Evaluation of Post-Operative Sensitivity of Bulk Fill Resin Composite versus Nano Resin Composite: A Randomized Controlled Clinical Study.
ABSTRACT: BACKGROUND:Despite recent advances in restorative dentistry adhesive restorations may cause postoperative sensitivity which leads to restoration failure. AIM:This study aimed to compare and evaluate the incremental and bulk fill resin Composite postoperative sensitivity in class II posterior restorations bonded with two adhesive systems (self-etch and etch-and-rinse). METHODS:Sixty patients were randomly selected, their age range from twenty-five to forty years old, divided into two groups according to the packing technique of resin composite material; incremental Tetric Evoceram and Tetric Evoceram bulk-fill resin composite. Thirty patients (n = 30) for incremental Tetric Evoceram resin composite restorations and according to the adhesive systems used they were equally divided (n = 15 teeth).Thirty patients (n = 30) for Tetric Evoceram bulk-fill resin composite restorations and according to the adhesive systems used (etch and rinse or self-etch), they were equally divided (n = 15 teeth). Post-operative pain assessed at 24 hours, 1 week and 1 month using the Visual Analog Scale Score (VAS). Each patient was instructed to put a mark on the VAS line at home to point out the intensity of pain at each assessment period. The problem of measuring the pain that pain tolerance of individuals may be different from the others. This may be due to different reasons, and it is not always because of a problem in the restoration. RESULTS:After 1 day, 1 week as well as 1 month, no statistically significant disagreement between the two resin composite types using self-etch adhesive strategy and total-etch adhesive strategy. Also, when the two adhesive systems were compared using Bulk Fill resin composite and incremental Nano resin composite no statistically significant disagreement between the two adhesive systems after 1 day, 1 week as well as 1 month. CONCLUSION:The post-operative hypersensitivity is related to many factors as the procedure of cavity preparation, adhesive approach, and type of resin composite used and placement technique of the resin composite.
Project description:The aim of the study was to compare under in vitro conditions marginal sealing of 4 different bulk-fill materials composite restorations of class II.Comparative evaluation concerned 4 composites of a bulk-fill type: SonicFill, Tetric EvoCeram Bulk Fill, Filtek Bulk Fill, and SDR. The study used 30 third molars without caries. In each tooth 4 cavities of class II were prepared. The prepared tooth samples were placed in a 1% methylene blue solution for 24 h, and after that in each restoration the depth of dye penetration along the side walls was evaluated.The highest rating (score 0, no dye penetration) was achieved by 93.33% of the restorations made of the SDR material, 90% of restorations of SonicFill system, 86.66% of restorations of the composite Filtek Bulk Fill, and 73.33% of restorations of the Tetric EvoCeram Bulk Fill.The performed study showed that bulk-fill flowable or sonic-activated flowable composite restorations have better marginal sealing (lack of discoloration) in comparison with bulk-fill paste-like composite.
Project description:Patient demand for tooth colored restorations and desire for minimally invasive restorations have made composites an indispensable part of the restorative process. An important factor affecting the intra-oral performance of composite restorations is bonding.Ninty six freshly extracted molar teeth were collected and occlusal 3mm is removed using a diamond disc to expose dentine. Following with samples were divided in to two main groups (self-etch & total etch). Each main group is again sub divided in to three groups each according to bonding agent used (Tetric N- Bond Universal, Single Bond Universal, Tetric N Bond Total etch in total etch group and Clear Fill SE in self etch group). Following which bonding protocol is followed according to manufacture instructions, a composite buildup of 2x3 mm is done on each specimen and then specimen were subjected to shear bond test under universal testing machine. All the readings were noted and subjected to statistical analysis using One way ANOVA and Tukey's posthoc test.It showed that there is no significant difference among the groups in both self-etch and total etch modes.It can be concluded that application of an etching step prior to Universal Adhesives significantly improves their dentine penetration pattern, although this does not affect their mean SBS. The bond strength values of the TBU regardless of application mode were comparable to SBU making them reliable for working under different clinical conditions. Key words:Dentine bonding agents, self-etch mode, total etch mode, shear bond strength.
Project description:Objective:The aim of this study was to evaluate the long-term clinical performance of a self-adhering flowable resin composite compared to a conventional flowable resin composite used with an etch&rinse adhesive system in minimally invasive Class I cavities. Materials and Methods:Twenty-five patients received at least one pair of Class I restorations (n=65). After class I cavities had been prepared, they were randomly restored either with a self-adhering flowable resin composite (VertiseFlow/Kerr-VR) [Group-1 (n=33)], or with a flowable resin composite (Luxaflow/DMG-LX) in combination with an etch&rinse adhesive (Teco/DMG) [Group-2 (n=32)] according to the manufacturers' instructions. The restorations were evaluated at baseline and yearly during 5 years according to the FDI criteria by two evaluators. A statistical analysis was carried out using the Pearson Chi-Square test and the Cochran Q-test followed by the Mc Nemar's test (p=0.05). Results:After 5 years a total of 47 restorations were evaluated with a recall rate of 68%. At 4-year, 3 (11.5%) VR and 2 LX (7.6%) restorations exhibited a cumulative retention loss. Seventeen (73.9%) VR and 14 LX (58.3%) restorations exhibited clinically acceptable (2) scores for marginal adaptation. At 5-year evaluations VR and LX showed similar results regarding all evaluated criteria (p > 0.05). The cumulative retention loss rates of VR and LX were 15.3% and 7.6%, respectively. None of the restorations demonstrated a recurrence of caries and post operative sensitivity. Both materials showed significant changes at 4 and 5 years regarding marginal staining when compared to baseline (p<0.001). Furthermore, significant changes were observed for VR and LX at 1, 2, 3, 4 and 5 years for marginal adaptation according to baseline (p<0.001). Conclusion:The use of both materials for the restoration of Class-I cavities demonstrated clinically acceptable performance at the end of 5-year. The self-adhering flowable composite exhibited a clinical performance similar to the conventional flowable applied with an etch&rinse adhesive.
Project description:The aim was to test the null hypotheses that there is no difference: (1) in carious lesion development at the restoration margin between class II composite resin restorations in primary molars produced through the atraumatic restorative treatment (ART) with and without a chemomechanical caries removal gel and (2) in the survival rate of class II composite resin restorations between two treatment groups after 2 years. Three hundred twenty-seven children with 568 class II cavitated lesions were included in a parallel mouth study design. Four operators placed resin composite (Filtek Z 250) restorations bonded with a self-etch adhesive (Adper prompt L pop). Two independent examiners evaluated the restorations after 0.5, 1, and 2 years using the modified Ryge criteria. The Kaplan-Meier survival method was applied to estimate survival percentages. A high proportion of restorations were lost during the study period. Therefore, the first hypothesis could not be tested. No statistically significant difference was observed between the cumulative survival percentages of restorations produced by the two treatment approaches over the 2-year period (ART, 54.1 +/- 3.4%; ART with Carisolv, 46.0 +/- 3.4%). This hypothesis was accepted. ART with chemomechanical gel might not provide an added benefit increasing the survival percentages of ART class II composite resin restorations in primary teeth.
Project description:OBJECTIVE:The aim of this randomized, controlled, prospective clinical trial was to evaluate the performances of two different universal adhesives and one etch-rinse adhesive for restoration of non-carious cervical lesions (NCCLs). MATERIAL AND METHODS:Twenty patients with at least seven NCCLs were enrolled. Lesions were divided into seven groups according to adhesive systems and application modes: GSE: GLUMA Universal-self-etch, GSL: GLUMA Universal-selective etching, GER: GLUMA Universal-etch-and-rinse, ASE: All-Bond Universal-self-etch, ASL: All-Bond Universal-selective etching, AER: All-Bond Universal-etch-and-rinse, SBE (Control): Single Bond2-etch-and-rinse. A total of 155 NCCLs were restored with a nano hybrid composite (Tetric N-Ceram). Restorations were scored with regard to retention, marginal discoloration, marginal adaptation, recurrent caries and post-operative sensitivity using modified United States Public Health Service (USPHS) criteria after one week, 6, 12 and 24 months. Statistical evaluations were performed using Chi-square tests (p=0.05). RESULTS:The recall rate was 81.9% after the 24-month follow-up. The cumulative retention rates for self-etch groups (GSE: 72.2%, ASE:75%) were significantly lower than other experimental groups (GSL: 93.7%, GER: 100%, ASL: 94.1%, AER: 100%, SBE: 100%) at the 24-month follow-up (p<0.05). Regarding marginal adaptation and marginal discoloration, GSE and ASE groups demonstrated more bravo scores after 6 and 12-month observations but differences were not significant (p>0.05). Only one restoration from ASL group demonstrated post-operative sensitivity at 6 and 12-month observations. No secondary caries was observed on the restorations at any recall. At the end of 24-month observations, no significant differences were detected among groups regarding any of the criteria assessed, except retention. CONCLUSION:GLUMA Universal and All-Bond Universal showed better results in etch-and-rinse and selective etching mode compared to the self-etch mode regarding retention. Etch-and-rinse and selective etching application modes of the current universal adhesives tended to provide better clinical outcomes considering the criteria evaluated at the end of 24-month evaluation.
Project description:To compare the clinical performance of Scotchbond™ Universal Adhesive used in self- and total-etch modes and two-bottle Scotchbond™ Multi-purpose Adhesive in total-etch mode for Class 5 non-carious cervical lesions (NCCLs).37 adults were recruited with 3 or 6 NCCLs (>1.5mm deep). Teeth were isolated, and a short cervical bevel was prepared. Teeth were restored randomly with Scotchbond Universal total-etch, Scotchbond Universal self-etch or Scotchbond Multi-purpose followed with a composite resin. Restorations were evaluated at baseline, 6, 12 and 24 months for marginal adaptation, marginal discoloration, secondary caries, and sensitivity to cold using modified USPHS Criteria. Patients and evaluators were blinded. Logistic and linear regression models using a generalized estimating equation were applied to evaluate the effects of time and adhesive material on clinical assessment outcomes over the 24 month follow-up period. Kaplan-Meier method was used to compare the retention between adhesive materials.Clinical performance of all adhesive materials deteriorated over time for marginal adaptation, and discoloration (p<0.0001). Both Scotchbond Universal self-etch and Scotchbond Multi-purpose materials were more than three times as likely to contribute to less satisfying performance in marginal discoloration over time than Scotchbond Universal total-etch. The retention rates up to 24 months were 87.6%, 94.9% and 100% for Scotchbond Multi-purpose and Scotchbond Universal self-etch and total-etch, respectively.Scotchbond Universal in self- and total- etch modes performed similar to or better than Scotchbond Multipurpose, respectively.24 month evaluation of a universal adhesive indicates acceptable clinical performance, particularly in a total-etch mode.
Project description:Resin composite and glass ionomer cement (GIC) are the most commonly used dental materials to perform direct restorations. Both have specific characteristics that explain their popularity and their limits. More than 20 years ago, the first attempt (followed by others) to combine the advantages of these two families was performed with compomers, but it was not very successful. Recently, new formulations (also called 'smart materials') with claimed ion release properties have been proposed under different family names, but there are few studies on them and explanations of their chemistries. This comprehensive review aims to gather the compositions; the setting reactions; the mechanical, self-adhesive, and potential bulk-fill properties; and the ion release abilities of the large existing families of fluoride-releasing restorative materials and the new restorative materials to precisely describe their characteristics, their eventual bioactivities, and classify them for an improved understanding of these materials. Based on this work, the whole GIC family, including resin-modified and highly viscous formulations, was found to be bioactive. Cention N (Ivoclar Vivadent, AG, Schaan, Lietschentein) is the first commercially available bioactive resin composite.
Project description:Introduction: Some studies have shown that laser irradiation on unpolymerized adhesives can improve composite-dentin adhesion. The aim of the present study was to evaluate the effect of the diode laser (810 nm) on the microleakage of multi-mode adhesive systems at enamel and dentin margins of composite restorations. Methods: Classic class V boxes were prepared on 48 sound premolar teeth and randomly divided into 6 groups (n=16). In the control groups, Scotchbond Universal (SBC), G-Premio (GBC), and Ambar U (AMC) were used by a self-etch mode. In the test groups (SBL, GBL, ABL), the 810 nm diode laser was irradiated (1 W) for 10 seconds before the polymerization of the adhesive. The boxes were restored by the resin composite. After finishing and polishing, the samples were thermocycled (5°C to 55°C) for 1000 cycles and then immersed in 0.1% methylene blue dye (48 hours). Dye penetration through the gingival and occlusal margins was measured by Stereomicroscope. The data were analyzed at the 5% significance level using Kruskal-Wallis and Mann-Whitney U tests. Results: Significant differences were found between the control and test groups (P < 0.05). The occlusal margins of the SBL and GBL groups and the cervical margin of the SBL group exhibited the lowest microleakage (P < 0.05). The AM control group showed maximum microleakage at cervical and occlusal margins. Conclusion: The irradiation of the 810 nm diode laser on the unpolymerized universal adhesive systems in a self-etch mode caused a significant reduction in enamel and dentin marginal microleakage of composite restorations.
Project description:Clinical studies are being conducted in less strict conditions in order to establish an adequate scientific basis for decision making. The aim of this pragmatic randomized clinical trial is to evaluate the effectiveness of single and multiple-surfaces restorations performed following the Atraumatic Restorative Treatment (ART) premises compared with Conventional Treatment (CT) using bulk fill composite restorations in primary and permanent teeth.A total of 1,214 5-to-13 year-old children with at least one single or multiple-surface dentin caries lesion in primary or permanent molars will be selected in public schools of Barueri-SP, Brazil. The participants will be randomly assigned into 2 groups: CT (caries removal with bur and restoration performed with Scotchbond™ Universal Adhesive system associated with Filtek Bulk Fill - 3 M/ESPE) and ART (Caries removal with hand instruments and restoration with high viscosity glass ionomer cement Ketac Molar Easy Mix - 3 M/ESPE). Ten untrained dentists will perform the treatment in in dental offices located at public schools. The restorations will be evaluated after 6, 12 and 24 months by an independent trained and calibrated examiner. The restoration and tooth survival, the cost-effectiveness analysis between the two groups and the operators' preferences regarding the techniques will be also evaluated. Kaplan-Meier survival analysis and log-rank test will be applied for the restoration and tooth survival. All the average event rates in the two groups will be modelled and compared with a Cox proportional hazard shared frailty model since there is an operator-cluster effect. The significance level for all analyses will be 5 %.Our hypothesis is that despite similar expected effectiveness between ART using high viscosity GIC and conventional treatment using bulk fill composite resin when treating single or multiple-surface in posterior primary and permanent teeth, ART will present superior cost-effectiveness. The results of this trial will support decision-making by clinicians and policy makers.NCT02568917 . Registered on May 10th 2015.
Project description:OBJECTIVES:To assess the color stability and surface microhardness of Bulk-Fill composite materials available in the Saudi Arabia market. METHODS:Five composite materials (Filtek Z350, Filtek Bulk-Fill, Tetric N-Ceram Bulk-Fill, Sonic Fill 2, and SDR) were investigated. Samples (n = 20; 10 mm in diameter and 2 mm in thickness) were fabricated using a stainless-steel mold and were immersed in tea, coffee, berry juice, and distilled water (control). Baseline (T0) shades of specimens were recorded using a spectrophotometer and after 10 (T1), 30 (T2), 60 (T3), and 90 days (T4) of immersion. Measurements were obtained against a black background and CIE L*a*b* data was used to calculate ?E for each group. Vickers microhardness values were obtained at T0 and T4. Data was analyzed using mixed model repeated measure ANOVA at 0.05 significance level. RESULTS:Time, material, and solution effects have statistically significant effect on ?E. Tea was the most staining solution. Z350 was associated with the highest ?E values while SDR showed the lowest values. No other materials showed significant difference between each other. Solutions were statistically different from each other. All materials were different from each other regarding microhardness. CONCLUSION:Bulk-Fill materials showed more color stability but lower microhardness values compared to universal resin control.