The influence of different placement techniques on the clinical success of bulk-fill resin composites placed in Class II cavities: a 4-year randomized controlled clinical study.

Abstract

The purpose of this double-blind and split-mouth randomized controlled clinical trial was to evaluate the clinical success of the placement technique (bulk-filling and incremental techniques) of a bulk-fill resin composite in Class II carious lesions. Two different bulk-fill resin composites, X-tra fil (Voco) and Filtek Bulk Fill (3M ESPE), were used in the bulk-filling and incremental techniques for 20 patients. The study was carried out in 4 groups, with 20 restorations in each group. Restorations were appraised at baseline, 6-month, 2-year, and 4-year recall. World Dental Federation (FDI) and the US Public Health Service (USPHS) criteria were used in the evaluations. The Friedman, Kruskal-Wallis, and Mann-Whitney U tests were used for the statistical analysis. At the end of year 4, there was no loss of restoration in any group. According to the USPHS and FDI criteria, there was a difference in the baseline and 4-year in marginal adaptation and marginal discoloration of the restorations (P < 0.05). When Filtek-Bulk was placed as an incremental technique, there was a minor fracture in four restorations (P > 0.05). In addition, Filtek-Bulk showed a color change according to the results based on both the USPHS and FDI criteria (P < 0.05). The difference between the two placement techniques of each resin composite was not significant at the year 4 recall when all criteria were evaluated (P ˃ 0.05). The 4-year clinical success of the evaluated bulk-fill composites is not dependent on the placement technique used. This study can help clinicians choose which technique (bulk fill and incremental techniques) bulk-fill composites can be used. US National Library of Medicine, www. gov , ID: NCT04565860 Registered on 10/09/2020. Clinical Evaluation of Bulk-fill resin Composites in Class II Restorations.