Clinical Performance of Short-fiber-reinforced Resin Composite Restorations vs Resin Composite Onlay Restorations in Complex Cavities of Molars (Randomized Clinical Trial)

Abstract

Background: Short-fiber-reinforced resin composite (SFRC) is a direct bulk fill resin composite specially indicated in large complex cavities. It is characterized by having high fracture toughness and load bearing capacity to decrease the incidence of fracture of the restoration. Materials and methods: In two parallel groups (n = 38 restorations), 76 participants having complex proximal cavities with asymptomatic vital pulp were randomly enrolled in this trial and received either SFRC (Ever X Posterior, GC, Japan) covered by Gaenial posterior (GC, Japan) or chairside indirect restorations (Grandioso inlay system; VOCO, Germany) fabricated on a silicon die. Materials were applied according to the manufacturer instructions with the corresponding adhesive system. Only 67 participants completed the trial, which was assessed using the modified United States Public Health Service (USPHS) criteria by two independent blinded assessors at 6 months and 1 year follow-up visits. Statistical analysis: Fisher's exact and Cochran's Q tests were used to analyze inter-and intragroup comparisons, respectively. The significance level was set at p ≤ 0.05. Results: No statistically significant difference was observed between both tested groups for all USPHS criteria at different follow-up periods except for marginal integrity favoring the SFRC at 12 months when the difference became significant (p < 0.001), and color match favoring the nanohybrid indirect resin composite restorations with significant difference in scores at all follow-up intervals (p < 0.001) was found. Cochran's Q test showed significant differences within the same technique during the follow-up period for some criteria. Conclusion: Direct SFRC and indirect nanohybrid resin composite complex proximal restorations showed an acceptable clinical performance along the 1 year follow-up period. Clinical relevance: Direct SFRC restorations could be a viable treatment option for complex restorative cases.

Clinical Fracture of Fiber Reinforced Resin Composite Versus Conventional Resin Composite Restorations in Endodontically Treated Molars: A Randomized Clinical Trial

“…While regarding the results of color match, there was a statistically significant difference between the two groups favoring the microhybrid resin composite restorations. These results in agree with ElAziz et al 2020 7 who reported that a grey color mismatch of SFRC restorations in teeth with dark sclerotic dentin present at the base of the cavity was due to the SFRC is highly translucent material, so the 1-2 mm remaining thickness of the covering microhybrid resin composite layer could not conceal the discolored dentin. Regarding the results of our study in cases of remaining deep stain at the base of the cavity, it is recommended touse an underlying opaquer under SFRC or increase the thickness of overlaying microhybrid resin composite more than 2 mm unlike the manufacturer recommendation that SFRC should be covered by 1-2 m. In contrast to our findings, Guney & Yazici 2020 12 who found that only one SFRC restoration at baseline and 6 months follow up, and two SFRC restorations at 12, 18, and 24 months follow up periods received a score of bravo.…”

Clinical Evaluation of Composite Restorations with and without Polyethylene Fiber in First Permanent Molars: A 24-Month Randomized Clinical Trial

“…Only minor changes for marginal adaptation, marginal discoloration, color match, and surface texture were observed, and no differences were detected between the evaluated criteria when comparing the baseline with any of the evaluation periods (p<0.05) [23]. Another study showed that no statistically significant difference was observed between fiber-reinforced resin composite and nanohybrid composite restorations tested groups for all USPHS criteria at different follow-up periods except for marginal integrity favoring the fiber restoration at 12 months when the difference became significant (p<0.001), and color match favoring the nanohybrid indirect resin composite restorations with substantial difference in scores at all follow-up intervals (p<0.001) was found [38]. In contrast to our study, everX Posterior and Gaenial Posterior restorations exhibited significant marginal discolorations after three years, and these changes were clinically acceptable and significantly increased over time [37].…”

“…The success of the fiber assembly can also be attributed to the discontinuous phase formed by the continuous polymer resin matrix due to the individual mixing of the strip fiber with the nanohybrid composite during restoration. There is also a high chance of void formation in this complex, which is known to form huge areas where oxygen is blocked and, therefore, is known to reduce the bending strength of the fibers [38,40]. Therefore, extreme care must be exercised during placement [41].…”

Restaurações indiretas e semi-diretas com resinas compostas em dentes posteriores

“…Uma das vantagens da realização da restauração por meio de técnica semi-direta com moldagem (extraoral) é a facilidade de adaptação da margem subgengival, por permitir acesso direto e visualização direta da restauração nas margens do preparo no modelo 27 .Outra vantagem da técnica semi-direta é que o profissional pode fornecer ao paciente uma restauração com baixo custo comparada às confeccionadas em laboratório e com possibilidade de confecção em uma única consulta, sem necessidade de restauração provisória (Elaziz et al, 2020;Alharbi et al, 2014).…”