Five-year randomized clinical trial to evaluate the clinical performance of high-viscosity glass ionomer restorative systems in small class II restorations.

OBJECTIVE: Evaluate and compare the 5-year clinical performance of three high-viscosity glass ionomer restorative materials in small class II restorations. MATERIALS AND METHODS: Forty patients, each with four class II restorations, were enrolled in this trial. A total of 160 restorations were placed, 25% for each material, as follows: three high-viscosity conventional glass ionomer restorative systems (Ketac Universal Aplicap, EQUIA Forte and Riva Self Cure HV) and a microhybrid resin composite system (Filtek Z250). Clinical evaluation was performed at baseline and after 1, 3, and 5 years by two independent examiners using FDI criteria. Epoxy resin replicas were observed under scanning electron microscope (SEM) to examine surface characteristics. Data were analyzed with Kruskal-Wallis, Mann-Whitney U, Friedman, and Wilcoxon signed-rank tests (p < 0.05). RESULTS: The success rates were 100% for resin composite, 97.4% for Ketac Universal, and 94.9% for both EQUIA Forte and Riva HV restorations. Statistically significant differences were observed between all groups in terms of surface luster and color match criteria (p < 0.05). Statistically significant changes were found over time for all criteria except for fracture of material, postoperative hypersensitivity, recurrence of caries, tooth integrity, periodontal response, adjacent mucosa, and oral health criteria (p > 0.05). SEM evaluations were in accordance with the clinical findings. CONCLUSIONS: Although drawbacks in surface luster and color match appeared over the 5-year evaluation period, the three high-viscosity glass ionomer restorative materials provided successful clinical performance in small to medium sized class II cavities compared to microhybrid resin composite. CLINICAL SIGNIFICANCE: Glass ionomer restorations exhibited clinical performance similar to that of microhybrid resin composite restorations in small class II cavities subsequent to 5-year evaluation.

Fracture resistance of prepared premolars restored with bonded new lab composite and all-ceramic inlay/onlay restorations: Laboratory study.

OBJECTIVES: To assess the influence of new light curing lab composite, lithium-disilicate glass-ceramic and yttrium-stabilized zirconia-based ceramic on the fracture resistance of maxillary premolars with class II inlay and onlay preparations. METHODS: Seventy sound maxillary premolars were divided randomly into seven main groups. The first group was left intact (control group). The remaining six groups were prepared with inlay and onlay cavities and restored with lab composite (SR Nexco), lithium-disilicate glass-ceramic (IPS e.max Press) and yttrium-stabilized zirconia-based ceramic (ICE Zirkon). The restorations were cemented with luting resin composite (Variolink N). All specimens were thermocycled 5000 cycles between 5°C ± 2°C and 55°C ± 2°C and were then cyclic loaded for 500 000 cycles. The specimens were subjected to a compressive load in a universal testing machine using a metal sphere until fracture occurred. The results were analyzed by 2-way ANOVA and Tukey HSD post hoc tests. The level of significance was set at P < .05. RESULTS: There were no statistically significant differences among the means of control group and the groups restored with zirconia ceramic inlays and onlays (P > .05). However, statistically significant differences were found among the means of control group and the groups restored with lab composite inlays, lab composite onlays, pressable glass ceramic inlays and pressable glass ceramic onlays (P < .05). CONCLUSIONS: The fracture resistance of prepared teeth for inlay and onlay restorations is inferior to the intact teeth when lab composite is used. Conversely, when a ceramic material being used, the prepared teeth for inlay and onlay restorations showed a comparable strength to the intact teeth especially zirconia ceramic. CLINICAL SIGNIFICANCE: Premolar teeth restored with zirconia ceramic inlays and onlays exhibited fracture resistance comparable to intact teeth.

The Effect of Finishing and Polishing Systems on Surface Roughness and Microbial Adhesion of Bulk Fill Composites: A Systematic Review and Meta-Analysis.

Objectives: This paper presents a systematic review and meta-analysis of the effect of different finishing and polishing (F/P) systems on surface roughness (SR) and microbial adhesion to bulk fill (BF) composites. Materials and Methods: An electronic search of 3 databases (the National Library of Medicine [MEDLINE/PubMed], Scopus, and ScienceDirect) was conducted. Only in vitro studies that evaluated SR and microbial adhesion to BF composites were included. The included studies were individually evaluated for the risk of bias following predetermined criteria. A meta-analysis of the reviewed studies was conducted to compare the SR values of both Filtek Bulk Fill and Tetric EvoCeram Bulk Fill with and without F/P using the Comprehensive Meta-Analysis software. Results: A total of 12 studies fulfilled the inclusion criteria. The meta-analysis showed no significant difference between Filtek Bulk Fill and Tetric EvoCeram Bulk Fill without F/P or after F/P using multi-step systems. Different F/P systems affected the SR values, on the other hand, did not affect microbial adhesion values. Conclusion: Both Filtek Bulk Fill and Tetric EvoCeram Bulk Fill had comparable roughness results. Multi-step systems may be preferable for F/P of BF composites.