Clinical Performance of Milled Resin Composite in Restoration of Endodontically Treated Posterior Teeth Over One Year
Condition: Endodontically Treated Teeth
MeSH terms: Tooth, Nonvital
Study type: Interventional

Summary: 
      In patients with endodontically treated teeth, will the Indirect Milled composite Endo-crown
      restorations have a better clinical performance and more wear resistance than the Direct
      Bulk-Fill resin composite restorations over one year?

      Primary Objective: To evaluate clinical performance of different Techniques of Composite
      Restorations (Indirect restorations using a CAD/CAM grinding process, BRILLIANT Crios,
      Coltène/Whaledent AG, Switzerland or Direct a light-cured, bulk-fill nanocomposite
      restorative material, Filtek™ One Bulk Fill Restorative, 3M ESPE Dental Products, USA) in
      Endodontically treated posterior teeth.
    

Detailed description: 
      The study will be conducted in Conservative Dentistry Department, Faculty of Dentistry, Cairo
      University; The operator in charge will be Esraa Esmeail Hussien.

      Null-hypothesis: There are no differences in the clinical performance of indirect CAD/CAM
      milled composite when compared to direct bulk-fil composite endocrowns when in the posterior
      area.

      Aim: This clinical trial will be conducted to assess the clinical performance of using
      indirect Milled composite or direct bulk-fill resin composite Endo-crowns for restoring the
      endo-treated teeth, as well to measure the amount of wear on the occlusal tables of both
      restorations using Digital Scanner.

      Patients will be selected from the outpatient clinic of the department Conservative Dentistry
      Department, Faculty of Dentistry, Cairo University

      Clinical Steps:

        -  A tapered stone with rounded end in a high-speed handpiece with air /water coolant will
           be used to properly prepare the cavity walls to receive the indirect restoration and any
           remaining carious dentin will be excavated and removed.

        -  Cuspal tipping will be done by a wheel stone about 1.5-2mm.

        -  The entrance to the pulpal canal will be opened. Gutta percha will be removed to a depth
           not exceeding 2 mm to take advantage of the saddle-like anatomy of the cavity floor.
           This should be done with a nonabrasive instrument to maintain the integrity of the
           canal's entrance. No drilling into the dentin will be carried out.

        -  Any remaining undercuts will be blocked with conventional resin composite.

        -  The impression will be taken, and the final restoration will be fabricated either direct
           or indirect.

        -  The final restoration should be checked intraorally for proximal contacts, occlusion and
           marginal fit before cementation.

        -  Isolation of operatory field using rubber dam.

        -  Selective enamel etching technique will be applied for bonding of tooth structure,
           35-40% phosphoric acid gel will be applied to the enamel margins only for 15 seconds,
           rinsed for 15 seconds and gently dried by cotton pellet.

        -  Adhesive will be used according to the manufacturers' instructions.

        -  Adhesive resin cement will be applied into the preparation. The restoration will be
           placed in the cavity and checked for complete seating. The cement will be light cured
           for only 2 seconds to facilitate removal of the excess. Then light curing will be done
           from all directions each for 40 seconds for achieving the final set.

        -  The proximal contacts will be checked with dental floss.

        -  The occlusion will be adjusted using articulating paper.

        -  Finishing and Polishing using finishing stones and polishing rubber points.

      Primary Objective: To evaluate clinical performance of different Techniques of Composite
      Restorations (Indirect restorations using a CAD/CAM grinding process, BRILLIANT Crios,
      Coltène/Whaledent AG, Switzerland or Direct a light-cured, bulk-fill nanocomposite
      restorative material, Filtek™ One Bulk Fill Restorative, 3M ESPE Dental Products, USA) in
      Endodontically treated posterior teeth.
    

Intervention name(s): Reinforced composite for the fabrication of permanent, indirect restorations using a CAD/CAM grinding process.
Intervention type(s): Other
Intervention description(s): Shock-absorbing effect due to the dentine-like modulus of elasticity makes BRILLIANT Crios extremely well suited for implant restorations.it is composed of dental glass (barium glass ˂ 1.0 μm), amorphous silica (Sio2 ˂ 20 nm), resin matrix (cross-linked methacrylates) and pigments
Other intervention name(s): CAD/CAM Composite endo-crown
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Endodontically Treated Teeth; Milled Composite; Clinical Performance; Occlusal Wear; IntraOral Scanner