The digital analysis at baseline showed significant differences only with the clinical acceptance criterion : G1=G2 was different from G3=G4 , p<0.05 . At one year , only the microporosity criterion showed any statistical differences : G1=G2=G3 was different from G4 , p<0.05 . CONCLUSIONS The resin-modified glass ionomer was easier to use and had a high retention rate , but it failed in terms of surface quality ( visual mode ) and porosity ( digital mode ) criteria compared to the others groups . Overall results showed no difference between groups G1 ( hard-polymerized ) and G2 ( soft-polymerized ) , and only G1 was affected by the marginal edge ( p<0.03 ) and integrity criteria ( p<0.02 ) at one year Aim : To evaluate the effect of application a new-generation bulk-fill flowable composite resin as an intermediate material between composite resin and dental substrates on micro-leakage in Class V composite restorations . Material s and Methods : A total of 144 Class V cavities were prepared in 72 human molars . Specimens were then r and omly distributed among three groups according to adhesive system applied ( Group 1 : Clearfil SE Bond ; Group 2 : Adper Easy One ; Group 3 : Adhesive 200 T ) , and each group was divided into three subgroups according to liner material used ( Group A : No liner-control group ; Group B : Aelite Flo LV , low viscosity microhybrid composite ; Group C : Smart dentin replacement ) . All cavities were restored using resin composite ( Aelite LS , low shrinkage posterior composite ) . Specimens were stained with 0.5 % basic fuchsin and evaluated dye penetration . Results : There was no significant difference in dye penetration was found between the control and the experimental groups . Conclusions : Micro-leakage is not affected by the application of either conventional or new-generation flowable composite resin as an intermediate material between composite resin and dental substrates AIM To comparatively assess the 5-year clinical performance of a 1-bottle adhesive and resin composite system with a resin-modified glass ionomer restorative in non-carious cervical lesions . METHOD AND MATERIAL S One operator placed 70 restorations ( 35 resin modified glass ionomer restorations and 35 resin composite restorations ) in 30 patients under rubber dam isolation without mechanical preparation .  The restorations were directly assessed by 2 independent examiners , using modified USPHS criteria at baseline and 6 , 12 , 24 and 60 months . RESULTS Twenty-two patients were available for recall after 5 years ( 73.3 % recall rate ) and 55 out of 70 restorations were evaluated . Excellent agreement was registered for all criteria between examiners ( kappa > or = 0.85 ) . Sixteen composite restorations were dislodged ( 51.5 % retention ) and 1 ionomer restoration was lost ( 96.4 % retention ) . The McNemar test detected significant differences in resin composite restorations between baseline and 5-year recall for marginal integrity ( p<0.001 ) and retention ( p=0.004 ) . For resin modified glass ionomer restorations , no significant differences were identified for all criteria ( p>0.05 ) . When comparing both material s , the Fisher exact test pointed out significant differences in retention ( p=0.002 ) after 5 years of clinical service . CONCLUSIONS After 5 years of evaluation , the clinical performance of resin modified glass ionomer restorations was superior to resin composite restorations OBJECTIVES This longitudinal r and omized controlled clinical trial evaluated the longevity of composite resin inlays in single- or multi-surface cavities up to 4 years . METHODS 21 dental students placed 75 Artglass and 80 Charisma composite resin inlays in class I and II cavities in posterior teeth ( 89 adult patients ) luted with dual-curing resin cements .  Clinical evaluation was performed up to 4 years using modified USPHS criteria . RESULTS 87.2 % of Artglass and 76.6 % of Charisma inlays were assessed to be clinical ly excellent or acceptable . Up to the 4-year recall 5 Artglass and 11 Charisma inlays failed mainly because of postoperative symptoms , bulk fracture , and loss of marginal integrity . No significant differences between both composite resin material s could be detected at 4 years for all clinical criteria ( Mann-Whitney U-test , p>0.05 ) . The comparison of restoration performance with time yielded a significant increase in marginal discolouration and postoperative symptoms ( p<0.05 ) , deterioration of surface texture quality , marginal and restoration integrity ( p<0.05 ) for both inlay systems . However , the changes were mainly effects of scoring shifts from alfa to bravo . Small inlays compared to large inlays and premolar restorations compared to molar restorations showed significant better outcome for some of the tested clinical parameters for the Artglass inlays ( p<0.05 ) . For Charisma inlays no such influences were revealed . CONCLUSIONS Clinical assessment of Artglass and Charisma composite resin inlays exhibited an annual failure rate of 3.2 % and 5.9 % that is within the range of published data . Within the limitations of this study indirect composite inlays are a competitive restorative procedure in stress-bearing preparations OBJECTIVES The aim of this study was to quantify the polymerization volumetric shrinkage of one regular and two low shrinkage bulk fill composites in class I cavities with or without an adhesive layer , using three-dimensional ( 3D ) micro-computed tomography ( μCT ) . METHODS Class I cavity preparations ( 2.5 mm depth × 4 mm length × 4 mm wide ) were st and ardized in 36 extracted human third molars , which were r and omly divided in six groups ( n = 6 each ) as follows : Group VIT ( regular composite without bonding agent ) ; Group SDR ( low shrinkage flowable composite without bonding agent ) ; Group TET ( low shrinkage composite without bonding agent ) ; Group VIT/P ( regular composite with bonding agent ) ; Group SDR/X ( low shrinkage flowable composite with bonding agent ) ; TET/T ( low shrinkage composite with bonding agent ) . Each tooth was scanned via µCT at cavity preparation , immediately after cavity filling , and after light-curing . Acquired μCT data were imported into Amira software for analysis and volume values evaluated between steps from cavity preparation until light-curing . RESULTS Both low shrinkage composites showed a significantly less volumetric shrinkage than VIT . The use of dental adhesive significantly decreased the average volumetric contraction similarly for the three composites , by about 20 % . CONCLUSION Both low shrinkage composites showed less volumetric polymerization contraction than the regular composite . The use of dental adhesive decreased the total volumetric shrinkage for all evaluated composites OBJECTIVES The replacement of an old amalgam Class II restoration  is a common treatment and will remain so for decades . In addition to effectiveness , possible adverse health effects and esthetics , the costs of the treatment options will play a role in the choice of material . The aim of this study was to yield information on the relative cost-effectiveness of the use of composite resins and amalgam for the rerestoration of amalgam Class II restorations . METHODS As part of a larger r and omized clinical trial , treatment effectiveness and treatment costs were estimated in 73 composite and amalgam Class II posterior re-restorations .  The main treatment outcome was longevity . Secondary outcomes included need of repair and quality of the margin while in situ . Costs were analyzed from the perspective of dentistry , assuming a treatment strategy aim ed at offering ' value for money ' . From this perspective , differential costs were based on personnel costs as approximated by treatment time . RESULTS Replacing an amalgam Class II restoration with amalgam is associated with lower costs than replacing with a composite resin . A sensitivity analysis , considering type of composite , increasing proficiency with the material , and time needed for future removal of material , demonstrated that these differences are fairly robust . The material s performed equally well for the first 5 years after placement with respect to longevity . Differences in secondary outcomes were minor and not all in favor of the same material . CONCLUSIONS It is tentatively concluded that amalgams are more cost-effective than composites for replacing existing Class II amalgam restorations Laboratory testing of dentin adhesive systems still requires corroboration by long-term clinical trials for their ultimate clinical effectiveness to be vali date d. The objective of this clinical investigation was to evaluate , retrospectively , the clinical effectiveness of earlier-investigated dentin adhesive systems ( Scotchbond , Gluma , Clearf il New Bond , Scotchbond 2 , Tenure , and Tripton ) , and to compare their clinical results with those obtained with four modern total-etch adhesive systems ( Bayer exp . 1 and 2 , Clearfil Liner Bond System , and Scotchbond Multi- Purpose ) . In total , 1177 Class V cervical lesions in the teeth of 346 patients were restored following two cavity design s : In Group A , enamel was neither beveled nor intentionally etched , as per ADA guidelines ; in Group B , adjacent enamel was beveled and conditioned . Clinical retention rates definitely indicated the improved clinical efficacy of the newest dentin adhesives over the earlier systems . With regard to adhesion strategy , adhesive systems that removed the smear layer and concurrently demineralized the dentin surface layer performed clinical ly better than systems that modified the disorderly layer of smear debris without complete removal . Hybridization by resin interdiffusion into the exposed dentinal collagen layer , combined with attachment of resin tags into the opened dentin tubules , appeared to be essential for reliable dentin bonding but might be insufficient by itself . The additional formation of an elastic bonding area as a polymerization shrinkage absorber and the use of a microfine restorative composite apparently guaranteed an efficient clinical result . The perfect one-year retention recorded for Clearfil Liner Bond System and Scotchbond Multi- Purpose must be confirmed at later recalls PURPOSE To evaluate and compare the 2-year clinical performance of an ormocer , a nanohybrid , and a nanofill resin composite with that of a microhybrid composite in restorations of small occlusal cavities made in posterior teeth . MATERIAL S AND METHODS Thirty-five patients , each with 4 occlusal restorations under occlusion , were enrolled in this study . A total of 140 restorations  was placed , 25 % for each material : an ormocer-based composite , Admira ; a nanohybrid resin composite , Tetric EvoCeram ; a nanofill resin composite , Filtek Supreme ; and a microhybrid resin composite , Tetric Ceram . Two operators placed all restorations according to the manufacturers ' instructions . One week after placement , the restorations were finished/polished and patients were advised to return for follow-up at 6 months , 1 year , and 2 years . All patients attended the 2-year visit where the clinical performance of all restorations was evaluated . Two independent examiners made all evaluations according to the USPHS modified Ryge criteria immediately after placement of restorations and at subsequent recall visits . The changes in the USPHS parameters during the 2-year period were analyzed with the Friedman test . Comparison of the baseline scores with those at the recall visits was made using the Wilcoxon signed rank test . The level of significance was set at p < 0.05 . RESULTS All material s showed only minor changes , and no differences were detected between their performance at baseline and after 2 years . Only one  ormocer and one  microhybrid composite restoration had failed after 2 years . No failure was detected in nanohybrid and nanofill composite restorations . Regarding the clinical performance , there were no statistically significant differences among the material s used ( p > 0.05 ) . CONCLUSION After 2 years , the ormocer , nanohybrid , and nanofill composites showed acceptable clinical performance similar to that of the microhybrid resin composite PURPOSE To compare the clinical performance of a silorane-based with a methacrylate-based restorative system in class 2 restorations after an 18-month follow-up . METHODS This r and omized , double-blind and controlled study included 33 subjects receiving 100 direct resin composite restorations that were completely r and omized to silorane-based group ( Filtek P90/Silorane System Adhesive - 3 M ESPE ) or methacrylate-based group ( Filtek P60/Adper SE Plus - 3 M ESPE ) .  The restorative system was determined by chance using a coin toss until 50 units for each group were completed . Each subject contributed with one to seven restorations . A single operator performed all of the restorative procedures . Two calibrated examiners ( kw > or = 0.7 ) assessed the restorations at baseline and after 18 months according to modified United States Public Health System ( USPHS ) criteria . The data were analyzed with Mann-Whitney U-test , Wilcoxon signed rank and Kaplan-Meier survival curves ( alpha = 0.05 ) . RESULTS After 18 months , 88 restorations were evaluated , and five unacceptable restorations were observed . Proximal contact loss was the main reason for failure ( three ) followed by composite fracture ( two ) . The marginal integrity of the silorane-based group was significantly worse than that of the methacrylate-based group ( P= 0.035 ) . Comparing baseline to 18-month evaluations , the silorane-based group showed significant differences for marginal discoloration , marginal integrity and surface texture ( P < 0.05 ) ; and the methacrylate-based group differed significantly for marginal discoloration and surface texture ( P < 0.05 ) . Combined survival rate for both groups together was 95 % . No statistically significant difference was found between methacrylate-based ( 98 % ) and silorane-based ( 92 % ) overall survival rate ( Log rank test ; P = 0.185 ) OBJECTIVE The objective of this r and omized controlled prospect i ve clinical trial was to evaluate the efficacy of a flowable resin composite ( SDR ) bulk fill technique in posterior restorations and to compare it intraindividually with a conventional 2 mm resin composite curing technique in a 3-year follow up . MATERIAL S AND METHODS Thirty-eight pairs Class II and 15 pairs Class I restorations were placed in 38 patients with a mean age of 55.3 years ( range 32 - 87 ) . Each patient received at r and om at least two , as similar as possible , Class II or Class I restorations of two restorative techniques . In all cavities a single step self-etch adhesive ( Xeno V ) was applied . In one of the cavities of each pair , a flowable resin composite ( SDR ) was placed , in bulk increments up to 4 mm as needed to fill the cavity 2 mm short of the occlusal cavosurface . The occlusal part was completed with a nano-hybrid resin composite ( Ceram X mono ) layer . In the second cavity , the hybrid resin composite was placed in 2 mm increments . The restorations were evaluated using slightly modified USPHS criteria at baseline and then yearly during 3 years . Caries risk and parafunctional habits of the participants were estimated . RESULTS After three years , 76 Class II and 28 Class I restorations could be observed . One molar resin composite-only tooth showed post-operative sensitivity during 3 weeks for temperature changes and occlusal forces . Two failed Class II molar restorations in the resin composite-only group were observed during the first year , one cusp fracture and one resin composite fracture . An annual failure rate of 1.3 % was found for the resin composite only restorations and of 0 % in the bulk-filled restorations ( n.s . ) . Ten participants were estimated as having high caries risk and eleven showed active bruxing habits . SIGNIFICANCE The 4 mm bulk-fill technique with the flowable resin composite SDR showed highly clinical effectiveness , which was comparable during the 3-year follow-up with the 2 mm resin composite layering technique While a one-year report had been previously published , this study was undertaken to evaluate the clinical performance and appearance of a resin-modified glass ionomer and a resin composite over two years . Thirty-seven pairs of restorations of FujI II LC and Z 250/Single Bond were placed in caries-free cervical erosion/abfraction lesions without tooth preparation . Restorations were clinical ly evaluated at baseline , 6 , 12 , 18 and 24 months using modified Ryge/USPHS criteria . No statistically significant difference ( p = 0.13 ) was observed in the overall performance of the material s. Retention was 96 % for the resin-modified glass ionomer and 81 % for the resin composite , with no additional restorations of either material lost after one year . As previously reported , retention of the Z 250 restorations at six months was below the minimum specified in the ADA Acceptance Program for Dentin and Enamel Adhesives . The resin composite restorations generally had a better appearance , with a 100 % alpha rating in color match , versus 85 % for the resin-modified glass ionomer PURPOSE This prospect i ve long-term clinical trial evaluated and compared the three-year clinical performance of an ormocer , a nanofilled , and a nanoceramic resin composite with that of a microhybrid composite placed in Class I and Class II cavities . METHODS Forty patients , each with four Class I and II restorations under occlusion , were enrolled in this study . A total of 160 restorations were placed , 25 % for each material , as follows : an ormocer-based composite , Admira ; a nanofilled resin composite , Filtek Supreme XT ; a nanoceramic resin composite , Ceram X ; and a microhybrid resin composite , Tetric Ceram . A single operator placed all restorations according to the manufacturers ' instructions . Immediately after placement the restorations were finished/polished . Clinical evaluation was performed at baseline and at yearly intervals after placement by two other independent examiners using modified US Public Health Service ( USPHS ) criteria . The changes in the USPHS parameters during the three-year period were analyzed with the Friedman test . Comparison of the baseline scores with those at the recall visits was made using the Wilcoxon signed rank test . The level of significance was set at p < 0.05 . RESULTS All material s showed only minor changes , and no differences were detected between their performance at baseline and after three years . Only two ormocer , one nanofilled , and one microhybrid restorations in molars failed because of loss of retention . Regarding the clinical performance , there were no statistically significant differences among the material s used ( p>0.05 ) . CONCLUSIONS The ormocer , nanofilled , and nanoceramic composites provided acceptable clinical performance over a three-year period PURPOSE To compare the clinical performance of a resin composite and a polyacid-modified resin composite ( compomer ) in non-carious cervical lesions using a one-step self-etch adhesive . METHODS Thirty patients , each with two non-carious cervical lesions ( 60 restorations ) , received one composite ( Pertac-II ) restoration and one compomer ( Hytac ) restoration , both used in conjunction with a self-etch adhesive ( Prompt L-Pop ) and placed following the manufacturer 's instructions . Evaluations were at baseline , 6 , 12 and 36 months after placement for retention , margin adaptation , marginal discoloration , anatomic form , secondary caries and postoperative sensitivity . Statistical analysis with the Pearson Chi-square test was undertaken . RESULTS Retention rates were 86.6 % for composite and 86.7 % for compomer at 36 months . 3.3 % of composite and 6.7 % of compomer restorations showed a deficiency in marginal adaptation . Both material s showed a slight marginal discoloration of 7.7 % . More deterioration in anatomic form occurred with the compomer ( 11.5 % ) than the composite ( 3.8 % ) . None of the restorations exhibited secondary caries or postoperative sensitivity problems . There was no significant difference in performance between the material s in any of the categories evaluated The aim of this study was to obtain information on the restorative dental care of adults in Finl and . A r and om sample of private dentists was drawn from the register , and in spring 2000 they were sent a question naire requesting them to record information for each restoration placed during one ordinary working day . A total of 800 dentists were contacted and 548 responded . The dentists reported placement of 3,455 restorations .  Of these , 5 % were Class I , 36 % were Class II , 13 % were Class III , 9 % were Class IV , 21 % were Class V , and 16 % were extensive restorations including 4 or more surfaces . Overall , composite resin was the most common restorative material , and it was used in 79 % of the restorations , whereas amalgam was used in 5 % , compomers in 4 % , and glass ionomers ( either conventional or resin‐modified ) in 7 % of cases . In 5 % of the cases , the tooth was restored with indirect restorative methods , using either gold or ceramic material s. Of the treatments , 65 % were replacements of previous restorations . Secondary caries was the most common reason for replacement ( 36 % , 52 % , and 41 % for composite , glass ionomer , and amalgam , respectively ) . Other common reasons were fractures of the tooth or restoration ( 23 % , 11 % , and 22 % for composite , glass ionomer , and amalgam , respectively ) and lost composite restorations ( 16 % ) . The median age of failed restorations was 15 years for amalgam , 6 years for composite , and 7 years for conventional glass ionomer . Although the longevity of tooth coloured restorations was shorter than that of amalgam , comparisons with our previous studies indicate improved survival periods for tooth coloured material BACKGROUND Research has suggested that packable resin-based composites inserted with a placement technique similar to amalgam condensation can reduce the sensitivity associated with posterior restorations . The authors evaluated the clinical performance , including associated sensitivity , of two packable composites  in a r and omized five-year clinical trial . METHODS A single operator r and omly placed two restorations in each of 33 patients : one restoration consisting of Alert ( Jeneric/Pentron , Wallingford , Conn. ) and the other consisting of SureFil ( Dentsply/Caulk , Milford , Del. ) . There were 30 Class I and 36 Class II restorations . Two independent evaluators evaluated the restorations by using modified U.S. Public Health Service criteria . The authors analyzed data by means of the Fisher , chi(2 ) and McNemar tests at P < .05 . RESULTS Of 60 restorations evaluated at five years , two Class II restorations ( one SureFil , one Alert ) failed . All other restorations received the highest score possible for sensitivity and vitality . The only difference between the composites at the five-year recall was the significantly better surface texture of SureFil . The authors observed significantly different scores between the baseline and at five years for marginal discoloration ( Alert and SureFil ) , surface texture ( Alert and SureFil ) and color ( SureFil ) . CONCLUSIONS Both packable resin-based composites showed excellent durability during the five-year follow-up . CLINICAL IMPLICATION S The investigated resin-based composites are suitable for posterior restorations The aim of this article was to report the results of an 18-month longitudinal r and omized clinical trial that evaluated the clinical performance of microhybrid , packable and nanofilled resin composite restorations placed in Class I cavities of molar teeth . Three Class I resin composite restorations were placed in each of 35 patients . Each patient received one microhybrid ( ' Point 4 ' ; Kerr , Orange , CA , USA ) , one packable ( ' Packable Premise ' ; Kerr , Orange , CA , USA ) and one nanofilled ( ' Nanofilled Premise ' ; Kerr , Orange , CA , USA ) resin composite restoration .  Clinical evaluation was performed at baseline ( 2 weeks after placement ) , and after 6 , 12 and 18 months after placement using modified Ryge criteria . No patients were lost from the study . At the final appointment ( after 18 months ) , 95.4 % , 93.7 % and 96.2 % respectively of the microhybrid ( ' Point 4 ' ) , packable ( ' Packable Premise ' and nanofilled ( ' Nanofilled Premise ' ) resin composite restorations received Alfa ratings . Regardless of the type of restorative material , no significant changes were observed in the modified Ryge criteria at the baseline and 18-month recalls ( P < or=0.05 ) . Three restorations ( one from each group ) exhibited post-operative sensitivity at the baseline and 6-month appointment . After 18 months , one packable resin composite restoration  failed because of secondary caries , while secondary caries was not detected on any of the other restorations . The clinical performance of microhybrid ( ' Point 4 ' ) , packable ( ' Packable Premise ' ) and nanofilled ( ' Nanofilled Premise ' ) resin composite restorations was acceptable after 18 months . Further studies with longer follow-up periods are recommended to investigate the long-term survival of these restorations BACKGROUND The clinical performance of various tooth-coloured material s used to restore Non-Carious Cervical Lesions ( NCCLs ) has been evaluated . However , most of these evaluations were in western societies where soft diets requiring little mastication were common . The present study sets out to evaluate resin composite and RMGIC in the restoration of NCCLs among a Nigerian sub population group with fibrous diet requiring more rigorous mastication . PATIENTS & METHODS The study included all adult patients that presented at the Dental Hospital , Obafemi Awolowo University Teaching Hospitals Complex , Ile-Ife , Nigeria with non-carious cervical lesions over a period of six months . The teeth with non-carious cervical lesions in each patient were allocated into treatment with either resin composite or resin-modified glass ionomer cement by simple r and om sampling using ballots . The depth of the NCCLs was measured using a graduated flat ash periodontal probe . All the treatment was done by the first author according to the manufacturer 's instructions . Patients were recalled and evaluated at 48- hours , 3- months , 6- months and 12- months using the USPHS criteria . Data analysis was done using SPSS version 15 . The level of significance was put at 0.05 . RESULTS At the end of 12 months , 143 resin composite and 144 RMGIC restorations were evaluated , out of which 37 resin composite and 13 RMGIC restorations were dislodged , giving a retention rate of 74.1 % and 91.0 % respectively . The difference was statistically significant ( p<0.05 ) . For marginal discolouration , marginal adaptation , abrasion wear resistance , post operative sensitivity , and secondary caries , there were no statistically significant differences in the performance of resin composite and RMGIC . There was more retention failure of both resin composite and RMGIC restorations in NCCLs in m and ibular teeth than in maxillary teeth . The differences were statistically significant ( p<0.05 ) . CONCLUSION RMGIC demonstrated a higher retention rate in the restoration of non-carious cervical lesions than resin composite over a period of 12 month PURPOSE To evaluate the 10-year durability of a nanohybrid resin composite in  Class II restorations in a r and omized controlled intraindividual comparison with its conventional hybrid resin composite predecessor . MATERIAL S AND METHODS Each of 52 participants received at least two Class II restorations that were as similar as possible . The cavities were chosen at r and om to be restored with a nanohybrid resin composite ( Excite/Tetric EvoCeram ( TEC ) ; n=61 ) and a conventional hybrid ( Excite/Tetric Ceram ( TC ) ; n=61 ) . The restorations were evaluated with slightly modified USPHS criteria at baseline and then annually for 10 years . The overall performance of the experimental restorations was tested after intra-individual comparison and their ranking was tested using Friedman 's two-way ANOVA . The level of significance was set at 5 % . RESULTS Four patient drop-outs with 8 restorations ( 4TEC , 4TC ) were registered during the follow-up . A prediction of the caries risk showed that 16 of the evaluated 52 patients were considered as high risk patients . In total , 22 restorations , 11 TEC ( 3 premolars , 8 molars ) and 11 TC ( 3 premolars , 8 molars ) restorations failed during the 10 years . The main reason for failure was secondary caries ( 50 % ) . 63 % of the recurrent caries lesions were found in high caries risk participants . The overall success rate at 10 years was 80.7 % , with an annual failure rate of 1.9 % . No statistically significant difference was found in the overall survival rate between the two investigated resin composites . CONCLUSION The nanohybrid and the conventional hybrid resin composite showed good clinical effectiveness in extensive Class II restorations during the 10-year study The present study aim ed at the determination of changes of tooth-colored cervical restorations  in vivo using an optical 3-dimensional laser scanning device . The study was performed on 197 cervical restorations placed on incisors , canines , and premolars . Four different tooth-colored restoration material s , a composite , a polyacid-modified resin composite , and two resin-modified glass ionomer cements , were used for the restoration of the lesions . For the determination of changes , images were taken at baseline and 15 , 24 and 36 months after the placement of the fillings using a 3D-laser scanning device . The images were superimposed automatically , and digital subtraction was made by a specially developed image analysis software . The total substance loss on the entire filling surface at 36 months for the resin-modified glass ionomer Photac-Fil was 44 ( + /-23 ) microm , for Fuji II LC 45 ( + /-26 ) microm , for Dyract 71 ( + /-47 ) microm and for Tetric 18 ( + /-12 ) microm . Differentiating between the class of lesion , a higher wear rate was observed at 36 months on restorations which had been placed in erosion/non-carious cervical cavities ( 66 ( + /-33 ) microm ) . In conclusion , the composite material demonstrated a distinctly lower surface wear rate over time in comparison to the resin-modified glass ionomer cements and the polyacid-modified resin composite This r and omized study evaluated a flowable resin composite bulk-fill technique in posterior restorations and compared it intraindividually with a conventional 2-mm resin composite layering technique over a 6-yr follow-up period . Thirty-eight pairs of Class II restorations and 15 pairs of Class I restorations were placed in 38 adults . In all cavities a single-step self-etch adhesive ( Xeno V ) was applied . In the first cavity of each pair , the flowable resin composite ( SDR ) was placed , in bulk increments of up to 4 mm . The occlusal part was completed with a layer of nanohybrid resin composite ( Ceram X mono ) . In the second cavity of each pair , the hybrid resin composite was placed in 2-mm increments . The restorations were evaluated using slightly modified US Public Health Service ( USPHS ) criteria at baseline and then annually for a time period of 6 yr . After 6 yr , 72 Class II restorations and 26 Class I restorations could be evaluated . Six failed Class II molar restorations , three in each group , were observed , result ing in a success rate of 93.9 % for all restorations and an annual failure rate ( AFR ) of 1.0 % for both groups . The AFR for Class II and Class I restorations in both groups was 1.4 % and 0 % , respectively . The main reason for failure was resin composite fracture
The meta- analysis of the data in the included studies demonstrated that only one variable ( marginal adaptation after 12 months ) showed statistically significant outcomes , in which methacrylates-based composites presented significantly better results than resin composites containing modified monomers .
The good level of the scientific evidence as well as the overall low risk of bias of the included studies indicate that composites with silorane , ormocer or bulk-fill type modified monomers have a clinical performance similar to conventional resin composites
Polymerization shrinkage of resin composite can compromise the longevity of restorations .
To minimize this problem , the monomeric composition of composites have been modified .
The objective of this study was to conduct a meta- analysis to assess the clinical behavior of restorations performed with low polymerization shrinkage resin composite  in comparison with traditional methacrylates-based resin composite .