Class II Comparison of Highly Filled and Flowable Resin-Based Composites

Resin-based composites (RBC) are used by 80% of the dentists practicing in the United States. New products are introduced often to circumvent problems associated with material performance. Variables based on ADA specifications for ADA approval include assessment of color match, marginal adaptation, marginal discoloration, proximal contact, caries and sensitivity. We compared one composite resin with two different viscosities. Objective: This in vivo study compared Grandio composite (VOCO) and Grandio Flow (VOCO) using Scotchbond MP adhesive (3M ESPE) in Class II restorations. Materials and Methods: 32 patients were selected with moderate sized Class II lesions, with good oral hygiene, tooth in proximal and occlusal contact, with no periapical pathology after obtaining informed consent. Utilizing rubber dam isolation, preparations were made with conventional high-speed handpieces. Grandio or Grandio Flow composite was placed in 2 mm increments into preparations and polymerized (64 restorations). Restorations were evaluated using modified Ryge criteria by 2 evaluators for anatomic form, color match, marginal discoloration, marginal integrity, proximal contacts, caries, pain and gingival index (GI) using Loe and Silness gingival index. Subjective patient response to pain was measured using a pellet soaked in refrigerant and applied to the restoration for 3 seconds and rated using a visual analog scale from 0 (lowest) to 10 (highest). 28 of 32 patients were available for recall. McNemar's test compared filled with flowable for modified Ryge criteria. Wilcoxon Signed Rank test was used to analyze pain index (PI) and GI as these data were not normally distributed (a=0.05). Results: No significant difference was discovered in any category when the flowable and highly filled composite resins were compared as class II restorations (p>.05). Conclusions: When using a highly filled flowable (80.2%w/w) the clinical performance is the same at two years as the highly filled Grandio (87%w/w). Supported in part by VOCO.