Three-year Randomized Clinical Study of a One-step Universal Adhesive and a Two-step Self-etch Adhesive in Class II Composite Restorations.

PURPOSE: To evaluate in a randomized clinical evaluation the 3-year clinical durability of a one-step universal adhesive and compare it intraindividually with a 2-step self-etch adhesive in Class II restorations. MATERIALS AND METHODS: Each of 57 participants (mean age 58.3 years) received at least two extended Class II restorations that were as similar as possible. The cavities in each of the 60 individual pairs of cavities were randomly distributed to the 1-step universal adhesive (All-Bond Universal: AU) and the control 2-step self-etch adhesive (Optibond XTR: OX). A low shrinkage composite (Aelite LS) was used for all restorations, which were evaluated using slightly modified USPHS criteria at baseline and 1, 2, and 3 years. RESULTS: 114 Class II restorations were evaluated at three years. Eight restorations, 3 AU and 5 OX, failed during the follow-up, resulting in 94.7% (AU) and 91.2% (OX) success rates (p > 0.05). Annual failure rates were 1.8% and 2.9%, respectively.The main reason for failure was composite fracture. CONCLUSION: Class II composite restorations placed with a 1-step universal adhesive showed good short-term efficacy.

Randomized 3-year clinical evaluation of Class I and II posterior resin restorations placed with a bulk-fill resin composite and a one-step self-etching adhesive.

PURPOSE: To evaluate the 3-year clinical durability of the flowable bulk-fill resin composite SDR in Class I and Class II restorations. MATERIALS AND METHODS: Thirty-eight pairs of Class I and 62 pairs of Class II restorations were placed in 44 male and 42 female patients (mean age 52.4 years). Each patient received at least two extended Class I or Class II restorations that were as similar as possible. In all cavities, a one-step self-etching adhesive (XenoV+) was applied. One of the cavities of each pair was randomly assigned to receive the flowable bulk-fill resin composite SDR in increments up to 4 mm as needed to fill the cavity 2 mm short of the occlusal cavosurface. The occlusal part was completed with an ormocer-based nanohybrid resin composite (Ceram X mono+). In the other cavity, only the resin composite CeramX mono+ was placed in 2 mm increments. The restorations were evaluated using slightly modified USPHS criteria at baseline and then annually for 3 years. Caries risk and bruxing habits of the participants were estimated. RESULTS: No post-operative sensitivity was reported. At the 3-year follow-up, 196 restorations - 74 Class I and 122 Class II - were evaluated. Seven restorations failed (3.6%), 4 SDR-CeramX mono+ and 3 CeramX mono+ only restorations, all of which were Class II. The main reason for failure was tooth fracture, followed by resin composite fracture. The annual failure rate (AFR) for all restorations (Class I and II) was 1.2% for the bulkfilled restorations and 1.0% for the resin composite-only restorations (p > 0.05). For the Class II restorations, the AFR was 2.2% and 1.6%, respectively. CONCLUSION: The 4-mm bulk-fill technique showed good clinical effectiveness during the 3-year follow-up.

A calcium aluminate cement as restorative material in Class V cavities.

Recently a calcium aluminate cement (Doxa Certex, Uppsala, Sweden) has been developed intended to be used as direct restorative filling material. The aim of this study was to evaluate intra-individually the experimental calcium aluminate cement (CAC) and a resin composite (RC;Tetric Ceram) in Class V restorations. Each of 46 participants received at least one pair of restorations of the same size, one CAC and one RC. The 119 restorations were evaluated clinically, according to slightly modified USPHS criteria, at baseline, after 6 mths, 1, 2 and 3 yrs. None of the patients reported post-operative sensitivity. At 3 yrs, 111 restorations were evaluated. Significantly better clinical durability was shown for RC. Two non-acceptable CAC restorations were observed at 6 months, 3 CAC and 1 RC at 12 months, 5 CAC and 2 RC at 24 months, and 8 CAC at 36 months. This resulted in a cumulative failure frequency of 32% for the CAC material and 5% for the RC material. Main reason for failure for the CAC was total or partial lost restorations, and for the RC lost restorations. It can be concluded that the CAC showed a non-acceptable clinical failure rate for Class V restorations.