Twenty-four Month Clinical Comparison of Bulkfilled and Nanofilled Composite Restorations
Objectives: To evaluate the clinical performance of a nanofilled and a bulkfilled resin composite in Class II restorations.
Methods: In accordance with a split-mouth design, 50 patients received at least one pair of restoration restored with a nanofilled resin composite (Filtek Ultimate-FU) and with bulkfilled resin composite (Tetric EvoCeram Bulk Fill-TBF). Each restorative resin was used with it’s respective adhesive system according to the manufacturers’ instructions. A total of 104 Class II restorations were placed by two operators. The restorations were blindly evaluated by two examiners at 6, 12,18 and 24 months using modified Ryge/USPHS criteria. The comparison of the two restorative materials for each category was performed with the chi-square test(p<0.05).The baseline scores were compared with those at the recall visits using Cochran-Q test(p<0.05).
Results: At 6.,12.,18. months the recall rate was 100%, 98%, 94% respectively with a retention rate of 100%. At 24 months, 85 restorations were evaluated in 41 patients with a recall rate of 82%. For marginal adaptation, one restoration form TBF group, 8 from FU group rated as Bravo. Seven restoration from FU group showed marginal discoloration. There were statistically significant differences between two restorative resins in terms of marginal discoloration and marginal adaptation(p<0.05). No differences were observed between the restorative resins in terms of retention(p>0.05). The retention rate for TBF and FU was 100%. One restored teeth from FU group were crowned. In FU group, 2 restorations showed slightly rough surface and one restoration showed slight mismatch in color. None of the restorations showed postoperative sensitivity, secondary caries, or loss of anatomic form. Among the evaluated criteria, only marginal discoloration and marginal adaptation presented an increased percentage of Bravo scores that increased with time for FU group(p<0.05).
Conclusions: Tested bulkfill restorative resin demonstrated better clinical performance in terms of marginal discoloration and marginal adaptation.