Dental Caries Class II Clinical Trial
Official title:
Clinical Evaluation of Bulk-fill vs Layered Composite Resin in Class I and II Posterior Restorations: A Randomized Controlled Pilot Study
The aim of this study is to evaluate the clinical performance of Filtek Bulk Fill Posterior Restorative in Class I and Class II restorations compared to the conventional incremental technique using Filtek Z350XT over the period of 2 years. The null hypothesis of this study is that the bulk-fill composite will exhibit same result and clinical performance as conventional composite using incremental technique which has been used widely by dentists nowadays.
In recent years, people are more concerned with the aesthetic qualities of dental
restorations and in response to enhancements in the resin technologies, tooth-colored resin
composite materials are increasingly being used for posterior teeth instead of amalgam
fillings. Developments during the years in chemical composition, filler reinforcement, and
adhesive techniques have resulted in many new modified categories of materials. Some
researchers recommend the use of the incremental technique, in which the composite material
is gradually placed in layers of 2mm or less.
This approach to restore teeth has a number of advantages, for example, it results in better
light penetration and better polymerization of composite resin, reduction in cavity
configuration factor, reduction in polymerization shrinkage stress and ensures that the resin
adheres to the cavity walls. During curing of the resin, a network of polymers is formed,
which becomes rigid due to increased cross linking of the polymer chains. Decreasing mobility
of the network causes further shrinkage and results in a strain on the resin composite and
cavity margins. The resulting stress has been associated with marginal deficiencies, enamel
fractures, cuspal movement, and cracked cusps, which in turn may result in microleakage,
post-operative sensitivity, and secondary caries. It has been stated that posterior class II
and especially class I cavities with a high C-factor will result in greater stresses due to a
larger number of bonded surfaces.
However, there are number of disadvantages associated with the use of an incremental approach
to place the resin. For example, voids can be trapped in between the increments, bonding
failure can occur in between the increments, difficulty in placing the composite material
after cavity preparation and the long time taken for the procedure. In an effort to counter
these problems, a new restorative material has been introduced in 2009 which is known as
'bulk-fill' composite, in order to increase efficiency of the operator. However, many
clinicians who have accustomed to the incremental cure philosophy when placing the
light-cured composite quite rightly question what has been changed to make these bulk-fill
light-cured composite a variable alternative. According to some researchers, bulk-fill
composite offers more advantages compared to the layered composite. These include increased
efficiency in working time, reduced polymerization shrinkage and reduces the risk of
contamination and voids forming between the resins.
The aim of this study is to evaluate the clinical performance of bulk-fill composite as
compared to the layered composite technique in class I and class II restorations over the
period of 2 years.
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