Short-term effect of adhesive system on clinical performance of bulk fill composite

Vanessa Cristiane Araújo Oliveira,Claudia Silami Magalhães,João Gabriel Silva Souza,Isabella Pereira Marques,Fabíola Belkiss Santos De Oliveira,Fernanda Piana Santos Lima De Oliveira,Mayara Dos Santos Noronha,Daniela Araújo Veloso Popoff

doi:10.20396/bjos.v21i00.8665042

Vanessa Cristiane Araújo Oliveira, Claudia Silami Magalhães + Show 6 more

Open Access

https://doi.org/10.20396/bjos.v21i00.8665042

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Abstract

Aim: Although bulk fill composites have been widely used as restorative material, there is no consensus regarding the best clinical protocol in terms of composite technique and adhesive system. Therefore, this clinical trial evaluated the clinical performance of bulk fill composites for class I restorations under different protocols. Methods: A randomized clinical trial including 155 class I restorations was conducted using different adhesive systems: conventional technique (phosphoric acid + conventional three-step adhesive system) (Group 1, 2 and 3); or self-etching adhesive system (Groups 4, 5 and 6). Control groups 1 and 4 were restored with conventional composite; groups 2 and 5 with low viscosity bulk fill and conventional composite as occlusal coverage; groups 3 and 6 with high viscosity bulk fill. The FDI criteria was used for clinical evaluation at baseline and after 6 months. Results: All groups showed good clinical performance. At baseline, the adhesive system did not affect postoperative hypersensitivity. After 6 months, group 5 showed a significant reduction in color and translucency; group 6 a reduction in terms of anatomical form and for postoperative sensitivity and an improvement in patient satisfaction (p<0.05). Considering the same restorative technique, the use of the self-etching adhesive system showed a significant decrease in color and translucency (p<0.05). Conclusion: All groups showed favorable clinical performance, and promising results were found for the conventional adhesive system and high viscosity bulk fill protocol.

Highlights

The improvement of dental materials, as well the increased demand for esthetic treatments by patients, have improved the development of less invasive restoration techniques and the use of composites with enhanced biomechanical and esthetic properties[1,2,3], even for posterior teeth[4]
The results suggest no clinical effect of the adhesive system
The clinical evaluation of this restorative material under different techniques allows the standardization of appropriate protocols[4]

Summary

Introduction

The improvement of dental materials, as well the increased demand for esthetic treatments by patients, have improved the development of less invasive restoration techniques and the use of composites with enhanced biomechanical and esthetic properties[1,2,3], even for posterior teeth[4]. The polymerization shrinkage and the development of stress in the tooth-restoration interface, still being an important clinical problem that can degrade the adhesive layer, create cracks, and, lead to treatment failure[5]. In this sense, different incremental techniques have been developed to reduce the material shrinkage[6,7]. Bulk fill composites have been widely used for tooth restoration and shown enhanced translucence and polymerization properties compared to conventional composites, allowing the use of a single increment (4–5 mm) These properties reduce clinical time and the polymerization shrinkage stress[9,10]. Modifications in the organic matrix of bulk fill composites, such as monomers with higher molecular weight and the size of particles, explain these advantages[9,11]

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Conclusion