Clinical Evaluation of Snow-plowTechnique Versus Bulk Fill Technique in Restorations of Class II Cavities

Study Overview
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Brief Summary
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The aim of the study is to assess the performance of  snow-plow technique as compared to Bulk Fill technique in restoration of class II cavities.

Detailed Description
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With limited evidence-based information about the clinical performance of resin composite in class II cavities. it is beneficial to compare the newly introduced snow-plow' technique using a randomized clinical trial to test the null hypothesis that this new technique has the same clinical performance. The comparator will be the bulk fill technique as an alternative to the conventional layering technique. This is because it has shown lower polymerization shrinkage when comparing it to the conventional composite. Bulk fill has reduced the chair time for the patient. It is done by the application of 4mm increment and cured at once. Patients are selected according to the eligibility criteria discussed in the following section. local anesthesia will be administered and the operative field will be isolated before starting the restorative procedure. A standard class II cavity will be prepared at the two-surface cavities. The preparation will be performed using rotary instrumentation for cavity preparation by a water-cooled high-speed hand-piece by the same operator. The teeth are then restored using one of the two techniques according to their allocation with the same steps discussed in the different arms. The restorations are assessed using the modified USPHS criteria at the time intervals stated in the outcome measures.

Official Title
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Clinical Evaluation of Snow-Plow Technique Versus Bulk Fill Technique in Restoration of Class II Cavities: Randomized Clinical Trial

Conditions
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Class II Dental Caries

Intervention / Treatment
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* Procedure: Snow-plow technique
* Procedure: Bulk fill technique


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: class II carious lesions in premolars and molars. Vital upper or lower teeth with no signs of irreversible pulpitis. Presence of favorable occlusion and teeth are in normal contact with the adjacent teeth. Exclusion Criteria: Deep carious defects (close to pulp, less than 1 mm distance). Periapical pathology or signs of pulpal pathology. Endodontically treated teeth Tooth hypersensitivity. Possible prosthodontic restoration of teeth. Heavy occlusion or occlusal contacts or history of bruxism. Severe periodontal affection.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: 1:1
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Snow-Plow technique<br>In class II cavities, application of X-tra Base bulk fill flowable composite (VOCO) in 1 mm thickness without curing followed by X-tra Fill bulk fill packable composite (VOCO) to restore the proximal wall. Polymerization as one unit for 20 seconds. | Procedure: Snow-plow technique<br>* In class II cavities, application of X-tra Base bulk fill flowable composite (VOCO) in 1 mm thickness without curing followed by X-tra Fill bulk fill packable composite (VOCO) to restore the proximal wall. Polymerization as one unit for 20 seconds.<br>|
| Active Comparator: Bulk Fill technique<br>In class II cavities, application of 4 mm increment of X-tra Fill bulk fill packable composite (VOCO) to restore the proximal wall. then the restoration id fully polymerized. | Procedure: Bulk fill technique<br>* In class II cavities, application of 4 mm increment of X-tra Fill bulk fill packable composite (VOCO) to restore the proximal wall. then the restoration id fully polymerized.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| clinical performance | USPHS Criteria | day 1 | 
| clinical performance | USPHS Criteria | 3 months | 
| clinical performance | USPHS Criteria | 6 months | 
| clinical performance | USPHS Criteria | 9 months | 
| clinical performance | USPHS Criteria | 12 months |