Three-year clinical evaluation of class II posterior composite restorations placed with different techniques and flowable composite linings in endodontically treated teeth

Abstract

The objective of this study is to evaluate the clinical performance of direct resin composite restorations placed with different techniques (incremental or bulk) and different flowable linings (conventional or bulk-fill) in endodontically treated teeth. Forty-seven pair class II (mesio-occlusal or disto-occlusal) composite restorations were placed in 37 patients. In all cavities, Adper Single Bond 2 was used. In one of the cavities of each pair, a conventional flowable composite, Aelite Flo, was applied in approximately 2 mm thick, and the remaining cavity was restored incrementally with GrandioSO. In the second cavity, a bulk-fill flowable composite, x-tra base, was applied in approximately 4 mm thick in bulk increments and the remaining 2-mm occlusal part of the cavity was restored with GrandioSO. All cavities were restored with open-sandwich technique by the same operator. At baseline and after 6-month, 1-, 2-, and 3-year follow-up visits, restorations were evaluated by modified USPHS criteria. At 3-year recall, 33 restorations with Aelite Flo lining and 33 with x-tra base lining were available. Two restorations from each group (6.0 %) were scored as Bravo in terms of surface texture. One restoration's color match from x-tra base group scored as Bravo (3.0 %). All other evaluated criteria were scored as Alfa (100 %) for all restorations. No statistically significant difference between the two groups was found in all evaluated criteria during 3-year period (p > 0.05). Bulk-filling technique showed clinically acceptable performance comparable to the incremental technique. Restorations placed with bulk-filling technique with x-tra base lining and incremental technique with a conventional flowable lining showed highly clinical performance over 3-year period.