Clinical trial NCT05623423: Evaluation of Clinical Performance of Class IV Restoration Using Organically Modified Ceramic (OMNOCER) in Comparison to a Methacrylate Based Composite Resin
Official title: Evaluation of Clinical Performance of Class IV Restoration Using Organically Modified Ceramic (OMNOCER) in Comparison to a Methacrylate Based Composite Resin a Randomized Clinical Trial
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Shade Match
Keywords: class IV restoration
ORMOCER
methacrylate based composite resin
Lead sponsor: Cairo University
Sponsor class: OTHER
First posted: 2022-11-21
Enrollment: 26
Sex: ALL
Minimum age (years): 18
Maximum age (years): 40
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Evaluation of clinical performance of class IV restoration using organically modified ceramic (ORMOCER) in comparison to a Methacrylate Based Composite Resin: A randomized clinical trial

Detailed description: Statement of the problem:

Resin composites have been the most popular material in esthetic dentistry since 1960's. Esthetic restorative material should resemble the natural tooth; in both color match and stability, and should have adequate strength, wear and sealing characteristics

. Longevity of anterior restorations varied in earlier studies depending on the restorative material and cavity class. Involvement of the incisal angle in anterior teeth resulted in accompanied reduction in average survival time. In contrast to class I, II, III and V cavity configurations, class IV restorations are stressed at the incisal angle, posing a challenge to the tooth restoration interface. Because the majority of class IV restorations lack mechanical retention; the tooth-bonded interface faces additional obstacles. In addition, color is one of the most important factors of esthetic restorations, since color change may be due to intrinsic factors as; changes in the filler, matrix and silane coating as well as extrinsic staining; as absorption of stains, chemical reactivity, diet and oral hygiene. But the recent advances in the resin composite restoration in their monomer chemistry, filler type and structure have been continuously developed to improve their mechanical and physical properties.

Rationale:

In order to optimize the properties of the material and facilitate deeper light transmission, manufacturers incorporated an advanced composite filler technology and resin matrix modifications by introducing Organically Modified Ceramics with pure silicate technology showing superior material properties, which was claimed to be better than Methacrylate Based Composite Resin. Moreover, polymerization shrinkage stresses depend on many factors, like composition of resin matrix, quantity of filler and degree of conversion. Ormocer induces polymerization as a result of a matrix of long inorganic silica chains with organic lateral chains. This type of Ormocer enhances aesthetics, color stability, abrasion resistance, and reduces polymerization shrinkage and surface roughness due to the presence of ceramic polysiloxane, which has low degree of polymerization shrinkage (1.25%)

Eligibility criteria: Inclusion Criteria:

participant:

1. Age of patient (18-40) years old.
2. Good oral hygiene.

Teeth:

1. Having no active pulpal or periodontal conditions.
2. Normal Occlusion.
3. Able to return for follow-up assessments as illustrated by the examiners. -

Exclusion Criteria:

participant:

1. Patients with Edge-to-Edge occlusion.
2. Patients with high caries index.
3. Patients with uncontrolled para-functional habits (e.g. bruxism or clenching).
4. Patients with inadequate oral hygiene.
5. Patients with periodontal or gingival conditions.
6. Patients with orthodontic appliances.
7. Patients with spontaneous pain or sensitivity to percussion
8. Pregnant Patients -

Primary outcomes:
measure: Shade match
timeFrame: T1: 1 week (baseline)
measure: Shade match
timeFrame: T2: 3 months
measure: Shade match
timeFrame: T3: 1 year.
Secondary outcomes:
measure: a) Retention rate
timeFrame: T1: 1 week (baseline)
measure: a) Retention rate
timeFrame: T2: 3 months
measure: a) Retention rate
timeFrame: T3: 1 year
Other outcomes:
Locations:
city: Cairo
country: Egypt
facility: Cairo university
Study officials:
affiliation: Cairo University
name: Mostafa Abdulhameed, Professor
role: STUDY_DIRECTOR
References:
citation: Barcellos DC, Batista GR, Silva MA, Pleffken PR, Rangel PM, Fernandes VV Jr, Di Nicolo R, Torres CR. Two-year clinical performance of self-etching adhesive systems in composite restorations of anterior teeth. Oper Dent. 2013 May-Jun;38(3):258-66. doi: 10.2341/11-397-C. Epub 2012 Oct 30.
citation: Blum SL, Horn M, Olms C. A comparison of intraoral spectrophotometers-Are there user-specific differences? J Esthet Restor Dent. 2018 Sep;30(5):442-448. doi: 10.1111/jerd.12407. Epub 2018 Aug 25.
citation: Cetin AR, Unlu N, Cobanoglu N. A five-year clinical evaluation of direct nanofilled and indirect composite resin restorations in posterior teeth. Oper Dent. 2013 Mar-Apr;38(2):E1-11. doi: 10.2341/12-160-C. Epub 2012 Dec 5.
citation: Demirci M, Tuncer S, Sancakli HS, Tekce N, Baydemir C. Five-year Clinical Evaluation of a Nanofilled and a Nanohybrid Composite in Class IV Cavities. Oper Dent. 2018 May/Jun;43(3):261-271. doi: 10.2341/16-358-C. Epub 2018 Mar 13.
citation: Frese C, Wohlrab T, Soliman S, Hahn B, Busch C, Babai A, Krastl G, Wolff D. A Multicenter Trial on the Long-term Performance of Direct Composite Buildups in the Anterior Dentition - Survival and Quality Outcome. J Adhes Dent. 2020;22(6):573-580. doi: 10.3290/j.jad.a45514.
citation: Gresnigt MM, Kalk W, Ozcan M. Randomized controlled split-mouth clinical trial of direct laminate veneers with two micro-hybrid resin composites. J Dent. 2012 Sep;40(9):766-75. doi: 10.1016/j.jdent.2012.05.010. Epub 2012 Jun 2.
citation: Karaman E, Yazici AR, Ozgunaltay G, Ustunkol I, Berber A. Clinical Evaluation of a Silorane- and a Methacrylate-Based Resin Composite in Class II Restorations: 24-Month Results. Oper Dent. 2017 Jul/Aug;42(4):E102-E110. doi: 10.2341/15-286-C.
citation: Llena C, Fernandez S, Forner L. Color stability of nanohybrid resin-based composites, ormocers and compomers. Clin Oral Investig. 2017 May;21(4):1071-1077. doi: 10.1007/s00784-016-1850-z. Epub 2016 May 16.
citation: Rajeev V, Arunachalam R, Nayar S, Arunima PR, Ganapathy S, Vedam V. "Ormocer an innovative technology": A replacement for conventional cements and veneer? A comparative in vitro analysis. Eur J Dent. 2017 Jan-Mar;11(1):58-63. doi: 10.4103/ejd.ejd_113_16.
citation: Ribeiro JS, Peralta SL, Salgado VE, Lund RG. In situ evaluation of color stability and hardness' decrease of resin-based composites. J Esthet Restor Dent. 2017 Sep;29(5):356-361. doi: 10.1111/jerd.12319. Epub 2017 Jul 24.
citation: Romero MF, Haddock FJ, Freites AG, Brackett WW, Brackett MG. Restorative Technique Selection in Class IV Direct Composite Restorations: A Simplified Method. Oper Dent. 2016 May-Jun;41(3):243-8. doi: 10.2341/15-158-T. Epub 2016 Feb 26.
citation: Ruschel VC, Martins MV, Bernardon JK, Maia HP. Color Match Between Composite Resin and Tooth Remnant in Class IV Restorations: A Case Series. Oper Dent. 2018 Sep/Oct;43(5):460-466. doi: 10.2341/17-132-S. Epub 2018 Mar 16.
citation: Sebold M, Lins RBE, Sahadi BO, Santi MR, Martins LRM, Giannini M. Microtensile Bond Strength, Bonding Interface Morphology, Adhesive Resin Infiltration, and Marginal Adaptation of Bulk-fill Composites Placed Using Different Adhesives. J Adhes Dent. 2021 Oct 1;23(5):409-420. doi: 10.3290/j.jad.b2000221.
citation: Torres C, Augusto MG, Mathias-Santamaria IF, Di Nicolo R, Borges AB. Pure Ormocer vs Methacrylate Composites on Posterior Teeth: A Double-blinded Randomized Clinical Trial. Oper Dent. 2020 Jul 1;45(4):359-367. doi: 10.2341/19-079-C.
citation: van Dijken JW, Pallesen U. Fracture frequency and longevity of fractured resin composite, polyacid-modified resin composite, and resin-modified glass ionomer cement class IV restorations: an up to 14 years of follow-up. Clin Oral Investig. 2010 Apr;14(2):217-22. doi: 10.1007/s00784-009-0287-z. Epub 2009 Jun 6.