Two-year evaluation of a nano-hybrid and a bulk-fill resin composite: a randomized, double-blind split-mouth clinical study

Abstract

Objectives The aim of this study was to compare the 2-year clinical performance of a bulk-fill composite resin and a nano-hybrid-filled composite resin in 6-12-year-old children in a split-mouth design. Materials and methods This randomized, split-mouth, and double-blind study was conducted on 89 patients aged 6–12 years with caries on bilateral mandibular first molars. In a split-mouth design, restorations of mandibular permanent molars were completed with nano-hybrid organically modified ceramic (ORMOCER)-based bulk-fill composite resin Admira Fusion x-tra (Voco GmbH, Cuxhaven, Germany) and nano-hybrid composite Grandio (Voco, Cuxhaven, Germany). Futurabond U single dose (Voco, Cuxhaven, Germany) was used with selective enamel etching. The clinical success of the restorations was evaluated using USPHS and FDI criteria at 6, 12, and 24-month follow-up controls. Results In the 2-year follow-up, all restorations were clinically acceptable. Grandio was significantly worse than Admira Fusion x-tra in terms of surface luster and superficial change (p < 0.05). Surface staining and color match scores increased in Admira Fusion x-tra compared with Grandio significantly (p < 0.05). Conclusions Although both materials showed acceptable clinical performance over 2 years, a significant difference was observed between the surface luster, surface staining, marginal adaptation, and staining of the nano-hybrid composite placed with the incremental technique and the bulk-fill ORMOCER-based composite resin. Clinical relevance As an alternative to nano-hybrid composite resins, using bulk-fill restorative materials, which can be indicated in the proper case, may contribute to shortening treatment procedures and increasing patient and physician comfort, leading to clinical success.

Five-Year Survival of Class II Restorations with and without Base Bulk-Fill Composite: A Retrospective Data Collection Study

“…That said, data collection studies and randomized controlled trials can complement each other. The randomized controlled trials comparing bulk-ll and conventional lling materials have not been performed in practice-based environments which might in part explain their low failure rate and equal longevity for restorations with and without bulk-ll composites [11][12]17]. The high survival rate of class II molar restorations with the base bulkll composite in our data prompts the question: "Does the base bulk-ll technique improve the longevity of class II molar restorations placed in general practice?".…”

“…Contrary to common belief, restorations with bulk-ll composites show minimal cuspal de ection and have good marginal integrity [9][10][11]. Additionally, bulkll composites exhibit good surface lustre and colour match [12,13]. Notably, owable base bulk-ll composites and conventional paste-like composites have nearly identical chemical-physical properties [14].…”

“…Employing this "base bulk-ll technique" reduces the time needed to ll a large class II cavity by 60% or four and a half minutes compared to the conventional incremental technique [16]. But more importantly, the clinical performance of restorations with or without a bulk-ll composite is comparable in randomized controlled clinical trials [11,12,17].…”