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Comparison of surface finish of new aesthetic restorative materials.

This study compared the surface finish of eight different types of aesthetic restorative materials. The materials included resin-modified (Fuji II LC [FL], GC) and highly viscous (Fuji IX GP Fast [FN], GC) glass ionomer cements, a compomer (F2000 [FT], 3M-ESPE), minifilled (Z100 [ZO], 3M-ESPE) and microfilled (A110 [AO], 3M-ESPE) composites and materials based on recently introduced ormocer (Admira [AM], Voco), nanomer (Filtek Supreme Translucent [FST], 3M-ESPE) and nanocluster technology (Filtek Supreme [FS], 3M-ESPE). Sixteen specimens (3-mm long x 3-mm wide x 2-mm deep) of each material were divided into two equal groups. Specimens in Group 1 received no further treatment after polymerization against a matrix strip, while the specimens in Group 2 were roughened with 320 grit grinding paper using a lapping device and were finished/polished with a graded abrasive disk system (Super-Snap, Shofu). The mean roughness (Ra, microm) of materials was determined using a surface profilometry. Data was analyzed by ANOVA/Scheffe's test at significance level 0.05. Mean Ra values ranged from 0.04 to 0.16 microm for Group 1 specimens and 0.15 to 0.68 microm for Group 2 specimens. Results of statistical analysis were as follows: Group 1-FS, FST, FL, FN, AM > FT, AO, ZO; Group 2-FN, FT, FL > AO, FS, ZO, AM, FST (> indicates significantly greater Ra values). For the finished/polished composite materials, Ra values observed for AM and FST were significantly lower than for AO and FS. The surface finish of glass ionomers and compomer was significantly poorer than composites. Composite materials based on ormocer and nanomer technology were significantly smoother than those based on microfillers and nanoclusters.

Analysis of Variance↗

Time dependence of composite shrinkage using halogen and LED light curing.

OBJECTIVES: The polymerization shrinkage of light cured dental composites presents the major drawback for these aesthetically adaptable restorative materials. LED based light curing technology has recently become commercially available. Therefore, the aim of the present study was to investigate if there was a statistically significant difference in linear and volumetric composite shrinkage strain if a LED LCU is used for the light curing process rather than a conventional halogen LCU. METHODS: The volumetric shrinkage strain was determined using the Archimedes buoyancy principle after 5, 10, 20, 40 s of light curing and after 120 s following the 40 s light curing time period. The linear shrinkage strain was determined with a dynamic mechanical analyzer for the composites Z100, Spectrum, Solitaire2 and Definite polymerized with the LCUs Trilight (halogen), Freelight I (LED) and LED63 (LED LCU prototype). The changes in irradiance and spectra of the LCUs were measured after 0, 312 and 360 min of duty time. RESULTS: In general there was no considerable difference in shrinkage of the composites Z100, Spectrum or Solitaire2 when the LED63 was used instead of the Trilight. There was, however, a statistically significant difference in shrinkage strain when the composite Definite was polymerized with the LED63 instead of the Trilight. The spectrum of the Trilight changed during the experiment considerably whereas the LED63 showed an almost constant light output. The Freelight I dropped considerably in irradiance and had to be withdrawn from the study because of technical problems. SIGNIFICANCE: The composites containing only the photoinitiator camphorquinone showed similar shrinkage strain behaviour when a LED or halogen LCU is used for the polymerization. The irradiance of some LED LCUs can also decrease over time and should therefore be checked on a regular basis.

Analysis of Variance↗

Sealant and composite bond strength to enamel with antibacterial/self-etching adhesives.

INTRODUCTION: The enamel in pits and fissures undergoing preventive or ultraconservative resin restorations may be affected by secondary caries. An antibacterial adhesive bond may be a useful choice to prevent and reduce demineralization. OBJECTIVES: The purpose of this study was to determine the shear bond strength of an experimental antibacterial bond, a self-etch bond, and an ormocer-based adhesive bond using an ormocer-based fissure sealant and a composite resin on intact enamel. METHODS: Twenty-four extracted human molars were sectioned bucco-lingually to obtain two flat and sound enamel surfaces. Forty-eight specimens were randomly assigned into four groups. The groups were prepared to receive the following treatments: (1) Admira Bond + Admira Seal (n = 10); (2) ABF Bond + Admira Seal (n = 11); (3) Clearfil SE Bond + Clearfil AP-X (n = 12); and (4) ABF Bond + Clearfil AP-X (n = 11). A cylindrical mould was placed over the bonded surface, and both materials were applied according to the instructions. The teeth were thermocycled 500 cycles between 5 and 55 degrees with a dwell time of 30 s. For shear bond strength testing, the load was applied vertically to the base of the mould. The cross-head speed was 5 mm min(-1). RESULTS: The maximum load that a specimen can withstand until failure was determined and shear bond strength was calculated by dividing the load at failure by the surface area of the mould. The results (median, minimum and maximum, respectively) for the four groups were: (1) 7.9, 4.2 and 13.6 MPa; (2) 8.6, 2.6 and 15.9 MPa; (3) 5.9, 5.3 and 8.2 MPa; and (4) 8.8, 3.0 and 19.2 MPa. Kruskal-Wallis and Mann-Whitney U-tests were performed for the statistical analysis. Groups 3 and 4 were statistically significantly different (P = 0.005; P < 0.05). There was no statistically significant difference between the sealant and composite groups for ABF (P = 0.375). Fracture sites were viewed by microscope under x 16 magnification to determine if the mode of failure was adhesive or cohesive. The results (number of adhesive failed specimens and number of cohesive failed specimens, respectively) for the four groups were: (1) 7 and 3; (2) 3 and 8; (3) 2 and 9; and (4) 8 and 3. CONCLUSION: The ABF bond has sufficiently physical qualities to be used under fissure sealant and composite resin on uncut enamel, its antibacterial efficiency notwithstanding.

Acid Etching, Dental↗

Polish retention of new aesthetic restorative materials over time.

New aesthetic restorative materials claiming superior polish retention have recently been introduced. This study compared polish retention of eight different types of aesthetic restorative materials including ormocer and nanofill composites over a 6-month ageing period in distilled water. Eight specimens of each material were fabricated and roughened with 320 grit grinding paper using a lapping device and finished/polished with a graded abrasive disk system. Mean roughness was then determined using a surface profilometer. The specimens were then stored in distilled water at 37 degrees C and roughness measurements were repeated after 3 and 6 months of ageing. Mean surface roughness values ranged from 0.15 to 0.68 microm for immediate readings and 0.17 to 1.02 microm after ageing for 6 months. With the exception of the highly viscous glass ionomer cement, the surface polish of most materials did not deteriorate much over time. At all time intervals, composite materials based on ormocer and nanomer technology were significantly smoother than all other materials evaluated.

Ceramics↗

Two-year evaluation of a new nano-ceramic restorative material.

The purpose of this prospective study was to evaluate the clinical performance of a new restorative material (Ceram.X) in combination with a new primer-adhesive (K-0127). One operator placed two Class I or II restorations in molars of 43 patients. One molar was restored with Ceram.X/K-0127, the other one with Tetric Ceram/Syntac Classic. At baseline, after 1 and 2 years, the restorations were evaluated by one evaluator using modified Ryge's criteria. After 2 years, 31 patients were examined. One Ceram.X-restoration had to be removed for root canal treatment due to pulpitis. Thus, failure rate of Ceram.X was 3.2% and of Tetric Ceram, 0%. In both groups, no sensitivity, no recurrent caries, and no changes in surface texture were recorded after 2 years. One restoration in each group showed slight changes in color stability (score B). Marginal discoloration (score B) was found concerning three Ceram.X-restorations (10.0%) and two Tetric Ceram-restoration (6.5%). Marginal integrity was score B for four Ceram.X-restorations (13.3%) and for four Tetric Ceram-restorations (12.9%). No statistically significant differences were found (p>0.05). After 2 years of clinical service, 96.8% of Ceram.X/K-0127 and 100% of Tetric Ceram/Syntac Classic restorations were in place and performed clinically well.

Ceramics↗

Color stability of resin matrix restorative materials as a function of the method of light activation.

The purpose was to investigate the influence of curing devices and curing times on the yellow value (b-value) of composites, ormocers and compomers after performing a suntest (EN ISO 7491). Eight samples of Charisma (CH), Durafill (DU), Definite (DE), and Dyract AP (DY) each were light cured with Translux Energy (tungsten halogen light) for 20, 40 or 60 s and with Apollo 95-E (plasma light) for 3, 10 or 20 s. All samples were subjected to a suntest. Before and after the suntest the yellow values (b-values) were determined and the change (Delta b) was calculated. When cured with Translux Energy for 20 and 40 s DU, CH, and DY revealed significantly negative Delta b-values. The b-value of DE remained nearly constant. When cured for 60 s, DU and DE shifted to more yellow while CH and DY still bleached a little. When cured with Apollo 95-E, a dramatic bleaching process of all materials investigated occurred after the suntest (significant negative Delta b). It may be concluded that the bleaching of composites, ormocers and compomers depends on (i) the used light curing device and (ii) the chosen curing times. The tungsten halogen light provided highly significantly superior results.

Ceramics↗

Fracture resistance of endodontically treated premolars restored with ormocer and packable composite.

In this study, mesiodistocclusal (MOD) cavity preparations of endodontically treated maxillary premolars that were enlarged to size #50 were restored using three restorative materials (one ormocer, one packable composite, and one high-copper amalgam) and two application techniques (with or without coronal radicular technique). Copper rings were filled with self-curing polymethylmethacrylate resin and the teeth were placed into resin up to the level of the CEJ. The teeth were grouped according to the restorative material and technique, mounted in a Universal Testing Machine, and the buccal walls subjected to a slowly increasing compressive force until fracture occurred. The force of fracture of the walls of each tooth was recorded and the results in the various groups compared. The group restored with packable composite without radicular extension showed the highest resistance to fracture (p < 0.05). Both groups restored with amalgam were significantly weaker than all the other groups (p < 0.05).

Analysis of Variance↗

The effect of bleaching agents on the surface hardness of tooth colored restorative materials.

AIM OF THE STUDY: The aim of this study was to evaluate the effect of at-home (Opalesence/Dr. kit 15%, Ultradent, Products, Inc. South Jordan, UT, USA) and in-office (Superoxol 35%, Sultan Chemists, Inc., Englewood, NJ, USA) bleaching on the surface hardness of the following tooth colored restorative materials: composite resin, Point-4 (P4), Kerr Corporation, Orange, CA, USA; ormocer, Admira (AD),VOCO, Germany; compomer Dyract AP (DY), Dentsply DeTrey GmbH, Germany; and resin modified glass ionomer cement, Fuji II LC (FL), GC Corporation, Japan. METHODOLOGY: Sixty specimens were prepared; 15 specimens of each material (each group n = 5, control after 15 days, at-home and in-office). All specimens were stored in distilled water at room temperature for 24 hrs before testing. A universal testing machine (Micromet 2100 series micro hardness testers) was used for testing Vicker's surface hardness for the three groups for every tested material. All results were statistically analyzed with one way analysis of variance (ANOVA), Post hoc Tukey HSD tests (P < 0.05), and percentage changes for Tukey. RESULTS: All the tested materials showed an increase in Vicker's surface hardness between base line (24 hrs) and the control group after 15 days storage in distilled water except DY which showed a decrease in surface hardness. All tested materials showed a decrease in surface hardness from control group after 15 days and both at-home and in-office bleaching agents except DY which showed increased values. SIGNIFICANCE: At-home as well as in-office bleaching agents have a softening effect on some tooth colored restorative material, and the patient must be aware before using them.

Analysis of Variance↗

Fracture resistance of teeth with Class II bonded amalgam and new tooth-colored restorations.

This study compared the cuspal fracture resistance of posterior teeth restored with four different adhesive restorations. Fifty sound, maxillary human premolars were randomly divided into a control group and four experimental groups with 10 teeth in each. Specimens in the first group were intact teeth that were tested as unprepared. The remaining four groups received mesio-oclusodistal cavity preparations and were restored with a hybrid composite (Filtek Z250), a packable composite (Filtek P60), an ormocer (Definite) and an amalgam (SDI Permite) with an amalgam bonding agent (Amalgam Bond Plus). All groups were stored in water at 37 degrees C for 15 days and thermocycled 1000 times between 5 degrees-55 degrees C. The specimens were preloaded five times in compression to 10 kg using two metal rods that contacted only the teeth on the cuspal inclines. The teeth were then loaded occlusally in an Instron Universal Testing Machine until fracture occurred. The means of force required to fracture the teeth in each of the five groups was analyzed using one-way ANOVA and Tukey Test. The difference between the mean cuspal fracture resistance of the unprepared control teeth and those restored with amalgam groups was found to be statistically significant (p < 0.05). No significant differences in resistance to cuspal fracture were found among the restoration groups, the unprepared control group and those teeth restored with hybrid composite, packable composite and ormocer groups (p > 0.05).

Analysis of Variance↗

[Restoration of Class V cavities with the Ormocer-based filling system Admira].

The aim of this study was to evaluate the clinical effectiveness of an Ormocer-based restorative system for treatment of mixed carious and non-carious class V cavities. 70 restorations in 25 patients were placed with the condensable material Admira (group 1). In a second group of eight patients, the treatment of 25 cavities took place with the flowable material Admira Flow in combination with composite-bonded to-flowable technique or with the flowable material alone. The clinical evaluation was carried out using a modified clinical criteria system (Böhm et al. 1991) after Lutz et al. (1977) and Ryge (1980). Restorations of group 1 reached the two-year-level, those of group 2 the one-year-level. Good results were obtained with both condensable material and flowable material despite the small number of failures in the various clinical criteria. The retention rate of the flowable composite was 100% after six and twelve months and was the only parameter superior to those of the condensable material (98.6% resp. 93.9%). After two years, group 1 showed significant differences to base line with respect to volume behaviour and surface texture. No significant differences were determined with respect to of colour match, bond zone morphology and clinical acceptance. A SEM evaluation of replicas confirmed clinical results but also revealed clinically invisible failures of bond zone morphology.

Ceramics↗

Selected characteristics of an Ormocer and a conventional hybrid resin composite.

OBJECTIVES: The objective of this in vitro study was to evaluate surface roughness, hardness and wear resistance of an Ormocer (Admira), polymerized by a plasma arc system. A secondary objective was to investigate two placement technique bulk or incremental layers. METHODS: Blocks from Admira and Amelogen (a microhybrid composite) were prepared in cylinders, 3 mm in diameter, and 2 and 5 mm in thickness (bulk or incrementally placed) and polymerized by a plasma arc and a conventional light system. Surface roughness measurements were taken by a Surface Profilometer on the top of the specimens. Vickers hardness measurements, with a load of 600mN were taken on the top and bottom of 2 mm and top, intermediate and bottom of 5 mm thick specimens. For the wear test, specimes (8 mm in diameter and 2 mm in thickness) of Admira, Amelogen and amalgam were tested in a ball-on design, by circular movements of the antagonist (alumina ball; diameter 10 mm) under 10 N load. For the statistical evaluation of the results of surface roughness, microhardness and wear test; a paired samples t-test and Kruskal-Wallis analysis of variance test, were performed. RESULTS: Admira showed highest hardness values in all polymerization types at the top surface and this was statistically significant (p < 0.05). These highest hardness values were obtained with conventional polymerization (81.84 +/- 1.167 VHN). Meanwhile, the wear resistance of Admira was found to be higher than Amelogen (Wd(admira) = 0.024 +/- 0.00149 mm3; Wd(amelogen) = 0.032 +/- 0.00075 mm3). However, Admira demonstrated the highest surface roughness value compared to Amelogen, with plasma arc 5 s (0.65 +/- 0.023 microm). Amelogen was found to have the lowest surface roughness value with conventional 40 s (0.45 +/- 0.012 microm). SIGNIFICANCE: The results indicated that Ormocer, which was developed by Ormocer technology, demonstrated higher microhardness and wear resistance when compared to a hybrid composite; however, the polishability of Ormocer needs further investigation. Also the selection of visible light activated composite resins exhibited higher surface microhardness values when polymerized with conventional rather than with plasma arc.

Analysis of Variance↗

Effect of in-office tooth bleaching on the microhardness of six dental esthetic restorative materials.

OBJECTIVES: The aim of this in vitro study was to evaluate the effect of the in-office bleaching technique on the microhardness of six dental esthetic restorative materials. METHODS: Four composite resins (a hybrid, a flowable, a micro-hybrid and a nano-hybrid), an ormocer and a ceramic were tested, after the use of an in-office bleaching product. Fourteen specimens of each composite and the ormocer were fabricated and randomly divided into two groups of seven samples each. One group was polished and the other group remained unpolished. For the ceramic, seven polished samples were fabricated. Two samples of each group were used as negative controls. The specimens were bleached for 15, 30 and 45min. Five Knoop microhardness measurements were made on each sample, for each of the following periods tested: before bleaching, after 15, 30 and 45min of bleaching, 24h and 1 month after the bleaching procedure. Data were analyzed by the repeated measures analysis of variance with three between factors and one within. RESULTS: The differences in the microhardness values between the bleached and the control samples for the composites and the ceramic, were not statistically significant (hybrid: p=0.264; flow: p=0.584; micro-hybrid: p=0.278; nano-hybrid: p=0.405; ceramic: p=0.819). For the ormocer, although bleaching did not have any significant effect on the unpolished samples (p=0.115), it caused an increase on microhardness of the polished samples. SIGNIFICANCE: Bleaching with 38% hydrogen peroxide does not reduce the microhardness of the restorative materials tested. Therefore, no replacement of restorations is required after bleaching.

Ceramics↗

Influence of dietary solvents on strength of nanofill and ormocer composites.

The objective of this study was to determine the influence of dietary solvents on the shear punch strength of nanofill (Filtek Supreme [FS], 3M-ESPE) and ormocer (Admira [AM], Voco) composites. The strength of these materials was also compared to a minifill composite (Z250 [ZT], 3M-ESPE), a compomer (F2000 [FT], 3M-ESPE) and a highly viscous glass ionomer cement (Ketac Molar Quick [KM], 3M-ESPE). Thirty-two specimens (8.7 mm diameter and 1-mm thick) of each material were made, randomly divided into four groups of eight and conditioned for one week as follows-Group 1 (control): distilled water at 37 degrees C; Group 2: 0.02M citric acid at 37 degrees C; Group 3: 50% ethanol-water solution at 37 degrees C and Group 4: heptane at 37 degrees C. After conditioning, the specimens were restrained with a torque of 2.5 Nm and subjected to shear punch strength testing using a 2-mm diameter punch at a crosshead speed of 0.5 mm/minute. The shear punch strength of the specimens was computed and data subjected to ANOVA/Scheffe's tests at significance level 0.05. With the exception of AM, the strength of all materials was not significantly influenced by dietary solvents. For AM, conditioning in heptane resulted in significantly higher shear strength values. The strength of the nanofill and ormocer composites was lower than the minifill composite but higher than the compomer and highly viscous glass ionomer cement investigated.

Analysis of Variance↗

Importance of water sorption and solubility studies for couple bonding agent--resin-based filling material.

This study investigated the water sorption and solubility of two light-cured resin composites (Filtek P60 and Solitaire 2), one compomer (Compoglass F), one ormocer (Admira) and the associated bonding agents (Scotchbond 1 [Scotchbond 1 = Scotchbond Single Bond in USA], Gluma One Bond, Excite and Admira Bond, respectively) and of a RMGIC (Fuji II LC). Five disks of each product type were subjected to water sorption and solubility tests based on ISO 4049 requirements. The data were subjected to Kruskal-Wallis and non-parametric multiple-comparison tests using ranked sums at 95% confidence interval. Fuji II LC showed the highest water sorption (167.5 microg/mm(-3)). Fuji II LC and Compoglass F had higher solubility values (8.3 and 10.0 microg/mm(-3), respectively) than the other materials. Bonding agents have very high water sorption and solubility values (between 77.4 and 355.4 microg/mm(-3) and between 75.9 and 144.9 microg/mm(-3), respectively) compared to the restorative materials. Gluma One Bond and Admira Bond showed lower sorption and solubility than Excite and Scotchbond 1.

Absorption↗

The effect of different bleaching agents on the surface texture of restorative materials.

This blind in vitro study evaluated the effect of a home and an in-office bleaching agent on the surface texture of different tooth-colored restorative materials. Four composites (a hybrid, a flowable, a microhybrid and a nano-hybrid), an ormocer and a ceramic were used, and 2 bleaching agents were tested: 38% hydrogen peroxide and 15% carbamide peroxide. For 38% hydrogen peroxide, the surface morphology of the restorative materials was evaluated after the following time periods: before bleaching, after 15, 30 and 45 minutes of bleaching, 24 hours and 1 month after bleaching. For 15% carbamide peroxide, the time periods were: before bleaching, after 8 and 56 hours of bleaching and 24 hours and 1 month after bleaching. For the 4 composite materials and the ormocer, 2 samples groups were prepared; in 1 group, the specimens were polished and in the other, they stayed unpolished. For the ceramic group, polished samples were prepared. For every material, 3 samples per category and time period were prepared, respectively. Subsequently, the appropriate bleaching procedure was performed on samples of every group. Scanning electron micrographs were produced at 60x, 200x and 2000x magnifications of respective areas of the samples. The results showed that the effect of bleaching on the surface texture was material- and time-dependent. Within the limitations of this study, it was concluded that bleaching with 38% hydrogen peroxide and 15% carbamide peroxide did not cause major surface texture changes on the polished surfaces of the restorative materials.

Carbamide Peroxide↗

One-year evaluation of an Ormocer restorative-a multipractice clinical trial.

The purpose of this ongoing prospective long-term study was to evaluate the clinical performance of Ormocer restorative material in combination with a self-conditioning adhesive. Five operators at five clinics placed 356 restorations (48 class I, 150 class II, 63 class III, 32 class IV, and 63 class V) in 117 patients aged 17 to 65 years. All fillings were placed with cotton roll isolation and clear matrix bands for class III and IV restorations, and metal matrix bands and an incremental placement technique were used for class II restorations. In follow-up examinations after 6 and 12 months, modified Ryge criteria were recorded on all restorations. With 33 randomly selected class I and II restorations, measurements of occlusal wear (via 3D laser scanner) and qualitative and quantitative marginal analysis (via scanning electron microscope) were performed using a replica technique. After placing the fillings, patients reported postoperative hypersensitivity corresponding to B scores in 19 cases and to C scores in four cases. At 12-month recall, 328 restorations were available for evaluation. Losses in the five cavity classes (I, II, III, IV, V) numbered 0, 2, 0, 1, and 6, respectively. The percentages of retained restorations for clinical parameters in four categories (Alpha, Beta, Charlie, Delta) were: 94.7, 5, 0.3, and 0 (marginal integrity), 81.2, 18.8, 0, and 0 (marginal discoloration), 75.2, 24.8, 0, and 0 (anatomic form), and 95, 4.7, 0.3, and 0 (fracture), respectively. Marginal analysis showed 48.7% "continuous margin" initially and 17.7% at 12 months (difference statistically significant, P=0.05). The occlusal wear at 12 months was 10.0 microm (SD 11.6) for premolars and 22.0 microm (SD 24.1) for molars. Over the 12-month observation period, the Ormocer restorative was clinically effective in combination with a self-conditioning adhesive, and concern persists related to the marginal quality and retention of class V restorations.

Adolescent↗

The effect of different types of flowable restorative resins on microleakage of Class V cavities.

This study evaluated the microleakage of Class V cavities restored with three different types of flowable resin restorative material and compared the effects of using their respective manufacturer's dentin adhesive or a different brand. Class V cavities with the occlusal margin in enamel and the gingival margin in dentin were prepared on the buccal and lingual surfaces of 48 non-carious human molars. The teeth were randomly assigned to three equal groups of 16. The first eight teeth in each group were restored with one of the flowable restorative materials (Filtek Flow, Dyract Flow, Admira Flow) using the manufacturer's recommended dentin adhesive (Single Bond, Prime & Bond NT, Admira Bond), and the remaining eight molars were restored using a different brand of dentin adhesive (Gluma Comfort Bond). The samples were thermocycled 200 times (5 degrees C-55 degrees C) with a one-minute dwell time. They were then immersed in a 2% basic fuchsin solution for 24 hours, sectioned and analyzed by stereomicroscopy. There was no statistically significant difference at the occlusal margins for either restoration used with its respective dentin adhesive. At the gingival margins, there was a significant difference among all groups. Flowable ormocer (Admira Flow/Admira Bond) displayed the least leakage at the gingival margins. When these flowable restoratives were used with a different brand of dentin adhesive, statistically significant differences were observed both on enamel and dentin. None of the restoratives tested fully prevented leakage at the gingival margins. No significant differences in microleakage were observed among the restorative materials used with respect to the manufacturer's dentin adhesive or a different brand except for Admira Flow restorative at the gingival margins. The gingival margins had significantly more microleakage than the occlusal margins (p < 0.05) except in the Admira Flow group, where microleakage at the occlusal and gingival margins was almost equal.

Bisphenol A-Glycidyl Methacrylate↗

Two-year clinical evaluation of ormocer and nanofill composite with and without a flowable liner.

PURPOSE: The aim of this clinical follow-up study was to determine the clinical performance of ormocer and a new nanofill composite material, lined or not lined with flowable composites, after 2 years. MATERIALS AND METHODS: Occlusal restorations (n = 108) were placed in 54 patients with two symmetric restorations per patient. In one of the two restorations in each patient, cavities were first lined with the flowable composite material Admira Flow or Filtek Flow after applying the two-step total-etch one-bottle adhesive (Admira Bond) or single bond adhesive (Single Bond). Admira or Filtek Supreme was then applied. Restorations were examined using the USPHS modified Ryge criteria for retention, color matching, cavosurface marginal discoloration, anatomic form, marginal adaptation, surface texture, and secondary caries by two previously calibrated dentists. The overall performance of the restorations was evaluated by Wilcoxon signed ranks test. The chi-square test was used to determine differences in the performance of the restorations in which the flowable composite was applied first. RESULTS: There was no secondary caries or postoperative sensitivity in any of the restorations at the 6-month, 1-year, and 2-year follow-up examinations. After 2 years, only one Admira restoration had failed; all other restorations were available for evaluation. There were no statistically significant differences among the materials regardless of the prior use of flowable material (p > 0.05). There was no statistically significant difference between the restorations with and without the prior application of flowable materials (p > 0.05). CONCLUSION: The clinical performance of occlusal restorations using ormocer or nanofill composite did not benefit from the additional use of the flowable composite. Both of the restorative materials exhibited ideal clinical performance.

Adolescent↗