Abstract
Objectives: The aim of this study was to evaluate the clinical performance of a nano filled flowable and nano hybrid bulk fill resin composite in class I restorations.
 Methods and Materials: Twenty patients were selected for this in vivo study. Each patient received at least one pair of restorations, restored with nano hybrid bulk fill resin composite (IPS Empress direct [IED]) and nano hybrid Tetric N Ceram flowable composite [TNC]. Each restorative resin system was used with its respective adhesive system according to manufacturers’ instructions.
 A total of 40 class I restorations were placed by one operator. Restorations were blindly evaluated by two examiners at baseline and 3, 6, and 12 months respectively using modified US Public Health Service Ryge criteria.
 The data obtained was statistically analyzed using Chi square test to compare the two restorative materials for each category.
 Results: At 3, 6 and 12, months, recall rate was 100%, 95% and 85%, respectively, with a retention rate of 100%. There were statistically significant differences between the two restorative resins in terms of marginal adaptation and marginal discoloration (p<0.05).
 No differences were observed between the restorative resins in terms of retention (p<0.05). None of the restorations showed postoperative sensitivity, or loss of anatomic form.
 Conclusion: Within the limitations of this study, nano hybrid bulk fill composite resin viz. IPS EMPRESS DIRECT showed better clinical performance than nano filled flowable composite in terms of marginal discoloration and marginal adaptation.
 Keywords: direct composite, bulk, hybrid filled resin
Highlights
With the elimination of Amalgam, the utilization of composites is the option of decision and routine technique for the restoration of posterior teeth.[1,2] Resins have demonstrated us promising esthetics, improved mechanical properties as good as amalgam, and have conquered worries over mercury toxicity.[2,3] their preparation is very conservative
Objectives: The aim of this study was to evaluate the clinical performance of a nano filled flowable and nano hybrid bulk fill resin composite in class I restorations
One of the significant changes in resin based composite innovation is the development of bulk fill composites which have conquered numerous issues like polymerization shrinkage and increased chair time
Summary
With the elimination of Amalgam, the utilization of composites is the option of decision and routine technique for the restoration of posterior teeth.[1,2] Resins have demonstrated us promising esthetics, improved mechanical properties as good as amalgam, and have conquered worries over mercury toxicity.[2,3] their preparation is very conservative. Various advancements in composites are by and large consistently created to improve their mechanical and physical properties, be that as it may, conquering polymerization shrinkage despite everything stays a primary challenge.[4,5] Polymerization shrinkage stresses aggregated at the adhesive interface can prompt marginal breakdown, peripheral spillage, and even cuspal crack, secondary caries, and restoration loss.[6,7] To defeat polymerization shrinkage stresses, incremental placement of resin composite is the basic method embraced to avoid depth-of-cure limitations. Bulk fill composites can be set up to 4-mm in thickness with uniform polymerization and low polymerization shrinkage.[11, 12]
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