Clinical behavior of direct composite restorations after 12 months using Adhese Universal

Objectives: To evaluate clinical performance of universal adhesive Adhese Universal (Ivoclar Vivadent) in cavity classes I, II using etch&rinse- protocol for direct composite restorations after 12 months.
Methods: 40 (16 class I and 24 class II) cavities were treated with Adhese Universal using etch&rinse-technique (Fig.1-5: clinical example). Composite fillings were placed with Tetric EvoCeram Bulk Fill (Ivoclar Vivadent) for class I/II (table 1: detailed application protocol ). The restorations were evaluated after 12 months of clinical service concerning their aesthetic, functional and biological properties (FDI criteria). Furthermore a semi-quantitative clinical evaluation-method (SQUACE) was used.
Results: After 12 months 100% of the restorations, available for evaluation (3 drop-outs), were still in place. All restorations showed FDI grading ranging between excellent and good (table 2). Referring to marginal staining 99.5% of the total margin length (SQUACE) was rated as excellent. Documented marginal flaws (marginal irregularities) affected only small portions of the total margin length (10.9% rated as good, after correction very good). No post-operative sensitivities were reported.
Tetric EvoCeram Bulk Fill showed excellent to good aesthetic results referring surface luster, surface staining and color match. No fractures or cracks of material or tooth occurred.

Conclusions: The combination of Adhese Universal and Tetric EvoCeram Bulk Fill seems to be reliable to restore class I/II cavities effectively. Although only two universal shades of Tetric EvoCeram Bulk Fill were used, 75% of the restorations showed excellent aesthetics. Due to the effective bonding no postoperative sensitivities were reported and the composite fillings showed excellent margins after 12 months.