Two-year clinical evaluation of packable and nanostructured resin-based composites placed with two techniques

Background. The authors conducted a two-year clinical trial to evaluate the effectiveness of two resin-based composite materials for Class 11 restorations placed according to two filling techniques. Methods. Twenty-six patients received 105 Class II restorations, which the authors distributed randomly into three groups of 35 each. The resin-based composite restorations in group A were composed of average-density material (Ceram X mono [CXM], Dentsply DeTrey, Konstanz, Germany) placed according to the oblique incremental technique (OIT). Restorations in group B were composed of average- and high-density materials (CXM and SureFil [SF], Dentsply DeTrey) placed according to the modified incremental technique (MIT). Restorations in group C were composed of the high-density material (SF) placed with the OIT. The authors evaluated the restorations according to modified U.S. Public Health Service criteria. Results. At the two-year recall visit, 92 (88 percent) of 105 restorations were available for examination. Restorations in groups A, B and C had success rates of 96.7 percent (29 of 30 restorations), 96.8 percent (30 of 31) and 100 percent (31 of 31), respectively. Esthetic parameters revealed significant (P < .05) cavosurface marginal discoloration in group B and a rougher surface in group A. With regard to functional parameters, one (3.3 percent) of 30 restorations in group A exhibited reparable changes in marginal integrity. Conclusions. Restorations in group B performed worse (P < .05) in terms of esthetic (cavosurface marginal discoloration) and functional (marginal integrity) parameters. Clinical effectiveness was highest in group C and lowest in group B. Clinical Implications. The two resin-based composite materials are effective in Class 11 clinical situations when placed with either the OIT or MIT.