Five Year Clinical Evaluation of Filtek™ Silorane versus Tetric Ceram

Objectives: Polymerization contraction has been a clinical problem for resin composites. Manufacturers have attempted to develop materials that have less contraction. The aim of this clinical investigation was to evaluate the performance of Filtek™ Silorane (3M ESPE), a low shrink composite, used in conjunction with a dedicated experimental adhesive system, that was never commercialized, and compare to Tetric Ceram bonded with AdheSE (Vivadent). Methods: The materials were placed in teeth in individuals that needed at least two box shape class II restorations of similar size. The restorations were placed by one operator in private practice. A total of 53 restoration pairs were placed in 31 patients. The restorations were evaluated by two trained examiners using USPHS criteria. Results: At five years 49 restoration pairs were available for reevaluation. One Tetric restoration had been removed because of tooth sensitivity excluding that patient and three couldnxt be reached. All but three contacts scored normal, color match and gingival status was unchanged and neither secondary caries nor sensitivity reported. Slight chipping (Beta) was reported for four Tetric and five Silorane restorations, while two Tetric and four Silorane restorations showed some surface roughness. When marginal integrity was evaluated 2/3 scored Alfa for both materials and 45% Tetric and 35% Silorane restorations scored Alfa for interfacial staining. 16(33%) Tetric and 33(67%) Silorane scored Beta and one restoration (2%) Charlie for anatomic form. There was no significant difference between the materials tested for any of the criteria evaluated except anatomic form (p<0,001). Conclusions: At five years Silorane showed significantly more wear than Tetric. In both groups high incidence of marginal discoloration and marginal breakdown suggest that improved or different adhesive systems are needed. This study was supported by 3M ESPE, Seefeld, Germany and Univesity of Iceland.