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The objective of this study was to evaluate the clinical performance of a bulk-fill composite resin (3M ESPE Filtek Bulk Fill, St Paul, MN, USA) in restorations placed in occlusal cavities by comparing different placement techniques (bulk vs. incremental) using modified USPHS criteria.
A total of 50 patients (n=108), each with two or four occlusal cavities having a depth of at least 4 mm, were randomly assigned to two groups. A bite-wing radiograph was taken for each tooth. The Single Bond Universal Adhesive (3M, ESPE, St Paul, MN, USA) was applied using the selective-enamel-etch mode. One tooth from each patient was restored using the bulk technique while the other was restored using the incremental technique. All restorations were placed by a single operator. Two experienced and calibrated examiners who were blinded to the placement technique evaluated the restorations at one week and subsequently at 6-, 12-, 24-, 36-, and 48-month follow-ups according to modified USPHS criteria. Spontaneous post-operative sensitivity was assessed through restorative procedures up to 24 hours post-treatment, as well as one week and six months later utilizing a Visual Analog Scale (VAS). The chi-square test was employed for comparing both restoration techniques within each category (p<0.05).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group 1 | Other | Bulk-filling placement technique |
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| Group 2 | Other | Incremental placement technique |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| bulk tecnique | Procedure | The bulkfill resin composite was placed bulk tecnique and light cured with the same LED for 20 s by the same operator. |
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| Measure | Description | Time Frame |
|---|---|---|
| RETENTÄ°ON | The retention criterion determines how long a restorative material functions in the oral environment, it is the most important criterion that shows the success of the material. Alpha: The restoration is present. Charlie: The restoration is absent. | From baseline to 6 year the change of restorations was evaluated |
| Marginal Discoloration | The marginal discoloration that occur at the edge staining restoration boundaries are generally thought to be due to microleakage. Alpha: No discoloration at margins. Bravo: Shallow discoloration, clinically acceptable. Charlie: Deep discoloration clinically unacceptable. | From baseline to 6 year the change of restorations was evaluated |
| Marginal Adaptation | Marginal adaptation is achieved by fully ensuring the integrity of the tooth-restoration joint border. Alpha: Restoration is closely adapted to the tooth. Bravo: Visible evidence of a crevice along the margin, dentin not exposed, clinically acceptable. Charlie: Explorer penetrates into crevice, dentin is exposed; clinically unacceptable. | From baseline to 6 year the change of restorations was evaluated |
| Color match | Color match is the evaluation of the restoration according to the darkening or lightening of the color, taking into account the tooth tissue surrounding restoration. Alpha:Matches tooth. Bravo: Acceptable mismatch. Charlie:Unacceptable mismatch. | From baseline to 2 year the change of restorations was evaluated |
| Post-op Hypersensitivity | Determination of sensitivity after restorations are placed. Alpha: Absent. Charlie: Present; clinically unacceptable. | From baseline to 6 year the change of restorations was evaluated |
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Inclusion Criteria:Good general health, 18 years of age or older, Acceptable oral hygiene level, Present at least 20 teeth in the occlusion, Have at least two or four posterior teeth in need of restorative treatment. Have carious lesions, defective restorations replacement due to esthetic reasons).
Exclusion Criteria:Poor oral hygiene, Having possible allergy to resin-based restorations, Advanced periodontal disease, Xerostomia, Pregnancy or breastfeeding, Severe systemic disease, Diagnosis of bruxism, Bleaching treatment or orthodontic treatment.
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| Name | Affiliation | Role |
|---|---|---|
| A. Ruya Yazici, Professor | Hacettepe University | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hacettepe University Faculty of Dentistry | Ankara | 06100 | Turkey (Türkiye) |
Study not completed
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| ID | Term |
|---|---|
| D003731 | Dental Caries |
| ID | Term |
|---|---|
| D017001 | Tooth Demineralization |
| D014076 | Tooth Diseases |
| D009057 | Stomatognathic Diseases |
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A total of 108 occlusal carious lesions in 50 patients will be randomly divided into two groups. Bulkfill resin composite will be restored with Filtek Bulk Fill placed with bulk-filling or incremental technique. Universal Adhesive was applied in a selective-etch mode according to the manufacturer's instructions. One tooth was restored using the bulk-filling placement technique, while another was restored using the incremental placement technique. The placement technique for the bulk-fill composite was determined via a coin toss for the respective teeth.This randomization was blinded to participants and evaluators. It was not known which placement technique was applied to which teeth of the participants.
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| incrementally technique | Procedure | The bulkfill resin composite was placed incrementally (2mm) and light cured with the same LED for 20 s by the same operator. |
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| Secondary caries | Secondary caries is the progression of caries in the tooth tissue adjacent to the restorations. Caries formation means restoration failure. Alpha: Absent. Charlie: Present; clinically unacceptable. | From baseline to 6 year the change of restorations was evaluated |